CPTSD vs. OSDD "Parts"

[OwnSide]

So I have been processing this for a while but I am wondering what thoughts the community has.

You may be familiar with Internal Family Systems, which stipulates that everyone has parts (https://www.verywellmind.com/what-is-ifs-therapy-internal-family-systems-therapy-5195336). There is also the structural theory of dissociation, which proposes that there are different degrees of dissociation among parts of the personality depending on the timing, nature, and number of traumas and maps different diagnoses onto these levels (https://did-research.org/origin/structural_dissociation/). For example, PTSD is a form of primary structural dissociation (i.e. one apparently normal part and one emotional part), C-PTSD, BPD, and OSDD are forms of secondary structural dissociation (i.e. one apparently normal part and several emotional parts), and DID is tertiary structural dissociation (i.e. multiple apparently normal parts and emotional parts).

Okay, great. Being a multi-faceted human being is normal. If you have trauma, you might have some dissociative barriers between you and your parts. And, at least looking from the outside, the criteria for DID seem rather unambiguous -- you have multiple parts and they front and you have amnesia about it (https://icd.who.int/browse/2024-01/mms/en#1829103493). (I also validate that realizing it from the inside is extremely complicated -- but since I don't have it I can easily see I don't have it). But how do you know if your "parts" are C-PTSD related or if you have OSDD/PDID as well?

The ICD-11 tries to clear this up, and I'm wondering if this resonates with those who have C-PTSD with or without OSDD/PDID. This is from the section on Partial Dissociative Identity Disorder (which is comparable to OSDD in the DSM-V):

"Boundary with Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder: Partial Dissociative Identity Disorder involves pervasive alterations in identity and sense of agency. In Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder, such alterations can occur but are limited to episodes of re-experiencing traumatic events (e.g., during flashbacks). If symptoms consistent with dissociative intrusions occur exclusively during such episodes in the context of Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, an additional diagnosis of Partial Dissociative Identity Disorder is not warranted." (https://icd.who.int/browse/2024-01/mms/en#988400777)

So I have "intrusions" but I hear/see/feel them on a daily basis, not just during flashbacks. They have their own thoughts and feelings and ways of seeing the world and themselves. They have begun asking me to "treat us like real people". It's getting very difficult to deny because now when I try they are very quick to remind me that "we're here and we're real". Of course sometimes I still deny it. At first I didn't think there was switching but now I'm becoming aware of subtle shifts in how I speak and hold my body and sometimes when I see a trigger coming it's like "the space inside my head changes" and then I have a completely different attitude about it.

I have a friend with DID who has given me information and support as I explore this part of my experience. It's been extremely helpful, but I still have trouble rationalizing that I could have gone through something significant enough to warrant the C-PTSD/OSDD symptoms I seem to be experiencing. Even now, whichever version of me I am is more connected to the feelings and thus, believes that the feelings are real and is willing to speculate that something might have happened that I/we don't remember. But then, later, I will be very not connected to the feelings and then it's all, well, I have no good reasons to feel this way and if I just tried harder I would be okay...

I've been exploring this for over a year and so at this point I can more readily say this is an enduring phenomenon and not just "mood swings".

I'm wondering if this resonates with anyone else's experience, and, if so, where you fall in this continuum of dissociation. What do "parts" look like for you? Are they self-aware? Do they want to be seen? Can you converse with them? What do they do? Do they feel like "real people"?

I haven't seen a thread about this anywhere else so I thought I would start one -- but if it already exists please refer me 


Abbreviation key:
BPD = Borderline personality disorder
DID = Dissociative identity disorder
DSM-V = Diagnostic and Statistical Manual of Mental Disorders 5th revision
ICD-11 = International classification of diseases 11th revision
OSDD = Other specified dissociative disorder
PDID = Partial dissociative identity disorder

[dollyvee]

Hi Ownside,

Thanks for sharing this well thought out write up. I've only briefly heard about OSDD from blueberry's write ups and have never heard of PDID.

For me, I became aware of "dissociation" and checking out at certain times (after reading your post for example - haha), learned it is a part of cptsd through Joanne Twombly's IFS and Dissociation, but am still trying to understand "how my brain works." When I was initially doing IFS, which has now fallen off probably because of dissociation to some extent (?), I noticed parts that appeared to be layered, or trapped under something like ice. I observed this at the time, but didn't really understand it until the passage in Joanne's book where she describes this effect (layered/frozen parts) as how dissociation shows up. At the time, I also noticed "dual" parts, which sort of stuck out. Though I attributed this to how I feel like I have a part of my brain to get things done, so another can be free to do what it wants to do (and go off and "explore").

