When the Self Rifts—and How It Repairs

Produced by author, from original source material, with Open Evidence and GPT5, multiply reiterated with sophisticated prompting.

In The Garden of Forking Paths (Borges, 1941), a spy named Yu Tsun races to send a message before he is caught. He visits a scholar, Stephen Albert, who reveals that Yu Tsun’s ancestor’s labyrinth was not a physical maze, but a novel in which time branches endlessly. Every possibility is realized somewhere; all paths exist, diverging and reconverging. Yu Tsun completes his mission by committing a terrible act the meaning of which unfolds along one of those branches. The story leaves us with a peculiar clarity: life is not a single line but a mesh of choices, some noticed, many unseen.

Day to day, our choices are smaller, but the narrowing feels similar. Give ourselves delimited choices: go outside or meditate inside. The weather’s good, so we abandon the cushion; or the calendar’s full, so we close the blinds and breathe. The fork seems obvious—until it doesn’t. One morning, you carry your practice into the park. You walk slowly, feel the air on your forearms, count ten breaths with your steps. Outside and meditate. The moment is modest, and then it isn’t. You realize how often you’ve split options that could have been held together. Looking back, the map is different: not a single path with missed exits, but a set of routes you can braid.

This is the spirit of rift and repair. Under pressure, the mind narrows—either/or takes over. With steadier footing and a little careful attention, both/and returns. In the pages that follow, we’ll consider how that narrowing happens, how it shows up in ordinary life, and how, once you see it, your choices—and your sense of continuity—change.

Sometimes experience forks. You notice it in retrospect: a conversation you can’t account for; an hour that felt like foam; the way your body goes cold and distant while you keep answering emails. Under overload—especially when threat is entangled with love or trust—the mind can create a protective rift in how it organizes experience. One path carries daily life forward. Another holds what felt impossible to feel. This isn’t a flaw. It is an adaptation.

The question that matters is what happens next. Under the right conditions—safety, a particular kind of listening, a deliberate welcome to joy as well as pain—those paths can reconnect. The result is not a pristine fusion, but something better: euconnectivity, a flexible, humane re-linking that lets you carry more of yourself, more of the time.

What follows is a tour of rift and repair. We’ll use the first level of structural dissociation as our working model—one path optimized for functioning, another fixated in unprocessed pain—while noting that more complex histories can produce secondary and tertiary rifts: more parts, more internal boundaries, more complicated switching. We’ll keep the science light and the language plain, but precise. The aim is not to romanticize suffering. It is to describe, faithfully, how minds survive—and how they come back to life.

The Rift: How a Protective Split Forms

A rift tends to form at intersections where human systems are least able to reconcile competing imperatives:

- Threat fused with attachment. A caregiver who is sometimes safe and sometimes dangerous. A partner you need and fear. The nervous system is asked to approach and avoid at once.

- Betrayal in high-trust contexts. A leader who violates a code. A community that looks away. A rupture that threatens your sense of what kind of person you are, or what kind of world you live in.

- Inescapable shame or terror. Situations in which feeling fully would overwhelm available supports—developmental, relational, cultural.

In these conditions, the mind’s most generous move is to partition. One stream (call it the task-self) holds roles, routines, and outward continuity. Another stream (call it the pain-self) holds intense affects, sensations, and meanings that couldn’t be integrated at the time. The partition is not arbitrary. It is guided by phobias that make sense: an internal phobia of certain feelings, memories, bodily states, or “parts”; and an external phobia of situations that might re-trigger collapse—closeness, dependence, conflict.

At the first level—primary structural dissociation—this simple architecture can be remarkably stable. Many people live for years with a competent surface and a sealed basement. When histories are heavier or earlier, the system may fork again—secondary dissociation (multiple task-selves and pain-selves)—or again—tertiary dissociation (even more parts and internal rules). Subjectively, each additional fork raises complexity.

What the Rift Feels Like

The rift is less a drama than a texture. If you know what to look for, you can feel its weave.

- Detachment. You are present, but not all the way. Food tastes like memory of food. Your hands type while “you” watch. Depersonalization (I feel unreal) and derealization (the world feels unreal) are part of this weave.

- Missing time or missing edges. Not cinematic amnesia, usually, but gaps: you can describe the outline of an event and none of the inside, or the inside with no time-stamp. Sometimes there is “amnesia for amnesia”—you don’t know you don’t know.

