De dónde viene el término «Sistema» en el TID. Referencias

Hay justo ahora en Twitter un hashtag que dice #NoSoyUnSistema. Entre varias cosas mencionadas, hay un grupo de gente que parece molesta por varias cosas que se han creado en el movimiento de visibilidad del TID, particularmente Youtube.

Uno de los argumentos es que la palabra «Sistema» fue creado por un grupo en Tumblr, «romantiza el trastorno», y que las personas con TID «no funcionan como sistemas ni de forma organizada», y alegan que «se está desinformando».

La comunidad de TID en Youtube no pretende romantizar el trastorno, sino alejarlo de los mitos del cine.

El esfuerzo para la visibilidad del TID no es un «juego de rol». Quienes participamos activamente en la comunidad estamos en tratamiento, nos educamos, nos respetamos y nos apoyamos.

Vamos a revisar el uso del término «sistema».

Nos dimos a la tarea educativa de encontrar en nuestro material (que por supuesto hemos leído) referencias del uso de la palabra sistema en referencia al conjunto de identidades/alters/estados/personalidades/partes disociadas:. Esto encontramos:

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Recognizing that (1) alters vary in their complexity and elaboration, and (2) different persons’ systems or complexes of alters have different styles of operation.
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Traducción:
Reconociendo que (1) los alters varían en su complejidad y elaboración, y (2) los sistemas o complejos de alters de diferentes personas tienen diferentes estilos de operación,

Paul F. Dell. Dissociation and the Dissociative Disorders (p. 385). Taylor and Francis. Kindle Edition.

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Yet DID patients often will acknowledge that their personality systems are actively switching and/ or far more active than it would appear on the surface (Loewenstein et al., 1987).

Paul F. Dell. Dissociation and the Dissociative Disorders (p. 600). Taylor and Francis. Kindle Edition.

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I am allowing myself to hope that Mariska’s personality system and, therefore, she, will be more readily accessible than in most DID patients.

Paul F. Dell. Dissociation and the Dissociative Disorders (p. 609). Taylor and Francis. Kindle Edition.

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• Dissociation is a creative way of keeping the unacceptable out of sight. • It is a way for the DID internal system to protect secrets and continually learn to adapt to the environment.

Haddock, Deborah Bray. The Dissociative Identity Disorder Sourcebook (Sourcebooks) . McGraw-Hill Education. Kindle Edition. 2001

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Also, the dissociative personality system is usually set up to avoid detection.

Haddock, Deborah Bray. The Dissociative Identity Disorder Sourcebook (Sourcebooks) . McGraw-Hill Education. Kindle Edition. (p. 56) 2001

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Alters who are in place to protect the system are going to be very careful about not letting the therapist get too close initially.

Haddock, Deborah Bray. The Dissociative Identity Disorder Sourcebook (Sourcebooks) . McGraw-Hill Education. Kindle Edition. (p. 83) 2001

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Keep the whole system in mind. When we explore the internal system of parts, we must think of the whole picture and try to include all parts and voices.

Mosquera, Dolores. Working with Voices and Dissociative Parts. A trauma-informed approach

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Al pasar el tiempo, ir acumulando más experiencias negativativas y sentirse rechazadas por el resto del sistema, acaban funcionando como persecutorias. El paciente describe sintomáticamente esto como fenómenos de influencia (siente que una parte de él o algo ajeno a él le impone pensamientos, sentimientos o acciones), alucinaciones o pensamientos obsesivos.

Anabel González;Dolores Mosquera. Trastorno de identidad disociativo o personalidad múltiple (Psicología) (Spanish Edition) (p. 89)

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Si esta introyección corresponde a un abusador, acabará constituyendo una parte persecutoria en el sistema. A veces el paciente llega a estar realmente convencido de que esa parte de su mente es realmente el abusador.

Anabel González;Dolores Mosquera. Trastorno de identidad disociativo o personalidad múltiple (Psicología) (Spanish Edition) (p. 89)

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Se refuerza aquí la función protectora de esta parte que la asusta, tratando de ayudar a la paciente a entender mejor la estructura de su sistema interno.

