NYAPRS Note: This article does a terrific job summarizing the often inextricable connection between trauma and addiction. Although those who have experienced trauma will not necessarily develop an addiction, statistics show it to be a salient predictor of addiction behavior. In fact, research suggests that 25-75 percent of people who have survived violent trauma or abuse will develop issues with alcohol abuse.
Because trauma affects the brain in ways that often seem overwhelming to survivors, drugs and alcohol help reduce those sensations making it easier to develop an addiction. But as the article says, “Without your consent trauma changes you, often into a person you’d rather not be.
At NYAPRS’ Executive Seminar, April 21-22, Steve Samra and Jeffrey McQueen will discuss this very topic in a workshop entitled, “Coming Back, Moving Forward: Recovery from Trauma and Addiction.” For more information, including regstration, please visit: https://rms.nyaprs.org/wp-content/plugins/files/civicrm/persist/contribute/files/2016%20NYAPRS%20AgendaFinal4b.pdf
Trauma and Addiction: 7 Reasons Your Habit Makes Perfect Sense
By Michele Rosenthal Recovery.org March 30, 2015
Let’s imagine that you can float up above the timeline of your life, turn and face the past as it stretches out behind you, and gently drift back to when your addiction first started. Now, let’s drift back a little farther to before that moment. What was happening back in those days, weeks, months or years prior to when your addiction began? Did you experience an event that was less than nurturing? Did you survive a moment that overwhelmed your ability to cope? Did you live through an ordeal that changed how you perceive your place in the world? If so, then you’ve experienced trauma.
The reason it’s significant to identify and acknowledge this is because research proves that trauma can activate survival oriented behaviors that lead to addiction.
The Trauma-Addiction Connection
While experiencing a trauma doesn’t guarantee that a person will develop an addiction, research clearly suggests that trauma is a major underlying source of addiction behavior. These statistics (culled from a report issued by the National Center for Post-Traumatic Stress Disorder and the Department of Veterans Affairs) show the strong correlation between trauma and alcohol addiction:
- Sources estimate that 25 and 75 percent of people who survive abuse and/or violent trauma develop issues related to alcohol abuse.
- Accidents, illness or natural disasters translate to between 10 to 33 percent of survivors reporting alcohol abuse.
- A diagnosis of PTSD (post-traumatic stress disorder) increases the risk of developing alcohol abuse.
- Female trauma survivors who do not struggle with PTSD face increased risk for an alcohol use disorder.
- Male and female sexual abuse survivors experience a higher rate of alcohol and drug use disorders compared to those who have not survived such abuse.
Similar research linking trauma and addiction exists for other habitual behaviors, including drug abuse and eating disorders. Delving deeper into the trauma-addiction connection reveals addiction as part of an extended post-trauma coping mechanism.
How Trauma Affects the Brain
As a thirteen year old girl in 1981 I survived a horrific trauma that left me with intense anxiety, repetitive nightmares and debilitating fear. Within a few years I had developed an addiction that would last for two decades and seriously threaten my health: I became addicted to not eating—anorexia. The high I got from depriving myself of food was delicious. The release from the emotional pain I was in, ecstasy. Even when it caused serious medical issues and I knew the behavior had reached a dangerous level the compulsion to restrict food consumed me. I needed the behavior although I couldn’t have explained why.
Today it’s much easier to see how trauma and addiction go hand in hand. Due to advances in neuroscience we now know:
- The amygdala (your brain’s threat detection center) can become overactive, engaging in a constant program of looking for, seeing and assessing threat. This will cause you to feel intensely anxious, vulnerable and fearful.
- The hippocampus (your brain’s center for processing memories) can become underactive. Rather than consolidating and then placing memories in the outer layer of the brain for long-term storage, memories get hung up in a present-day loop. The result: You will experience and re-experience intrusive, disturbing and uncomfortable recollections.
- The cortex (your brain’s center for executive control) becomes interrupted by survival-oriented instincts from deep inside your inner brain. These instincts overrule logical thinking, diminish cognitive processing and decrease your ability to inhibit behavior. Even when you try to refrain from addictive behavior you will experience an unstoppable urge to engage in it.
