Soothing the Pain: The Relationship Between Trauma & Addiction
Photo by Mika Baumeister on Unsplash
Featuring an interview with Patrick Devlin Co-founder of Skyline Recovery
Addiction and substance abuse are widespread problems in our culture, and often we become so invested in the discussion about the use of substances, we can overlook underlying factors, most commonly, trauma. Studies have shown that 70 percent of those in treatment for substance abuse have had exposure to trauma. The relationship between addiction and trauma is significant, and as we explore the recovery process, trauma work is a necessity.
Trauma Defined
Dr. Gabor Mate, an expert on trauma, shares his perspective that we need to broaden our view of trauma, since every person has an individual interpretation of what is traumatic. He suggests we look at the Greek meaning of the word trauma, which is “wound.” We tend to think about trauma as a severe set of circumstances that are life-threatening or involve a risk of imminent harm. Dr. Mate suggests that, depending on the unique factors of an individual, including sensitivity levels, genetic makeup, and nurturing, trauma can mean many different things. When we think about trauma in this broader sense, it is easy to envision the many ways in which an individual may be inadvertently traumatized, even when their circumstances do not necessarily seem “that bad” from an outsider’s perspective.
Exploring addiction as a response to trauma makes so much sense. People turn to substances as an “attempt to solve a problem”. The aspects of substance use that make it appealing for trauma survivors are:
A sense of soothing one’s emotions
Illusion of feeling closer to others
Reducing the burden of stress and pain
These compelling results of substance use become the perceived solution to the problems caused by trauma. Rather than “why is the person addicted,” we should ask ourselves, “why is this person in pain?”
Treating Addiction from a Trauma Informed Lens
When substance use disorder and trauma are treated simultaneously, the outcomes far exceed siloed treatment. No one knows this better than Patrick Devlin, psychotherapist, substance abuse counselor, and co-founder of Skyline Recovery in Bend, Oregon. Devlin and his team treat young adult men with addiction, and co-occurring trauma.
Patrick shares his observation that, over the past 15 years in the field, there has been an increase in the number of adolescents and emerging adults presenting with the impacts of trauma. He notes that the increase is related to the field of mental health finally catching up and recognizing the role of trauma as an underlying factor in not only substance abuse, but also conditions such as eating disorders, behavioral and attention related issues. This increased awareness has resulted in treatment providers delving into these factors more with clients, which in turn results in people being more cognizant of the ways their trauma impacts daily life and sharing their experiences. Devlin notes Dr. Gabor Mate’s wise words, (paraphrased), not everyone who experiences trauma becomes and addict, but every addict has experienced trauma.
In his work with young adults, Patrick has seen how trauma affects the young adult mind. He states, “we know that trauma has a significant impact on the way a person sees themselves, their sense of safety, their relationship to their body, the comfort or lack thereof in their own skin, and their ability to tolerate or feel their own feelings. When you couple these impacts with the primary developmental task of adolescence as identity development (as opposed to adults that have a fully developed sense of self), this creates the conditions for deeply entrenched negative behavioral patterns, view of the world and low self-esteem.”
Healing From Trauma and Addiction
Though Patrick and his team at Skyline Recovery treat each teen as unique individuals and work on the specific needs of each person in the program, he notes that there are certain types of treatment that have been particularly helpful for those in recovery with trauma histories. One important aspect of treatment is family work, as Patrick explains that “addiction and substance use is a family issue and never exists in a vacuum.”
Devlin notes that increasing awareness and educating all family members about the systemic patterns is an important first step. He also emphasizes the importance of family members getting needed supports such as therapy, siblings getting support at school, medication, and other resources. Because it is a family issue, Patrick says that each member of the family must be aware of their own needs and boundaries, take care of themselves and ask for help with it as needed. Decreasing patterns of co-dependency is an important step in families growing and becoming healthier, even if some family members continue to struggle.
Patrick recommends tried and true resources such as 12-step programs, mindfulness-based recovery programs and Al-Anon for families. He also suggests that parents and mentors educate themselves and help young people get connected to trauma-informed care. Devlin reminds us that, “you can lead a horse to water, but you can’t make them drink (although you can help make them thirsty by not enabling self-destructive patterns). There is a point in which you have to let go and give them the space to have their own journey. Also, to try to maintain a balance between support and detachment. Healthy detachment is an art that takes a lifetime to explore, but it is THE way to best support a person struggling with trauma and addiction.”
In terms of treatment for trauma, Patrick points to the growing body of evidence that talk-therapy is not as impactful as we would like. He also states, “addiction is not a rational problem but is largely emotional in nature and about dissociation.” Devlin advises that all types of therapy should be trauma-informed and support young people to be “in their bodies, and process feelings in a healthy way.” He suggests treatments such as somatic experiencing, attachment-informed psychotherapy, EMDR and Brainspotting. Patrick also shares that ego-states or “parts” work is helpful in working through trauma and addiction.
Avoiding Common Patterns of Self-Sabotage
Patrick Devlin’s path toward helping others began with his own journey of trauma healing and recovery. He openly shares part of his story in the interview, stating, “I grew up in an environment where I was struggling with things that I didn’t have words for and the only solace I found was in substances. The groundwork was laid for me to fall into addiction and eventually lead me to the proverbial rock and a hard place that so many addicts encounter.” He further shared that he had a great deal of support and after several relapses was ready to get sober. “This led me toward being of service to other people suffering as part of my recovery and I quickly found that I loved the work and the power of people making profound changes in their lives. Now I am inspired by all my clients and feel so honored to be a part of peoples healing journey. I can’t imagine doing anything else.”
Patrick refers to the role of self-sabotage in mental health and recovery. He notes that Peter Levine, trauma expert, talks about the trauma repetition cycle and the ways people get stuck. The powerless feelings and sense of victimization people experience as a result of trauma can lead to an effort to exert control and regain personal power. Though the desire for self-actualization and autonomy is a healthy one, it can sometimes be misdirected into self-sabotage. Patrick has seen this pattern play out repeatedly over his years in the field of recovery. He suggests that families make an effort not to add shame to the person going through this type of regression, as this can reinforce the pattern. “The more shame an addict feels the more avoidant, dissociated, and unconscious they become. There is a difference between having boundaries as a loved one of an addict, detaching with love as they say in al-anon, and punishing them with your boundaries because you are angry that they regressed again.”
Trauma and addiction can be treated effectively with the right interventions. Understanding one’s pain and trauma, and the underlying thoughts, feelings and beliefs that have stemmed from it can help people in recovery heal. Trauma-informed care for substance use can help individuals and their families recover, reconnect, and heal.
Talley Webb, M.A., CRMC
Journey to Better, LLC
