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The above video was recently released after one of the authors of Structural Dissociation lost his license for life and can never practice again. It gives a better picture of the full story of the conference we attended, by the writers of the theory. I suggest to first read the article and then watch the video. There is also a second article about the TOP DD study with a 12.8% success rate. Thank you.
Archived article reporting on this (Dutch)
Court case (Dutch and his name erased to protect him…)
It’s not easy to proof that this is all really about Onno van der Hart. As the courts hide the names of the convicted and accused doctors.
But he isn’t in the BIG-register anymore, due to transgressive behavior. See screenshot above.
In the Netherlands, we don’t have a lot of professors who educate, write books and make public speaking appearances, and treat trauma, but even less of them have lost their big registerstation.
”Almost all complaints are well-founded, the therapist may never practice his profession again. He has already had himself deregistered from the professional register, but is never allowed to register again by the disciplinary committee. ‘As far as I know, that has never happened to a professor in the Netherlands,’ says disciplinary law expert Hubben.”
From: https://web.archive.org/web/20200608170057/https://www.sin-nl.org/tuchtzaak-beroepsverbod-tegen-hoogleraar-onno-van-der-hart-psychotherapeut-ivm-grensoverschrijdend-gedrag/
”Certainly in view of the positions he takes in his books and propagates at conferences, it is incomprehensible that the defendant, in the complex situation in which he found himself, did not provide proper feedback and/or intervision, but merely sought advice from and involved of colleagues in the treatment and advice of colleagues until the end of the relationship has always not followed.”
”Defendant has been an educator for years and that makes his conduct all the more pressing.”
”The Commission does not follow the position of the complainant that due to the sudden termination of the therapy at the end of 2015, the defendant acted carelessly and inadequately and that his reputation, [public speaking] appearances and refusal to provide openness made it impossible for the complainant ever to receive the correct treatment again. from another therapist.”
From the court case: https://tuchtrecht.overheid.nl/zoeken/resultaat/uitspraak/2019/ECLI_NL_TGZRAMS_2019_223?zoekterm=psychotherapeut+grensoverschrijdend&Pagina=1&ItemIndex=3
Want to learn more about the difference between integration, (final) fusion, unification, blending and merging? Click here.
Anyone who has watched a DID youtube video, or read a few posts in a support group, has seen it pass by: The theory of Structural dissociation, written by Ellert Neijenhuis, Onno van der Hart, Suzette Boon and Kathy Steele.
It’s good to know that in 1987, the writers of this theory already referred to us as parts, not personalities or alters, as the common terms were back then. Now, you might think this was progressive, ahead of its time — but was it really?
I want to start by setting a few things straight.
It was actually, psychologist and psychiatrist Charles Samual Myers, who in 1916 wrote about Apparently Normal Part (ANP) and Emotional Part (EP) after acute trauma in WW1. So it is fair to say that the theory of Structural dissociation borrowed these terms, not introduced them, as is readable in the haunted self. (page 4)
We read in the same book (page 7) ‘’Structural dissociation involves hindrance or breakdown of a natural progression toward integration of psychobiological systems of the personality that have been described as discrete behavioral states.’’ (Putnam, 1997).
This is what most people refer to when explaining that we are not broken, not split off. We are all born with different states and early childhood trauma survivors can’t integrate in early childhood due to that trauma. But as you can see it was actually Putnam in 1997 who introduced this idea.
It is also good to realize that the theory of Structural dissociation is neither about DID, nor is it about alters, as many of us Plurals know them. They speak of ‘dissociative parts of the personality’, caused by trauma. Nota bene, not early childhood trauma, trauma in general. As this theory of structural dissociation also explains single trauma, repeated trauma in adulthood and (early) childhood trauma. It is used to describe changes that are diagnosed as (c)PTSD, trauma related borderline personality disorder, DID and more.
Table of Contents
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As you can see in this image, all types of Structural dissociation have EP and ANP elements which Myers talked about. In other words, the theory puts forward that all traumatized people have ‘dissociative parts of the personality’ as this is just the collective name for the EP and ANP. Thus, plurality does not just happen in DID, as many people with DID like to claim. As we read on page 6, ‘’In severe cases of secondary and in all cases of tertiary dissociation, more than a single part may have a strong degree of elaboration’’ (e.g., names, ages, genders, preferences.)’’
From which we can conclude that OSDD, complex PTSD, borderline personality disorder or extreme stress may also have alters as we Plurals know them, or at least as the ‘dissociative parts of the personality’, which this theory of structural dissociation calls us. – From a Plural perspective, I do not understand the differences, besides being integrated less in DID (or tertiary Structural dissociation) compared to more integrative capacity in secondary Structural dissociation of the personality.