- The body speaks first. Headaches, gut jolts, chest pressure, numbness, tremors—bodily states that feel disproportionate or unbidden. Language lags.

- Role-strong, context-fragile. In one domain—work, caregiving—you are exacting. Another domain—intimacy, conflict—becomes a trapdoor.

One tidy way to track this is to borrow an old clinical mnemonic and treat it as a lens: B‑A‑S‑K—Behavior, Affect, Sensation, Knowledge.

In a healthy flow, these four streams move together. Under rift conditions, they drift. Behavior stays on script while affect is flat, sensation is electric, and knowledge is fragmentary. Or affect floods with no clear object, sensation shuts down, behavior freezes, and knowledge splinters into helplessness or self-blame.

Two Composites: Everyday Life with a Rift

A medic comes home from a tour. In crisis, he could thread an IV in the dark. Back in a safe city, he can’t make it past the pantry aisle if the coffee is burned. He tells himself it’s ridiculous. He parks and walks away. At work he is efficient, perhaps a little beloved for being calm. At home he rages at the smallest things or disappears into a screen for hours. He knows exactly what happened overseas. He cannot feel it without either flipping the table or going blank.

A woman raised by a parent whose love turned on a dime grows into a precise professional. Her team trusts her eye. In close relationships, a minor disagreement sends her off the map. She goes still. She hears nothing. Later she can recount the conversation word for word and has no memory of what she felt. Her body handles it: a migraine, a frozen neck, a heavy sleep that doesn’t restore.

In each case, B‑A‑S‑K is out of sync. In each case, the rift preserved function at a cost. And in each case, repair is possible.

The Lightest Touch of Science

You do not need a wiring diagram to understand what’s happening. A small metaphor suffices. Think of your mind’s major systems as teams that coordinate: one for handling goals and decisions, one for wandering through your inner world and sense of self, one that notices what matters and calls the switch between teams. Under overload, each team huddles tighter inside itself. The passes between teams drop. One team runs your day. Another loops old alarms. The referee calling the switch is late to the whistle.

Emotionally, it looks like this: the threat alarm can keep sounding even in safe rooms. The part of you that usually coaches perspective and timing is offline or ignored. When conditions improve—safety, meaning, the right kind of practice—the alarm quiets, the coach returns, and the teams start passing again.

There is one more element worth noting, because it rarely gets its due. Strong positive experiences—joy, awe, a moment of profound love or creative absorption—can do more than feel nice. They can shift the tone of the system. A single peak of tenderness with a newborn; standing under a night sky; finishing a repair you thought you couldn’t do—these can displace the intensity of rage or self-attack with an equally intense, integrating state. It is not a bypass. It is a change in the music of the room. Used wisely, it helps.

Complexity, Entropy, and How a Rift Feels from the Inside

A brief detour for those who like their concepts crisp. When a system forks under load, two things happen that are easy to miss:

- Local entropy drops. Within each path, experience becomes narrower and more predictable. The task-self stays in well-worn grooves. The pain-self loops through a small set of states.

- Global complexity rises. The system now has more boundaries, more switching rules, more chances for mis-timed handoffs. From the inside, this can feel paradoxical: rigid in some contexts, chaotic in others.

Repair reverses that trade-off. As the paths reconnect, adaptive variability increases—you can move across contexts without rigid strategies—while pathological complexity decreases—fewer walls, more bridges, less need for emergency switching. The felt sense is more continuity and more choice. You still get surprised by life. You get hijacked less.

What Enables Repair (Euconnectivity)

Repair isn’t magic, but it can feel like it. A few conditions, consistently tended, open the door.

- Real-world safety and physiological steadiness. It is harder to heal when you don’t know where you’ll sleep or what you’ll eat. Consistent routines help. Breath practices that lengthen your exhale and deepen your belly—nothing fancy—help. Sleep hygiene helps. These are not cures; they are the ground in which cures grow.

- A particular kind of conversation. There is an old method, deceptively simple: say whatever comes; be listened to with evenly suspended attention. That is, talk without policing your own mind; be heard by someone who isn’t rushing to categorize or fix you. This stance invites the two paths to notice each other. It increases useful variability without flooding. Weak signals—small memories, faint feelings—can find a bridge.

