Dr. David Fawcett
Trauma can often be identified in the histories of those who combine drugs and sexual behavior. Adverse childhood experiences such as sexual, physical, or emotional abuse, along with issues like neglect and bullying, can all set the stage for adverse coping mechanisms like dissociation, compartmentalization, and chronic sympathetic (fight or flight) or parasympathetic (freeze) patterns set in the nervous system.
Various addictive behaviors are used to help the addict separate from or numb emotional pain. Sadly, this reinforces compartmentalization and dissociative tendencies. Thus, addicts never really learn how to properly identify and express their needs or correctly note and process their emotions. In recovery, many of these essential skills of living need to be learned for the first time.
Trauma impacts our beliefs about ourselves and others and frames our expectations of how the world and the people in it will treat us. It impacts our ability to trust others, to be vulnerable, and to take care of our own needs. It “corrupts” our arousal template (as sex researcher John Money described it) by inserting unwanted attractions and/or revulsions. Perhaps most damaging of all, the experience of trauma undermines our belief in ourselves.
In my opinion, long-term recovery from addiction depends on resolving some of the mistaken beliefs about ourselves and healing the wounds that have occurred, in many cases years ago. It is critical, however, that the timing of such trauma therapy be carefully considered so as not to overwhelm a person in early recovery.
Remember that addictions are maladaptive coping mechanisms that help us numb or separate from emotional pain. While highly flawed, they do help us “cope” (largely through avoidance). When we move into recovery and thus give up our coping mechanisms, we have to learn new and healthier ways to manage our feelings. This new “toolkit” includes emotional regulation skills, grounding techniques, mindfulness, building robust support networks, and so on.
Unfortunately, if I, as a well-meaning trauma therapist, dive into therapy on an addict’s old wounds too early in the recovery process, I create the very real risk of overwhelming that person’s ability to cope. As such, I could initiate a relapse. The good news is that a few months of coping skill development can make a significant difference.
It is also important to recognize that trauma is a mind-body phenomenon. Sometimes trauma occurs to very young infants who don’t have the ability to put the experience into concepts or words. The traumatic experience may then become a series of sensations locked in the body. The same can be true for traumatic experiences that occur later in life. There are frequently no words to describe the traumatic event(s), no coherent story. Often, there are just flashes of memory, images, or sensations. Indeed, a main goal of trauma therapy is to enable the person who experienced the trauma to create a story of survival and resilience from these fragments of experience.
The only way to accomplish this is to treat trauma with modalities that recognize that trauma is not just memories in the mind; it is also held in the nervous system of the body. This is beautifully explained in Bessel van der Kolk’s book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.
Talk therapies (such as cognitive behavioral therapy and exposure therapies) are based on the left brain, which is about linear and analytic thought. This can be useful for processing that which is conscious. But with trauma, much of what needs to be healed (“memories” stored in the body) is inaccessible using these modalities.
Somatic therapies – therapies that include one or more components that recognize the body are based on right brain activity and should always be included in trauma work. Incorporation of these techniques allows a more complete resolution of trauma — not just trauma held in the mind, but trauma held in the body.
In my next post to this website, I will discuss the various modalities that can effectively be used in the treatment of addicts.