The Book Brigade talks to addiction-and-families expert Claudia Black.
Posted Jan 04, 2018
What makes addiction so stubborn a condition? The roots of the disorder may extend deep into families. Certainly its effects do.
What led you to write your book on the effects of trauma and addiction within the family?
My professional life is working with families affected by addiction. The missing piece to their recovery is often trauma that is not identified and addressed. I have been in the field for over 40 years and this is my 16th book. In my early books I certainly discussed the violence and abuses that occurred in families hit by addiction, but since that time the understanding of and treatment associated with trauma has greatly expanded.
Aren’t there enough other books on the topic?
There are many books today about trauma, and many about addiction, but few about the relationship of the two. And, surprisingly, there are no other books that speak to the interplay of trauma within families affected by addiction.
How are trauma and addiction disorders related?
When a family is ill with addiction, its members are much more likely to experience trauma than nonaddicted families. The trauma is more likely to be more serious and more painful, and it is likely to take longer to heal. In short, addiction worsens every dimension of trauma. To be in such a family often means to be in a family with a steady diet of trauma. These traumas are often blatant, but more so they are referred to as Little-T traumas, those that are more subtle, often a process versus an event. Whether blatant or subtle, the traumas are often chronic. For children this occurs while the very structure of their brain is still developing. The consequence is emotional dysregulation leading to a constant flight, fight, or freeze response. It is played out in anxiety, depression, seeking of drugs and alcohol and other self-medicators. Without appropriate intervention, generational repetition occurs; the trauma responses show themselves throughout the generations to come.
What kinds of effects do they have?
While there are many different factors that influence the effects trauma and addiction have on someone, identifiable consequences include hypervigilance, emotional reactivity, dissociation, learned helplessness, somatic complaints, self-injury, and control issue.All of these dynamics become a part of peoples’ behavioral and substance addictions, their mood and anxiety disorders, their unhealthy and repetitive relationship patterns.
How do they play out in families?
Shame permeates these family systems. Shame is the belief that who you are is not good enough, that you are inadequate, that you are not worthy, that you are not of value. The shame makes you feel alienated, defeated, not good enough to belong, therefore creating a sense of disconnection from others. The vulnerability in the experience of shame is that you go to great lengths to hide, from yourself and others, that part of you which you believe is so ugly and exposed. It is often masked as perfectionism, rage, control behavior, use of substances, behavioral addictions, and more. While all of us are exposed to experiences that could be traumatic, not all losses and crises have long term impact. Different people have differing levels of resilience.
Factors that fuel experiences to become traumatic are ones such as accumulated stress, a negative outlook on life, lack of a sense of security, and/or trauma perpetrated by someone supposed to love you. This defines life in an addicted family system. But more important is the impact of previous traumas; sadly in such a family system there is a steady, progressive diet of trauma.
One factor that creates resiliency is receiving support at the time that trauma is experienced. Adults in addictive families become isolated and don’t seek support, and adult family members do not provide it consistently to their children. They are often operating with the Don’t Talk rule fully intact.
Who is most vulnerable?
Clearly, children are the most vulnerable. A child who is not protected, not talked to honestly about what is occurring, and not supported at times of fear is vulnerable. The child’s personality and nervous system are still developing.
Why are the effects so far-reaching?
Childhood injuries related to addiction can have long lasting effects because they occur while the very structures of the body, brain, and personality are being formed.
Are the effects on the family unaddressed or overlooked in many circumstances?
The effects on the family are often unaddressed or simply overlooked. When family members seek treatment, they don’t usually present as the partner, spouse, or child from an addictive family. They present as socially anxious, having parenting problems, relationship problems, and/or depressed. The issues of trauma and addiction are often not even assessed.
Are typical treatment approaches adequate?
In addiction treatment programs, families are often not a part of the treatment process. When they are, involvement is often limited, and the focus is primarily on their enabling behavior and need to practice tough love. Not recognized is that their fear of rejection, need for approval, and fear of conflict sabotages their ability to practice the non-enabling behavior and is related to their traumas.
What kinds of factors would treatment ideally address?
As long as behavioral health practitioners keep isolated in their own schools of thought and do not collaborate or cross-train, clients will continue to be mistreated, ignored. And they will be over represented in our mental health clinics, primary health care physician offices, and family service centers.
At a minimum, treatment would involve history and assessment of one’s family of origin as it relates to both subtle and blatant trauma and addictive disorders. A strong genogram is warranted. Treatment would ideally incorporate understanding of behavioral and substance addictions, assist clients in being able to recognize shame-based beliefs and defenses, and ground patients in emotional regulation through any educational and cognitive behavioral work. Ideal treatment calls on knowledge of trauma and addiction specialists as resources
Who would most benefit by reading your book?
I hope anyone impacted by addiction, be it the addict and/or other family members, will read this, even if they don’t recognize a role of addiction in their history. There is a much for them that will offer a direction in healing. My hope is that any practitioner who has ever worked with a client who has had trauma or addiction in their life (I say this facetiously, as this is every clinician) will read this book. It will provide a framework for how to present these issues to clients as well as some tools to offer the client.
If you had one piece of advice, what would it be and for whom?
If I had one piece of advice or one message, it would be that experiencing trauma is not a life sentence. There is much you can do and it is possible to create a new legacy for yourself.
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