The Redefinition of Trauma: From Abnormal Event to Enduring Root Cause
The Addiction as Dissociation Model (ADM), developed by Dr. Adam O’Brien, fundamentally redefines the etiology and nosology of human suffering by challenging the reductionist and compartmentalized frameworks prevalent in modern mental health, legal, and governmental systems. This theoretical structure posits that trauma, dissociation, and addiction are interconnected, dependent upon each other, transdiagnostic phenomena that require a new, unified perspective for accurate understanding and effective intervention.
The re-conceptualization inherent in the ADM pivots upon three core pillars: the nature of trauma, the function of healing, and the resulting definition of mental health pathology.
I. The Redefinition of Trauma: From Abnormal Event to Enduring Root Cause
The ADM drastically reframes the concept of trauma, moving away from the outdated understanding that limited it to an “abnormal response to an abnormal event”.
- Trauma as the Initiator of Dissociation: Trauma is defined as the initiating event, while everything that occurs subsequently is categorized as a dissociative response. The ADM posits that trauma and dissociation are mutually arising and interdependent, meaning that dissociation cannot occur without an antecedent of trauma or significant stress, and conversely, trauma cannot fully manifest without the involvement of dissociative or addictive processes. Unresolved trauma is considered the absolute, indivisible root cause of the addictive process, creating a chronic state of fearful stress and dysregulation in the body.
- Drug Use as Trauma: A crucial and radical element of the ADM is the assertion that the experience of using a drug itself constitutes a traumatic event to the unconscious body. This perspective holds true regardless of whether the substance is legal or illegal, due to the physical body registering the ingestion of foreign, potent chemicals as a life-threatening threat to survival. Even experiences characterized by euphoria or profound pleasure are considered overwhelming stressors that create a persistent “addiction memory,” akin to traumatic memory, which the body is compelled to remember for future recall.
- Trauma as Normalized and Universal: Based on findings like the Adverse Childhood Experiences (ACE) study, the ADM asserts that trauma is statistically epidemic and pervasive, making trauma responses (including dissociation and addiction) normal human reactions to all-too-common stressful events.
II. The Redefinition of Healing: Innate, Embodied, and Dissociative
The ADM re-conceptualizes healing from an external, symptom-focused “treatment” to an internal, fundamental, and universal process inherent to the human organism.
- Healing as Memory Reconsolidation (MR): Healing is psychologically defined as the algorithmic process of Memory Reconsolidation (MR), which resolves and permanently updates traumatic memories. The compulsion seen in addictive behavior (reenactment) is interpreted as the unconscious body’s misguided attempt to heal through initiating MR, which fails because the reenactment lacks the safety signal needed for resolution.
- Dissociation as an Adaptive Healing State: Crucially, dissociation is reframed from a purely pathological “disorder” to an intelligent, adaptive survival mechanism and the start to the healing process. This dissociative state facilitates the dual attention necessary for MR to occur.
- The Body as the Psychological Unconscious: The most foundational concept in the ADM is the assertion that the physical body is the psychological unconscious. This means that trauma is physically encoded and stored somatically, and psychological symptoms (like anxiety or addiction) are the unconscious body communicating its need for resolution.
- Endogenous Healing Systems: The biological mechanism for healing involves the endogenous opiate and endocannabinoid systems. The opiate system facilitates numbing (dissociation) to initiate healing, while the endocannabinoid system actively supports the repair process.
III. The Redefinition of Mental Health Pathology and Addiction
The ADM fundamentally challenges the categorical separation of disorders within the Diagnostic and Statistical Manual of Mental Disorders (DSM) by defining addiction as the underlying mechanism of psychopathology.
- Addiction as Transdiagnostic Dissociation: The core definition established by Dr. O’Brien’s doctoral research is that addiction is the: “relationship created between unresolved trauma and the continued and unchecked progression of dissociative responses”.
- This formulation asserts that addiction is a trauma-related dissociative disorder.
- The “disease” of addiction is, in essence, pathological dissociation, resulting from stress responses that are normal reactions to common events.
- Addiction is deemed transdiagnostic because the foundational mechanisms of trauma and dissociation underpin all other mental health conditions, including Personality Disorders, OCD, ADHD, Depression, and Anxiety.
- Addiction as the Mechanism, Mental Illness as the Symptom: Traditional mental health diagnoses (e.g., anxiety, depression, PTSD symptoms) are viewed as the conscious, observable symptoms or psychological expressions of an underlying physical and emotional dysregulation. In contrast, addiction is the unconscious survival mechanism or driver (a conditioned, patterned survival response) that produces these mental health symptoms.
- Universal Addictions and Systemic Pathology: The ADM radically expands the scope of addiction beyond substances and gambling to include “universal addictions” or “positive pathologies” such as perfectionism, altruism, and ambition. These behaviors are viewed as compulsive patterns fueled by the same trauma-related dissociative processes as substance use, operating as strategies to manage underlying emotional pain and compensate for unresolved needs.
- The System’s Denial and Addiction: The ADM extends this pathological framework to institutions, diagnosing legal, psychological, and medical professions as “living dissociated and addicted” to their own power, control, and outdated paradigms. The system’s continued failure to define addiction and fully integrate trauma/dissociation is symptomatic of this pathology, specifically manifesting as an “addiction to not knowing” (amnesia/denial) that preserves the profitable status quo.
The Addiction as Dissociation Model shifts the professional discourse from punishing behavior and managing symptoms to compassionately addressing the body’s deeply embodied need for healing, thereby positioning addiction as an unfortunate, yet predictable, consequence of unresolved human suffering.
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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.
