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A Heaven in a Wild Flower: Self, Dissociation, and Treatment in the Context of the Neurobiological Core Self

Fosha, Diana

This paper considers how a clinical understanding of self, dissociation, and therapeutic process is shaped by: (a) current affective neuroscience work on the neurobiological core self (Damasio, 1999, 2010; Northoff & Panksepp, 2008; Panksepp & Northoff, 2008); (b) longitudinal developmental research on attachment patterns and dissociation (Dutra, et al., 2009a; Dutra, et al., 2009b; Lyons–Ruth, 2003, 2006; Ogawa et al., 2007); and (c) neurobiological research on how dissociation affects the brain (Bluhm et al., 2009; Lanius et al., 2006, 2010, 2011). I explore how the fundamentally coherent nature of the neurobiological core self relates to self as clinically conceived (Faranda, 2009; Frederickson, 2003). With a clinical method based on the moment-to-moment tracking of the phenomenological manifestations of affective experience, I focus on moments that possess qualities of integrative experience, i.e., moments possessed of coherence, vitality, energy and/or subjective truth: I propose that such moments of experience are manifestations of the fundamentally integrative neurobiological core self in fractal form. Attending to them all the while being immersed in the fragmented world of dissociative experience is important: they contain resources to be recruited for the trauma and neglect work ahead. Thus equipped, both in this paper and in treatment, dissociation and its impact on self, and then its treatment, can be considered. I conclude with some snapshots from clinical work with a patient manifesting dissociation as neurobiologically defined here. The mechanism of recognition is shown to play a major role in the search-and-rescue mission for and of the patient's felt sense of self.

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