Entender la consciencia como un espectro es vital para entender el TID, y en este artículo demostraremos que se ha discutido este fenómeno en la bibliografía de disociación traumática.
El elemento característico del Trastorno de Identidad Disociativo es la existencia de dos identidades suficientemente autónomas, con su propio sentido de identidad distinto, que alternan la consciencia y el control ejecutivo. Es decir, una puede estar consciente (“aware”) mientras la otra no lo está. Ambas pueden llevar la vida diaria. Es el elemento clave del TID. Pero hay mucho más allá de eso.
La co-consciencia es un término acuñado por Morton Prince en 1906 cuando encontró que “subconsciente” era un término que no se ajustaba al fenómeno de dos consciencias concomitantes, refiriéndose a una de las partes de Christine Beauchamp, su paciente con TID.
Digamos que tenemos la identidad A, y la identidad B.
A puede irse a dormir, pero justo cuando pensó que iba a dormir, B se levanta, consciente de que A iba a dormir, y se decide mirar televisión porque tiene miedo de dormir.
A se despierta en el sofá con la televisión encendida.
A no sabe cómo llegó al sofá. Siente que no ha dormido.
En este ejemplo, A no estaba consciente cuando B estaba consciente, pero B sí estaba consciente de A.
A vivió un blackout (laguna mental, apagón, tiempo perdido).
B estaba co-consciente. A no lo estaba.
Lo anterior es la co-consciencia de una vía. (También llamado amnesia de una vía).
La co-consciencia de dos vías sucede cuando A y B están conscientes de la presencia de la otra, al mismo tiempo, y pueden experimentar lo que se vive al mismo tiempo. Ambas podrían estar comiendo un pastel y lo experimentarían de distintas formas.
En personas que no tienen partes disociadas estructuralmente, estaríamos hablando de algo similar a la meta-consciencia o «el yo observador».
El sistema de partes en una persona con TID puede tener diferentes grados de amnesia, barreras amnésicas y co-consciencia. Y esto puede cambiar a lo largo de la vida. Las barreras amnésicas pueden crecer o volverse porosas entre distintos grupos de alters.
Las barreras amnésicas entre alters son mecanismos automáticos, pero que pueden resistirse o promoverse. Existen alters que se formaron para resistir esta necesidad emocional de separarse por completo, por ejemplo, para estar siempre alerta de peligro. Hay algunos tipos de alters que se vuelven intérpretes, administradores y mensajeros entre alters que no saben qué está sucediendo.
Lo más importante de recordar es que la co-consciencia no solo es posible, sino que la integración de memorias, fusión entre partes y la unificación no puede suceder sin co-consciencia.
Un alter no puede integrar una memoria si nunca está presente al mismo tiempo que el alter que la vivió.
A continuación presentamos muchas referencias bibliográficas.
Nota: Como no muchas referencias usan el término co-consciencia, agregaremos referencias que sugieran el concepto como: el diálogo, coordinación, comunicación, consciencia de las partes (awareness), cofronting (o estar en control al mismo tiempo), co-presencia, o procesos mentales de hacer consciencia de distintas partes del self/yo.
2. in cases of dissociative identity disorder, a person’s sense of having access to coexisting, distinct personalities. —coconscious adj. [described by U.S. physician Morton Prince (1854–1929), who preferred coconscious to the term subconscious]
Although B I and B IV as personalities were not subconscious— in the sense in which this term is used in this study — to each other, yet certain isolated, disconnected, «scrappy» memories of each sometimes persisted and formed a coconsciousness to the other.
Prince, M. (1906). The dissociation of a personality: A biographical study in abnormal psychology. Longmans, Green and Co. https://doi.org/10.1037/10006-000
Another use of the term is to define those perceptions and mental states of which we are only partially aware at any given moment, and which may figuratively be said to lie in the fringe of the focus of consciousness.
This, of course, is equivalent to coexistence. After all, it is only a matter of definition, but we must have some term to designate coexistent dissociated thought, and this seems to be the natural meaning of » subconscious ; » that is, something that at the moment actually streams under the primary consciousness. A much better term for such thought is, a » co-consciousness » or » concomitant consciousness,» but the conventional term has become so widely accepted that the best we can do is to limit its meaning.
Prince, M. (1906). The dissociation of a personality: A biographical study in abnormal psychology. Longmans, Green and Co. https://doi.org/10.1037/10006-000
The development of internal cooperation and co-consciousness between identities is an essential part of Phase 1 that continues into Phase 2. This goal is facilitated by a consistent approach of helping DID patients to respect the adaptive role and validity of all identities, to find ways to take into account the wishes and needs of all identities in making decisions and pursuing life activities, and to enhance internal support between identities.
Early in the treatment, therapists and patients must establish safe and controlled ways of working with the alternate identities that will eventually lead to co-consciousness, co-acceptance, and greater integration.
