Trauma-related dissociation and altered states of consciousness: a call for clinical, treatment, and neuroscience research

Eur J Psychotraumatol. 2015 May 19:6:27905. doi: 10.3402/ejpt.v6.27905. eCollection 2015.

Abstract

The primary aim of this commentary is to describe trauma-related dissociation and altered states of consciousness in the context of a four-dimensional model that has recently been proposed (Frewen & Lanius, 2015). This model categorizes symptoms of trauma-related psychopathology into (1) those that occur within normal waking consciousness and (2) those that are dissociative and are associated with trauma-related altered states of consciousness (TRASC) along four dimensions: (1) time; (2) thought; (3) body; and (4) emotion. Clinical applications and future research directions relevant to each dimension are discussed. Conceptualizing TRASC across the dimensions of time, thought, body, and emotion has transdiagnostic implications for trauma-related disorders described in both the Diagnostic Statistical Manual and the International Classifications of Diseases. The four-dimensional model provides a framework, guided by existing models of dissociation, for future research examining the phenomenological, neurobiological, and physiological underpinnings of trauma-related dissociation.

Keywords: Dissociation; anterior cingulate; complex PTSD; consciousness; dissociative subtype; emotion; insula; interoceptive awareness.