Grievances Around Some Plural Terminology and Assumptions
We've been around plurality topics for a while now, even if our awareness of what we experience has only stabilized recently, and it has led to a lot of reflections and questions.
While searching for answers, to better introspect, and to better understand ourselves and other systems, we've been looking at terminology. Terms are incredibly important because they package descriptions of experiences. They are tools to better explain what's going on - but they will never be perfect, as every system will experience their systemhood differently. However, there are common concepts, metaphors, that fit a large variety of experiences, even if the interpretations may differ.
I repeatedly keep seeing some terms lately, some that we've been told that they are too medicalized or outdated, and yet we keep seeing them. I'm not sure why. It has forced me to give more thoughts about those terms, to educate ourselves more: some bare more than just a meaning, some bare assumptions that I think deserve to have a critical lens and new perspectives to be applied onto them.
To be extremely clear, the goal of this post isn't to invalidate lived experiences. I want to propose new perspectives, interpretations, some potential risks with some terms I will talk about, and why that is.
To get going, here's a quick summary of the things I'll talk about in this post:
- System member terms
- Split
- Assumptions around DID Diagnostic Criteria in the DSM-5 and ICD-11
- Conclusion
System member terms
Let's start with terms for system members, or headmates1, or even constant companions2.
I think these terms have extremely significant meanings. Not only for the purpose of singlets properly understanding our lived experiences, so they can better support us, but it's also extremely important for systems, especially newly-discovered systems who will be in search of answers.
Terms that come with several assumptions may lock someone into a specific interpretation of a lived experience, disregarding other perspectives which might be more accurate.
This has been our case: we've lost ourselves over role terminology and medianness, and as a result we've denied ourselves the full agency we could have reached, which led to a journey of having to rediscover ourselves after 2 years of losing the awareness of each other. Even though our journey isn't specific to system member terms, it has taught us to be more careful with them, and to give a little more thought about the meaning of each terms instead of throwing blanket words.
Another part that motivates me to write about system member terms is that I'm French, which means I also need terms in French to be able to properly communicate our and other systems' experiences, and sadly French doesn't have good equivalents; headmate doesn't have a direct translation, instead in French we'll primarily see some terms I'll talk about here. This brings up another reflection on how appropriate the available vocabulary is in French.
Alter
Let's start with one I'm surprised to see so often: alter. Most of my surprise comes from the fact that spaces I've interacted in have taught me that alter is an outdated and medicalized term, and we should use headmate instead. It's also a term that I encounter a lot in French.
So, what does alter mean? Where does it come from?
Let's quote Pluralpedia for this:
The term "alter" has been used to refer to system members since at least 19823 and may have been proposed as the preferred term for system members (in contrast to "personality") by Coons in this paper in 1984, according to Kluft4. The descriptors "altered state of consciousness", "alternative states of consciousness", and "alter personalities" may have been used as early as 1889 by Pierre Janet, though they may have been applied to reference his work only later by van der Hart5. Since the original publication is in French, pinpointing a connection to the English term is difficult. Janet describes "states" and often refers to "alternations" in behaviour and memory6. Therefore, the term "alter" could be derived from either "alternate" or "altered". The terms "alter self" and "alter personality" have been used since at least 19727.
We can immediately deduce that this is a term that finds its roots in psychiatry, mostly as part of the research on Dissociative Identity Disorder (DID).
Aside from being a medical term (making it unfit for many systems), I think the word's meaning has inherent issues.
Some parts of the quote above really stand out to me:
- mentions of the word "personality", which I'll address below;
- the fact that "alter" can be expanded to "alternate" or "altered".
"Alternate" is a tricky word; it implies that headmates are a deviation from a "state" that would otherwise be considered "normal". This may make sense from an external perspective for systems with host/core members, but this feels very singlet-normative. From the perspective of a society that assumes everyone is a singlet, systems are a deviation from the norm, which leads to the belief that headmates are a variation of the "otherwise singlet" core/host headmate.
The term already starts getting weak when we consider that systems may not have a host; either because a system might not have roles, or may have multiple hosts. When that happens, then what can even be considered the "normal state"? "Alternate" doesn't make much sense when there is no "normal state".
