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: splitting or shame?

Splitting

Splitting can simplify unbearable ambivalence but may destabilise relationships, teams, and self-experience.

DefenceInterpersonalAffect+1

Shame

Shame often links trauma, attachment threat, avoidance, concealment, anger, self-criticism, and disengagement from care.

AffectTraumaAttachment+1

Definition

AAn all-or-none way of organising self, others, or situations into wholly good or wholly bad categories when mixed representations feel intolerable.

BA painful self-conscious affect in which the self is experienced as exposed, defective, unacceptable, or at risk of rejection.

Core process

AConflicting positive and negative representations are not integrated, so affective state strongly shapes the current view.

BGlobal negative self-evaluation and anticipated social devaluation drive hiding, appeasing, attacking, or withdrawal.

Look for

ASudden idealisation or devaluation · Team splitting

BDowncast gaze · Concealment

Patient language

A“They are the only one who understands me”

B“There is something wrong with me”

Maintaining cycle

AAttachment threat -> intense affect -> polarised appraisal -> rupture -> threat increases

BExposure -> shame -> hiding or attack -> isolation or rupture -> shame intensifies

Treatment leverage

AHelp the patient tolerate mixed representations without escalating shame or abandonment fear.

BReduce concealment and self-attack while building tolerable interpersonal safety.

Check before using

AThe person can hold mixed views but is making a stable, evidence-based judgement.

BThe primary affect is guilt about a specific harm with intact self-worth.

Formulation language

Under attachment threat, splitting may make it hard to hold mixed feelings about self and others, intensifying rupture and repair cycles.

Open full guide

Formulation language

Shame appears to organise the patient around hiding and self-protection, reducing exposure but maintaining isolation and self-criticism.

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: splitting or shame?

Splitting

Splitting can simplify unbearable ambivalence but may destabilise relationships, teams, and self-experience.

DefenceInterpersonalAffect+1

Shame

Shame often links trauma, attachment threat, avoidance, concealment, anger, self-criticism, and disengagement from care.

AffectTraumaAttachment+1

Definition

AAn all-or-none way of organising self, others, or situations into wholly good or wholly bad categories when mixed representations feel intolerable.

BA painful self-conscious affect in which the self is experienced as exposed, defective, unacceptable, or at risk of rejection.

Core process

AConflicting positive and negative representations are not integrated, so affective state strongly shapes the current view.

BGlobal negative self-evaluation and anticipated social devaluation drive hiding, appeasing, attacking, or withdrawal.

Look for

ASudden idealisation or devaluation · Team splitting

BDowncast gaze · Concealment

Patient language

A“They are the only one who understands me”

B“There is something wrong with me”

Maintaining cycle

AAttachment threat -> intense affect -> polarised appraisal -> rupture -> threat increases

BExposure -> shame -> hiding or attack -> isolation or rupture -> shame intensifies

Treatment leverage

AHelp the patient tolerate mixed representations without escalating shame or abandonment fear.

BReduce concealment and self-attack while building tolerable interpersonal safety.

Check before using

AThe person can hold mixed views but is making a stable, evidence-based judgement.

BThe primary affect is guilt about a specific harm with intact self-worth.

Formulation language

Under attachment threat, splitting may make it hard to hold mixed feelings about self and others, intensifying rupture and repair cycles.

Open full guide

Formulation language

Shame appears to organise the patient around hiding and self-protection, reducing exposure but maintaining isolation and self-criticism.

Open full guide

Browse the map Use both hypotheses