- Naming phobias and pacing by consent. It is helpful to state, aloud, the things you are afraid to feel, remember, or want—and the external situations you avoid because they threaten your careful balance. It is also helpful to agree that nothing important will be forced. Consent is not a slogan; it is a method that stabilizes the whole enterprise.

- Addressing self-betrayal and practicing self-attachment. Many people cope by turning against themselves. The task-self abandons the pain-self to get through the day. The pain-self attacks the task-self for being a sellout. Naming this internal politics isn’t blame; it’s clarity. Repair begins with a vow: I won’t abandon my own pain again. Then come small acts of self-attachment: sleep, food, saying no, bringing something beautiful into your day. Later, when it stops feeling like a trick, self-forgiveness.

- Inviting joy and peak moments as catalysts. People sometimes distrust joy because it has been used to minimize harm. We are not talking about that. We’re talking about moments that feel unmistakably alive and true, which can reset the tone of a system. Treat these moments as evidence and fuel. Write them down. Return to them on purpose. Let them have weight equal to pain.

Mechanisms of Reconnection

On the surface, repair looks like a hundred small, ordinary events. Underneath, a few mechanisms are doing the work.

- Micro-bridging across B‑A‑S‑K. Pair a sensation with a word. Pair a behavior with a feeling. Pair a thought with an image. Each link is a stitch.

- Time-stamping. “That was then; this is now.” It sounds trite. It isn’t. Many residues of trauma feel timeless. Marking time restores order.

- Ownership. Moving from “not me” to “mine.” Not everything that happened is your fault. Much of it is your life. Owning it is different from endorsing it. Ownership gives you the leverage to change.

- Values in motion. Repair is not a purely inner event. Doing one small thing that matches who you mean to be—returning a call, telling the truth kindly, picking up a piece of trash on your street—feeds both paths. It cuts a new channel.

The Ethical Seam: Repair of Harm and Self-Respect

There is a particular kind of wound that travels with the rift: the sense that you violated your own code, or the world violated a code you thought you could rely on. You do not have to use the term for it to be real. The repair sequence is practical and quiet:

- Acknowledge what happened. Neither minimize nor catastrophize.

- Take responsibility that fits the facts. Not global condemnation; not total exoneration. If there is something to own, own it. If not, refuse to carry what isn’t yours.

- Make amends you can stand behind. Not grand gestures; small, honest acts that point in the right direction.

- Forgive. This is the step people try either to skip or to impose. Neither works. When you are ready, forgiveness—especially of yourself—releases energy that has been tied up in self-attack. It restores a capacity to act. Sometimes it is precipitated by a moment of grace you didn’t plan.

- Return to a community that shares your values. Isolation distorts. Belonging calibrates.

Two Pitfalls to Avoid

Two traps slow repair more than any others.

- Forcing. The urge to “get it over with” by charging straight into whatever has been avoided—desensitize the memory, flood the feeling—can deepen the rift. It is not that direct approaches never work. It is that, under high dissociation, they often strengthen the wall by confirming the phobia: See? This is unmanageable. The solution is not avoidance. It is pacing and consent. The line is thin and important.

- Bypassing with competence. When you and your clinician both fall in love with your high-functioning self and collude to let it run the therapy, repair stalls. The work looks good. Nothing moves. A quick diagnostic question—Are we making room for the parts of you that hurt, or are we talking about them from across the room?—can save months.

What Help Looks Like

If you seek help, you are not shopping for a brand. You are shopping for a stance. Useful therapy for rift-and-repair tends to share a few features:

- It welcomes free associative speech and is patient with silence.

- It treats your internal divisions as intelligent adaptations, not pathologies to be erased.

- It listens for both fear and shame.

- It monitors dissociation and adjusts pace accordingly.

- It does not force exposure, but it also does not collude with avoidance.

- It treats joy, interest, and awe as legitimate tools.

Techniques can be folded in as needed—trauma-focused exposure, EMDR, parts work, sensorimotor approaches, compassion practices—but they are used as instruments to facilitate linking, not as hammers to break through walls.

When to Get Help Now

Calm clarity can co-exist with urgency. Seek professional support quickly if you are losing time while caring for children or driving; if you have frequent blackouts; if you are actively planning to harm yourself or someone else; if voices or impulses feel uncontrollable; if substance use is carrying you. These are not moral judgments. They are risk assessments.

