The theory of structural dissociation of the personality was developed by Dutch psychiatrist Onno van der Hart and colleagues in the 1990s as a way to conceptualize dissociative disorders. This theory provides a framework for understanding dissociative psychopathology, including dissociative amnesia, dissociative identity disorder, depersonalization-derealization disorder, and dissociative conversion disorder.
Structural dissociation is based on the idea that individuals can develop separate mental structures or states kept apart by psychological barriers or walls. These structures are thought to be comprised of different self-states with varying degrees of coherence that become active at different times. The concept also includes an inner platform for adaptive functioning, which is seen as a unifying factor between dissociative states.
The theory of structural dissociation proposes that psychological trauma can cause an individual’s personality to divide into distinct components, which can appear as different identities or states of mind. These components are seen as psychological structures and not necessarily fixed aspects of the person, allowing them to move and change over time. The theory also explains how these dissociated parts may have varying degrees of awareness toward one another and how they work together to cope with trauma. Structural dissociation is a very effective model for understanding complex trauma symptoms, particularly those observed in survivors of abuse and other psychologically traumatic events. Studies have demonstrated the importance of processing trauma memories like EMDR with attachment-based models such as this to provide comprehensive treatment for people suffering from psychological trauma.
Assessment of structural dissociation typically involves psychological tests and interviews, including psychometric and personality assessments, dissociative symptom inventories, and trauma-focused assessments. Once dissociated structures are identified, treatment focuses on integrating dissociative parts while providing adequate containment for the individual. Eye Movement Desensitization and Reprocessing (EMDR) has been found to be effective in treating dissociative symptoms related to structural dissociation. Psychotherapy that combines both approaches may be most beneficial for individuals struggling with dissociation.
In conclusion, the theory of structural dissociation provides a valuable framework for understanding dissociative psychopathology. Assessment and treatment typically involve an integrative approach that combines approaches such as EMDR, IFS, and Sensorimotor therapy.
Cognitive-behavioral interventions are not recommended as they can retraumatize the client or even generate more fragmentation. With adequate care, individuals can learn to manage dissociative symptoms and work towards integrating dissociated mental structures.
References:
Van der Hart, O., Nijenhuis, E., & Steele, K. (2006). The Haunted Self: Structural dissociation and the treatment of chronic traumatization. New York, NY: W.W. Norton & Co.
Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press: New York
Shapiro, F. (1995). Eye movement desensitization and reprocessing: Basic principles, protocols and procedures (2nd ed.). New York, NY: Guilford Press.