The Dissociative Process: Expanding the Conceptualization and Clinical Implications

Dissociation is a response to an overwhelming event where the integration of present experience is disrupted. Traditionally, the physiological mechanism behind this failed integration has been linked to the hypoaroused, parasympathetic-dominant freeze state. In this paper, I argue that the traditional conceptualization of dissociation is too narrow in its frame of reference. Relying on recent developments in the fields of clinical neuroscience and relational psychoanalysis, I propose an expanded conceptualization of dissociation, referred to as the dissociative process, which is not limited to a specific state of arousal. Rather, the dissociative process is conceptualized as any failure to integrate aspects of present experience due to a dysregulating affect state. According to this conceptualization, the dissociative process occurs due to the inability to regulate states of hyper- or hypoarousal resulting in the neglect and/or distortion of present experience. The paper is presented in three main sections. First, recent literature is reviewed in order to demonstrate that the dissociative process is the byproduct of dysregulating affect states that consequently interfere with successful integration of present experience. Second, the clinical implications are discussed. Third, a clinical vignette is presented to illustrate how the dissociative process can be observed and addressed in-session