The Dissociative Promise of Psychedelic Therapy
A New Era for Trauma and Addiction: Psychedelic Therapy vs Psychedelic Care
For decades, the conversation around psychedelic substances has been shrouded in stigma and misunderstanding. Yet, a quiet revolution has been brewing in the scientific and medical communities, culminating in a significant milestone: the FDA’s 2021 “breakthrough status” for MDMA-assisted therapy for Post-Traumatic Stress Disorder (PTSD). This isn’t just a fleeting trend; it signals a profound shift in how we approach mental health, ushering in a new era for the treatment of trauma and addiction.
At the heart of this burgeoning field lies a powerful neurobiological process known as Memory Reconsolidation (MR) (O’Brien, 2023a). Imagine your brain as a vast library of experiences. When a memory is traumatic, it can get “stuck” in a painful, unprocessed loop, constantly replaying and causing distress. Memory Reconsolidation is an innate ability to reprocess old, often problematic memories, update with new belief structures, and effectively “rewrite” their emotional charge (O’Brien, 2023b). The fact that psychedelic therapies directly access this crucial mechanism is a key indicator of their potential to become truly evidence-based trauma resolution modalities.
The implications extend far beyond PTSD. Research increasingly points to the transdiagnostic nature of trauma and dissociation, meaning these conditions often underpin a wide array of psychological and physical ailments. Adam O’Brien’s (and Dr. Jamie Marich) groundbreaking Addiction as Dissociation Model (ADM) takes this a step further, suggesting that addiction itself is fundamentally a “trauma-bond” to these dissociative responses that leaves aspects of self living dissociated reenacting dissociative material. This model offers a comprehensive lens through which to understand how psychedelic therapy can address the deeply interconnected roots of trauma, dissociation, and addiction, rather than just their surface symptoms.
Despite these promising findings and the rich history of psychedelic use across cultures for millennia, a significant knowledge gap persists. Many clinicians, policymakers, and the general public remain unaware of the common “mechanisms of action” (MoA) that universally facilitate MR, leading to persistent myths, misconceptions, and stigmatization. This lack of understanding prevents countless individuals from engaging in their own innate repair processes or accessing these ancient healing practices.
This is precisely why understanding psychedelic therapy vs psychedelic care is so vital. It challenges the traditional biomedical model is singular focus on symptom reduction through pharmacotherapy, but rather directly experiencing the feeling of healing. Psychedelic leverages fundamental psychological and neurobiological processes shared with other established, non-pharmacological interventions just like EMDR, Brainspotting, and any meditation based approach (O’Brien, 2023b). This reframing suggests that the “medicine” in psychedelic therapy acts as a powerful catalyst, unlocking an inherent healing process rather than being the sole agent of change, but that it is the dissociative state and what one does in this state (e.g., memory reconsolidation). It points towards a future where mental health treatment shifts from chemical symptom management to a process-oriented, memory-reprocessing paradigm, offering profound and lasting change, which is what psychedelics do. While the promise of psychedelic therapy is what people want, what they need is psychedelic care to tell them that psychedelics are not healing them as much as the innate healing dissociative states.
In our next post, we’ll delve deeper into the fascinating world of memory, exploring the critical distinction between Memory Consolidation and Memory Reconsolidation, and how this understanding is revolutionizing trauma therapy.
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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/
