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A Guide to Treating Trauma and Addiction Together

It is so important to treat trauma and addiction together when a patient presents with both conditions. Surprisingly, this isn’t always the way these cases are handled. Up until a few decades ago, these two conditions (as well as other co-occurring disorders) were treated separately. The result was more relapses, and more people who found it impossible to recover from their addictions.

Suffering through a traumatizing event is one of the hardest challenges to endure. If this is something you have faced, you know what the struggle is like. You may have turned to substances as way to cope because it was all you knew how to do. Using drugs or alcohol may be the only way you were able to feel more like yourself. We want you to know that we understand where you’re coming from. Getting the right trauma therapy is critical for you if you suffer from an addiction as well.

To help, we’d like to offer you this guide, and it is our hope that you’ll see the benefit of treatment. You don’t have to continue living your life in this constant, destructive cycle. Healing is available to you for both trauma and addiction.

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What is Trauma and is it the Same as PTSD?

The word trauma comes from the Greek word, which means, “wound.” It can be used to describe any type of event that causes psychological harm. This could apply to a physical event that had negative mental consequences for the individual. It could also apply to an emotional event that caused a lot of suffering and anguish.

Traumas can cause lasting damage for anyone who experiences them. Some people are able to get through traumatic events and process them rather well. Other people have a more difficult time. This may be because they lack a solid support system to help them. They may also lack the necessary coping skills.

Sometimes people will develop post-traumatic symptoms, but only for a short time. Others will develop post-traumatic stress disorder, or PTSD. This is a condition that is closely related to anxiety due to exposure to a traumatic event.

The terms trauma and PTSD are very similar, but one causes the other. It is possible to have lived through a trauma and not have yet developed PTSD. For these individuals, even though they don’t have the symptoms of the disorder, coping is still hard. They will often turn to substances as a way to self-medicate and find relief.

There are many different types of trauma, and these events can occur at various levels of severity. This is because trauma is highly subjective. What one person views as a traumatic event, another person might not.

According to SAMHSA, some examples of the different types of trauma include:

  • Being sexually assaulted
  • A child who suffers from neglect
  • A child who is physically abused
  • Sexual abuse of a child
  • The emotional abuse of a child
  • Domestic violence
  • War zone events that are traumatic
  • Being involved in a terrorist attack
  • Combat related trauma
  • School violence
  • Bullying at school
  • Being diagnosed with a medical condition
  • Grief due to a loss
  • Being involved in a natural disaster
  • Being a victim of a car accident

A traumatic event can quickly change the course of someone’s life forever. If left untreated, the experience can develop into PTSD over time. This creates an even greater problem. The individual is unsure of how to cope and handle what occurred. They may play the scene over and over in their minds. It almost becomes a nightmare that they are trapped in.

There are some events that are so traumatic that the brain actually tucks those memories away. These are called repressed memories. They occur subconsciously, blocking the individual’s ability to recall that they ever happened.

What’s interesting about repressed memories is that they often still affect the person. For instance, they may struggle with socialization or relationships, but they have no idea why. Others may notice that the person is different from others. It’s common for these individuals to suffer from severe anxiety. However, when they’re questioned, they’re not able to define the source of it.

Repressed memories are very difficult. People tend to not seek out treatment because they’re not aware that anything is wrong. For many, the discovery of the event can only happen through excellent trauma therapy.

In other cases, repressed memories can come flooding back to the surface quickly. It is possible to trigger these past events, and this can happen in many different ways. The individual may visit a place that is associated with the memory. They could hear a sound, or see an object that forces it to emerge to the conscious mind. As you might imagine, this can be incredibly debilitating.

Trauma bonding is something that many people find difficult to understand. It is something that often occurs when one person is stuck in a violent or otherwise abusive relationship. Outsiders may wonder why they continue to do this if they’re being mistreated.

Someone who suffers with this condition is essentially addicted to the emotional rollercoaster. Quite often, the victim may not even realize that they’re in an abusive relationship. They tend to see the relationship with veiled eyes, only seeing the good in the person. They see this as the abuser’s true self.

