therapy – LIBERTY PSYCHOLOGICAL ASSOCIATION

Synergetic Play Therapy (SPT) is a relationship based therapeutic approach:

Synergetic Play Therapy (SPT) is a relationship based therapeutic approach that may use play as the primary language for helping children regulate emotions, process experiences, and build resilience. It blends traditional play therapy with neuroscience, attachment theory, and mindfulness.

What makes it “synergetic”?

The term refers to the idea that the therapist and child form a co-regulating system. Change doesn’t come just from the client expressing themselves, it emerges from the interaction between the client and therapist.

Instead of the therapist staying neutral, they actively use their own emotional presence to help the client learn regulation.

Core principles

1. Regulation before resolution
SPT prioritizes helping client their nervous system before trying to “fix” behavior.
A dysregulated client can’t process or integrate experiences effectively.

2. The nervous system is central
SPT draws heavily on concepts from interpersonal neurobiology
Play becomes a way to work directly with arousal, stress responses, and emotional states.

3. Co-regulation, self-regulation
The therapist models calm, grounded presence. Over time, the client internalizes this and develops their own regulation skills.

4. Authentic therapist presence
Unlike strictly non-directive models, the therapist may:

Set limits
Share observations
Stay emotionally engaged rather than neutral

How it looks in practice

A session might include:

Free play (to access the child’s inner world)
Emotional expression through toys, art, or movement
Therapist tracking the client ’s internal state (“Your body looks really tight right now…”)
Gentle boundary-setting when needed

Example:
If a client becomes aggressive in play, the therapist doesn’t just stop the behavior, they help the client notice and regulate the underlying activation.

What it’s used for

SPT is commonly applied with children experiencing:

Anxiety or emotional dysregulation
Trauma or attachment disruptions
Behavioral challenges
ADHD-related impulsivity
Social or relational difficulties

How it differs from classic play therapy

Approach	Therapist role	Focus
Child-Centered Play Therapy	Mostly non-directive	Expression & self-discovery
Synergetic Play Therapy	Actively engaged, regulating partner	Nervous system + relationship

Why it’s effective

SPT aligns with modern neuroscience:

Emotional regulation is learned through relationships
The body (not just cognition) stores and processes experience
Safe relational experiences reshape neural pathways

A grounded perspective

Given your background in psychology and interest in deeper mechanisms:
SPT is not about mystical or external influences, it’s rooted in observable processes like:

autonomic regulation
attachment dynamics
mirror neuron systems

It can feel powerful or even “intuitive,” but its mechanisms are well explained within developmental and clinical science.

Shervan K Shahhian

The NeuroAffective Relational Model (NARM) is a contemporary therapeutic approach:

The NeuroAffective Relational Model (NARM) is a contemporary therapeutic approach designed to treat developmental trauma, the kind that arises from chronic early-life experiences like neglect, misattunement, or inconsistent caregiving, rather than single shocking events.

Core Idea (in plain terms)

NARM looks at how early relational experiences shape:

your identity
your emotional regulation
your sense of connection to self and others

Instead of asking “What happened to you?” it also asks:

“How did you adapt to survive, and how are those adaptations affecting you now?”

The 5 Developmental Survival Styles

NARM proposes that people develop patterns to cope with unmet needs in childhood:

Connection: Difficulty feeling belonging or connection
Attunement: Disconnection from one’s own needs
Trust: Issues with reliance and safety in relationships
Autonomy: Trouble asserting oneself or setting boundaries
Love/Sexuality: Conflicts around intimacy and self-worth

These aren’t “pathologies”, they’re intelligent adaptations that once helped you survive.

How NARM Works in Therapy

Unlike traditional trauma models that focus heavily on past events, NARM emphasizes:

1. Present Moment Awareness

Focus on what is happening right now in your body and emotions
Tracks patterns as they arise in real time

2. Identity Level Healing

Works with core beliefs like:
- “I’m not enough”
- “I don’t matter”
These are seen as adaptations, not truths

3. Relational Healing

The therapist-client relationship becomes a corrective emotional experience
Emphasis on authenticity and mutual presence

4. Bottom Up, Top Down Integration

Combines body awareness (bottom-up) with cognitive insight (top-down)

What Makes NARM Different

Compared to something like Cognitive Behavioral Therapy or classic Psychoanalysis:

It doesn’t pathologize symptoms
It avoids over-identifying with trauma narratives
It focuses on agency, not just wounds
It works directly with shame and identity, not just behavior

Example

Someone who grew up feeling unseen might:

