{"id":737,"date":"2017-09-13T23:12:09","date_gmt":"2017-09-14T03:12:09","guid":{"rendered":"http:\/\/www.exunoplures.org\/main\/?page_id=737"},"modified":"2024-12-18T14:36:31","modified_gmt":"2024-12-18T19:36:31","slug":"three-problems","status":"publish","type":"page","link":"https:\/\/www.exunoplures.org\/main\/articles\/medicalisation\/three-problems\/","title":{"rendered":"Three problems with Medical-Model-Only Thinking"},"content":{"rendered":"

Over the past two decades, psychiatrists and therapists have moved beyond a reflexive belief in fusion therapy as the gold-standard treatment for DID, but many are still convinced that all plurality must fit neatly into the medicalised DID or OSDD-1 model to be valid, even if they are loath to push fusion in the way they used to.<\/p>\n

The medical model does fit some systems; nevertheless, it is not universal. Here are three reasons why this kind of thinking doesn\u2019t always work:<\/p>\n

    \n
  1. Under the structural<\/a>–dissociation<\/a> model of DID, people are born without an integrated sense of self; a unitary self-concept arises later in childhood.<\/strong> For people who have experienced severe trauma at a young age, a integrated self-concept never emerges. We don\u2019t know, however, whether other contributors may cause systems to have discrete identities. More research \u2013\u00a0especially cross-cultural research \u2013\u00a0is needed to understand how self-concepts change across the lifespan. It\u2019s premature to claim that these interpretations of multiplicity, whether trauma-based or not, are the final word.<\/li>\n
  2. Everyone experiences trauma differently, so what may be traumatising for one person may not be for another.<\/strong> For example, verbal abuse may prevent the creation of an integrated self in one case, but not in another. We used to see ourselves as entirely non-trauma-based in part because we didn\u2019t think our traumatic experiences\u2014verbal abuse, emotional neglect, early physical neglect, bullying\u2014were bad enough. (That was before we realised we\u2019d been sexually abused as well, but my point still applies.) Although trauma is associated with more obvious events like rape, war, and torture, other misfortunes like bullying, psychological abuse, and religious indoctrination can also leave lasting scars.<\/li>\n
  3. Plurality is not intrinsically pathological.<\/strong> For DID to be diagnosable under the DSM-5, it has to cause significant distress in someone\u2019s life, which is a departure from previous versions that considered the presence of multiple selves a disorder with or without distress. Systems may need help to manage daily life, get along with one another, and process traumatic memories, and all these tasks are possible while remaining separate people. The emphasis on an idealised singular self, the treatment of newly formed system-members as \u201calters” or \u201cparts” of a self that never existed in the first place, and the emphasis on fusion therapy are further reasons for our former reluctance to connect our plurality with past traumas. The idea of being a mere “dissociated part,\u201d rather than being a proper person with opinions, feelings, values, philosophies and preferences, was and is a bit insulting. We\u2019d like to have our existence acknowledged and work through our traumas; these goals are not mutually exclusive.<\/li>\n<\/ol>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    Over the past two decades, psychiatrists and therapists have moved beyond a reflexive belief in fusion therapy as the gold-standard treatment for DID, but many are still convinced that all plurality must fit neatly into the medicalised DID or OSDD-1 model to be valid, even if they are loath to push fusion in the way […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1234,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"coauthors":[12],"class_list":{"0":"post-737","1":"page","2":"type-page","3":"status-publish","5":"entry"},"_links":{"self":[{"href":"https:\/\/www.exunoplures.org\/main\/wp-json\/wp\/v2\/pages\/737","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.exunoplures.org\/main\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.exunoplures.org\/main\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.exunoplures.org\/main\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.exunoplures.org\/main\/wp-json\/wp\/v2\/comments?post=737"}],"version-history":[{"count":9,"href":"https:\/\/www.exunoplures.org\/main\/wp-json\/wp\/v2\/pages\/737\/revisions"}],"predecessor-version":[{"id":1690,"href":"https:\/\/www.exunoplures.org\/main\/wp-json\/wp\/v2\/pages\/737\/revisions\/1690"}],"up":[{"embeddable":true,"href":"https:\/\/www.exunoplures.org\/main\/wp-json\/wp\/v2\/pages\/1234"}],"wp:attachment":[{"href":"https:\/\/www.exunoplures.org\/main\/wp-json\/wp\/v2\/media?parent=737"}],"wp:term":[{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.exunoplures.org\/main\/wp-json\/wp\/v2\/coauthors?post=737"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}