People who find themselves in these situations often take the blame on themselves. They may feel that it’s their responsibility to change the person. Or, they may think that they have done something wrong that needs to be corrected. They tend to stay because they are determined to win the abuser’s affections.

Trauma bonding involves the lows of punishment and the highs of love and kindness. The body is responding in kind in these types of relationships. Cortisol is produced during the low periods. Higher levels of dopamine than normal are produced during the good times. It’s almost as if the trauma itself has become an addictive drug. Just like any other addiction, it’s nearly impossible to quit unless the victim gets help in some way.

Why Addiction and Trauma are Often Connected to Each Other

The question is, why is it that trauma leads to addiction?

Trauma and Addiction Guide

It doesn’t always, but in many cases it does. A traumatized individual is looking for a way to cope.

That person may or may not be aware that they’ve been through a traumatic experience. If they remember the event, something like a physical trauma may be viewed as just something bad that happened. They often don’t realize the devastating and long-lasting effects it can have. 

The fact remains that trauma is a risk factor for substance abuse. People begin using drugs and alcohol because they’re trying to manage their symptoms. This explains why so many traumatized young people turn to substances to numb their emotions. They’re simply too much for them to handle.

Studies show that the opposite is also true. Sometimes people begin using drugs or alcohol, and that puts them at risk for trauma. They may take risks that they wouldn’t normally take if they weren’t using. They also may spend time with others who take risks, which can lead to witnessing accidents or other incidents.

For alcoholics or drug addicts who experience trauma, the outcome is usually much worse. This is because they lack the necessary coping skills to deal with the situation. Studies actually show that teens with substance abuse disorders that experience trauma are twice as likely to develop PTSD.

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Trauma and Substance Abuse Statistics in the United States

When it comes to trauma and violence, SAMHSA tells us that:

25%

For women in the United States, as many as 25% of them have suffered from childhood or adulthood trauma.

44%

As many as 44% of women have been victims of domestic violence.

$8,300,000

Intimate partner violence for women and girls was believed to cost $8.3 billion in 2003.

COSTS

These costs were related to mental health services, medical care and productivity loss.

5%

In 2008, it was found that 5% of veterans suffered from symptoms related to PTSD and depression.

15.2%

9% of men and 15.2% of women have reported experiencing a natural disaster at some point in their lives.

Furthermore:

25%

Before the age of 16, one in four children suffer from a potentially traumatic event. Many of these adolescents have access to multiple types of psychoactive substances.

29%

29% of teenage girls have experimented with illegal drugs by the time they finish 8th. 41% of them have consumed alcohol.

20%

Every year 1 out of 5 teenagers in the U.S. has experimented with drugs or alcohol.

3

Teenagers who have experienced trauma are three times more likely to report substance abuse.

70%

For adolescents receiving treatment for addiction, more than 70% had a history of trauma.

59%

As many as 59% of young people with PTSD will eventually develop substance abuse problems.

These statistics are the reality that so many people live in every day. Perhaps you can identify with one or more of them yourself. It’s not unlikely that you are battling addiction if you have a history of trauma. That could very well be the cause of your substance abuse problem. What’s most important is that you get the help you need for both conditions. Healing is possible as long as you know where to turn.

What is Trauma Informed Care?

Trauma informed care is also called the trauma informed approach. This involves a program or organization that follows specific guidelines regarding the treatment of this condition.

Any system that is trauma informed will:

  • Realize the widespread impact that trauma has
  • Understand the potential paths for a successful recovery
  • Recognize the signs and symptoms of trauma within anyone involved in the system
  • Respond by integrating knowledge about trauma in policies and procedures
  • Act and seek to resist re-traumatization

This approach is vital for recovery for anyone who has a traumatized past. It is a premise that is built on six key principles, and these are:

  1. Safety
  2. Transparency and trustworthiness
  3. Peer support
  4. Mutuality and collaboration
  5. Empowerment
  6. Gender, historical and cultural issues

An individual who has survived a trauma needs to be respected. They also need to be informed about their treatment. Trauma treatment centers need to work in collaborative ways with victims. However, they also need to involve family members and friends. By connecting them with others, they can see that there is hope for their recovery. This is incredibly empowering for everyone involved.

