Dissociation as Neurological Injury

SE Gyges, writing on LessWrong, proposes a hypothesis psychiatry has largely overlooked: dissociation might arise from neurological injury to the NMDA system, a key brain receptor pathway targeted by surgical anesthetics. The proposal connects several known facts—NMDA antagonists are known to cause dissociative symptoms, childhood surgical anesthesia significantly affects this system, and many dissociative patients report their symptoms began after childhood surgery. Gyges proposes targeted investigation: checking which anesthetics were given to patients with dissociative symptoms and a surgical history, testing whether drugs targeting NMDA receptors might help, and reconsidering which anesthetics we use in children. The broader argument is that psychiatry and psychology typically explain symptom origins through trauma while overlooking direct neurological damage—a conceptual gap that might hide effective treatments.

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