Anabel González;Dolores Mosquera. Trastorno de identidad disociativo o personalidad múltiple (Psicología) (Spanish Edition) (p. 100)

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System. The structure of relationships within the internal world of an individual who has MPD… It is often helpful for a person with MPD to make a map or diragram of his/her internal personality system

M. Cohen, Barry. Giller, Esther. W. Lynn et al. Multiple Personality Disorder from the Inside Out. (1993) (p. 228)

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…have them help heal the distressed parts, and bring choice and conscious control to the whole of each client’s system.

Shapiro, Robin. Easy Ego State Interventions. Strategies for working with parts. (p. 29) (2016)

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Just as each individual responds to trauma differently, we would expect each client’s structurally dissociated personality system to be unique.

Fisher, Janina. Healing the Fragmented Selves of Trauma Survivors. Overcoming Internal Self-Alienation. (p. 26)

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The «decoding» of parts activity outside the normal life self’s consciousness is an extremely important focus of DID treatment that should never be conducted judgmentally, without empathy for the parts in question. And it helps the client become familiar with his or her own system –

Fisher, Janina. Healing the Fragmented Selves of Trauma Survivors. Overcoming Internal Self-Alienation.

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Mi extraordinario sistema de partes me había ayudado a desarrollarme como persona, a tener amistadoes y a destacarme en la escuela y en los deportes.

Trujillo, Olga R. La Suma de mis partes. Testimonio de una sobreviviente de trastorno de identidad disociativa. (p. 221)

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Parts that are «out» may be entirely unaware of the other parts of the system.

Van Der Kolk, Bessel. The Body Keeps the Score. Brain, Mind, and Body in the Healing of Trauma. (p.284) (2014)

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The first step in this collaboration is to assure the internal system that all parts are welcome and that all of them – even those who are suicidal or destructive – were formed in an attempt the self-system, no matter how much they now seem to threaten it.

Van Der Kolk, Bessel. The Body Keeps the Score. Brain, Mind, and Body in the Healing of Trauma. (p.284-285) (2014)

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Una vez que se han identificado las partes disociativas es recomendable que el terapeuta realice lo que se conoce como mapeo del sistema (Putnam, 1989)

Baita, Sandra. Rompecabezas. Una guía introductoria al trauma y la disociación en la infancia. (p.222) (2015)

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Perhaps because we were speaking about a single topic, searching for a coherent conclusion, our deliberations seemed more organized. That was remarkably new in an MPD system that had always been as fragmented and fractious in its conversations as in its personalities.

Oxnam, Robert. B. A Fractured Mind. My life with multiple personality Disorder. (2006)

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Como ya hemos indicado anteriormente, la personalidad de todo el mundo es un sistema dinámico complejo que, como todos los sistemas, conlleva continuas acciones y reacciones, en las que partes de dicho sistema interactúan para mejor o para peor.

Boon, Suzette/Steele, Kathy/Van der Hart, Onno. Vivir con disociación traumática (Biblioteca de Psicología) (Spanish Edition) . Dessclée De Brouwer. (p. 56)

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SYSTEM pictures depict an array of individual elements forming and working as a unit that represents the current internal organization of parts-selves.

Cohen, Barry M. Thayer Cox, Carol. Telling Without Talking. Art as a window into the world of multiple personality. (p. 17) (1995)

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The therapist working with MPD must always work within the system of alter personalities to effect change. «System» refers to the interrelation among alter personalities and other parts who inhabit the inner world of the MPD client and who usually function on her behalf. Just as any organization, members may work well together at certain points in time, and not at others.

Cohen, Barry M. Thayer Cox, Carol. Telling Without Talking. Art as a window into the world of multiple personality. (p. 21) (1995)

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Systems can have any number of alter personalities, from two to a great many. Generally, it is believed that the earlier the trauma occurs, the more extreme the trauma is, and the longer time during which it occurs directly bear upon the number of resulting parts. The kind and amount of support one receives at the time of the trauma, as well as afterward, can also make a difference.

A.T.W.. Got Parts? An Insider’s Guide to Managing Life Successfully with Dissociative Identity Disorder (New Horizons in Therapy Book 1) . Modern History Press. (2005)

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The System Map is like an internal family tree, though it can be drawn out in whatever format, in whatever way is easy for the System to understand. It will contain and illustrate information such as who split off from whom and how you all relate to each other. As you become more aware of your System over time, your System Map may grow as you encounter newly discovered parts.