IMO, like you, I haven't gone through anything "that bad" to create a split per se. However, I think developmental trauma as an infant is where this would/is probably stemming from. At that age, not bonding with a parent (mine was unNPD) would be taken as something so traumatic that it felt like a life or death experience. Healing Developmental Trauma has a description of this called the Connection Survival Strategy where as an infant, one doesn't fully "embody." I think having this experience as an infant also does something to affect your sense of Self (which is kind of like an internal rock IMO) as Joanne explains in her book, which then could be difficult to form a solid sense of Self. Though I also question if I experienced something that I don't remember, which there have been hints about.

Personally, I have a lot of I don't knows when NARM t is asking me about my feelings etc at times. It's just blank. I also feel like there's a part that sort of "gives up" at time when it feels threatened, but having access to this is difficult, and doesn't seem to function like other IFS parts where it shows up with form etc.

I'm sorry if you're finding it challenging to deal with these realizations at the moment. I would also like to feel that these things don't exist, but I guess facing the fear behind them is what I have to do, even if it was what probably created them in the first place.

There was also a very good thread by Denverite about uncovering repressed memories through MDMA.

Sending you support,
dolly

[Blueberry]

Hi Ownside,

Thanks for starting this thread.

I have been intending to start a thread on this topic for a while, more with links and some information than anything else because questions do come up on the forum... Good that you've done it now 

Dollyvee , 

IMO, like you, I haven't gone through anything "that bad"

and Ownside,

I still have trouble rationalizing that I could have gone through something significant enough to warrant the C-PTSD/OSDD symptoms I seem to be experiencing

that sounds like the usual: "my childhood wasn't that bad" that most of us on here have thought at one point or another and written on the forum. Yeah, it was that bad, otherwise we wouldn't be here with all those symptoms.

In inpatient treatment a couple of years ago I asked my T if it isn't the case that everybody with cptsd has dissociative parts of some sort?!? I can't imagine my cptsd without all these Parts turning up, refusing to do things and sometimes demanding that I do certain other things, like defend myself and tell certain therapists where to get off.  My inpatient T didn't really answer except to say that it sometimes takes a looooong time for the Parts to show themselves, like years, so it can be difficult for a therapist to know.

My understanding of what is going on is closer to the theory of structural dissociation than IFS, fwiw. Tho where I live the ideas behind Parts comes from some other place other than the therapists/psychologists/science behind IFS.

Yeah, everybody can have parts/Parts if they want but not working with mine, ignoring them, turns into a problem. Inner Child is talked about in different contexts - for some people it's their playful, artistic, good-impulsive/-spontaneous side and other people talk about having an Inner Child, an Adult and a Spiritual Being / or even a Wise Being of themselves in later years / Inner Wisdom to call on. Or people have a hurt Inner Child and a Whole (non-hurt) Inner Child. And I have Inner Children and Inner Teens of multiple ages, and it's just not the same. imho. I have used Inner Wisdom/ myself as an older Wise Woman etc too.

I'm wondering if this resonates with anyone else's experience, and, if so, where you fall in this continuum of dissociation. What do "parts" look like for you? Are they self-aware? Do they want to be seen? Can you converse with them? What do they do? Do they feel like "real people"?

Therapists argue and disagree about my case. Are the ICs and I.Teens more tools that I use than actual Parts? The thing is some of them started turning up before I knew anything about this kind of theory or that you could use them as tools...
The inpatient T said OSDD though possibly P-DID, but since not able to pinpoint, then OSDD for the moment.

The fact that I capitalise them - Parts - rather than 'parts' shows something of what they are to me. Individuals rather than bits, maybe. Some want to be seen, some don't. Some of the latter can be coaxed out to share what they think or what they really want to impart which has been showing up as hindrances to daily life, I could maybe say. I don't want to say they're difficult because there are reasons for them to be acting as they are, they're trying to tell me something, each one something different usually. They need me to work with them individually mostly. Do I work with them? No, often I don't. Or only in therapy. Altho when I know one of them more, it's easier to work with her outside therapy.

