Types of Alters In A Dissociative Identity Disorder System

300px-Dissociative_identity_disorder

All alters can be broadly classed as either Apparently Normal Parts of the Personality (ANPs), or Emotional Parts of the Personality (EPs). In additional, each can have one or more type or role, for example a child alter may also be a protector. People who are “very fragmented” (have a very large number of parts) may also have complex mixtures of ANP and EP. according to the Trauma Association. 

Apparently Normal Parts (ANPs) This term had previously been called a “host personality” or “host”. This is the identity who manages every day life and does not normally hold trauma memories.  There may be more than one ANP managing daily life at any one time, each with different roles. An ANP may be emotionally unconnected to, or amnesiac for, past traumatic events.

Emotional Parts (EPs) Emotional Parts of the Personality (EP) “hold traumatic memory, often being stuck in the sensory experience of the memory and unaware of the passage of time. Tasks involving daily life are managed by ANPs instead, e.g., working, cooking and parenting. All identities within a person can be categorized as ANPs or EPs. Despite their name, some EPs are not emotional.

List of Types of Alter

Animal Alters Abused children may develop animal parts/alters because they identify with animals and consider them friends. Animal parts may be able to express emotions that the Apparently Normal Parts can”t. Animals like tigers may function as protectors, growling when an Apparently Normal Part is distressed. Alters may also become to believe they are animals because abusers either told them they were or treated them like animals, e.g., dog alters. Some abusers are known to force children to act like animals, for example making them bark or use a dog bowl for food.Animal alters may also be created if the person was forced to harm others, as a way of containing the guilt of having to act in a way which feels more violent and animal than human. Complex trauma can leave even a non-dissociative person feeling “inhuman”. Animal or animal-like alters should be accepted, and treated just like any other alter. Animal alters can be taught that they are actually part of a human body, and can adapt. For example, a snake alter may be created when a child has arms and legs bound, and be tricked into believing that, like a snake, they do not have arms or legs. Animal alters often have a definite gender and can present, and be accepted, as human, without the person necessarily being aware they are communicating with an animal alter or any alter at all.

Abuser alter/ Persecutor See Persecutor. For abuser alters that may have taken on aspects or beliefs of a past abuser, see Introject.

Baby and infant alters These alters are pre-verbal (cannot yet express themselves with words). They may remain the same age, or grow older in age and begin to take on more responsibilities.  Their trauma memories consist primarily of emotions and bodily sensations.

Caretaker/Soother Caretaking alters are a type of a protector, they help manage and care for other alters, and sometimes external people (for example children). They are often motherly, and may be modeled on a real person. Caretaking alters lack awareness of self-care and become exhausted easy; they only have a limited role and have little capacity for play, exploration or socializing.

Child alters / Littles Often nicknamed “littles” or “little ones” are a common type of alter. Several child alters exist in most people with DID. Child alters often talk in a child-like way, but unlike a biological child they can normally understand abstract concepts and long words. They are often found to hold memories of child abuse which occurred at around the age the child alter feels he/she is. Some may have the speech or appearance of a very young child, the youngest being unable to talk, read or write. Child alters may gradually age of may remain the same age. Some child parts may hold feelings of terror and pain, while others may be playful and fun-living and have only positive memories. A child alter may also be an idealized representation of the “perfect child” from the “perfect” family, for example the “good boy”. Child alters should not be confused with the concept of having an “inner child”, which applies to non-dissociative people.

Core / Original Core personality. This term is now rarely used in scientific information. See Apparently Normal Part of the Personality.

Dead alter Usually this is an alter hidden from the rest of the system, often in a memory of a trauma in which they felt they were being killed. The child who survives a near-death experience may develop a “dead alter” to contain this experience. Alters can”t really die or be killed since the person”s brain is still alive, their feelings will still leak through into other alters. “Dead” alters can be revived.