A.T.W.. Got Parts? An Insider’s Guide to Managing Life Successfully with Dissociative Identity Disorder (New Horizons in Therapy Book 1) . Modern History Press. (2005)

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Although they may be harder to understand, these latter ego states are often the protectors of the system, because protecting the system, which seems ludicrous to an outsider, gives consistency to their inner world.

Hunter, Marlene E. Understanding Dissociative Disorders: A Guide for Family Physicians and Healthcare Workers. (2009) (p. 14)

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The goal is not to achieve a fusion – any results will be transient. Instead, it changes the characteristics of the alter system for a brief period of time, during which the patient may become more accessible to other interventions.

Kluft, Richard P, M.D., Fine, Catherine G., Ph.D. Clinical Perspectives on Multiple Personality Disorder. (p. 116) (1993)

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A Fifth pathway might be termed a «brokered departure». In such cases, an alter’s ceasing to be separate is virtually negotiated within the alter system. Such alters may report or be reported to have joined with one or several alters in a planful way.

Kluft, Richard P, M.D., Fine, Catherine G., Ph.D. Clinical Perspectives on Multiple Personality Disorder. (p. 121) (1993)

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El terapeuta que se acerca a sus primeros casos de TID corre el peligro de pasar a ser un elemento más del sistema de partes del paciente, cronificándolo más que ayudando a su evolución hacia sistemas mentales más adaptativos.

González, Anabel. Trastornos Disociativos. Diagnóstico y Tratamiento. Ediciones Pléyades. S.A. (2010) (p. 192)

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Todo el sistema interno del paciente ha de asumir la responsabilidad. El modo en que esto es manejado por el individuo está muchas veces conectado con la responsabilidad negada o puesta en otros de las figuras relevantes en la infancia del sujeto.

González, Anabel. Trastornos Disociativos. Diagnóstico y Tratamiento. Ediciones Pléyades. S.A. (2010) (p. 192)

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Cuando existen barreras muy marcadas entre los estados mentales, este proceso ha de ir acompañado, de modo paralelo, de un trabajo con el sistema interno, como describíamos en el capítulo del trabajo con partes.

González, Anabel. Trastornos Disociativos. Diagnóstico y Tratamiento. Ediciones Pléyades. S.A. (2010) (p. 237)

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Any increase in symtoms, reduction in function, or series of crises for no apparent reason, is a red flag. What is going on? The answer could be: ongoing trauma or conflict in the present; some internal system conflict; host resistance; or the therapy going too fast.

Ross, Colin A. M.D. Treatment of Dissociative Identity Disorder. Techniques and Strategies for Stabilization. (2018)

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In order to treat flashbacks in DID, it is essential to understand the system conflicts and dynamics that are driving them.

Ross, Colin A. M.D. Treatment of Dissociative Identity Disorder. Techniques and Strategies for Stabilization. (2018)

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If inner conflicts are minimized, DID alters can learn to cooperate like a well-coordinated soccer team; where all the players work together for a common goal. Each member of a soccer team has a particular position, using a specific skill set. This is directly analogous to a cooperating DID system.

Yeung, David. Engaging Multiple Personalities. Volume 1. Contextual Case Histories. (2014) Preface.

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In much the same way, dissociative clients can only start to talk about the untellable when the inner system is co-operating and the therapeutic environment is sufficiently contained.

Taylor and Francis. Editors. George F. Rhoades, Jr. PhD. Vedat Sar. MD. Trauma and Dissociation in a Cross-Cultural Perspective (pp. 310-311) (2006)

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Also, since Claire’s letter, Karen is becoming more aware of and familiar with her split-up internal system and I can now talk to her about it.

Baer, Richard. Switching Time. A Doctor’s Harrowing Story of Treating a Woman with 17 personalities. (2007)

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Although she feels there are other parts inside her that are more capable of talking to me, I regard Karen 3 as the person I’m talking to and treating. But I really have no basis for regarding her as any more dominant or primary than any other part in her system.

Baer, Richard. Switching Time. A Doctor’s Harrowing Story of Treating a Woman with 17 personalities. (2007)

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Este enfoque permite a los estados de ego tener un verdadero cambio con el terapeuta. Durante el tratamiento, se estimula a cada estado a contar sus propias experiencias dentro del sistema, y se le reconoce su participación.

