The Universal Mechanism of Action in Trauma Healing is Psychedelic
Introduction: Identifying a Unifying Mechanism for Transformative Therapies
Psychedelic Therapy (PT) has achieved FDA breakthrough status for the treatment of Posttraumatic Stress Disorder (PTSD), and established evidence-based therapies like Eye Movement Desensitization and Reprocessing (EMDR) continue to show high efficacy. However, a unifying mechanism of action (MoA) that neurobiologically explains their success is not widely understood by clinicians.
This briefing, drawing from the qualitative research of Adam O’Brien, PhD, and his Addiction as Dissociation Model (ADM), posits that Memory Reconsolidation (MR) is this universal process. The ADM provides a novel framework by reframing addiction as a manifestation of trauma-related dissociation, arguing that “drug use memory” is functionally equivalent to “traumatic memory.” Within this model, therapies effective for trauma are also effective for addiction because they target the same underlying neurobiological pathway of memory resolution. The purpose of this document is to detail the algorithm of MR as it is applied in the ADM, explain how both existing and emerging therapies access it, and present O’Brien’s argument that any therapy capable of facilitating MR is inherently evidence-based.
1. Defining Memory Reconsolidation (MR): The Brain’s Intrinsic Healing Algorithm
1. Core Definition
Memory Reconsolidation (MR) is the brain’s innate process for updating and neutralizing the emotional charge of traumatic or maladaptive memories. When an existing memory is recalled, it enters a temporary, labile state where it can be modified before being re-stored, or “reconsolidated.” O’Brien’s model identifies this process as the central mechanism for resolving distressing symptoms at their root.
2. MR’s Three-Step Process
The ADM utilizes the algorithm for unlocking MR as outlined by Ecker, Ticic, and Hulley (2012), which involves a precise three-step sequence:
1. Symptom Identification and Activation: This step involves the intentional or unintentional recall of a memory or felt experience, which activates the target learning that requires updating.
2. Retrieval and Mismatch Creation: This step requires the creation of contrast, conflict, or dissonance, where the old, problematic learning is experienced in juxtaposition with new, disconfirming knowledge.
3. Integration and Erasure: In this final step, the new, disconfirming knowledge is integrated, leading to the erasure of the old emotional response previously linked to the memory.
2. Accessing Memory Reconsolidation via Dual Attention States
1. The Concept of Dual Attention
Within the ADM framework, “dual attention” is a foundational MoA necessary to access and resolve traumatic memory. Synthesizing the work of Siegel (2007) and Shapiro (2018), O’Brien describes this state phenomenologically as “the dialectical relationship between reality and dissociation (e.g., being here but not being here at the same time).” It involves simultaneously holding awareness of the traumatic material (the past) while remaining grounded in the safety of the present, creating the necessary conditions for memory reconsolidation to occur.
2. Application in Evidence-Based Therapies
Established trauma therapies demonstrate high efficacy precisely because they engineer clinical methods that reliably create states of dual attention to facilitate MR:
• Eye Movement Desensitization and Reprocessing (EMDR): EMDR utilizes Bilateral Stimulation (BLS)—such as guided eye movements or alternating sounds—to create the necessary state of dual attention. O’Brien notes that research showing EMDR modulates the Default Mode Network (DMN) further supports its role as a key neurobiological factor in this process.
3. Psychedelic Therapy: A Powerful Catalyst for Memory Reconsolidation
1. The Neurobiological Pathway
O’Brien’s model argues that psychedelic medicines function as a powerful MoA that facilitates MR through two primary neurobiological changes:
• Decreased Default Mode Network (DMN) Activity: O’Brien posits that decreased activity in the DMN provides the profound neurological contrast or mismatch that is essential for engaging Step 2 of Ecker’s algorithm.
• Thinning of the Amnesia Barrier (AB): The Amnesia Barrier (AB) is the conceptual veil between the conscious and unconscious self (Van der Hart, Nijenhuis, & Steele, 2006). The thinning of this barrier during a psychedelic experience allows for deeper access to traumatic material held in the implicit memory system.