Una dificultad común al principio es la aparición de amenazas internas cuando trata de comunicar con partes suyas. Habitualmente proceden de una parte muy dominante y crítica. Dichas partes, como se expuso en capítulos anteriores, solo están intentando protegerle reaccionando con los patrones rígidos y limitados de respuesta que conocen. Estas partes necesitan ayuda para aprender formas más eficientes y empáticas de proteger y tratar con el miedo, la cólera y la vergüenza. Lo más fácil es empezar, si es posible a dialogar con una parte con la que se sienta más cómodo.
Boon, Suzette/Steele, Kathy/Van der Hart, Onno. Vivir con disociación traumática. Dessclée De Brouwer.
Awareness of the presence of other personalities has been widely reported in the empirical literature on DID [16–20,24,25,27,32,35]. Such awareness is a common occurrence in DID. Moreover, many patients who have DID hear or see what some personalities say or do when they are ‘‘out.’’ Many clinicians have incorrectly assumed that a person who has DID can never be aware of the activities of another personality
Dell, P. F. (2006). A new model of dissociative identity disorder. Psychiatric Clinics of North America, 29(1), 1-26. doi:10.1016/j.psc.2005.10.013
Dada la alta carga traumática del evento y que no hubo nadie que se diese cuenta o a quien pudiese contarlo, el evento traumático nunca fue asimilado ni integrado. La parte que se quedó sintiendo la experiencia – con toda su carga de dolor y angustia – y la parte que se desconectó nunca volvieron a reunirse, a experimentar a la vez ninguna experiencia, a tener lo que denominamos coconsciencia.
Anabel González;Dolores Mosquera. Trastorno de identidad disociativo o personalidad múltiple (p. 100)
The alters may be few or many, of various ages, including older than the body, same- or cross-gendered, hetero- or homosexual, alive or dead, with either or both coconsciousness and copresence to varying degrees, which may not be commutative (i.e., may be one-way), communicating not at all, or through hallucinations, or through direct thought transfer, manifesting different physiological signs in the body when out, clustered in various arrays of dyads, subgrouping, layers, purposes, and so on. Subhuman, animal, or imaginary alters are not uncommon, with likely links to children’s fantasy. When out, a given host or alter may appear globally to be mentally and behaviorally whole and normal or an exaggerated caricature or a single-function agent, and so on, but not necessarily congruent with the age and gender of the body.
Paul F. Dell. Dissociation and the Dissociative Disorders (p. 301). Taylor and Francis. Edición de Kindle.
As I met and built a trusting relationship with each alter and validated each one’s story, the boundaries between ego states became less rigid and psychic energy became more fluid. My client became aware of the other parts of herself(see Figures 2 and 3).
Hudson, S. (2000). Working with Dissociative Identity Disorder Using Transactional Analysis. Transactional Analysis Journal, 30(1), 91–93. doi:10.1177/036215370003000110
In Table 3 we can observe that the Puerto Rican alters are very similar to the ones reported by Coons et a!. (1988); Putnam, et a!. (1986); and Ross, et a!. (1989). Most of them have idiosyncratic tones of voices (80%), different handwriting styles (53%), report co-conscious states (80%), and, at times, are amnestic of others (73%).
Martinez-Taboas A. Multiple personality in Puerto Rico: analysis of fifteen cases. Dissociation 1991;4(4):189–92.
The choice of stance and selection of techniques often will be made in connection with a study of the patient’s ego strength, track record, character style, and an appreciation of what tasks often accomplished by techniques can be accomplished deliberately by the alter system. For example, a very strong DID patient with good accessibility to alters upon request and good capacities for coconsciousness might be treated from a strategic integrationalist stance in a psychodynamic psychotherapy with only a few modifications.
Kluft RP. An overview of the psychotherapy of dissociative identity disorder. Am J Psychother. 1999 Summer;53(3):289-319. doi: 10.1176/appi.psychotherapy.19126.96.36.1999. PMID: 10586296.
The development of internal cooperation and co-consciousness between personalities is an essential part of early phase treatment that then continues into the middle phase. The therapist must emphasize the adaptive role and validity of all personalities and encourage the host to find adaptive ways to accommodate the wishes and needs of all personalities.
Chu, J. A. (2011). Rebuilding shattered lives: Treating complex PTSD and dissociative disorders (2nd ed.). John Wiley & Sons, Inc.. https://doi.org/10.1002/9781118093146
How coconscious patients are also varies—that is, the extent to which they have knowledge of and are privy to the thoughts, history, and affairs of the other parts varies. Often, the part of the self that is in executive control is unaware of the thoughts and activities of other parts (often called one-way amnesia). However, this is a tricky topic to try to make clear. For example, coconsciousness may be minimal before beginning psychotherapy for DID but tends to increase considerably in the course of appropriate psychotherapeutic work. Although parts other than the part who is most often in executive control (often called the “host”) are more likely to know of each other and of the host, this is not always the case and is not always the same for different parts of the same patient. Some parts may be unknown by many of the others. The dissociative structure of each patient is different.
Howell, E. F. (2011). Understanding and treating dissociative identity disorder: A relational approach. Routledge/Taylor & Francis Group.
“Wait a minute,” Rikki interrupted. “What exactly are you talking about here, Arly? You mean like Sybil?”