Adapt by becoming hyper independent
Develop a belief: “I don’t need anyone”

NARM would gently explore:

The cost of that adaptation today
The longing underneath it
The possibility of reconnecting safely

Why It’s Gaining Attention

NARM aligns with modern understandings of:

Attachment Theory
Neuroscience
The role of implicit memory and regulation

It’s especially useful for:

Chronic relationship patterns
Identity issues
Complex trauma (often called C-PTSD)

A grounded note

NARM is a legitimate, clinically used model, but like all therapies:

It’s not a universal solution
Effectiveness depends on the therapist and the client fit
Shervan K Shahhian

Post-Divorce Counseling, a great explanation:

Post-divorce counseling could be a structured form of emotional and psychological support that helps individuals process the end of a marriage and rebuild their lives in a healthy, intentional way. It may not be just about “getting over it”, it’s about integrating the experience, stabilizing identity, and moving forward with clarity.

What It Focuses On

1. Emotional Processing

Divorce may trigger grief similar to bereavement, loss of a partner, identity, routine, and future expectations. Counseling could help process:

Sadness, anger, guilt, or relief
Emotional ambivalence (missing someone you chose to leave)
Unresolved attachment wounds

2. Identity Reconstruction

Some people experience a disruption in their sense of self after divorce:

“Who am I outside this relationship?”
Shifts in roles (partner to single parent, etc.)
Rebuilding self-worth and autonomy

This may overlap with concepts like identity stabilization and self-concept restructuring.

3. Coping & Regulation Skills

Counseling strengthens:

Emotional regulation (especially if there’s conflict or co-parenting stress)
Adaptive coping (vs. maladaptive patterns like substance use or avoidance)
Stress tolerance and resilience

4. Co-Parenting Support (if applicable)

For those with children, therapy may include:

Communication strategies with ex-partner
Reducing conflict exposure for children
Navigating loyalty binds and role confusion

5. Relationship Pattern Insight

A deeper layer:

Identifying attachment styles (anxious, avoidant)
Recognizing repetitive relational dynamics
Understanding projection, transference, and unmet needs

Some Of The Common Therapeutic Approaches

Cognitive Behavioral Therapy (CBT): reframing negative thought patterns
Emotionally Focused Therapy (EFT): attachment-based emotional healing
Narrative Therapy: rewriting the personal story of the relationship
Meaning-Centered Therapy: finding purpose and meaning after loss
Family Systems Therapy: understanding relational roles and dynamics

What Makes It Different from General Therapy?

Post-divorce counseling could be more of a transition-focused therapy:

It deals with a specific life rupture
It integrates grief work, identity work and future planning
Often shorter-term but can deepen into long-term growth work

Typical Outcomes

With effective counseling, people might often:

Reach emotional closure (not necessarily reconciliation)
Develop a clearer sense of self
Form healthier future relationships
Reduce bitterness and chronic resentment
Improve functioning (work, parenting, social life)

A Deeper Lens

From a more advanced or parapsychological/meaning-oriented perspective, divorce can also be seen as:

A disruption of shared psychic/relational fields
A forced individuation process
An opportunity to examine unconscious contracts or “soul-level” dynamics

Even without adopting those frameworks literally, some clients report a sense of existential reorientation after divorce.

Shervan K Shahhian

The Fawn Response, what is it:

The fawn response could be a psychological coping strategy that emerges in response to stress, fear, or trauma, especially interpersonal trauma.

It maybe considered a fourth trauma response, alongside:

fight
flight
freeze
fawn

What is the Fawn Response?

The fawn response may involve appeasing, pleasing, or accommodating others in order to avoid conflict, rejection, or harm.

Instead of fighting back or escaping, the person might:

“moves toward” the threat by becoming agreeable, compliant, or overly helpful.

Core Features

People using the fawn response may often:

Prioritize others’ needs over their own
Struggle to say “no”
Seek approval or validation excessively
Avoid conflict at all costs
Feel responsible for others’ emotions
Adapt their personality to please others

Why It Develops

The fawn response maybe linked to chronic relational trauma, such as:

Childhood emotional neglect
Living with unpredictable or volatile caregivers
Abuse where resistance made things worse

In these environments, the nervous system may learn:

“If I keep others happy, I stay safe.”