Demon, Demonic and ‘Evil’ Alters Demon and demonic alters are a type of spirit and supernatural alter but are not actually supernatural beings and may result from spiritual abuse and an abuser who blames the child for the abuse. In abusive groups, a young child can be severely traumatized in order for abusers to intentionally create an alter, and the alter can be tricked into believing they have been possessed by, and have become, a demon. Some survivors report being dressed to look like a “demon” with costumes and theatrical makeup, and being told to look in the mirror and told that they are a demon. Hallucinogenic drugs may also be used to cause supposedly “spiritual” experiences. [9]:68,337 Some demon alters may be told they are animals. They may be very intimidating, with names such as Demon, Lucifer, Satan or Devil, however they should be able to engage with psychotherapy, and all alters should be accepted. These “demonic” or “evil” alters may have the role of maintaining loyalty to the abusive cult which created them, in order to keep the whole person alive. They are often a form of protector known as a persecutor.[11]:142 [9]:337-338 These alters are usually hurt children who have been tricked into believing they are “evil”, and may have been tricked or forced into harming others. With “patience, persistence and kindness” they can be allowed to choose a different role once the person is safe from abusers. Attempts to banish them using religious techniques such as “deliverance” or exorcism do not work permanently, can be harmful and may prolong any internal war between alters and preventing healing. For Christian perspectives on healing trauma, including experiences of people with Dissociative Identity Disorder and alters who understand themselves to be demons, see http://thoughtsfromj8.com/christian-resources-for-healing. Disabled alter Alters may be disabled when the body is not, for example a blind or mute alter may be created in response to abusers instructions, e.g. “Don’t talk”, “You didn’t see anything”. These alters can regain their sight or hearing, for example, after working through the memories that caused their disabilities.  Famous people (introjects) Like alters based on fictional characters or people known to the person with DID, these alters are internalized representations (introjects). They are rarely described by psychotherapists and psychiatrists, except when referring to survivors of ritual abuse. Examples in military/political abusive groups include child alters who believe they are Hitler, famous doctors, generals, or other military leaders. There may be several alters who each believe they are the actual person they are based on, and are unaware of one another – e.g., several “Hitler” alters in the same person.  In ritual abuse with ‘religious’ beliefs, alters may believe they are Jesus, or supernatural beings like God or Satan.Unsurprisingly, a person who has an alter claiming they are a famous person may be misdiagnosed as having Schizophrenia or a Psychotic Disorder, because claiming to be a famous person is considered a delusion. Psychotherapist Alison Miller gives the highly unusual example of a person who developed alters that were copies of Axl Rose and rest of Guns’N’Roses band – and was misdiagnosed with Schizophrenia as a result. [10]:2 In DID/DDNOS, however, an alter can adapt their believe if presented with clear evidence that they are not that person, for example that Hitler is dead and the Nazis lost the war.

Note: Delusions can also exist in people with DID/DDNOS if they have a Psychotic Disorder or Schizophrenia as well. Fictional characters Alters may be created which are internalized representations (introjects) of fictional characters. Some people with DID refer to alters based on fictional characters as fictives but this term is not used in literature on DID, which only rarely describes examples of them and doesn’t classed as being a separate “type” of alter or given a particular name. Like any other alter, they can physically take control of the person’s body. The characters that alter personalities are based on may come from sources like nursery rhymes, fairy tales, children’s stories or books, music, and movies.[36]:493 One good description of alters based on fictional characters comes from a case of DID in Turkey: a woman aged 45 with a severe abuse history was found to have Dissociative Identity Disorder, and two of her alters were based on the classic story Snow White: “Two identities had been formed from childhood imaginary playmates: “Pamuk Prenses” (Snow White) and “Kraliçe” (The Queen). They both enjoyed parties at nights where the Queen looked after, protected and controlled the young “Pamuk Prenses” and enviously competed with her at the same time. Snow White danced and sang. When Snow White took control she saw her husband and children as “the relatives of that poor woman in the neighborhood” (Sad Halimé [another alter])… These identities had been formed at about the age of twelve; they knew the other personalities, but they saw themselves as distinct from all the others. Some abusive groups/cults have been known to traumatize children in order to force them to create alters based on particular characters which suits the needs of the abusers. Ritual abuse survivors in particular report being forced to create alters based on many different fictional characters, including: characters from Lewis Carroll’s story Alice in Wonderland, which has been made into several movies [39] An “everyday life” alter based on the character “Samantha” from an episode of the TV show “Bewitched” Charles Wallace and Meg (from Madeleine L’Engle’s 1962 book A Wrinkle in Time) – as part of MK-Ultra ritual abuse[37]:70:72 Peter Munk (a character from a German fairytale) who is “unemotional, obedient, lacking in self-awareness” and motivated to avoid pain, reported in a German survivor of ritual abuse during the “cold war” [35]:80 Sleeping Beauty, who believed she was dreaming when actually working as a government agent (as part of MK-Ultra)  Tinker-Belle (from Peter Pan), in a survivor of Monarch programming/ritual abuse The Wizard of Oz, including the scarecrow (who was told he had “no brain”, was obedient and suggestible), the cowardly lion (who held the emotion of fear), tin man (who was told he had no heart – meaning no empathy, and as such was able to be a trained killer following someone else’s orders)

