What is Trauma and What Causes It?
Trauma can be defined as stress that is harmful and inescapable. It can be created by a variety of sources, including abuse, neglect, and alcoholic or addictive homes. It is typically a painful, frightening experience such as a car accident, sudden life change, near-death experience, and even bullying. Trauma is also subjective, relying on your internal beliefs and mental/physical reactions to stressors, where the effects of trauma build slowly over time and can have dangerous results if not addressed and resolved properly.
What Happens to the Brain When Trauma Occurs?
When trauma occurs, your body and brain adjust to deal with the stress. The amygdala becomes overactive, constantly assessing for threat and creating anxiety, vulnerability, and fear. In contrast, the hippocampus slows, keeping memories stuck in the present instead of storing them, causing constant intrusive, disturbing, and uncomfortable recollections. The cortex (your brain’s executive control) is interrupted by survival instincts, not listening to logic or stopping potentially negative behaviors. Those struggling with addiction will experience an overwhelming urge to engage in those behaviors. Most, if not all, have the access to substances that can dull the stress of trauma.
What is the Relationship Between Addiction and Trauma?
The research confirms that the more stressful and atypical your experiences, the greater odds of a later life addiction. According to the National Center for Post-Traumatic Stress Disorder and the Department of Veterans Affairs, 25-75% of people who survive abuse/trauma develop alcohol abuse, where a diagnosis of PTSD increases the risk of developing alcohol abuse. Additionally, the Adverse Childhood Experiences study found correlations between severe childhood stress and various types of addictions. The National Survey of Adolescents reported that those who experienced abuse/assault were three times more likely to report substance abuse than those without a history of trauma and more than 70% of patients receiving treatment had a history of trauma exposure. Thus, trauma increases the risk of developing substance abuse, and substance abuse increases the likelihood of trauma.
For those who have past trauma, there is a desire for safety/control. Traumatic situations typically result in fear/helplessness, leading to struggles with depression, anxiety, and addictive/impulsive behavior. Substance use avoids/reduces the overpowering feelings of trauma by taking away the distress through “feeling good”, or self-medicating. With substances, things lost through trauma are regained – staying safe, escaping memories, soothing pain, being in control, creating a tolerable world, being treated fairly, and defining who we are. Addiction becomes a way to manage the unmanageable – an unhealthy survival instinct. Addiction creates a cycle of negative behavior, making it harder to recover after trauma occurs. What began as one problem (trauma) becomes complicated by another (substance use), until the coping mechanism becomes so troublesome that treatment is needed.
What Does This Mean for Your Recovery?
When we first acknowledge our addiction, we often feel embarrassed, ashamed, frustrated, and so on. But a positive perspective is to view your addiction for the good intention beneath – a desire to make yourself feel better. There are roots in addiction related to positive outcomes such as the relaxation of fear, relief from the painful memories, and restoration of control in our own behavior. By working towards achieving the “good intention” through other, healthier ways, the less you will need the addiction to manage the trauma.
To assist in recovery, treatment must address the ways in which the trauma is related. This means that the trauma must be explored within therapy sessions alongside your addiction. Making sure that you work with your therapist to discuss skills/interventions focused on your trauma and its relationship to your addiction is critical. Treatment plans can be developed with your therapist to pay special attention to the signs/symptoms of PTSD, substance abuse, and the relationship between the two. By addressing both the trauma and addiction simultaneously, your recovery is much more likely to be successful and prevent relapse. More information on trauma-informed addictions interventions and resources can be found on the SAMHSA website and with IITAP.