Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Which pattern better explains the sequence, protective function, and consequences: dissociation or perfectionism?

Dissociation

Dissociation can reduce overwhelming distress during threat but may later impair memory integration, presence, agency, and relational engagement.

TraumaAffectBehaviour+1

Perfectionism

Perfectionism can drive achievement but may maintain anxiety, depression, shame, procrastination, avoidance, and burnout.

CognitionBehaviourAffect+1

Definition

AA disruption or disconnection in memory, identity, emotion, perception, behaviour, body experience, or sense of self.

BA rigid pattern of setting excessively high standards and linking worth, safety, or acceptability to flawless performance.

Core process

AOverwhelming arousal or threat is managed by disconnection, detachment, numbing, derealisation, depersonalisation, or memory compartmentalisation.

BConditional self-worth and threat appraisal attach high emotional cost to mistakes, uncertainty, or ordinary limitation.

Look for

ATime loss · Spacing out

BAll-or-nothing standards · Difficulty finishing

Patient language

A“I was not really there”

B“If it is not perfect, it is a failure”

Maintaining cycle

AThreat cue -> overwhelm -> dissociation -> reduced processing -> cue remains potent

BHigh standard -> threat of mistake -> overcontrol or avoidance -> temporary relief -> standard remains rigid

Treatment leverage

AIncrease present-moment orientation and safety before intensive processing.

BReduce the link between worth and flawless performance.

Check before using

AThe person is deliberately avoiding while awareness and memory remain intact.

BHigh standards are flexible, values-based, and not associated with significant distress or impairment.

Formulation language

Dissociation appears to protect against overwhelming affect, but it may also interrupt integration and reduce present-moment agency.

Open full guide

Formulation language

Perfectionism appears to protect against shame through high control, but it increases self-criticism and avoidance when standards cannot be met.

Open full guide

Browse the map Use both hypotheses

Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Which pattern better explains the sequence, protective function, and consequences: dissociation or perfectionism?

Dissociation

Dissociation can reduce overwhelming distress during threat but may later impair memory integration, presence, agency, and relational engagement.

TraumaAffectBehaviour+1

Perfectionism

Perfectionism can drive achievement but may maintain anxiety, depression, shame, procrastination, avoidance, and burnout.

CognitionBehaviourAffect+1

Definition

AA disruption or disconnection in memory, identity, emotion, perception, behaviour, body experience, or sense of self.

BA rigid pattern of setting excessively high standards and linking worth, safety, or acceptability to flawless performance.

Core process

AOverwhelming arousal or threat is managed by disconnection, detachment, numbing, derealisation, depersonalisation, or memory compartmentalisation.

BConditional self-worth and threat appraisal attach high emotional cost to mistakes, uncertainty, or ordinary limitation.

Look for

ATime loss · Spacing out

BAll-or-nothing standards · Difficulty finishing

Patient language

A“I was not really there”

B“If it is not perfect, it is a failure”

Maintaining cycle

AThreat cue -> overwhelm -> dissociation -> reduced processing -> cue remains potent

BHigh standard -> threat of mistake -> overcontrol or avoidance -> temporary relief -> standard remains rigid

Treatment leverage

AIncrease present-moment orientation and safety before intensive processing.

BReduce the link between worth and flawless performance.

Check before using

AThe person is deliberately avoiding while awareness and memory remain intact.

BHigh standards are flexible, values-based, and not associated with significant distress or impairment.

Formulation language

Dissociation appears to protect against overwhelming affect, but it may also interrupt integration and reduce present-moment agency.

Open full guide

Formulation language

Perfectionism appears to protect against shame through high control, but it increases self-criticism and avoidance when standards cannot be met.

Open full guide

Browse the map Use both hypotheses