One of the most important components of trauma informed care for you is the relationship of trauma and substance abuse. The two are inherently linked to one another as evidenced by the above statistics. To ignore this relationship is only going to make your situation worse. To appreciate it means that you have a chance of being successful in your recovery from both.

Why Trauma Therapy is so Important in Addiction Recovery

Making the connection between trauma and substance abuse is vital. This connection is why trauma therapy is so important. Every addiction has an underlying cause, and in many cases, it goes back to trauma.

It wasn’t that long ago when these conditions were treated separately from each other. It was never even considered that they could be linked. Someone who suffered from addiction was placed in a drug or alcohol detox program. Once they had detoxed, the mental health issues were addressed.

This method was not successful because people would frequently just go back to using later. It became a vicious cycle in which people were constantly relapsing. Finally, it was decided that something needed to change.

Dual diagnosis treatment was the result of that decision. This allowed patients to receive treatment for both conditions at the same time. The addiction and the trauma were recognized as being connected in some way. Most of the time, the traumatic event was what led to the addiction. However, this wasn’t always the case. Regardless, outcomes began to improve and people started to truly heal.

Types of Therapy Used When Treating Addiction and Trauma Together

There are specific types of support therapies that are proven to work to heal trauma. Therapists who work with patients in this type of setting always assess them first. This is because not all forms of therapy will work for everyone.

It’s important to understand what each patient is struggling with. At that point, a therapist can pinpoint exactly what will benefit each person individually.

EMDR stands for Eye Movement Desensitization and Reprocessing. This is a type of psychotherapy that helps people heal from trauma. By using this form of therapy, studies have shown dramatic and remarkable results in very little time. Unfortunately, it has always been assumed that emotional trauma takes a long time to heal. With EMDR, it has been shown that this is no longer the case.

In the same way that the body heals from physical trauma, the mind can also heal. For example, if you cut yourself, your body starts working immediately to close that wound. When something repeatedly irritates that area, it causes pain and it can also delay healing. Once that irritation is removed, healing is able to progress as normal. The same can be said about the mind when someone experiences trauma.

Your brain’s natural information system is always moving toward good mental health. It is always working to heal itself in some way, shape or form. This also occurs when you experience a traumatic event. If something occurs to block the natural progression of that healing, this can lead to intense suffering. Removing that blockage causes healing to begin again.

EMDR helps people re-activate the natural healing processes of the brain. It usually doesn’t take very long, and many people see improvement in as little as three sessions. This type of therapy has been groundbreaking in the area of treating trauma.

Cognitive behavioral therapy, or CBT, is based on empirical research. It is commonly used to help patients who are struggling with both trauma and addiction. It begins by looking at where specific problems originated. For someone in your position, this would involve looking at both your substance abuse and traumatic past.

CBT is based on one core belief. This is that the way you perceive a situation is more closely connected to your reaction than the situation itself. It works by helping people change the way they think and behave. This automatically leads to improvements in how they feel, their moods, and how they function.

CBT is one of few types of psychotherapy that has been scientifically tested. During clinical trials, it was found to be effective for many types of disorders, including trauma. It tends to be more dedicated to solving problems than other forms of therapy. People are able to learn new coping skills that will benefit them for the rest of their lives. They will understand how to modify their beliefs, change their behaviors, and relate to others in different ways.

One type of therapy that has shown to be effecting in healing trauma is prolonged exposure therapy. By definition, people who have lived through traumatic events tend to avoid those memories. They view them as painful, and they may be terrified of reliving them over and over again. As a result, they may change almost everything about their lives. For example, if they were in a car accident on the way to work, they might avoid taking that route.