What do they look like? Sometimes I see an image of one of them, usually that shows me roughly how old that particular one is. Sometimes, especially when a Part feels newish, I can feel an emotion, often it feels a bit 'out of control'. Some of mine also have lots of energy that has been missing all my life basically. I'm almost always short on energy, except sometimes when I can tap into a Part with energy for a particular activity.

I can certainly converse with my Parts! For me that's nothing like writing with my left hand, as some people suggest, to get in touch with a different part of my brain. The conversation runs in my head, I guess. Sometimes I report out loud e.g. if I'm in therapy. My inpatient T said however it occurs is fine. Sometimes I hear words, sometimes I have an image of a smaller Me nodding or shaking her head. Or moving towards me e.g. to sit on my knee. And I know that it's 'true'. It's not something I've thought up in order to be crazy or special or... 

After therapeutic work of this kind, it may not feel as if much happened, there's maybe not much to write down but I have felt totally and utterly exhausted at times. Once I told T of-8-years that I felt like I'd just run a marathon.

Are mine self-aware? Idk I need a differently worded question to figure that out. They are sometimes aware of each other though. I've had some in the same Inner Safe Place. (Some) Inner Children were terrified when the first Inner Teens showed up. I wasn't in therapy at that time... My Adult of that time was terrified too. Tho having worked with I.Teens in therapy, I'm no longer terrified, not of those particular ones anyway.

I definitely don't have DID. Once when badly re-traumatised, some Parts of me were doing things that my Adult didn't know about and I was moving in and out of consciousness (not as if I had concussion, I didn't have any kind of new physical brain injury) and there's a lot of that time that I still have no recollection of, a protective measure. That's OK. But it was only once and it scared me so badly that I've avoided anything that might retraumatise me that badly again.

I don't know about NARM, haven't looked into it at all. I try and use the tools I already have since there's a ton of them and I definitely know some of them work, if I'll only use them... Well, I do use them sometimes.

NOTE: I think, as far as I can feel, it's been OK for me to write about my Parts and so it's OK for people to read about them too and then write about their own Parts, but please no 'helpful hints' for me on working with mine. I've had that from non-trauma-informed / non-trauma-educated therapists over the years and it's not helpful. I could maybe say that they're Inner Children, but they are also not children who need to be taught about xyz and 'brought up'. 

[dollyvee]

I will also add that sometimes I "talk to myself," or say things out loud, but I do wonder if it is an anxious part, or part in particular that does this when I am apprehensive/second guess myself etc. However, there is no sense of switching, or the clarity that you, Ownside, or blueberry describe. I also noticed quite a while ago (as in 20 years, though am sure it's happened since then) that there would be sort of a running commentary in my head before bed about reactions to things etc, which I suspect were/are parts. I guess the elephant in the room about this topic is that I didn't want to seem crazy, or thought I was "crazy" probably for having this response. So, I wonder how much of this has been suppressed.

blueberry - thank you for sharing about your parts, and to Ownside as well. It's been very informative to see how this shows up for other people because I wonder how much of my own dissociation I have "suppressed" because it doesn't seem to fit? As an aside, I wonder about your response to NARM. Not in a bad way, but I think it's curious as NARM is very much about giving agency, or building a sense of agency within the self. I take it from your comment about helpful how tos, which I also find difficult at times, though am sure I have also been guilty of as well, that agency, and letting your parts do their thing, is important to you. This is actually one of the things that drew me to NARM. Not a sense that the therapist "knows better," but uncovering and encouraging that part(s) of ourselves that do know what is best for us.

I'd be interested to hear more about this:

Tho where I live the ideas behind Parts comes from some other place other than the therapists/psychologists/science behind IFS.

[Blueberry]

As an aside, I wonder about your response to NARM. Not in a bad way, but I think it's curious as NARM is very much about giving agency

I quite simply haven't read about it or read up on it!

The Parts therapy I've done comes from somebody whose work has not been translated into English for whatever reason. And then I experienced it live with therapists who'd done accreditation courses with this doc/psychotherapist, but I think they might also have read about IFS, idk exactly. I suppose the most important thing is: these therapists changed their working modus over time with their real life therapeutic experience with people like me. They said they learnt a lot from me and my reactions... And what I experienced in these groups is not something that correlated to what I heard about IFS, if that makes sense. It may well have a lot of similarity with IFS, idk. I sometimes get put off by a word or something very small and that was the case when I was listening to an intro to IFS on one of those freebie conferences. Those therapists whose groups I was in - one of them sadly died about 3 years ago and the other two are no longer doing quite that type of therapeutic work. In inpatient therapy and now my new outpatient therapy, Parts work in accordance with these untranslated works is being used again. It's known in this country, just not really outside it.

