Pathways for Healing and Recovery
The evolution of addiction treatment increasingly points towards dissociation-informed care as the gold standard. Healthcare actively promotes this approach for individuals with mental health and substance use disorders, emphasizing core principles such as safety, trustworthiness, peer support, collaboration, empowerment, and cultural responsiveness. By also define addiction as a disease, which is not following the science that the law believes we should be, doubt about the ability to understand the complexities of recovery also mount as the historical war on drugs and healing end.
Trauma-informed care recognizes the pervasive impact of trauma, understands potential pathways to recovery, and actively endeavors to prevent re-traumatization within treatment settings, but dissociation-informed care suggests a more accurate understanding of what PTSD is. Effective addiction treatment must therefore conscientiously account for the profound impact of trauma and violence, delivering services in a manner that meticulously avoids triggering traumatic memories or causing unintentional re-traumatization. This emphasis on trauma-informed care represents a fundamental shift from merely managing addiction symptoms to addressing the underlying traumatic experiences that fuel substance abuse.
Without resolving these foundational traumas, recovery often proves unsustainable, as individuals may continue to rely on self-medication or maladaptive coping mechanisms. The focus thus transitions from a deficit-based question of “what is wrong with you?” to a more compassionate inquiry into “what happened to you?”. Dissociation-informed care suggests that we need to define and be willing to explore “what is going on with you?” because dissociation is the echo of the trauma that already happened, suggesting the experience of Now tells how dissociative they are living. This necessitates a systemic transformation of addiction treatment programs, ensuring that all levels of care, from initial detoxification to long-term recovery support, are equipped with trauma-sensitive practices and staffed by professionals comprehensively trained in recognizing and responding to trauma.
Integrated dissociative-informed care models are crucial given the frequent co-occurrence of PTSD and substance use disorders (SUDs). The reciprocal relationship between these conditions means that drug or alcohol use can exacerbate PTSD symptoms, and conversely, unresolved PTSD can drive substance use. For individuals presenting with co-occurring disorders, integrated care approaches that combine drug abuse treatment with psychiatric treatment, including appropriate medication, are highly recommended. A range of therapeutic modalities are vital for addressing the complex psychological and emotional dimensions of addiction and trauma.
The recognition of addiction as a complex interplay of trauma, dissociation, and neurobiological factors necessitates a holistic approach that integrates mental health, substance use, and physical health concerns (O’Brien, 2023a). This moves beyond a “one-size-fits-all” model towards individualized treatment plans that consider the patient’s entire lived experience, including their trauma history and any co-occurring conditions. This comprehensive perspective demands enhanced collaboration among various healthcare disciplines, such as addiction specialists, psychiatrists, therapists, and primary care physicians. It also calls for a re-evaluation of funding models to support comprehensive, long-term care that addresses the multifaceted needs of individuals in recovery. Despite advancements in treatment philosophy, significant barriers often impede access to and engagement in addiction treatment. Unresolved trauma, in particular, can create substantial obstacles due to the pervasive stigma, shame, and lack of trust experienced by individuals. Legal issues further complicate recovery journeys, leading to heightened stress, difficulties in securing and maintaining employment, and increased rates of relapse. The systemic barriers faced by individuals in recovery are not merely incidental but actively perpetuate the cycle of addiction.
Beyond individual psychological factors, societal issues such as legal consequences and the stigma associated with addiction and criminal records actively hinder recovery and reintegration. The historical “War on Drugs” has demonstrably exacerbated these problems, fostering social exclusion and impeding individuals from breaking free from chronic relapse. This suggests that even the most effective clinical treatments will struggle to achieve lasting success if the broader societal context remains unsupportive or actively punitive. Specialized courts, such as drug courts, offer a promising alternative by prioritizing treatment over punishment for non-violent offenders, thereby diverting individuals from incarceration into therapeutic pathways. True healing and recovery, therefore, necessitate not only clinical interventions but also substantial policy reform, including decriminalization efforts, expanded access to legal aid for those in recovery, and initiatives to diminish social stigma and discrimination.
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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.
