Is There a Trauma-Addiction Connection?

Posted on October 15, 2015 by Melissa Killeen
Melissa Killeen

Melissa Killeen

Is there a trauma-addiction connection? Adverse childhood experiences (trauma) are well known to significantly increase the risk of psychiatric disorders in adulthood. Ample evidence has shown that childhood trauma endangers the brain’s development, structure and function. Several traumatic experiences could make a person susceptible, later in life, to problems related to memory, judgment, reasoning, and could affect emotional and decision-making skills. Psychiatric illnesses, including schizophrenia, major depression, bipolar disorder, Post-Traumatic Stress Disorder (PTSD), and addiction, are also linked to adverse childhood traumatic experiences.

Traumatic life experiences, such as physical and sexual abuse as well as neglect, occur at alarmingly high rates in the United States and is considered a major public health problem. Other examples of traumatic life experiences could be witnessing family violence, parental separation and divorce, experiencing a catastrophic weather event such as Hurricane Katrina, losing your home as a result of a wild fire, moving several times in childhood or going hungry.

The link between traumatic experiences and substance abuse has been well-established. For example, in the National Survey of Adolescents, teens who had experienced physical, or sexual abuse or assault were three times more likely to report they had abused a substance than those without a history of trauma.

In surveys of adolescents receiving treatment for substance abuse, more than 70% of the adolescents reported a history of some sort of trauma.

While experiencing a trauma doesn’t guarantee that a person will develop an addiction, research clearly suggests that trauma is a major underlying source of addiction behavior. Founder of HealMyPTSD.com and author Michele Rosenthal culled statistics from a report issued by the National Center for Post-Traumatic Stress Disorder and the Department of Veterans Affairs to show the strong correlation between trauma and alcohol addiction:

  • Sources estimate that 25 and 75 percent of people who survive abuse and/or violent experiences develop issues related to alcohol abuse.
  • Accidents, illness or natural disasters translate to between 10 to 33 percent of survivors reporting alcohol abuse.
  • A diagnosis of PTSD (post-traumatic stress disorder) increases the risk of developing alcohol abuse.
  • Female trauma survivors face increased risk for an alcohol-use disorder.
  • Male and female sexual abuse survivors experience a higher rate of alcohol- and drug-use disorders compared to those who have not survived such abuse.
  • 27 percent of veterans in Veterans Administration care diagnosed with PTSD also have Substance Use Disorder (SUD)

Similar research linking trauma and addiction exists for other habitual behaviors, including sexually compulsive behavior and eating disorders. Delving deeper into the trauma-addiction connection tells us that addiction is a coping mechanism. Addictions often help reduce the sensation of the overwhelming anxiety, stress and fear that trauma triggers create. Individuals participating in the research confirm that addictions are implemented as an attempt to self-manage (or self-medicate) what comes up for them when unmanageable trauma memories appear. These forms of self-management or self-medication are used as a positive survival instinct, but have very negative consequences. The key is to recognize the use of substances to manage trauma responses and to choose another tool for self-management.

Next week’s post will go further exploring the link of addiction and trauma.

References used in this post:

Mills KL, Teesson M, Ross J, Peters L (2006) Trauma, PTSD, and substance use disorders: findings from the Australian National Survey of Mental Health and Well-Being. American Journal of Psychiatry. 2006 Apr;163(4):652-8., http://www.ncbi.nlm.nih.gov/pubmed/16585440

Public Interest Directorate- Children, Youth, and Families, An American Psychological Association Directorate-Advancing the creation, communication and application of psychological knowledge to benefit society and improve people’s lives. Activity Summary- August 2012 – August 2013Website: http://www.apa.org/pi/families/index.aspx

Kilpatrick DG, Saunders BE, Smith DW.(2003). Youth Victimization: Prevalence and Implications [Electronic]. U.S. Department of Justice, Office of Justice Program, National Institute of Justice. Available at: http://www.ncjrs.gov/pdffiles1/nij/194972.pdf

