Many people who seek treatment for alcohol or drug use have histories of trauma. In fact, addiction is a common and anticipated outcome of adverse experiences in childhood such as abuse, neglect, violence and other traumas. The more adverse experiences a person was subjected to in childhood, often the greater the risk of an addiction, and not just addictions to alcohol and drugs. Addictions such as overwork, compulsive shopping, eating disorders, sex addiction, gambling, videogames and sport. Some addictions are more socially acceptable than others, but all can be understood in the context of underlying trauma.
In order to survive extreme early stress, the person affected “has to” come up with coping mechanisms to get through what is happening to them. Whereas these coping mechanisms are protective initially, they can come at a high cost to the person and their wellbeing later on in life. In adulthood, many addictions can be seen in the context of coping with an impossible situation.
The fact that addictions are coping strategies and attempts to ‘solve the problem’ of the trauma experienced is often not understood or identified by people experiencing addictions, nor by some services, which consider single problems in isolation. In a research study conducted in 2010 by then ASCA (now Blue Knot Foundation) interviews were conducted with people using services who had a history of childhood abuse and drug and alcohol use. Survivor participants commonly reported that the links between their abuse and their use of alcohol and drugs were not always clear to them until they entered treatment.
Before entering treatment, they had their own explanations for the difficulties they were experiencing in their lives. Commonly they felt ‘bad’ or ‘weak’ and tended to blame themselves:
“I believed there are good people and bad people and I was a bad person. My mum and grandmother used to say I was bad, naughty, giving mum a bad time. You end up thinking “I’ll show you how bad I can be!” They [counsellors] wanted to talk about my childhood and I remember saying “I don’t see the relevance”. (Female service user)
“I went to counselling. It was painful and I wasn’t making the links [between alcohol/drug use and child abuse]. I still held the reservation that no one could help me. I was un-helpable, unfixable. I knew the self-doubt and lack of trust. I didn’t trust anyone. I really loved my partner but I couldn’t work out why he loved me. I used to niggle at him till he shouted at me. That made sense.” (Female service user)
Many users of the services identified that the link between their abuse and their alcohol and drug use became clearer in services which themselves understood the links and did not work in a siloed way, only treating the alcohol or drug use of the mental health issues. When this happened those interviewed often felt more shame and stigma.
“If a psychiatrist or psychologist had been able to say to me ‘you know that twitching you have when you speak of molestation, that’s because of not being safe at home’. Instead they said ‘it’ll be better in long term rehab. to get a bit of distance and learning life skills.’ I thought because I was bad, I was being sent away.” (Female service user)
As survivors made the links and reflected on their childhood, they could often trace back to the ways in which they coped with their abuse in childhood, and with the pain and distress it caused.
“I used to steal food and binge-eat at 6-7 years. As soon as I had a voice and was going to school I started to comfort myself. Now I have accepted the abuse side of things, my behaviours are more understandable. Back then I thought ‘I need chocolate’. Now I know behaviour (e.g. smoking) is the same.” (Female service user)
“Looking back there were always risk taking behaviours to cope, but they were masked by this behaviour being the norm, besides one friend who pulled me aside and expressed concern about my drinking.” (Male service user)
Advances in neuroscience tell us about the plasticity of the brain (in particular, the newer parts) and opportunities for healing. Although adaptive responses often become less constructive, they actually are ‘strengths’ which helped the child, and now, the adult to survive.
Addictions are a way of soothing pain, distress and self-discomfort and of numbing those feelings. They become an emotional pattern of behaviours for the person and often occur across the generations, in different families. This doesn’t mean they are genetic but rather replicated patterns. This is not about blame but about an attempt to escape from the pain or the experience of having been hurt.
In addition, trauma in childhood affects the brain, limiting the development of the brain’s reward chemicals and circuits which regulate stress. As a result, people abused as children often don’t develop the internal capacity for pleasure and joy of people who haven’t been traumatised. For this reason, they seek ‘pleasure’ from outside of them to take the place of what can’t be generated from within.
The capacity to self-soothe and manage big feelings (regulate) comes from living in safe environments with well attuned caregivers. Many survivors who have not had caregivers who are consistent or who can help them make sense of what is happening have challenges in managing their emotions and levels of arousal. Being addicted can be an attempt to help to manage these highs and lows, anxieties and agitation.
If you are experiencing challenges with any of the issues raised in this article there is help and there is hope for recovery with the right support. Many alcohol and drug services are becoming trauma-informed and introducing trauma screening, so that issues related to prior trauma, and overwhelming stress, can be identified and people seeking help can be supported holistically through trauma-informed recovery programs. Programs which are safe, compassionate and collaborative, respond to the harm done and meet the person with empathy and understanding as to their current challenges promote long-term healing.