Author Archives: Shervan K Shahhian, LIBERTY PSYCHOLOGICAL ASSOCIATION, The Most Comprehensive Online Library Regarding Mental Health, Psychology and Parapsychology in the World.

Doctored Degree in Clinical Psychology (PSYD) (ABD) All But Dissertation, a Masters (M.A.) in Clinical Psychology, a Bachelor's Degree (B.A.) in Psychology, a Associate Degree (AA) in Liberal Arts with an emphases in Psychology, Certification in Anger Management, Certification in MRT-Moral Reconation Therapy®, Certification in Clinical Hypnotherapy, and Certification in Advanced Hypnotherapy.

Repeated Interpersonal Threat, explained:

Repeated Interpersonal Threat refers to ongoing or recurring exposure to danger, intimidation, harm, or perceived harm coming from another person or group of people. Unlike a single traumatic event, this involves chronic relational stress, often embedded in attachment or social systems.

1. Core Features

Repeated interpersonal threat typically involves:

Ongoing exposure (not one-time)
Unpredictability
Power imbalance
Relational proximity (family, partner, caregiver, authority, peer group)
Limited escape options

Examples:

Chronic domestic violence
Emotional abuse
Coercive control
Bullying
Childhood maltreatment
Captivity or trafficking
Repeated betrayal trauma

2. Neurobiological Impact ,

“CONSULT WITH A NEUROLOGIST”

Chronic interpersonal threat dysregulates:

“CONSULT WITH A NEUROLOGIST”

Over time, the nervous system may shift into:

Persistent hyperarousal
Freeze/collapse states
Dissociation
Fragmented self-organization

This is (COULD BE) strongly associated with Trauma and Recovery as complex trauma.

3. Psychological Sequelae

Repeated interpersonal threat is more likely to produce:

Complex PTSD
Dissociative symptoms
Identity instability
Chronic shame
Attachment disorganization
Emotional dysregulation
Somatic symptoms
Altered self-concept (“I am unsafe,” “I am bad”)

When the threat occurs in childhood, especially within caregiving relationships, it disrupts:

Internal working models
Affect regulation capacity
Self-cohesion
Trust calibration

4. Developmental Context

If exposure occurs during critical periods, it often leads to:

Disorganized attachment
Defensive structural dissociation
Relational hypervigilance
Trauma-bonding patterns

The threat is especially destabilizing when:

The perpetrator is also the attachment figure.
The victim must maintain relational proximity to survive.

5. Possible Clinical Differentiation

Repeated interpersonal threat differs from:

Single-incident trauma	Repeated interpersonal threat
Acute PTSD more common	Complex PTSD more common
Memory-focused symptoms	Identity and relational disturbances
Fear-based	Shame-based plus attachment-based

6. Adaptive Function

Importantly, many symptoms are adaptive:

Hypervigilance: survival detection
Dissociation: overwhelm regulation
Emotional numbing: energy conservation
Fragmentation: containment of intolerable states

The nervous system organizes around survival, not coherence.

Shervan K Shahhian

Dissociated Self-States, what are they:

Dissociated self-states are distinct parts of a person’s personality or identity that operate somewhat independently from one another due to psychological dissociation.

Rather than experiencing the self as fully integrated, the person experiences separate “modes” of being that may have:

Different emotions
Different beliefs about self and others
Different behavioral patterns
Different memories or access to memories
Different bodily sensations

What Is Dissociation?

Dissociation is a disruption in the normal integration of:

Consciousness
Memory
Identity
Emotion
Perception
Body awareness

It exists on a continuum, from mild (e.g., daydreaming, highway hypnosis) to severe (e.g., dissociative disorders).

How Dissociated Self-States Form

Most commonly, dissociated self-states develop in response to:

Early attachment trauma
Chronic emotional neglect
Overwhelming stress
Repeated interpersonal threat

When experiences are too overwhelming, especially in childhood, the mind may compartmentalize them into separate “self-organizations.”

Types of Self-States (Structural Dissociation Model)

The theory of structural dissociation:

Apparently Normal Part (ANP)
- Handles daily life
- Avoids traumatic memories
- Focused on functioning
Emotional Part (EP)
- Holds traumatic memories
- Carries intense fear, rage, shame, or grief
- Often activated by triggers

In more complex cases (e.g., Dissociative Identity Disorder), multiple ANPs and EPs may exist.

