Co-consciencia. Referencias

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. Es el elemento clave del 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 pone a 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 tuvo un blackout (laguna mental, apagón, tiempo perdido) en lugar de ir a dormir.
B estaba co-consciente.

Hay una simplificación del TID en la explicación básica que tiende a concluir que una parte no es consciente de la otra. Y aunque es verdad que debe existir esta falta de consciencia respecto a partes internas para calificar como TID (por el factor amnesia), es poco acertado y hasta perjudicial para entender la evolución y la naturaleza cambiante de un mismo sistema de partes.

La co-consciencia es un término acuñado por Morton Prince en 1906 cuando encontró que “subconsciente” era un término que no se ajustaba perfectamente al fenómeno de dos consciencias concomitantes, refiriéndose a una de las partes de Christine Beauchamp, su paciente con TID.

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.

Referencias:

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]

APA Dictionary of Psychology

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.

Journal of Trauma & Dissociation. International Society for the Study of Trauma and Dissociation. Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. 2011

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.

Journal of Trauma & Dissociation. International Society for the Study of Trauma and Dissociation. Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. 2011

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 (Biblioteca de Psicología) (Spanish Edition) . 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

Pese al muro, la aproximación a los contenidos traumáticos pone a prueba el sistema, y activa la fobia entre las partes, que mantiene la separación disociativa.

Anabel González;Dolores Mosquera. Trastorno de identidad disociativo o personalidad múltiple (Psicología) (Spanish Edition) (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.1999.53.3.289. 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 PersonalityNew YorkKnopf.

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[3]. 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.

Moskowitz, I. Schäfer & M.J. Dorahy, (Eds.), (2008) Psychosis, trauma, and dissociation: emerging perspectives on severe psychopathology

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.

Haynes, Jeni; Blair-West, George. The Girl in the Green Dress (pp. 347-348). Hachette Australia. Edición de Kindle.

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- consciousness (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.

Shapiro, Francine. Ph.D. Eye Movement Desensitization and Reprocessing (EMDR) Therapy, Third Edition Basic Principles, Protocols, and Procedures. 2018. The Guilford Press.

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.
Prince, W. F. (1916). The Doris case of quintuple personality. The Journal of Abnormal Psychology, 11(2), 73–122. https://doi.org/10.1037/h0072650
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

 

(actualizando poco a poco)

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