Mental Health Communities: A Reactionary Liberal /Conservative Battleground
I take issue with mental health communities on social media, more specifically communities that are built around a shared mental illness. These are not exclusive to any one website, but for the purpose of this blog, I’ll be talking mostly about the Tumblr DID community, as it’s the one I have the most experience with and I feel that Tumblr in particular is the prime website for fostering what I’d like to call a reactionary battleground between liberalism and conservatism.
A long-standing problem within these kinds of communities that has become increasingly prominent is the conflict between the self-diagnosed and the professionally diagnosed. Over the years, “self-diagnosed” has expanded to include those who were able to self identify a diagnosis before being professionally diagnosed, depending on how the fake-claiming accuser feels about them. Liberals, in this context, are those who favor expanding their understanding of mental illness to include those with more mild and/or self-identifiable traits. Conservatives favor a preservation of the traditional diagnosis almost exclusively, or rather, their idea of the traditional diagnosis. To put it in more community-relevant terms, conservatism is about validating authority while liberalism is about validating individuals.1, 2 Both of these camps have shifted their viewpoints over the years, with the liberals coining their own unique terms for the sake of including those that would normally be excluded from a diagnosis completely and conservatives creating narrower and narrower criteria, almost none of which reflect the reality of psychiatry at this moment. This shifting of priorities is reactionary, meaning in direct response to one another. Here’s some examples of what that looks like in practice within the DID community:
Conservative DID systems with a large amount of fragments, easy splitting, and a complex internal structure (subsystems, layering) use the term “polyfragmented” to distinguish themselves from DID systems with a more typical structure, who they feel invalidate their unique experiences. This term is supported by older literature about DID, often focused on clusters of fragments that specialists felt needed to be condensed before proper treatment could begin.3 An increasing amount of liberal DID systems identify as polyfragmented due to a large number of alters (rather than fragments) without the unique complex structure, often fictive-heavy, that many conservative polyfragmented systems consider invalidating to their own experience. In reaction, the conservative polyfragmented systems coin terms like C-DID and HC-DID to distinguish themselves from typical DID systems yet again. “Complex” and “highly complex” are also supported by older literature, technically, but there's sure as hell nothing in any modern literature.4, see note The term HC-DID in particular is usually asserted by conservative DID systems to be exclusively caused by ritual abuse. [This is not supported by any modern study and it's incredibly unlikely anyone that currently researches DID would even attempt to argue it. Dissociative specialists can’t even say with utmost certainty that DID is exclusively a childhood trauma-caused disorder,5, see note and the concept of Complex MPD was abandoned for a good reason.]
Conservative DID systems assert that the term “traumagenic” not only describes the formation of a system, but the formation of any alter within it, primarily for the sake of distancing themselves from the dreaded non-traumagenic systems. Liberal DID systems that have alters who split in different contexts don’t feel represented by this. In reaction, they coin new origin terms to describe the many unique ways alters and systems themselves can be formed, often non-exclusive to DID. [There is very little research into the specifics of individual alter formation because, by and large, dissociative specialists view “parts” as simply a symptom as a result of the disorder rather than unique entities within it for the sake of appealing the concept of DID to skeptics of “multiple personalities.”6 Specialists don’t care about this aspect of systemhood in the ways actual systems do. Note that many term coiners are not personally DID systems, this essay just isn't about them specifically.]
If you were to ask a liberal system or a conservative system who is the source of this community strife, they’re going to point fingers at each other. Much like liberalism and conservatism in national/local politics, both groups exist under a capitalist framework, of which they both support and struggle against. In this case, psychiatry is capitalism's representative.
Psychiatry categorizes a large number of potentially relatable experiences into neat little disorder boxes. As the internet makes the field more accessible to the average person, an increasing number of individuals find themselves identifying with these things for one reason or another. Many of these people seek out community before they seek out professional treatment, whether that be because professional treatment is too expensive, frightening, unwanted, straight-up denied, or some other reason. The diagnostic criteria for mental disorders is made more and more narrow with each iteration of the DSM, which means that people who met the criteria for one thing in the DSM-IV might no longer meet the criteria in the DSM-V. In both the DSM-III and the DSM-IV, there was no requirement for the symptoms of MPD/DID to cause clinical distress in order to be diagnosed.7, 8 In theory, psychiatry says that it’s possible to have non-disordered or unconventional kinds of multiplicity. In practice, those with non-disordered and unconventional kinds of multiplicity are considered not worthy of support, attention seekers, and/or malingerers, both by psychiatrists and community members that gargle said psychiatrists’ nuts.