How It Feels Subjectively

People with dissociated self-states may experience:

“Part of me feels this, another part feels that.”
Sudden shifts in mood or worldview
Feeling like a different person in different contexts
Gaps in memory
Internal dialogues between parts
Strong emotional reactions that feel “not fully me”

Importantly, this does not automatically mean psychosis. The person usually retains reality testing.

Clinical Examples

A highly competent professional who collapses into a terrified child-like state when criticized.
A nurturing caregiver who becomes emotionally numb and detached under stress.
A trauma survivor who alternates between hyper-control and emotional overwhelm.

Each state serves a survival function.

Distinguishing from Psychotic Fragmentation

Dissociated self-states:

Often trauma-linked
Context-triggered
Have internal coherence
Maintain overall identity continuity (except in severe cases)

Psychotic fragmentation:

Involves loss of reality testing
Delusions/hallucinations
Identity disruption not necessarily trauma-compartmentalized

In Modern Therapies

Several modalities work directly with self-states, including:

Internal Family Systems (IFS)
Ego State Therapy
Phase-oriented trauma therapy

These approaches aim for integration, not elimination, of parts.

Key Concept

Dissociated self-states are not pathology in themselves, they are adaptive survival strategies that became rigid.

Integration means:

Increasing communication between parts
Reducing avoidance
Developing compassionate self-leadership

Shervan K Shahhian

Stimulant Use Disorder Treatment, how:

Stimulant Use Disorder (SUD) refers to problematic use of substances like:

Cocaine
Methamphetamine
Amphetamine (including misuse of prescription stimulants)

Treatment is evidence-based, behavioral-first, and increasingly integrated with medical and trauma-informed care.

Core Treatment Approaches

1. Behavioral Therapies (First-Line)

Contingency Management (CM)

Could be The strongest evidence-based treatment for stimulant use disorder?

Provides tangible rewards for drug-free urine screens or treatment attendance
Directly targets dopamine-driven reward circuitry

Highly effective for cocaine and methamphetamine use.

Cognitive Behavioral Therapy (CBT)

Identifies triggers and high-risk situations
Builds coping skills and relapse prevention strategies
Addresses cognitive distortions (“I need it to function”)

Often combined with CM.

Community Reinforcement Approach (CRA)

Rebuilds natural reward systems (work, relationships, health)
Replaces drug reinforcement with life reinforcement

Matrix Model

Developed specifically for stimulant addiction.
Combines:

CBT
Relapse prevention
Psychoeducation
Drug testing
Family involvement

2. Medications

“Consult With a Medical Center for Alcohol and Drug Abuse”

Research continues, but behavioral therapy Could remain primary?

3. Treatment Settings

Outpatient programs
Intensive outpatient (IOP)
Residential treatment (if severe or unsafe environment)
Dual-diagnosis programs (if co-occurring disorders present)

Stimulant use and abuse disorder frequently co-occurs with:

Trauma disorders
ADHD
Mood disorders
Dissociation
Personality vulnerabilities

Integrated care Could improve outcomes?

4. Withdrawal & Early Recovery

Stimulant withdrawal “COULD BE” psychological?

Common symptoms:

Fatigue
Depression
Anhedonia
Sleep disturbance
Suicidal ideation (MUST BE monitored closely)

Crash phase: 24–72 hours
Subacute dysphoria: weeks

Monitoring for major depression is essential.

5. Relapse Prevention

Focus areas:

Trigger mapping
Craving wave surfing
Sleep stabilization
Rebuilding dopamine naturally (exercise, novelty, mastery)
Social restructuring

Neurobiologically: recovery MIGHT requires restoring mesolimbic dopamine sensitivity. “Consult With a Medical Center for Alcohol and Drug Abuse”

6. Emerging Approaches

Transcranial Magnetic Stimulation (TMS)
Digital therapeutics
Trauma-informed somatic therapies
Psychedelic-assisted therapy (research stage only)

Prognosis

“Consult With a Medical Center for Alcohol and Drug Abuse”

Recovery is very possible, but stimulant addiction often has:

High relapse rates early on
Gradual brain recovery over 6–18 months

Long-term outcomes improve dramatically with:

Structure
Community
Accountability
Meaning reconstruction
Shervan K Shahhian

Internal Voices vs Psychotic Voices, what are the differences:

The distinction between internal voices and psychotic voices is clinically important, especially in trauma work, dissociation, and psychosis-spectrum conditions.

