Cover -- Title -- Copyright -- Contents -- Contributors -- Foreword -- Preface -- Reference -- Introduction: The Ubiquity of Dissociation -- Part I: Toward a Neurobiological Model of Dissociation -- Dissociation-Multiple Phenomena -- The Autonomic Nervous System (ANS)-Sympathetic, Dorsal Vagal, and Ventral Vagal -- Ubiquity is Hardwired-Everybody Can Dissociate -- Learned Helplessness (LH), Tonic Immobility (TI), and Anesthetic Neurochemicals -- Severity of Peritraumatic Dissociation and Attachment -- Integrative Capacity -- Part II. Treatment: Being Embodied and Safely Telling the Truth -- Ebb and Flow, Affect Modulation, and the Window of Tolerance -- Association and Dissociation-Accelerator and Brakes -- Integrating Different Information Processing Therapies -- Body-Oriented and Somatic Therapies -- Ego State Therapy -- EMDR -- Adjunctive Pharmacological Interventions-Opioid Antagonists -- References -- Part I: Neurobiology -- Introduction: Dissociation and Neurobiology -- Traumatic Dissociation -- Peritraumatic Dissociation, Anesthetic Neurochemicals, and Structural Dissociation -- Toward a Neurobiological Understanding -- References -- Chapter 1: Dissociation: Cortical Deafferentation and the Loss of Self -- The Brain-An Associative Organ -- Loss of Integrative Capacity-Toward a Functional Mechanism of Dissociation -- Brain Architecture Reflects Horizontal Layers -- Brain Architecture Also Reflects Vertical Columns -- Sensory Integration Plays a Critical Role in Horizontal and Vertical Integration -- How Does the Brain Conduct Sensory Integration? -- A Switchboard-The Role of the Thalamus in Vertical and Horizontal Integration -- Superior (SC) and Inferior Colliculi (IC) and Sensory Integration -- The Role of the Corpus Callosum in Horizontal Integration -- Trauma Impairs Sensory Integration.

Trauma and Stress-The Role of Analgesic Neurochemicals -- Sensory Integration Under Threat-Dissolution and the Loss of Higher Cortical Functioning -- The Thalamus-Analgesic Chemicals and Retraction of Consciousness -- PD-When the Thalamus Acts as Circuit Breaker for the Cortex -- The Effect of Endogenous Opioids on Thalamic Function -- The Role of the Thalamic Nuclei in Integrative Functioning of the Brain -- Opioid Activation, Deafferentation, and Symptom Specificity -- Pierre Janet-Field of Consciousness, Partial Catalepsy, and Deafferentation -- The Nature of Affective Circuits and Structural Dissociation -- Analgesic Response and Separate Self-States: ANPs and EPs -- Truncated Affective Circuits, Structural Dissociation, and Self-States -- Loss of Higher Cortical Functioning-Positive and Negative Symptoms -- Somatoform Dissociation and Deafferentation -- Summary and Future Directions -- References -- Chapter 2: Threat and Safety: The Neurobiology of Active and Passive Defense Responses -- Case Summary: Defense Responses in Response to Social Threat -- The Range of Defense Responses -- Trauma has an Impact on the Representations of the Self in the Midbrain -- Waiting, Watching, and the Security Motivation System -- Proximity of Threat and Activation of the Midbrain -- Potential Threat and the ACC -- Perceived Threat and the SC -- Threat Requires Rapid Motor, Attention, and Arousal Responses -- A Taxonomy of the Midbrain's Range of Defense Responses -- Orienting to Threat -- Orienting to Threat at Different Levels of the Brain -- Avoidance: Withdraw, Hide, and Cringe Responses -- The SC and the PAG in Avoidance/Hiding/Withdrawal -- Using the Urge to Avoid in Therapy -- Flight -- Fight -- Immobility -- Social Threat: Cortical and Midbrain Responses -- Submission -- The Mesolimbic Defensive Response to Environmental Stress -- Summary -- References.

Chapter 3: Peritraumatic Dissociation and Tonic Immobility: Clinical Findings -- Peritraumatic Dissociation -- Definition of PD -- PD and Risk of Developing Posttraumatic Stress Disorder (PTSD) -- PD in Different Populations -- Tonic Immobility -- TI as a Peritraumatic Response -- TI and the Defense Cascade Model -- TI in Laboratory Animals -- TI and Fear -- TI Research in Humans -- TI and Later Psychopathology -- Comparing and Contrasting PD and TI -- PD and TI During Traumatic Events and their Long-Term Effects -- Correlation of PD and TI in Clinical Studies -- PD, TI, and Memory -- PD, TI, and the Defense Cascade -- Conclusion -- References -- Chapter 4: A Social-Cognitive-Neuroscience Approach to PTSD: Clinical and Research Perspectives -- Self-Referential Processing and the DMN in PTSD -- Theory of Mind in PTSD -- Theory of Mind and Direct Eye Contact -- Conclusions -- References -- Chapter 5: Dissociation and Endogenous Opioids: A Foundational Role -- Endogenous Opioids: A Functional Mechanism of Dissociation -- From the Outside and Within: Endogenous and Exogenous Opioids -- The Opioid System: Opioids, Opioid Receptors, and Opioid Antagonists -- The Foundational Role of Endogenous Opioids -- Endogenous Opiates, Dissociation, and Parasympathetic Regulation: A Braking System -- Prolonged Stress and Neglect-From Dimmer Switch to Hairline Trigger -- The Loss of Life Energy: Opioids and Breathing -- Freeze and Immobilization-Passive Defensive Responses and Dissociation -- Endogenous Opioids-Inhibition of Active Defensive Responses -- LH as a Model for Dissociation -- SIA: An Animal Model for Numbing -- Perceived Control, Severity of Stress, and Analgesia -- SIA and the Ubiquity of Dissociation-The Role of Cognitive Factors -- SIA, Emotional Numbing, and Alexithymia: No Feeling.