Prolonged exposure is so effective because it forces victims to think about those memories. Exposure may be gradual at first, and then it may increase in its intensity. By confronting these memories, victims are able to come to terms with what happened to them. As time goes on, they learn how to deal with the memories in a healthy way. The result is a dramatic reduction in their symptoms.

There are different ways that practitioners may perform prolonged exposure. They may begin by having patients talk about the traumatic event. They’ll ask them to retell the story over and over again, adding plenty of details. This causes the patient to face their fears head-on. Therapists may also ask patients to confront certain difficult situations that they have been avoiding. These situations are safe, but they remind the victim of the trauma.

People often find a tremendous amount of healing occurs through cognitive processing therapy. When someone has been traumatized, the thoughts that accompany that are very debilitating. Victims can end up living their lives in a constant state of feeling upset and unsettled. CPT helps by teaching victims how they change the way they think. In doing so, they can also change the feelings that accompany those thoughts.

Many trauma victims end up blaming themselves for what happened to them. Other times, their experiences cause them to believe that the world is a dangerous place to live. You can see how this can be paralyzing. This type of belief system keeps someone stuck in trauma, and they’re never able to move past it. Eventually, they will develop PTSD.

CPT works by showing victims that there are other ways to handle these thoughts. People learn the skills that will teach them to think in different ways. It supports critical thinking, which can assist victims in thinking about the issue from a different point of view. They may examine the event using supportive thoughts or unsupportive thoughts. In the end, they get to decide if they want to use a different perspective.

Therapists may use worksheets to help victims work through their thought patterns. They guide them through the entire process, offering supportive ideas along the way.

Traumatic incident reduction is a very simple method for eliminating the negative effects of past traumas. This involves the viewing of a traumatic memory under different conditions. These conditions help to eliminate distractions and make the individual feel safe.

During TRI, the trauma patient does all of the work involved. The therapist is there to offer instructions so that the event is viewed appropriately. Otherwise, the therapist doesn’t intervene at all.

TRI works by allowing the patient to go through the story of the event. The therapist will then ask the victim to repeat the story. With each run-through, the goal is for the patient to become more confident and comfortable. Eventually many of the negative emotions attached to the story will start to diminish.

At the end, patients are usually very insightful about the incident. People often feel much more calm and serene. This is the end point of the session, which can last as long as 3 to 4 hours.

It can take several sessions before the patient really starts to feel better overall. However, with repeated use, this type of therapy has shown to be very effective.

The counting method is a relatively simple form of therapy that is often used for traumatized individuals. It helps them to master the memories and gain control over them. It was originally developed for the treatment of PTSD.

It works by having the patient think about the traumatic memory. They’re asked to play it over in their minds. As they are doing this, the therapist will count out loud from 1 to 100. This connects the memory to the therapists voice, as well as to the experience of therapy.

The amount of time that passes during the counting is very short; only about two minutes. This acts by confining that memory to only two minutes of time. Rather than being a situation that is outside of their control, the victim is able to think of it much differently. This results in less anxiety related to that memory in the future.

When this particular memory comes to mind later on, it should be connected to therapy. This can help to minimize the horror of it and provide the victim with some peace. As time goes on, the healing process continues even more.

For many trauma victims, the events that they have endured take over their memories. It’s difficult for them to focus on many of the good experiences they have had. This is one of the reasons why recovering is so difficult for them. Narrative exposure therapy aims to change that.

Rather than focusing on the traumatic event, NET encourages an entire life biography. Patients are asked to tell the story of their lives as they occurred from beginning to end. This forces them to think about other events that happened to them. They begin thinking about positive childhood memories and other similar occurrences as a result.

When they begin to detail the traumatic event, framing it in the context of their life helps. It allows them to see things in perspective, and from a different angle. This has shown to bring great relief to those who suffer from trauma.

The ultimate goal is to keep everything connected to the present as much as possible. It can be challenging for people to relieve those thoughts and memories. However, they are able to see that they are memories, and this helps them process them as such.