A Note on Complexity Beyond the First Rift

If your history includes early, repeated, or severe adversity, you may recognize a system with more than two paths. Multiple task-selves tuned to different contexts. Multiple pain-selves with specific triggers. Rules and alliances between them. The outline above still holds. It is simply applied more times, more gently, with more patience. Subjectively, it may feel like you are trying to negotiate a coalition government inside your head. It is doable. It takes longer. Repair still looks like increased continuity and choice.

Joy as a Force, Not a Decoration

We have already touched this point, but it deserves its own brief section because so many people have been harmed by false cheer. Joy that denies pain feels like an insult. Joy that enters alongside pain—on purpose, in doses you can stand—changes the economy of the system. It displaces high-intensity anger or self-attack with equally strong, integrating states.

Here are examples of the kind of moments that often matter:

- You are halfway through a public apology you dreaded and realize you can keep breathing.

- You watch a kid belly-laugh and feel your ribs ache in a way that is not grief.

- You finish a repair—a chair, a spreadsheet, a sentence—you told yourself you couldn’t do.

- A piece of music you loved at fifteen finds you again.

- You notice, in the middle of a fight, that you want to be kind more than you want to win—and you act on that.

These are not “positivity.” They are proofs of life. Treat them as such.

A Brief Return to the Science, to Keep the Intellectual Compact

Readers with a taste for mechanisms may want to hear at least a sentence about why the practices above work. It is enough to say: under overload, the systems that handle goals, inner life, and salience reduce their communication. Threat alarms dominate. The capacity to switch gracefully narrows. Practices that increase safety and variability without flooding—free speech with steady listening, deliberate pacing, micro-bridging across Behavior, Affect, Sensation, and Knowledge—restore switching and encourage the systems to pass information again. Strong positive experience increases the weight given to new, prosocial meanings. None of this requires you to picture circuits. It is enough to notice that, over time, it gets easier to stay yourself in more rooms.

What Repair Feels Like, When It’s Working

It is useful to have a feel for the target, not as a fantasy of arrival but as a way to recognize progress.

- Continuity. You begin to feel like the same person across contexts. Not the same mood. The same person.

- More options. You notice the moment before the old reaction and find you can choose something else once in a while.

- Time settles. Memories take their place. They still hurt. They do not bleed into everything.

- The body becomes less of a stranger. Sensations stop arriving as either blare or blank. You can trade in generalizations (“I hate my body”) for specifics (“My chest is tight, my hands are cold”).

- Anger and self-attack lose their monopoly on intensity. Other strong states—the good ones—get a vote.

- Values stop being slogans and become directions you can walk.

None of this will make you invulnerable. Life will still throw its weight around. But the system that once had to rift under pressure can flex instead. That is worth wanting.

An Ending That Refuses Tidiness

It is tempting to end with an image of seamlessness: rift closed, wholeness restored. The better ending is humbler and more accurate. Rift and repair is not a one-time story. Under stress, the mind will always consider forking. And sometimes it should. The difference, after good repair, is that you know the lay of your own paths. You can feel the early signs of a split and decide whether to let it form, and how far. You can build bridges faster. You trust yourself enough to carry more truth. You have more say over which parts of you get to speak in which rooms.

If you like a term for that, euconnectivity will do. If you prefer something plainer, call it being able to bring more of yourself to the things that matter. Either way, the aim is not brightness for its own sake. It is the sober freedom of continuity and choice, earned by a mind that did what it had to to survive and then did what it could to live.

If you found this helpful, the following take a deeper dive:

From Rift to Rejoining — A Psychoanalytic Neuroscientific Framework (unlisted)

Published book: Making Your Crazy Work For You — From Trauma and Isolation to Self-Acceptance and Love

This Blog Post (“Our Blog Post”) is not intended to be a substitute for professional advice. We will not be liable for any loss or damage caused by your reliance on information obtained through Our Blog Post. Please seek the advice of professionals, as appropriate, regarding the evaluation of any specific information, opinion, advice, or other content. We are not responsible and will not be held liable for third party comments on Our Blog Post. Any user comment on Our Blog Post that in our sole discretion restricts or inhibits any other user from using or enjoying Our Blog Post is prohibited and may be reported to Sussex Publisher/Psychology Today/Medium/Substack. Grant H. Brenner. All rights reserved.

