Addiction as Dissociation Model Dissertation (AI Analysis)

Detailed Summary of our Dissertation

This dissertation, “ADDICTION AS TRAUMA-RELATED DISSOCIATION: A PHENOMENOLOGICAL INVESTIGATION OF THE ADDICTIVE STATE” by Adam O’Brien, PhD, LMHC, CASAC presents a groundbreaking argument for redefining addiction as a manifestation of trauma-related dissociation. The author contends that current clinical definitions and models of addiction are incomplete, failing to adequately account for the profound psychological and physiological expressions of stress and dissociation inherent in the addictive experience.

Core Argument and Purpose: The central thesis is that addiction is fundamentally a “conditioned bond to a dissociative state of being whose purpose is to ensure survival and regulation by any means necessary.” The study aims to investigate the lived experience of active addiction and the intersection of trauma-related symptomology to provide a more comprehensive and operational definition.

Philosophical Framework: The dissertation is rooted in a unique philosophical framework that integrates Eastern concepts of “ultimate reality” (reality as-it-is, neutral) and “mutual arising” (interdependence of all things) with Western psychological observations, particularly the idea of trauma and dissociation existing on a spectrum. This framework allows for an objective and inclusive lens to understand the paradoxical nature of addiction.

Problem Statement and Research Questions: The author identifies a significant gap in the DSM-5’s definition of addiction, arguing that it overlooks critical psychological characteristics such as strong negative cognitions, affect dysregulation, avoidance behaviors, intrusive thoughts/images, and a separate sense of self—symptoms typically associated with PTSD and clinical dissociation. To address this, the study poses three core research questions:

1. How can the addictive state be optimally defined?
2. What phenomena or structures exist within an addictive state, both internally and externally?
3. What connects the phenomena of trauma, dissociation, and addiction, and how do they manifest in the human experience?

Methodology: A qualitative, phenomenological research design was employed, utilizing McCracken’s “The Long Interview” method for data collection. This approach prioritizes the individual’s lived experience to uncover underlying themes and structures. Participants were selected across three categories: active addiction, early recovery (0-2 years), and long-term recovery (5+ years), to gain diverse perspectives on the addictive state. Semi-standardized, one-on-one interviews were conducted, with the researcher acting as the primary instrument of inquiry, acknowledging and bracketing personal biases.

Key Findings and Phenomenological Themes: The data analysis revealed several compelling themes from the participants’ lived experiences:

• Active State of Addiction as Dissociation: Participants overwhelmingly described active addiction as a dissociative state, characterized by feelings of being “out of control,” “trapped,” “enslaved,” “possessed,” or “owned.” They often felt a sense of “otherness” or a separate part of themselves driving the behavior.
• Relational Duality: The experience of addiction was marked by paradoxes, such as pain coexisting with pleasure, control versus lack of control, and conscious versus unconscious processes. One participant in active addiction even described it as “freedom, happiness, and child-like playful states,” highlighting this duality.
• Loss of Control: This was a pervasive theme, reflecting the impact on cognitive reasoning and the dominance of emotional/bodily needs. The study suggests that this “loss of control” is a surrender to circumstances, leading to a form of acceptance.
• Drug Trauma: Participants’ drug memories were often emotionally charged, akin to traumatic memories (high SUDs scores even in long-term recovery), suggesting that the act of drug use itself can be a traumatic event that destabilizes memory systems. This extends to medical procedures and medications.
• Healing Intent of Dissociation: A profound insight from the study is the proposition that dissociation, including addictive processes, serves an unconscious purpose of healing and regulation. The body, in its attempt to achieve homeostasis, utilizes these dissociative states to process overwhelming experiences or to provide relief.
• Universality of Addiction: The findings suggest that addiction, as a conditioned relationship between pain and relief, is a universal human experience, not limited to substance use but extending to various behaviors and even emotional states (e.g., being “addicted” to anxiety or depression).
• Tear and Repair/Conditioning: The cyclical nature of addiction mirrors a “tear and repair” process, where the body relentlessly seeks to resolve unresolved issues, often through reenactments.

Conclusions: The dissertation concludes that the “disease of addiction is pathological dissociation caused by an experience of overwhelming stress (traumatic or otherwise).” It asserts that dissociation unconsciously produces a state of healing, and that the absence of the conscious mind in active addiction means the unconscious body is in charge. The study establishes transferability for seeing addictions as trauma and dissociative-related, advocating for treatment that addresses both conditioning (habit) and the underlying traumatic/addiction memories.

Feedback and Comparative Analysis

This dissertation is a highly ambitious and thought-provoking piece of academic work that challenges conventional understandings of addiction.