If DID is not Plurality, then why have such a thing as a DID diagnosis? What is the difference then between complex PTSD and DID, if not the Plurality? – More on this topic next time!
The haunted self states that Structural dissociation has become chronic in those patients with trauma-related disorders. (page 12.) Which, first and foremost, means that Structural dissociation is not a (trauma-related) disorder on it’s own, as some people claim these days.
However, I point this quote out for a different reason. The theory of Structural dissociation idolizes integration. And although they say that ‘’no one has to go away’’, they also clearly explain to therapists, to not engage with us ‘dissociative parts of the personality,’ unless absolutely needed. Instead it is suggested that the therapist speaks whenever possible, through the ANP fronting. We the Plurals, then have the most integrative capacity, which basically means we can integrate the experience best. Which should be encouraged by the therapist at all times. I can understand how it is useful that ‘everyone’ listens in during therapy. But this should not be the case when we express ourselves!
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To me, it sounds as if they want to make us all like OSDD, where one part regularly fronts and others speak through them. And although I think there is a dissociative spectrum, I do not think that changing the diagnostic criteria we meet from the diagnosis of DID to OSDD will lead to ‘healing.’ And in DID, in particular, requiring all communications to relay through one particular (perhaps malleable or favored) ‘alter’ that sounds a lot like silencing to me. Because the therapist (or any other outside person,) can never know (for sure) whether the part who is presenting, is truly conveying all information which is coming from inside. This book talks a lot about shame, but forgets that our ANPs might not feel comfortable repeating what those EPs just said inside, and that the information may be so overwhelming for them as to cause them to have intense dissociative symptoms. Half-truths might reach the therapist.
The writers of this theory of structural dissociation explain dissociation as experiencing separation in simple terms and in more difficult terms use the meaning of the term dissociation, formulated by Pierre Janet (1859–1947), ‘’Structural dissociation is a particular organization in which different psychobiological subsystems of the personality are unduly rigid and closed to each other. These features lead to a lack of coherence and coordination within the survivor’s personality as a whole.’’ (Preface Haunted self)
They explain integration as ice cubes melting and the water coming together, or dams breaking and water coming together. Which to them equals no one goes away. Everyone is still there, it’s just one body of water now. To me, it sounds more like soup, because not everyone in a system is the same, like with water. So you throw in your EPs and ANPs (and those are very limited terms for our diversity!) and then you have a soup. Although soup is great, it is not the same as the loose ingredients. A potatoe is a potatoe. A carrot is a carrot. But potatoe-carrot soup is something new and different. You cannot remove the potatoe from the soup, it is no longer a whole potatoe. And potatoe-carrot soup cannot do the same things the original potatoes and carrots could do.
We know from a 6 year follow up study that only 12.8% of participants were able to reach integration as described in the theory of Structural dissociation. (page 4)
That is a very low percentage. In any scientific research for medicine or therapy for example, a 12.8% positive outcome would not be tolerable. Yet the whole theory of treatment within Structural dissociation is based on it.
A chronic disorder, often debilitating, with a much-respected and idolized healing option with only 12.8% success rate, sounds ableist to me. Favoring OSDD over DID comes from singular normative biased thinking. The haunted self has a chapter dedicated to phobia of dissociative parts. Maybe the writers, should re-read the chapter and apply it to their own way of thinking. It also sounds to me, as if clinicians say something else to our face, then what they write in their books. Especially when it comes to alter integration or final fusion as Kluft calls it.
Although I do not think personalities is the right term for us, nor is the word parts. It is derogatory, dehumanizing & it is taking away from our autonomy, roles and authenticity as individuals. And so I often wonder whether the alter integration they desire, equals just not being Plural anymore in the minds of the writers of Structural dissociation. If it does, it makes sense to diminish us to parts. And it also makes sense to claim “no one has to go away”, if they never believed we are separated in the first place. After all, it is the ‘experience of separation’, not actual separation, as they say, we did not split off. So was using the term ‘parts’ in 1987 progressive, or a step to further diminish, gaslight and silence us?
Here is my problem with how the DID community treats this theory. From the community feedback it seems that many of you do not want integration, as explained in this theory. And you cannot cherry-pick the sweet parts, when it comes to theories like this. Especially not when integration is so interwoven with this theory. The theory of Structural dissociation is often presented as truth in our communities, even though this theory is not widely accepted, not acknowledged, not proven (or provable) and hence just a theory like any other – there are many theories about DID.
You also cannot say you like the application of this theory for DID, but not for borderline and vice versa. The theory comes as a package deal by explaining a progression of Structural dissociation. I think many people did not read all of the haunted self, as it’s long and dry. And even though most quotes from this article come from the first few pages, it is information many do not know. I read the book twice and followed a conference with its writers. I hope this article explains things, to those who endorse this theory without having actually read it. There are many more questionable things about this, but I cannot address them all.