Psychological Mechanism

From a possible clinical perspective, the fawn response may involve:

Hyper-attunement to others’ emotional states
Self-abandonment (disconnecting from one’s own needs)
A survival-based form of attachment regulation

It may overlap with concepts like:

codependency
people-pleasing
trauma bonding

Example

Someone with a strong fawn response might:

Agree with a partner even when they feel uncomfortable
Apologize excessively, even when not at fault
Stay in unhealthy relationships to avoid abandonment
Feel anxious when someone is upset, even if it’s not about them

Long-Term Effects

If it becomes a habitual pattern, it might lead to:

Loss of identity or unclear sense of self
Resentment and emotional exhaustion
Anxiety and depression
Difficulty forming authentic relationships

Healing & Integration

Recovery may focus on reclaiming the self while maintaining connection:

Learning boundaries (“no” without guilt)
Reconnecting with personal needs and emotions
Tolerating conflict and discomfort safely
Developing secure attachment patterns
Trauma-informed therapy (somatic or relational approaches)

A Deeper Frame

From a possible existential or parapsychological lens, the fawn response can be seen as:

A distortion of relational sensitivity, where intuitive attunement becomes survival-driven compliance
A misalignment between authentic self-expression and external energetic regulation

In other words:

A natural capacity for empathy becomes hijacked by fear.

Shervan K Shahhian

Dynamic Process of Adaptation to Loss, explained:

The dynamic process of adaptation to loss may refer to how people actively and continuously adjust, emotionally, cognitively, behaviorally, and even biologically, after experiencing a significant loss (such as death, separation, or major life change). It’s not a fixed sequence, but an evolving, nonlinear process.

Here could be the key ways modern psychology understands it:

1. Not Linear, but Oscillating

Denial, anger, bargaining, depression, acceptance suggested a progression, but research now shows:

People move back and forth between different states
Emotions can recur, overlap, or intensify unexpectedly
There is no universal “endpoint”

2. Dual Process Model (Core Modern View)

This is one of the most influential frameworks.

It describes adaptation as an oscillation between two modes:

Loss-oriented coping
- Grief, yearning, remembering
- Emotional pain, rumination
Restoration-oriented coping
- Adjusting to new roles and life changes
- Distraction, rebuilding, problem-solving

Healthy adaptation involves moving back and forth between these, not staying stuck in one.

3. Meaning Reconstruction

Loss might disrupt one’s assumptive world (identity, beliefs, purpose)
Adaptation involves:
- Reconstructing meaning (“Why did this happen?”)
- Rebuilding identity (“Who am I now?”)
- Integrating the loss into one’s life story

4. Continuing Bonds

Instead of “letting go,” modern theory might emphasize maintaining a transformed relationship with the deceased or lost object:

Internal dialogue
Symbolic connection (dreams, memories, rituals)
Emotional presence without physical presence

This can be especially relevant to bereavement-related anomalous experiences you’ve been exploring.

5. Biopsychosocial Adaptation

Adaptation operates across multiple systems:

Biological: stress hormones, sleep disruption, immune changes
Psychological: emotion regulation, memory, identity shifts
Social: role changes, support systems, cultural expectations

6. Individual Differences

Adaptation varies based on:

Attachment style
Type of loss (sudden vs expected)
Cultural and spiritual framework
Prior trauma or resilience

7. When Adaptation Becomes Complicated

Sometimes the process becomes stuck or prolonged, leading to conditions like:

Prolonged Grief Disorder
Persistent inability to integrate the loss
Functional impairment over time

Integrative Insight (Clinical + Parapsychology Angle)

From a strictly clinical perspective, adaptation is about internal regulation and restructuring.

From a parapsychological perspective (which you’re familiar with), some researchers suggest:

Experiences like after-death communications or bereavement visions may facilitate adaptation by:
- Providing perceived continuity
- Reducing existential disruption
- Supporting meaning reconstruction

This overlaps with, but is interpreted differently than, conventional models.

Bottom Line

The dynamic process of adaptation to loss is:

An ongoing, oscillating reconstruction of emotional life, identity, and meaning in response to absence.

It’s less about “getting over it” and more about learning to live with it in a transformed way.

Shervan K Shahhian

War and PTSD, the connection:

The connection between war and Post-Traumatic Stress Disorder (PTSD) can run very deep, well-documented, and central to modern psychology and related fields.

1. Why war is a powerful trigger for PTSD

War exposes individuals to extreme, repeated trauma, which is the primary cause of PTSD. These include:

Life-threatening combat situations
Witnessing death or severe injury
Killing or believing one has killed others
Moral conflicts (harming civilians)
Constant hypervigilance and unpredictability

This might align with the core mechanism of PTSD: overwhelming stress that exceeds the mind’s ability to process and integrate the experience.

