As a therapist, I utilize the trauma healing therapies of EMDR and Progressive Counting to address addiction, trauma, and mental health conditions. Treating addiction and trauma is a passion of mine and I continue to see clients make positive gains when they address the impact of these conditions using trauma resolution. However, what I would like to see more trauma resolution therapy in addiction treatment. There are some helpful existing ways of applying trauma resolution to the treatment of addiction, but I feel that there are some critical philosophical misunderstandings regarding what addiction is and these misconceptions are obstructing trauma resolution from being applied a wider scale. By exploring these misunderstandings and exploring how else to apply these therapies, I believe that it would help more clinicians to apply trauma resolution with certainty.
I treat addiction with trauma resolution because I see trauma and addiction clinically as the same side of the coin. Philosophically, and quite literally, they represent pain. The other side of the coin is healing and recovery, which philosophically usually represents pleasure. The coin really represents the human condition. The relationship between pain and pleasure creates our human drama. Acknowledging the relationship that is created between pain and pleasure (really between any polar experiences), gives me the opportunity to introduce the name of the blog. Mutual Arising is a Taoist concept that recognizes that things come into existence together and they create a relationship that is symbiotic, interdependent, and inseparable (Watts, 1975). For our purposes here: where there are wounds, there is healing. For me, healing and trauma resolution are synonymous because of what I witness almost daily. The importance of acknowledging this relationship is critical to our understanding of how to address addiction/trauma and the human condition.
I came to apply the healing practices of trauma resolution to addiction from personal experience and academic study. I have found drugs absolutely fascinating ever since I first took them in 9th grade. I had heard about them in D.A.R.E. class when I was in 5th grade. Even at that age, I remember feeling like that there was an escape route and when I had a chance, I took them. 2 dollars for 10 hours of seeing cartoons like images, tasting bright colors, opening new ways of thinking and different doors of perception was not something to pitch to someone looking for an escape.
Now, 5th-grade D.A.R.E. class may not seem like a trauma by any standard definition, but I came to see it as one when I did a floatback intervention. A floatback (Shapiro, 2001) is a therapy technique used in trauma resolution therapies where the client “floats back” from a similar memory to an earlier one. When I was learning about EMDR in my graduate studies, I started to see that drug use could be “stuck” in the memory system and could impact the body in the same way a trauma does. So, I was not surprised when I landed back in the 5th grade again and could see myself getting high simply off the idea of drugs, however, my floatback did not finish there.
My floatback went back further to when I was 2-years-old and was in different medical offices with my parents seeking relief for a genetic skin condition that was triggered by environmental stressors that shook my healthy attachments. This personal experience helped me see how these types of memories can help clients during the trauma resolution phase of treatment. I have been targeting these learned relief behaviors that symbolically represent the relief of the drug and clients have reported benefit. I also will treat it as a theme or memory cluster (Greenwald, 2007) and then target the first drug use all the way up to the most recent use. Similar to my experience their floatbacks lead to different times when they were not responsible for their “choice” of taking a drug or relief behavior. Clients have also identified their parents giving them alcohol for an illness as a child, stealing sips of alcohol on the route back from the fridge, and early medical operations as the moment that they first fell in love with the effects of the drug or learned that the drug was a practical solution to an emotional pain problem. Other clients have identified with excessive exercise or sports involvement, sibling relationships, parental perfectionism, their designated family role, and observing other relief behaviors as targets to address. Clients will identify that they transfer their learned relief behavior from food, sex, or risky behaviors. Conversely, clients also report that their traumas are things that did not happen, for example, emotional connection, parental guidance, or supportive socialization.
All of these can be seen as developmental traumas because they change the course of the development and can be treated with trauma resolution if they still hold emotional value (positively or negatively). All traumas create an emotional imprint for learning addiction and this conceptualization supports Gabor Maté’s (2010) stance that addiction is rooted in trauma and it also supports addiction as a learning disorder by Maia Szalavitz (2016).
I view addiction, and most mental health conditions, in the diagnostic category of a Trauma and Stress-Related Disorder. Also, as outlined in my story above, addiction may be the poster child for a possible sub-diagnosis of Developmental Trauma Disorder, which has been presented by Bessel van der Kolk (2014). There is further evidence in my story that stress triggers physical disease as stated by Gabor Maté (2003). These may not be the linchpin for every case because there are other factors like major trauma, socialization, temperament, genetics, and epigenetics that impact the development of an addiction, but philosophically knowing how to identify addiction-related developmental traumas, supported by reason and clinical observation, allows us to treat it with trauma resolution. This may not be new to most clinicians reading this, but it does offer the philosophical foundation of this blog.
To establish the philosophical foundation further, all experiences are neutral and it is how and when we emotionally learn our relief behaviors that we create different personal values on them. These lessons learned under emotional stress are coded and hardwired in the memory system to be remembered for the benefit of our survival (Ecker, Ticic, & Hulley, 2012; Szalavitz, 2016). So, a drug use or relief behavior is a neutral experience but can take either a positive or negative value, dependent upon the relative point of view of the observer. Targeting these memories with trauma resolution methods like EMDR and Progressive Counting has improved my client’s recovery process and my own. How I specifically address this will have to be discussed in later blogs.
This blog will continue to explore the relationship dynamic that mutually arises when we see addiction and trauma as the same side of the coin and healing/recovery as the other. It will advocate for ending the stigma of addiction and mental health as anything other than normal human behavior within a spectrum of human conditions. The implications reach much farther so we will have to explore them as well.
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. (2007). EMDR: Within a phase model of trauma-informed treatment. Binghamton, NY: Haworth Press, Inc.
Maté, G. (2003). When the body says no: Understanding the stress-disease connection. Hoboken, NJ: John Wiley & Sons, Inc.
Maté, G. (2010). In the realm of hungry ghosts: Close encounters with addiction. Berkeley, CA: North Atlantic Books.
Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic principles, protocols, and procedures. New York, NY: Guilford Press.
Szalavitz, M. (2016). Unbroken brain: A revolutionary new way of understanding addiction. New York, NY: Picador.
van der Kolk, B. (2014). The body keeps the score: Brain, mind and body in the healing of trauma. New York, NY: Penguin Books.
Watts, A. (1975). Tao: The watercourse way. New York, NY: Pantheon Book.
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.