Arly nodded. “In a way, yes,” she said, “although in Sybil’s case her personalities were so separate she would black out completely whenever they came out. I don’t think Cam experiences that. His alters take over to greater or lesser degrees at different times. He’s aware of them when they’re out, and they seem to be aware of each other. That’s called coconsciousness.”
West, C. (1999). First person plural: My life as a multiple. New York: Hyperion.
Dr. George put his fingertips together. “Because other therapists have tried that in conditions like yours, Billy. And it doesn’t seem to work. The best hope you have of improving is to bring all these aspects of yourself together, first by communicating with each other, then by remembering everything each of them is doing, getting rid of the amnesia. We call that co-consciousness. Finally, you work at bringing the different people together. That’s fusion.”
Keyes, D. (1981). The Minds of Billy Milligan. New York: Bantam Books
I have recently begun talking to my therapist about how the split that exists in my system between host and alters, which was so vital for a time in my life, is not very conducive to moving towards co-consciousness or integrative functioning, as it requires artificially pushing them away when we have to function in the outside world. This is exhausting and can result in a pressure-cooker environment from which they erupt, and is not very representative of how we live. It also denies them the things that they can do and skills they can develop. Not that they should be obviously out if it is not appropriate, but that is different to committing to a postgraduate study that would ask them to go away for large periods of time.
Bowlby, X. and Briggs, D., 2014. Living with the Reality of Dissociative Identity Disorder : Campainging Voices. [ebook] London: Routledge.
Three personalities sat down in our single body in the crowded, noisy bar. Suddenly, and for the first time, Kendra, Isis, and I were co-conscious. All there, at the same time, but still separate. Kendra sipped her beer and squinted at Lynn through the smoke. “OK,” she said, “Renee, Isis, and I are ready to talk about it.”
“Talk about what?” Lynn asked. She seemed confused.
“All three of us are able to listen and talk to one another and to you,” Kendra explained with a trace of impatience. “Treat it like a conference call. Let’s talk about whether or not we should fuse.”
“Kendra, is that you?” Lynn asked.
“Yes, it’s me,” Kendra said, grinning wickedly at Lynn’s surprise. “Remember, you’re the one who started this conversation.”
“It’s me too,” Isis said in her breathy, delicate voice.
“And, by the way,” I added, “it’s me, Renee, too.”
Lynn shook her head in wonder and looked around at the strangers sitting at her elbow. She gulped her beer and plunged into the conversation. “OK, I guess nobody around us will be able to make sense of the discussion anyway.”
Casey, J.F. with Lynne Fletcher (1991) The Flock: The Autobiography of a Multiple Personality. New York: Knopf.
One sign of new professionalism is terminology. We have a prodigious flight of mixed metaphors. To quote from a single recent paper on adolescent multiples (average number of personalities, 24.7): ’detoxifying the environment’, ’fusion’, ’titrating abreactions’, ’metabolizing the trauma’, ’contracting’ (Dell and Eisenhower, 1990). Readers can guess what ’fusion’ means – the ’alters’ are made ’coconscious’ and then fused, i.e. brought together to form one whole person.
Hacking, I. (1992). Multiple personality disorder and its hosts. History of the Human Sciences, 5(2), 3–31. doi:10.1177/095269519200500202
La forma de TID que tengo se caracteriza por lo que se conoce como co-conciencia. Esto quiere decir que hay un “yo” central al que siempre se regresa de esos estados de aislamiento…() Después de haber ganado la fuerza suficiente para saber de estas habitaciones y poder tener acceso al contenido de las mismas, desarrollé una co-conciencia, o una conciencia compartida de todas mis partes para así poder comunicarme.
Trujillo, O. (2019). La suma de mis partes: Testimonio de una Sobreviviente de Trastorno de Identidad Disociativa. Tortuga Publishing
El TID comprende una gama de trastornos que incluyen la disociación y la creación interna de partes para protegerte de un trauma severo. En tu caso, fuiste capaz de mantener un ‘yo’ central que siempre está presente en algún nivel. Este yo central puede estar consciente de tus otras partes. Tus partes también pueden conocerse e interactuar entre sí. Esto se llama co-consciencia”.
Trujillo, O. (2019). La suma de mis partes: Testimonio de una Sobreviviente de Trastorno de Identidad Disociativa. Tortuga Publishing
Good DID therapy involves promoting co-consciousness. With co-consciousness, it is possible to begin teaching the patient’s system the value of cooperation among the alters. Enjoin them to emulate the spirit of a champion football team, with each member utilizing their full potential and working together to achieve a common goal.
Yueng, D. (2020) Engaging multiple personalities volume 4 the collected blog posts.
The patient reported states of coconsciousness with one alter identified as “The Persecutor,” and another as “The Witness,” who was visualized by the patient as “starting off as a body and ending as a fluid substance or brown cloud”…() The patient also experienced the presence of childlike alters of preschool age.
M. Steinberg, Handbook for the Assessment of Dissociation: A Clinical Guide. Washington, DC: American Psychiatric Press, 1995.
An essential component of co-consciousness requires knowing who is present (out). This point may seem obvious, but it is crucial.
