Watching a loved one struggle with any kind of substance dependence fills many of us with worry, confusion, and questions. What can we do?
Understanding trauma’s role in addiction will help more of us lead the change in attitude we need. If the struggle with drug addiction is so often painful and deadly, why does it happen? How can we understand addiction to offer a more healing response?
Drug Chemistry Is the Wrong Explanation
Addiction prevention campaigns used to focus on tolerance to explain the risk of dependence.
We know that addictive substances stimulate the brain’s “reward” system. A person can trigger a surge in feel-good hormones like dopamine by using. But over time, the body adapts, and more of a substance is needed to get the same effect.
But the chemistry-based explanation leaves out the most important factor: emotional pain. Emotional dysregulation underlies the vast majority of substance use issues.
As a trauma-informed therapist, I ask: Why would a person need to do something so dangerous to feel better or actually less badly in daily life? How does this make sense? By working carefully with a person struggling to cope by using, we find trauma at the root of addiction.
Understanding Addictive Behavior As a Survival Strategy
Using may start as experimentation or fun. Addictive behavior begins as a survival strategy. A person uses to get through life each day, because of how using makes them feel (or not feel).
Using is a way to numb, self-soothe or fight back against distressing thoughts, feelings, and intrusive memories that have become unmanageable.
It is an attempt to dissociate — disconnecting with one’s own negative thinking, intolerable emotions and painful inner world.
“Substance abusers are on autopilot, running an ineffective, inefficient program” to cope with unresolved distress, says Denise Tordella, Licensed Professional Counselor and co-presenter in our workshop, “Understanding and Treating the Impact of Trauma, Domestic Violence and Substance Abuse on Adolescents.”
- In surveys of adolescents receiving treatment for substance abuse, more than 70% of patients had a history of trauma exposure.
- More than 13% of 17 year olds (1 in 8) have experienced posttraumatic stress disorder in their lives.
The Partnership for Drug Free Kids points to a study that finds “a high rate of childhood trauma in adult alcoholic inpatients. The researchers suggest childhood trauma should be considered when developing prevention and treatment strategies for adults with alcoholism.”
Helping People See the Need for Treatment
Many people take up drinking or using socially. They may not consider their life experience to include trauma.
So, it’s important to ask yourself, do you drink or use to manage your emotions?
You deserve to feel safe in your own skin without having to numb, escape, or alter how you feel inside. If you do, it’s time to start looking at the issues behind the substance use.
You may have a dependence that needs treatment, even if you don’t drink or use every night.
Warning signs that drinking or substance use needs professional treatment include:
- Recurring binge drinking, or drinking or using to excess.
- An inability to leave unfinished alcohol behind (for example, a person without alcohol dependence may leave wine served with a meal unfinished; a person with a dependence problem or disorder is unable to leave unfinished alcohol behind)
- Feeling you have to be using or drinking to socialize–you can’t go to a party and tolerate being there without taking or drinking what others are
- Using or drinking even when you are not feeling well
- Drinking and driving, or using and driving
- Normalizing the using behavior: “Everybody in the club drinks this much.”
- Drinking or using for effect — to alter the mood you are feeling.
- Drinking to help regulate emotions or to numb psychological pain: “I don’t want to think about that right now; I don’t want to deal with that right now.”
- Loved ones and colleagues tell you that your use hurts them, worries them or is damaging your relationship
Addiction Recovery Through Trauma-Informed Therapy
Trauma-informed therapy is the best way I know to go from coping to living fully and freely without depending on drugs or alcohol.
Trauma-informed therapy recognizes a person’s substance use as a way to cope with overwhelming emotions and intrusive memories of feeling unsafe or threatened.
Safety is the priority in a trauma-informed approach. A trauma-informed therapist develops ways to help the client manage triggering flashbacks or overwhelming responses before exploring how trauma has played a role in the person’s life.
The therapist works gradually, while helping a person find personal resources and connections with supportive people.
Recovery empowers individuals handle situations that triggered using behavior before.
Trauma-informed therapy for alcohol and substance abuse involves:
- Creating a respectful, compassionate, safe arena for doing the work
- Fostering an understanding of the link between underlying mental health related issues, such as trauma and mood disorders and the course of addictions
- Supporting self-compassion and self-respect to counteract the shame and guilt that is the inevitable byproduct of a person’s experience with addiction and underlying experience with mental health issues and trauma
- Helping individuals develop their own healthy solutions to the problems that they have identified
- Finding outside resources for support; such as recovery groups like AA, SAA, NA, OA, etc.
Let’s Break the Cycle of Addiction
Drug addiction itself is not something people choose; it a desperate attempt to cope with dysregulating stress, trauma, anxiety, depression, flashbacks, and to numb negative thoughts and emotions.
We may still wonder why people put drugs or alcohol into their body. But it’s a mistake to label them bad people. We wouldn’t do that if we saw them as people in pain, struggling mightily just to get by.
Substance use may seem like a baffling or bad decision. If we want to help, we’ll remember: People struggling with addiction deserve — and need — our compassion and support to heal.
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