Childhood Trauma Linked to Dissociation and Psychosis


Research into associations between childhood trauma and dissociation in 62 first-episode and 43 chronic patients with psychosis symptoms finds chronic patients reported the highest level of dissociation, and that more severe childhood trauma was associated with greater dissociative symptoms in all groups, but especially in chronic patients. Emotional abuse showed the strongest association with dissociation. Results appear in Psychiatry Research.

Abstract →Braehler, C., Valquette, L., Holowka, D., Malla, A.; Childhood trauma and dissociation in first-episode psychosis, chronic schizophrenia and community controls. Psychiatry Research. Online July 1, 2013.

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. Cap’t Obvious finally came around and said something.

    All anyone has to do is listen on any group therapy session for addiction or any mental illness to notice the trauma link.

    They preach and preach that these mental problems are diseases, “you were born that way” wile something like nine out of ten people in group therapy report childhood trauma was the beginning of there problems.

    Thanks Cap’t Obvious for writing a paper about this !

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    • Nine out of ten, yes. And I would have been no. 10, unable to put my finger on anything traumatizing in my life. Okay, a few things maybe hadn’t been that much fun to experience. But hey, I was untouchable, wasn’t I! Yeah sure. So much so that I wasn’t even one of these pitiably fragile human beings. — “Delusions”? Or just a desperate attempt to keep up a sense of self in the face of annihilation? — That, after all, I was one of these pitiably fragile human beings, and pretty much hurt, shattered actually, on top of it, was an excruciatingly painful realization. I do understand why sometimes labeled people have a hard time letting go of the illusion of the perfectly happy childhood: “Trauma?! What do you mean, trauma?! I wasn’t traumatized!!” I guess, we’ve all heard that one. Often vocalized in this quite telling, somewhat indignant, aggressive manner. The sad thing about this is that you can’t put the pieces (back) together and heal, unless you realize that you were born neither untouchable nor with a broken brain, but simply as a human being, pitiably fragile maybe, but also with an unlimited ability to heal.

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  2. From the perspective of “unconscious” nervous system regulation, not just the brain alone, is psychosis a spontaneous need to “re-orientate to “reality as it is,” within the anxiety of the lived moment? My own birth trauma & subsequent life experience, conditioned an “internalized” sense of threat, to which my nervous system adopted a non-conscious “wary” defense of my self-preservation. Yet how to become “aware” of a defensive motivation, which happened before I ever learned to think?

    Please consider;
    Is Mental illness – An Existential Crisis & Right of Passage?
    Please consider a comparison between a rather poetic conception of existential crisis, and the science of human development, which informed my new understanding;

    “So, we finally arrive at the final and perhaps most important question in this discussion:
    “Why would an individual’s psyche intentionally initiate psychosis?”

    In other words, how can something as chaotic and as potentially harmful as psychosis act as a strategy to aid someone in transcending an otherwise irresolvable dilemma? To understand this, it helps to use as a metaphor the process of metamorphosis that takes place within the development of a butterfly. In order for a poorly resourced larva to transform into the much more highly resourced butterfly, it must first disintegrate at a very profound level, its entire physical structure becoming little more than amorphous fluid, before it can reintegrate into the fully developed and much more resourced form of a butterfly.” _Paris Williams. (read more here)

    Yet how do we understand this common metaphor “psyche” and how can I explain how neuroscience gave me clues to understanding the internal NEED for my experience of “mania?” Please consider;

    “A second core assumption of systems theory is that self-organization is characterized by the emergence and stabilization of novel forms from the interaction of lower-order components and involves “the specification and crystallization of structure.” This mechanism also describes how hierarchical structural systems in the developing brain self-organize. Developmental neuroscience is now identifying the “lower” autonomic and “higher” central brain systems that organize in infancy and become capable of generating and regulating psychobiological states.

    Developing organisms internalize environmental forces by becoming appropriately structured in relation to them, and by incorporating an internal model of these exogenous signals they develop adaptive homeostatic regulatory mechanisms which allow for stability in the face of external variation. The regulation of the organism, which maintains internal stability and output regulation and enables effective response to external stimuli, therefore depends on the formation of a dynamic model of the external environment. Self-organizing systems are thus systems that are capable of generating new internal representations in response to changing environmental conditions. (p, 94)

    The human is a nonlinear dynamic system, an inherently dynamic energy-transformation regime that coevolves with its environment, one that self-organizes when exposed to an energy flux. The infant becomes attuned to an external object in its environment who consistently responds in a stimulating manner to the infant’s spontaneous impulsive energy dissipating behaviors. (p, 95)

    The nonlinear self acts “iteratively”, so that minor changes, occurring at the right moment, can be amplified in the system, thus launching it into a qualifiedly different state. Indeed energy shifts are the most basic and fundamental features of emotion, “discontinuous” states are experienced as “affect responses,” and nonlinear psychic bifurcations are manifest as rapid “affective shifts.” (p, 96)

