What We Know, What We Don't, and What Comes Next

Dissociation research has matured enormously in 30 years — but significant scientific, clinical, and ethical questions remain open. Intellectual honesty requires holding both what we know and what we cannot yet say.

• Established: dissociation is real, measurable, neurobiologically supported, strongly associated with trauma and disorganized attachment, and exists on a spectrum. Phase-based treatment is evidence-supported.

• Contested: the recovered memory debate remains unresolved — both authentic trauma forgetting and false memory creation are empirically documented; clinicians must hold both truths simultaneously without collapsing into either extreme

• Contested: the trauma model vs. sociocognitive model of DID — neuroimaging increasingly favors genuine structural differentiation, but methodological debates continue; neither model fully accounts for all cases

• Emerging: psychedelic-assisted therapy (particularly psilocybin and MDMA) is producing early evidence for trauma and PTSD — but implications for highly dissociative individuals are poorly understood and require careful research

• Future directions: predictive processing frameworks (Friston, Seth) offer a promising neuroscientific account of dissociation as a failure of self-modelling; the integration of developmental neuroscience, attachment research, and clinical phenomenology represents the most productive convergence zone

"The study of dissociation is ultimately the study of how minds hold themselves together — and what happens when they can't. In that sense, it is the study of what it means to be a self at all."

- Paraphrase of a theme common across van der Kolk, Nijenhuis, and contemporary consciousness researchers

Biggest myth to leave behind: that dissociation is rare, dramatic, or something that happens to other people. It is a fundamental human capacity — one that saves lives, shapes identities, and quietly writes the hidden chapters of millions of ordinary lives.