What makes someone a dissociative episode

A trauma is an event perceived as life-threatening that exceeds one's own coping capabilities and floods the affected person with feelings of helplessness, intense fear or horror. When neither fight nor flight is possible, i.e. body and soul cannot escape the situation, the human organism switches to survival strategies. Humans freeze (similar to the dead reflex in animals) and dissociate.

Dissociation is the ability to split something off from everyday consciousness. To a certain extent, a lot of people know this. For example, if someone does not feel any pain shortly after a serious traffic accident despite being injured, organizes help with clear thinking and later perhaps only remembers it partially. This is a sensible reaction of the human organism in dangerous situations. If the danger persists, dissociation can become a permanent coping strategy in young children. Your personality is not yet fully developed and therefore very malleable. Young children are dependent on and dependent on close caregivers, even if they neglect the child and / or are violent.

The splitting of the personality enables survival in such hopeless living conditions. This dissociation is not a decision, but happens involuntarily and cannot be controlled by those affected. However, there are also groups of perpetrators in which dissociative identity structures are created using specific methods (see ritual violence).

Different personalities

First of all, the personality is divided into two areas. The "everyday self" tries to function in everyday life, ie to go to school, play with other children, learn new things, etc. In the other area of ​​the personality, the memories of the violent situations and the feelings associated with them are stored.

If the violence continues and is unbearable, the personality will be further split. Some parts only retain a fragment of memory or a sensory perception (e.g. the pictorial memories of an act of violence or a feeling of suffocation without memories of the original situation). Other parts live on relatively independently of one another, gain further experiences in situations they experience, acquire skills, develop peculiarities, their own scripts, preferences, names.

After all, there are independent personalities who "share" a body, but can be very different. Some have stopped developing at the age at which they came into being. Therefore, in a 40-year-old body, for example, there can be an or give several 40-year-old everyday personality / s and at the same time also personalities who are like a baby, toddler, six-year-old child or 15-year-old adolescent in terms of self-perception and in their effect on other people and in their development.

There can be personalities of different ages who are jointly responsible for everyday life. Some personalities still live in the memory of the threatening situation at that time or still experience violence today.

The separation between the personalities can be more or less extensive. Stimuli and situations that are similar to the situation at that time (so-called triggers) can break this separation. They can then lead to an inundation of the “everyday self” with the split-off experiences of violence, or they can cause a change of personality. With dissociative / multiple people it is often the case that some personalities know each other, others only know some and still others very often have "gaps in time".

Symptoms

There are a variety of symptoms that multiple people report. The following symptoms may or may not occur:

Time gaps - Amnesia for what happened just before, e.g. no memory of how you got to this place, why you are wearing this item of clothing or who is the person you are talking to. Amnesias for your own life story (little / no memories of childhood)

Depersonalization / derealization - the body or the environment feel strange and unreal at times

Flashbacks - Sudden memories of threatening situations or parts of them in the form of images, sounds or body sensations

hear voices - Voices in the head that e.g. comment on something, argue, threaten, cry ...

fears - These can be specific fears of e.g. people or fire or a general basic fear. The origin of the fears is often incomprehensible at first.

Body pain and movement disorders - Pain in different parts of the body without the body being currently ill or injured, sometimes not being able to control movement sequences

Selfharming behaviour - Repeated cutting or burning of the skin, overeating or starvation, substance-related addictions, failure to care for yourself

Different behaviors, fonts, preferences, skills … 

Such symptoms can be very different at different times and also vary in severity from personality to personality.

In addition to getting to know the different personalities and learning inner communication, it is necessary for many people to work through their own history or parts of it due to the stressful symptoms. There are various options for this, such as trauma-specific therapy or counseling. Ultimately, it can be about integrating the traumatic experiences.

integration

Integration means the realization: "Yes, I have experienced that - and it is over!". The violence is a thing of the past. The sufferer can remember this without being inundated with flashbacks. This is an enormous gain in quality of life. However, the task still remains to live with the knowledge of the violence experienced and its consequences.

For some professionals and multiple people, integration also means a fusion, i.e. "merging" of the different personalities of a multiple person into a single, unified personality. In our opinion, that should be the decision of the multiple person himself. There are multiple in which all personalities decide after a long common path to a complete merger or this just results because the walls are no longer necessary. With other multiples, only a few personalities join together.

Sometimes, however, all or some of the strong everyday personalities decide that they want to remain independent and shape everyday life together. There are many ways and possibilities.

