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 worry?

Dissociation

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

TraumaAffectBehaviour+1

Worry

Worry attempts to prepare for danger but may maintain anxiety by overestimating threat and under-testing coping.

CognitionAffectBehaviour+1

Definition

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

BRepetitive future-oriented thinking about possible threats, uncertainty, or negative outcomes.

Core process

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

BFuture threat simulations create an illusion of preparation while increasing vigilance, arousal, and safety behaviours.

Look for

ATime loss · Spacing out

BWhat-if chains · Reassurance seeking

Patient language

A“I was not really there”

B“What if something goes wrong?”

Maintaining cycle

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

BUncertainty -> worry -> temporary control -> more threat scanning -> more uncertainty

Treatment leverage

AIncrease present-moment orientation and safety before intensive processing.

BSeparate solvable problems from hypothetical threat loops.

Check before using

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

BThe main loop is past-focused rumination rather than future threat simulation.

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

Worry gives a brief sense of preparation, but it also sustains threat monitoring and prevents uncertainty tolerance.

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 worry?

Dissociation

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

TraumaAffectBehaviour+1

Worry

Worry attempts to prepare for danger but may maintain anxiety by overestimating threat and under-testing coping.

CognitionAffectBehaviour+1

Definition

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

BRepetitive future-oriented thinking about possible threats, uncertainty, or negative outcomes.

Core process

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

BFuture threat simulations create an illusion of preparation while increasing vigilance, arousal, and safety behaviours.

Look for

ATime loss · Spacing out

BWhat-if chains · Reassurance seeking

Patient language

A“I was not really there”

B“What if something goes wrong?”

Maintaining cycle

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

BUncertainty -> worry -> temporary control -> more threat scanning -> more uncertainty

Treatment leverage

AIncrease present-moment orientation and safety before intensive processing.

BSeparate solvable problems from hypothetical threat loops.

Check before using

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

BThe main loop is past-focused rumination rather than future threat simulation.

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

Worry gives a brief sense of preparation, but it also sustains threat monitoring and prevents uncertainty tolerance.

Open full guide

Browse the map Use both hypotheses