Addiction as Trauma-Related Dissociation with AI

Summarizing the phenomenological investigation of Adam O’Brien, PhD, LMHC, CASAC dissertation: Addiction as a Trauma-Related Phenomenon. As an investigation into the intersectionality of dissociative and addictive unconscious and implicit processes, Dr. Adam’s work will provide readers a glimpse into the depths of where this research will inevitably lead. 

The Central Problem: An Incomplete Definition

Current clinical definitions of addiction are critically incomplete. They often describe symptoms but fail to address the underlying mechanisms rooted in trauma and dissociation.

The dissertation argues that symptoms typically linked to PTSD—such as intrusive thoughts, emotional dysregulation, and a fractured sense of self—are not just comorbid but are foundational to the addictive state itself. This oversight hinders effective treatment and perpetuates stigma.

A New Framework: The Addiction-Dissociation Model

Addiction is redefined as a “conditioned bond to a dissociative state whose purpose is to ensure survival and regulation by any means necessary.” It’s not a moral failing or simply a brain disease, but an adaptive, albeit pathological, response to overwhelming stress.

1. Overwhelming Experience (Trauma)

This can be a classic trauma OR the overwhelming physiological/psychological experience of drug use itself.

2. Dissociative Healing Response

The mind/body disconnects to survive, creating a state of numbness, altered reality, or relief.

3. Unconscious Healing/Regulatory Attempt

The body unconsciously seeks this dissociative state to regulate stress and attempt repair. This state is perceived as a “solution.”

4. Conditioning & Bonding

Through repetition, a powerful bond forms with the dissociative state. The behavior becomes an automatic, compulsive reenactment.

5. Pathological Addiction

A state where the conscious mind has lost control to this unconscious, survival-driven process.

The Lived Experience: “Loss of Control”

Participants consistently described their addictive state not as a choice, but as a total loss of agency to an external or separate force.

The Lived Experience: Relational Duality

The experience of addiction is profoundly paradoxical, with opposing feelings and states coexisting simultaneously.

Drug Trauma

The act of drug use itself is a traumatic event for the body, creating emotionally charged “addiction memories” that function like PTSD memories.

Healing Intent

Dissociation isn’t just escape. It’s an unconscious, biological attempt to heal and regulate from overwhelming stress, even if the method is ultimately destructive.

Universal

The process of forming addictive bonds to states of relief is a universal human experience, extending beyond substances to behaviors, emotions, and beliefs.

Implications for Healing: A Paradigm Shift

This framework demands a shift from viewing addiction as a problem of willpower to understanding it as a response to trauma. Effective treatment must go beyond managing behaviors.

Treat the Trauma

The primary target for therapy should be the underlying trauma and “addiction memories,” not just the substance use.

Embrace Dissociation

Clinicians should work *with* dissociative states, understanding their protective and healing intent, rather than simply trying to eliminate them.

Focus on Memory

Modalities that facilitate memory reconsolidation are key to resolving the root cause of the addictive compulsion.