Michele Rosenthal (2015) Trauma and Addiction: 7 Reasons Your Habit Makes Perfect Sense, Published on March 30, 2015 in Behavioral Health, Living in Recovery, Living with Addiction and at Recovery.org website: http://www.recovery.org/pro/articles/trauma-and-addiction-7-reasons-your-habit-makes-perfect-sense/

and  http://healmyptsd.com/

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Addiction is a Symptom of Untreated Trauma

Posted on October 8, 2015 by Melissa Killeen

melissa-new-post“What is addiction, really? It is a sign, a signal, a symptom of distress. It is a language that tells us about a plight that must be understood.” — Alice Miller, author of Breaking down the Wall of Silence

I am a recovery coach. A recovery coach or sober companion is often called in to work with the most difficult addict, the chronic relapser. A chronic relapser is an individual that has been to several rehabs, often 7, 8 or 9 visits in less than five years. Who has not been able to put together 90 sober days, except in treatment. Whose family, spouse or children have given up on them. In reality, a chronic relapser is an addict that is acting out in their addiction. Their addiction is just a symptom of untreated trauma.

Often, calling a recovery coach is the last resort.

My first job, of course, is to make sure this person doesn’t drink, use or act out. And to find some redeeming qualities of this addicted person so I can approach healing the behaviors driving the addiction. This is the key point that brought me to the understanding that many of my clients have experienced some form of trauma, early in their childhood or adolescent lives.

I always ask the client for their story. I provide all of my clients the ACE study questions. ACE means Adverse Childhood Experiences. The ACE study is an ongoing collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego. It started in 1976 with the purpose of finding more about childhood trauma, and the later-life health and well-being of participants. (For more information on ACE, see my blog post dated August 20, 2015). The ACE study poses such questions as: Did you move a lot? Did you ever go hungry? Did you experience a childhood that was less than nurturing? Did you ever have a moment that overwhelmed you? Did you live through an ordeal that changed how you think about people, places or things? The results of the ACE questions, and the addict’s story that comes after it, always profoundly moves me. I get a much more honest story than most clinicians, mainly because of these questions.

The reason it’s significant for me to identify and acknowledge trauma, is because research proves that trauma can activate behaviors that lead to addiction. My clients are using a drug or alcohol as a way of self-protection, of calming down, as life preservation. Everyone in the rooms (AA, NA meetings) knows addicts “use” in order to “numb out.” Well, let’s rethink that, turning it a bit to say: victims of trauma are really using a drug or drink to:

  • Stay safe: After trauma the addict’s own mind can feel like a danger zone, which makes being “out of it” feel safer than being in it.
  • Escape memories: Unwanted and unresolved memories have a way of popping up incessantly after trauma; addictions offer the mind a different area of, or reduced capacity for focus that helps suppress reminiscing.
  • Soothe pain: Substances or the adrenalin rush of self-destructive behaviors change the addict’s body chemistry, releasing endorphins and other mood enhancers that reduce discomfort.
  • Be in control: Sometimes, engaging in addictive behaviors can lead an addict to feel strong, resilient and courageous, an experience that is tremendously alluring when trauma from the past intrudes on the present.
  • Create a world the addict can tolerate: The intense feelings brought on by fear, memories and anxiety can make any moment seem overwhelming. The release of tension brought on by addiction-oriented behavior helps facilitate a manageable experience.
  • Treat yourself the way you feel you deserve: Trauma can leave an addict feeling less-than, worthless, hopeless, and damaged. The more self-destructive the addict behaves, the more it can feel like he or she is living in alignment with who they truly are. While this is false, it can help reduce feelings of otherness and disconnection.
  • Redefine who the addict really is: Trauma changes an addict’s identity all the way down to the core of their beliefs and self-definition. It can seem as if no one understands them. Engaging in addictions can help create a sense of community by connecting the addict to others who feel, see, think and behave as they do. Addictions can help the addict revise their self-perception by allowing them to engage in and act out behaviors that allow them to feel stronger, more courageous, capable, etc., than trauma has left them feeling.[1]

This puts the addiction-trauma link into perfect perspective for me, and I hope it opens some eyes for other addicts, alcoholics, and clinicians that are reading this post. Next week’s post will go on to explain the scientific research that backs up this discovery that addiction is just a symptom of untreated trauma.

