Can dissociative symptoms exist without an underlying dissociation of the personality? Yes!

Abstract

In his article “Trauma-related dissociation: an analysis of two conflicting models”, Van der Hart (2021) provides an overview of two major models of trauma-related dissociation that he contributed to develop. Van der Hart also discusses the theoretical reasons behind his current preference for the most recent model of structural dissociation of the personality, which is based on a narrow view of dissociation as a division of the personality, over his previous multidimensional model. While I praise Van der Hart's intellectual honesty in clarifying his current position, I contend that he derogates the dimensional models of dissociation available in the literature, despite there is evidence that these models are theoretically consistent, empirically supported, and clinically useful. I also suggest that the criterion of dissociative subsystems having their own sense of self, which is at the core of the structural dissociation theory, might not be necessary for identifying trauma-related dissociative phenomena. Finally, I propose that understanding dissociation as trauma-related alterations, rather than alternations, of consciousness and its functions might be particularly consistent with current research findings and with the actual symptoms displayed by individuals who had suffered from complex trauma.