A Hypothesis on Medical Mislabeling of Dissociative Experiences
Structured Abstract
- Background: Clinical presentations characterized by transient loss of awareness (Absence Seizures, AS) and progressive cognitive decline (Fading Memory Disorder, FMD, often related to Mild Cognitive Impairment, MCI) are conventionally categorized as primary neurological or cognitive disorders. However, a significant body of research links these phenomena, especially non-epileptic seizures, to trauma-related dissociation. This paper posits that many instances of AS and FMD are not isolated primary diseases but are rather physiological expressions of structural dissociation [1], rooted in the body’s attempt to survive overwhelming stress.
- Hypothesis: Certain forms of Absence Seizures and Fading Memory Disorder represent the functional collapse of the thalamocortical circuitry, induced by the body’s chronic adherence to dissociation as a primary survival mechanism. The loss of awareness (AS) or loss of detailed memory (FMD) are pathologically conditioned, involuntary overrides of the conscious mind (the “Appearing Normal Part” of the self) by the unconscious body (the “Emotional Part”).[1] This process is actively mediated by the Endogenous Opioid System (EOS), which produces peritraumatic analgesia and subsequent dependence on the resulting neurochemical state—the core pathology of the Addiction as Dissociation Model (ADM).
- Conclusions: Misdiagnosis of these dissociative phenomena (e.g., AS as primary epilepsy or FMD as irreversible aging) perpetuates a therapeutic blind spot, reinforcing the stigma and systemic denial of trauma. A unified, trauma-informed model is required, positioning these symptoms on the dissociative spectrum. This reframing mandates a shift in treatment toward memory reconsolidation and dissociative-affirmative care to resolve the underlying trauma-conditioned neurobiological bond.
1. Introduction: Reconciling Symptoms and Source
Medical science often struggles to identify the primary etiology when psychological distress translates into physical, measurable dysfunction. Absence Seizures (AS), characterized by brief interruptions of consciousness, and Fading Memory Disorder (FMD), characterized by the gradual loss of cognitive detail, frequently fit this paradigm. In many cases, non-epileptic seizures—known as functional or dissociative seizures (Psychogenic Non-Epileptic Seizures, PNES)—are routinely misdiagnosed as epilepsy, contributing to costly and ineffective interventions.
The philosophy of the Wounded Healers Institute (WHI) maintains that the physical body is the psychological unconscious, where traumatic memories are physically encoded and retained. From this viewpoint, both AS and FMD are interpreted as the unconscious body’s means of communication, forcing a cessation of conscious function to protect the organism from perceived threat, or to attempt an innate healing process.[1]
2. The Dissociative Nature of Memory and Awareness
The central premise linking FMD and AS is dissociation—the fundamental mechanism of severing connection from the present moment.[1]
2.1. Fading Memory Disorder as Dissociative Fragmentation
FMD, or MCI, is typically seen as a degradation of explicit, factual memory. However, research on memory under stress suggests that the brain prioritizes high-level semantic and emotional content while allowing peripheral, low-level sensory details to weaken. This is not merely cognitive loss; it is a selective, protective fragmentation consistent with a dissociative response. The individual loses conscious access to the context (the explicit, detailed memory) but the emotional, implicit memory—the body’s physical “score” of the trauma—remains active and influential. The conscious mind reports “I can’t remember,” while the unconscious body repeats the emotional pattern that demands relief.[1]
2.2. Absence Seizures as Thalamic Dissociation
AS presents as a transient lapse in awareness, sometimes mistaken for a moment of simple inattention. However, emerging research links AS-like activity to dysfunction in the thalamus. The thalamus acts as a critical relay hub, integrating widespread connections throughout the cortex. Disruption of thalamocortical communication is a known functional mechanism in states of unconsciousness, including that induced by general anesthesia. Trauma-related stress, through chronic neurobiological dysregulation, forces the thalamic gate to interrupt this communication, functionally mimicking a seizure.
This mechanism aligns perfectly with the understanding of severe dissociation: the brain is essentially administering its own internal anesthetic to halt the overwhelming emotional input from the trauma, leading to an adaptive shutdown (hypo-arousal) of the conscious experience. The experience of being “here but not here” is the physiological manifestation of the thalamocortical disconnect.
3. The Addiction Paradox: Bonding to the Loss of Control
The link between these physiological collapses and the Addiction as Dissociation Model (ADM) is crucial. The ADM defines addiction as a conditioned bond to a dissociative state, sought for survival or relief.
- The Loss of Control: The core phenomenological symptom of both AS and active addiction is a feeling of loss of control.[1] This experience is the conscious self (the Appearing Normal Part, ANP) acknowledging that the emotional, survival-oriented part (the Emotional Part, EP) of the unconscious body has taken charge.[1]
- The Survival Mandate: The psychological drive to repeat this collapse, this “numbing” or “checking out” (whether through a seizure, memory lapse, or substance use), is rooted in the activation of the Endogenous Opioid System (EOS). Peritraumatic Opioid Activation releases natural pain-relieving agents, creating a powerful, conditioned association between the dissociative state and immediate safety or analgesia. This bonding to the dissociative state, whether via chemical dissociation (substance use) or somatic dissociation (AS/FMD), is the addictive mechanism.
- The Misunderstanding: The medical system misinterprets the thalamic shutdown (AS) or the neurocognitive disorganization (FMD) as isolated brain diseases. In reality, they are desperate, involuntary attempts by the addicted, dissociative system to force the body back into a state of chemical safety and pain relief—a relentless pursuit of self-regulation.[1]
4. Conclusions
The hypothesis that Absence Seizures and Fading Memory Disorder are frequently manifestations of trauma-related dissociation provides a unified explanation for two phenomena currently fragmented within distinct medical specialties. The common factor is a mechanism of chemical and structural disorganization—a collapse of the thalamocortical gate—driven by the chronic allostatic load of unresolved trauma. This reframing demands Recovering Common Sense in clinical and medical practice: acknowledging the wisdom of the body as the unconscious and prioritizing trauma resolution techniques to heal the dissociative bond at its root.[1]
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References
O’Brien, A. (2023a). Addiction as Trauma-Related Dissociation: A Phenomenological Investigation of the Addictive State. International University of Graduate Studies. (Dissertation). Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/
O’Brien, A. (2023b). Memory Reconsolidation in Psychedelics Therapy. In Path of the Wounded Healer: A Dissociative-Focused Phase Model for Normative and Pathological States of Consciousness: Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/
O’Brien, A. (2023c). Path of the Wounded Healer: A Dissociative-Focused Phase Model for Normative and Pathological States of Consciousness: Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2024a). Healer and Healing: The re-education of the healer and healing professions as an advocation. Re-educational and Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2024e). Path of the Wounded Healers for Thrivers: Perfectionism, Altruism, and Ambition Addictions; Re-education and training manual for Abusers, Activists, Batterers, Bullies, Enablers, Killers, Narcissists, Offenders, Parents, Perpetrators, and Warriors. Re-Education and Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2025). American Made Addiction Recovery: a healer’s journey through professional recovery. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
*This is for informational and educational purposes only. For medical advice or diagnosis, consult a professional.
