Encompassing the contributions of expert clinicians and researchers in the area of traumatic stress and dissociation, this volume is the first to integrate current neuroscience research regarding traumatic dissociation with several cutting-edge approaches to treatment, providing a comprehensive, neurobiologically based treatment approach.

The text discusses current neuroscientific research regarding traumatic stress and dissociation that includes attachment, affective neuroscience, polyvagal theory, structural dissociation, and information processing theory, yielding a comprehensive model that guides treatment and clinical interventions for traumatic dissociation. It then integrates this model with stage-oriented treatment and current therapeutic interventions, including EMDR, somatic and body psychotherapy approaches, Ego State Therapy, and adjunctive pharmacological interventions. Readers are given hands-on practical guidance regarding clinical decision making, enabling them to make sound choices about interventions that will facilitate optimal treatment outcomes.

Key Features:

Provides a broad-based treatment approach to traumatic stress syndromes and dissociation
Offers accessible current research in the basic neurosciences relevant to our understanding of attachment, traumatic stress, and dissociation
Includes practical suggestions for integrating EMDR, somatic, and body psychotherapy approaches with Ego State Therapy and adjunctive pharmacological interventions
Integrates concepts from the affective and cognitive neurosciences and the study of consciousness
Presents a comprehensive neurobiological model that accounts for the therapeutic effects of both somatic therapies and EMDR, as well as adjunctive pharmacological interventions

Contents

Contributors ix

Foreword by Jaak Panskepp, PhD xi

Preface xv

Introduction: The Ubiquity of Dissociation by Sandra L. Paulsen and Ulrich F. Lanius xix

PART I. NEUROBIOLOGY

Introduction: Dissociation and Neurobiology 1

Ulrich F. Lanius

1. Dissociation: Cortical Deafferentation and the Loss of Self 5

Ulrich F. Lanius, Sandra L. Paulsen, and Frank M. Corrigan

2. Threat and Safety: The Neurobiology of Active and Passive Defense Responses 29

Frank M. Corrigan

3. Peritraumatic Dissociation and Tonic Immobility: Clinical Findings 51

Michelle J. Bovin, Elise Ratchford, and Brian P. Marx

4. A Social–Cognitive–Neuroscience Approach to PTSD: Clinical and Research

Perspectives 69

Ruth Lanius, Paul Frewen, Anthony Nazarov, and Margaret C. McKinnon

5. Dissociation and Endogenous Opioids: A Foundational Role 81

Ulrich F. Lanius

6. Attachment, Neuropeptides, and Autonomic Regulation:

A Vagal Shift Hypothesis 105

Ulrich F. Lanius

7. Defense Responses: Frozen, Suppressed, Truncated, Obstructed, and

Malfunctioning 131

Frank M. Corrigan

8. The Clinical Sequelae of Dysfunctional Defense Responses: Dissociative Amnesia,

Pain and Somatization, Emotional Motor Memory, and Interoceptive Loops 153

Frank M. Corrigan

9. Shame and the Vestigial Midbrain Urge to Withdraw 173

Frank M. Corrigan

10. Attachment and Attachment Repair 193

Frank M. Corrigan, Alistair Wilson, and Deirdre Fay

11. Dissociation, EMDR, and Adaptive Information Processing: The Role of Sensory

Stimulation and Sensory Awareness 213

Ulrich F. Lanius and Uri Bergmann

PART II. TREATMENT

Introduction: Dissociation and Psychotherapy 243

Sandra L. Paulsen and Ulrich F. Lanius

12. Seeing That Which Is Hidden: Identifying and Working

With Dissociative Symptoms 247

Sandra L. Paulsen and Ulrich F. Lanius

13. The Compassionate Self 269

Frank M. Corrigan, Alistair Wilson, and Deirdre Fay

14. Stabilization Basics 289

Sandra L. Paulsen and Joan Golston

15. Stabilizing the Relationship Among Self-States 321

Sandra L. Paulsen and Joan Golston

16. Alexithymia, Affective Dysregulation, and the Imaginal: Resetting the Subcortical

Affective Circuits 341

Sandra L. Paulsen, Katie O’Shea, and Ulrich F. Lanius

17. Fractionating Trauma Processing: TOTEMSPOTS and Other

Attenuating Tactics 367

Sandra L. Paulsen and Ulrich F. Lanius

vi Contents

18. Accelerating and Decelerating Access to Self-States 383

Sandra L. Paulsen

19. Integrating Body and Mind: Sensorimotor Psychotherapy and Treatment of

Dissociation, Defense, and Dysregulation 399

Pat Ogden and Janina Fisher

20. Temporal Integration of Early Trauma and Neglect 423

Sandra L. Paulsen

21. Toward an Embodied Self: EMDR and Somatic Interventions 447

Ulrich F. Lanius and Sandra L. Paulsen

22. Opioid Antagonists and Dissociation: Adjunctive

Pharmacological Interventions 471

Ulrich F. Lanius and Frank M. Corrigan

Index 499

Authors

Ulrich F. Lanius, PhD, RPsych, BCETS, is a clinical and neuropsychological psychologist, EMDRIA Approved Consultant, and EMDR Institute Facilitator who is currently in private practice in British Columbia, Canada.

Sandra Paulsen, PhD, is co-founder of the Bainbridge Institute for Integrative Psychology, WA. She provides consultation to individuals and organizations, emphasizing clinical specialties including EMDR, energy psychology, trauma, dissociation, ego state therapy, and consultation.

Francis Martin Corrigan, MD, is the Consultant Psychiatrist at Argyll & Bute Hospital, Scotland, with responsibilities for general psychiatric evaluations for all in/out patients. He is a psychiatrist, neuroscientist and researcher, and an accredited EMDR consultant - EMDR Association UK & Ireland.

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