Understanding trauma is understanding your addiction

Trauma & Addiction

Trauma affects everyone differently, whether it’s a one-time event or repetitive occurrence. 

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Whilst many trauma sufferers display symptoms associated with PTSD, others will show resilient responses that fall out of the diagnostic criteria.

The impact of trauma can vary. It can be subtle, insidious or outright destructive. [1]

What is important to bear in mind is that traumatic stress reactions are normal – they are normal reactions to very abnormal experiences. More on trauma and addiction.

Traumatic reactions

Traumatic stress often evokes two rather opposite emotional extremes:

1. Feeling too much (overwhelmed)
2. Feeling too little (numb)

Trauma treatment can help a patient find the optimal level of emotions and help them regulate difficult and bothersome feelings and thoughts.

Therefore, the goal here is to help patients regulate their emotions without the use of substances or any other form of unsafe or risky behaviour. Learn more about trauma therapy.

Survivors’ immediate reactions to traumatic events are complicated and can vary due to the person’s experience, support system, family relationships, coping skills and their position in the wider community.

Initial reactions include:

• Exhaustion, confusion
• Sadness, anxiety, agitation
• Numbness, dissociation, confusion
• Physical arousal blunted effects

Although reactions may range in their severity, even the most destructive of reactions are natural responses to manage your pain and trauma.

Delayed responses to trauma:

• Unable to rest, persistent fatigue
• Sleep disorders, nightmares,
• Fear of recurrence, anxiety, flashbacks
• Depression, avoidance of emotions, sensations or activities
• Experiencing emotions like anger, fear, sadness and shame (emotional dysregulation is common for trauma survivors)

Severe responses:

• Continuous distress without periods of calm or rest
• Severe dissociation symptoms
• Intrusive and intense recollections

Resilient responses:

• Better bonding with family, friends or community
• Redefined sense of purpose or meaning
• Commitment to a personal mission
• Revised priorities
• More giving or charitable

In clinical terms, the way someone reacts to trauma is less important in relation to how they continue their life after it.

• Can you regulate emotions?
• Sustain your self-esteem?
• Maintain and enjoy personal relationships?

Some trauma survivors have difficulty regulating emotions such as anger, anxiety, sadness, and shame—this is more so when the trauma occurred at a young age. [2]

However, individuals can also encounter some difficulty identifying and traumatic emotions and this can be for various reasons, which include a lack of emotional expression in their family, feel emotional expression might be dangerous, the fear of not being believed or lead to them feeling out of control.

On the other hand, traumatic experiences can often lead some individuals to disassociate completely and deny that they have any feelings associated to their traumatic experiences.

You’re almost there.

Coping mechanisms

Many people instinctively believe that survivors of trauma need to express their emotions associated with the trauma, however, certain research has shown that survivors who do not process their trauma can be just as psychologically healthy as those who do.

Therefore, it’s about respecting how the sufferer chooses to cope with their trauma – what keeps them going. It’s not about valuing one type over the other, but ensuring that the patient has strong coping mechanisms in place.

Coping with trauma varies from action-orientated, reflective, emotionally expressive and reticent.

Below, we show the psychological symptoms of trauma, which had not previously been represented in the Diagnostic and Statistical Manual of Mental Disorders.

Trauma is often misunderstood

“Trauma can affect one’s beliefs about the future via loss of hope, limited expectations about life, fear that life will end abruptly or early, or anticipation that normal life events won’t occur (e.g., access to education, ability to have a significant and committed relationship, good opportunities for work).” [3]

Surprisingly, there is little education amongst the public about what real trauma is. They may have preconceived notions of what trauma it is; which is often centred around child abuse or sexual abuse.

This often means that many do not really recognise the other aspects of trauma.

99.9% of people that enter our treatment centres with mood or anxiety disorders have experienced some kind of developmental trauma, which more often than not is a result of growing up with inconsistent parenting. – Paul Rayner

For example, just this morning we were talking with a patient about how adoption can be a traumatic experience. We explained how this can affect their relationships throughout life, can form co-dependencies and an inability to navigate through negative emotions, feelings or relationships.

We’ve got a lot of patients who experience many unique and isolated traumatic events. Some have experienced self-harm, suicidal ideation and family troubles. Those often coming into treatment have multi-generational issues, where trauma has existed and been passed on by older generations of the family.

“So much that we’re left with that’s not even ours, but we have to deal with it in a day-to-day basis.” – Phil Grant

 “My childhood was good”

Many people are unsure of where their anxiety has come from. Many describe their childhoods as “happy” or “good” – all that existed was anxiety.

So for us, it becomes clear that there is something underlying there. From here, we introduce a topic called the ‘Window of Tolerance’, which is an explanation of what developmental trauma is.