Parts inside need to be aware of and know who is ‘out’ at all times; they also need to know and be able to identify who they are as well. If asked (by your therapist, or by someone in your DID group—in other words, by someone who has a legitimate need or reason to know), the part who is out needs to know, and be willing to answer the question “Who’s here?” or “Who am I talking with?”
A.T.W. (2004). Got Parts? An Insider’s Guide to Managing Life Successfully with Dissociative Identity Disorder (New Horizons in Therapy)
Many alters are unaware that others exist within the same individual. This is especially true of the host, who at the beginning of treatment commonly denies being a multiple. On the other hand, some alters may know about other alters and actually be acquainted with them, talk with them, or jointly engage in some activity.
This is called co-consciousness. The alters argue with each other, snarl, or console. One alter may be out and yet have another alter yammering away beside the left ear, telling her what a ninny she is. Many therapists try to introduce different alters to each other, believing that thoroughgoing co-consciousness is a necessary step toward integration.
Hacking, I. (1995). Rewriting the soul: Multiple personality and the sciences of memory. Princeton University Press.
Entendemos por coconsciencia «un estado de conciencia en el que una parte de la personalidad es capaz de experimentar directamente los pensamientos, sentimientos, percepciones y acciones de otro álter», según Morton Prince (1906)
(citado en Kluft, 1984).
González, A. (2010) Trastornos Disociativos. Ediciones Pléyades.
However, it was further predicted that when two identities capable of mutual awareness (co-consciousness) each focused on a different aspect (i.e. reading or listening) of the divided attention task, performance would be improved compared to the single identity’s dual task performance. These hypotheses were supported and suggest that attentional capacity in DID may be increased if dissociative identities can process different aspects of complex environmental tasks.
Creating co-consciousness, then, is the process of making these barriers more porous to allow more information crossflow. It involves a lowering of the security clearance threshold and allowing greater access, by more parts, to information. The solution that we came up with was both simple and effective.
It also depends on your degree of co-consciousness. If there is a lot of co-consciousness between your front person and the rest of the parts, you might not be able to process memories without the front person coming to know the content. If your front person has developed strength over the years, you might want him or her to know what happened.
Miller, Alison. Becoming Yourself: Overcoming Mind Control and Ritual Abuse. 2014. Karnak.
Until you are able to establish co- conasciousness (an awareness of and ability to communicate with the other alters), you are likely to have problems communicating with the others. There are many ways to improve co- consciousness and to decrease the difficulty communicating with your alters, and these will be presented in chapter 5.
Alderman, Tracy, Ph.D., Marshall, Karen, L.C.S.W. Amongst Ourselves: A Self Help Guide to Living with Dissociative Identity Disorder. 1998. New Harbinger Publications.
One issue might be the degree of communication and co-consciousness between parts thought necessary for one’s definition of functional. While therapeutic work on developing co-consciousness and communication has frequently been promoted by DID therapists, this has only been portrayed as a step along the way towards integration (Kluft, 1993). Rivera’s stance (p. 41 & p. 122) moves towards seeing communication and co-consciousness as a therapeutic end in itself, but still with the goal of developing a functional “I”.
Clayton, Kymbra. (2005). Critiquing the Requirement of Oneness over Multiplicity: An Examination of Dissociative Identity (Disorder) in Five Clinical Texts. E-Journal of Applied Psychology. 1. 10.7790/ejap.v1i2.21.
When EMDR therapy (or other treatments; e.g., hypnotic abreaction) has successfully resolved the traumatic material, the need for the compartmentalization lessens, amnestic barriers between the personality states dissolve, “co-consciousness” increases, and integration can occur.
This paper develops the thesis that co-consciousness is not only a feature of severe dissociative syndromes like multiple personality, or of “altered states” of consciousness like hypnosis, but is a universal feature of healthy living… The overriding therapeutic implication is that dissociation can no longer be viewed only like a pathological “entity” to be gotten “rid of,” but as a basic given which we should learn to use more effectively. The treatment paradigm becomes that of taking dissociative phenomena from the realm of the dysfunctional to that of healthy co-consciousness. so that what was once a symptom becomes a skill.
Being able to control switching and ‘dissociating’ (by which we mean an altered state of consciousness) is a vital component of that, but is not an end in itself. Developing co-consciousness and collaboration between parts is also important, and it’s true that traumatic memories are only properly metabolised and processed when the front brain is online. But grounding is only one small technique in that entire process: grounding is not the point.
• Help parts develop ongoing awareness (co-consciousness) and cooperation regarding functioning in daily life and the postures and actions that support this functioning.
• Help all parts develop self-compassion as expressed to various parts, and find physical actions that demonstrate compassion.
(2) Co-consciousness does not impair the individuality of personalities. The well-known interrelations of secondary personalities could lead to the inquiry how far any of the witnesses was of independent authority, and how far she simply reflected the memories of another.
We find that the «rule of shared responsibility» helps children decrease inappropriate behavior and may help to ultimately increase co-consciousness. We tell the child that «everyone» (child and his or her dissociated parts) is responsible and «everyone» will have to pay the consequences for wrong behavior.
