The Venn diagram of psychosis, developmental trauma and dissociation

If we go back over a century to Bleuler’s four “A’s” of schizophrenia (ambivalence, autism, affective incongruity, and association disturbances) (Bleuler, 1911) it is not hard to see a place for dissociation. However, with more modern definitions (e.g. ICD-11) dissociation doesn’t feature as a symptom, with the emphasis now being firmly upon positive and negative symptoms.

There is evidence that patients with psychosis and developmental trauma have worse clinical outcomes and more severe symptoms, in comparison to those without (Bailey et al 2018). Trauma related dissociation is a common clinical consideration, however it doesn’t currently feature as a factor in psychosis.

Within the woodland we have…