What Most People Don't Know About Trauma and Addiction
The invisible, undeniable link between trauma and addiction, and their treatment
Posted Jul 06, 2020
If you are like most people, you may think addiction is a rampant problem in our society. And you're partially right. It is. But that misses the forest for the trees. It's not the root problem itself. It's actually a failed solution to the underlying problem: the pandemic of unhealed, psychological trauma. It’s essential to realize that addiction is often the symptom of the problem in reality. It's no coincidence that about 28 percent of those with diagnosable PTSD have an addiction issue and another 35 percent have a full-blown, serious, physiologically-dependent addiction. The good news is it's very treatable, but it takes effort. So, a more relevant question when thinking of addiction, is not why the addiction, but first, what's the pain and past traumatic event(s) driving it?
The sooner we understand this, the better. If you're reading this, the odds are that you know someone struggling in the throes of addiction. Approximately 50 percent of clients in the U.S. pursuing mental health services are directly or indirectly affected by addiction (and therefore psychological trauma too, by default). If you or health professionals focus only on their addiction, again they'd be missing the bigger picture. The real problem is the pain and trauma (often rooted in deep relational ruptures) driving the addiction.
With psychological trauma, the brain's alert system (limbic system or fear center) can get locked "on." When this happens, the rational and decision-making part of our brain, the outer cortical layers essentially shut down because all the blood flow goes to the panic system. Addiction then starts to serve as an effective short-term remedy for this, but an increasingly deleterious long-term, creating another serious problem.
What does this mean in terms of healing addiction and trauma? Addiction is the failed attempt to heal and treat the underlying pain residing from untreated emotional wounds. Actually, the opposite of addiction is more trauma relief and healing, and human connection. So, they must be healed concurrently, as Jaime Marich beautifully explains. People and health professionals often assume that all is needed is to treat only trauma or only addiction instead of carefully heeding both. The general public also may often think that if you heal one of them, the other will also naturally heal on its own. This is a misconception. All too frequently in addiction treatment, like in 12-step groups, the psychological trauma fueling the addiction can be neglected. Moreover, many of my international and national colleagues fear treating psychological trauma. They avoid it or refer out. Don't get me wrong, there has been progress here, especially with the recent advent of trauma-informed care, but still, a considerable degree of "trauma resistance" in the mental health field remains.
Compared to depression, which can be significantly helped by antidepressants alone (arguably not thoroughly cured by any means); there's no magic bullet for healing psychological trauma. The same applies, for example, to bipolar and psychosis; psychotropic medication significantly helps but not so much with trauma. With PTSD, psychotropic medication may also help with symptom reduction, but nothing medically can be given to fully heal psychological trauma. The good news is the brain can be trained to not go into fight-flight-freeze (or trauma-mode) so easily, but it takes mindfulness, quality psychotherapy like EMDR, holistic healing methods, and dedication. Fortunately, contrary to popular belief, it doesn't necessarily need to take a lot of time. EMDR, for example, often only takes three to six sessions to notice a significant change in healing trauma and addiction concurrently.
Unfortunately, many health practitioners and therapists believe that if you heal the underlying trauma, the addiction will also naturally decrease, but as stated, the addiction also needs to be addressed. If you don't like 12-step groups there are effective variations like SMART recovery, Moderation Management, and Dharma Recovery (previously called Refuge Recovery) that can work too.
Cognitive behavioral therapy (CBT) is known as a gold-standard in psychotherapy in many contexts, or a variety of mental health issues. While it's unequivocally useful in many contexts, it can fall flat in treating addiction and arguably trauma as well. This is because certain variations of CBT may neglect the physiological storage of trauma. Those struggling with trauma and addiction are often disconnected from their bodies, its cues, its needs, its signals, especially its respective trauma and addiction triggers. EMDR therapy in tandem with addiction support may work more effectively and get to the true root of the problem (the unhealed wounds and psychological trauma). The sooner we understand this, the more likely we are to heal the global pandemic of trauma and addiction.
Maté, G. (2008). In the realm of hungry ghosts: Close encounters with addiction. Random House Digital, Inc..
Marich, J. (2012). Trauma and the twelve steps: A complete guide to enhancing recovery. Warren: Cornersburg Media.