El término coconsciencia se utiliza para describir las experiencias compartidas entre estados del yo y/o partes disociativas y es uno de los aspectos clave en el proceso de integración. Desde la perspectiva de la teoría de los estados del yo, Phillips y Frederick (1995) proponen diferentes etapas en este camino hacia la integración: reconocimiento, desarrollo de comunicación, desarrollo de empatía, actividades de cooperación, sensaciones internas compartidas, coconsciencia y coconsciencia continuada. Está relacionada con el proceso de superación de la fobia hacia las partes disociativas de la personalidad y el conflicto interno. La coconsciencia se explica detalladamente en el capítulo 11.
Disposición para explorar la co-conciencia. De la misma forma que es importante que al terapeuta se le permita acceso al sistema de estados de ego, es igualmente importante que los propios pacientes logren ese acceso. En las primeras etapas de la terapia, este concepto de coconciencia es, en el mejor de los casos, extraño, y en el peor de los casos, imposible de concebir. Por lo general, cuando la co-conciencia comienza se hace bastante evidente. El paciente pudiera decir. «Vi a una mujer extraña preparando la cena en mi cocina anoche.» Esto, naturalmente, conducirá a una discusión sobre quién pudiera ser esa persona. Alcanzar la co-conciencia es un paso de avance enorme en el tratamiento, y el paciente deberá ser felicitado.
Ross (1989) uses the metaphor of a corporate business structure to describe the process of establishing co-consciousness. Bearhs (1982) speaks of symphony orchestra in which the conductor rather than the CEO must insure cooperation and communication within the organization. My multiple patients have referred to their personality systems more often as families.
Rullo, Anthony J. Multiple Personality Disorder. Two Cases in Progress. 1993
In DID, what may at first appear to be elaborate fantasy constructions turn out to be brittle and impermeable personified dissociative states that manifest in an unusually limited repertoire of behavior, affect, and cognition. Some alter personalities demonstrate more diversity, capacities, and elasticity than others—which is fortunate, because the by-products range from the potential for greater coconsciousness with other part-selves to the potential for greater participation In life and also in the therapy process. But other patients’ alters excel only at specific tasks, functions, or attitudes that sustain the dissociative organization of self, as a result of the defensive development of parallel realities with limited, internal space for the reconciliation of reality with fantasy.
The person will often know parts of herself in detail but only be aware of others as «voices» heard coming from far back in the psyche. As the person progresses through the active phases of MPD therapy, these voices are engaged, take executive control, achieve coconsciousness, and are integrated.
Joan N. Berzoff. Dissociative Identity Disorder: Theoretical and Treatment Controversies. 1995
Now a maturely developed young woman (she had started puberty at age 9), Penni was animated and friendly. She remembered the last visit 2 days earlier, and asked whether she could play with a certain toy that she had enjoyed then. In the interview, she talked about developing her coconsciousness (i.e., the sense that several of her alter personalities were simultaneously present). Still, there were many angry inner voices, and at times she could not think «cause of the noise inside.»
Frank W. Putnam. Dissociation in Children and Adolescents: A Developmental Perspective. 1997
Relating specifically to working with DID and people with very defined parts, Dr. Korn sees herself as constantly doing group therapy with the presenting client. She is always working toward increasing someone’s coconsciousness and to bring parts into communication, observing that “People need help with scooping up and then stitching together the components of experience.” Dr. Korn maintains that the therapeutic relationship is everything in terms of creating a safe container for the work between the provider and their client. This relational container is essential for undoing the aloneness, and offering co-regulation that allows people to be courageous enough to approach the material that’s been unapproachable.
If dissociation is unformulated experience, how do we understand dissociative identity disorder, in which large aspects of experience or self-states are dissociated from each other, but appear to be consistent within themselves and to be “formulated experience” from that perspective? My answer is that this apparent formulation is only true from the perspective of an outside observer; these dissociated self-states (“not-me”) are unknown by “me.” They are unformulated by at least some other self-states, quite often including the host. Certain self-states or alters are more coconscious, aware of, and in communication with others; in that case they are relatively more formulated, each to the other, than those that are amnestic of the others’ activities.
In other words, the more dissociated such self-states are, the more unformulated they are to each other. The same argument goes for the concept of splitting.
Elizabeth F. Howell. The Dissociative Mind. 2013
‘This is really significant, Patricia,’ the professor said. ‘You might say you are the gold standard for DID!’ he smiled. ‘You are one hundred per cent not coconscious.’
‘What does that mean?’
‘It means there is absolutely no seepage between personalities. The majority of dominant personalities in people with DID have some level of awareness of the other alters. Some hear voices, some can see what’s going on when they’re not in control. Some can even talk to all the different personalities in their head.’
‘I can’t do that.’
‘No,’ he agreed. ‘It’s remarkable, isn’t it? I’ve never met anyone like you.’
