Table 3 Theories of Dissociation identified
Theory of Dissociation | First Author, Date | N | Description of Theory |
|---|---|---|---|
Attachment-based | (Liotti, 2004; Liotti, 2009) | 2 | Proposes dissociation is in itself a painful experience that occurs interpersonally rather than intrapsychically and disrupts caregiving |
Relational Psychoanalysis | Blizard, 2003 | 1 | Proposes dissociation as a mechanism for disrupted caregiving (mother) and to deal with ‘double-bind’ situations whereby the child is subject to seeing its caregiver as hostile or aggressive |
Theory of Structural Dissociation of the Personality (TSDP) | Mosquera, 2014 | 1 | Proposes that dissociation happens intra-psychically and splinters the personality in such a way that it become impossible to access certain ‘parts’ of the personality, usually divided into ‘emotional’ and ‘apparently normal’ parts, leading to disrupted caregiving in those who have dissociated ‘parts’ of the personality |
Diagnostic and Statistical Manual (DSM) | Hulette, 2011*; Lewis, 2020; Ozturk, 2006 | 3 | Dissociation is defined broadly as any interruption to subjective integration of various mental systems (behavioural, emotional, sensory etc.), which may lead to lapses in effective parenting |
Neuropsychoanalysis | Mucci, 2021 | 1 | Dissociation is located as a right-brain-hemispheric phenomena that occurs in respect to ‘relational’ trauma of a pre-oedipal kind (i.e. developmentally early). Dissociation is seen as an intrapsychic defence against overwhelming emotions that are triggered in infants in response to human-inflicted trauma. Dissociation then operates unconsciously and pre-verbally and is associated with internalisation of split-off ‘victim-persecutor’ internal working models, which then govern emotional response to others including in a caregiving setting i.e. in BPD adults providing care for offspring |
Betrayal Trauma Theory* | Hulette, 2011* | 1* | Dissociation most likely to occur in those who have a close relationship to the perpetrator. In mothers who have BPD or suffer high betrayal trauma and dissociation, the theory states that the awareness of external threats to their offspring may be diminished due to overreliance on defensive dissociation to deal with stressful or affectively salient stimuli and situations |
Psychoneurobiology | Schore, 2001 | 1 | Dissociation is discussed in terms of a neurobiological defence against metabolic dysregulation occurring as a part of stress cascade responses in the face of unregulated emotional activation. The neurobiology of dissociation in infants is discussed, as well as the interpersonal consequences of dissociation and the long-term effects of (infant) dissociation. Maternal dissociation is an automatic blunting response, primed from infancy, and disrupts infant attachment through ‘suboptimal neurobiological priming’ i.e. Mothers are unable to effectively regulate their own offspring due to their own dissociative responses |
No theory offered but dissociation subsumed under other issues | Hesse, 2000; Reinelt, 2014 | 2 | Dissociation is seen as a symptom of BPD but not necessarily discussed as a causative agent of mother–child disruption |
None (not explicated) | Crandell, 2003; Haltigan, 2019; Hobson, 2005; Hobson, 2009; Kiel, 2011; Lyons-Ruth, 2012; Macfie, 2014; Stepp, 2012; Zalewski, 2014 | 9 | Dissociation is implied or explicitly addressed, but no definition is offered for the construct by the authors |