As I prepare for giving a presentation on Trauma Informed Care (TIC), I am wondering what blocks people living with addictions from getting access to treatment from both sides of the fence. Then I hear reports regarding its “public health crisis” status, how people believe that it is easy to just stop drugs; as if drugs were the only addiction that needs to stop. We can’t advertise our way out of addiction. I firmly believe that there needs to be more understanding around what addiction is on a societal and policy level. So I decided to create Addiction-Informed Care (AIC).
AIC (a term I am coining here) would be built on respect, understanding, and equality. AIC would be similar to Trauma-Informed Care (TIC) but with one key difference. For those who don’t know, TIC is defined as “an organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma (2017).” For AIC’s definition, I substitute the word addiction for trauma because I believe they are the same thing because addiction itself is a trauma. TIC already accepts that trauma is at the heart of addiction but addiction-causing trauma is not part of the discussion. Trauma and addiction are in relationship with each other and are inseparable, so philosophically they are the same thing because they are a part of the same process. Trauma can be seen as pain and addiction can be seen as reward/pleasure. They are both rooted in our survival mechanisms because they ride on the pain/reward pathway in the brain but when seen in a social context, they are viewed as out of range of normal behavior. When in fact, since the pain/pleasure (rewards) system is the basic motivator of all human behavior, they are normal responses. Everyone has the propensity to become traumatized or addicted because we all have the propensity to feel pain and pleasure.
Addiction is a dysfunction in the brain caused by a trauma on biological, psychological, social, or existential/spiritual level. As a result of this trauma, a relationship is formed. Addiction is not about the drug or a particular behavior, it is about our individual “need” to have a relationship with the drug or behavior. Since we can form a relationship to anything, we can become addicted to anything that entices our pain/reward pathways. This includes power, control, righteousness, democracy, patriotism, ideals, morals, money, drama, or any desired outcome. Now, since addiction is a paradoxical play on right and wrong, one can become addicted to the other side i.e. humility, compassion, and righteousness.
AIC would be based on a thorough understanding of how addiction impacts an individual, communities, institutions, businesses, industries, systems, and the course of human history and development. AIC would help us understand our current state of the union and the human condition.
AIC would be built on mutual respect and understanding. It would be rooted in how neurological, biological, psychological, social and spiritual aspects of addiction impact our individual lives, communities, institutions, and systems. It would recognize that trauma and addiction are primal motivators for all human behavior, which can be linked to an abuse of power and a (conscious or unconscious) intention to cohesively control and stay in control. AIC would actively engage to confront blatant disregards for facts and observable conclusions relating to all manifestations of addiction.
AIC acknowledges why people, institutions, and systems become abusive, coercive, and dysfunctional. If one cannot stop something, would hurt someone over it, kill, die, or cannot live without for it, you’re in a state of being addicted to it. TIC recognizes the abuse of power but does not acknowledge why it occurs. Before there was trauma, there was addiction. Trauma appears to be at the root of human behavior because we remember the event, but addiction is there too. Addiction is happening in the honeymoon phase of the relationship, the trauma is the abuse. What unmet need/want caused the trauma? What was the need/want that was trying to get satisfied? Examples of addiction can be seen when the greater good is sacrificed for individual gain or self-preservation.
Examples being under the influence: inability to empathize or accept the other sides point of view, lack of concern for greater good, only seeking their needs to be met, unable or willing to listen to reason, and disregard for the law.
Reasons why individuals are unable to change: they are addicted to the outcome of an entrenched belief and can stand no contradiction to what the belief provides i.e. invested interest, and/or they are traumatized themselves, marked by an inability to accept progress or change.
When survival or “us vs. them mentality” are the only rules of the game, then you are either addicted to the game or are being traumatized by it. This is because our higher orders of thinking become compromised by our need for survival. The difference between surviving and thriving is overcoming the relationship between trauma and addiction within ourselves. This view can be extrapolated to societies.
TIC and AIC may seem confrontational but that is not the intent. The intention is to advocate for understanding, change, and to carry a message to those who need to hear this because it is getting to the point of the story (his-story) when the character asks, “what’s really going on here?” The conclusion is hopefully to ask and accept help.
All conflicts come down to a lack of understanding due to lack of information, either by choice or by psychological influence. For those who read this and do not feel that they have an addiction, please know that I believe that you do on some level. Addiction is a matter of degrees. Think of addiction on a spectrum with healthy, neutral, and unhealthy versions. They all end but some will end quicker than others. One can label one’s addiction as love, passion, materialism, or “the good life” but when we define addiction as “a want labeled as a need” or “something that one cannot stop” then a whole new avenue of thinking opens up.
At the heart of human existence, we are either addicted to life or death. From a higher order of thinking, there are no such things as life and death. Life simply fuels death and death fuels life. There is no “right or wrong;” only desired/undesired outcomes because of our addictions. The severity of our need for desired outcomes greatly impacts human development. The best we can do is minimize the impact of our desires on the outcomes and maximize our healthy relationships.
One man’s loss is another man’s gain, however, when future generations stand to lose (or have lost) a healthy ecology, basic human rights, and individual freedom as a result of our addictions, we have to re-evaluate our way of life and adjust accordingly. From a psychological standpoint, if someone is defensive they are protecting what they value. Any perceived value is a judgment and can become a “need.” This relationship over “want and need,” “love and hate,” “right and wrong,” “pain and pleasure,” “attachment and non-attachment,” “clinging and letting go,” has been discussed forever. The difference is that we have a solution for our unhealthy relationships to our addictive behaviors and can make the necessary changes to improve our lives through a process of recovery.
If we truly want to address the addiction crisis, then everyone would be in trauma and addiction treatment. I strongly recommend that each person looks at what is fueling their role in enabling these institutions if they want to see lasting change. Anything we put in front of the individual’s right to chose how they live their life, we stand to lose.
The US opioid/opiate crisis is not about the drug, but rather our nation’s relationship to addictive behavior. I would like to see is more informed policies based on the research and not on political gain, accountability to policymakers and businesses, and treatment options for the people who do not recognize their addiction or their addiction to trauma/drama.
2017/11/2. Retrieved on http://www.traumainformedcareproject.org/ Frontpage.
by Adam O’Brien LMHC, CASAC, EAS-C is the owner/clinician of Mutual Arising Mental Health Counseling, PLLC in Chatham NY. He works primarily with people suffering from their addictions but is also a trauma therapist working with victims of crime. In these freelance writings, he brings a variety of experiences and points of view to entertain and educate. He is an EMDRIA certified EMDR therapist/Consultant-in-Training and is trained in Progressive Counting and Brainspotting.