Obviously it is not needed to throw away the baby with the bath water either, that is not what I am proposing. What I am proposing though, is that you take a second look at the theory you endorse and why.
Because if you just like the part about how we are not split off, but born with different self-states you can quote Putnam.
And if you like the idea of PTSD consisting of EPs and ANPs, you can quote Myers.
And if you like fusion integration, you can quote theory of Structural dissociation.
As always, we encourage you and your System to follow your own truth, to soul search, to find words, labels, visions, theories and communities that aren’t only within your values but also match your lived experience and/or long term goals, so that you might find belonging and don’t have to try to fit in.
Thank you for investing the time to read this article. Please, feel free to leave comments or feedback in the comment section.
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Disclaimer: Thank you for reading our peer article; we hope it was empowering, informative and helpful for you and your System. There are as many Plural experiences, as there are Plurals. So not all information on this website might apply to your situation or be helpful to you; please, use caution. We’re not doctors or clinicians and our nonprofit, our work, and this website in no way provide medical advice, nor does it replace therapy or medication in other ways.
About the authors
The Stronghold System are the proud volunteer founders & CEO of The Plural Association Nonprofit. They are from the Netherlands and reside in a 30-something-year-old body, are nonbinary, parents of an amazing child & 3 cats. They got diagnosed with Dissociative Identity Disorder over 10 years ago & also self ID as Plural.
I gladly share this article for people who want to read more: http://www.exunoplures.org/main/articles/deconstructing-structural-dissociation/?fbclid=IwAR0MOVS_mswRuBCfXp3EXPqYZ6oXJkxxzpBGAeBYKmEIo-orjUE9NapRGEw
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I am not sure what happened with me.
I know in 1991 I was referred to NIMH and under Frank Putnams guidelines I was given diagnoses of DID. I really would like to have my records. For though I went twice a week to a Barbra Oppenheimer I have no memory of the therapy.
I do remember I left therapy because after two years any hidden trauma I wanted to leave it alone.
I hope you can get your records or if someone else from inside can help you remember.
Just forgot to click on notify me with email
There is quite a bit of the book devoted to explaining Janet, and it does quite a nice job in explaining the differences between structural dissociation and how it gets confused with other uses of the term. The second third of the book is of limited use to not-clinicians. The third focuses on treatment and is fairly useful, not the treatments proposed seem fairly standard and lack any deep understanding of what it’s like to live with this.
Strongly encourage a thorough read if you’re doing therapy, at least the first and probably the third section. Understand the basis of what your therapist thinks they’re doing.
I highlighted and shared that with my therapist and asked them to read it, so we can discuss.
It is very distressing to me that this article fails to mention the differences of OSDD1a and Osdd1b and DID. All three are very different and not to mention that there is more than one type of osdd really makes me feel like some more research needs to be done and perhaps less opinions.
Please don’t leave out OSDD1a next time
Thank you for the comment. This article is based mostly around the conference we attended. At which they failed completely to talk about OSDD, as they keep claiming this theory is about ALL trauma disorders. I mentioned OSDD 9 times in this article. I write from personal experience, I live with DID and Plurality, not OSDD, i am not a doctor or therapist and the title of this article contains the words ‘a strong opinionated article.’ Thank you for taking the time to read our opinions on this theory.
Really love your soup analogy. Being in the process of experiencing a spontaneous “final fusion” (which is a PROCESS!) that is exactly what it feels like. It’s actually something like a major identity crisis for us, but in a good way. It is less like becoming one “somebody,” and more like “becoming nobody” at all. I don’t mean that in a negative way, it’s like a distancing from ego identity all together, which results in less and less suffering, and we experience it more as a “spiritual awakening” than the way it’s laid out in clinical terms.
We become less and less of our conditioned parts, created by our nervous system’s response to environmental trauma. And more and more a sort of empty vessel for gaining pure consciousness, free from the identities we constructed to frankly, survive extreme trauma and navigate a traumatic society and environment. That is to say, as we become less and less somebodies, we have become this new thing, with some personality aspects of all our alters but something new entirely.
It’s actually kind of wonderful because it’s like getting to choose who we really are (with complete respect to and deep compassion for all that we were) versus who we became because of trauma, and all our other social identities. It’s also a really intense process that should never happen a moment before it’s time, or be forced on anyone. We can’t even imagine having to go through that, what a nightmare it would be. We just provided a loving safe space for all our alters to self express, and they began to heal and grow into this new sort of soup, or super-self (pun intended). It’s also hard and a true process, because big enough triggers still lead to fragmentation, and yet none of our alters are who they were before, so navigating that is super confusing.