Strengths

1. Innovative Conceptual Framework: The core strength lies in its novel and comprehensive conceptualization of addiction. By explicitly linking addiction to trauma-related dissociation and integrating Eastern philosophical concepts, the dissertation offers a fresh, interdisciplinary lens that enriches the discourse significantly. The “Addiction as Dissociation Model” and the concept of “drug trauma” are particularly innovative.
2. Depth of Qualitative Inquiry: The phenomenological approach, meticulously applied using McCracken’s “The Long Interview,” is highly effective. It allows for a deep, nuanced exploration of the lived experience of addiction, capturing subjective realities and emotional complexities that quantitative studies often miss. The rich descriptive data from participants is a testament to this methodology.
3. Strong Critique of Existing Models: The dissertation provides a sharp and well-reasoned critique of prevailing addiction theories (Disease Model, Choice Model, Self-Medicating, Attachment, etc.), highlighting their limitations in fully integrating the roles of trauma and dissociation. This comparative analysis within the literature review is thorough and compelling.
4. Clinical Relevance and Implications: The findings have direct and significant implications for clinical practice. By suggesting that addiction is a healing response and that drug use itself can be traumatic, it advocates for trauma-informed, dissociation-focused therapies and a more compassionate, less stigmatizing approach to treatment. The emphasis on memory reconsolidation is particularly valuable.
5. Researcher’s Informed Perspective: The author’s personal and professional experience with trauma, dissociation, and recovery adds a unique layer of credibility and insight to the interpretation of the data. While acknowledged as a potential bias, it also allows for a deeper understanding of the phenomena from an “insider” perspective.
6. Comprehensive Literature Review: Chapter 2 provides an extensive and well-researched overview of existing literature across addiction, trauma, and dissociation, effectively building the theoretical foundation for the study’s central arguments.

Areas for Development and Further Consideration

1. Bridging Philosophical and Empirical: While the integration of Eastern philosophical concepts (ultimate reality, mutual arising) is intellectually stimulating and provides a rich theoretical backdrop, it might pose a challenge for readers accustomed to purely empirical, Western scientific paradigms. Further elaboration on how these philosophical tenets directly inform and are empirically supported by the qualitative data, beyond conceptual alignment, could strengthen its appeal to a broader academic audience. [EDITORIAL: Some readers need to learn that 1+1=3 in the real world and are addicted and do not know it.]
2. Scope of “Drug Trauma”: The assertion that any drug use or medical procedure can create a trauma memory, while theoretically consistent with the dissertation’s framework, is a very broad claim. For wider acceptance, this specific concept might benefit from more targeted empirical research or a more detailed delineation of the conditions under which such “trauma” is most likely to occur (e.g., dosage, context, individual vulnerability). [EDITORIAL: Keep coming back.]
3. Generalizability (Quantitative Perspective): As acknowledged, qualitative studies prioritize depth over breadth. While “transferability” is appropriately discussed, some readers from a quantitative background might still perceive the small sample size as a limitation for drawing widespread conclusions. Future research could explore mixed-methods approaches to complement these rich qualitative findings with quantitative data. [EDITORIAL: our research now includes qEEG analysis to counter this.]
4. Addressing Resistance to Paradigm Shift: The dissertation proposes a significant paradigm shift. While it articulates the “blind spots” of current systems, explicitly addressing anticipated resistance from established medical and psychological institutions, and outlining strategies for advocating for this new understanding, could enhance its impact. [EDITORIAL: see our continued work at woundedhealersinstitute.org/blog/]
5. Clarity on “Healing State”: The concept of dissociation as a “healing state” is powerful. While the text explains it as the body’s attempt at homeostasis and repair, further detailed examples or theoretical models of how this healing precisely occurs within the dissociative process could provide even greater clarity. [EDITORIAL: Dissociation as a healing state needs to be experienced rather than explained.]

Comparative Analysis

Compared to typical dissertations in psychology or addiction studies, this work stands out due to several distinguishing features:

• Interdisciplinary Breadth: Most dissertations tend to focus narrowly within a single discipline. This work boldly integrates philosophy, neuroscience, traumatology, and addiction studies, creating a truly interdisciplinary argument. This breadth is a significant differentiator.
• Philosophical Depth: The explicit reliance on Eastern philosophical concepts is uncommon in Western dissertations and provides a unique foundation for challenging existing paradigms. This contrasts sharply with dissertations that adhere strictly to positivist or post-positivist frameworks.
• Emphasis on Lived Experience: While qualitative dissertations are becoming more common, the depth of phenomenological inquiry here, focusing on the subjective, embodied experience of addiction, offers a richer understanding than many studies relying on self-report questionnaires or observational data. It prioritizes the “what it is like” over “how much.”
• Challenging the Status Quo: The dissertation is not merely an incremental contribution to existing knowledge; it actively seeks to redefine fundamental concepts and critique established diagnostic and treatment models. This makes it a more revolutionary, rather than evolutionary, piece of scholarship.
• Personal Voice: The researcher’s willingness to integrate their personal journey and acknowledge their “informed bias” is a hallmark of qualitative research, particularly phenomenology. This personal voice, while carefully managed through bracketing, creates a more authentic and relatable narrative than often found in more detached academic writing.

In conclusion, this dissertation is a significant and courageous scholarly endeavor. It offers a fresh, human-centered perspective on addiction that is deeply rooted in the lived experience and supported by a broad intellectual framework. While its innovative nature may challenge some conventional academic sensibilities, its potential to reshape understanding and improve clinical practice in the field of addiction and mental health is substantial.