Addiction as Dissociation Model OVERVIEW

The DSM lacks an operational definition of addiction, resulting in gaps in different diagnoses because our work found that it is transdiagnostic (O’Brien, 2023a). This disconnect misinforms legal and medical systems interpretations of mental expressions of distress and concern, which are then unable to apply scientific understanding effectively. Understanding that drug use can encode trauma and addiction-related memories is essential for addressing individual suffering and shaping societal and cultural responses to mental health, public health, and legal reform.

Trauma creates dissociative effects. Trauma memories implicitly and explicitly express themselves dissociatively and can eventually manifest as mental health symptoms or conditions if left unresolved, unrecognized, and unidentified. As emotional experiences are not inherently irrational, they are reflected in the unconscious and bodily processes shaped by implicit memory and explicit perception. Drug use itself can be traumatic or become addictive due to factors such as potency, route of administration, external agents (e.g., adjuvants), or the threat of death; whether real, remembered, or learned. These experiences are stored in the physical body, which can be understood memories that become the physical body; therefore, the physical body is the psychological unconscious that encapsulates lived experience (e.g., memories). As the body, genetics, and time are all forms of memory, the subjective nature of how experiences are identified contributes to the degree of implicit bias, which is not encoded outside conscious awareness, but is what houses the consciousness of the unconscious.

Since unconscious consciousness has been defined, unconscious informed consent becomes a viable concept. This opens the door to reducing drug-related trauma and the distress it causes. Diet and environmental toxins may also exert a cumulative traumatic effect over time. Individuals with unresolved dissociation, whether from drugs, medical interventions, or parental dynamics can be retraumatized by present-day exposures, reactivating dissociative memories or genetic vulnerabilities that can lead to disease and expressions of illness. However, dissociation is not the disease of addiction because dissociation is not a disease; it is a normal response to all too common events.

Clarifying definitions is critical. A “drug” here refers to a manufactured substance, not organic or plant-based compounds like psychedelics. Psychedelics have been shown to fit into serotonin perfectly so we can see how we are a manifestation of that reality. Common medical procedures, such as vaccines, flu shots, or anesthesia can generate trauma when unconscious hesitancy is present. For instance, trauma may arise from vaccine adjuvants or contaminants like fentanyl in illicit substances, triggering dissociative symptoms, latent disease expression, or manifest bodily in physical health conditions such as autoimmune disorders or cancers. As emotional experiences are not inherently irrational, they are reflected in the unconscious and bodily processes shaped by implicit memory and explicit perception. The unconscious mind often retains what the conscious mind cannot distinguish, but since there is a consciousness to the unconsciousness (e.g., lived experience), then we can let the unconscious speak, draw, inform, provide, and remind us of what we are, who we are, and where we come from. As the disorder of addiction is dissociation, treating dissociation appears to make the most sense until one learns that psychedelics ground (increase alpha) people to the present and heal (O’Brien, 2023a).

Why Understanding Drug Use as a Source of Trauma Is Important

Drug use can be life-threatening and produce psychological or dissociative symptoms that are often misunderstood or dismissed, not identified, or denied as possibilities.
Memory shapes the body and forms the basis of our perceived reality.
Traumatic memories can trigger dormant illnesses and unresolved dissociative responses.
A drug is a drug—regardless of legality or prescription status. The body responds neutrally to what it receives.
Factors such as route of administration, potency, drug consistency, and method of delivery influence the type of memory formed. (Classic psychedelics are not categorized as drugs; O’Brien, 2023b.)
Adjuvants, used to activate the immune response in vaccines, can themselves induce trauma when introduced without conscious consent.
Supernormal stimuli demonstrate that unconscious processes often override rational thought without conscious awareness or control.
The power structures behind drugs – profit, control, and prescription – further complicate their psychological impact of trauma.

Why Defining Addiction as Dissociation Matters

It more accurately reflects the nature of addiction as a psychological state.
It depersonalizes the term “addiction” and removes its historical stigma.
It redefines addiction as dependence; a relational stage, not a disorder.
It helps individuals identify patterns of reenactment and unresolved trauma.
It opens a more integrative path for healing and treatment.

Why Recognizing the Body as the Psychological Unconscious Is Crucial

Memory is both the foundation of our physical being and our lived reality.
This view bridges the gap between professions historically treated unequally.
It makes unconscious informed consent a viable and ethical practice.

Why Unconscious Informed Consent Is Essential

It helps reduce trauma by recognizing and addressing unconscious responses.
The unconscious is not passive; it holds lived experience and agency.
Communicating with the unconscious is now a realistic and necessary therapeutic approach to safeguard dissociative material and realities from forming.

Trauma, Toxins, and Mental Health

Trauma therapists increasingly recognize that routine medical interventions and environmental toxins, especially at preverbal or prenatal stages with now common medical interventions, shape mental health outcomes. Toxins include not just pharmaceuticals or their biproduct, but also processed sugars, sleep deprivation, and chronic workplace stress.

The absence of natural healing modalities—such as organic psychedelics, secure attachment, and developmental attunement—compounds modern stress. These factors can activate dormant conditions, including mental health disorders (e.g., autism as a regressive, dysregulated state) and inherited genetic vulnerabilities.

