Psychotherapy for Attachment, Trauma and Dissociation

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Dissociation is sometimes thought as being a range of experiences on a continuum.




It is totally natural to become so engrossed and focused in a movie or a good book and the other experiences going on around us to disappear. This can be termed as the 'non-pathological' end of the continuum, in that it includes common experiences such as daydreaming while driving a vehicle.

In the lower end of the the continuum, dissociation can be regarded as a coping or a defense mechanism which may help a person to master, minimize or tolerate stress.

Dissociative disorders, including dissociative fugue and depersonalisation disorder with or without alterations in personal identity or sense of self can cause a range of limiting experiences and can be thought of as pathological as can include:

  • A sense that self or the world is unreal (depersonalisation and derealisation);
  • A loss of memory (amnesia);
  • forgetting identity or assuming a new self (fugue);


"Without realizing it, I fought to keep my two worlds separate. Without ever knowing why, I made sure, whenever possible, that nothing

passed between the compartmentalization I had created" (van Derbur, 2004, p. 26)

Fragmentation of identity or self into separate streams of consciousness (dissociative identity disorder, formerly termed multiple personality disorder) and complex post-traumatic stress disorder.

For this reason they are typically experienced as 'startling, autonomous intrusions into the person's usual ways of responding or functioning' and Due to their unexpected and largely inexplicable nature, they tend to be quite unsettling.

Dissociative disorders are sometimes triggered by trauma, but may be preceded only by stress, psychoactive substances, or no identifiable trigger at all.

The 'Accommodation Complex' (Cross, 2012)

If the traumatic experience has originated inside a significant interpersonal childhood relationship, it should follow that the recovery and the healing process should need to take place within a socially interpersonal conscious significant experience such as a safe therapeutic relationship. 

The ‘‘accommodation complex’’ refers to the reality that for many clients their experiences, which are so contradictory and confusing, cannot be accommodated naturally. To do so means the compartmentalisation of experiences (structural dissociation – creation of emotional segments related to traumatic experiences which have not been effectively processed to be assimilated and accommodated), to deal with the fact that an equilibrium in the internal emotional world cannot be attained, e.g. ‘‘dad of the night and dad of the day’’.

I contend that the context in which the psychological injury takes place can assist in understanding the specific interventions that will be appropriate to aid getting to a new place for the client. In this way, the experiences which have been ‘‘hard wired’’ into the child’s or adults neurological safety preservation system (survival – we all seek to survive) can be integrated (integrated effectively) and re-connected to an internalised experience characterised by safety, stability, boundaries and attachment.

Since all relationships inevitably have problems, this system involves a conscious rupture and repair process, in which the child and adult can learn that apparently broken relationships (non abusive) can be retrieved.


Cross, R (2012) Interpersonal childhood trauma and the use of the therapeutic community in recovery, The International Journal of Therapeutic Communites, p39 - 58, vol 33, no 1 

van Derbur, M. (2004), Miss America by Day: Lessons Learned from Ultimate Betrayals and Unconditional Love, Oak Hill Press, Denver, CO


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