CPTSD vs. OSDD "Parts"

[AphoticAtramentous]

Thanks for starting this thread. Am always interested in learning more about this stuff, and hearing of other's experiences.

Personal Theory Stuff:
My own perception on the dissociation spectrum concept: I think "splitting" of one's identity is way more common than we realise. Now, I'm no scientist or medical professional, I'm just some guy on the internet, so take this with a grain of salt - but to me it seems that dissociation primarily takes place when the situation is inescapable. When you use fight, fawn, flight, or freeze, but still get hurt - that's when dissociation hits the hardest. And when that happens over and over, for example - CPTSD, where the core of the trauma comes from the inability to escape, then I think it's very natural for the mind to split. Because when all defense mechanisms fail, it's easier for the brain to pretend you're not there at all.

So I believe that everyone with PTSD/CPTSD has some kind of fragmentation, which you can see very clearly in the case of flashbacks - where you are "taken back to the past moment". That alone is a type of dissociative experience. And sometimes it gets to a point where you dissociate/switch just to get through the day, let alone a trigger - that being DID. Also, it doesn't matter how "bad" your trauma was, it doesn't matter what was done to you - if you couldn't escape, you're probably going to dissociate. That's just how the brain likes to do things. And then the more you dissociate, the more fragmented things tend to become.

Again, not a professional, don't quote me. But this theory works for my own experiences. I didn't have the worst childhood in the world, but I did dissociate quite a bit. And it doesn't surprise me that I don't remember a lot of things, and why I guess I was recently diagnosed with DID.

If anyone has any feedback on this theory I would be interested to hear it, but no pressure.

It is at least pretty universally agreed that this dissociation stuff works on a spectrum. Commonly it ranges from...
Highway Hypnosis/Day-dreaming -> Concentration -> PTSD -> CPTSD -> OSDD -> DID -> C-DID (complex DID). You could be a "low" OSDD, a "high" DID, or anywhere on the scale. But I find for many, the line between CPTSD and OSDD is VERY blurry.

Personal Stuff:
One thing I find interesting, and perhaps what makes me DID and not OSDD, is reading the experiences of others who still classify their parts as an alternate version of themselves. Whereas for me, my alters don't feel like me at all. Sometimes I look in the mirror and it feels wrong, or I get called by a name that just isn't correct. It comes with a lot of different experiences but it would take forever to list.

I also wanted to boost Blueberry's argument on the importance of these diagnosis labels, especially within therapy settings. I was in therapy for 3 years and me and my therapist mutually ended our sessions together because I felt like I could handle things myself. But now I realise, she only helped resolve the trauma of ONE alter. Things felt OK for some time but the other alters appeared as they do. It took me a year to realise that I actually wasn't OK - probably because the amnesia stops me from remembering how poorly my other alters are. I think this is at least one example of why these diagnoses can be so important to know about, because it does very much change the way your therapy should go.

Sorry for the long read!

Regards,
Aphotic.

[fozzie55]

Hi Blueberry and AphoticAtramentous
I am familiar with Pete Walker's books and have read them several times.
As he says in "From surviving to thriving" CPTSD and it's recovery is , above all, complex.
I am well aware of the symptoms and getting lost in what it all means. I have a background in nursing, so I am aware of the psychological necessity of diagnoses.
I am also aware of feeling that you are on the wrong path due to misdiagnosis.
As I said I am not trying to belittle suffering or to say I am right about what I say. I am simply offering the opinion that whilst some see the necessity of multiple diagnoses, others feel the need to simply deal with what is in front of them  regardless of what it is called. Surely I am not the only one to think this?
I also agree with both of you that there are definitely days when a positive attitude simply does not work but should that really stop us from trying?
I read a book called "Constructive Wallowing" which I found very helpful. It suggests we simply accept the emotions we are feeling and acknowledge them. The aim is to not let feelings fester but to experience them and move on.
Life is difficult enough as it is, more so for those of us with CPTSD and it's associated issues. All I am saying is why make it more difficult than it needs to be.
By the way I truly accept and respect your views and opinions. We are all in this together.
Best wishes.

[Kizzie]

Just my thoughts, but personally I'm of the opinion that "If you can name it you can [begin to] tame it." Just as importantly, if therapists are able to correctly identify what we are suffering from then they will be better informed when treating us.

[Blueberry]

Hi fozzie,

Life is difficult enough as it is, more so for those of us with CPTSD and it's associated issues. All I am saying is why make it more difficult than it needs to be.
By the way I truly accept and respect your views and opinions. We are all in this together.

