While we can’t say that addiction is specifically caused by trauma, we can definitively say that the two are highly correlated. Over the years of my experience of working with addictions, I have encountered thousands of addicts and come to know their personal stories-and the sources of their anguish and trauma are often a significant part of their psychological make up. It is has also been true in my experience that the treatment of addiction must include the treatment of trauma.
The treatment of trauma in addiction treatment is a process. I have often come in contact with consumers, usually family members of my patients, who want the trauma treated immediately. While this is sometimes an option, it is also largely dependent upon the coping skills of the patient. If a 24 year old heroin addicted woman comes in for treatment for her substance use disorder and her family wants to see her treated for a sexual assault as well, this is a very reasonable combination of points of treatment. With that said, we also have to proceed very carefully with how intense we make treatment in early recovery. Someone in their first thirty days of recovery has an easily activated nervous systems which can set them up to experience clouded, distorted thoughts, irrational thoughts, and intense, overwhelming emotions. It may be better to start treating this person with the acquisition of coping mechanisms before the actual traumatic event is launched directly into. Doing otherwise can actually cause for a retraumitization and result in more firmly entrenching the neural networks that the trauma is currently stored in.
The good news is there are options. I have found eye movement desensitization and reprocessing therapy (EMDR) to be very helpful to people in early recovery. For others, utilizing trauma focused cognitive behavioral therapy is a more effective pathway. I have also had very good success using the Trauma Resiliency Model (TRM) to treat trauma. This model is a more somatic based therapy that utilizes tracking sensation, grounding, and the building of internal resources to increase the patients resiliency zone (thereby leaving the patient’s nervous system less activated).
It is better to be effective than to be quick when it comes to trauma. Patients will benefit greatly from a warm and supportive therapist who is trained in trauma informed treatment approaches as well as specific treatment approaches for trauma. They may also benefit from slowing down. When they are also seeking help for an addiction it is imperative that the treating provider have more more than a general point of view on addictions as the treatment of trauma, even by trauma experts, can lead to relapses which set the patient back in their recovery from both issues. Overwhelming a patient too early, without arming them with healthy coping skills can be a form of well meaning cruelty to the patient in the case of these co-occurring problems.
Founder and Director
True North Recovery Services