The Potential for Non-traumagenic Systems to be Diagnosed with DID/OSDD

A discussion of what it is like living as an endogenic system while having DID, from a community standpoint, and exploration of the perception that only traumagenic systems can be diagnosed with DID/OSDD.

Hello, everyone!

Welcome to the second year of the Plural Positivity World Conference. We’re the Lunastus Collective (aka TLC), formerly known as the Trashcan Collective. We’re so honored to be back again to talk to you all about the importance of an inclusive community.

At last year’s conference, we wrote about how endogenic and traumagenic— as terms indicating how a system formed— came to be, and our journey as a system. We wrote about community history, how that and our experiences led us to the proposal of those terms, and the importance of community solidarity. Today, we come to you with an update of our journey, but the message remains the same— that unity in the plural community was, is, and always will be vital, especially if we ever hope to reach wider acceptance.

Just as a refresher, let’s go over what it means to be endogenic or traumagenic, and explain some of the newer terminology that evolved after the 2019 plural conference.

The terms traumagenic and endogenic, which are now often used to try and divide the community into “fake” and “real” systems, were never meant to be used as such. We proposed them, and a few other terms, back in mid 2014 just as a way for people to move away from medicalized terms, to help phase out the term “natural system”, and give non-medicalized systems words they could use to better describe their experiences.

Endogenic simply means, a system not formed from trauma or other negative life experiences. It doesn’t mean they never experienced trauma, just that it isn’t what formed them. It doesn’t mean “healthy” or “non-disordered”. Endogenic systems can and sometimes do experience amnesia, dissociation, distress, and dysfunction. There are quite a few hypotheses out there for how endogenic systems form, but in the end, we just don’t know how the brain works in regards to plurality. It could be psychologically, physiological, spiritual, who knows. The point is, endogenic systems exist and are a completely valid expression of plurality.

Traumagenic means a system that formed from trauma or other negative life experiences. That’s it, full stop. There are no criteria besides that, there are no age limits. If it happened at five, twenty five, or fifty five, that’s all acceptable and valid. Traumagenic is not a synonym for “DID system” or “OSDD system”; DID and OSDD are medicalized terms for how a system functions, or doesn’t function, not terms for how the system itself formed. There are traumagenic systems that do not have DID or OSDD, and just as there are endogenic systems that do experience amnesia and distress, there are traumagenic systems that do not.

There are other terms used within in the plural community-- parogenic, protogenic, and quoiogenic are other "-genic" origin labels. Emmengard and some of their friends proposed five terms as well, as more inclusive alternatives. In April of 2019, we corresponded with Emmengard to help promote those terms:

Adaptive, meaning systems formed through negative life experiences, becoming plural in order to adapt and survive. It replaces traumagenic, which has fallen out of favor for a few reasons, including that it places too much emphasis on trauma. Spontaneous, meaning systems formed on their own without any known traumatic event to cause it. Created, meaning systems intentionally or unintentionally created-- this can include tulpas, soulbonds, characters that take on a life of their own, etc. Unknown, meaning systems who don't know their origins. Mixed, meaning a system that may have more than one origin, complex origins, or system members with various origins.

We worked with Emmengard to create a new version of the interlocking ring symbol, which is a popular symbol for the plural community, with a ring and a color dedicated to each system origin. Yellow for unknown systems, green for adaptive systems, blue for spontaneous systems, and red for created systems. The middle, a swirl of all four colors, represented mixed systems. Seeing as how the rainbow is also a vivid symbol of pride within the queer community, it felt right.

As Emmengard wrote when they announced the new terms, and the symbol design:

"Wouldn't it be nice if new systems were greeted gently and told not to worry, they were already a part of our symbol, a part of our flag, a part of our community, by default? Wouldn't it be nice if they were told that it is simply okay to not know, and if they change how they identified later it was okay too? Wouldn't it be nice to give them that moment to allow their own system, their own truth, to unfold to them in its own time?"