BBM

I don't believe that I, or others, who wonder about their position on the OSDD, P-DID, DID spectrum are making life or their healing journey more difficult for themselves. So, we're just going to have to agree to disagree on that.

As I said I am not trying ... to say I am right about what I say. I am simply offering the opinion that whilst some see the necessity of multiple diagnoses, others feel the need to simply deal with what is in front of them  regardless of what it is called. Surely I am not the only one to think this?

I don't know if you're the only person to think as you do, quite possibly not. You say "we're all in this together" and in a way that's true of course, but if you don't care whether or not you're on the OSDD to DID spectrum, then we're not ALL in EVERYTHING together. And that's totally OK!! Not everybody on the forum has to follow the same healing path or agree on everything!

I don't think that this particular thread is the place to discuss the necessity of multiple diagnoses! Even if reading this thread is what made you think of it. This is the first discussion thread on this forum on the spectrum of OSDD to DID, that I remember anyway, and personally as somebody who identifies as being on the spectrum, I'd really appreciate if we could remain on topic! Most people on the thread are detailing their own experiences of Parts and where they think they are on the spectrum.

If you really want to discuss the necessity of multiple diagnoses, maybe start your own thread? Maybe you'll find many people on the forum agree with you. That would be fine too.

[dollyvee]

I recently (briefly) joined a "trauma" group and one of the guidelines was to refrain from using "we" language and instead make "I" statements. I sort of thought about it and it makes sense to not lump everyone's experiences together because even though we have all experienced trauma, who am I to say that what I am feeling is the same as someone else? I also think that using we IMO, is a way to redirect that pain outward and not inward on our own experiences, which need examining (ie the attachment we are so often looking for). IMO it helps to be able to name and identify what is going on in my own internal world and how parts show, or do not show up.

Not sure if this is the space to put that, but these are just my thoughts. I also am weary of always looking at the "positive" side of things all the time. Yes, on one hand it helps to focus on coping mechanisms instead of the negatives, and tbh it's probably how I survived to a great deal. However, speaking for myself, I wasn't allowed to have "negative" feelings growing up in an NPD household because my caretakers couldn't handle them as it would require them to recognize me as seperate, something that is important for the adult me to do. So, spending time with "negative" feelings when they come up is important. I think you're suggesting this in when you talk about wallowing, but IMO it's also about hearing them as we would an exile in IFS, where we do that without an agenda of "getting over it."

[Armee]

That makes a lot of sense to me DollyVee.

[Papa Coco]

Dolly,

I had a similar experience early in therapy when I used the word "You" instead of "I". Ever since then, I catch people doing it all the time. Example: News interviews of an accident survivor who says to the world via camera, "When the bus started to slam into the barriers, you sort of feel like you are going to fly...blah blah blah."

I realize by reading your post that this is exactly what's happening. When people talk about things that they don't want to be connected to, they might say, "you feel this" when this happens or "you feel that" when that happens. I politely joke around with it, asking, "how do you know what I feel when something happens to you?", but the truth is its deflection. Exactly the same as saying "we" instead of "I".

Up until now, I've thought of it solely as my desire to be the expert witness rather than the vulnerable victim. I think that I'm trying to raise my status up from being a victim to being a teacher to help others by saying, "here's what you will feel if it happens to you."

I guess both can be true. It makes sense to me now. By wanting to elevate ourselves out of the victim role, we use "You" or "We" instead of "I" to describe what didn't feel so good when it happened. I'd rather be an expert witness than a victim.

PS: I'm never cruel with my humor, but these days, I do now see that people who use deflective words like this are doing it from being in pain somewhere down deep. It's not funny. I use gentle humor to help break the ice and form a bond. And these days I'm finetuning that to make the humor even gentler and more about bonding than teasing. It's sort of the Patch Adams effect of using humor as a healing tool.

[LaylaDalal]

So I have been processing this for a while but I am wondering what thoughts the community has.

You may be familiar with Internal Family Systems, which stipulates that everyone has parts (https://www.verywellmind.com/what-is-ifs-therapy-internal-family-systems-therapy-5195336). There is also the structural theory of dissociation, which proposes that there are different degrees of dissociation among parts of the personality depending on the timing, nature, and number of traumas and maps different diagnoses onto these levels (https://did-research.org/origin/structural_dissociation/). For example, PTSD is a form of primary structural dissociation (i.e. one apparently normal part and one emotional part), C-PTSD, BPD, and OSDD are forms of secondary structural dissociation (i.e. one apparently normal part and several emotional parts), and DID is tertiary structural dissociation (i.e. multiple apparently normal parts and emotional parts).