I think this may be where the term starts causing harm (similarly to the other terms below). If we consider that this is an "alternate" of a "normal state", does that mean the "normal state" has more importance? This term implies a relationship, and I think falling into this mindset can be dangerous for systems who struggle with their systemhood, because it means they may be tempted to suppress or deny the agency their other headmates deserve. It is important to be mindful of this.
Alter seems like a problematic term to us, but what about the alternatives?
Personality
Let's talk about another word I've heard of a bit.
A personality can be defined as characteristic patterns of thoughts, feelings, moods, and behaviors. With this in mind, we can probably think of quite a few things that fit this definition.
However, there's something that bothers me. While "Multiple Personality Disorder (MPD)" was renamed to DID, and one of the reasons for this rubs me the wrong way:
[...], while for a patient with DID, the switches between identities and behavior patterns is the personality.
In a way, what this says is that being a (DID) system
is a personality? That doesn't sound right. Wikipedia cites
Cardena, E., Gleaves, D.H. (2011). "Dissociative disorders". In Hersen, M., Turner, S.M., Beidel, D.C. (eds.). Adult Psychopathology and Diagnosis. John Wiley & Sons. pp. 473–503. ISBN 978-0-471-74584-6. Annoyingly, it's not an easy book to get, but the edition on Google Books still allows searching for quotes even in non-public pages. Luckily, I've been able to obtain the actual non-paraphrased quote:
Another reason for the name change is that the term personality refers to characteristic pattern of thoughts, feelings, moods, and behaviors of the whole individual. The fact that patients with DID consistently switch between different identities, behavior styles, and so on is a feature of the individual's overall personality. Our phrasing changes in diagnostic criteria clarified that although alters may be personalized by the individual, they are not to be considered as having an objective, independent existence.
Cardena, E., Gleaves, D.H. (2011). "Dissociative disorders"
The Wikipedia article not only waters down the original quote too much (losing important meaning) but the quote is awful. This is so dismissive of what systems experience and of their stories. It feels like the view from this quote is systems "emulate" headmates, and they don't actually have any objectiveness. It's as if whoever wrote this doesn't even believe headmates can be real.
This is especially frustrating as there's neuropsychiatric research which shows that we can observe switches and system members fronting with brain activity scans. For example, in Dr Alexander Jatzko's work8 9, he found that when asking a system to shove every member to the back, the scans showed a significant decrease of activity, and the cerebrum wasn't active either, which means the consciousness centres were less active. With additional measurements, the cerebrum's activity was shown to be 10 to 20 times lower than when you look straight ahead and don't think about anything. There have also been cases where scans taken while different headmates fronted showed reproducible patterns of brain activity, with each headmate showing distinct patterns.
With this in mind, I disagree with the idea that system members can't have an objective, independent existence. As shown through neuroimaging, they objectively exist and they are somewhat independent: while they share the same neurons, the same brain and the same body, the activity patterns are independent.
To return to the topic at paw, I find it concerning that the Wikipedia quote is the way it is, and I've seen this point repeated in other spheres. I also find it extremely reductive of systemhood, it isn't a personality, it's so much more than that - especially with the little peek into neurology above.
These terms need to also be understandable by the general population and by systems going through discovery. During discovery, the terms a system will encounter may end up deeply influencing how they will treat their systemhood. Discovery is often a time of confusion, with a lot of new vocabulary to learn about. Nuance here will be hard to grasp, and as such, I think adopting a more general perspective for the term personality is required.
When I initially wrote about personality, I made the mistake of conflating it with personas. After quite the back-and-forth with my dear proofreaders, I've realized that I almost approached this from the wrong angle as well. I initially thought that personality is something that can be swapped depending on the social context, and the nuance is more that the outward personality that is willingly shown is the one that changes, not the internal one. One thing that still remains from what I initially wrote is that, even though I change my outside behaviors to remain socially appropriate; I still am me, I adapt myself.
So, what then? The issue in the above quote is that the authors minimize the fact that experiences will shape different system members' individual personalities differently. By painting the idea that it's an illusion created by the system, it not only alienates the author from systems - why would we trust someone who believes that the personality of a headmate is a creation of our mind? - but it also ignores the fact that headmates evolve their personality differently from each other.