We supported, and still fully support, this message. It's good and right to acknowledge the pitfalls of terminology, especially as time goes on and the community evolves. It's important to lift up the concept of community solidarity, and encourage inclusiveness through improved terminology. Now more than ever, all marginalized communities, including the plural community, need to stand strong together in demanding acceptance, accurate representation, and improved standards of care for our most vulnerable members. This often starts with the language we use for ourselves and each other, and making sure that our community embraces diversity in our experiences. This includes systems that may have origins outside of trauma, systems who are unsure of their origins, and systems who's understanding of their existence changes over time.

Our journey falls into the latter category, though at the time of the first conference, we had no idea that would be the case.

The first plural conference took place in March 2019, and we identified as endogenic. We’d been plural since our first memories, before any memorable trauma, and our secondary original was firm that she had been here with our primary original since birth; it's what made sense to us. Although we had been told by a therapist a couple years prior that we had DID, we rejected the idea for quite some time. We had been taught that having DID meant that your system as a whole must be adaptive, and that was how it had been since the late 90s and early 2000s. The popular 1980s and early 1990s image of DID was a weak, tormented cisgender woman who had been abused until her psyche had shattered; she was ignorant of her "multiple personalities" and the chaos they were inflicting on her life. That didn't jive with who we were, and are.

There was a push for "empowered multiplicity" at the time we first entered the community in the late 90s. It hadn't been that long since plurality had been considered "hysterical neurosis" (up to 1980) and the first monographs on DID (known then as MPD) had only started appearing in 1986. "Interpersonality amnesia" had been removed in 1987. The DSM-4 had changed criteria yet again in 1994, and MPD was renamed DID. The movies Primal Fear (1996) and Fight Club (1999) were still fresh in the public eye, with the movie Identity (2003) lurking in the near future. It was a scary, tumultuous time. The online communities were fairly new, small; a lot of it was limited to webrings, newsgroups, IRC chatrooms, personal webpages, and text-based forums like Yahoo Groups. A lot of systems were tired of being called fake, "hysterical", brainwashed, or having to be at the mercy of psychologists who often insisted on "putting them back together again". (By force, if necessary.) Empowered multiplicity arose from a desire to shrug off the idea that systems needed a diagnosis to be plural, and a desire to prove that plurality didn't have to be disordered or a nightmare. Integration was often regarded with discomfort, and the concepts of cooperation and improved communication were held as superior options.

The movement welcomed non-adaptive systems, median systems (often called "midcontinuum" back then), systems with spiritual explanations for their systems, and soulbonders. Even though we weren't quite ready to admit we were plural at the time, it was still a lovely and mostly-welcoming community. But even as systems rejected medicalization and railed against dangerous stereotypes, it was still a common assumption that DID/OSDD was caused by trauma, so that meant the system with DID/OSDD must also be caused by trauma.

Now, as a disclaimer, in case we weren't clear already-- we don't believe that you need trauma to be plural. We don't think you need a diagnosis to be plural. We don't think adaptive systems need to have a diagnosis or even be disordered to be adaptive. The choice to seek a DID/OSDD diagnosis or not is entirely up to each individual system, based on their experiences and any troubles they may be having. The ability to be diagnosed professionally is also a privilege that not everyone can afford; we were lucky to be in therapy already when we were diagnosed.

We don't blame the systems we met back in those days for the fact that DID and OSDD were (and still are) considered synonymous with adaptive plurality. It seems natural to assume that the trauma that caused DID/OSDD would be the same trauma that caused the system. And at the time, for us, what did it matter? DID and OSDD aren't required to be plural. Plurality doesn't have to be disordered, and although we did have some problems, endogenic systems sometimes do. Still, it was something that gnawed at us. For us, personally, it was less about having a diagnosis and more about what having a diagnosis could mean, and how it related to our origin as a system.

