By Ken Seeley, Founder Ken Seeley Communities
We are all equipped with a certain faculty that allows us to bounce back from adversity. It is called resilience. Each person has his or her own psychological make-up and personality, which means that the capacity for resilience is not uniform. Some people are more resilient than others. This is just a simple fact of our human nature.
When we encounter a traumatic event it can be very destabilizing. Whether we simply witnessed something horrific, or actually experienced it personally, the trauma registers in our psyches and causes a deep disturbance. How we process that event, and eventually overcome its effects, is highly individual.
For some, the trauma does not resolve easily. In order to deal with the psychological impact—the emotional pain, nightmares, flashbacks, detachment, avoidance, and anxiety—there is a tendency to use a substance to help numb the effects. For example, there is a tendency to rely on alcohol or benzodiazepines to help diminish the painful effects of the upsetting memories, or related depression or anxiety symptoms.
A trigger, or being exposed to the people, places, or situations related to the initial traumatic event, can exacerbate the disturbance by rekindling the associated emotions. Trauma triggers only drive the substance abuse, setting up a cycle that could result in addiction.
Dual diagnosis treatment tackles both issues at once. These specialized programs address the trauma while also treating the co-occurring substance use disorder. Obtaining treatment for both disorders simultaneously will improve overall recovery results.
What is Emotional Trauma?
A trauma is a shocking and often unpredictable life event. The range of traumatic events is diverse, but basically a trauma is anything that evokes a deep sense of fear and anxiety caused by a perceived danger to self. Examples of traumatic events include:
- An event where there is perceived risk of physical or psychological harm
- Death of a family member, spouse, or close friend
- Physical injury, such as being in a serious car accident
- Divorce
- Stress related to combat
- A serious illness
- Abandonment or neglect in childhood
- Sexual abuse or rape
- Domestic abuse
- Physical assault
- Natural disasters
Traumatic events that are experienced during childhood have a significantly higher potential to result in addiction later in life. According to the Adverse Childhood Experiences (ACE) study, there is a clear relationship between cumulative adverse events in childhood and subsequent substance addiction or dependency.
Whether a trauma occurred in childhood or adulthood, there is an increased likelihood that alcohol or drug use will result. This is especially true when there were multiple traumas experienced.
Post-Traumatic Stress Disorder (PTSD)
PTSD is an anxiety disorder than impacts 7%-8% of the population. PTSD features a persistent response to an overwhelming traumatic event. Debilitating PTSD symptoms may last for a month or more. There is a high occurrence of a co-existing substance use disorder among individuals with PTSD, as well as comorbid depressive symptoms.
Symptoms of PTSD are generally expressed in these four categories:
- Intrusive memories. Unwanted thoughts or memories of the trauma are experienced repeatedly through recurrent flashbacks, vivid memories, or nightmares.
- Avoidance. People with PTSD may choose to avoid any people, places, or situations related to the past trauma, as they may trigger the disturbing memories. They will also avoid discussing the trauma.
- Hyper-arousal. The individual may be easily startled, irritable, quick to anger, easily frightened, and may suffer from insomnia. Alcohol or anti-anxiety medications may be used to numb these symptoms.
- Negative thoughts. People with PTSD may have a negative demeanor. They may display a sense of hopelessness about their life, and put themselves down. They may exhibit anger, guilt, shame, and fear.
Addiction and Trauma
Substance abuse is a common response to the anxiety and/or depression symptoms that may develop after experiencing a trauma. According to a 2012 article published in Current Psychiatry Reports, about 50% of patients receiving treatment for a drug or alcohol addiction met the diagnostic criteria for co-occurring PTSD.
This can be explained by the use of unhealthy coping strategies accessed in the aftermath of a highly traumatic event. While some might seek the help of a therapist or use exercise or holistic strategies to overcome the effects of the trauma, others may lean on a substance.
Someone with PTSD may have experienced impairment in the brain’s limbic system. The change in brain chemistry caused by the traumatic event can actually set up the reward system to be hijacked by substance abuse. The limbic region is where impulsivity, decision-making, and other executive functions occur. When these functions are disrupted, compulsive use of a substance may result.
Addressing Trauma in Dual Diagnosis Treatment
Substance use disorder with co-occurring PTSD or trauma disorder is called a dual diagnosis. A dual diagnosis program will provide the clinical recovery elements for treating the substance use disorder along with psychiatric support for trauma-focused therapies. These therapies include:
- Trauma-Focused Cognitive Behavioral Therapy. TFCBT helps individuals overcome trauma by reshaping the thoughts that have led to the maladaptive behaviors. By guiding the person to safely express their feelings about the experience, the therapist will show them how those thoughts have led to adverse mood states and also substance abuse. Through this therapeutic process, the negative thoughts slowly lose their potency.
- Exposure Therapy. This is a short-term behavioral therapy that uses prolonged exposure techniques to help the person become less sensitive to the memories of the trauma. By encouraging discussion of the event, and incrementally exposing them to the triggers within a safe environment, the therapist is able to gradually reduce the impact of the trauma.
- Eye Movement Desensitization Reprocessing. EMDR is a type of exposure therapy that involves an 8-step process. Part of this process has the person follow a therapist’s finger back and forth with their eyes while they discuss the traumatic event. This process also helps to reduce the effects of the trauma.
Someone who has difficulty resolving the impact of a trauma may be more susceptible to a substance use disorder. A dual diagnosis program can be an effective tool in restoring wellness.
About the Author
Ken Seeley is an internationally acclaimed interventionist, having years of experience in this field. Certified as a Board Registered Interventionist-Level 2, Seeley has worked full-time in the business of recovery and intervention since 1989. He is a regular contributor to CNN, MSNBC, NBC, CBS, Fox, and ABC on the topics of addiction and intervention. He was one of three featured interventionists on the Emmy Award winning television series, Intervention, on A&E. He is also the author of “Face It and Fix It,” about overcoming the denial that leads to common addictions while bringing guidance to those struggling with addiction. Ken Seeley is the founder and C.E.O. of Ken Seeley Communities, a full spectrum addiction recovery program located in Palm Springs, California.
