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Addiction is a Symptom of Untreated Trauma

Posted on October 8, 2015 by Melissa Killeen

“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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Posted in Addiction, Addiction Recovery Posts, alcohol, Alcoholism, Drug Abuse, Family Dynamics, Gambling, Health, mental health, Parents, Recovery Coaching, Relapse, Research, Sex Addiction | Tagged ACE Study, addiction, Adverse Childhood Experiences, Center for Disease Control and Prevention, dr. gabor mate, Kaiser Permanente Health Appraisal Clinic, Michelle Rosenfield, San Diego, the effects of trauma causes addiction, trauma | Comments Off

Adverse Childhood Experiences Study

Posted on August 20, 2015 by Melissa Killeen

The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being. The study is a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego[i].

More than 17,000 Health Maintenance Organization (HMO) members who underwent a comprehensive physical examination were also asked to provide detailed information about their childhood experience of abuse, neglect, and family dysfunction. The initial phase of the ACE Study was conducted at Kaiser Permanente from 1995 to 1997. More than 17,000 participants completed a standardized physical examination and an ACE survey. No further participants will be enrolled, but the study group is tracking the medical status of the baseline participants.

The ACE Study findings suggest that certain experiences are major risk factors for the leading causes of illness, including addiction, leading to poor quality of life, as well as death. It is critical to understand how some of the worst health and social problems in our nation can arise as a consequence of adverse childhood experiences. Realizing these connections is likely to improve efforts towards prevention and recovery.

Compared to persons with no adverse childhood experiences, the risk of heavy drinking, self-reported alcoholism, and marrying an alcoholic were increased twofold to fourfold by the presence of multiple adverse childhood experiences, regardless of parental alcoholism. Subsequent reviews of the study found that the prevention of adverse childhood experiences and treatment of persons affected by adverse childhood experiences may reduce the occurrence of adult alcohol problems[ii]. Adverse childhood experiences seem to account for one-half to two-thirds of serious problems with drug misuse by adolescents[iii].

Children in alcoholic households are more likely to have Adverse Childhood Experiences. The risk of alcoholism and depression in adulthood increases as the number of reported adverse experiences increases. Depression among adult children of alcoholics appears to be largely, if not solely, due to the greater likelihood of having had Adverse Childhood Experiences in a home with alcohol-abusing parents[iv].

Clearly, children that have experienced emotional, physical or sexual abuse in their early childhood are at a severe risk for addiction. To show you how small an amount of abuse is needed to tip the scales of raising a healthy child or an at risk child, read the last series of questions from the ACE Questionnaire, which are highly revealing questions.

Did a parent or other adult in the household swear at you, insult you, put you down or humiliate you?
Did a parent or other adult in the household push, grab, slap, or throw something at you?
Did you often or very often feel that no one in your family looked out for each other, no one felt close to or supported each other?[v]

This survey gives you an idea how delicate and impressionable a young child is.

For a sample of the ACE Questionnaire, click on this link: http://www.cdc.gov/violenceprevention/acestudy/questionnaires.html

References used in this blog:

[i] ^{^[i]} “The Relationship of Adult Health Status to Childhood Abuse and Household Dysfunction“, published in the American Journal of Preventive Medicine in 1998, Volume 14, pages 245–258.

And

http://www.cdc.gov/violenceprevention/acestudy/index.html

[ii] Addict Behav. 2002 Sep-Oct;27(5):713-25.

Adverse childhood experiences and personal alcohol abuse as an adult.

Dube SR¹, Anda RF, Felitti VJ, Edwards VJ, Croft JB.

[iii] Pediatrics. 2003 Mar;111(3):564-72.

Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study.

Dube SR¹, Felitti VJ, Dong M, Chapman DP, Giles WH, Anda RF.