Okay, great. Being a multi-faceted human being is normal. If you have trauma, you might have some dissociative barriers between you and your parts. And, at least looking from the outside, the criteria for DID seem rather unambiguous -- you have multiple parts and they front and you have amnesia about it (https://icd.who.int/browse/2024-01/mms/en#1829103493). (I also validate that realizing it from the inside is extremely complicated -- but since I don't have it I can easily see I don't have it). But how do you know if your "parts" are C-PTSD related or if you have OSDD/PDID as well?

The ICD-11 tries to clear this up, and I'm wondering if this resonates with those who have C-PTSD with or without OSDD/PDID. This is from the section on Partial Dissociative Identity Disorder (which is comparable to OSDD in the DSM-V):

"Boundary with Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder: Partial Dissociative Identity Disorder involves pervasive alterations in identity and sense of agency. In Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder, such alterations can occur but are limited to episodes of re-experiencing traumatic events (e.g., during flashbacks). If symptoms consistent with dissociative intrusions occur exclusively during such episodes in the context of Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, an additional diagnosis of Partial Dissociative Identity Disorder is not warranted." (https://icd.who.int/browse/2024-01/mms/en#988400777)

So I have "intrusions" but I hear/see/feel them on a daily basis, not just during flashbacks. They have their own thoughts and feelings and ways of seeing the world and themselves. They have begun asking me to "treat us like real people". It's getting very difficult to deny because now when I try they are very quick to remind me that "we're here and we're real". Of course sometimes I still deny it. At first I didn't think there was switching but now I'm becoming aware of subtle shifts in how I speak and hold my body and sometimes when I see a trigger coming it's like "the space inside my head changes" and then I have a completely different attitude about it.

I have a friend with DID who has given me information and support as I explore this part of my experience. It's been extremely helpful, but I still have trouble rationalizing that I could have gone through something significant enough to warrant the C-PTSD/OSDD symptoms I seem to be experiencing. Even now, whichever version of me I am is more connected to the feelings and thus, believes that the feelings are real and is willing to speculate that something might have happened that I/we don't remember. But then, later, I will be very not connected to the feelings and then it's all, well, I have no good reasons to feel this way and if I just tried harder I would be okay...

I've been exploring this for over a year and so at this point I can more readily say this is an enduring phenomenon and not just "mood swings".

I'm wondering if this resonates with anyone else's experience, and, if so, where you fall in this continuum of dissociation. What do "parts" look like for you? Are they self-aware? Do they want to be seen? Can you converse with them? What do they do? Do they feel like "real people"?

I haven't seen a thread about this anywhere else so I thought I would start one -- but if it already exists please refer me 


Abbreviation key:
BPD = Borderline personality disorder
DID = Dissociative identity disorder
DSM-V = Diagnostic and Statistical Manual of Mental Disorders 5th revision
ICD-11 = International classification of diseases 11th revision
OSDD = Other specified dissociative disorder
PDID = Partial dissociative identity disorder

Hey,
I'm aware that this is an old post but I can just relate to it very much and maybe there is some value in me answering after all this time even.
I am currently in a deep process of figuring out if I need to go for an official diagnosis of PDID/OSDD or if its better to stay with my general feeling of multiplicity and I can therefore relate to all the different answers here from (at least) two sides.
I personally believe that humans are always multiple and that the gift of complex trauma enables those who had to suffer this horror to be more aware of their own multiplicity (like shamans). There are so many teachings in the world that help me deeply to understand my multiplicity and the diagnosis of DID as a disorder often feels invalidating of peoples inner geniouses. At the same time, its incredibly helpful to learn from and connect with others diagnosed with DID/OSDD (just as with CPTSD) and feel validated and inspired by their worldview.
Also because it shows the immense struggles that come with it.
I relate to those struggles. I have parts who are very distinct, who use names and I have amnesia with them. They do things that I consider dangerous. I also experience coconsciousness in the forms of watching them doing things, that I cant stop. I also experience coconsciousness, more and more so, in the form of being able to have conversations with them in my head, which is an incredibly helpful, new development. Young parts only "talk" in therapy or through drawing, some of them named themselves by now and I feel so grateful. Generally, drawing and dance (and writing to an extent) help me to develop co-consciousness, dramatically.
I feel extreme exaustion from trying to appear normal and functioning in the world (and I can to an extent) but I do it because I feel so afraid of amnesia and what can happen during those times. I got lost before but the worst fear is that I will end up being in dangerous sexual situations again like it happened so many times before.
So, the intense pressure of trying to mask multiplicity, that many people with DID describe, feels very familiar to me.
I'd be interested to hear other peoples experiences. I am determinded to believe, that our multiplicity is a deep gift, we share, despite the extreme difficulties it can bring.