No Feeling and Vehement Emotions-Alexithymia and Affective Dysregulation -- Opioids and Loss of Memory: Amnestic Mechanisms -- Opioids and Neuroplasticity: Obstructed Growth and Learning -- Summary -- References -- Chapter 6: Attachment, Neuropeptides, and Autonomic Regulation: A Vagal Shift Hypothesis -- Opioids, Oxytocin, and Vasopressin: Attachment and Autonomic Regulation -- Mammalian Species and Attachment: Dorsal Vagal Versus Ventral Vagal Immobilization -- Maternal Behavior-Opioids Interfere, Oxytocin Facilitates -- Oxytocin and Parturition -- Mammalian Species and Nourishment-The Need for Social Bonds -- Attachment and Endogenous Opiates -- Avoidant Attachment: Opioids and Social Withdrawal -- The Oxytocin-Opiate System Modulates Attachment and Affiliation -- Separation Vs. Attachment-Panic and Seeking -- Seeking for Food to Ensure Survival -- Separation Anxiety-A Biological Leash -- Responses to Separation-Proximity Seeking Versus Despair -- Opioids and the Quietening of the Separation Cry-The Loss of the Relational -- Kappa Opioids Produce Dysphoria and Dissociation -- Oxytocin-Attachment and Social Connection -- Oxytocin-A Physiological Mechanism for Healing the Body and the Soul -- Oxytocin and Amygdala Activity-Effects on Trust, Pain, and Fear -- Oxytocin Reduces the Addictive Potential of Opioids -- Oxytocin and Vasopressin-Differential Effects on Memory -- Vasopressin Promotes Active Defensive Behavior: Avoidance and Aggression -- Attachment and Trauma-Opioid and Vasopressin System Dysregulation -- Opioid Modulation of Oxytocin and Vasopressin -- Opioids Inhibit Oxytocin and Vasopressin Secretion: A Vagal Shift Hypothesis -- Remediating the Effects of Trauma-Ventral Vagal Engagement and Active Defensive Responses -- Summary -- References -- Chapter 7: Defense Responses: Frozen, Suppressed, Truncated, Obstructed, and Malfunctioning.

Prolonged Arousal -- Types of Freeze Response -- Introduction: Taxonomy of Freeze Responses -- Submissive or Dorsal-Vagal Freeze and the vlPAG -- Frozen Fight and Frozen Flight: Coactivation of Rostral/Caudal l/dlPAG and vlPAG? -- Tonic Immobility -- The Window of Affect Tolerance and Freeze Responses -- Self-Loathing and Freeze Responses -- Attentional Focus and Vigilance Freeze States -- Obstructed Fight and Flight: Cortical Regulation of Defense Responses -- Submission and Depression -- Traumatic Stress and the Projections From the Midbrain to the Ventral Striatum and PFC -- Clinical Implications of the Changes in the Mesolimbic Dopamine System -- Submission and Shame: Withdrawal and Hiding -- References -- Chapter 8: The Clinical Sequelae of Dysfunctional Defense Responses: Dissociative Amnesia, Pain and Somatization, Emotional Motor Memory, and Interoceptive Loops -- Threat Can Produce Involuntary Movement and Dissociative Amnesia by Interrupting Thought and Evoking Subcortical Circuits -- Hippocampal Deactivation at a Time of Peril -- Hippocampal Volume Reduction in Dissociative Disorders -- High Arousal and Low Arousal Produce Different Dissociative Symptoms -- Neurochemical Contributors to SIA and High-and Low-Arousal Dissociation -- High-Arousal and Low-Arousal Peritraumatic Dissociation: Endocannabinoids and Endogenous Opioids -- Cortical Contributors to High-Arousal Dissociation -- Endocannabinoids and the Long-Term Consequences of Trauma -- Chronic Pain, Chronic Dissociative Analgesia, and Somatization Symptoms -- A Clinical Example Illustrates the Relationship Between Trauma and Somatoform Symptoms -- Micturition and the Midbrain Defense Response Areas -- Maternal Separation in Animal Models of Pain Syndromes -- Interoceptive Pathways and Pain -- Pain and Arousal -- Chronic Pain and Allodynia.

Numbing of Pain in Dissociative Disorders: Possible Anatomical Substrates.