Now that we've established the right level of granularity, we're still stuck with an important question: is personality the right term? No, personality isn't a good term for a system member. A headmate can have a personality (or a range of personalities), headmates can share personality traits, etc. However, the term personality has some implications - a person isn't just a personality. Personhood is much more, and there are key components that's missing with this term. I will list those key components after talking about identity, as this other term shares similar issues with personality.
Identity
Identity is a term I've often encountered to refer to system members, both in English and in French. It's also a word that is part of the DID acronym, but it's not strictly reserved to systems with a DID diagnosis.
However, fundamentally, what is an identity? An identity is the set of qualities, beliefs, personality traits, aspects of appearance, or expressions that characterize a person or a group. It's a word frequently used as a way to describe - usually through labels - externally observable components of a person.
We can again see the mention of personality, which reinforces what we've seen already so far.
In some systems, we can differentiate system members by their qualities, their beliefs, their personality traits, their appearance (through the presentation of their body, and/or in headspace if there is one), their expressions, and those will characterize each system members.
However, this term might be lacking some details, some key components, and might reduce system members to something less than a person. A person is not only characterized by their identity or their personality, a person is also characterized by reason, morality, consciousness and/or self-consciousness.
Compared to an identity or a personality; a person has wants, needs, and agency. And it is important to see those key components as something that a headmate also has.
This is why I've been already hinting towards this when talking about personality: while headmates share the same body, they deserve their own agency. They are as much of a person than what is usually described as a person. And any terms that may minimize this will come with assumptions, it's an open door to see headmates as just some gimmick, as some quirky thing, as something that can be controlled, suppressed, or even undesirable. This is so dangerous, because it means that instead of working through acceptance, understanding each other, systems could be tempted to do the opposite, and this is how you end up with systems with headmates that are hurt, because their own personhood has been denied.
Even in the case of systems that take the form of fragments or parts, I think it's valuable to have this perspective. The fragments or parts metaphor/framework can still benefit from being considered to have wants, needs, agency.
Maybe what I'm suggesting here is a bit extreme, maybe I've taken too much time into looking at the meaning of those terms beyond the surface-level vague understanding; but I think it is important to have this in mind, to better understand the choice of terms.
Considering headmates as people encourages having empathy, to better consider their needs, their boundaries, their wants, and to better communicate with them. Life for systems is, in a way, teamwork, and for a team to succeed they need to work together. This simple notion is an incredible tool to help systems thrive.
A quick note about system accountability: this doesn't mean a system cannot be held accountable for the actions of a headmate. The team metaphor holds true: a team is still accountable for the actions of team members, and is expected to take steps to prevent bad behavior.
This is most of what I had to say around system member terminology for now, but it's not the end of this post yet, let's take a look at some other terms.
Split
A split and splitting are interesting terms. While the noun is sometimes used as a system member term, it also refers to the event of the formation of system members. Let's see what the word actually means:
A split is the formation of one or more new headmates through external stress, usually breaking up an existing headmate into multiple (although the origins of some splits may be unknown).
Any type of stress can cause a split and splits can create any number of headmates from one event. A "split" may also refer to the new headmate, both directly and in relationship to their precursor.
It's also a term whose origin comes from psychiatry, especially from some initial theories around how DID forms, which mostly points to the concept of a core member splitting into multiple members.
If I want to talk about this term, it's because it assigns very specific assumptions around system member formation, and I see it used a fair bit. Given the prevalence of psychiatry-originated terms amongst the plural community, I do have to wonder if in most cases it's not used just as a "default", while some words might better describe the experience with more nuance.
I do need to repeat the warning from the introduction: my goal is not to invalidate anyone's lived experiences. If split is an accurate term for you, please do use it! My goal, however, is to make sure the perspective and the assumptions of the terms are understood.
I am personally fond of the term discover when we find new headmates we haven't encountered previously, as it allows giving a lot of room for further introspection and better identify their origin before jumping to conclusions. It's a mistake Aurore has made in the past: which led to a very misunderstood system, and an unstable awareness.
