The theory of structural dissociation helps to further understand how childhood trauma impacts the development of personality.  With structural dissociation explained in simple terms, the differences in dissociative disorders becomes easily apparent.

To understand structural dissociation, it’s important to understand that we are all born with multiple personalities. 

This theory operates on the previously stated information about when the personality of a child integrates.  It’s thought that every infant is born with several different ego states that handle different facets of growing.  These ego states are designed to take care of one part of life – for example, one part for nourishment, one part for attachment to adults and one part for exploring.  Researchers believe that over time these ego states evolve into one cohesive personality.  While there isn’t a specific age or way to know when this occurs in development, most professionals believe that the merging of the ego states happens between the ages of 6 and 9 in most children.

Children who endure repeated trauma prior to the merge of those ego states can develop differently than those who do not and even those who only have one traumatic experience in childhood. When a traumatic experience occurs prior to the personality fully integrating, it’s both possible and likely that some of the trauma memories will not integrate.  These not integrated states and how many of them there are often tell the story of the trauma survivor.  Children who have inconsistent parents or attachment figures will often be unable to fully integrate into one personality – causing that trauma survivor to develop structural dissociation.

There are 3 types of Structural Dissociation: Primary, Secondary and Tertiary.

Structural Dissociation is not exclusive to DID or OSDD systems nor are the lines drawn in the sand for who falls into what category.  Just like the trauma they endured, every individual who lives with structural dissociation will experience it in their own way. This is simply because the brain did what it thought it had to do in order to survive – that looks different for everyone and also looks different from trauma to trauma.

The theory of structural dissociation explains the symptoms and behaviors of many trauma related disorders.  Categorized based on the structure – patients with PTSD, C-PTSD, BPD, OSDD and DID all fall under the blanket of structural dissociation.  While they all have similarities, they are also different.  Classification is based on the number of apparently normal parts (ANP) and emotional parts (EP) that are within one’s sense of self.

Read more about ANPs and EPs here

Primary Structural Dissociation: PTSD and other dissociative disorders

illustration of 1 apparently normal part and 1 emotional part

This label is given to those who have a sense of self that is broken into two parts.  This is most common after a single traumatic experience and doesn’t have to occur in childhood.  Dissociation is a common response for the brain to trauma that it doesn’t know how to process or handle.  In individuals who experience primary structural dissociation, they (most often) have dissociated or separated their “going on with life part” from their “had a traumatic experience” part.

In this type of structural dissociation – there are 2 parts.  One apparently normal part and one emotional part comprise the whole identity or sense of self.  This theoretical model occurs in simple dissociative disorders and also in patients with PTSD.  Although structures vary from person to person, in primary structural dissociation, typically the ANP handles daily life, social interaction etc and the EP handles all responses to triggers or potential sources of trauma.

Secondary Structural Dissociation: C-PTSD and BPD

illustration of one apparently normal part and multiple emotional parts

In this type, there is still one ANP or “going on with life part” as with primary structural dissociation.  The difference between the two types is solely based on the number of emotional parts.  When trauma begins at a young age or lasts over a period of time, it’s common that one EP can’t handle it all – so additional emotional parts are needed to handle the load.  This does not have to occur in childhood – although it often starts there.

In an attempt to contain the traumatic experiences, the brain  houses like experiences into the same emotional part.  In this type it’s common to see an ANP and several different parts that respond to potential or actual abuse in a specific set of ways.  C-PTSD (complex post traumatic stress disorder) and BPD (borderline personality disorder) patients often have this type of structure with an apparently normal part living life while being “hijacked” by emotional parts that may respond very differently and sometimes all at once.

Patients with secondary structural dissociation commonly have different parts to handle different responses (like fight or flight shown in the graphic)  Having all of these parts running rampant can make emotional regulation challenging and in some cases nearly impossible.  Many patients see improvement by learning DBT skills and others suffer until they learn to befriend their dysregulations.

Patients with very fragmented parts may be diagnosed with OSDD.  While structurally for some OSDD  systems this may be accurate, many systems diagnosed with OSDD have multiple ANPs – which technically makes them a different classification.

Tertiary Structural Dissociation: DID (Dissociative Identity Disorder)

an illustration of multiple apparently normal parts and several emotional parts

This type is virtually synonymous with dissociative identity disorder (DID).  This type of structure is more complex than the other types of dissociation and can only come from enduring repeated trauma before the ego states merge.  Enduring repeated trauma that early in life causes the brain to need more than one ANP to get continue to survive the trauma from day to day.  The number of ANPs present in tertiary dissociation is no longer one.  This is fundamental difference between this type and the other types of structural dissociation.

With more than one ANP, the system functions in a more fragmented way.  Often ANPs are entirely dissociated from one another and some even have easier access to specific EPs, this creates dissociative amnesia as a symptom.   In this type, it’s common for more ANPs and EPs to be created throughout life in times of high stress or trauma.  Sometimes the system itself can create additional ANPs when previously active ANPs have grown too tired and weary to handle the stressors daily life presents.

Read about this happening in our system: MaKayla has stopped fronting and Jewel came ready to handle that

It’s important to note that systems with tertiary structural dissociation are extremely unique and diverse.  Based on their trauma, their brain adapted by creating ANPs and EPs to endure what they were going thru.  Needing multiple ANPs to survive isn’t unique to only DID but also occurs in some systems diagnosed with OSDD.  When multiple ANPs are present it’s common for each one to take care of specific parts of life, just like the ego states in infancy once did.

Our experience with tertiary structural dissociation

As a DID system, we live with the last type listed here in this blog.  This means we have multiple ANPs.  We refer to them as “going on with life parts.” During high times of stress and re-traumatizing sometimes our EPs would be our going on with life part.  In our case that was because our fight part, Lydia, was constantly needed just to survive for several years.

Over time, because we kept enduring trauma, our ANPs split and got their own EPs and ANPs which further fragmented us and made more parts necessary to go on with daily life.  It may sound hopeless – constantly splitting but there is hope and recovery is possible.  Identifying parts, befriending parts and working together with parts to make life seamless is the treatment model we chose to use and believe it can help everyone who experiences structural dissociation.

Do you live with structural dissociation?  We’d love to hear your story.  Share it in the comments or contact us to add your experience to our blog!

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