On top of all that, the community that had cropped up between when we first discovered the community and when we got diagnosed was full of exclusionists insisting that in order to "really" have DID, you had to be this way or this way, that if you did that or that you were fake, and we couldn't handle it. We were already struggling to come to terms with being plural, the loss of our primary original in 2012, and the abuse we were still going through. The idea of trying to untangle a mess of a DID diagnosis and what it meant for us as a system was too much, especially with so many people insisting that systems with DID or OSDD fit into a very rigid box with strict rules, and a tendency to look down on-- if not outright harass-- anyone who didn't fit.

As we got more involved with the inclusive plural community around the time of the conference, we learned more about what the DSM-5 says, what it doesn't say, and various hypotheses surrounding how DID/OSDD works. We learned that the DSM-- besides being flawed in general-- doesn't demand trauma for a system to exist. Here are the diagnostic criteria for DID, according to the DSM-5:

A. Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption of marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.

B. Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The disturbance is not a normal part of a broadly accepted cultural or religious practice. Note: In children, the symptoms are not better explained by imaginary playmates or other fantasy play.

E. The symptoms are not attributable to the physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or another medical condition (e.g., complex partial seizures).

Essentially, the DSM-5 states that in order to qualify for a DID diagnosis-- without getting into the politics and gatekeeping around getting the diagnosis-- all that's required is plurality, some type of amnesia, and marked distress and/or dysfunction (but not necessarily both). It says nothing about what caused the plurality itself, it doesn't require system members not be aware of one another, and it actually allows for cultural and religious or spiritual plurality.

It is important to note that, stripped of the ongoing dialogue surrounding the disorder and hypotheses set aside, the criteria states exactly nowhere that the "personality states" must be caused by trauma. DID isn't defined by trauma, but by disorder and dysfunction. It is not a diagnostic label meant to indicate a system's origins, but a diagnostic label meant to declare that plurality is being experienced, and that the state of the system is disordered/dysfunctional. Much like how a car can be described as being in "fair condition", without saying where the car is from or how it was made, DID/OSDD describes the condition a system is in rather than how it came to exist to begin with.

With that in mind, it's easier to see how exclusive mindsets within the community can lead to confusion, as well as feelings of invalidation. If a system doesn't remember trauma causing their system, but they are disordered and need help, where are they to go? Is their suffering equally as valid as systems who do identify as adaptive? Do they deserve to be told that, because they weren't formed from trauma, that they haven't experienced trauma at all or don't belong in survivor spaces? And what of adaptive systems that don't experience disorder, and don't need nor want a diagnosis? Putting a professional diagnosis on a pedestal, and holding diagnostic manuals up to some golden standard of what plurality is or isn't, is troubling enough. Using them to attack other systems that don't fit is even worse. Using it to attack other systems, with wording and perimeters that aren't even part of the diagnostic criteria, is ridiculous.

Although a diagnosis, professional or self-given, isn't required to be part of the plural community, it's a fact that some systems find a benefit in it. Why? For validation reasons. To give a name to something they're struggling with. For health care reasons. To find community. To help explain what they are experiencing to other people. Regardless of why, a diagnosis can and sometimes does help disordered systems, and that shouldn't be taken from them because of overzealous, community-appointed rules that aren't even in the psychiatric "rulebook". For some it can be interesting to discuss and debate exactly how DID/OSDD works, but the criteria are what they are, outside of whatever the current hypothesis is.

This is especially vital for younger or newly awakened systems that are just finding their way to the plural community, often through the DID/OSDD side of things (as we did) because that is the form of plurality most visible and discussed in society. It is so important to not market DID/OSDD as the only form of plurality, both for very real non-adaptive and/or non-disordered systems, and for systems who may be adaptive and/or disordered but aren't ready to explore that yet.

We entered the plural community on Twitter December 2018 as an endogenic system who had faced trauma from-- we assumed at the time-- about five years old to the present, and had been rendered disordered because of it. We had a mostly spiritual stance regarding our plurality and how system members formed or arrived. We fought so hard against our DID diagnosis. Without the inclusive community, we never would have sat down and seriously taken another look at the literature available. The ability to relax, be ourselves, and explore our plurality without feeling forced to poke at trauma or label ourselves allowed us the time and freedom to get to a place-- mentally and emotionally-- where we could accept our DID diagnosis.