I think this approach can also be beneficial in systems that work around the traditional approach to DID, because it can easily disregard (just like alter) other possibilities. I've seen a specific theory multiple times now that try to explain how DID forms, both on the Internet and a documentary8 - sadly I've not yet been able to properly track down a paper about it. This theory flips a bit the usual perspective of a single coherent self that gets split, instead it proposes that we initially are made of parts, and through growing up those parts end up integrating to form the single self, but some events like trauma may disrupt this process and lead to multiple selves.
This theory is fascinating because it doesn't prevent the existence of multiple headmates before trauma, destroying some assumptions around DID like that there's almost always a core, and that headmates formation is always through splitting.
With this in mind, I think the best way to go about it is to have a second thought before jumping on this term. Discover is a great term to keep it vague. Another term that might be interesting is unfolding, which is quite close to splitting but instead of considering that there's a single unit prior to the formation, the resulting units were previously folded or tangled up, making their bounds hard to grasp, until it starts clicking into place.
For this section I've also talked a lot about DID, both because of the origin of the term, and because the research is more commonly available. I think it's important to consider the neuroplasticity of the brain: what I've said here doesn't preclude other means of formation of headmates either.
Assumptions around DID Diagnostic Criteria in the DSM-5 and ICD-11
In this post I've talked a lot about DID, and I'd like to take the opportunity to talk about its diagnostic criteria, both in the DSM-5 and in the ICD-11. I've encountered a lot of assumptions and misinformation around what is required to be diagnosed, and it saddens me because this ends up hurting not only systems with a DID diagnosis but the plural community as a whole.
A surprisingly pervasive idea is that DID centers around amnesia. However, both the ICD-11 and DSM-5 disagree that this is a hard requirement:
Essential Features:
- [...]
- [...] There are typically episodes of amnesia inconsistent with ordinary forgetting, which may be severe.
- [...]
Additional Clinical Features:
- Alternation between distinct personality states is not always associated with amnesia. That is, one personality state may have awareness and recollection of the activities of another personality state during a particular episode. However, substantial episodes of amnesia are typically present at some point during the course of the disorder.
Dissociative amnesia (Criterion B) manifests in several major domains: 1) gaps in any aspect of autobiographical memory (e.g., important life events like getting married or giving birth, lack of recall of all school experiences before high school); 2) lapses in memory of recent events or well-learned skills (e.g., how to do one’s job, use a computer, cook or drive); and 3) discovery of possessions that the individual has no recollection of ever owning (e.g., clothing, weapons, tools, writings or drawings that he or she must have created). Dissociative fugues, with amnesia for travel, are common. Individuals may report suddenly finding themselves in another city, at work, or even at home: in the closet, under the bed, or running out of the house. Amnesia in individuals with dissociative identity disorder is not limited to stressful or traumatic events; it can involve everyday events as well. Individuals may report major gaps in ongoing memory (e.g., experiencing “time loss,” “blackouts,” or “coming to” in the midst of doing something). Dissociative amnesia may be apparent to others (e.g., the individual does not recall something others witnessed that he or she did or said, cannot remember his or her own name, or may fail to recognize spouse, children, or close friends). Minimization or rationalization of amnesia is common.
When reading the DSM-5, it might be easy to affirm that, yes, amnesia is required. However, this is not what it nor the ICD-11 say:
- the ICD-11 uses the word "typically", which means that yes, most cases will have episodes of amnesia, but there are also less common cases where that doesn't happen;
- the DSM-5 uses a lot of important keywords as well: "may", "can", "common".
These are all formulations that hint towards this being a recurring, key feature of DID, but not a requirement. The DSM-5 also states that the amnesia can also be much more subtle, or isolated to traumatic events.
Folks often assume that trauma is a requirement for a DID diagnosis, and sometimes end up harassing systems without known traumatic origins. The ICD-11 and DSM-5 disagree:
Dissociative Identity Disorder is commonly associated with serious or chronic traumatic life events, including physical, sexual, or emotional abuse.
