Structural dissociation

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The theory of structural dissociation was developed by Ellert Nijenhuis , Onno van der Hart and Kathy Steele , among others , through years of observation and research into dissociative disorders. She assumes that persistent trauma in early childhood can lead to a structural division of the personality with the aim of ensuring survival and maintaining the functioning of the psyche if the associated coping strategies are no longer integrated due to complex trauma . The severity of the splitting off of personality parts moves on a continuum of dissociation and ranges from primary to secondary to tertiary dissociation. The split in personality can lead to very different symptoms depending on the severity, but they are all attributed to the same principle.

Structural dissociation model

After a trauma perceived as life-threatening, the personality separates into at least the following two personality parts.

Apparently normal personality portion (s) (ANP)

The ANP is responsible for everyday activities and survival. He takes care of work, the household, meeting friends, raising children, caring for hobbies, etc. The ANP is less able to vibrate emotionally and no longer corresponds to the full original personality. He is phobic towards the emotional parts of the personality (EP) and avoids them. This leads to more or less pronounced amnesias , feelings of numbness and indifference. This is an adaptation of the human being in order to be able to continue to exist and function “normally” in everyday life despite the unprocessed trauma.

Emotional personality (EP)

The EP is the so-called carrier of the trauma suffered. He gets stuck in the past traumatic event. It is insufficiently fixed in the present and represents fragments of the traumas suffered. This shows up as intrusions in the ANP which can look like this:

  • Positive symptoms (of having a little more) such as fear, despair, unexplained physical pain, flashbacks
  • Negative symptoms (from having a little less) such as numbness, insensitivity to pain, freezing

The strength and severity of the split personality moves on a continuum of dissociation and is dependent on the age, severity and duration of the trauma. The previous trauma-related disorders diagnoses are embedded in this continuum and indicate the severity of the dissociation.

Primary dissociation

One speaks of a primary dissociation when the personality is divided into an ANP and an EP due to a mostly one-time, life-threatening event. It has been linked to post-traumatic stress disorder .

Secondary dissociation

Secondary dissociation is usually the result of prolonged or repeated trauma. The personality is divided into an ANP and several EPs. The complex post-traumatic stress disorder and the dissociative disorder, unspecified (ICD-10 F44.9, in the ICD-11 then partial dissociative identity disorder ) are included here.

Tertiary dissociation

In tertiary dissociation, humans are made up of several ANPs and several EPs. This corresponds to the strongest dissociation and occurs almost without exception after many years of early childhood trauma from close attachment figures. This form of dissociation has been linked to dissociative identity disorder .

research

Attempts are being made from various sides to confirm the theory of structural dissociation by means of imaging methods . The following study should be mentioned:

Using imaging methods, it was found that, depending on whether an ANP or an EP is active, different neurophysiological activation patterns are obtained in response to a traumatic stimulus. In her research on dissociative identity disorder, Yolanda Schlumpf (University of Zurich) showed patients pictures of angry and neutral faces. These were shown so briefly between a sample that the test subjects didn't even know afterwards that they had even seen pictures. With EP you can see an activation of the brain regions that are responsible for fear and anxiety. This can be explained by the fact that DPs perceive threatening stimuli more strongly. If an ANP is active, you can see the opposite. The brain activity is reduced and the presented stimuli are processed less emotionally. In comparison, it has researched actors who were supposed to play emotional or apparently normal personalities. No different activation patterns in response to traumatic stimuli could be found in these. This finding is consistent with the theory of structural dissociation.

history

Pierre Janet already assumed that the trauma-related dissociation was due to an "organized" separation of personality. The idea of ​​the separation between ANP and EP was also described by Pierre Janet. It also appears in Charles Samuel Myers , who examined traumatized soldiers of the First World War ( war tremors ), and whose publications influenced the first authors on structural dissociation.

See also

literature

  • Harald J. Freyberger , Carsten Spitzer, Dennis Wibisono: Theories for understanding dissociation. In: Günter H. Seidler , Harald J. Freyberger, Andreas Maercker (eds.): Handbuch der Psychotraumatologie. Stuttgart, Klett-Cotta 2015. ISBN 978-3-60896-258-1 . Pages 22-37.
  • Ellert Nijenhuis: The trauma trinity: ignorance - fragility - control. The Development of the Concept of Trauma / Trauma-Related Dissociation: Concept and Facts. Göttingen, Vandenhoeck & Ruprecht 2016. ISBN 978-3-525-40261-0
  • Ellert Nijenhuis, Onno van der Hart, Kathy Steele: The persecuted self . Paderborn, Junfermann 2008. ISBN 978-3-87387-671-2

Individual evidence

  1. ^ Ellert Nijenhuis, Onno van der Hart, Kathy Steele: The pursued self . ISBN 978-3-87387-671-2 .
  2. ^ Nijenhuis, Steele, van der Hart: The haunted self: structural dissociation and the treatment of chronic traumatization . 1st ed. WW Norton, New York 2006, ISBN 0-393-70401-7 .