Acknowledgment of Sources

For readers who want to see where these ideas live in the literature: the structural dissociation framework organizes the architecture of the rift; work on large-scale brain networks clarifies why switching falters under overload and how it recovers; clinical writing on moral injury explains the ethical seam and the steps of repair; research on positive emotion and attention lends weight to the role of joy and awe as catalysts. The particulars matter less than the fidelity of the pattern. The pattern holds across disciplines and lives.

If you have read this far, you already know enough to begin. Notice where your experience forks. Refuse to call it failure. Create conditions for repair. Build small bridges. Protect your pace. Let joy in when it knocks. And keep going, not because the destination is tidy, but because the path you are making is a good one to walk.

References checked and summarized with Open Evidence

1. Lebois LAM, Kumar P, Palermo CA, et al. Deconstructing Dissociation: A Triple Network Model of Trauma-Related Dissociation and Its Subtypes. Neuropsychopharmacology. 2022;47(13):2261-2270. doi:10.1038/s41386-022-01468-1.

This study applies the Triple Network Model to trauma-related dissociation, identifying distinct patterns of functional connectivity in the central executive, default, and salience networks for different dissociative subtypes, including dissociative identity disorder. The findings suggest that dissociation is neurobiologically heterogeneous and that network-specific alterations may serve as biomarkers and treatment targets for dissociative symptoms.[1]

2. Şar V. Parallel-Distinct Structures of Internal World and External Reality: Disavowing and Re-Claiming the Self-Identity in the Aftermath of Trauma-Generated Dissociation. Frontiers in Psychology. 2017;8:216. doi:10.3389/fpsyg.2017.00216.

This integrative review proposes that trauma-generated dissociation disrupts the integrity of consciousness and self-identity, leading to parallel but distinct internal and external realities. It emphasizes the role of betrayal and boundary violations in the development of dissociative syndromes, including DID, and frames these as adaptive responses rather than inherent personality disorders.[2]

3. Griffin BJ, Purcell N, Burkman K, et al. Moral Injury: An Integrative Review. Journal of Traumatic Stress. 2019;32(3):350-362. doi:10.1002/jts.22362.

This review synthesizes research on moral injury, highlighting its psychological, biological, and social consequences following exposure to events that violate moral values. It discusses the limitations in current definitions and measurement, and the need for targeted interventions distinct from those for PTSD.[3]

4. Barr N, Atuel H, Saba S, Castro CA. Toward a Dual Process Model of Moral Injury and Traumatic Illness. Frontiers in Psychiatry. 2022;13:883338. doi:10.3389/fpsyt.2022.883338.

This article introduces a dual process model for understanding moral injury and traumatic illness, emphasizing the importance of role appraisal (perpetrator, witness, victim) and the need for interventions that address values, character, and identity domains, which are not fully targeted by standard trauma treatments.[4]

5. Lebois LAM, Li M, Baker JT, et al. Large-Scale Functional Brain Network Architecture Changes Associated With Trauma-Related Dissociation. The American Journal of Psychiatry. 2021;178(2):165-173. doi:10.1176/appi.ajp.2020.19060647.

This study demonstrates that trauma-related dissociation can be objectively estimated using functional connectivity patterns, particularly in the default mode and frontoparietal control networks. These findings support the use of brain-based biomarkers for dissociation severity, independent of PTSD and trauma history.[5]

6. McKinnon MC, Boyd JE, Frewen PA, et al. A Review of the Relation Between Dissociation, Memory, Executive Functioning and Social Cognition in Military Members and Civilians With Neuropsychiatric Conditions. Neuropsychologia. 2016;90:210-234. doi:10.1016/j.neuropsychologia.2016.07.017.

This review links dissociative symptoms to cognitive dysfunction, including impairments in attention, executive function, memory, and social cognition, across neuropsychiatric disorders. It discusses neurobiological mechanisms such as thalamic sensory deafferentation and altered network connectivity.[6]

7. Békés V, Szabó D, Lévay EE, Salgó E, Unoka Z. Moral Injury and Shame Mediate the Relationship Between Childhood Trauma and Borderline Personality Disorder, PTSD, and Complex PTSD Symptoms in Psychiatric Inpatients. Journal of Personality Disorders. 2023;37(4):406-423. doi:10.1521/pedi.2023.37.4.406.