2. The Psychedelic Experience Mapped to MR’s Algorithm
Within the ADM framework, a guided psychedelic session maps directly onto the three-step MR algorithm. First, as psychological defenses are turned off by the medicine, imagery, symbolism, somatic expressions, and implicit memories emerge, fulfilling Step 1 (Activation). As this unconscious material enters conscious awareness, the cognitive brain’s loss of control creates conflicting emotions and an eventual surrender; this juxtaposition of old learning with a new state of being creates the necessary Step 2 (Contrast/Conflict). Finally, from this state of surrender, new patterns of understanding and a “child-like/beginner’s mindset” emerge, allowing for the acceptance and integration of new, adaptive knowledge and completing Step 3 (Integration).
4. Clinical Implications and a New Definition of “Evidence-Based”
1. A Universal Principle for Healing
The central conclusion of O’Brien’s Addiction as Dissociation Model is that any therapeutic approach that reliably facilitates a state of dual attention to access the neurobiological process of Memory Reconsolidation can be considered evidence-based. From this perspective, healing is not the proprietary domain of a single modality but is an innate, predictable process accessible through various mechanisms. With a clear understanding of dissociation, screening and assessment can be used to help people heal, rather than be injured by treatment.
2. Supporting Argument
This principle is supported by Dr. O’Brien’s provocative assertion that:
any mechanism of action that helps access memory reconsolidation is already evidence-based, which includes, but is not limited to: meditation, walking, talking, reading, singing, working, psychedelics, and breathing.
3. Required Clinical Proficiencies
Adopting the ADM framework yields a clear takeaway for practitioners. All clinicians working with PT or other trauma-focused therapies must become proficient in understanding, assessing, and treating the broad range of dissociation with MR, as this is positioned as the central process of healing for both trauma and addiction. This proficiency is essential for navigating the deeper realms of the psyche and ensuring effective, lasting client outcomes. For this, we highly suggest our Meeting Area Screening and Assessment (MASA).
I am pleased to provide a detailed, promotional overview of the Wounded Healers Institute (WHI) signature programs and services: the Meeting Area Screening and Assessment (MASA), the Posttraumatic Growth (PTG) Gym/Spa, and the professional extension known as the Rabbit Hole.
These services represent the practical application of the Addiction as Dissociation Model (ADM) and the core educational mission of WHI, which is to facilitate healing from developmental traumas, normative dissociation, and universal addictions. Our programs are intentionally structured as evidence-informed, spiritual journeys to foster recovery and combat the systemic denial pervasive in traditional healthcare models.
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I. Meeting Area Screening and Assessment (MASA)
The Meeting Area Screening and Assessment (MASA) is WHI’s critical diagnostic and preparatory tool, designed to achieve Unconscious Informed Consent (UIC) prior to engagement in any deep healing work. MASA fundamentally addresses the need for accurate clinical definition and assessment of transdiagnostic conditions that mainstream psychological and medical professions have failed to operationalize.
Core Features and Purpose:
• Operationalizing the Unconscious: MASA is based on the foundational premise that the physical body is the psychological unconscious. By accessing the “Meeting Area” (a hybrid of the Dissociative Table concept), Healers can directly communicate with the body and the ego states (past, present, and future selves) residing within.
• Comprehensive Assessment: MASA is a structured, scripted approach used by providers and clients alike. It screens and assesses several critical dimensions that dictate readiness for healing:
◦ Degrees of conscious awareness and unconscious access.
◦ Range of dissociation and stage of universal addiction and recovery.
◦ Level of moral development.
◦ Identification of dissociations and addictions.
• Obtaining Unconscious Informed Consent (UIC): The key function of MASA is to ensure that all aspects of the self, including the younger, traumatized parts, are consciously and unconsciously willing to participate in the healing process. It lowers treatment resistance by providing feedback on unconscious occurrences.
• Diagnostic Direction: MASA utilizes a Light system (Red, Yellow, Green) for instantaneous feedback, reflecting the Constant Installation of Present Orientation (CIPOS), which measures how present a client is during the orientation phase.
• Training Availability: WHI offers a dedicated 1-day MASA training, designed to increase knowledge of the ADM framework and the clinical assessment and screening of dissociation and addiction, enabling participants to apply MASA to their personal and professional lives.