Environmental. In the context of family and attachment pathology, early life trauma (e.g., neglect and physical, sexual, and emotional abuse, usually before ages 5–6 years) represents a risk factor for dissociative identity disorder. In studies from diverse geographic regions, about 90% of the individuals with the disorder report multiple types of early neglect and childhood abuse, often extending into late adolescence. [...]
Genetic and physiological. Twin studies suggest that genetics account for around 45%–50% of the interindividual variance in dissociative symptoms, with nonshared, stressful, and traumatic environmental experiences accounting for most of the additional variance. [...]
Important keywords like "commonly", or "risk factor" are present again. Even if trauma played a part into the formation of DID in some systems, I don't think systems seeking a diagnosis should be denied one just because the disorder will try to hide trauma as a defense mechanism.
With those facts, it's essential to consider that this means the diagnosis doesn't disallow systems who formed without trauma. Nor does it mean that every system should be diagnosed: a diagnosis is a classification of a disorder that affects your daily life. This doesn't apply to most systems! DID diagnosis doesn't mean "you are plural", it means "you are plural, but you need support to healthily deal with life".
As a quick note: the diagnostic criteria also focus on a social aspect, which I think might be interesting to ponder about, though this would be a whole other essay. In the meantime, here's a thought experiment: if plurality was more socially accepted and understood, would some DID diagnosis still be relevant?
Those are points that are very critical to have in mind. They also deconstruct a lot of sysmedicalist arguments: if you've had a sysmedicalist approach, I hope this will help to reconsider your position and show more empathy to the rest of the plural community.
Conclusion
This has been quite the piece to write. This is the result of quite a long reflection about terminology and common assumptions around plurality. It just started out as some debates on Discord, me educating myself more and more, and realizing that maybe there's a need of a voice for those perspectives outside small-form messages or social media posts that quickly loose nuance.
I've talked quite a lot about DID, and I do want to affirm that I think the sections about terminology can also be easily applied to the rest of the plural community, outside the medicalized lens. I think it's essential to be mindful of it: a lot of systems thrive, and this should be the goal. Ultimately, plural systems are not lab rats, we deserve our own agency and respect. No medicalization should ever be a requirement.
I hope this has been interesting perspectives to read and that it will give a lot of things to think about. It's through questioning that we can find tools to better describe lived experiences.
There are some questions that are left without satisfying answers though, especially my grievances around the French plural terminology lacking alternatives to the system member terms I've talked about. I've recently heard of the word colocatête, which is a literal translation of headmate. The only issue I have with it is it doesn't roll of the tongue as well. Though maybe this is a me-problem. This is not just an issue in French, this issue is shared with multiple other Roman languages. I'm curious to see how other languages will solve this issue, as through etymology once one figures it out, the other languages that share the same roots can easily be figured out as well. I've tried workshopping other terms in French but to no avail so far.
I'd like to thank a lot my partners who've been very kind to proofread this article, and especially to Mathilda for putting so much nicely into words what I was trying to get at about personality and nudging me back into the right tracks.
- Headmate is the contraction of the words "head" and "mate", akin to the words "flatmate", "housemate", etc. Read more on Pluralpedia. ↩
- Term inspired from Jamie Paige's album Constant Companions, which has several plural-coded tracks. We're particularly fond of this term. ↩
- Kluft, R. (1982) Varieties of Hypnotic Interventions in the Treatment of Multiple Personality ↩
- Kluft, P. (1988). The phenomenology and treatment of extremely complex multiple personality disorder ↩
- van der Hart, O. (1989). The dissociation theory of Pierre Janet ↩
- Janet, P. (1889). L'automatisme psychologique ↩
- Ludwig, A. (1972). The objective study of a multiple personality. Or, are four heads better than one? ↩
- Documentary from Arte: Un moi au personnalités multiples/Das Geteilte ich. Its main focus is around DID, sadly it is not widely available anymore. ↩
- I first came across Dr Alexander Jatzko's work an Arte documentary8, in which some of his slides from Gibt es multiple Persönlichkeiten hirnphysiologisch? were shown. Do have in mind that this research is centered around DID, which focuses on trauma. However, I think parts of this research can still be interesting for the wider plural community. ↩