And what a revelation it felt like, too, to realize-- endogenic systems and other types of systems can also be diagnosed with DID/OSDD, or be disordered.

It wasn't a joyous realization. Contrary to what some exclusionists believe, no one *wants* to be disordered. It’s not some fun game, and systems of all origins know this. But it's infuriating to think that there are systems out there like us who need help, yet are too afraid to seek it because they've got it in their head that it's not possible, or that they'd be "stealing resources" from systems that "actually need it". It's baffling! Regardless of your system origins, or your beliefs on how your plurality works, if you're struggling and need help then you have every right to access it.

Similarly, it is sad to know that there are adaptive systems out there who, initially considering themselves endogenic, might pull away from adaptive spaces because they are told repeatedly-- sometimes violently-- that if they deviate in any sort of way from whatever the newest "standard" is that they aren't adaptive at best and should harm themselves at worst. Exclusionists often claim that endogenic systems keep adaptive systems from getting help, but remain silent on the fact that exclusionist attitudes silence large portions of the plural community, including adaptive and/or disordered systems that shy away after being told they don't belong.

Our journey could have easily taken that turn. Thankfully, we're 32 years old and have been around or directly in the community since the late 90s. We have our feet firmly under us, for the most part. Shortly after the 2019 conference, we embraced our DID diagnosis, though we still considered ourselves endogenic. Of course, there were a few folks who took issue with that. If we were younger, newer, less sure of ourselves, it could have done some serious harm to hear repeatedly that we were delusional, fake, spreading lies, etc. It helped that we had the more inclusive side of the plural community at our back; not only did systems there inspire us to accept the fact that we're disordered, they supported us and helped us when we came out with that fact. For every negative comment, there were more positive ones. We felt cared for, we felt uplifted, and we felt like we had the freedom to continue exploring our plurality without fear-- on our own time, without feeling anxious about having to reveal trauma that may or may not have been there.

The start of quarantine, early 2020, gave us time and space to focus more on what was happening in our head. We were stuck living with our abusive family, as we are disabled and had nowhere else to go. The abuse began to get worse again, since both of our abusers were around almost 24/7 for months on end. It made us remember more of our childhood, and reflect upon the timeline of our abuse; it also made us rethink the nature of our abusers in general. The end result, after doing some research and speaking with inclusive, accepting systems of all origins, was our system realizing that our trauma history began before we were even born. Studies have shown that a fetus exposed to stress, and to abuse happening outside the carrier's body, can be impacted negatively by it. While we'll never know for sure if that is absolutely where our system began, it does back up our primary and secondary originals who claimed they were born in the body together. That is something we still don't question. It is what it is, and we can't disprove it.

But the idea of it-- the fact that we're adaptive, not endogenic-- is something we're sure of now. We wish to reiterate that our journey is not the journey of any other system. Endogenic systems are real, and they matter. Not all endogenic systems will discover some pre-formation trauma. It is so, so important that the community doesn't take our story, and stories like ours, and use them to "prove" that endogenic systems are secretly adaptive. Even if that were somehow true, that journey is for each system to make on their own, and a belief in endogenic systems doesn't harm the plural community anyways. Systems have to come to their unique truth on their own time, without pressure or demands. And, for systems that have already arrived at their own truth, it is vital to leave room for things we-- as a society-- don't understand. Plurality is absolutely one of those things that isn't yet fully understood. It might never be.

We must resist the urge to rely too heavily on the models of plurality set up by psychiatry, and resist allowing those models to dictate how the plural community is shaped. While those models can be useful for some, they can also be used against systems. If we rely on doctors and therapists to define us, as a community, it opens us up to erasure and abuse. This isn't to say that therapy isn't useful, only that there is a major risk in allowing people outside the community to define those within it, especially if they are in positions of authority and power. If they decide tomorrow that plurality doesn't exist, and some already don't believe it exists, then what? If we defer to brain scans, while intriguing, what happens when those in charge declare "this brain isn't plural enough"? Or when they decide we're too dangerous, either to ourselves or others, to exist in society? It's a very real concern. Psychiatry, as an institution, has been steeped in racism, ableism, and other prejudices for as long as it has existed.