    One of the fundamental characteristics of an emotional episode… is the synchronization of the different components of the organism’s efforts to recruit as much energy as possible to master a major crisis situation (in a positive or negative sense). (my mania in 1980) I suggest the principle applies to the developmental crisis that must be mastered as one moves along the lifespan. The continuing growth spurts of the right hemisphere that mediate attachment, the synchronization of right-brain activities between and within organisms, thus occur as the developing individual is presented with the stresses that are intrinsic to later stages of life, childhood, adolescence, and adulthood. (p, 172)

    Vagal tone is defined as “the amount of inhibitory influence on the heart by the parasympathetic nervous system.” (p, 301)

    In light of the principle that birth insult and stress interact and impair later stress regulation , early right-amygdala function, including olfactory contributions to proto-attachment communications, should be evaluated in the perinatal period. (p, 304)

    Affect dysregulation is also a hallmark of Bipolar Disorders that involve manic episodes. Manic depressive illnesses are currently understood to represent dysregulatory states. The developmental psycho-pathological precursor of a major disorder of under-regulation can be demonstrated in the practicing period histories of infants of manic depressive parents. I suggest that the necessary gene environment condition is embedded specifically in practicing period transactions. (P, 410).

    Noting the commonalities between elation as a basic practicing period mood in infants and manic symptomology in adults, Poa (1971) observes Elation as a basic mood is characterized by an experience of exaggerated omnipotence which corresponds to the child’s increasing awareness of his muscular and intellectual powers. The similarity between the two is striking. Manic disorder has also been described in terms of a chronic elevation of the early practicing affect of interest-excitement; this causes a “rushing” of intellectual activity and a driving of the body at uncontrollable and potentially dangerous speeds. (P, 410-411).” (Schore, 2003)

    Please note the my reference to mania and its implications for Paris Williams more eloquent formulation, of psychic transformation. There is even a reference to vagal-tone and birth insult, as the hints which enabled my transformation of a birth-trauma, and family dynamic, conditioned FEAR response, within the subconscious functioning of my nervous systems, into a more joyful approach to life. Yet the difficulty in sensing unconscious processes, in a culture, now addicted to Descartes famous error, of “I think therefore, I am,” is compounded by our “instinctive” underpinning of our intelligence, with a NEED for quick and easy phrases and statements. Hence, although Paris and others like him have contributed much towards re-framing the mental health debate, in America, little will really change, until we address our common, subconscious functioning, and really makes us tick.

    The positive energies of elation, as a metabolic resource for brain/nervous system structure, is what was missing in my childhood. Hence my first experience of psychosis, was a right of passage need to face the social world, as it really is. Managing the excitement of spontaneous social engagement, had always been my downfall, in relationships, where my “frozen” facial expressions met with an equally “defensive” response. All, occurring at speeds, to fast, to breech the threshold of conscious awareness. Hence, only a “sensate” approach towards understanding the sensations within my body, has helped me to re-connect with my mind’s creator, and heal a wound, long forgotten, because it happened, before I ever learned to think.

    Best wishes to all,

    David Bates.

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  3. Why look at a car that’s been wrecked in an “accident” and say the car was poorly manufactured? Congratulations, you’ve FINALLY been HONEST that trauma isn’t the same thing as a natural-born “brain disease”.

    The effects of trauma (disorders and dysfunctions) are the equivalent of shattered glass, smashed body and mangled frame of a car that’s been in a wreck.

    My WIRING is horrific. I have a horn or siren that won’t stop screaming. I’m wired weird. Neurological, you think? Chemical and Electricity? LOL.

    There is NO real “help” in this world. You’re wasting time, and people’s lives, with theses “studies”.

    Here’s a recent observation I’ve made:

    EMERGENCIES are sent home and scheduled for a future “appointment”. Don’t you think there’s something wrong with that?

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  4. “chronic patients reported the highest level of dissociation”. To report chronic patients “dissociation” is ridiculous, as the duration of time after being given a psychiatric diagnosis may be a significant cause of their “dissociation”. After a psych diagnosis the patient gets no skills (education or trade), no job, no (normal) friends, no family, no (money) material possessions. Which came first, the chicken or the egg?

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    • Psych diagnosis is the equivalent of a damnation or condemnation, I swear it. I’m focused on “equality” and “equivalency” these days, though I haven’t a clue why.

      Some individuals, such as myself, have NO LIFE beyond “psychiatry”. Twenty years of my so-called “life” and MY VERY SOUL have been CULTIVATED in this CULT called psychiatry. I look to “god” for the reason and “purpose” in this, as I apply the belief that “everything happens for a reason” and this “path” and “journey” of my “life” were “pre-created” and “co-created” before my birth, to be lived, on purpose – for GOD ONLY KNOWS WHAT. OMG.

      The only conclusion I’ve been able to reach, so far, is that I finally see this planet’s “anti-christ” and it can ONLY be psychiatry. Still, how the …

      How is this HELPING anybody to live a life, and not SUFFER IT?

      Business and occupation, as usual. Everybody needs to have something to DO, to keep them busy and occupied. People need to get paid, so they can have a nice house, nice clothes, nice family, nice vacations and nice achievements, accomplishments and victories.

      Great going, “god”. Now what am I going to do with a JUNK SOUL?

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