What question did this study set out to answer?

To propose a theoretical framework explaining depersonalization/derealization as a neurobiological response related to disorganized attachment.

February 25, 2026Open Access

The Two-Stage Evacuation Model: Neurobiological Mechanisms of Depersonalization/Derealization as Hierarchical Autonomic Shutdown in Disorganized Attachment

Q: What does this research mean for the field?

The Two-Stage Evacuation Model reframes depersonalization/derealization as a predictable, hierarchical autonomic shutdown sequence in individuals with disorganized attachment histories. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Points

To propose a theoretical framework explaining depersonalization/derealization as a neurobiological response related to disorganized attachment.
Introduced the Two-Stage Evacuation Model for understanding dissociative experiences.
Described two hierarchical stages: somatic-to-cortical flight and cortical-to-dissociative collapse.
Discussed the ECS-Depletion Hypothesis linking anandamide levels and KOR sensitivity to disorganized attachment.
Identified how anterior insula hypoactivation and prefrontal cortex hyper-cognition contribute to depersonalization.
Demonstrated differential vulnerability based on attachment styles, particularly in the disorganized/vlPAG-dominant profile.
Pharmacological studies indicated KOR agonist effects aligning with depersonalization experiences.

Abstract

This paper proposes the Two-Stage Evacuation Model, a neurobiologically grounded theoretical framework reframing Depersonalization/Derealization (DP/DR) as a predictable, hierarchical autonomic shutdown sequence in individuals with disorganized attachment histories. Stage 1 (Somatic-to-Cortical Flight) involves evacuation of interoceptive awareness via anterior insula hypoactivation, forcing conscious processing into prefrontal cortex hyper-cognition. Stage 2 (Cortical-to-Dissociative Collapse) occurs when PFC processing capacity is overwhelmed, defaulting to ventrolateral periaqueductal gray (vlPAG)-mediated dorsal vagal shutdown and dynorphin/kappa-opioid receptor (KOR) flooding — producing the phenomenological experience of depersonalization and derealization. The paper introduces the ECS-Depletion Hypothesis as the missing mechanistic bridge: chronic anandamide depletion via FAAH upregulation removes the tonic inhibitory buffer that prevents disinhibited vlPAG activation, while early life stress simultaneously sensitizes the KOR system. The model predicts differential vulnerability across ABM attachment profiles, with the Special Forces profile (disorganized/vlPAG-dominant) uniquely predisposed to the full two-stage sequence. Pharmacological validation includes KOR agonist-induced dissociation (Salvinorin A) and naloxone/naltrexone reversal studies. Clinical implications support a strict hardware-first intervention sequence: ECS restoration before interoceptive re-entry before cognitive consolidation. Part of the ABM Blueprint Independent Research Series. For clinical tools and implementation, visit abm-blueprint.org. This preprint has not been peer-reviewed. Published under open access for scholarly discussion. Paper 23 in the ABM Blueprint Independent Research Series. The Two-Stage Evacuation Model introduces the ECS-Depletion Hypothesis as a novel mechanistic bridge between disorganized attachment and dissociative collapse — a contribution absent from existing DP/DR literature. ORCID: 0009-0002-3770-5007.

Read Full Paperexternally

Mark Helpful

Bookmark

Relay

View Full Paper