about DID/OSDD

information about Dissociative Identity Disorder
& Other Specified Dissociative Disorder

• what is DID/OSDD
• terminology
• common questions

additional resources

• did-research.org
• the CTAD clinic
• OSDDID terms masterlist
• what is RAMCOA
• more about RAMCOA

this carrd was created by @ourstarsys on discord to compile information about DID/OSDD as well as additional resources to aid people's understanding of the disorders.if you have any questions or concerns, feel free to reach out.

what is DID/OSDD

Table of Contents

Overview

Dissociative Identity Disorder (DID) is a dissociative disorder characterised by recurrent episodes of amnesia and disruption of identity, in which there are two or more distinct personality states with marked discontinuities in the sense of self and agency between them (dissociative identities, known as alters). The presence of multiple distinct dissociative personalities with amnesia and discontinuities between them is referred to as a system.

Other Specified Dissociative Disorders (OSDD) has multiple subtypes, but the only subtype where a system is observed is OSDD-1, of which there are two further categories: OSDD-1A and OSDD-1B.

OSDD-1A is characterised by episodes of amnesia however there is less distinction between the dissociative identities, whereas OSDD-1B is characterised by distinct identities but with lessened amnesia.Notably, these subcategories aren't official diagnoses; the diagnosis would be OSDD-1, and the A or B is more of a colloquialism used within the community to better convey the experience of the system to others.

Information from the DSM-V and the IDC-11.

What can this look like?

1) Billy has DID. He is a system of 10 alters, including himself, each of who is very different from himself. His system experiences moderate levels of amnesia, and it can sometimes be difficult for Billy to figure out what other alters in his system did while fronting because of this.

2) Sally has OSDD-1A. She is a system of 4 alters, including herself, but they can be difficult to differentiate. For example, one of the alters in Sally's system is Sally when she was 8 years old, and another alter is Sally as a boy. Sally's system experiences high levels of amnesia, and it is often difficult for Sally to figure out what other alters in her system did while fronting without reading notes that the alter wrote.

3) Alyx has OSDD-1B. They are a system of 26 alters, including themself, each of who is very different from themself. Their system doesn't experience much amnesia day-to-day, however many of the people in their system struggle with recalling traumatic experiences, and Alyx sometimes finds that they can remember facts about events that took place but they feel emotionally disconnected from the memories, almost as if what happened was a story told to them by a friend.

Formation

DID and OSDD-1 are recognised to be caused by long-term exposure to overwhelming experiences, traumatic events, abuse, and/or neglect in early childhood.

In normal development, the different aspects that make up a child's personality and identity integrate around the ages of 7-9 years old to form one stable sense of self. However, in the case of prolonged traumas in early childhood, the brain may develop dissociative barriers that allow the child to continue to function.

These barriers cause a level of amnesia and/or disconnect (dissociation) between the different parts of the self, for example, a barrier between when the child is being traumatised and when the child is not. The child's sense of self is now unable to integrate as normal because of conflicts of interest (such as disorganised attachment to caregivers, differing needs, etc.), trauma responses, memory differences, and more caused by these dissociative barriers. Instead, these "self-states" continue to develop as individuals (dissociative identities, alters) despite sharing one brain and body.

Information from did-research.org.

What can this look like?
(cw: alcoholism, child neglect)

Maartin's mother scares him sometimes because she likes to drink a lot of alcohol and act unpredictably. Maartin still loves his mother because she takes him to the park every Saturday morning, although sometimes Maartin's mother isn't able to take care of Maartin at all.

When Maartin is at the park, he doesn't remember his mother's drinking and he is happy to be around her. However, sometimes when Maartin's mother has been drinking, he finds it difficult to remember her being sober and going to the park with her, and he feels as though he's constantly trapped in a world where his mother is scary and he is left to fend for himself. When he does have to take care of himself, like make dinner, Maartin sometimes feels a calming presence within him, and he manages to make food and clean up after himself, even if he isn't really sure how.

Later in life, Maartin is diagnosed with OSDD-1. Through therapy, he manages to develop better communication with other members of his system and learns that one of his alters is a little boy who is still scared of his mother and another alter is a motherly woman who took care of him when his mother was unable to.

Further Information

Overt/covert presentations of DID/OSDD
DID/OSDD may present overtly or covertly, that is, with or without symptoms being "obvious" to other people.

Overt presentations are sometimes described in clinical texts as "posession-form", in that the individual may present as though they have suddenly been taken over or "possessed" by another force, spirit, or being as an explanation for why they are suddenly acting so differently from their typical behaviour. This might look like a typically introverted person suddenly acting in a very extroverted way, stating they go by a name that the individual does not use, and referring to things that did not happen or happened differently.

Contrastingly, covert presentations tend to manifest more internally than externally. For example, a person may notice over time that they have periods when their sense of self changes greatly, such as greatly preferring different pronouns at different times or experiencing drastic changes in mood for no discernible reason.

