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Apparently-normal-part Quote by Elizabeth F. Howell

“Secondary structural dissociation involves one ANP and more than one EP. Examples of secondary structural dissociation are complex PTSD, complex forms of acute stress disorder, complex dissociative amnesia, complex somatoform disorders, some forms of trauma-relayed personality disorders, such as…” quote by Elizabeth F. Howell
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““Secondary structural dissociation involves one ANP and more than one EP. Examples of secondary structural dissociation are complex PTSD, complex forms of acute stress disorder, complex dissociative amnesia, complex somatoform disorders, some forms of trauma-relayed personality disorders, such as borderline personality disorder, and dissociative disorder not otherwise specified (DDNOS).. Secondary structural dissociation is characterized by divideness of two or more defensive subsystems. For example, there may be different EPs that are devoted to flight, fight or freeze, total submission, and so on. (Van der Hart et al., 2004). Gail, a patient of mine, does not have a personality disorder, but describes herself as a "changed person." She survived a horrific car accident that killed several others, and in which she was the driver. Someone not knowing her history might see her as a relatively normal, somewhat anxious and stiff person (ANP). It would not occur to this observer that only a year before, Gail had been a different person: fun-loving, spontaneous, flexible, and untroubled by frightening nightmares and constant anxiety. Fortunately, Gail has been willing to pay attention to her EPs; she has been able to put the process of integration in motion; and she has been able to heal. p134””

Elizabeth F. Howell

About This Quote

Source Book: Trauma and Dissociation, Van der Hart et al., 2004

The quote explains that secondary structural dissociation is a trauma‑related condition where a primary personality (ANP) coexists with multiple emotional parts (EPs), leading to fragmented responses and possible personality change over time.

In simple terms: Trauma can split the mind into several defensive parts that may act independently.

Key Takeaway

Recognize and integrate fragmented self‑states for healing.

Themes

trauma identity integration psychiatry psychotherapy

Mood

empathetic reflective

Type

clinical educational

When to use this quote

  • clinical assessment
  • therapy planning
  • patient education
  • self‑monitoring
  • support groups

Key Concepts

dissociation defensive subsystems complex PTSD

Questions to Reflect On

  • How can clinicians safely support patients in identifying and integrating EPs?
  • What daily practices help maintain a cohesive sense of self?
A Different Perspective

Integration can be slow and may trigger intense distress if not paced carefully.

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