Challenges in Treating Substance Abuse and Trauma

There’s no denying that there are challenges that face therapists who treat victims of trauma. Those challenges are multiplied when someone also has a substance abuse disorder. When they first come to treatment, not using often causes their symptoms to get much worse. This is one reason why going through a drug or alcohol detox is so important in most cases.

People are also usually very defensive. They don’t want to talk about the trauma, and they may be fragmented emotionally. It’s common for people to put up walls in order to protect themselves. They could be easily triggered by seemingly benign events. Their boundaries are skewed, and they tend to have relationships that are either too close or too distant.

Finally, trauma victims often have very little self worth. They feel as though they have failed almost everyone around them. They’re also failures to themselves.

Barriers to Treatment You May be Experiencing

There are a lot of reasons why you might hesitate to get treatment for your co-occurring disorder. If you suffer from trauma, you might:

  • Have significant trust issues. You might have very few personal relationships. It’s not easy for you to open up to anyone; especially someone you don’t know well.
  • Feel afraid that what you have been through is too much for the therapist to handle. You might worry that you’ll upset them, and then they’ll no longer want to work with you.
  • Be unable to remember all of some of the details of the trauma. You could have some repressed memories that are only coming out in pieces. This is very typical for people who have gone through traumatic events.
  • Feel very ashamed of almost everything about yourself. You may blame yourself for what happened, and you don’t know how to take responsibility for it. It can be hard to talk with a complete stranger when this is how you feel.
  • Be afraid that if you talk about the trauma, your symptoms will only get worse. Victims spend a lot of their time running away from those painful memories. They don’t want to think about them, and they try to avoid them whenever they can. The idea of dealing with that inner turmoil is just too much.

Any one of the above is a reason for you to avoid getting the help you need. However, you need to understand that your therapist seeks to create a safe environment for you. It does take some amount of trust to open up initially. However, once you do, you’ll find that you’re able to face your fears and begin the healing process.

Healing from Trauma and Recovering from Addiction

While it is possible to heal and recover, it doesn’t happen overnight. This is a process of 3 stages, but you can see it through until it is completed.

Stage One

The first stage of the process is that you feel safe. You are able to connect with the present and you identify trauma as happening in the past. You feel both emotionally and physically safe, which is something that will be very new to you. You’re no longer using drugs or alcohol. You begin to reconnect with others and rebuild relationships that may have been damaged.

Stage Two

The second stage of the process allows you to remember and mourn the past. You have been through a terrible event, regardless of what happened to you. It’s important to learn how to process that trauma appropriately. You may need to grieve as a part of that process. During this time, you gain a lot of support, and you also learn new coping skills. This is going to help you re-file those events in your mind as memories of the past.

Stage Three

The third stage of the process helps you to reconnect to the future. Up until this point, the future might have seemed pretty bleak to you. It was as though you were simply repeating the same steps of your life over and over again. As you reconnect to the future, you rediscover joy and happiness. You learn how to create new memories and you reintegrate back into your daily life.

Taking Steps to Get Help for Addiction and Trauma

You may be suffering from a trauma induced addiction. Or, it’s possible that you had an addiction and then lived through a traumatizing event. Either way, those disorders are now co-occurring. You no longer want to live with them, and you’re ready to seek out some help to recover and heal.

Realizing that something needs to change in your life is the very first step in recovery. It may scare you to think about talking with someone about all that you’ve been through. Know that you’re not alone if that’s how you feel. By its very definition, trauma is often paralyzing, and it can make you feel trapped. When you also suffer from an addiction, it only makes matters worse.

Here at Northpoint Recovery, we know how to effectively treat patients with both substance abuse disorders and trauma. We use a combination of many of the above therapies to achieve success in recovery. We also take the time to talk with you and find out what it is that you need most in order to heal. You are an individual, and with us, you’re always treated like one.

Maybe you feel that you have a lot to learn about the connection between trauma and addiction. Do you have unanswered questions about treatment? Please don’t hesitate to contact us. We will assist you right away, and answer all of your questions.

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