The danger is that, more so in recent years, those models and the toxic assumptions, prejudices, and removal of selves-determination that often come with them, have been seeping into the plural community— not through singlets, but systems. It can be so tempting to convince yourselves, and try to convince others around you, that if we just abide by the “rules” put out by various mental health manuals across the world that we will be accepted. That if we weed out the “weird” systems that don’t fit the medical models, that plurality will be more palatable, and finally we’ll be treated like real people. Tempting, yes, but wrong. There is no proof that only trauma causes plurality. There is no proof that all systems must be disordered to be real. A diagnosis will not save any system from a world that is overtly hostile to plurality. And systems coming up with senseless “checklists” to exclude other systems, such as “having fictives from recent media means you’re fake”, will never help, either.

The only thing that really will help, in the long term, is adopting an inclusive attitude towards systems. Regardless of origins, regardless of how systems function, regardless of diagnosis— by embracing one another and allowing all systems to label themselves, allowing them the room to explore their system and how it functions, and giving systems the space and the respect to come to their own conclusions. Whether they change labels or find buried trauma or not should be irrelevant. What matters more than the terms we use to define ourselves, is how we treat one another. Words and descriptions and terms change, but the acceptance or bigotry we direct at other systems leave lasting and sometimes deep impressions. As a community, it should be our pride and honor to be more welcoming, supportive, and affirming than those outside the community. It harms no one.

Acknowledging the reality of one another, and how we all describe our origins, experiences, and path forward, only serves to help the community and bring it together. As we did last year, we bring this talk to a close with a call for unity and understanding.

Singlets do not, and shouldn’t be allowed to, define plurality; the standards they make up to define systems are often used to hurt more than help, and foster rifts within the community due to hypotheses that are scientifically unproven. And, tomorrow, it could all just be gone anyways if those in charge decide it. Systems need to have control over how they define themselves, and the community needs to be as inclusive as possible to shelter systems regardless of how they define themselves. The exclusive attitudes of singlet authority figures can’t be allowed to flourish within our community. We, as a community, need to discuss our community’s issues, as well as concerns of individual systems, thoughtfully and with as much care as possible. We can’t hope to grow and learn otherwise, or foster an environment where systems actually feel safe to be systems.

We are a system that thought they were endogenic, and turned out to be adaptive instead. We are a system that has accepted the fact that they’re disordered, when they resisted the idea before. It’s not the journey of all systems, but there have been and will be others like us who will go through that difficult and sometimes heartbreaking process. The only thing that got us through that process was the support and love from the inclusive plural community, and the support and love of our non-traumagenic family. We likely never would have even explored our past and origins closer, had it not been for them, and for the inclusive community assuring us we could do so safely and at our own pace.

We won’t ever understand the arguments against an inclusive community, when the medicalized models are so overwhelmingly restrictive, hateful, and hostile to systems. What we do know is that those attitudes won’t win out, because a healthy, safe, informed, and strong community cannot be formed on exclusive attitudes. It’s our hope that, someday, all exclusionists will realize this. We hope they realize that non-adaptive systems, non-disordered systems of various origins, and those who support them, aren’t the enemy— and aren’t stealing anything, taking away resources, or furthering misinformation.

The thought that— no matter the terms we do or don’t use for ourselves, no matter our trauma history or lack thereof— there’s a community waiting to help lift us up and offer us support, to us, is a comfort. We only hope that more people see it the way we do— as a blessing— and choose to fight for its existence. All of our voices are needed, as always, if plurality is to make any sort of progress in gaining acceptance on a world-wide level.

Thank you for your time. Have a safe and happy Plural Pride Day, and please remember, you’re real, you’re valid, and your life matters.