Dissociative Disorder Not Otherwise Specified
A client with Dissociative Disorder Not Otherwise Specified (DDNOS) does not meet the criteria for a specific dissociative disorder and has fewer distinct subpersonalities or ego states. These operate covertly, influencing the client by telling the client or other alters what to do, but do not take over the body and cause amnesia. To dissociate means “to sever the association of one thing from another” (Braun, 1984d, p. 171). The extreme on the range of dissociation is the polyfragmented MPD client who has usually been ritually abused and has hundreds of fragments. Braun (1986) defines a fragment as “an entity that is less than a personality. Fragments have a consistent and ongoing set of response patterns to given stimuli. . .” Other terms in the literature that Braun (1986) defines are:
The personality that has executive control of the body for the greatest percentage of time during a given period.
The entity that first comes in for therapy; it may be the original personality; the host personality; or a fragment.
The entity that developed first after birth and split or remained separate from the rest of the thought processes. The original personality is often difficult to locate and work with, but this needs to be done to achieve a stable and lasting integration.
The entity or alter that can take control of the body at different times and make the client unconscious or amnesiac to what is happening during those times.
The creation of an entity by the splitting off or coalescing of energy that forms the nucleus of a separate personality or fragment.
Going back and forth between already existing personalities and fragments.
The simultaneous presence of two or more personalities with or without their knowing of one another’s existence or current presence. Co-presence can occur with or without an influence of one upon another.
The state of being aware of the thoughts or consciousness of another personality. It can be uni-directional or bi-directional, with or without co-presence, and/or with or without an influence of one upon another.
The act or instance of bringing together two or more personalities or fragments in order to blend their essence into a single entity. This is usually accompanied by some neuro-psychophysiological signs.
The process of bringing together the separate thought processes (personalities or fragments) and maintaining them as one. It is a process that starts before fusion and continues after it.
Internal Self Helper:
Another term to be familiar with is Internal Self Helper (ISH). This is an alter that helps the internal system of the client and gives information to the therapist, which may or may not be accurate. Some people have an atypical MPD that would fit under DDNOS and some people have “ego states that are organizations of behavior and experience separated by semi permeable boundaries” (Watkins & Watkins, 1988, p. 67). All of us have an inner child in the general sense of a view of ourselves when we were children.