I guess with IFS, I was reading about it / listening to talk on it which is much different to experiencing the therapy itself in a group retreat over several weekends for several years.

[Armee]

Interesting thread.

I've struggled to figure out where I fit on the dissociative spectrum. OSDD, pDID, or just full- on DID. I suspect it is DID. I do have multiple "normal" adult parts as well as multiple "emotional" or "younger" or "exiled" or "protective" parts.

I do have amnesia. They do front. The only thing that doesn't quite fit is there is almost always some base level of awareness when one is fronting. Even if I am totally out of it, I do later remember observing it. I don't know which part observes.

Best exemplified by the other week when I must have had a part triggered or flashing back while in the tub. I was not aware at the time as a functional adult that this part was trying to drown itself. I heard the conversation though going on inside but was not present enough to know what was happening was bad. When I slipped under the water per the plan hatched by parts the water rushed up my nose and I "came to" enough to sit up but not enough to regain adult consciousness. Later I passed out in the empty tub.

I woke up, went to bed. And woke up the next morning my "normal" adult self...the mom one. I got ready got the kids ready drove to school with no memory of the night before. But then once the kids were gone I slipped into a different "normal adult" part and regained memory of what had happened the night before and it scared the crud out of me.

I have no clue how this fits with the delineations of dissociative disorders. I'm not sure it matters much. I don't identify as being multiple, but I am. But I still think of myself as myself it's just these parts come through. They are also myself. I dunno.

I do switch. They do have different ways of acting and speaking and dressing and even walking sometimes. But I also always recognize myself in the mirror.

While I was in the hotel room in Greece with my T last month processing what had happened there in my past different parts were coming out that had experienced what happened there in the past. All knew and understood what I was doing there and why but had their own reactions and ways of being.

Then one part came out who was very very confused. Why were we there, why were we in a hotel room with our therapist, what was going for on. And then the room looked so strange. I started laughing because everything looked so small almost like a large doll house. The light looked so tiny. The walls and doors so short.

T said "the way it would look to a kid?" And I was confused because to a kid everything would look really big so I denied that. But on reflection I realize now that if a kid part was looking through an adult sized body everything indeed would look amusingly small because they are used to being tiny and everything being big. But now they are big so everything looks tiny.

I never identified with the descriptions of DID in the past. It's just as you work you become more aware of these things.

[Lakelynn]

This is quite provocative. I've generally avoided thinking about it because I didn't want to know.

Joanne Twombly's IFS and Dissociation

This interview with Joanne Twombley here gives a detailed look at theory, personal practice and the pitfalls that can happen if a strict method is applied. I just lost an hour reading, but saw so many thoughts which gave me clarity.

One of these addresses the idea of accessing a small part of the trauma history. And this is more than enough:

[Joanne: Well and as that 5% or 1% gets unburdened, then the person has that much more energy and they have more confidence that they can do it. I mean a lot of people don't think they can ever look at this material because it's so traumatic and they certainly don't want to.

And I'm like, yeah, I don't want to either. If there were some other way of healing, we'd be all over it. But you know, just pushing things away.

We're biologically wired to heal, and you can push it away. But the analogy I like, somebody else told me this, it's the pee analogy, it's like peeing, you can hold it back but only for so long then it starts trickling out, then it wooshes.

You want to use coping skills, you want to be able to, you know, notice when you have to pee and go before it wooshes. Right. That's what it's like with trauma. You can put it away, but it starts to ooze out and then you can get like massive wooshes of flashbacks.

And there is literature that says that if somebody's managed to avoid it all until they get much older that, you know, there's a population of people with dissociative disorders in nursing homes where they don't, they can't run around and avoid the way they used to.

Their friends have died off, they're alone, the traumatic material starts coming up and they look senile or they look crazy. And it's untreated dissociative and traumatic material.]

Italic emphasis mine. This is what's happened to me in the last year. Scary and disorienting. Now I have some clue as to why.