All alters may adapt and change over time, and some may even choose to take on the form of fictional characters if that serves a helpful purpose. Dr Colin Ross, a well known psychiatrist and Dissociative Disorders specialist, states that a group of demonic alter personalities in a survivor of Satanic Ritual Abuse chose to become Ewoks (from Star Wars) as part of healing.

Fragment Some alters are very limited in their role, for example they may only have a small number of emotions, hold particular isolated memories or have a very limited job. These ‘partial’ alters are sometimes known as fragments.Fragments can either have a range of emotions but only a limited life history, or a more substantial life history but be unable to feel a range of emotions (for example, always sad, either angry or fearful). Special purpose fragments are even more limited, for example existing to carry out a very limited role and never acting beyond that. Memory fragments hold a very limited knowledge of an event, and only experiencing very limited emotions. Several fragments together may hold a single event. Gatekeeper alter This type of alter has the job of keeping traumatized alters from appearing. They may also hold back memories or control which alters can take control of the body, and when.

Host, Presenting Part, Front Person, or Fronter The personality part/alter that “has executive control of the body for the greatest percentage of time during a given time period.”A person with DID will have more than one host over their lifetime. See Apparently Normal Part of the Personality. Insiders This term covers many different kinds of alter who are not primarily responsible for everyday life, they often hold trauma memories. They often have been so separated from everyday life that they are unaware of the years that have passed and do not know that the body have physically grown up.See Emotional Part of the Personality. Internal Self-helper (ISH) These alters are helper parts. They have extensive understanding of different alters and how they work together, and often help by explaining things to the therapist. [16]:64 Also known as Managers or sometimes Inner Self-Helpers.

Introject / Copy Alter These alters believe may they are another person entirely, such as an abuser or a close relative.  They have the characteristics of another person, for example a paternal introject with the behaviors and views of a person’s abusive father. Introjects which are mimicking abusers are trying to “keep you inline” in order to protect you from external abusers. “Introject” is a term used in general psychology to refer to taking on and internalizing the views and thoughts of others without reviewing them. This is part of normal development in early childhood, these introjected parts/aspects of a person can be either healthy and helpful, or abusive. For example, an adult verbally abused as a child may have an introject which states “nobody likes you” or “it’s a dog eat dog world” – both of these would negatively affects a person’s likelihood of making friends. In people without DID/DDNOS, introjects will not be alters, but become incorporated (introjected) into their personality. Introjects can change with psychotherapy.

Manager Alter/System Manager See gatekeeper and internal self-helper.

Military and Political Alters Alters may be soldiers of different ranks, or believe they are well known political leaders. These alters are often been created within abusive groups with a particular set of political/military or religious beliefs, the alters are indoctrinated to force them to take on the beliefs of the group. They may have titles of military ranks, like generals, or names like Hitler. Groups which are known to have carried out ritual abuse using dissociation to create alters include the US government (e.g., MKUltra, which included many Nazi doctors operating on behalf of the CIA), neo-Nazi groups, and white supremacists including the Ku Klux Klan. See demon, demonic and ‘evil’ alters, for alters which are copies of actual people see introject.

Opposite-sex alters Some alters may have a different gender to that of that body, for example a male alter in a physically female body. Opposite sex alters are usually more like a young girl’s idea of how a boy would be an actual boy, or a young boy’s idea of how a girl would be. Normally they have personality traits which associated with the gender of the opposite sex. A female alter in a male body may be very fearful or frightened, and a male alter in a female body may be very angry, feel physically strong, or be very brave. An alter may be have an opposite gender because of sexual abuse, for example a male alter does not have vagina, so will not fear being vaginally raped as the female body was. A female alter may be created in a male because that alter was forced to take on a female role in having sex with men.

