In this video, psychiatrist Dr Sanil Rege breaks down the neuroscience of dissociation — a crucial yet often misunderstood dimension of trauma and PTSD. While most clinicians associate PTSD with hyperarousal, Dr Rege explains the other half of the picture: dissociation — emotional numbing, detachment, and shutdown driven by the brain’s defensive circuitry. You’ll learn how to recognise dissociation in your patients, understand the underlying brain circuits and neurotransmitters, and apply evidence-based treatment strategies that prevent retraumatisation. Dr Rege is a consultant psychiatrist, educator, and founder of The Academy by Psych Scene, where he’s trained over 10,000 mental-health professionals globally. 🕒 CHAPTERS 0:00 – What Is Dissociation? 2:24 – Two Faces of Trauma: Hyperarousal vs Dissociation 3:28 – The Brain’s Defence Cascade and the Role of the PAG 4:13 – Neurotransmitters in Dissociation: Mu & Kappa Opioids, Endocannabinoids 5:03 – Clinical Pitfalls: When Therapy Reinforces Dissociation 5:38 – How to Recognise Dissociation in Practice 6:05 – Treatment Strategies: Matching Interventions to Brain State 7:01 – Role of Medication in Dissociation: Naltrexone, SSRIs, and Clonidine 8:02 – Phase-Oriented Trauma Therapy Explained 🔍 Key Insights for Clinicians & Learners 1. Dissociation ≠ Weakness — it’s the brain’s survival mechanism when escape feels impossible. 2. Hyperarousal and dissociation represent opposite ends of trauma circuitry: emotional under-modulation vs over-modulation. 3. Neural drivers: Prefrontal-limbic inhibition, periaqueductal grey (PAG) activation, and opioid-endocannabinoid systems. 4. Clinical red flag: Flat affect, detachment, or “blankness” during trauma exposure may indicate in-session shutdown. 5. Therapeutic principle: Match intervention to arousal state — down-regulate hyperarousal, up-regulate dissociation. 6. Avoid pitfalls: Relaxation or benzodiazepines can deepen dissociative shutdown. 7. Best practice: Phase-oriented therapy → (1) Safety & Stabilisation (2) Processing (3) Integration. #Trauma #Dissociation #PTSD #Neuroscience #PsychiatrySimplified #PsychScene #DrSanilRege #MentalHealthEducation #Neurobiology #Psychotherapy #BrainScience #CPTSD --- Related Content --- What Mental Health Disorder Did Amber Heard Have? Exploring PTSD, BPD, & Complex PTSD https://youtu.be/XG5DKbR-H5k -🎓 Explore the full trauma curriculum: https://www.academy.psychscene.com -- 🎓RESOURCES BY PSYCH SCENE: 🌐 The Academy by Psych Scene: PSYCHIATRY EDUCATION REDEFINED https://academy.psychscene.com/ Revolutionary psychiatry learning. 🌐 Psych Scene Hub: PSYCHIATRY TEXTBOOK OF THE FUTURE https://psychscenehub.com/ The Hub is devoted to making you a better mental health professional. Our team of academic and clinical experts bring you powerful summaries, videos and interviews in psychiatry and neurosciences. 🌐 Psych Interview Online: REAL WORLD SKILLS FOR REAL WORLD SUCCESS https://www.psychinterview.com/ The Psych Interview online courses offer high-quality training to help you improve your psychiatric interview skills through self-study. They are suitable for Psychiatrists, Psychiatry trainees, Mental health practitioners, Nurses and General Practitioners. 🌐 Psych Scene Online: THE ONLINE COURSES TO HELP YOU SUCCEED https://ranzcpexams.psychscene.com/ Learn at your own pace with the RANZCP Written Exam prep online courses, psychotherapy online course and CEQ podcasts brought to you by the Psychiatry Training Experts. 🌐 Psych Scene: THE PSYCHIATRY TRAINING EXPERTS https://psychscene.com/ Psych Scene offers specialised training and professional development for Psychiatry Trainees, Psychiatrists, General Practitioners and Mental Health Practitioners. Here you can find our upcoming live courses. -- 📱SOCIALS Subscribe for weekly videos on Psychiatry and Neuroscience: https://www.youtube.com/@drrege Instagram: https://www.instagram.com/psychiatry.excellence/ Facebook: https://m.facebook.com/PsychSceneHub – 👋 LET’S CONNECT! Follow Sanil Rege on LinkedIn: https://www.linkedin.com/in/sanilregepsychiatrist/ For business inquiries, speaking gigs or partnership opportunities, please email me at sanil@psychscene.com #ptsd #posttraumaticstressdisorder #posttraumaticstress