At other times I can’t or I don’t pull back from the brink, and I disappear inside. If I’m aware of it, it’s like falling into sleep or an anaesthetic. Sometimes, when I’m inside, deep, deep down inside myself, I can see what’s happening still on the surface. But I’m watching it from afar, and it’s not me I’m watching. This is co-consciousness, the strangest feeling in the world. I can see myself talking and interacting and doing and feeling, and yet it’s not myself, it’s just someone else, someone I don’t know, someone I have no connection with. And what they do and what they say surprises me.
Spring, Carolyn. Recovery is my best revenge: My experience of trauma, abuse and dissociative identity disorder (p. 70). Carolyn Spring Publishing. Edición de Kindle.
Facilitation of Coconsciousness
Hypnosis can be used to facilitate coconsciousness, which most authorities believe to be a necessary precondition for successful fusion/integration, as well as being extremely important in promoting day-to-day cooperation within an unintegrated multiple personality system.
Putnam, Frank. W. Diagnosis and treatment of multiple personality disorder. 1989
For this intervention to be safe, organized, and therapeutic, however, it is generally accepted that the client must sufficiently exhibit “coconsciousness”; that is, be capable of “listening” to what each part of herself is expressing in each of the two chairs. The intervention is less safely conducted if there is little co-consciousness such that, for example, when the client occupies the voice’s chair, she fully assumes that role as her “singular self,” thereby becoming so fully absorbed in the exercise that she loses concomitant awareness of the perspective that occupied the previous
Paul Frewen, Ruth Lanius, Bessel van der Kolk M.D., David Spiegel. Healing the Traumatized Self: Consciousness, Neuroscience, Treatment. 2011
Yet this total unawareness is by no means the only, and perhaps not the commonest, feature of multiples’ interself epistemology. We must look also at the notion or notions of «coconsciousness.»
The term ‘coconsciousness‘ has been the bearer of several different meanings since its introduction by Morton Prince in his early case descriptions of multiple personalities (Prince 1906, Beahrs 1983). Because of the ambiguity the term carries, we might begin by rehearsing Stephen Braude’s (1991) understanding and definition of ‘coconsciousness‘ and associated terminology.
On Braude’s taxonomy, self A is said to be coconscious with self B when one of two states obtains between the two selves. A may be «cosensory» with B or «intraconscious» with B. A is cosensory with B when both A and B seem to be simultaneously aware of external events, such as sights and sounds. A is intraconscious with B when A claims knowledge of B’s mental states, such as feelings, beliefs, and memories.
Radden, Jennifer. Divided minds and successive selves. Ethical issues in disorders of identity and personality. 1996
In one-way amnesic relationships, the most common relationship pattern, some subpersonalities are aware of others, but the awareness is not mutual. Those who are aware, called coconscious subpersonalities, are «quiet observers» who watch the actions and thoughts of the other subpersonalities but do not interact with them. Sometimes while another subpersonality is present, the coconscious personality makes itself known through indirect means, such as auditory hallucinations (perhaps a voice giving commands) or «automatic writing» (the current personality may find itself writing down words over which it has no control).
Comer, Ronald J. Fundamentals of abnormal psychology. 2016
For example, one woman in her twenties reported sexual abuse by a baby-sitter between ages eleven and thirteen that did not involve intercourse. She had one alter personality with whom she was almost fully coconscious, and she accepted the fact that the alter personality was a part of her without difficulty. Complex inpatient cases, in comparison, often resist accepting the fact that their alter personalities are part of themselves.
In recent years, research such as that by Nissen, Ross, Willingham, MacKenzie, and Schacter (1988) has shown that even in patients who suffer from full-blown DID, the dissociations between implicit and explicit memory stores of normal and dissociative states, and among the stores of different dissociative states, are not absolute; some degree of coconsciousness among different ego states is common.
Van der Kolk, Bessel A., McFarlane Alexander C., Weisaeth, Lars. Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society. 1996
THE CRUCIAL IMPORTANCE OF DUAL ATTENTION
To achieve these results, EMDR requires dual attention, or coconsciousness, between the personality part that is well-oriented to the safe present and the parts that hold the memory containing the posttraumatic disturbance. (Actually, this need for dual attention is necessary not only for therapy within the EMDR model but also within other models of treatment for trauma and dissociation.) Dual attention means that the person sitting in the therapist’s office is able to maintain a sense of orientation to the present, orientation to needed positive qualities of self, and awareness of the therapist’s liking, respect, and competence.
Knipe, Jim. EMDR Toolbox: Theory and Treatment of Complex PTSD and Dissociation. 2015
Metaphors of team members playing a favorite sport or different ingredients mixed together for a favorite dessert (symbolizing parts of the self blending together) are an effective and fun means to help dissociative children understand coconsciousness, erode amnesic barriers, and promote integration. This metaphor can be used throughout treatment to reinforce unity and eventually integration—one unified child playing hockey. This final symbolic picture could be drawn at the time of integration (Waters and Silberg, 1998b).