Traditional medical and rationalist models often fail to address these complexities due to missing key elements. The Addiction-Dissociation Model (ADM) fills these gaps by linking trauma, memory, and bodily experience in a unified framework that has been captured in the Path of the Wounded Healer.

Addiction as Dissociation Model (OVERVIEW)

1. The Human Brain

Integration: The brain’s capacity to integrate experience is essential for mental health and resilience against dissociation.
Adverse Experiences: Trauma can lead to dissociation, where the brain disconnects from reality as a survival mechanism.
Temporal Perception: Trauma and addiction often distort time perception and affect memory recall.
Survival-Oriented Processes: Under threat or stress, survival mechanisms override higher-order cognitive functions like reasoning and decision-making.
Dissociation: A protective response that disconnects the self from immediate reality, commonly found in both trauma survivors and individuals with addiction.
Addiction Spectrum: Addiction is conceptualized as part of a broader spectrum of dissociative behaviors, where substances are used to escape psychological pain.
Memory Dynamics: Trauma and addiction create deeply embedded memories that drive behavior and symptom expression.
Neurotransmitters: The endogenous opioid and cannabinoid systems regulate pain, reward, and attachment, and are central in trauma and addiction responses.

2. The Trauma–Dissociation–Addiction Connection

Survival Needs: Addiction often emerges as a desperate attempt to meet unmet needs for safety, security, or emotional regulation.
Unresolved Trauma: When trauma remains unprocessed, it can lead to chronic dissociation and reinforce addictive patterns.
Dissociative Symptoms: Addictive behaviors may act as self-abuse, deepening dissociation and detachment from reality.
Re-enactments: Fluctuating dissociative states can trigger reenactments of past trauma, creating a feedback loop of suffering.
Attachment Substitutes: Addiction can serve as a dysfunctional replacement for healthy attachment and connection.
Stress Management: Substance use may become a maladaptive method of coping with emotional or physiological stress.
Opioid System Role: Trauma can dysregulate the endogenous opioid system, increasing susceptibility to addiction and dissociation.

3. Treatment and Healing Implications

Janet’s Three-Stage Model:
- Stabilization: Managing acute symptoms and ensuring safety.
- Trauma Processing: Reintegrating traumatic memories to reduce their behavioral impact.
- Reintegration: Supporting long-term resilience through adaptive coping strategies.
Naltrexone: Used to reduce cravings by blocking opioid receptors and lessening dissociative effects.
Traditional Approaches: Helpful for stabilization but often inadequate for resolving deep-rooted trauma without integration.
Memory Reconsolidation: Body-based therapies (e.g., somatic experiencing) can help update and integrate trauma memories.
Mind–Body Integration: Recognizing the link between physical sensations and psychological states is key to holistic recovery.

4. Expanded Perspectives

Legal and Professional Accountability

Unconscious Informed Consent: Advocates for recognizing the unconscious as capable of informed consent, particularly in trauma and addiction contexts.
Systemic Diagnosis: Suggests that institutional behavior patterns (e.g., law enforcement, healthcare) may reflect trauma-related conditions like PTSD or dissociation, warranting systemic intervention.

Government and Science

Scientific Integrity: Calls for rigorous, transparent science in public health, especially regarding vaccine development and psychedelic legalization.
Ethical Oversight: Critiques premature promotion of treatments (e.g., vaccines, “non-addictive” opiates) without sufficient scientific backing.

Psychology and Law

Developmental Maturity: Points out that legal systems often operate at a cognitive level below adult maturity, impairing ethical decision-making.
Moral vs. Legal Psychology: Argues that moral psychology has evolved beyond traditional legal models, demanding a more integrated framework in policy-making.

5. Intergenerational and Societal Implications

Intergenerational Trauma: Dissociation and trauma can be passed through generations, shaping societal norms and reinforcing systemic dysfunction.
Collective Healing: Addressing societal trauma and addiction requires reform across legal, medical, and educational systems.

6. Conclusion

The Addiction as Dissociation Model (ADM) presents a comprehensive, integrative framework connecting trauma, memory, brain function, and sociopolitical systems. By redefining addiction as a dissociative response to unresolved trauma, ADM advances treatment possibilities and challenges outdated models in law, medicine, and mental health. ADM calls for systemic accountability, scientific transparency, and culturally informed healing practices to promote sustainable change and collective well-being.

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. (2024b). Diagnostic Privilege: Meta-Critical Analysis. In Healer and Healing: The re-education of the healer and the healing profession as an advocation. Re-educational and Training Manual and Guide. Appendix 2. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/

O’Brien, A. (2024c). Meta-Critical Analysis: The “Science” of Pseudoscience. In Healer and Healing: The re-education of the healer and the healing profession as an advocation. Re-educational and Training Manual and Guide. Appendix 3. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/

O’Brien, A. (2024d). Moral-Ethics. In Healer and Healing: The re-education of the healer and healing professions as an advocation. Re-educational and Training Manual and Guide. Chapter 14. 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/