Chapter 5

Conceptualizing the DCS

The dynamic consciousness system metaphor is a reflection of how the central nervous system is actually functioning. By grounding a model of identity in a neurological theory, I hope to build connections between the understanding and interface of the mind and body. It is important to make this link in order to understand the full systemic impact of child abuse and the development of multiple identities.

The Role of Neurology

Neurological research implies that the brain functions as a fairly decentralized set of subsystems that mutually inhibit and self-regulate their processes. Grigsby, Schneiders & Kaye (1991) argue that there is a "strong case for the brain as a distributed, massively parallel, self-organized, modular system. The brain is comprised of myriad heterarchically organized structural-functional units (modules), operating in parallel and in series. These modules influence and are affected by one another at nearly every level of integration (p.39)"

The brain is a distributed system, not a hierarchically organized unit. The modules operate relatively independently, but are interconnected through re-entrant signals (Edelman, 1987) which give the brain an incredible capacity for synthesis.

Early studies of commisurotomy suggest that all people have parallel multiple selves, differentially inhibited through the process of hemispheric "dominance" (Gazzaniga et al., 1977). Further research clearly indicates that "each self-representation which is mediated by a neural network is in essence a modular component of the self, and each neural network is comprised in turn of a number of modular units (e.g. affect, perception, cognition), each of which is itself a modular system" (Grigsby, Schneiders & Kaye, 1991, p.42). There is no differentiation between the physical and mental structures and processes in this model. The traditional idea of the body/mind split fails to account for the myriad of ways that the mind-body system interacts. Modern neurological models include nervous system components that regulate somatic operations. Hemispheric "dominance" is really the inhibition of one hemisphere from the awareness of the other. The various chemical inhibitions existing between modules change depending on the circumstance and in response to a variety of stressors. Disinihibited neural processes involved in "switching" identities may account for the headaches reported in 78.7% of Dissociative Identity Disorder patients (Ross, Norton & Wozney, 1989). These headaches are commonly reported to accompany dissociative episodes. Hemispheric inhibition normally prevents simultaneous awareness of both hemispheres. However, disinhibition can lead to the awareness of "other" thoughts and emotions, which come from the other hemisphere. The "executive personality," therefore, is only a temporary status of the identity currently responding to the environment. The interactions between the dynamic consciousness system and the environment are a dialogue, as the central nervous system continually responds to new stimuli.

Theoretical framework for relating brain structures to multiplicity

Little research has been done on brain structure and multiplicity since early experiments that investigated an apparent relationship between Dissociative Identity Disorder and epilepsy (Mesulam, 1981; Schenk & Bear, 1981; Drake, 1986). Changes in identity have been observed in patients with seizure disorders following a seizure, and the patient was amnesiac for the changes, however these patients did not really meet the criteria for Dissociative Identity Disorder. Coons, Bowman & Milstein (1987) reported a 14% incidence of psychogenic seizures and 10% incidence of organic seizures in Dissociative Identity Disorder patients, and concluded that although epilepsy occurs in a small number of Dissociative Identity Disorder patients, it does not cause the dissociation. However, it is possible that these seizures are a result of the disinhibition of the parallel modular systems of individuals with multiple identities.

The neurological map of the DCS is a modular system, with both parallel modules that are vertically integrated, and networks between modules that produces lateral integration. Each module is capable of inhibiting within its own structure as well as being capable of inhibiting parallel relays. In normative multiplicity, there is a moderate and frequently uneven degree of inhibition occurring between parallel relays. For example, the "dominant" hemisphere may not be fully inhibiting the impulses from the other hemisphere, but picks up thoughts, images and other input. The thoughts, feeling and so on may or may not be experienced as "self" or "parts of the self" (Kelley & Kodman, 1987), but are experienced as emerging from "inside the head" (Ross et al. 1990).

Hypothesizing the development of multiple identities within this framework, multiplicity may result from a strong inhibition of re-entrant signals between modules. At the same time, a number of modules would be disinhibited, and new modular systems formed. They could overlap to varying degrees with existing modules and vary in size. Thus, while the modules (which are the basis of the identities) experience developmental growth and are activated when cued by different circumstances, they are also not communicating with each other.

Double consciousness

Early research into Dissociative Identity Disorder reported "double consciousness" as a common phenomenon (Janet, 1889; Breuer, 1893). A report of Dissociative Identity Disorder occurring in adulthood as a result of combat trauma, also reported only two personalities (Young, 1987). Three case studies in India (Adityanjee, Raju & Khandelwal, 1989) were reported as Dissociative Identity Disorder although there were only two personalities and the authors indicated no history of childhood abuse. While these are too few cases to draw any firm conclusions, it would be worthwhile to examine if there is a subgroup of Dissociative Identity Disorder patients whose alternate identities emerge in adulthood, who never develop more than two identities.

A pattern of dual personalities in adult onset may be a result of the fact that no matter what socialization exists to produce the unified self, the hemispheres of the brain represent two major modular systems with radically different functions (Grigsby, Schneiders & Kaye, 1991). Because of the channelling effect between hemispheres, they may be more likely to become dissociated from each other than other brain subsystems. In adulthood, when the modular patterns and interrelationships are fairly well established (Grigsby, Schneiders & Kaye, 1991), a shift in the dominant self-representations located in different hemispheres may be possible through a relatively simple disinhibition. Such a disinhibition in other parts of the brain, would involve complicated processes because of the extensive network of interrelationships established between modules. Further research into Dissociative Identity Disorder in adults could explore this possible connection.

