What is DID/OSDD and how does it work? - A Guide by Little PsyCrow (pt.1)

Before we begin, let me tell you about the scale or spectrum of dissociation.

The dissociative scale looks like general dissociation (such as just zoning out for a bit), depersonalization/derealization, dissociative amnesia, OSDD (otherwise specified dissociative disorder), and DID (dissociative identity disorder). OSDD and DID involve splitting and multiple states of consciousness. How does that happen? Basically, when we're young (all people), our sense of self isn't fully formed. Instead of having a solid, unified identity, our brains start out with different states of mind or aspects of the self that gradually come together as we grow. This process of integration typically completes by around the age 9-ish. However, if severe, repeated trauma occurs before that full integration happens, the brain may develop dissociative barriers and amnesia between those fragments to protect the child as a whole. The trauma was too great to be able to go on with life, functioning— The brain had no choice but to divide and place walls in between. So instead of fusing into a single, unified identity, these fragments remain separate and go on to develop into distinct states of consciousness, or alternate states of consciousness (aka alters). 

- Each alter can hold different pieces of memory—some might carry parts of the trauma, like certain emotions, smells, or images, while others might hold entire memories. And some might not remember any trauma at all. For example, the host. The host is the fragment/alter that the brain chooses to remain at front (present, conscious, and in control of the body) the most. Because they need to be able to function in life, the host won’t have any recollection of the trauma or know it ever happened. They also won’t know that they are fragmented, because to be fragmented means that trauma happened to cause it. So the brain keeps the host in a completely unaware state, and even creates cycles of denial and doubt to make sure they stay that way. (It’s also important to note that just because the host is the one who’s present the most, that doesn’t mean they’re “more real” than the others, or “more important” and the rest are just “side characters.” Imagine a pane of glass that is shattered. No one piece is more real or more of the original than the rest. Every shard is equally as real and important and the pane of glass is not whole without all of them). Annnnd, hosts can also change over time, depending on the system and also internal or external factors. One alter may be the host for many years and then something happens that requires the system to set a new host in place. While the host is at front, the others may have their own roles to keep the person as a whole safe and functioning as best as possible. Some hold trauma, some might be there to manage symptoms and/or emotions, some might manage who can take over the front and “switch” with the host. 

- Switching occurs when the host dissociates and leaves the front as another alter becomes conscious and takes over. This can happen due to specific triggers of sorts or if the system feels it is necessary for another part to come out. (Maybe something is too overwhelming or potentially triggering for the host, or maybe the host felt threatened by something.) Typically in DID, amnesia causes the host to not remember that switching occurred. They were not conscious for anything that happened while another alter was fronting. On top of that, they’ll often have amnesia for their amnesia, meaning they won’t even realize they just lost a chunk of time to a blackout. To make matters more complicated, not all systems (people with DID or OSDD) experience overt switching and blackouts. OSDD type 1b consists of switching without amnesia, making it even more covert and difficult to recognize when switches happen (which is what distinguishes OSDD-1b from DID. OSDD type 1a includes amnesia but the parts/alters are not as distinct from one another as you’d see in DID or OSDD-1b. Instead of having different names and looks, they often all go by the body name. Whereas in DID and OSDD-1b, alters can be very distinct, have different names, different internal voices and even their own visual idea of what they look like.) 

- With the right therapy/special care people with DID and OSDD require, systems can become more integrated and functional. Amnesia barriers can come down enough to allow alters to be able to communicate with one another internally. Switching can be recognized and sometimes even more manageable at times (this doesn’t necessarily mean switching stops— it can just become either to either manage or recognize when it’s happening). Another thing is that if the body feels it is either necessary for any reason or safe enough to, two or more alters may fuse into one. And sometimes, after years of intensive therapy (with a good psychologist that specializes in dissociative disorders), it’s possible for a system to fuse completely into one solid identity the way they would have if the trauma never happened. But this is something that can only occur naturally if the brain and body see it safe enough or necessary to. It cannot be forced, pushed, or even expected from a system. Total fusion is rare. Depending on the person/system and their trauma, staying fragmented could actually be more functional than fusing. So a good therapist that specializes in these areas will work towards functional multiplicity instead, where alters can communicate and cooperate. And if the brain see it fit, fusions may occur naturally down the road, but it is not the goal and it doesn’t mean the person/system needs it to happen in order to heal. It is also possible for splitting to happen again as life goes on, often as a result of severe triggers, memory flooding, or added traumas. This is because the brain already learned very early on that dissociation and splitting is a successful way to escape and cope with trauma. 

- Internal communication between alters can come in many different forms. An alter may communicate with another or host by sharing a sudden foreign and strong emotion, physical sensation, or they may even communicate verbally internally. This is not the same as auditory hallucinations experienced in psychosis. Someone with psychosis who experiences auditory hallucinations typically perceives the voices as an external entity and they struggle with feeling like it’s really out there. When somebody with DID or OSDD hears from another alter, they recognize that it’s coming from within. All systems are different because all brains are different, but sometimes when an alter speaks up, the other alter or host may also feel their presence, a physical sensation, or even get an automatic visual glimpse of that alter or their headspace or inner world. Many DID and OSDD systems have what is called a headspace or an inner world, which is an internal world or mental space that alters can go to rest/exist when they aren’t fronting. For some, it might be a single room or a house. For others, it could look like a city or an entire world! Again, it all depends on the brain. While many don’t need to consciously create this world because it forms on its own early on, there also many systems that don’t have any visual sense of an inner world and it’s just darkness. However, they may (or may not) work to create one in therapy as it can serve as a useful tool for communication within the system as well as compartmentalization when necessary. 

- It’s very important to remember that this is a disorder that only develops after severe repeated trauma in early childhood. And since it develops within a child’s brain, there are often many childlike aspects a system can have. An inner world may consist of childlike fantasies or aspects. I think every system has at least one or two alters who remain at a very young age mentally, often the age the trauma(s) happened. They are often referred to as Littles.

There are many other technical terms for the roles that alters/parts may take on or develop, but I’ll leave you with all of that for now!