A Phase-Oriented Framework for Emotion Regulation in Traumatized Individuals With Dissociation: A Narrative Review

Abstract

Symptoms of emotion dysregulation and dissociation are common among people with a history of psychological trauma, and can complicate treatment effectiveness. Phase-based approaches to treatments, which begin with a stabilization and skills phase before moving to trauma-oriented interventions allow for flexible, integrable, and effective approaches that can be applied across various therapeutic modalities and delivery contexts. This narrative review describes empirically supported methods (e.g., Dialectical Behavioral Therapy) for targeting emotion dysregulation within phase-based treatments for trauma and dissociation. The flexibility and efficiency of these approaches can increase access to care (e.g., through telehealth, group formats, and brief interventions) and address current limitations of the mental healthcare system, including provider shortages. This review discusses (1) the current scientific understanding of emotion dysregulation and dissociation secondary to trauma exposure, (2) the range of flexible, evidence-based approaches for treating emotion dysregulation, (3) the translational and practical implications of a phase-based, emotion-regulation-focused treatment for traumatized individuals who experience dissociation, and 4) potential limitations to phase-based approaches including the delaying of trauma processing.