The Body that Knows the Score: How Trauma and Addiction May Shape Healing Experience
In our previous post, we introduced the groundbreaking idea that many characteristics associated with autism might be adaptive dissociative responses to early overwhelming experiences. But how exactly does this happen? How does trauma, particularly in early development, become so deeply embedded that it shapes an individual’s very way of being in the world, manifesting as traits we typically label as “different”, “intellectually challenged”, “learning disabled”, “differently abled” or even “autistic”?
The answer lies in the profound connection between our minds, bodies, and nervous systems. As Dr. Bessel van der Kolk famously articulated in his seminal work, “The Body Keeps the Score,” trauma is not just a psychological event; it’s deeply encoded in our biology, influencing everything from our sensory processing to our capacity for connection. Dr. Adam’s dissociative perspective adds that there is a “body that knows the score” and defines that as the psychedelic system (O’Brien, 2023a). Mind-manifesting means that the mind that tells the story of the unresolved trauma, is not necessarily the one that experienced it. Furthermore, adding positive addictions (transdiagnostic status), express dissociative reenactments, and shared lived experiences, O’Brien’s (2025) offers modern day pathology and treatment; all because addiction is not operationally defined in the DSM.
The Autonomic Nervous System: Our Internal Regulator
At the heart of this understanding is the Autonomic Nervous System (ANS), our body’s control center for automatic functions like breathing, heart rate, and digestion. It also plays a crucial role in our responses to safety and threat. Dr. Stephen Porges’ Polyvagal Theory provides an invaluable framework for understanding how the ANS orchestrates our engagement with the world.
According to Polyvagal Theory, our ANS operates through three main pathways:
- Ventral Vagal Complex (VVC): The “social engagement system.” When activated, we feel safe, connected, and capable of social interaction, emotional regulation, and calm.
- Sympathetic Nervous System (SNS): The “fight or flight” response. Activated when we perceive danger, preparing us for action. This can manifest as anxiety, hyperactivity, or irritability.
- Dorsal Vagal Complex (DVC): The “freeze or shutdown” response. Activated in extreme, inescapable threat, leading to numbing, dissociation, collapse, or profound withdrawal.
When the System Overwhelms: Dissociation as a Survival Strategy
In early childhood, especially when a developing nervous system encounters chronic overwhelm, a lack of co-regulation from caregivers, or relational trauma, the ANS can become dysregulated. Instead of moving fluidly between states, it can get “stuck” in defensive patterns.
- Hyper-arousal (Sympathetic Dominance): Imagine a child constantly feeling on edge, hyper-vigilant to every sound, light, or touch. This can manifest as extreme sensory sensitivities, restlessness, or intense emotional outbursts – traits often seen in autism. This isn’t a “sensory processing disorder” in isolation, but a nervous system stuck in a perpetual state of “fight or flight.”
- Hypo-arousal (Dorsal Vagal Shutdown): When the threat is too overwhelming to fight or flee, the system may collapse into a dorsal vagal shutdown. This can look like profound withdrawal, emotional numbing (alexithymia), flat affect, or a general detachment from the environment. This is a deep dissociative state, where the body attempts to “play dead” to survive.
- Dysregulation of the Social Engagement System: Chronic activation of defensive states (fight/flight/freeze) inhibits the ventral vagal system. This directly impacts a child’s capacity for social connection, eye contact, reciprocal communication, and emotional attunement – core challenges in autism. The social difficulties are not a lack of desire for connection, but a nervous system prioritizing survival over social engagement.
Somatic Experiencing: Healing from the Body Up
Peter Levine’s Somatic Experiencing (SE) highlights the body’s innate capacity to process and release traumatic energy. When trauma occurs, the body’s natural fight, flight, or freeze responses may not complete. This “stuck” energy can lead to chronic nervous system dysregulation. SE emphasizes gentle, titrated (small, manageable doses) re-negotiation of these responses, allowing the body to complete what it couldn’t at the time of the overwhelming event.
For individuals with autistic presentations linked to dissociation, somatic approaches are crucial. They help to:
- Regulate the Nervous System: By building capacity for tolerance and discharge of activation, reducing hyper- or hypo-arousal.
- Increase Somatic Awareness: Helping individuals reconnect with their internal sensations, a vital step in integrating dissociated experiences and emotions.
- Restore a Sense of Safety: Creating an internal environment where the body feels safe enough to move out of defensive postures.
Understanding autism through this lens shifts our focus from simply managing symptoms to addressing the root causes within the nervous system. It offers a powerful, hopeful path toward integration and healing.
In our next post, we will explore the practical therapeutic implications of this understanding, focusing on how we can help individuals “unmask the autistic self” and heal through integration.
Dr. Adam O’Brien is a leading voice in trauma-informed care and neurodiversity. He is the founder of the Wounded Healers Institute, dedicated to bridging the gap between academic research and practical application in mental health.
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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 purposes only. For medical advice or diagnosis, consult a professional.