Las metáforas de los miembros del equipo que juegan un deporte favorito o diferentes ingredientes mezclados para un postre favorito (que simbolizan partes del yo que se mezclan) son un medio efectivo y divertido para ayudar a los niños disociativos a comprender la coconciencia, erosionar las barreras amnésicas y promover la integración. Esta metáfora se puede usar a lo largo del tratamiento para reforzar la unidad y eventualmente la integración: un niño unificado que juega al hockey. Este cuadro simbólico final podría dibujarse en el momento de la integración (Waters y Silberg, 1998b).
Wieland, Sandra, PhD. Dissociation in Traumatized Children and Adolescents. 2010
Do not talk too much about integration or fusion between parts, especially at the start. In many cases, parts are afraid that if this happens they will die. It works better to talk about walls between “inside people” no longer being needed than about the “people” disappearing or merging. Respect their choice not to fuse until and unless they are ready. My experience is that as parts share experiences and memories, the walls between them dissolve, either gradually (when they are coconscious much of the time) or suddenly (during a major piece of memory work), and the integration naturally happens when they are ready. Not all survivors will be capable of integration, and it can be dangerous to insist on it. It takes inordinate strength to tolerate awareness of all of a life of horrendous abuse.
No hable demasiado de integración o fusión entre partes, especialmente al principio. En muchos casos, las partes tienen miedo de que si esto sucede morirán. Funciona mejor hablar de muros entre «personas internas» que ya no son necesarios que de «personas» que desaparecen o se fusionan. Respete su elección de no fusionarse hasta que estén listos. Mi experiencia es que a medida que las partes comparten experiencias y recuerdos, los muros entre ellos se disuelven, ya sea gradualmente (cuando son coconscientes la mayor parte del tiempo) o repentinamente (durante un trabajo de memoria importante), y la integración ocurre naturalmente cuando están listos. . No todos los sobrevivientes serán capaces de integrarse y puede ser peligroso insistir en ello. Se necesita una fuerza desmesurada para tolerar la conciencia de toda una vida de horrendo abuso.
Hoffman, Wendy. Miller, Alison. From the Trenches: A Victim and Therapist Talk about Mind Control and Ritual Abuse. 2017
The first psychophysiological study of DID was done by the eminent neurologist-psychologist Morton Prince and a psychiatrist colleague (Prince & Peterson, 1908). The objective was not to study DID per se, but to determine if the psychogalvanic reaction (SCR) could be useful to corroborate the existence of coconscious (sometimes called subconscious) ideas. The DID patient was «made use of» as particularly suitable for this purpose. The patient had a «normal» identity and two alters, one of which claimed amnesia for both other identities. The identities could all be hypnotized, and only one of these hypnotic states was coconscious with the other hypnotic states as well as the unhypnotized identities. A number of studies were performed on this patient using electrodermal reactions to words that on the basis of bad dreams or past experiences had conscious emotional significance to some identities (and/or hypnotic states) and not to others.
El primer estudio psicofisiológico del TID fue realizado por el eminente neurólogo y psicólogo Morton Prince y un colega psiquiatra (Prince & Peterson, 1908). El objetivo no era estudiar el TID per se, sino determinar si la reacción psicogalvánica (SCR) podría ser útil para corroborar la existencia de ideas coconscientes (a veces denominadas subconscientes). El paciente TID fue «utilizado» como particularmente adecuado para este propósito. El paciente tenía una identidad «normal» y dos alters, uno de los cuales reclamaba amnesia para las otras dos identidades. Todas las identidades podían ser hipnotizadas, y solo uno de estos estados hipnóticos era coconsciente con los otros estados hipnóticos, así como con las identidades no hipnotizadas. Se realizaron varios estudios en este paciente utilizando reacciones electrodérmicas a palabras que, sobre la base de malos sueños o experiencias pasadas, tenían un significado emocional consciente para algunas identidades (y/o estados hipnóticos) y no para otras.
Larry K. Michelson. William J. Ray. Handbook of Dissociation: Theoretical, Empirical, and Clinical Perspectives. 1996
COCONSCIOUSNESS AND COPRESENCE
Coconsciousness is a term that has been used in the dissociation field since the 19th century, when dyspyschism was a major model of the mind (Ellenberger, 1970; R. P. Kluft, personal communication, April 1, 2013). The term refers to the degree to which parts are aware of each other internally. If the amnesia barriers are quite impermeable, there is little coconsciousness. If the amnesia barriers are thin and permeable, the parts may be said to be highly coconscious. A patient’s parts may vary in how much coconsciousness they have with some parts versus other parts (Kluft, 1984a).
In contrast, copresence, a term introduced by Kluft (1984b) to address important nuances not captured by the term coconsciousness, refers to the degree to which a patient’s parts can be forward in the body, executive, and aware of their presence in, for example, the therapist’s office at the same time. A part is said to be present when that part experiences itself seated in the chair in the therapy office, is observed by the therapist to be present at least in executive control of part of the body, and is using the first-person pronoun, “I.” Sometimes it happens that the therapist observes that one part seems to have control of the mouth, or mouth and head, but not the rest of the body.