Nonhuman Alters Alters are the result of severe dissociation; they are “constructed by the ‘logic’ of dream or trance”, and can be strongly influenced by a person’s culture. As a result, they can take any form; some alters may not view themselves as human, and may either feel (or fully believe) that they are not part of a human being. They may view themselves as having a different physical form (or no physical form at all, for example a spiritual being), this is recognized within the DSM-5’s description of DID. Prolonged and severe interpersonal trauma can leave a person feeling “no longer human”, and has been reported in people with Complex PTSD for example as a result of being a prisoner in a concentration camp, or severe child abuse. Given the trauma history of the vast majority of people with Dissociative Identity Disorder and DDNOS, it is unsurprising that parts of the mind may have taken on a nonhuman identity. Some examples include alters that identify as animals, demonic or ‘evil’ alters, spirits, ghosts or spiritual beings,, mythical figures, robots or machines, or even inanimate objects. Some people with DID or DDNOS refer to such alters collectively as “otherkin”, although the word otherkin can have different meanings, including meanings not relevant to Dissociative Disorders. Object Alter Alters which identify as inanimate objects are a type of nonhuman alter, for example a tree.[24]:80 Alters can also be hidden inside animate objects, for example inside natural-looking structures in the inner world, e.g., mountains, trees, lakes or rivers. [9]:49 Persecutor A common type of alter, often acts in a harmful way but there is a protective logic behind a persecutor’s actions. [7]:17-19 Persecutors often have a distorted view of reality, and may disrupt therapy or intentionally injure the person’s body, for example to punish child alters for disclosing abuse that has been kept secret. All alters “should be treated with equal kindness,” despite their behaviors, and persecutors are often seen as “misguided protectors” which can be negotiated with.[9]:41, [28] Some persecutors may threaten to “kill off” the ANP (host) and appear to have no positive or protective intentions, however these can still be engaged with.[29]:95 Some persecutors may be introjects of abusers. Download Therapeutic alliance with abuser alters in DID for more information on responding to a persecutor.

Protector Protector alters are common, there are three main types: ‘fight’ parts, persecutors and caretakers. The ‘fight’ parts and persecutors are types of EP which have defensive intentions, despite their often self-destructive behaviors such as self-injury or eating disorder behaviors. The term ‘fight’ does not necessarily refer to violence, but to the ‘fight’ reaction present in PTSD, which often involves verbal aggression. A diagnosis of DDNOS or Dissociative Identity Disorder is not associated with crime or “wild aggression”.[26] [27] Therapist Jo Ringrose, who has considerable experience of working with alter identities, states that violent alters exist, but has never met one. [27]:8 Protector alters try to manage rage and anger, and avoid feelings of hurt, fear or shame. They focus on perceived threats, and find dependence, emotional needs and close relationships (attachment) threatening. Protectors may view themselves as a very tough child or teenager, a powerful animal, or a physically strong, adult male. They can act internally, or show external hostility, e.g., telling a therapist that other alters don’t need them and warning the therapist to leave them all alone. Defensive “acting out” may be directed at a therapist or others close to the person; the ANP may have no behavioral control or memory of it. However, the “whole person” (all alters collectively) should still be held responsible for the behavior of all parts.[6]:132 A protector may follow an alter that is “needy and searching desperately for attachment” in order to protect it.[24]:87 Internal perceived threats may include the crying and dependency needs of a traumatized child part, which an internal persecutor may silence with rage or self-harm. [24]:82-83 Protector parts may see the partner of an ANP (host) as a threat, for example the partner initiating sex may cause a switch to a protector alter, who perceives it as an attempt to rape, and fights off the partner. Communication and negotiation can improve safety, and no attempts should be made to “get rid” of any alters. “With DID patients, if they feel hostility or aggression they take it out on themselves with self-harm… They’re self-destructive and repeatedly suicidal, more so than any other psychological disorder. So that’s what’s typical – not this wild aggression, or stalking women…” —Dr Bethany Brand Psychotic Alter Some alters have psychosis or psychotic symptoms. However, many symptoms which appear psychotic are not. For example, visual flashbacks may be mistaken for hallucinations, and strange body sensations (body memories) which are physical flashbacks of past trauma can be mistaken for tactile hallucinations.Hearing “voices” is a common experience in people with DID/DDNOS, the “voices” are alters trying to talk, and occasionally may come from outside the person’s head rather than inside, which is more common. “Thought snatching” (taking away your thoughts) can be caused by the actions of alters. Beliefs caused by trauma can be mistaken for paranoia, for example a person may be told that a “bug” has been implanted by abusers to record any dislosures they make. Working through the memory of the trauma will resolve the paranoia that it caused. [9]:129 Some people who have been abused within ritually abusive groups may have alters who are trained (programmed) to produce psychotic-like symptoms under certain circumstances. It is possible to have an alter with a psychotic disorder, or to have schizophrenia as well as DID/DDNOS. This appears to be relatively rare. Schizophrenia is a common misdiagnosis for people with Dissociative Identity Disorder, although many people with DID/DDNOS believe they are going “crazy” they do not have a break with reality. Abusive groups are known to have created alters who carry out “jobs” which make a person appear either “crazy” or learning disabled, for example scrambling or garbling words and numbers so they cannot be understood, hearing high pitched sounds and feeling “lost in a maze” in the back of your head, making your mind go foggy or misty or being spatially confused and unsure what the truth is. Anti-psychotic medication will not “remove” alters but can make the communication needed to heal more difficult.[9]:129 Robot or Machine Alter Alters who believe they are robots or machines, and have no understanding of emotions, have been reported in survivors of ritual abuse. These alters were told they were robots or machines, and were not allowed to feel any emotions, were trained to follow instructions and not to think, and may have been made to believe that they cannot move. If a large number of similar robot parts exist, it is more effective for them to agree to fuse (integrate together permanently) rather than repeating the same therapy with each. Robot and machine parts are actually part of a person, and can be helped to feel more human, and to learn how to think for themselves, rather than just responding to the instructions past abusers gave. Sexual Alter Sexual alters may be created to handle sexual abuse and rape, and to keep that knowledge away from other parts. One alter or group of alters may handle sexual abuse from men or boys, while others are created to handle sexual abuse and rapes from women or girls.