In this video, psychiatrist Dr Sanil Rege breaks down the neuroscience of dissociation — a crucial yet often misunderstood dimension of trauma and PTSD. While most clinicians associate PTSD with hyperarousal, Dr Rege explains the other half of the picture: dissociation — emotional numbing, detachment, and shutdown driven by the brain’s defensive circuitry. You’ll learn how to recognise dissociation in your patients, understand the underlying brain circuits and neurotransmitters, and apply evidence-based treatment strategies that prevent retraumatisation. Dr Rege is a consultant psychiatrist, educator, and founder of The Academy by Psych Scene, where he’s trained over 10,000 mental-health professionals globally. 🕒 CHAPTERS 0:00 – What Is Dissociation? 2:24 – Two Faces of Trauma: Hyperarousal vs Dissociation 3:28 – The Brain’s Defence Cascade and the Role of the PAG 4:13 – Neurotransmitters in Dissociation: Mu & Kappa Opioids, Endocannabinoids 5:03 – Clinical Pitfalls: When Therapy Reinforces Dissociation 5:38 – How to Recognise Dissociation in Practice 6:05 – Treatment Strategies: Matching Interventions to Brain State 7:01 – Role of Medication in Dissociation: Naltrexone, SSRIs, and Clonidine 8:02 – Phase-Oriented Trauma Therapy Explained 🔍 Key Insights for Clinicians & Learners 1. Dissociation ≠ Weakness — it’s the brain’s survival mechanism when escape feels impossible. 2. Hyperarousal and dissociation represent opposite ends of trauma circuitry: emotional under-modulation vs over-modulation. 3. Neural drivers: Prefrontal-limbic inhibition, periaqueductal grey (PAG) activation, and opioid-endocannabinoid systems. 4. Clinical red flag: Flat affect, detachment, or “blankness” during trauma exposure may indicate in-session shutdown. 5. Therapeutic principle: Match intervention to arousal state — down-regulate hyperarousal, up-regulate dissociation. 6. Avoid pitfalls: Relaxation or benzodiazepines can deepen dissociative shutdown. 7. Best practice: Phase-oriented therapy → (1) Safety & Stabilisation (2) Processing (3) Integration. #Trauma #Dissociation #PTSD #Neuroscience #PsychiatrySimplified #PsychScene #DrSanilRege #MentalHealthEducation #Neurobiology #Psychotherapy #BrainScience #CPTSD --- Related Content --- What Mental Health Disorder Did Amber Heard Have? Exploring PTSD, BPD, & Complex PTSD https://youtu.be/XG5DKbR-H5k -🎓 Explore the full trauma curriculum: https://www.academy.psychscene.com -- 🎓RESOURCES BY PSYCH SCENE: 🌐 The Academy by Psych Scene: PSYCHIATRY EDUCATION REDEFINED https://academy.psychscene.com/ Revolutionary psychiatry learning. 🌐 Psych Scene Hub: PSYCHIATRY TEXTBOOK OF THE FUTURE https://psychscenehub.com/ The Hub is devoted to making you a better mental health professional. Our team of academic and clinical experts bring you powerful summaries, videos and interviews in psychiatry and neurosciences. 🌐 Psych Interview Online: REAL WORLD SKILLS FOR REAL WORLD SUCCESS https://www.psychinterview.com/ The Psych Interview online courses offer high-quality training to help you improve your psychiatric interview skills through self-study. They are suitable for Psychiatrists, Psychiatry trainees, Mental health practitioners, Nurses and General Practitioners. 🌐 Psych Scene Online: THE ONLINE COURSES TO HELP YOU SUCCEED https://ranzcpexams.psychscene.com/ Learn at your own pace with the RANZCP Written Exam prep online courses, psychotherapy online course and CEQ podcasts brought to you by the Psychiatry Training Experts. 🌐 Psych Scene: THE PSYCHIATRY TRAINING EXPERTS https://psychscene.com/ Psych Scene offers specialised training and professional development for Psychiatry Trainees, Psychiatrists, General Practitioners and Mental Health Practitioners. Here you can find our upcoming live courses. -- 📱SOCIALS Subscribe for weekly videos on Psychiatry and Neuroscience: https://www.youtube.com/@drrege Instagram: https://www.instagram.com/psychiatry.excellence/ Facebook: https://m.facebook.com/PsychSceneHub – 👋 LET’S CONNECT! Follow Sanil Rege on LinkedIn: https://www.linkedin.com/in/sanilregepsychiatrist/ For business inquiries, speaking gigs or partnership opportunities, please email me at sanil@psychscene.com #ptsd #posttraumaticstressdisorder #posttraumaticstress

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