Research used in this blog:

Centers for Disease Control and Prevention, http://www.cdc.gov/violenceprevention/acestudy/about.html

Adverse Childhood Experiences Study, Posted on August 20, 2015 by Melissa Killeen, https://www.mkrecoverycoaching.com

[1] Trauma and Addiction: 7 Reasons Your Habit Makes Perfect Sense, by Michele Rosenthal. Published on March 30, 2015 in Behavioral Health, Living in Recovery, Living with Addiction and at http://www.recovery.org

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What kind of credential do I need to be a Professional Recovery Coach?

Posted on October 1, 2015 by Melissa Killeen
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Melissa Killeen

When I published my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2013, the term professional recovery coach or professional recovery life coach was not in frequent use.

A professional recovery coach is trained in professional coaching techniques, which means he or she has been educated in group dynamics (how people act in a group), how to develop high performing individuals (leadership) or how to facilitate change. Additionally, they have training in the addiction recovery models, motivational interviewing and Harm Reduction. They may use their experiential knowledge of their own recovery to augment their professional recovery coaching faculties. Professional coaches work in many fields: executive coaching, business coaching, finance coaching, wellness coaching or life coaching. Recovery coaching fits nicely into the life coaching model.

International Coaching Federation (ICF)

There is one worldwide organization that is recognized as issuing professional coaching credentials, the International Coaching Federation (ICF), http://coachfederation.org. There are three levels of ICF coaching credentials. The Associate Certified Coach (ACC) Credential is for the coach who is just beginning in the field, and is the first credential that can be completed with ICF. The Professional Certified Coach Credential (PCC) is for the more experienced coach and the Master Certified Coach (MCC) Credential is for the expert coach.

When seeking to be credentialed as an Associate Certified Coach (ACC), the coach has to have completed an entire ICF Accredited Coach Training Program (ACTP). On the ICF website is a list of all of the accepted training programs from which the ICF will accept training credentials. The ICF does not offer a unique recovery coaching credential, nor a peer recovery-support credential.

There is one organization, Family Recovery Resources, listed in the ICF Accredited Coach Training Program that offers a family-in-recovery coaching course for a family recovery coach certificate. There are no other recommended organizations that offer any recovery coach orientated courses. If a recovery coach has received training from any organization specializing in recovery coaching training, it is likely that the training would not be credited toward an ICF certificate. There is a very interesting selection of courses in the ICF Accredited Coach Training Program, such as executive coaching, end-of-life coaching, divorce coaching, Neuro-Linguistic Programming, wellness coaching, conflict coaching and several other excellent learning opportunities, on the ICF web site.

The ACC applicants must work while they learn, and complete 100 hours of client-to-coach experience during their coach-specific training program. In addition the applicants are required to receive 10 hours of Mentor Coaching, and 100 hours (75 hours to be paid) of coaching experience with at least 8 clients, post training. There is a performance evaluation (audio recording and written transcript of coaching session) and a Coaching Knowledge Assessment (CKA) to complete the ACC credentialing application. The ACC credentialing process costs are dependent on the types of training courses a coach must take to complete the requirements for the certificate. The ACC credentialing process can take from 18 months to two years complete.

It is my hope that the information transmitted in the past few posts will help a person interested in recovery coaching see the path to certification a bit more clearly. Please feel free to contact me with any questions you have about the path you should take in seeking your recovery coaching training and credentialing.

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