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Madan, N. Bellin, E. Haden, S.C. (2015). Avoidant Coping as a Mediator between Persistent Dissociation and PTSD. J. Amer. Psychoanal. Assn., 63(3):541-548.

(2015). Journal of the American Psychoanalytic Association, 63(3):541-548

Research News & Reviews: Poster Summaries

Avoidant Coping as a Mediator between Persistent Dissociation and PTSD

Neeru Madan, Elisheva Bellin and Sara Chiara Haden

Relational psychoanalysis considers it important to understand the role of trauma and dissociation in understanding psychopathology. During a healthy developmental process, various self states exist together in harmony, giving the illusion of a cohesive sense of self. Traumatic experiences disrupt this illusion, and dissociation is often a response and pervasive sequela to a traumatic event (van Ijzendoorn and Schuengel 1996). Dissociation disrupts the normal integration of thoughts, feelings, and experiences into the stream of consciousness and memory (Bernstein and Putnam 1986). Bromberg (1993) has defined pathological dissociation as “defensive impairment of the reflective capacity brought about by detaching the mind from the self (p. 275). While pathological dissociation protects the self against any recurrence of trauma, the dissociative processes make it difficult for trauma survivors to symbolically represent the traumatic experience and associated feelings.


When an individual dissociates, it allows for the avoidance of unpleasant emotions during a traumatic event (peritraumatic dissociation) and after (persistent dissociation), thereby interfering with the emotional processing that would extinguish the fear. This then increases the likelihood that distressing emotions will continue to be experienced, culminating in the development of PTSD symptoms (Kumpula et al. 2011; Rassin and van Rootselaar 2006).

Peritraumatic dissociation is one of the strongest predictors for the development of PTSD symptoms to be found in the empirical literature (Ozer et al. 2003).

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