Neuro-Affirming Dissociation Spectrum 101
A resource for both therapists and clients about the dissociation spectrum!
*Trigger warning: brief mentions of ritual abuse, mind control, and organized abuse*
What causes dissociation?
What creates dissociation depends on who you ask - there is no consensus about the exact mechanisms that contribute to or cause dissociation. Because dissociation is a spectrum, it also depends on what kind of dissociation is being discussed. Dissociation by way of trance involves multiple brain structures, and though studies aren't conclusive, they largely indicate changes in areas of the brain involving senses and perception. Most theories about multiplicity suggest that both unmet attachment needs and inescapable aversive or unsafe dynamics contribute to its development. Though science and research are both important, the lack of consensus doesn't negate the legitimacy of both dissociation and multiplicity.
The prevailing theories
Structural Dissociation Theory
Structural Dissociation Theory (SDT) by Hart, Nijenhuis, and Steele posits that there are three types of dissociation: primary, secondary, and tertiary. All three types involve an “apparently normal part” (ANP) of self that is responsible for everyday tasks. After a traumatic experience, a new part is created which SDT refers to as the “emotional part (EP).” This part reportedly holds the information about or experience of the trauma. In primary dissociation (PTSD), there is one ANP and one EP, in secondary dissociation (OSDD) there is one ANP and multiple EPs, and in tertiary dissociation (DID) there are multiple ANPs and EPs.
It is important to note that multiplicity advocates largely reject this theory. Outside of the ableist language, it often doesn’t describe the actual experience of multiplicity. It also devalues the importance of and misstates the roles of parts who might hold more emotional content. Lastly, it frequently advocates for integration of parts which is a rejected priority for many in the multiplicity advocacy community.
Discrete Behavioral States Theory
Discrete Behavioral States Theory (DBST) by Frank Putnam and supported by the International Society for the Study of Trauma and Dissociation hypothesizes that everyone has many different “states of being” or parts and that it is through met attachment needs during infancy and childhood that people are able to integrate aspects of self such as identity and behavior across all parts. Met attachment needs in infancy and childhood facilitate the safety necessary for the development and integration of sense of self. Putnam asserts DBST can be applied to almost all diagnoses in the DSM but specific to dissociation and multiplicity DBST states that these occur in order to maintain attachment to an inconsistent, unreliable, or otherwise unsafe caregiver.
DBST also describes caregiver betrayal as integral to the development of multiplicity; because infants are dependent on caregivers to meet all of their needs, their only option when faced with unmet needs or active harm is to further develop existing states of being in order to make continued attachment most likely (again, a biologically driven choice without any cognition involved!). Because these separate states of being are required to maintain attachment while allowing for survival, an infant thus cannot integrate the necessary aspects of self across all parts.
Deep Brain Reorienting
Dr. Frank Corrigan and his novel trauma reprocessing modality Deep Brain Reorienting suggest there are four types of dissociation: 1. Supracortical dissociation, or a turning away from or disowning painful content which is facilitated in part due to the superior colliculi and the periaquiductal grey area, both of the midbrain structure, 2. Intracortical dissociation which results in derealization and depersonalization or general disruptions in perception of space and time and involves ascending neurogenic pathways which support norepinephrine and the modulation of arousal, attention, and sensory processing, 3. Neurochemical dissociation or a nervous system response involving the increased production of endogenous cannabinoids which reportedly mediate high arousal dissociation and involve emotions like shame, fear, and sadness, and endogenous opioids which facilitate a collapse response including tiredness, numbness, decreased respiratory rate, and muscle limpness, and 4. Structural Dissociation, à la the above Structural Dissociation Theory.
Additional considerations
Outside of theory in the origin of dissociation, we know that parts or members of the collective can be intentionally created by way of torture and are in situations involving ritual and sadistic abuse and mind control. Parts are created to exploit or further prevent traumatic content from emerging. Purposeful parts creation by way of torture is typically seen in human trafficking and creation of child sex abuse materials, religious and satanic ritual abuse, crime networks, and some government agencies. These areas are often interconnected.
There are many other ways to describe the development and mechanisms of dissociation and there are just as many theories to explain it. There is no 100% agreed upon explanation or understanding. It’s okay that we as a society and as therapists supporting those who experience dissociation and multiplicity are unsure. I also think it’s okay to tell our clients we’re unsure. The need for certainty and the prioritization of scientific knowledge around dissociation over the lived experience of dissociation are born of white supremacy culture. See “Importance of Cultural Humility” for more.
Dissociation is a topic near and dear to my heart! If you're a therapist who has questions about it or an organization interested in learning more, I offer consultation so please don't hesitate to reach out below!