[dollyvee]

Thanks for your explanation blueberry.

Lakelynn - I read something this morning that discusses ANP (apparently normal parts) and EPs (emotional parts) and how many etc contribute to the spectrum of dissociation and structural dissociation. So, people with DID will have a few ANPs and lots of EPs while those with a "trauma" will have an ANP and an EP. So, I guess our ANPs work until they don't anymore.

I feel like my t has sort of breezed over when I've talked about dissociation and I think the reason is because I have a very functional apparently normal part that makes sure everything is ticking along, but when faced with connection and relationships for example (ie intimacy and actual authenticity I guess), that goes out the window. I don't think it's switching, it's just dissociated something that's been kept at bay. It happened the other session when I couldn't make eye contact talking about something, and internally, just felt very hyper, but I can't really articulate why. I feel like most people look at this and think I'm fearful or scared, but I feel like accessing that part with the anxiety wouldn't be able to give any answers either (I've sort of tried). It's like it's there, but there's not enough self or awareness to look at it.

It's interesting that Twombly also asks, or enlists, the help of competent managers in the system to do the unburdening with enough self energy, and not Self (as those I guess those with dissociation have difficulties being in Self).

[Lakelynn]

dollyvee,

You bring up a good point about ANP's functioning and the T's assumption that "what you see is what you get." It's difficult to really address that, because when that EP is present, obviously, it's risky or feels unsafe to reveal that. 

Twombley's article zapped me a couple times by new ideas. First, that the goal is to dissociate "better." Second that a young part that I've tried to control nearly all last year, might have triggered a young part in someone I am close to. I never in my life considered that. I don't know why.

Third, that there are proponents of IFS that discourage coping. Thanks for your input. It's helpful.

[CactusFlower]

Armee's description really resonates with me. Nothing diagnosed here, and my previous therapist felt my "parts" were more of a trauma response and the C-PTSD than actual DID. I'm not certain.

I am aware of them. They do each have their own unique voices and even looks some will converse with me, some refuse to. As I progress in therapy, I begin to understand why they're the ages they are compared to when things actually happened. A couple are the opposite sex, which confused me at first, but made sense later. But I definitely have had occurrences where there was amnesia around the fronting, yet a small part of me somewhere "knew" someone else was in control. The typical questions about it like "Do you find things you don't remember buying" or "Do you 'wake up/come to' somewhere and you don't know how you got there or maybe where you are" or "Do people seem to know you and you don't remember meeting them", I can say yes to all that. it's not frequent and I know a couple of them have zero interest in fronting ever. Yet none of them are my "Inner Critic". My IC is a personalization of the criticality I hear in the male parental unit's voice.

So, I don't know if I'd ever technically qualify as DID. But I do know these parts have their own voices, looks, goals, likes/dislikes, hopes, triggers, all that. And they are distinct and unique.

I've struggled to figure out where I fit on the dissociative spectrum. OSDD, pDID, or just full- on DID. I suspect it is DID. I do have multiple "normal" adult parts as well as multiple "emotional" or "younger" or "exiled" or "protective" parts.

I do have amnesia. They do front. The only thing that doesn't quite fit is there is almost always some base level of awareness when one is fronting. Even if I am totally out of it, I do later remember observing it. I don't know which part observes.

I do switch. They do have different ways of acting and speaking and dressing and even walking sometimes. But I also always recognize myself in the mirror.

[fozzie55]

I am new to this forum and I have read this debate with interest.
I firmly believe that everyone has a valid opinion and I sympathise with people who are confused or worse by not knowing what their diagnosis is. Been there, done that.
The conclusion I came to is simply that it doesn't matter what my diagnosis is. I spent too long trying to find a name for it and not enough time dealing with it! These days I simply treat the symptoms as they arise, follow a positive lifestyle and hope for the best. What other people label it does not concern me.
This is not meant to be dismissive of the pain anyone is going through, rather it is a suggestion that we all have enough to deal with without making it more difficult by needing to put a label on it.
Apologies if this upsets anyone. Just trying to help.