Neurology and multiple identities

Some of the physiological studies of Dissociative Identity Disorder report a variety of indications that electrochemical changes in the brain, and changes in hemispheric dominance, are occurring when identities change. Coons (1988) reviewed studies indicating changes in brain electrical activity, regional cerebral blood flow, seizures, changes in handedness and visual evoked potentials (changes in the brain's response to light stimulation). Other physiological changes (such as sensitivity to pain, vision, handwriting changes, blood pressure, heart rate and palpitations, galvanic skin response, allergies, different responses to medication, dermatitis, genitourinary pains and gastrointestinal disturbances) likely reflect variations in sensitization and conditioning processes, as well as emotional states (Coons, 1988).

There is no indication to support the hypothesis that neurological dysfunction is at the root of Dissociative Identity Disorder. While drug therapy has been used in the treatment of Dissociative Identity Disorder, its role is limited to controlling sudden mood swings as the process of therapy continues, not acting as a cure itself (Loewenstein, 1991). Miller & Triggiano (1992) reported on insomnia in multiple personality patients, but found no evidence of temporal lobe dysfunction, and attributed the insomnia to post-traumatic emotional states. This indicates that emotional shifts and conditioned responses that are the consequences of abuse are responsible for the corresponding physical changes.

>Coons (1988) noted that physiological studies have used small samples or single case designs, and that further research is needed to understand the physiological relationship between alternate identities and their physiological states. Miller & Triggiano (1992) also noted that some findings have been contradictory, and that many of the studies suffer from methodological flaws that make generalizeability difficult.

Models for the DCS

One way to conceptualize the DCS is to imagine the cast of characters representing different modules or identities. Each has an individual role, but they also create something different than the sum of the parts, they create an overall posture or interrelationship (DCS). Different functions are heterarchically organized, with vast parallel systems and decentralized and mutually inhibiting processes determining the outcome of responses, conflicting emotions and thoughts. The power is not exactly collectively shared, but it is decentralized and modular in nature. Some states have executive control for some aspects of behaviour, but little say in other systems.

The unifying quality of the DCS is the structure created by the modules, the shape of the interrelations between modules is the shape and boundaries of the psychological structure. The DCS, as an entity, is more than the sum of its parts, just as the brain is more than a sum of neurons.

Graphic model

The following model describes a simplified system of modules and submodules. It uses the BASK dimensions, which integrates somatic, cognitive, intellectual and emotional functions (Braun, 1988). [My HTML skills completely fail me here. Until I convert my nice model into a gif file, you'll just have to imagine these points being connected. For example, M1 (Module 1, is connected to B1, K1, A1 and S1. Module 2 is connected to B2, K2 and so on. M3 is the system connected to all others and M4 is connected to B4 - S4 and also overlaps with parts of M2. Won't you be happy when I draw this!]

M1 M2 M3 M4 Module

B1 B2 B3 B4 Behaviour

K1 K2 K3 K4 Knowledge

A1 A2 A3 A4 Affect

S1 S2 S3 S4 Sensation

Parallel systems are labelled M1 and M2. M3 contained more submodules than the other modules, to demonstrate the modules can vary in size and components. These parallel systems are only heuristic in value. They are not limited in number, because they can overlap with each other. For example, suppose that S2 and S3 actually represented the same component, that functioned differently in the context of different relays. One could conceptualize the potentiality of a virtually unlimited number of parallel systems. Using the BASK dimensions (Braun, 1988), this model shows that each parallel module is made of submodules. Theoretically, submodules are also modular. For example, S1 may be composed of a number of related cellular and tissue structures, which can be further broken down into intracellular chemical processes and so on (Grigsby, Schneiders & Kaye, 1991).

Re-entrant signals integrate information and stimulations throughout the system. Different disruptions in integration of information lead to different forms within the DCS. For example, learning to suppress sensations of hunger, hypothetically processed by M3, involves suppressing somatic indications, in this case hypothalamic neurons stimulate the sensation of hunger. In suppressing these sensations, the link between S3 and K3 is suppressed. Awareness of hunger only occurs when insistent signals from S3 are being transmitted. However, the cells still need nutrients and stimulation of the conscious awareness of hunger can come from other submodules. Perhaps S2 represents balance, and the person begins to feel dizzy after long periods without food. S2 might then stimulate K3 of the awareness of hunger. Each person's patterns become relatively idiosyncratic, and can also change over time.

Dissociation also takes place on a more horizontal axis, for example, if M4 is functioning as a self-contained system. This vertical "splitting" is a common conceptualization of multiple personality (Marmer, 1991). However, this is oversimplified. The isolated module did not previously exist and then was split off, the splitting simply refers to the inhibition of re-entrant signals between modules and strengthening integration of signals within the module. As the system is heterarchically organized, some modules and submodules may receive input without sending it. A possible example of the Executive Self model would be a central module that sent information to all other modules, but did not readily receive input.

The important aspect that this model does not adequately demonstrate is that none of these relationships are mutually exclusive. The spatial representation of parallel modules refers to their mutually inhibitive capacity. However, submodules can function in two different systems. For example, the identity of one identity still has access to memories and learned behaviours of how to dress, technical skills and other information, thoughts and feelings. Amnesia is often asymmetric (American Psychiatric Association, 1994), indicating that some modular systems are much larger than others, cross over in different ways and generally do not conform to the linear, singular operations that would make it easy to draw. Also, some submodules serve a collating function, and process signals from a number of related submodules. The one-to-one relationship of various components depicted here is oversimplified.

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