Dissociative Trauma: A Framework in Working With Substance Users in Vancouver's Downtown Eastside

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Issue Date
2025-05-18
Authors
Prasuhn, Erica "Ocean"
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Abstract
Dissociation, once narrowly defined as a rare and extreme disruption of consciousness, is now increasingly understood as a spectrum of responses to trauma, particularly in the context of complex developmental histories (van der Hart, 2021). This evolving understanding is highly relevant in addiction treatment, where individuals frequently present with unrecognized or under-treated dissociative symptoms stemming from chronic, relational, and developmental trauma (Huỳnh et al., 2016; Oviedo-Joekes et al., 2011). Emerging research indicates that complex trauma is disproportionately prevalent in populations with substance use disorders, often driving both the initiation and maintenance of addictive behaviours as maladaptive coping mechanisms (Baudin et al., 2022). Trauma-focused therapeutic approaches, including models like eye movement desensitization and reprocessing therapy (EMDR), have shown promise in addressing the underlying dissociative processes that fuel addiction (Bae et al., 2016; Deacon & Abramowitz, 2004; Karatzias et al., 2019). This paper advocates to incorporate dissociative symptom screening, and evidence-based trauma focused treatment into addiction recovery settings, emphasizing clinical strategies (van der Hart, 2010). By addressing the dissociative roots of addiction, treatment programs can offer more sustainable recovery pathways for this highly vulnerable population.
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Keywords
dissociative trauma , EMDR , SUD and trauma , addiction treatment , dissociation , addiction , Vancouver, BC , complex trauma , trauma-focused
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Attribution-NonCommercial-NoDerivs 3.0 United States , openAccess
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