Below is a structured comparison from a psychological lens.

Internal Voices (Non-Psychotic)

These are usually understood as forms of inner experience, not hallucinations.

They may occur in:

Normal inner speech (self-talk)
High stress
Trauma-related dissociation
Parts-based personality structures (e.g., IFS-style parts)
Grief
Intense imagination

Characteristics

Experienced as coming from inside the mind
Recognized as “my thoughts” or “a part of me”
Often dialogical (self arguing with self)
Usually retain reality testing
Can be influenced intentionally
Person knows they are not external beings

Examples:

“Part of me wants to leave, part of me wants to stay.”
Hearing a deceased loved one’s voice internally but knowing they are not physically present.
Critical self-talk with a tone or personality.

Neurocognitively, these relate to variations in inner speech generation and monitoring, often involving prefrontal–temporal circuits.

Psychotic Voices (Auditory Verbal Hallucinations)

These are typically associated with disorders like:

Schizophrenia
Schizoaffective disorder
Bipolar disorder (with psychotic features)
Severe major depression with psychosis

Characteristics

Experienced as external (outside the head)
Often perceived as autonomous entities
Not recognized as self-generated
May comment, command, or converse
Frequently intrusive and uncontrollable
Often accompanied by delusions
Impaired reality testing

Examples:

“The government is speaking to me through the wall.”
Voices giving commands.
Multiple distinct voices arguing about the person.

Neuroimaging studies suggest altered activity in speech perception areas (e.g., superior temporal gyrus) and impaired source monitoring.

“CONSULT WITH A NEUROLOGIST, and a PSYCHIATRIST”“

Trauma-Related Voices (The Gray Area)

This is where things get clinically nuanced.

In conditions like:

Dissociative identity disorder
Complex PTSD
Severe developmental trauma

Voices may:

Feel separate or “not me”
Have distinct identities
Represent dissociated self-states
But still exist within a dissociative framework rather than primary psychosis

Key difference:
Reality testing is often largely intact, and the voices are psychologically meaningful (linked to trauma memory, internalized figures, attachment disruptions).

Core Differentiators

Feature	Internal Voices	Psychotic Voices
Location	Inside mind	External space
Ownership	Recognized as self/part of self	Experienced as other
Reality testing	Intact	Impaired
Control	Some influence possible	Little to none
Associated symptoms	Dissociation, stress	Delusions, disorganization
Insight	Usually present	Often absent

Important Clinical Note

Voice hearing alone does not equal psychosis.

Many non-psychotic individuals report voice-like experiences, especially:

Trauma survivors
Highly imaginative individuals
Individuals under extreme stress
People in bereavement

The key question is:

Is reality testing intact?

From a Depth Psychology Perspective

Internal voices can represent:

Internalized parental objects
Superego structures
Dissociated ego states
Unintegrated affective fragments

Psychotic voices tend to reflect:

Breakdown in ego boundaries
Failed source monitoring
Projection of internal content into perceived external reality
Shervan K Shahhian

Clinical Dissociative Symptoms, an explanation:

Clinical dissociative symptoms are disruptions in the normal integration of consciousness, memory, identity, emotion, perception, body awareness, or behavior. They go beyond ordinary “spacing out” and are typically distressing, impairing, or trauma-related.

I will outline both descriptively and diagnostically.

Core Clinical Dissociative Symptoms

1. Depersonalization

A sense of detachment from oneself.

Feeling like an outside observer of your own thoughts or body
“I feel unreal” or robotic
Emotional numbing
Altered body perception

Seen prominently in Depersonalization/Derealization Disorder.

2. Derealization

Detachment from the external world.

Surroundings feel dreamlike or artificial
Visual distortions (foggy, flat, overly vivid)
Time distortion

Often co-occurs with depersonalization.

3. Dissociative Amnesia

Inability to recall important autobiographical information (usually trauma-related).

Memory gaps for specific events
“Lost time”
Sudden unexplained travel (fugue state)

Associated with Dissociative Amnesia and, in extreme form, dissociative fugue.

