Intergenerational Trauma-Related Dissociation in Neurodivergent Populations: The Wounded Healers’ Nexus
The striking comorbidity between Autism Spectrum Disorder (ASD) and Gender Discomfort/Gender Dysphoria (GD) presents a profound challenge to conventional mental health models. Studies consistently show that gender-diverse individuals are three to six times more likely to be autistic, and vice-versa, suggesting a deep, shared underlying mechanism.
This report, developed through the philosophical lens of Dr. Adam O’Brien and the Wounded Healers Institute (WHI), argues that the high co-occurrence of ASD and GD can be understood not merely as biological or social variance, but as a systemic manifestation of unresolved trauma and chronic dissociation stemming from medical traumas, drug traumas, and intergenerational genetic expressions triggering — a psychological reality masked by inadequate definitions of addiction, dissociation, and the unconscious mind (body as the unconscious) and society’s undeveloped desire to label others as other than themselves.
The Embodied Fracture: Dissociation-Informed Assessment of Gender Discomfort in ASD
A Call for Dissociative Transdiagnostic Screening with Meeting Area Screening and Assessment (MASA)
A. The Explanatory Deficit: Silos and Symptom Fixation
Current research acknowledges the strong link between ASD and GD/Gender Discomfort (GDC), with hypotheses categorized into biological, psychological (e.g., obsessive thinking), and social factors (e.g., resistance to social conditioning). However, these explanations remain descriptive, failing to provide a unified, etiological mechanism for the intensity of the emotional turmoil and distress (Gender Discomfort) that leads individuals to clinical presentation and related actions.
The central flaw lies in the adherence to the DSM’s siloed, symptom-fixated model, which attempts to categorize emotional turmoil (GDC) as a “marked incongruence”. This categorical approach entirely overlooks the transdiagnostic role of trauma-related dissociation, which is the core mechanism by which the psychological system copes with overwhelming, inescapable distress.
B. The Unified Theory: Body as Unconscious and Addiction as Reenactment
The WHI framework provides the necessary unifying mechanism by challenging three conventional definitions:
- The Unconscious is the Body: The WHI asserts that the “physical body is the psychological unconscious”. For the autistic individual, who often struggles with interoception (awareness of internal bodily states) and complex social/sensory processing, the core distress of GDC—the “mismatch” between assigned and felt gender—is experienced as an intense, somatic dissociation promoted by dissociative experiences like depersonalization and derealization. The body (the unconscious) is sending a critical, painful message of fundamental incongruence, manifesting as profound emotional turmoil.
- Dissociation as Undiagnosed Trauma: Dissociation is an adaptive response to overwhelming threat. Individuals with ASD, facing constant social stigmas, sensory overwhelm, and communication deficits, are highly vulnerable to chronic relational and environmental trauma. This trauma leads to persistent nervous system dysregulation. The lack of self-identity and sense of fragmentation often observed in GD/GDC may thus be interpreted as a severe structural dissociation—the mind detaching from an unbearable physical and social reality.
- The Addictive Reenactment: The obsessive thinking style associated with ASD, when combined with the emotional distress of GDC, can transform the pursuit of gender affirmation into an Addictive Reenactment Loop (ADM). The compulsive fixation on external identity validation or medical procedures becomes a misdirected attempt to soothe the internal trauma.
- The pursuit of external change acts as a substitute for confronting the “real pain” of the underlying trauma and dissociation.
- The rapid, urgent engagement with medical transition, driven by this compulsion, can create a Trauma Bond to the medical system or the new identity. This bond, characterized by intense dependency, temporarily relieves distress but fails to provide the true memory reconsolidation necessary for psychic resolution. The cycle repeats because the compulsive behavior is a tragically misdirected attempt by the body to heal itself.
C. Clinical and Ethical Imperatives
The current diagnostic limitations lead directly to misdiagnosis and unresolved trauma. Clinicians who fail to identify the dissociation underlying the obsessive focus risk performing interventions on a surface symptom (gender identity) that is being used by the unconscious mind as a maladaptive coping mechanism for trauma. Following the principles of dissociation-informed care, assessment for GDC in ASD populations must integrate:
- Dissociative Screening: Mandatory screening for relational, environmental, and developmental trauma, recognizing that the “mismatch” may be trauma-induced dissociation from the body, not solely neurobiological predetermination because medical interventions with medications (see our work with qEEG and on drug memories as somatic experiences).
- Dissociation Assessment: Utilizing specialized tools to assess structural and somatoform dissociation, recognizing that the gender distress may be a somatic manifestation of a fragmented psyche, where the “physical body is the psychological unconscious” and obtaining “unconscious informed consent”.
