Clinical Social Work Journal

, Volume 38, Issue 3, pp 260–268 | Cite as

The Therapist as Psychobiological Regulator: Dissociation, Affect Attunement and Clinical Process

Original Paper


Dissociation is defined as a protective coping mechanism employed on a broad spectrum: from day-to-day “spacing out” to psychic numbing to multiplicity. A convergence of recent insights in traumatology, neuroscience, and developmental theory is reviewed. These findings all point to the importance of affect regulation in infant and child development and in the therapeutic relationship, where attunement to implicit communication is crucial. Using such relational and intersubjective organizing principles as the concept of enactment and Beebe and Lachmann’s (Infant research and adult treatment: Co-constructing interactions 2002) “three principles of salience,” I discuss an analytic case in which dissociation is a central dynamic.


Dissociation Trauma Affect regulation Hyperarousal Enactment 



Thank you to Hillary Butler, Edith Gould, Amy Joelson, Linda Laughlin, Kristin Moore and Dorienne Sorter for your helpful comments. A shorter version of this paper was presented at the 2009 AAPCSW conference: Memory, Myth and Meaning in a Time of Turmoil.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Psychoanalytic Institute, Postgraduate Center for Mental HealthNew YorkUSA
  2. 2.Psychoanalytic Psychotherapy Study CenterNew YorkUSA
  3. 3.New YorkUSA

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