The liberal expands the definition of mental illness into something far more broad, back to earlier iterations of the DSM and beyond, but it nonetheless validates the existence of these oppressive categories that marginalize neurodiversity9 and disregard the impact of developmental trauma.10 The conservative clings to the oppressive categories so intensely that they deny even once acceptable, more mild presentations in the modern era that just don’t check off as many boxes as they do. Whether one is a liberal or a conservative in this community, a professional diagnosis is celebrated. A person with a psychology degree that many systems only meet once is given the power to decide definitively whether their identity is legitimate, whether they have a place in their chosen community, and whether they can find security in their ability to know themselves. No community should be built around such a power structure.
The DID community and communities like it, despite referring to itself as a community, isn’t really much of a community at all. It’s a virtual space to exist in and share your experience and argue the semantics of the so-called disorder you all have, but it’s not a way to build power, it’s not a support group, and it’s certainly not a place to foster recovery. In a world where psychiatry controls so much of the lives of people deemed mentally ill, genuine community is necessary to thrive. Intensive psychiatric treatment often dissuades patients from becoming friends or remaining in touch after being discharged, silently asserting that mental illness is a battle to be fought alone with medication and individual therapy. Forming a community over a shared condition should always be a radical act against this idea.
Citation and Notes
1. Courtland, Shane D., Gerald Gaus, and David Schmidtz, "Liberalism", The Stanford Encyclopedia of Philosophy (Spring 2026 Edition), Edward N. Zalta & Uri Nodelman (eds.). LINK.
2. Hamilton, Andy, "Conservatism", The Stanford Encyclopedia of Philosophy (Fall 2025 Edition), Edward N. Zalta & Uri Nodelman (eds.). LINK.
3. Braun, B. G. (1986). Treatment of Multiple Personality Disorder (p. 20). American Psychiatric Press.
4. Kluft, R. P. (1991). Clinical Presentations of Multiple Personality Disorder. Psychiatric Clinics of North America, 14(3), 605–629. LINK.
Extremely Complex MPD, Highly Complex MPD, and Complex MPD are things that Kluft described in the late 80s/early 90s and I feel like it should be obvious to anyone that reads about it current day that he pulled it out of his ass. The section where Extremely Complex MPD, also called Polyfragmented MPD, is described within the PDF (p. 622) includes shit like Secret MPD, Puppeteering MPD, Pseudo-False Positive MPD, just these strangely hyperspecific labels for different presentations that were never as distinct as Kluft and his research buddies claimed they were.
5. Şar, V., Dorahy, M., & Krüger, C. (2017). Revisiting the Etiological Aspects of Dissociative Identity Disorder: a Biopsychosocial Perspective. Psychology Research and Behavior Management, Volume 10(10), 137–146. LINK.
Can't really prove a negative but part of my statement felt a bit too contentious to not provide some clarity for. For those that don't check sources and just trust that they support whatever point the author is trying to make, this journal pretty thoroughly explains how DID (as psychiatry defines it) is caused by childhood trauma. Also, stop doing that, people lie.
My point is not that there is little evidence of DID being caused by childhood trauma, but that a theory is just that: a theory. Note phrasing like, “While current evidence is sufficient to firmly establish this etiological stance, given the wide opportunities for innovative research, the disorder is still understudied.” Our understanding of science (or a field of study that insists it's scientific) is constantly changing and many of the current theories for how DID actually develops are heavily criticized even by specialists, such as the Theory of Structural Dissociation.
6. Stronghold. (2023, April 18). How they took the Multiple out of Multiplicity – Understanding the History of Dissociative Identity Disorder (DID) Terminology. Power to the Plurals. LINK.
7. American Psychiatric Association. (1987). Diagnostic and Statistical Manual of Mental Disorders : DSM-III-R. (3rd ed., p. 269–272). American Psychiatric Association.
8. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders : DSM-IV-TR. (4th ed., p. 484–487). American Psychiatric Association.
9. Kiera Lyons. (2023, November 8). THE NEURODIVERSITY PARADIGM AND ABOLITION OF PSYCHIATRIC INCARCERATION. Columbia Law Review. LINK.
10. Van Der Kolk, B. (2015). The Body Keeps the Score (p. 151-170). Penguin Books.