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II. Posttraumatic Growth (PTG) Gym and Spa
The PTG Gym/Spa is WHI’s innovative membership platform and maintenance structure, offering non-pathologizing support that transcends the limitations of traditional therapy models. Since the normative range of trauma, dissociation, and addiction exist, these are often overlooked, but clinical experience the most painful and common human struggles that modern psychology has failed to adequately capture.
Services and Philosophy:
• Focus on Normative Conditions: PTG is specifically designed for individuals and professionals seeking maintenance healing, increased wellness, and performance enhancement for issues. We address the insidious nature of existential and universal addictions or conditions, such as perfectionism, altruism, ambition, work, shopping, and technology, which carry the same destructive outcomes as identified addictions.
• Maintenance and Prevention: The PTG program aligns with the Maintenance Phase of the Consensus Model of Trauma Treatment and the Stages of Change. It supports posttraumatic growth (PTG), which is the application of knowledge gained after a scar has healed. Prevention is key to continued success, minimizing the recurrence or reenactment of active symptoms of destruction.
• Core Methodologies (Mind-Body-Spirit Regulation): Members engage in a comprehensive suite of practices rooted in the ADM findings:
◦ Resiliency Training: Utilizing Biofeedback and Neurofeedback (NFB) regulation training to help people find their point of regulation. NFB is FDA-approved/cleared and used in conjunction with meditation and psychedelic care.
◦ Mindful Practices: Includes meditation-based training (e.g., Vipassana, MBSR), body-mind strength-building exercises, and self-care planning. These practices induce states of dual attention and dual attunement, which are key to therapeutic processing.
◦ Psychedelic Integration: PTG supports individuals who utilize legal cannabis products or other medicines for self-medication (selves-medication). The program teaches responsible use and adherence to a Medicine Wellness Plan, often guided by isokinetics and intuition reading, treating the body as the co-pilot.
• Membership Structure: PTG membership is crucial for participants in the Path of the Wounded Healer (PWH) program, with various tiers (Premiere, Prime, Maintenance) providing access to coaching, classes (like Dancing Mindfulness, Spiritual Pain Management, and Healing Breath Class), and events.
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III. The Rabbit Hole (Professional Enhancement)
The Rabbit Hole is the specialized professional domain of the Wounded Healers Institute, serving as both an advanced training phase (PWH-4) and a research/consultation lab for professionals committed to the ADM framework.
Advanced Professional Development (PWH-4):
• PWH-4 Curriculum: This final phase of the Path of the Wounded Healer program merges personal transformation with professional application. It focuses on professional development, advanced research techniques, advocacy, and community action.
• Enhanced Bracketing Techniques (EBT): A hallmark of the Rabbit Hole training. EBT is a methodology for mapping out unconscious intrusive moments that arise in daily life (e.g., during activities like showering or walking) and bringing those insights into a state of dual attention (Mindful Dissociation) during meditation for integration and synthesis.
• Consultation and Research: The Rabbit Hole is the venue where professionals participate in advanced consultation, review of WHI programming, and engagement with 2Q-Research (Qualitative/Quantitative Research) practices. WHI conducts ongoing in-house and non-clinical research on trauma, dissociation, and addiction.
• Training Track Requirements: PWH-4 is required for those pursuing the Consultant-in-Training (CIT) track. Professionals in the Rabbit Hole are expected to maintain an active PTG membership and participate in ongoing community action and consultation.
The Profession of the Healer:
WHI training, culminating in certifications such as the PWH Approved Consultant (AC) or Affiliate Faculty, supports the establishment of the Healer as a distinct profession based on Moral-Ethics (doing what is right). The Wounded Healer path is explicitly offered to a wide range of professionals—including clinicians, teachers, advocates, coaches, and medical staff—to learn universal healing principles and apply Mindful Dissociation to navigate altered states of consciousness. This comprehensive approach ensures that Healers gain expertise in memory reconsolidation (MR), the natural process underlying all effective trauma resolution (EMDR, Brainspotting, Meditation, Psychedelics).
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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.