[Blueberry]

I am new to this forum and I have read this debate with interest.
I firmly believe that everyone has a valid opinion and I sympathise with people who are confused or worse by not knowing what their diagnosis is. Been there, done that.
The conclusion I came to is simply that it doesn't matter what my diagnosis is. I spent too long trying to find a name for it and not enough time dealing with it! These days I simply treat the symptoms as they arise, follow a positive lifestyle and hope for the best. What other people label it does not concern me.
This is not meant to be dismissive of the pain anyone is going through, rather it is a suggestion that we all have enough to deal with without making it more difficult by needing to put a label on it.
Apologies if this upsets anyone. Just trying to help.

I think I sort of know what you mean and I think it could sometimes apply to me but ime and imo a diagnosis of at least being somewhere on the DID, P-DID, OSDD spectrum is important. It seems to affect how you respond to different types of trauma therapy. Therapists are still trying to figure it out in my case. Now that most seem to think I'm probably somewhere on that spectrum, they are going a lot more carefully than therapists generally used to. But they don't spend time e.g. on discussing whether my severe depression is part of cptsd or stands on its own. Not important. Knowing of the DID to OSDD spectrum diagnoses and knowing what they're called as well has been helpful to me in reading about them and especially knowing that others on this forum have been diagnosed with some of these or have figured it out for themselves, so hearing, as I did on here, that at least an opinion that therapists might end up helping me with inner parts work for a few more years before we can even consider EMDR is something worth knowing!! It helps me not harangue myself for my healing taking so long.

It feels kind of similar to the importance of knowing that I have a CPTSD as a diagnosis. It's like a sudden :lightbulb: - well, that explains a lot!! After years of a list of diagnoses that were symptoms, mostly, plus some personality disorders. Now that I've been officially diagnosed with CPTSD, the personality disorders have all been thrown off the list, and that's quite a few years ago now.

And I in fact have spent far too long trying to treat symptoms, or being with therapists trying to treat my symptoms, whose underlying cause was CPTSD. Much better to try and treat the CPTSD imho. Especially since I've discovered that symptoms can jump about and shift. Clear one up and a completely new one pops up. Never ending. Start treating CPTSD and several symptoms can reduce at the same time. I'm hoping for similar with OSDD or whatever exactly I have. Meanwhile just keep keeping on.
JMO

[Armee]

Yeah this rings true to me too Blueberry. And gets at I guess what I was thinking even though I didn't really "get it" when I said it...you said it really well. The exact diagnosis itself doesn't matter too much...pDID, DID, OSDD...but it does matter to know you are somewhere on there in the spectrum to understand how to approach things and the care with which things can be approached, and the timing. I don't know if this is helpful or not or if you've read it too Blueberry or others but somewhere I read on average it takes 7 years to treat DID AFTER an official diagnosis has been made. Helps me to know that.

[fozzie55]

Thank you for a different perspective.
You are right. a diagnosis can explain an awful lot that does not make sense without a diagnosis.
It also gives some hope that they are on the right path, which is crucial to their well being.
I just worry sometimes that it is not difficult to become obsessed with creating pigeon holes rather than looking for positive coping mechanisms.
I truly sympathise with anyone who suffers any mental health condition because of the actions of others. Both my parents and my ex-wife caused me so much pain and misery it is hard to put into words. I am not trying to belittle suffering. I am trying to be more positive and say let's look to a positive tomorrow rather than get stuck in today!   

[Blueberry]

Yeah this rings true to me too Blueberry. And gets at I guess what I was thinking even though I didn't really "get it" when I said it...you said it really well. The exact diagnosis itself doesn't matter too much...pDID, DID, OSDD...but it does matter to know you are somewhere on there in the spectrum to understand how to approach things and the care with which things can be approached, and the timing. I don't know if this is helpful or not or if you've read it too Blueberry or others but somewhere I read on average it takes 7 years to treat DID AFTER an official diagnosis has been made. Helps me to know that.

No, I didn't know that statistic - 7 years on average to treat DID after official diagnosis     but yeah, it does help to know that. I was told something like that for CPTSD years ago, I mean it was also 7 years treatment time, probably getting on for 15 years ago. Yes I've had that official diagnosis for quite a long time and then of course I wondered off and on why it didn't actually work out that way. Self-blame ensued - probably my own fault for not doing enough, not practising on my own enough, not trying hard enough      And on top of that the self-blame of being too long in contact with abusers (FOO), thinking they'd changed so not like 'an active abuse situation' like DV where you obviously have to get out, and then being massively re-traumatised twice in Horrendous FOO Events No.1 and No.2. 'Own' fault for that too. That threw me back obviously too.   But no, some professionals apparently didn't realise I had this co-morbidity or they were in denial about it (there were actually specific ones in denial about it and/or didn't understand it enough themselves, despite being accredited trauma therapists, so I believed them for quite a few years...), so the whole healing process has been taking longer than envisaged. And even now, my psych doc doesn't know enough about it and despite agreeing that my inpatient therapist is really, really good (he used to work in the same place she does and knew her well professionally), he doesn't believe her that I'm somewhere on that spectrum because he's only focussed on certain symptoms which are not part of OSDD as far as I know, just part of DID. Sigh. (Long rant over).

