Traumatic Effects Beyond Diagnosis

The Impact of Dissociation on the Mind–Body–Brain System

Mucci, Clara
Scalabrini, Andrea

Department of Psychological, Health and Territorial Sciences (DiSPuTer), G. d’Annunzio University of Chieti-Pescara

Clara Mucci, PhD, PsyD, and Andrea Scalabrini, PhD, PsyD, wrote the article. We thank Michelangelo De Amicis for his help with editing and references of this work. The authors declare no competing financial interests. This work is published in memory of Philip Bromberg (1931–2020).

Clara Mucci, PhD, PsyD, the Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino 2, Begamo (BG), Italy [email protected]

Andrea Scalabrini, PhD, PsyD, Department of Psychological, Health and Territorial Sciences (DiSPuTer), G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 33, 66100 Chieti (CH), Italy [email protected]

Received June 4, 2020

revised September 29, 2020

Accepted October 5, 2020

Psychoanalytic Psychology 38(4):p 279-289, October 2021. | DOI: 10.1037/pap0000332

Trauma-related disorders and their related phenomena remain a fundamental quibble in the psychopathological diagnosis. Only the Psychodynamic Diagnostic Manual-2 recognizes the long time enduring effects of trauma of human hand as distinct from accidents or natural catastrophes, while the Diagnostic and Statistical Manual of Mental Disorders–5 (DSM-5) does not. A response to trauma of human hand with effects on the mind–body–brain system is dissociation, a psychic mechanism denied for many years from Freud but reprised by the work of Janet and Ferenczi. Departing from psychoanalysis in a dialect relationship with neuroscientific research, we aim to highlight how dissociation is only in trauma of human agency and found its etiology in the three levels of interpersonal traumatization as proposed by Clara Mucci’s interdisciplinary and clinical observations. Trauma and dissociation couple the neuronal and abnormal functioning of brain and leave traces in body and on the implicit internalized past relationship from attachment. Clinicians and psychotherapists need to move beyond diagnosis and address all the implicit relational dissociative psychic states in order to re-establish a “physiological secure base” to maintain a cohesive and extended sense of self and relatedness.