Trauma can come from all different angles. It can come from so many different ways.- Phil Grant

Trauma often leads to addiction

Substance misuse is usually initiated or increased after a traumatic episode. There is no correlation to certain drugs of choice, as this is often selected by the user for specific effects they want to feel.

Some patients exhibit really complex traumas, which are a direct result of sexual or physical abuse. However, other patients may have experienced deaths within their families and others struggling with generalised anxiety disorders.

One thing we notice more is that individuals who cannot explain their anxiety have found drugs like cannabis early on – and as it is known to be relaxing, has shown the user that they can feel better through this medium.

Drugs or alcohol are used to:

• Self-soothe
• Self-medicate
• Avoid emotions

Patients who have experienced traumatic pasts also have a lot of physical pain alongside emotional difficulties.

Often those patients who feel sick consistently with no medical diagnosis or reason – can be referred to as somatisation. To manage this pain, patients self-medicate either with medication, alcohol or drugs. However, doing so can ultimately put them on the road to addiction.

Those who have turned to alcohol instead may have found that it had helped them disassociate from life in general.

“Alcoholism is a family illness as well, which is a traumatic experience… When you start to explain to them what trauma is and what developmental trauma is and what multi-generational trauma is, and that they can do something about it.”

Phil Grant

I was very interested in people who’d been brought up in alcoholic homes or dysfunctional environments, inconsistent parenting. I was brought up in an alcoholic home, so I had a personal interest in looking into trauma and became a driving force in my work.

For 15 years at Castle Craig, I ran the ACOA Group, Adult Children of Alcoholics and that was a very, very powerful group. We were looking at the time when you grow up in a dysfunctional environment you learn three core messages, and that’s don’t talk, don’t trust, and don’t feel. – Phil Grant

Trauma and addiction assessments

At Castle Craig, we do various addiction and mental health assessments. For example, there are assessments for anxiety, where we follow the Hamilton Anxiety questionnaires.

Other assessments our consult psychiatrists carry out include:

• The Beck’s Depression Inventory
• The Rosenberg Self-Esteem Inventory
• Trauma inventory
• Alcoholism assessments
• Drug addiction assessments

Initially, we explore all of these areas with a biopsychosocial assessment.

The biopsychosocial assessment is designed to dive into childhood issues, family issues and how you interact and get on with family members. Alongside this, we also explore what kind of upbringing you had and how your schooling may have impacted you today.

This then gives our medical staff and therapists a real understanding of what traumas you have.

Trauma treatment

• Identify triggers (reminder of the traumatic event) and potential triggers
• Draw connection between emotional reactions and triggers
• Develop coping strategies to manage these moments
• Managing flashbacks, nightmares and intrusive thoughts

“We have individual therapists, who can do specialised trauma treatment. We have CBT therapists who deal with trauma directly. We also offer EMDR here.” Teri Fairnie

Specialising in sensorimotor psychotherapy

Our therapy programmes allow us to help patients who have experienced either complex trauma, singular trauma, or developmental trauma.

We use sensorimotor psychotherapy to treat addicted individuals suffering from traumatic experiences. We don’t just jump into the big traumas, we teach about emotional regulation, developmental traumas and how the brain develops through trauma.

From here, we show people how to use and how to apply emotional regulation to these developmental traumas. If they can apply these to the developmental traumas, when the big trauma comes up, they can also apply that to their bigger traumas, or what we call the “actual traumas”.

How we can help

Here at Castle Craig, we aim to treat the addiction first but are very much a dual-diagnosis treatment centre. Currently, we treat trauma concurrently as a comorbid issue, so to access treatment here, you would need an addiction diagnosis first.

If we can’t help you, we’ll help find someone who can.

Just give us a call: 01721 722 763.

More on Trauma:

• Trauma Therapy Treatment
• Healing Trauma
• Trauma and Addiction Treatment 

Sources

[1] Treatment Improvement Protocol (TIP) Series, No. 57. Center for Substance Misuse Treatment (US). Rockville (MD): Substance Misuse and Mental Health Services Administration (US); 2014.

https://www.ncbi.nlm.nih.gov/books/NBK207191/

[2] Van der Kolk BA, McFarlane AC, Van der Hart O. A general approach to treatment of posttraumatic stress disorder. In: van der Kolk BA, McFarlane AC, Weisaeth L, editors. Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York: Guilford Press; 1996. pp. 417–440.

https://www.guilford.com/books/Traumatic-Stress/Kolk-McFarlane-Weisaeth/9781572304574

[3] Treatment Improvement Protocol (TIP) Series, No. 57. Center for Substance Misuse Treatment (US). Rockville (MD): Substance Misuse and Mental Health Services Administration (US); 2014.

https://www.ncbi.nlm.nih.gov/books/NBK207191/