Linking the Overwhelming with the Unbearable: Developmental Trauma, Dissociation, and the Disconnected Self

In this article, we propose a developmental trauma model of psychopathology, grounded in convergent findings in psychoanalytic, developmental, and affective neuroscience research. We suggest that dissociation is a key variable in understanding clinical disorders that have their roots in relationally traumatic experiences during childhood. Dissociation links the overwhelming with the unbearable: it inextricably binds the experiences of abuse, neglect, and disrupted communication with attachment figures during childhood with the development of unbearable self-experiences that cannot be integrated into the consciousness and therefore continue to disturb the individual throughout his or her entire life. In fact, developmental trauma often initiates maladaptive psychological and biological pathways in the individual's life, for on both an emotional and cognitive level, it is too much for a child to tolerate. In this case, dissociation may paradoxically protect the traumatized child from a fragmentation of the self through multiple disconnections in the self, occurring at both mental and bodily levels. These disconnections can derive from overt experiences of abuse and neglect, which may directly lead to intense affect dysregulation and lack of integration between self-states; or they can be more actively arranged to cope with perceived threats derived from procedural memories of the caregivers' specific failures to respond. Implications for treatment of adult patients who suffered from developmental trauma are discussed.