Shell A shell alter is an Apparently Normal Part (host alter/front person) which handles daily life and is designed to hide the existence of other alters from the outside world. Shell alters do not exist in DID, they only exist in one form of DDNOS (now renamed to Other Specified Dissociative Disorder). The apparently normal part (ANP) is a shell through whom the inside parts/alters act. The inside parts can come near the surface, temporarily blending with the ANP. The inner parts are not regarded as separate, distinct states although amnesia may exist between them. If DDNOS is caused by ritual abuse and mind control, the shell alter is not supposed to know about the others

Spirit, Ghosts, Supernatural beings and ‘Possession” Alters These types of alters are referred to directly in the DSM-5 diagnostic manual, underneath the diagnostic criteria for Dissociative Identity Disorder. Some people have alters which are all spirits, ghosts or supernatural beings such as angels or genies. These are regarded as possession-form identities, if a person is consciously aware of the actions of the alter then the person may describe themselves as feeling “possessed” by an outside person, spirit, deity (god), demon, or a “ghost”, for example of a person known to them who has died. Possession-form alters are not part of normal cultural possession experiences, they are involuntary, recurrent and distressing.  Animal alters are also common in this form of dissociation.People can also have one or more of this type of alter along with other types, for example child alters or protectors. Alters who believe they are spiritual or supernatural beings should be treated in the same way as any other type of alter identity, with psychotherapy (talking therapy). Exorcisms are known to be harmful and ineffective in treating complex dissociative disorders, and attempts should not be made to “get rid” of alters. Instead they should be understood as a way of coping with traumatic life experiences. Sub-parts An alter may have another dissociated part inside, which has a different role or function. [9]:141 Suicidal Alter/Internal Homicide A common type of alter. If somone with Dissociative Identity Disorder or DDNOS is suddenly suicidal, this may be due to the influence of a suicidal alter, although the ANP (host) themselves may be feeling suicidal. According to the DSM-5 psychiatric manual, over 70% of out-patients with DID attempt suicide and multiple attempts are common. Amnesia can make it difficult to assess the suicide risk, and there may be amnesia for a suicide attempt.  Some alters may be unaware that they share the same body as the ANP, and believe that killing off the ANP or others will not harm them; this increases the suicide risk further.See persecutor for alters who are threatening to kill the ANP (host).

See Negotiating with alters Teen alters Teenaged or adolescent alters may occur in people who had significant trauma during those years, or they may be child alters who have grown older Twin alters Twin alters are two alters of the same age who are normally opposites of each other in views and behaviors. Twin child alters are common, for example one may love the abuser, be eager to please and have only positive views towards him/her, and another may hold angry and rejecting views towards the abuser.

I would love to hear from you so please leave a comment. All feedback is much appreciated. Thank you. Erin