Hunter. E. Marlene. MD. FCFP(C) Canadá. Manual Médico Para el Personal Cubano de La Salud Sobre Trastornos Disociativos

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System. This is the word we use to refer to all of the different personalities in a person with DID. This includes the one who lives out front in the world, the ones who only come out sometimes, and the ones who never come out and only live inside.

Alderman, Tracy. Ph.D. Marshall, Karen, L.C.S.W. Amongst Ourselves. A Self-Help Guide to Living with Dissociative Identity Disorder. (1998) (p. 13)

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In this textbook he emphasized a treatment that involves intensive interaction with all the alters in a personality system. (Refiriéndose a Frank Putnam)

Hacking, Ian. Rewriting the Soul. Multiple personality and the sciences of memory. (p. 18) (1995)

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Se trata de una forma creativa de mantener aquello que es inaceptable fuera de la conciencia. Ayuda el sistema disociativo (TDI) a proteger sus secretos y adaptarse continuamente al medio ambiente.

Carvalho, Esly. Ph.D. Sanando la Pandilla que Vive Adentro: Como el EMDR puede sanar nuestros roles internos (Spanish Edition) (p. 35). Unknown. Kindle Edition. 2012. 2013

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The alter Chrissy needed to learn boundaries. Based on Christine’s presentation in therapy, I identified her as the primary personality and kept that position throughout our work with her “system.”

Pattillo, Christine. I Am WE: My Life with Multiple Personalities. Christine Pattillo LLC. Kindle Edition. (2014)

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Again, their system operated democratically despite the tension and hostility among them.

Mayer, Robert. Through Divided Minds. Probing the mysteries of multiple personalities. -A Doctor’s Story. (1988) (p. 81)

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But Lauren was too frightened to do anything, and her internal system was stalemated. She came to the next session blaming everyone from God on down for her misfortunes. I could hardly blame her.

Mayer, Robert. Through Divided Minds. Probing the mysteries of multiple personalities. -A Doctor’s Story. (1988) (p. 153)

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It may again be that a dissociated system falls into the subconscious, and keeps on repeating itself in the form of independent states, but vaguely connected with the principal personality.

Boris Sidis, M.A. PhD. M.D. (Harvard) and Simon P. Goodhart, Ph.B.. (Yale) M.D. Multiple personality. An Experimental investigation into the nature of human individuality. D. Appleton and Company. 1919 (p. 56)

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Clinicians working with DID patients generally must hold the whole person (i.e., system of alternate identities) responsible for the behavior of any or all of the constituent identities, even in the presence of amnesia or the sense of lack of control or agency over behavior (see Radden, 1996).

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

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As part of the emphasis on safety and self-management, the clinician will commonly develop “safety agreements” with the patient’s alternate identity system to provide a structure for the patient to reduce unsafe behaviors.

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

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Definitivamente, no en Tumblr

El lenguaje que decida usar un paciente es importante. Los alters no suelen querer llamarse a sí mismos «alters». Y no es obligatorio llamarse «sistema«. Eso lo entendemos y es importante no forzar a una persona a usar un término con el que no se identifica. Pero el término «sistema» no fue inventado en Tumblr (lanzado en el 2007, encontramos citas de 1919), sino que es usado por los autores más reconocidos de Trauma y Disociación en la actualidad y en el pasado.

Algunos tweets mencionados.

 

Por supuesto, fotos y screenshots de lo citado en caso de que haga falta.

 

No es necesario usar el término sistema para uno mismo. Pero se usa en la comunidad científica.

La mayoría de personas con TID (sistemas, múltiples, plurales, pacientes de TID, pacientes de disociación compleja) en esta comunidad pasamos la mayor parte de nuestros días en la defensa del reconocimiento del TID como un trastorno real, un trastorno que dificulta el funcionamiento, que no necesariamente te hace un asesino, que hay esperanza de tener una vida satisfactoria, que existen estudios, que hay gente que te cree y que te apoya.

Si requieren un screenshot de una página en especial o que nos falte, por favor avísennos. Pretendemos educar, y antes de hacerlo nos educamos. No tenemos problema alguno en debatir, argumentar y mostrar citas, referencias, y corregir en caso de que nos equivoquemos.

Creemos en la sana discusión científica y fundamentada, y no condonamos ad hominems o amenazas.

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