4. Identity Disturbance / Identity Fragmentation

Disruption in sense of self.

Feeling like different parts of self take control
Internal voices (not psychotic in origin)
Shifts in behavior, affect, skills

Most pronounced in Dissociative Identity Disorder.

5. Dissociative Numbing

Emotional shutdown or anesthesia.

Reduced emotional reactivity
Detachment during trauma reminders
Often part of trauma-spectrum disorders

Common in Post-Traumatic Stress Disorder (especially the dissociative subtype).

6. Absorption / Trance States

Extreme attentional narrowing.

Losing awareness of surroundings
“Autopilot” functioning
Hypnotic-like states

Mild forms are normative; clinical when frequent and impairing.

Clinical Clusters

Dissociation typically falls into three functional domains:

Domain	Symptoms
Detachment	Depersonalization, derealization, numbing
Compartmentalization	Amnesia, identity fragmentation
Altered Consciousness	Trance states, time distortion

Differential Considerations

Dissociative symptoms must be differentiated from:

Psychotic disorders (loss of reality testing)
Neurological conditions (e.g., temporal lobe epilepsy)
Substance-induced states
Severe anxiety or panic states
Personality disorders (e.g., borderline-level identity disturbance)

Unlike psychosis, dissociation typically preserves reality testing.

Trauma Link

Clinically significant dissociation is strongly associated with:

Early attachment disruption
Chronic childhood trauma
Overwhelming affect states
Developmental relational trauma

Neurobiologically, it reflects altered integration between:

“Consult a Neurologist, an MD”

Limbic system (emotional activation)
Prefrontal cortex (executive regulation)
Default mode network (self-processing)

When It Becomes a Disorder

Dissociation becomes clinically diagnosable when it:

Causes distress or impairment
Is recurrent and involuntary
Is not culturally normative
Cannot be explained by substances or medical causes, get a Medical Doctor’s Opinion”
Shervan K Shahhian

Clinical Dissociative Symptoms, an explanation:

I will outline both descriptively and diagnostically.

Core Clinical Dissociative Symptoms

1. Depersonalization

A sense of detachment from oneself.

Feeling like an outside observer of your own thoughts or body
“I feel unreal” or robotic
Emotional numbing
Altered body perception

Seen prominently in Depersonalization/Derealization Disorder.

2. Derealization

Detachment from the external world.

Surroundings feel dreamlike or artificial
Visual distortions (foggy, flat, overly vivid)
Time distortion

Often co-occurs with depersonalization.

3. Dissociative Amnesia

Inability to recall important autobiographical information (usually trauma-related).

Memory gaps for specific events
“Lost time”
Sudden unexplained travel (fugue state)

Associated with Dissociative Amnesia and, in extreme form, dissociative fugue.

4. Identity Disturbance / Identity Fragmentation

Disruption in sense of self.

Feeling like different parts of self take control
Internal voices (not psychotic in origin)
Shifts in behavior, affect, skills

Most pronounced in Dissociative Identity Disorder.

5. Dissociative Numbing

Emotional shutdown or anesthesia.

Reduced emotional reactivity
Detachment during trauma reminders
Often part of trauma-spectrum disorders

Common in Post-Traumatic Stress Disorder (especially the dissociative subtype).

6. Absorption / Trance States

Extreme attentional narrowing.

Losing awareness of surroundings
“Autopilot” functioning
Hypnotic-like states

Mild forms are normative; clinical when frequent and impairing.

Clinical Clusters

Dissociation typically falls into three functional domains:

Domain	Symptoms
Detachment	Depersonalization, derealization, numbing
Compartmentalization	Amnesia, identity fragmentation
Altered Consciousness	Trance states, time distortion

Differential Considerations

Dissociative symptoms must be differentiated from:

Psychotic disorders (loss of reality testing)
Neurological conditions (e.g., temporal lobe epilepsy)
Substance-induced states
Severe anxiety or panic states
Personality disorders (e.g., borderline-level identity disturbance)

Unlike psychosis, dissociation typically preserves reality testing.