Thank you for a different perspective.
You are right. a diagnosis can explain an awful lot that does not make sense without a diagnosis.
It also gives some hope that they are on the right path, which is crucial to their well being.
I just worry sometimes that it is not difficult to become obsessed with creating pigeon holes rather than looking for positive coping mechanisms.
I truly sympathise with anyone who suffers any mental health condition because of the actions of others. Both my parents and my ex-wife caused me so much pain and misery it is hard to put into words. I am not trying to belittle suffering. I am trying to be more positive and say let's look to a positive tomorrow rather than get stuck in today!   

I think there's a place and time for being positive. For example, I write quite regularly on Three Good Things Today  https://www.cptsd.org/forum/index.php?topic=16226.0 and similar threads and that helps me. That's just one example of my positive focus, I do other things too but it's still definitely not enough in the sense that I need completely other ways of healing.

Do you know about EFs (Emotional Flashbacks)? A term coined by Pete Walker - you'll find reference to him and his books here on the forum as well as links to his work and plenty of posts about EFs from forum mbrs. When I'm in an EF, positive thinking and/or concentrating on Good Things and reviewing them in my mind, writing them down, does not help in the least. Trying to accept that I'm stuck in an EF or even recognising that I am in an EF - that can certainly help. That's more focus on the negative than the positive, I'd say. Because I don't like being in an EF, don't like feeling into it at all, I'd rather distract myself by over-eating or binge-reading or sleeping for hours on end etc, rather than noticing that I'm feeling all sorts of hurt. I also had to learn all about EFs - and I'm still learning - in order to recognise them, grapple with them etc. I think we more or less all have to on this forum - there's lots of talk of EFs.

I have diagnoses within CPTSD - symptoms if you like, though they can stand on their own, some people have them without having CPTSD e.g. depression, anxiety, eating disorder etc etc etc. See, I don't even remember off-hand right now what I all have. In a sense, it's no longer so important for me to figure it out. However, having something on the spectrum of OSDD, pDID or DID is an additional 'beast'. Everybody with one of those diagnoses (OSDD, pDID or DID) has CPTSD, I mean you can't have them without CPTSD, but you can have CPTSD without one of them. It often takes a long time for therapists and doctors to figure out that you're on the OSDD, pDID, DID spectrum because we're good at hiding our Parts, though not intentionally. We're not doing it to deceive. It means more people are on that particular spectrum than know about it. We and our therapists need to know because it influences how they understand and help us and work with us. It's really important to know!! So it was good OwnSide started this thread    because on here we learn from discussing with each other  - this is how it is for me, how is it for you? kind-of-stuff rather than advice.

Imagine somebody has Borderline Personality Disorder OR Bipolar OR ADHD in addition to CPTSD (each of them are possible in addition, though not dependent on CPTSD) - the doctors and therapists can work better if they know about that additional diagnosis and it is much less confusing for the patient to know and therefore to better understand what's going on within themselves and their brain and their emotions. In my experience knowing what it is going on and sort of why is crucial (not necessarily the 'why' of how did this develop and also not 'why me? but rather how does traumatisation develop and what's going on in my brain and body and emotions, especially brain and body - that is, physiologically). In my experience and opinion same goes for OSDD-pDID-DID spectrum. Whole other ballgame on top of CPTSD and I need to be able to understand it in my case and how shows up in me and also how it affects me in order to function, come unstuck, all sorts of stuff.

I hope this might be more clear, maybe also for others on the forum. It is my impression that some forum mbrs on the OSDD-pDID-DID spectrum understand this far better than I do, so I'm open to learning more and if necessary being corrected, but this is as best I can explain why knowing about and being able to recognise this additional diagnosis is so important.