There are instances where overtly presenting people with DID/OSDD believe that they are actually undergoing possessions or that something religious (for example, holy or satanic forces) is happening to them, and there are instances where covertly presenting people with DID/OSDD believe that they may be gender fluid, have a mood disorder, or simply just multifaceted or performative, both types of instances typically occurring before a diagnosis.

It is possible for a person with DID/OSDD to present as both overt and covert, either simultaneously or situationally.


Alter functioning
Alters can be vastly different from one another despite being in the same system, whether it be in gender, sexuality, age, appearance, interests, opinions, preferences, behaviour, or even differences in sensation, perception, affect, cognition, and motor control.

Alters typically have "roles" within their systems that often revolve around why they formed and/or how they behave. Some common roles include hosts, protectors, caretakers, persecutors, holders, and littles.


Miscellaneous Information
– Although DID/OSDD forms in early childhood, alters can still form after this time period if the system undergoes new traumas.
– Outside of the diagnostic criteria, systems vary greatly from case to case, whether it be in the number of alters in the system, the amount of stress/trauma a system can undergo before forming new alters (referred to colloquially as "split tolerance"), and even the role each alter in a system performs (many systems even coin their own role terms outside of those more widely known to better describe their experiences). This has to do with what events led to the system forming in the first place, and even systems with similar backgrounds can develop very differently. It is very highly unlikely that you will ever meet two systems that are the same.
– It is possible for people with DID/OSDD to have other co-occurring diagnoses/conditions. People with DID/OSDD often meet the diagnostic criteria for (C-)PTSD (with reference to the Theory of Structural Dissociation, DID and OSDD are functionally more extreme versions of (C-)PTSD). Other comorbidities can include mood disorders, anxiety disorders, psychotic disorders, and personality disorders, as well as physical disorders/conditions.
– Symptoms and traits of DID/OSDD can be worsened by various psychological and/or psychosocial elements, including stress, comorbid disorders, culture, internal conflicts or dynamics, and emotional resilience. For example, a system may experience worsened dissociation when exposed to something that is a reminder of their trauma. This can also have an effect on the overt/covert presentation of the system, for example, a system may present more overtly or more covert/internal manifestations of symptoms may be noticed when the system is experiencing worsened dissociation, such as visibly spacing out or noticing changes in perception, opinions, or thoughts respectively.

Information from the DSM-V, the IDC-11, and other sources.

terminology

please note: this page is still under construction!

Table of Contents

Key

★ – Clinical Term
☆ – Community Term
☾ – Origin Unsure

SYMPTOMS & EXPERIENCES★ Amnesia — Memory loss, either partial or total.★ Dissociative Amnesia — Amnesia caused by the act of dissociating due to the disruption of cognitive functions such as memory and attention. Being unable to remember what happened while you were dissociating.★ Generalised Amnesia — Amnesia for all information about oneself and events that took place. Commonly referred to as a "blackout". Being unable to remember your name, age, location, past events, etc.☆ Greyout Amnesia — Used to refer to any amnesia that isn't generalised or "blackout" amnesia. Most commonly refers to emotional and/or selective amnesia.☆ Emotional Amnesia — Amnesia for emotions felt during an event. Eg. remembering a traumatic experience but not being able to remember how you felt in the moment.★ Localised Amnesia — Amnesia for parts of a period of time. Eg. remembering childhood but not any abuse that occurred.★ Selective Amnesia — Amnesia for some details of an event. Eg. remembering abuse occurring in childhood but not some of the specifics.☆ Fragmented Amnesia — Amnesia for the timeline of memories. Eg. remembering several events but not what order they happened in.★ Retrograde Amnesia — Amnesia for events taking place before a specific event. Eg. unable to remember information from before a traumatic event.★ Anterograde Amnesia — Amnesia for events taking place after a specific event. Eg. no longer being able to retain memories following a traumatic event.


★ Flashbacks — An involuntary, internal image of a past (traumatic) event. Flashbacks can both be triggered by external sources or randomly occurring. Flashbacks can be emotional, visual, somatic, or sensory.


★ Dissociation — An experience of disconnect between aspects such as thoughts, memories, emotions, perception, surroundings, actions, identity, consciousness, and more.★ Depersonalization — An experience of disconnect on an internal level, such as from identity, thoughts, or actions. "Being detached from oneself."★ Derealization — An experience of disconnect on an external level, such as from the world or other people. "Perceiving the world as being (somewhat) unreal."☆ Blurry — When an alter or multiple alters is/are unsure of who they are/who is who, typically caused by dissociation.


☆ Polyfragmentation — Sytems that are typically large (often over 100 alters) with many fragments and often have several subsystems. Associated with more severe trauma and more severe symptoms.★ Splitting — When a system undergoes (more) traumas/stressors, the brain may create new dissociative barriers, hence forming (splitting) another alter.☆ Split Tolerance — Used to describe how easily/frequently a system splits. Eg. a system that splits easily because of things that other people may not consider to be particularly traumatic/stressful, they likely have a low split tolerance.

common questions

please note: this page is still under construction!