ANP and EP, CPTSD, DID ANP, DID DD PTSD, Dissociatieve Identiteitsstoornis, Dissociative Identity disorder, Ellert Nijenhuis, Onno van der Hart, personality disorder, PTSD, PTSS en CPTSS, Structural Dissociation, Tertiaire structurele dissociatie, Topreferent Traumacentrum, Trauma, TRTC
What do we have already…
SD = Structural Dissociation
ANP = Apparently Normal Personality part
EP = Emotional Part of the personality
DD = Dissociative Disorder
DID = Dissociative Identity Disorder *
Keep in mind, every person presents only ‘one’ unique personality !
A Trauma related Dissociative Disorder (PTSD+DD) can occur throughout whole your life.
Trauma is Trauma.
DID is just one Trauma Type but it isn’t the only diagnose that goes with Trauma.
A Dissociative Identity Disorder is a Dissociative Disorder (DD)
But not every Dissociative Disorder is a Dissociative Identity Disorder (DID)
If an ANP doesn’t suffer a personality disorder you although can suffer a type 1, 2 or 3 Trauma related Dissociative Disorder (DD)
A Dissociative Disorder (DD) is a clinical Disorder (Axis I, DSM-IV)
The three levels of a trauma related Structural dissociation of the personality (SD) – a Dissociative Disorder = DD:
- Trauma type-I, Traumatized, primary SD
an apparently normal personality ANP and a traumatized emotional part of the personality EP
- complex Trauma type-II, Childhood Trauma, secondary SD
an apparently normal personality which switches between different traumatized emotional personality states ANP + EP’s
- very complex Trauma type-III, Infant to Childhood Trauma, tertiary SD
a personality that switches between ‘emotional- and daily life task handling systems ‘ ANP‘s + EP‘s
The tertiary structural dissociation is the only level that is related to a Dissociative Identity Disorder *
I would prefer to call this a trauma related development disorder. But then again I’m not a clinical psychologist, neuropsychologist or Ph.D. to define such a thing. But I can give some explanation to the existence and on how a tertiary structural dissociation of the personality can occur
A human is not born with a unified personality, but instead infants have biological determinants that were meant to integrate through a process of experience and relationships. To let that happen there are four autonomic emotional systems that are present at birth which include anger, pleasure, sadness and fear. Team players by nature. These systems integrate to develop into one unified task and emotional life system which ultimately shapes our own personality.
Leg of integration
The parasympathetic nervous system and the limbic system are what actually convey feelings from the body to the brain and from the brain to the body. Without those you would never have actually had the feelings that needed to be dissociated.
In TSD an infant is traumatized prior to integration of the autonomic emotional systems, which then results in structural dissociation. This is not splitting, but instead is a lack of integration. The emotional systems stay separate and starts to develop as ANP-EP task and emotional action systems. If there were no trauma in infancy then dissociative identity disorder would not occur.
The four autonomic emotional systems can partially integrate with each other. For example, anger and pleasure integrate, and sadness and fear integrate resulting in two ANP – EP action systems. Over time those systems become more dominant eventually resulting in autonomic functioning ANP – EP action systems. Later on in life, in TSD and very rare: if the current systems can’t handle the EP load another emotional system can split of to functioning also as an autonomic ANP-EP action system. To give an example of such a rare situation; Experiencing the emotional and physical pain during childbirth and becoming a mother can cause an EP overload. Sadness and fear – or – anger and pleasure, can still split.
Now we have more than two ANP-EP action systems.
This type of trauma becomes very close to a type-III trauma
SSD can result instead of TSD when there has been sufficient integration in early life of the four emotional systems. In this case structural dissociation results in only one ANP, but as with TSD there are always two or more EP, however the EP in SSD are less elaborate, emancipated and distinct than in TSD.
In this case the personality sufficiently integrated early in life, but later when a trauma occurs that cannot be integrated then structural dissociation occurs resulting in one ANP and one primitive EP.
This can occur as a full dissociation:
The ANP doesn’t remember a thing of the traumatizing experience (EP)
This can occur as a partial dissociation:
The ANP can remember parts of the traumatizing experience but it doesn’t feel like reality
or an own experience, the EP holds a part of the traumatizing experience.
client at the Dutch TRTC trauma center Drenthe-Assen
I explain by my own words the theory of the Structural Dissociation of the Personality such as given by:
Ph.D. E.R.S. Nijenhuis working at the Mental health care department Drenthe-Assen
Ph.D. Onno van der Hart, Psychotraumatologist
K. Steele, MN, cs
Book advise: The Haunted Self
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