2. Historical recognition

The link between war and PTSD has been observed for centuries, though labeled differently:

“Soldier’s heart” (American Civil War)
“Shell shock” during World War I
“Combat fatigue” in World War II

The formal diagnosis of PTSD emerged after former Wars, when many veterans showed persistent psychological distress.

3. Core symptoms in war veterans

PTSD in combat veterans typically includes:

Intrusion

Flashbacks (reliving combat)
Nightmares

Avoidance

Avoiding reminders (people, places, conversations)

Negative mood & cognition

Guilt, shame, emotional numbness
“Moral injury” (conflict with one’s values)

Hyperarousal

Constant alertness (as if still in combat)
Irritability, sleep disturbance

4. The neurobiology of war-related PTSD

Consult with a Psychiatrist

War trauma alters mind systems involved in fear and memory:

Amygdala: overactive (heightened fear response)
Hippocampus: impaired (fragmented memory processing)
Prefrontal cortex: reduced regulation of fear

This leads to a mind that is essentially “stuck in survival mode.”

5. Why war PTSD may be especially severe

Compared to civilian traumas, war often involves:

Chronic exposure: (not a single event, but repeated trauma)
Moral injury: (violating deeply held beliefs)
Unit bonding loss: (loss of comrades: grief and identity disruption)
Reintegration difficulty: (civilian life feels unreal or unsafe)

6. Prevalence

Rates might vary by conflict, but:

Combat veterans might develop PTSD
Higher rates in high-intensity combat zones
Many might experience subclinical trauma symptoms

7. Clinical vs. meaning-based interpretations

It’s worth noting two interpretive layers:

Clinical model

PTSD: trauma-related disorder with biological and psychological mechanisms
Focus: treatment (CBT, EMDR) (medication: Consult with a Psychiatrist)

Existential / parapsychological perspectives

War trauma may trigger:
- Altered states of consciousness
- Dissociation or anomalous experiences
- Heightened sensitivity to meaning, death, and survival

Some researchers might even explore overlaps between trauma and psi-related experiences, though this remains controversial.

8. Treatment and recovery

Possible evidence-based treatments include:

Trauma-focused CBT
EMDR (Eye Movement Desensitization and Reprocessing)
Exposure therapy
Group therapy (especially veteran groups)

Recovery maybe possible, but often involves reintegrating the traumatic memory into a coherent life narrative.

The Bottom Line

War could be one of the most potent environments for producing PTSD because it combines:

Extreme threat
Repetition
Moral complexity
Loss and grief

PTSD, in this context, can be understood as the mind and emotions adapting to survive war, then after struggling to readapt to peace.

Shervan K Shahhian

Mentalization-Based Therapy (MBT), explained:

Mentalization-Based Therapy (MBT) is a form of psychodynamic psychotherapy that helps people better understand their own mental states and the mental states of others, such as thoughts, feelings, intentions, and motivations. This ability is called Mentalization.

Core Idea

Mentalization means being able to ask questions like:

“Why did I react that way?”
“What might the other person have been thinking or feeling?”
“Could I be misinterpreting their intention?”

MBT helps people pause and reflect on internal experiences rather than reacting impulsively.

Research later showed it might also help with:

trauma-related disorders
depression
attachment difficulties
emotional dysregulation

Key Principles of MBT

1. Improving Awareness of Mental States

Patients learn to recognize:

their own emotions and thoughts
how those affect behavior
how others may experience situations differently

2. Reducing Misinterpretations

People under emotional stress often lose the ability to mentalize, leading to:

jumping to conclusions
assuming hostile intentions
relationship conflict

MBT helps restore reflective thinking during emotional situations.

3. Attachment Focus

MBT is strongly linked to Attachment Theory.

The therapy examines how early attachment relationships affect emotional regulation and understanding of others.

What Therapy Looks Like

MBT usually involves:

Individual therapy

exploring emotions and relationship events
examining misunderstandings in interactions

Group therapy

practicing mentalizing in real-time social interactions

Therapists often ask questions like:

“What do you think was going through their mind?”
“What were you feeling at that moment?”
“Could there be another explanation?”

Goal of MBT

The main goals are to:

improve emotional regulation
strengthen self-awareness
improve relationships
reduce impulsive behavior and conflict

Why It’s Powerful

Studies show MBT might reduce:

self-harm
suicide attempts: (SEEK IMMIDIATE EMERGENCY CARE)
emotional instability
interpersonal chaos

especially in individuals with Borderline Personality Disorder.

In simple terms:
MBT might train the mind to slow down and understand minds, both your own and other people’s.

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

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

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