Addictions often help reduce the sensation of overwhelm that post-trauma changes create. In fact, when addictions are implemented as an attempt to manage what becomes unmanageable after trauma they can become a negative example of a very positive survival instinct. The key is to recognize this and learn how to turn it around. When I finally began to resolve how trauma affected me I slowly released my anorexic compulsion. The more whole and healed I became the less I needed that old coping mechanism until I released it completely.
Every “Bad” Behavior Begins With a Good Intention
You didn’t wake up one day and decide to become an addict. More likely, if you have trauma in your history you woke up with the conscious or unconscious desire for what all trauma survivors want: safety and control. The good intention behind your addictive behavior, then, has its roots in positive outcomes, including relaxation from the hyper vigilance of fear; relief from the up swell of memories; restoration from the inability to choose your behavior.
You can look at your addictive behavior and feel embarrassed, ashamed, frustrated, or a whole slew of other negative emotions. Or, you can observe your addiction for the good intention that lies beneath it: the desire to make yourself feel better. Acknowledging this allows you to begin understanding that while the addiction outcome is less than desirable the behavior makes perfect sense, especially if the addiction is driven by one or more of these seven desires:
- Stay safe: After trauma your own mind can feel like a danger zone, which makes being “out of it” feel safer than being in it.
- Escape memories: Unwanted and unresolved memories have a way of popping up incessantly after trauma; addictions offer the mind a different area of or reduced capacity for focus that helps suppress reminiscing.
- Soothe pain: Substances or the adrenalin rush of self-destructive behaviors change your body chemistry, releasing endorphins and other mood enhancers that reduce discomfort.
- Be in control: Sometimes, engaging in addictive behaviors can lead you to feel strong, resilient and courageous, an experience that is tremendously alluring when trauma from the past intrudes on the present.
- Create a world you can tolerate: The intense feelings brought on by fear, memories and anxiety can make any moment seem overwhelming. The release of tension brought on by addiction-oriented behavior helps facilitate a manageable experience.
- Treat yourself the way you feel you deserve: Trauma can leave you feeling less than, worthless, hopeless, and damaged. The more self-destructive you behave the more it can feel like you’re living in alignment with who you truly are. While this is false it can help reduce feelings of otherness and disconnection.
- Redefine who you are: Trauma changes your identity all the way down to the core of your beliefs and self-definition. It can seem as if no one understands you. Engaging in addictions can help create a sense of community by connecting you to others who feel, see, think and behave as you do. Or, addictions can help you revise your self-perception by allowing you to engage in and act out behaviors that allow you to feel stronger, more courageous, capable, etc., than trauma has left you feeling.
Identifying the good intention behind addiction behavior opens the door to healing. The more you learn to achieve the “good intention” outcomes in healthy ways the less you will need your addiction manage post-traumatic stress.
Creating A Healing Process
Fear drives all post-trauma related behaviors; healing focuses on resolving the fear. Sometimes this means allowing the addiction to persist while first treating the need for the addiction. Julie, a childhood sexual abuse survivor, discovered this first-hand. Her aggressive cocaine habit helped her outrun the flashbacks, nightmares, and anxiety that plagued her. Attempts to eliminate her addiction without offering her ways to reclaim control over her mind and body, plus resolve the trauma of her past, had led to nothing but frustration and disappointment, both in Julie herself and those who cared about her.
Finally, however, Julie came to understand how the trauma of the past was driving her addiction in the present. She agreed to engage in a trauma resolution process that included the traditional approach of cognitive therapeutic approaches (e.g. talk therapy) and also alternative treatment methods that processed out the stuck energy of trauma (e.g. Emotional Freedom Technique and Somatic Experiencing). Julie also dedicated herself to the daily practice of methods designed to help change the neurophysiological alterations that trauma had caused: Meditation, mindfulness, breathwork and yoga helped Julie reduce anxiety, transform fear and increase her ability to manage her emotions. When the benefits of this trauma-centric approach began to take hold Julie noticed a reduction in intrusive thoughts and memories, plus a more calm internal sensation that allowed her to refrain from her addiction for short and then longer periods of time.
Without your consent trauma changes you, often into a person you’d rather not be.
That’s a normal part of what happens after trauma. In every moment, however, you have the opportunity to change again. From deep inside your brain to your interaction with the outer world you have enormous healing potential; the goal is learning to access it—and then to use that potential to heal the pain, release addiction, and reach a glorious freedom.