COCONCIENCIA Y COPRESENCIA
Coconciencia es un término que se ha utilizado en el campo de la disociación desde el siglo XIX, cuando el dispsiquismo era un modelo importante de la mente (Ellenberger, 1970; R. P. Kluft, comunicación personal, 1 de abril de 2013). El término se refiere al grado en que las partes se conocen internamente. Si las barreras de amnesia son bastante impermeables, hay poca coconsciencia. Si las barreras de amnesia son delgadas y permeables, se puede decir que las partes son altamente coconscientes. Las partes de un paciente pueden variar en la cantidad de coconsciencia que tienen con algunas partes versus otras partes (Kluft, 1984a).
Por el contrario, la copresencia, un término introducido por Kluft (1984b) para abordar matices importantes no captados por el término coconciencia, se refiere al grado en que las partes de un paciente pueden estar adelantadas en el cuerpo, ejecutivas y conscientes de su presencia en, por ejemplo. ejemplo, la oficina del terapeuta al mismo tiempo. Se dice que una parte está presente cuando esa parte se siente sentada en la silla en la oficina de terapia, el terapeuta observa que está presente al menos en el control ejecutivo de una parte del cuerpo y está usando el pronombre en primera persona, “ I.» A veces sucede que el terapeuta observa que una parte parece tener el control de la boca, o boca y cabeza, pero no el resto del cuerpo.
Ulrich F. Lanius PhD, Sandra L. Paulsen PhD, Frank M. Corrigan MD. Neurobiology and Treatment of Traumatic Dissociation: Towards an Embodied Self. 2014
A dissociative child who is amnesic to his behavior may not be able to admit to his behavior unless he has coconsciousness and awareness of his alter’s offending behavior. My experience with dissociative children indicates that while behavioral interventions need to be in place, they have minimal impact on the child’s ability to control himself and learn from the consequences.
Un niño disociado que es amnésico a su comportamiento puede no ser capaz de admitir su comportamiento a menos que tenga coconsciencia y conocimiento del comportamiento ofensivo de su alter. Mi experiencia con niños disociativos indica que, si bien es necesario implementar intervenciones conductuales, éstas tienen un impacto mínimo en la capacidad del niño para controlarse a sí mismo y aprender de las consecuencias.
Joyanna L. Silberg. The Dissociative Child: Diagnosis, Treatment, and Management. 1998
Rather the coconscious personality reports the experiences of the other as something of which he becomes aware as experiences foreign to himself; he knows what the other thinks and feels, but he has also his own thoughts and feelings about the same object or topic.
In just such a way was Eve Black coconscious with Eve White and Jane with both Eves. eve White enjoyed no coconsciousness with either of the other two. Eve Black, it will be recalled, never gained access to Jane’s consciousness.
Thigpen, C. H., & Cleckley, H. M. (1957). The three faces of Eve. McGraw-Hill.
The appearance of these alter personalities may be on a «coconscious» basis (ie, simultaneously coexistent with the primary personality and aware of its thoughts and feelings) or separate consciousness basis (ie, alternating presence of the primary and alter personalities with little or no awareness or concern for the feelings and thoughts of each other), or both.
Ludwig AM, Brandsma JM, Wilbur CB, Bendfeldt F, Jameson DH. The objective study of a multiple personality. Or, are four heads better than one? Arch Gen Psychiatry. 1972 Apr;26(4):298-310. doi: 10.1001/archpsyc.1972.01750220008002. PMID: 5013514.
In this passage, the child alter personality, Elizabeth, who holds paternal-incest memories, is asking to come into therapy and disclose the trauma, and the adult host personality is coconscious and agreeing to the request. If this is correct, then the proper response would be to work actively with Elizabeth in therapy. How do the biographer and Dr Orne justify suppressing Elizabeth as a regressive role-play?
On page 57, the biographer devotes several paragraphs to doubting the reality of the sexual abuse, pointing out that Anne was reading about incest at the time she was making the disclosures, and adducing the family’s denial as evidence in favour of the memories not being real. What about Dr Orne?
Ross, Colin. The Osiris Complex: Case Studies in Multiple Personality Disorder. 1994
Develop Coping Skills for All Available Parts
Besides information on developing skills taught in Chapter 4, people with DID benefit from being encouraged/taught to use their parts to manage life. For example, the part/s who manage work may come home tired. They can rest in their safe spaces while other parts take over to make dinner. Or, if a part is triggered, another part can take over to help. Clients can also be encouraged to have more than one part out at once/be coconscious, which for example, simplifies discussing plans. Parts working together inside, leads to more integrated functioning.
Joanne Twombly. Trauma and Dissociation Informed Internal Family Systems: How to Successfully Treat C-PTSD, and Dissociative Disorders. 2023
What is the structural status of an alter personality late pre-integration? Prior to fi nal fusion, the EP and host ANP are fully co-conscious, there are no intrusions or withdrawals, and everything has been processed and healed. All that remains is the integration ritual. At this stage the EP still has a subjective sense of self but there is no pathological dissociation going on.
After the fusion, the ANP mourns the loss of the EP and says, “She’s still with me in my heart.”
Ross M.D., Colin A.. Structural Dissociation: A Proposed Modification of the Theory. Manitou Communications, Inc.. Edición de Kindle.
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