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Defining Addictions from a Trauma Perspective

The first time I got high, I came home and my sister asked me “who is she?” She thought I was in love. Well, I was, but with the experience of freedom to different underlying issues that I had been experiencing my whole life. After the drug wore off and the psychological cravings started, then the biochemical reminders of adrenaline and serotonin began and the voids of loss felt like the vastness of space. Emotional confusion was compounded by love withdrawal and this lingered for weeks until I was able to hook up with the drug again.

Addiction is the paradoxical two-way mirror into the human condition and to avoid the reality of it is to deny its’ existence. Addiction takes hold when a “want” is labeled as a “need” and you need more to satisfy it. Addiction is a rollercoaster ride you feel like you can’t escape because it threatens your very existence.

From a psychological perspective, addiction is toxic passion. Passion drives us to get our emotional need met. We all have been in an intoxicated state of passion so we know what it feels like. In the case of addiction, a behavior or substance meets our unmet needs and fulfills the role of healthy relationships. Maybe more accurately, the behavior or substance replaces our basic human needs, supposing they were met before. The question becomes: Why do our needs need replacing?

What I continue to purpose in my blogs is that we are addressing addiction at the root when we conceptualize that the drug use (or learned relief behavior) as a/the trauma. Again addiction is paradoxical in that what feels good is not actually good for you. Now, I know that some will say that trauma is not in root in every case, but I would argue that if trauma is subjective, then no claim could be laid to that. I would agree that not all traumas equal Post Traumatic Stress Disorder (PTSD) however, I have yet found a person with an identified addiction not have a trauma whether it be real, perceived, witnessed, or existential in nature. As Gabor Maté (2010) stated, “not why the addiction, but why the pain.” The main culprits of pain stem from early childhood environment with school, parenting styles, and/or the family dynamics. If miraculously a trauma is not there, then the introduction of the toxin, behavior, or drug to the body becomes a trauma.

Defining addiction is often paradoxical, especially if we do not take into account the trauma that happens in everyday life. When we take trauma into account, defining addiction becomes clearer. Under the lure of security, hope, desire, pain relief, and/or unconditional love, addictive behavior progresses and grows into dysfunction. The definition of addiction appears to be firmly rooted in trauma but it is not widely recognized by people who do not interact with active addiction or people in recovery from their addiction. This blind spot effects governmental policy and perpetuates the stigma of addiction. Ultimately, it affects how we treat addiction because we spend so much time educating on what addiction is, rather than treating the root causes.

American Society of Addictive Medicine state “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors (ASAM Board of Directors, 2012).”

On the whole, I agree with this definition because it reveals the underlying trauma used to define it; but also the solution. “Dysfunction” in the brains “memory and related circuitry” is the underlying trauma. And, the solution is: if the client changes their relationship to the memory, can you heal the dysfunction? The answer is yes; I have done it. And to be fair, ASAM does recognize that trauma and stress are involved in addiction (ASAM Board of Directors, 2012).

In his book Anatomy of Addiction (2016) Dr. Mohammad points to a medical definition of disease and identifies genetic predisposition and excessive triggering of the pain/reward pathway as main ingredients to creating an addiction. To support this position Dr. Mohammad states, “overstimulation of the reward circuitry factor significantly in addiction but it creates false memories of the experience. The brain regards the experience as ‘better than expected,” even when the experience wasn’t all that great. Because the memory is a permanent part of your mental makeup, anything and everything that reminds you of that memory also remind you that the experience was better than expected and triggers an instant desire to re-experience something that perhaps wasn’t anywhere as good as you remember (p. 56).”

If trauma resolution has shown me anything, it is that our memories and relationship to them is anything but permanent. Memories, reminders, triggers, objects, people, places, and things can be desensitized to help stop enactment because ultimately it is our relationship with them that changes. Addiction and relapse are a form of trauma re-enactment and it can be treated more effectively with trauma resolution. Trauma resolution is done through memory reconsolidation (Ecker, Ticic, & Hulley, 2012) and the therapies that exemplify these are Eye Movement, Desensitization and Reprocessing (EMDR) (Shapiro, 2001) and Progressive Counting (PC) (Greenwald, 2013).

Addressing memory in the context of a human beings life addresses the root cause of any behavior. The coping skill of addictive use is what is stuck in the body and brain like a trauma and it can be alleviated through trauma resolution. Addiction alters the brain and its accompanying guilt and shame can be seen as a trauma. People who are addicted, their families, and communities who have been impacted by addiction, know that at some point the addiction becomes traumatic. Addiction is a rollercoaster that you feel like you cannot get off. Actuality, you can, but you have to climb on another one, which also has its twists and turns, its highs and lows. This other rollercoaster is the ride of life.

References

ASAM Board of Directors, 4/19/2011. Retrieved on 8/11/17 at http://www.asam.org/for-the-public/definition-of-addiction

Ecker, B., Ticic, R., & Hulley, L. (2012). Unlocking the emotional brain: Eliminating symptoms at their roots using memory reconsolidation. New York, NY: Routledge.

Greenwald, R. (2013). Progressive Counting: Within a phase model of trauma-informed treatment. New York, NY: Routledge.

Maté, G. (2010). In the realm of hungry ghosts: Close encounters with addiction. Berkeley, CA: North Atlantic Books.

Mohammad, A. (2016). Anatomy of Addiction: What science and research tells us about the true causes, best preventive techniques, and most successful treatments. New York, NY: Perigee.

Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic principles, protocols, and procedures. New York, NY: Guilford Press.

Adam O’Brien LMHC, CASAC, EAS-C is the owner/clinician of Mutual Arising Mental Health Counseling, PLLC in rural 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 currently becoming certified in EMDR and Progressive Counting and is aiming to support others by consulting and training. These blogs are to advocate for trauma services in the field of addiction but also serve as a way of reaching a wider audience.

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