Trauma Link

Clinically significant dissociation is strongly associated with:

Early attachment disruption
Chronic childhood trauma
Overwhelming affect states
Developmental relational trauma

Neurobiologically, it reflects altered integration between:

“Consult a Neurologist, an MD”

Limbic system (emotional activation)
Prefrontal cortex (executive regulation)
Default mode network (self-processing)

When It Becomes a Disorder

Dissociation becomes clinically diagnosable when it:

Causes distress or impairment
Is recurrent and involuntary
Is not culturally normative
Cannot be explained by substances or medical causes, get a Medical Doctor’s Opinion”
Shervan K Shahhian

Disassociated Behavior, explained:

Dissociated behavior (more commonly called dissociative behavior) refers to actions, experiences, or mental states that occur when a person becomes partially disconnected from their thoughts, emotions, body, memory, or sense of identity.

Dissociation exists on a spectrum, from normal and mild to severe and clinical.

Normal / Mild Dissociation (Common Human Experience)

These are everyday examples:

“Zoning out” while driving (highway hypnosis)
Daydreaming
Losing track of time while reading
Feeling slightly detached during stress

These are usually harmless and temporary.

Stress-Induced Dissociated Behavior

Under high stress or threat (related to the freeze response in the autonomic nervous system), a person may:

Appear emotionally numb
Speak in a flat tone
Seem “far away” or spaced out
Have slowed responses
Report feeling unreal or detached

This is often protective, the nervous system dampens overwhelming emotion.

Clinical Dissociative Symptoms

When dissociation becomes chronic or disruptive, behaviors may include:

Depersonalization

Feeling detached from your body
Watching yourself from the outside
Feeling robotic or unreal

Derealization

The world feels dreamlike or artificial
People seem distant or distorted

Dissociative Amnesia

Memory gaps
Not remembering important events
“Lost time”

Identity Fragmentation

Seen in severe trauma-related conditions like Dissociative Identity Disorder:

Distinct identity states
Behavioral shifts that feel outside conscious control

Behavioral Signs Others Might Notice

Sudden personality shifts
Blank staring episodes
Mechanical or automatic behavior
Inconsistent recall of conversations
Emotional responses that don’t match the situation

Why Dissociation Happens

From a trauma-informed perspective, dissociation is a defensive adaptation:

Overwhelming childhood trauma
Attachment disruption
Chronic stress
Emotional flooding
Nervous system hyperarousal followed by shutdown

It is often linked to polyvagal shutdown (dorsal vagal response),

“Consult with a neurologist/ an MD“

Important Distinction

Dissociation X psychosis.

In psychosis, reality testing is impaired (e.g., delusions, hallucinations).
In dissociation, the person often knows something feels “off” or unreal.

Shervan K Shahhian

Self-Visualization, what is it:

Self-visualization is the deliberate use of mental imagery to imagine yourself thinking, feeling, or performing in a particular way. It’s widely used in psychology, performance training, and psychotherapy.

Guided, intentional self-imagery that influences cognition, emotion, and behavior.

1. What It Is (Psychological Definition)

Self-visualization involves:

Mentally picturing yourself (first-person or third-person)
Engaging sensory details (sight, sound, body sensation)
Rehearsing a desired state or outcome
Linking imagery to emotional and somatic experience

It activates neural pathways similar to real behavior, a principle strongly used in performance psychology and sports science.

2. Two Main Forms

First-Person (Internal) Visualization

You see through your own eyes.

You feel the body
You experience emotions directly
More effective for emotional conditioning and nervous system regulation

Third-Person (Observer) Visualization

You see yourself from outside, like watching a movie.

Good for identity restructuring
Helpful for self-concept work
Used in trauma distancing techniques

3. Clinical & Performance Applications

Performance Psychology

Used by athletes to mentally rehearse races.

Mental rehearsal improves motor coordination, reaction time, and confidence.

Cognitive Behavioral Therapy (CBT)

Visualizing successful coping
Replacing catastrophic imagery

Trauma Therapy

Safe-place visualization
Rescripting traumatic memory imagery
Strengthening ego-state stability

Identity & Self-Concept Work

Used in:

Future-self work
Self-compassion imagery
Rebuilding identity after destabilization

4. Nervous System Effects

(CONSULT A NEUROLOGIST)

When done properly, self-visualization can:

Reduce sympathetic arousal
Increase vagal tone
Strengthen neural circuits of desired behavior
Create state-dependent memory encoding

If emotionally overwhelming, it can also:

Trigger dissociation
Activate trauma networks
Intensify shame or fear imagery

So regulation capacity matters.

