Does the past shape the present, or does dissociation shape the the past? A comparison between the trauma model and the fantasy model of dissociation, and five reasons to endorse the trauma model

In the last 20 years, many researchers and clinicians have been involved into a fierce debate on dissociation and dissociative disorders. Such debate concerns the very origins of dissociative disorders, especially dissociative identity disorder. Trauma model (TM) theorists endorse the view that dissociative disorders have their roots in traumatic experiences, while a competing fantasy or socio-cognitive model (SCM) conceives dissociation as a personality trait involving a weak sense of self and high suggestibility. A review of the available literature on the validity, assessment, and treatment of dissociation and dissociative disorders has been performed to compare these two models of dissociation. The construct of dissociation proposed by TM theorists shows more than adequate content validity (consistent patterns of symptoms involved in dissociative disorders), criterion validity (high inter-rater reliability between clinicians), and construct validity (psychological and neurobiological findings supporting the predictions of TM theory). Longitudinal and cross-sectional findings support the view that dissociation is trauma-related and neglect-related. Treatment studies show that TM treatment is effective for dissociative disorders, while there is a total lack of treatment studies based on the SCM. TM theory showed adequate empirical support, whereas SCM theory showed limited empirical support. Therefore, people who show high levels of dissociation will likely benefit from trauma-informed treatment, rather than from other interventions that minimize the role of trauma in the onset and maintenance of dissociative symptoms.