- The Path of the Wounded Healer: Adopting a non-confrontational, moral-ethical stance, that respects the client’s agency while seeking to address the root cause of the suffering—the unresolved trauma and addiction to certainty/control.
II. The Body’s Cry—Reframing the Autism-Gender Nexus
The Invisible Wound: Why Autism and Gender Distress are Trauma’s Echoes
There is overwhelming data confirming that autistic individuals are far more likely to experience intense Gender Discomfort or Gender Dysphoria. Why? Conventional science stops at the cognitive style—”they’re obsessive thinkers”—but this is shortsighted logic.
The Wounded Healers Institute argues the core link is unresolved trauma and dissociation.
- The Default Setting is Pain: Autistic existence is often a constant state of being overwhelmed by sensory and social environments. This chronic overload is, psychologically, prolonged trauma. The nervous system lives in a perpetual “fight or flight” state.
- The Escape Mechanism: Dissociation is the mind’s ultimate escape. If reality is too painful, the mind fragments. When the core sense of identity is fragmented by trauma, the body (the unconscious) screams for change. That desperate need for a coherent, validated identity can latch onto the concept of gender transition, turning it into a Positive Addiction—a compulsive, all-consuming pursuit that temporarily masks the deeper wound.
- The Misdiagnosis Trap: If clinicians do not accurately define and screen for dissociation and trauma, they will misdiagnose this intense pursuit as a purely autonomous desire, missing the underlying trauma reenactment loop that truly drives the suffering. The solution is not always the external change, but the internal healing of the fragmented self.
The Logic of the Unconscious: When Your Mind Doesn’t Know Your Body
As many people seeking healing wonder what could have cause neurodivergence and how unresolved aspects of trauma-related symptoms may be impacting today. The profound truth missed by reductionist psychiatry is that the physical body is the psychological unconscious. In the context of gender discomfort, psycho-social-spiritual personality development and the identity formation, with periods of intense distress, medical interventions, and aspects of unresolved trauma (particularly emotional dependence, developmental events, and attachment issues) — the feeling that they themselves are fundamentally wrong can be a somatic echo of dissociation, shame-dependent system that relates to unresolved trauma in implicit years of growth. It is the body, the unconscious scorekeeper of trauma and gatekeeper to the dissociative healing experiences, rejecting the external packaging that it associates with years of pain, misunderstanding, or social invisibility.
These observations means your body is a map of your unhealed memories, beliefs, and trauma. Individuals struggling with the concept of complex social and family identity, may find temporary clarity in the binary structure of a new identity. With an obsessive focus, however, risks becoming an Addiction to Control or a Trauma Bond to a specific, external outcome (the new identity or the medical process). This is the very definition of the Addiction as Dissociation Model (ADM): the compulsive and impulsive (unconscious) behavior (obsessive identity focus) is a tragic attempt to perform memory reconsolidation (trauma healing) that the rigid, trauma-impaired nervous system cannot achieve on its own. The healing goal is not just an external adjustment, but a profound internal integration that makes the body feel safe enough to embrace its own existence.
Transforming Fixation into Freedom: Path of the Wounded Healer
The ultimate challenge for those navigating neurodivergent presentations nexus is breaking the addictive dependency patterns in the Addictive Reenactment Loop., including intergenerational and environmental factors. This loop is sustained by the mind’s attachment to certainty and control, which it finds in the obsessive focus on identity change. In the dissociative awareness of the Wounded Healers Institute, we advocates for the Path of the Wounded Healer which
- Acknowledge the Wound (Not the Weakness): First, recognize that the intense distress is a sign of wounding, not weakness. The feelings of anxiety and depression experienced during identity confusion or transition are rational withdrawal symptoms from the dependency on the old identity or the dependence on the singular focus.
- Regulate the Fragmentation: Use dissociation-informed techniques (like grounding, neuroregulation, and mindfulness) to re-establish the connection between the mind and the body-unconscious. This is the prerequisite for healing.
By adopting this dissociation-informed framework, we empower individuals to transform their deepest, most painful compulsions into their greatest sources of wisdom, thus becoming Wounded Healers themselves.
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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/
O’Brien, A. (2025a). American Made Addiction Recovery: a healer’s journey through professional recovery. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2025b). Applied Recovery: Post-War on Drugs, Post-COVID, and What Recovery Culture and Citizens Require Moving Forward. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2025c). Recovering Recovery: How Psychedelic Science Is Ending the War on Drugs. 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.