5. Psychological Mechanisms

Self-visualization works through:

Neuroplasticity
Mirror neuron activation
Emotional conditioning
Implicit memory reconsolidation
Expectancy effects

The brain does not sharply distinguish between vividly imagined and actual experience at the neural activation level.

6. Healthy vs Unhealthy Self-Visualization

Healthy

Grounded in reality
Enhances functioning
Builds embodied confidence
Improves adaptive behavior

Unhealthy

Grandiose fantasy
Escape from reality
Reinforces avoidance
Inflates unstable identity

Shervan K Shahhian

SMART frameworks, a great explanation:

The SMART framework is a structured method for setting clear, actionable goals. It’s widely used in performance psychology, business, coaching, and clinical work.

What SMART Stands For

S: Specific The goal is clearly defined and unambiguous. Instead of: “Improve mental health. ”Use: “Practice 10 minutes of diaphragmatic breathing daily.”

M: Measurable You can track progress with observable criteria. “How will I know I’m succeeding?”

A: Achievable Realistic given current resources, time, and constraints. It should stretch you, but not overwhelm your nervous system.

R: Relevant Aligned with your deeper values, priorities, and identity. In therapy terms: congruent with ego strength and developmental capacity.

T: Time-bound Has a defined timeframe.

Example: “For the next 6 weeks.”

Example (Performance Psychology)

Instead of:

“I want to reduce anxiety.”

SMART version:

“For the next 8 weeks, I will practice 5 minutes of paced breathing before work at least 5 days per week and track my anxiety levels on a 1–10 scale.”

Variations of SMART

Over time, researchers and practitioners have expanded it:

SMARTER: Adds:
- E: Evaluated (regular review)
- R: Revised (adjust as needed)
SMARTR: The final R: Reward (reinforcement principle)
CLEAR goals (alternative model), Collaborative, Limited, Emotional, Appreciable, Refinable

Psychological Value of SMART

From a clinical perspective:

Reduces cognitive diffusion and vague rumination
Converts abstract distress into behavioral activation
Builds self-efficacy
Creates measurable feedback loops
Supports executive function stabilization

It moves a person from existential overwhelm: operational agency.

Shervan K Shahhian

How Does Psychosomatic Illness develops:

Psychosomatic illness develops when psychological stress or emotional conflict leads to real physical symptoms or worsens an existing medical condition. It’s not “imagined” , the body truly reacts to mental and emotional strain through biological pathways.

Here’s how it typically develops step-by-step:

1. Emotional or Psychological Stress

A person experiences ongoing stress, anxiety, depression, trauma, or unresolved emotional conflict.

Examples: grief, work pressure, relationship problems, guilt, fear.

2. Activation of the Stress Response

(CONSULT A NEUROLOGIST/MD)

The fight-or-flight system (sympathetic nervous system) becomes chronically activated.

The brain (especially the hypothalamus) signals the adrenal glands to release stress hormones , mainly adrenaline and cortisol.

3. Physical Changes in the Body

(CONSULT A NEUROLOGIST/MD)

These hormones affect many body systems:

Cardiovascular: increased heart rate, blood pressure.
Digestive: reduced digestion, stomach acid imbalance.
Immune: suppressed or overactive immune response.
Muscular: tension, pain.

If stress persists, these changes stop being temporary , they start to damage tissues or organs.

4. Symptom Formation

(CONSULT A NEUROLOGIST/MD)

Over time, this leads to physical symptoms such as:

Headaches, migraines
Stomach ulcers or irritable bowel
Chest pain, palpitations
Chronic fatigue, muscle pain
Skin rashes, eczema
Hypertension

The symptoms are real but are triggered or worsened by psychological factors.

5. Reinforcement Cycle

The physical symptoms cause more worry and stress, which further increases physiological arousal , creating a vicious cycle of mind–body interaction.

6. Chronic Condition or Disorder

(CONSULT A NEUROLOGIST/MD)

Without addressing the psychological roots (through therapy, stress management, or emotional processing), the symptoms can become chronic and difficult to treat medically alone.

Shervan K Shahhian