The subjective/phenomenological model of pathological
dissociation Is actually a generalized formulation of the eight Schneiderian passive-influence
experiences. According to the subjective/phenomenological model of pathological
dissociation, the phenomena of pathological dissociation are recurrent, jarring
intrusions into executive functioning and sense of self by self-states or alter
personalities. Such dissociative phenomena are startling, alien invasions of
one’s mind, functioning, and experience. These intrusions are always confusing
[65–67] and often frightening. They frequently cause persons who are
dissociative to fear for their sanity. The subjective/phenomenological model of
pathological dissociation has four corollaries.
Pathological dissociation can affect every aspect of human
experience No aspect of human experience is immune to invasion by dissociative symptoms.
Dissociative intrusions can affect one’s conscious awareness and one’s
experience of one’s body, world, self, mind, agency, intentionality, thinking,
believing, knowing, recognizing, remembering, feeling, wanting, speaking,
acting, seeing, hearing, smelling, tasting, and touching.
Most phenomena of pathological dissociation are subjective
and invisible. The overwhelming majority of dissociative phenomena are
subjective and invisible, rather than objective and visible [4]. Relatively few
objective signs of dissociation exist, and the few objective signs that do
exist are unreliably discerned, even by well-trained observers [68].
There are two major kinds of pathological dissociation:
intrusions and amnesias
Two major kinds of pathological dissociation exist:
dissociative symptoms that are partially dissociated from consciousness
(intrusions), and strictly speaking, identity confusion is not a dissociative
intrusion. Rather, identity confusion is the result of undergoing recurrent
dissociative intrusions.
Testing the subjective/phenomenological model of
dissociative identity disorder because no instrument comprehensively measured
the hypothesized dissociative symptom-domain of DID, it was necessary to
develop the Multidimensional Inventory of Dissociation (MID) [65]. The MID has
23 dissociation scales that assess the subjective/phenomenological domain of pathological
dissociation and the hypothesized dissociative symptom-domain of DID (see Box
1).
DELLTable 2
Incidence of 23
dissociative symptoms in 220 persons who have dissociative identity disorder
General dissociative symptoms:
Memory problems (5/12) 100 94 93 98
Depersonalization (4/12) 95 95 94
98
Derealization (4/12) 93 92 89 98
Posttraumatic flashbacks (5/12) 93
92 90 96
Somatoform symptoms (4/12) 83 83 81
88
Trance (5/12) 88 87 84 96
Partially-dissociated intrusions
Child voices (1/3) 95 95 94 95
Internal struggle (3/9) 100 96 95
98
Persecutory voices (2/5) 88 90 87
96
Speech insertion (2/3) 85 83 81 86
Thought insertion/withdrawal (3/5)
93 91 90 95
‘‘Made’’/intrusive emotions (4/7)
95 91 90 96
‘‘Made’’/intrusive impulses (2/3)
85 89 87 93
‘‘Made’’/intrusive actions (4/9) 98
95 93 98
Temp loss of knowledge (2/5) 90 82
80 91
Self-alteration (4/12) 98 95 94 98
Self-puzzlement (3/8) 98 95 93 98
Fully-dissociated intrusions (ie, amnesia)
Time Loss (2/4) 88 88 87 89
‘‘Coming to’’ (2/4) 78 79 75 88
Fugues (2/5) 83 75 71 86
Being told of actions (2/4) 85 86
85 88
Finding objects (2/4) 61 74 72 77
Evidence of actions (2/5) 71 77 76
81
Abbreviations: MID ¼ multidimensional inventory of
dissociation; SCID-D, Structured Clinical Interview for DSM-IV Dissociative
Disorders-Revised; Temp loss of knowledge, temporary loss of well-rehearsed
knowledge or skills; Self-alteration, experiences of self-alteration; Being
told of actions, being told of disremembered actions; Finding objects, finding
objects among one’s possessions; Evidence of actions, finding evidence of ones
recent actions. The first numeral is the number of items that must receive a
clinically-significant rating by the test-taker for that symptom to be
considered present; the second numeral is the number of items on that scale.
(5,730/837)
I so wish I understood Zach better, his disassociation actually showed up on his brain scans. Yet, at times it seems so contrived.
ReplyDeleteHow did it show up Christina? Very interested ... I've only gotten as far as their being less grey matter, but am so interested in how the brain is affected - even sometimes damaged because of the previous abuse. It would seem the more one knew the more one could learn to compensate those particular losses.
ReplyDeleteI just read that a great amount of the response as a multiple is subjective rather than objective. That would lead maybe to your thoughts on it being contrived. It seems that a lot of multiplicity is adapting and like you start dealing with one personality and get a handle on it, but then the parts switch to other parts that need to learn similar lessons in that area, so then you might be losing that feeling that you covered this ground and should be moving on. Love to hear more discussion on this kind of stuff. Proud of the "mom-work" you are doing!
THANKS for posting!
LOVE YOU,
Ann