In my own words

“In the meantime, I've known a number of triggers that cause change in me. It is mostly outside influences: certain smells, special aftershave, voices and similarities in people you meet, noises or when I talk about stressful situations in therapy. For a long time I didn't know that I was switching. I just lacked a little time or could only remember fragments of situations or conversations. Now I notice it a lot. (...) I usually get severe headaches and visual disturbances beforehand or other sudden pains. "
Alexa, in Striebel, C. (2008): Step by Step into Life. A compact self-help book for people with dissociative identity disorder and intermediate forms, p. 92/93.

“[Meanwhile] I can see both sides of being multiple. On the one hand, we still live through it today. I always have someone to talk to. If I'm not doing so well, someone else can take over my duties. We can have a lot of fun together. On the other hand, I'm never really alone. A lot has to be decided together, everything that concerns the body. So just going to haircut doesn't work, everyone wants to have a say. Because, after all, everyone has to run around with their hair. And there is always a lack of time. No matter how well I have planned everything, the time, the day is always too short. "
Sternenfänger, in Striebel (2008), pp. 55/56

"At last! Found a helpful therapist. To be able to build and shape a stable, trustworthy working relationship. - For us this also included the wish, the possibility that everyone could get in contact with her. It deeply affected our BEING level. Even today I cannot imagine how an entire “school class” should learn when only the “class representative” has the right to communicate. The picture is of course lagging, as it is more about “emotional learning and understanding”. How does this work differently than through direct contact? "
Rainbow song, in: Huber, M. (2011): Many be. A Handbook, p. 288

“The time it took to come to terms with it was cruel. The time of waking was hell. I was torn from my silent universe. I was catapulted into this reality with a roar and rumble ... it just hurt. And with talking came EMOTIONS. UNBEARABLE!! For now. If someone had told me beforehand what will happen with TALKING, I would never have volunteered. I wanted to go back to my silent vacuum! My life got history. My life got names, my life slowly got color, tone and taste. Because of the constant talking, all the dirt slowly got out of me and there was finally room for new things. I got to know a different side of life that I had never known before. I didn't even know there was such a thing. Life offers color ?? Life offers abundance? Wealth and exciting challenges ... I am still overwhelmed now. I would never have thought that life would hold such wealth in store for me - NEVER! "
Anonymous, in: Independent Commissioner for Coming Up With Child Sexual Abuse (2011). Final report of the independent commissioner for dealing with child sexual abuse, Dr. Christine Bergmann. P. 247/248, http://www.beauftragter-missrauch.de

“In the past (...) everything was still very torn apart, everyone survived for himself. Today we only say "Team". At some point it was as if colors were mixed, like yellow and blue turn into green and the whole thing was formatted into a circle. That's how it is with us in stable times. (.. .) But in bad times the circle falls apart. "
Leah Nadine in Striebel (2008), p. 73

literature

Fliß, C., Igney, C. (Eds.) (2008): Handbuch Trauma und Dissoziation. Lengerich: Pabst Science Publishers.

Gast, U., Wabnitz, P. (2017): Recognizing and treating dissociative disorders. Stuttgart: Kohlhammer.

Gysi, J. (2018): Changes in the ICD-11 in the area of ​​trauma & dissociation. Available at: https://www.jangysi.ch/Therapie,-Medizin,-Journalismus/

Huber, M. (2011): To be many. A manual. Paderborn: Junfermann.

Schultheis, R. (2018): Advice and support for women with dissociative identity disorder. Bachelor thesis, for download

Striebel, C. (2008): Step by Step into Life. A compact self-help book for people with dissociative identity disorder and intermediate forms. Leipzig: Engelsdorfer Verlag.

Steele, K., Boon, S., van der Hart, O. (2017). Treatment of trauma-based dissociation. Lichtenau: G. P. Probst.

Van der Hart, O, Nijenhuis, E. R. S., Steele, K. (2008): The Persecuted Self. Structural dissociation and the treatment of chronic trauma. Paderborn: Junfermann.

VIELFALT e.V. (2015): Many being. Survival and everyday life. A brochure for dissociative / multiple people and their supporters.

VIELSEITS GmbH and VIELFALT e.V. (2016): Doctor's appointments and medical examinations. A compilation of experiences and suggestions for internal and external preparation for people with Dissociative Identity Structure (DIS).

VIELSEITS GmbH (2018): Trauma and Dissociation. Fragmentation of identity in the survival space of extreme violence. www.vielseits.de