Instead of these terms for integration/fusion, we like Ram Dass’s idea of “becoming nobody” much more, and he was of course the brilliant Harvard psychologist Richard Alpert, once upon a time. Before he dissolved his own ego. We are actually currently considering becoming a Buddhist monastic soon.
So, to conclude this rambling processing of a process that has only been poorly described by psychologists (most of whom have never experienced it) perhaps final fusion is not so great if you want to keep your somebody-ness, in general (which is a personal choice!!). Because, in our experience, it’s less of a singular ego formation and more of a complete dissolution. Which, for us, makes it difficult to function in any capacity within society’s framework of allowed social constructs of identity.
I sense OSDD is (to some extent) a more “Functional Multiplicity” from my limited rooting around in Plurality. This is my “Estimation” that DID is less adaptive (Than OSDD) to the Society that we live in. However…the “Society we live in” is in Shambles…SOCIETY COULD LEARN A LOT FROM HOW A STABLE DID SYSTEM OPERATES.
I’m working on some ideas around how the ROLES for DID / OSDD on a CONTINUUM OF PLURALITY could Potentially better Align Our Lives.
Thank You for this Summary of the INCOMPETENCE IN STRUCTURAL DISSOCIATION…Well Done!
Thank you. I certainly think dissociation and plurality are on a spectrum, i think different people in different systems are on different places on that spectrum, depending on various socio-economic, environmental and other conditions. I do not think it is fair to say that those with OSDD are (to some extent) more functional. Both need clinical distress to be diagnosed. There is no other disorder where you can go from one to the next because your situation improved. The current set up is flawed imho. Have you looked into the new ICD-11? Thank you!
As someone with OSDD and who is a practicing therapist specializing in treating patients with DID/OSDD using a psychoanalytic and structural dissociation model, I’d disagree with a few key points. First, while it’s absolutely true that the model is focused on increasing communication between all parts – or alters, if you prefer – and that the end goal of that increased communication is seen to be ultimate integration, that by no means takes away from the strength of the core intervention here, not removes the patient’s autonomy to choose whether they wish to integrate or not. The core intervention is one I should think any system would be glad to receive: help communicating internally, resolving blocks to doing so, developing better internal collaboration and decreased conflict, and increased understanding of one another and the importance each part has to play in the system – and making use of this deepend understanding and communicative skill to better work together to achieve the system’s goals. This seems to me a desirable goal regardless of whether one wishes to integrate or not. It is true these things lead to thinner dissociative barriers between alters, as conflict decreases and collaboration increases, but integration remains a system’s choice, as it should be. Some find they reach this point of healthy multiplicity and want to feel more joined through fusion – others feel most whole and happy remaining multiple and are glad to work on solidifying these internal gains. Both are valid choices and expressions of an agency that everyone deserves the opportunity to assert in their own healing. Both are reasonable outcomes of a structural dissociation informed treatment with a competent and ethical therapist.
Very interesting opinion piece! I am a dutch singlet writing my ‘profielwerkstuk’ or research paper about improving the diagnostic process of DID. Considering I have to explain DID to people who know nothing about it yet, I focus on the structural dissociation theory, because it is the one that is most talked about and most researched, however, I COMPLETELY agree that it is flawed and that Steele’s whole part about integration being the one and only goal of therapy is strange and doesn’t take the feelings of systems into account. The whole idea of only talking to ‘the ANP’ is outright ridiculous to me, as most DID systems have multiple ANPs, and many ANPs are amnesiac which would make the therapy process more difficult (working with a EP who has traumatic memories/beliefs may relieve the trauma, right..?) Besides, there are alters that are both ANPs and EPs. Furthermore, they’re acting as if BPD and OSDD fall into the same category, while I personally know a few OSDD systems who are way closer to DID than BPD, considering they may have multiple ANPs. So again, the theory is very flawed, but I do think it provides somewhat of an understanding of the etiology of DID and other stress/dissociative disorders. I’ll definitely take your opinion into account when writing my section about structural dissociation. Thank you!
Hi, I am a psychology student, I had been interested in trauma and dissociation for a long time, and I thought that the books of Onno Van der Hart were a good idea, but after reading this I want to know what authors you recommend
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Just discovered your website and am very interested also in what books you recommend. My copy of the Haunted Self is signed by both Onno van der Hart and Kathy Steele as I saw them in person in Atlanta, GA, USA. I am a therapist and trauma survivor. Most of the time lately I have been using Richard Schwartz’ Internal Family Systems model which I find to be very gentle and easily understood by clients.
Hi thank you! I like the books by Emma Sunshaw, including the workbook: https://www.systemspeak.org/books
I also very much appreciate the books by Criss Itterman: https://leanpub.com/u/revCriss