This study finds that moral injury and shame mediate the impact of childhood trauma on symptoms of borderline personality disorder, PTSD, and complex PTSD, highlighting the importance of these constructs in understanding the development of trauma-related psychopathology.[7]

8. Lynn SJ, Polizzi C, Merckelbach H, et al. Dissociation and Dissociative Disorders Reconsidered: Beyond Sociocognitive and Trauma Models Toward a Transtheoretical Framework. Annual Review of Clinical Psychology. 2022;18:259-289. doi:10.1146/annurev-clinpsy-081219-102424.

This review argues for a transtheoretical perspective on dissociation, integrating trauma, sociocognitive, and other models. It suggests that dissociation reflects failures of adaptive systems and highlights the need for multivariable research to advance understanding of dissociative disorders.[8]

9. Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. Published 2022-02-01.

The American Psychiatric Association states that early life trauma, especially before age 6, is a major risk factor for dissociative identity disorder, with neurobiological correlates in the orbitofrontal cortex, hippocampus, parahippocampal gyrus, and amygdala. Ongoing trauma and revictimization worsen outcomes and contribute to personality complexity and a sense of injustice.[9]

10. Leichsenring F, Heim N, Leweke F, et al. Borderline Personality Disorder: A Review. JAMA. 2023;329(8):670-679. doi:10.1001/jama.2023.0589.

This review describes borderline personality disorder as characterized by pervasive dysfunction in affect and interpersonal regulation, distinguishing it from dissociative identity disorder, which involves longitudinal variability in personality style due to inconsistency among identities.[10]

Summarized References

1. Deconstructing Dissociation: A Triple Network Model of Trauma-Related Dissociation and Its Subtypes. Lebois LAM, Kumar P, Palermo CA, et al. Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2022;47(13):2261-2270. doi:10.1038/s41386-022-01468-1.
2. Parallel-Distinct Structures of Internal World and External Reality: Disavowing and Re-Claiming the Self-Identity in the Aftermath of Trauma-Generated Dissociation. Şar V. Frontiers in Psychology. 2017;8:216. doi:10.3389/fpsyg.2017.00216.
3. Moral Injury: An Integrative Review. Griffin BJ, Purcell N, Burkman K, et al. Journal of Traumatic Stress. 2019;32(3):350-362. doi:10.1002/jts.22362.
4. Toward a Dual Process Model of Moral Injury and Traumatic Illness. Barr N, Atuel H, Saba S, Castro CA. Frontiers in Psychiatry. 2022;13:883338. doi:10.3389/fpsyt.2022.883338.
5. Large-Scale Functional Brain Network Architecture Changes Associated With Trauma-Related Dissociation. Lebois LAM, Li M, Baker JT, et al. The American Journal of Psychiatry. 2021;178(2):165-173. doi:10.1176/appi.ajp.2020.19060647.
6. A Review of the Relation Between Dissociation, Memory, Executive Functioning and Social Cognition in Military Members and Civilians With Neuropsychiatric Conditions. McKinnon MC, Boyd JE, Frewen PA, et al. Neuropsychologia. 2016;90:210-34. doi:10.1016/j.neuropsychologia.2016.07.017.
7. Moral Injury and Shame Mediate the Relationship Between Childhood Trauma and Borderline Personality Disorder, PTSD, and Complex PTSD Symptoms in Psychiatric Inpatients. Békés V, Szabó D, Lévay EE, Salgó E, Unoka Z. Journal of Personality Disorders. 2023;37(4):406-423. doi:10.1521/pedi.2023.37.4.406.
8. Dissociation and Dissociative Disorders Reconsidered: Beyond Sociocognitive and Trauma Models Toward a Transtheoretical Framework. Lynn SJ, Polizzi C, Merckelbach H, et al. Annual Review of Clinical Psychology. 2022;18:259-289. doi:10.1146/annurev-clinpsy-081219-102424.
9. Diagnostic and Statistical Manual of Mental Disorders. Dilip V. Jeste, Jeffrey A. Lieberman, David Fassler, et al. American Psychiatric Association (2022).
10. Borderline Personality Disorder: A Review. Leichsenring F, Heim N, Leweke F, et al. JAMA. 2023;329(8):670-679. doi:10.1001/jama.2023.0589.