Tag Archive: Ph.D. Nijenhuis

Can a DID part have BPD? (Pag.3)

So can an ANP, an identifiable stable act system, DD-BPD-DID
an Apparently Normal Personality part of a personality that suffers a DID,
suffer a BPD in order of a double diagnose DID and BPD ?

There I also want to answer with a ‘No’.
And I will explain why I think so.

Concised view of defined terms:
An ANP is a Host, an identifiable part of the personality, an act system, an Apparently Normal Personality
An EP is an Emotional Personality part of the main Personality. Each ANP can have stored all sorts of traumatized EP’s.
DID is a dissociative Identity Disorder with more than one identifiable Host act system (ANP’s)
DID is not a personality disorder
BPD is a Borderline Personality Disorder

Edit: 18-4-2014
An additional reaction from my therapist

after reading all my own writings on my Blogsite in order to explain a ‘structural dissociation of the personality’, the PTSD levels and the difference between DID and OSDD (complex PTSD level II and III). Probably a more compact clinical clarification and additional to the difference between ANP-EP and DID-OSDD by my therapist.
ANP’s don’t do to personification. They focus purely on tasks of everyday life and leave aside the EP’s of their consciousness mind. The influence of EP’s that they do experience, they experience not as a part of their own lives (they think it’s not a part of me)
EP’s don’t do to presentification (don’t live in the present time). They only think from out the past and don’t take notice of the fact that it’s already 2014.

In case of a OSDD there is one ANP and a lot more EP’s. Those EP’s don’t completely take over the consciousness mind of the ANP. So the ANP stays more a less in contact with the EP’s.

In case of a DID there are more than one ANP, and the EP’s can take over the consciousness mind of that or that particular ANP on that moment (that cause losing time in the daily functioning of the ANP’s). Amnesia is therefore also a typical symptom that goes with a tertiary dissociation of the personality.

No Pain

So each person has only one personality !

Lets look closer to a personality that suffers a DID:
You can identify different DID-ANP’s of a personality that suffers a DID (stable act systems).
BPD is a personality disorder and not a partial identity disorder.
There you only could ask yourself the next question:
‘can a DID-ANP part suffer symptoms of a Borderline structure?’
Yes that is possible, but than a less that isn’t a BPD.

If the main host suffers a BPD, then the personality can’t handle or develop stable DID act systems (DID ANP’s EP’s). The total personality will always go under the influence of that personality disorder. One of the main symptoms of BPD is impulsive and acting out behavior, and they suffer also a very high influence of EP’s (emotional PERSONALITY parts). That isn’t a DID symptom, where one of the main symptoms is: More than one ANP and more than one EP = Together they form very stable act systems, identifiable DID-ANP’s, which don’t leave a lot of room to the EP’s to take control over the personality. The ANP’s are protecting each other, and the personality, against the influence of those painful EP’s (a survival system that didn’t learn how to synthesize)

A often heard explanation in answering the main question ‘can a part (ANP) of a DID personality suffer a Borderline personality disorder?’, is:
Most given answer: Yes, it is possible because there are people with both diagnosed disorders.
My first reaction there is: ‘Could it be that such a double diagnose is wrong?’
And ‘that’ is possible. Because diagnosing a trauma related dissociative disorder can only be done by experienced specialists which are trained to do so

Than de difference from a therapy need and point of view:

Identities of a personality which suffers a DID (ANP’s – apparently normal personality) protect each other against the influence of painful emotional personality parts. They don’t leave a lot of room to the EP’s to interfere (take control of the personality).
DID: In therapy and only within therapy, we learn the ANP’s to give room to the EP’s so they can make a start to integrate within the ANP (they need to give more room to the EP’s to work with)
OSDD: In therapy the Host (1 ANP) has to learn to take more control over the influence of EP’s, because there they have too much room to take over the behavior of the main APN (the EP’s have to much room and influence, in taking control of the personality).

Love to you all
Nique

ps:
A little language barrier

Sometimes a laugh is also very important to survive…

goodmorning

After 28 years no writing or speaking English, I have to learn English again to make myself understandable to you all.
But now I will learn you all a little bit Dutch.

So I’ll give you a Dutch sentence:
Mijn buurvrouw heeft koolmeesjes maar wat doet uw haan op mijn ezel.

Means:
My neighbor has great little birds, but what does your rooster on my donkey

And now go to google translator, see link:
http://translate.google.nl/?hl=nl#nl/en/mijn%20buurvrouw%20heeft%20koolmeesjes%20maar%20wat%20doet%20uw%20haan%20op%20mijn%20ezel

Coping with Trauma

A patient-oriented manual for complex trauma survivors

And the clinical theory behind this treatment

This training manual for patients who have a trauma-related dissociative disorder includes short educational pieces, homework sheets, and exercises that address ways in which dissociation interferes with essential emotional and life skills, and support inner communication and collaboration with dissociative parts of the personality. Topics include understanding dissociation and PTSD, using inner reflection, emotion regulation, coping with dissociative problems related to triggers and traumatic memories, resolving sleep problems related to dissociation, coping with relational difficulties, and help with many other difficulties with daily life. The manual can be used in individual therapy or structured groups.

 treatment trauma

Link to: the Book ‘Coping with Trauma-related Dissociation
Link to: table of contents
This book will give you a guideline to learn
How to Cope with Trauma-Related Dissociation:
Skills Training for Patients and Their Therapists

 

The Haunted Self

 

The use of imagery in phase 1
treatment of clients with complex dissociative disorders
written by Ph.D. O. vd Hart

 

And if you really want to give this book a try and your therapist is also in for it, you could also consider to read the clinical theory behind this treatment such as given in the book
The Hanted Self’.

It’s a clinical learning book.

 

 

Dissociation in Trauma: New Definition and Comparison

Dissociation in Trauma:
A New Definition and Comparison with Previous Formulations

Ellert Nijenhuis, Ph.D.
Onno van het Hart, Ph.D.ELLERT R. S. NIJENHUIS, PhD

Top Referent Trauma Center, Mental Health Care Drenthe, Assen,
The Netherlands

ONNO VAN DER HART, PhD

Department of Clinical and Health Psychology, Utrecht University,
Utrecht, The Netherlands

Published online: 10 Jun 2011

A New Definition and Comparison with Previous Formulations

THE PROPOSED DEFINITIONtandonline

The definition, which is not self-evident, reads as follows:

Dissociation in trauma entails a division of an individual’s personality, that is, of the dynamic, biopsychosocial system as a whole that determines his or her characteristic mental and behavioral actions.

This division of personality constitutes a core feature of trauma. It evolves when the individual lacks the capacity to integrate adverse experiences in part or in full, can support adaptation in this context, but commonly also implies adaptive limitations. The division involves two or more insufficiently integrated dynamic but excessively stable subsystems. These subsystems exert functions and can encompass any number of different mental and behavioral actions and implied states. These subsystems and states can be latent or activated in a sequence or in parallel. Each dissociative subsystem, that is, dissociative part of the personality, minimally includes its own at least rudimentary first-person perspective. As each dissociative part, the individual can interact with other dissociative parts and other individuals, at least in principle. Dissociative parts maintain particular psychobiological boundaries that keep them divided but that they can in principle dissolve. Phenomenologically, this division of the personality manifests in dissociative symptoms that can be categorized as negative (functional losses such as amnesia and paralysis) or positive (intrusions such as flashbacks or voices) and psychoform (symptoms such as amnesia, hearing voices) or somatoform (symptoms such as anesthesia or tics).


Read full article . . .

Download at tandfonline