The Addiction/Trauma Connection
Although I have worked with many patients over the years that enter treatment stating “I have never had trauma in my life”, I cannot remember a case wherein someone presenting for treatment for addiction, mood disorders and more, did not have a history of unresolved trauma. For those denying the existence of such in their lives, further exploration would reveal that what they had suffered was considered normal or they had created a reality minimizing or excusing the abuse. Often those denying trauma history were adults who were physically abused and/or sexually shamed in childhood but often claimed “I deserved it” or this “happens to everyone.” The commonality however was that the addictions and/or mood disorders were adaptations the individual had made to manage the psychic pain. Addiction is merely a symptom of root cause trauma.
Treatment for Trauma – Neuroplasticity
The brain is designed for safety and survival of the species. In the latter half of the 20th Century, signifi cant progress was made in the study of the human nervous system, which is the general field of neuroscience. Most notable in my opinion was the evidence that the human brain has the capacity to change itself and to change over the course of a lifetime- which is neuroplasticity. Learning the brain can change as a result of experiences in the environment makes sense to me that treatment for debilitating behavioral health and mental health issues must utilize this information and provide treatment services that will infl uence brain change in a positive desired way. When I developed The Sabino Model: Neuroscience Based Addiction and Trauma Treatment, the idea was to target root cause trauma as driving the dysfunctional adaptation and to use our knowledge of neuroplasticity to provide very specifi c and well researched activities, experiences, and environments that would expose a patient to compassionate, empathetic, and nurturing care in conjunction with daily exposure to the brain changing activities.
Consistent positive focused attention on someone that allows the person’s brain to change in response to the experiences, allows for new and healthier responses to day-day experiences. Through the consistent, genuine experiences of feeling cared for over a period of time, a person can gain the safety, self-worth, connection and trust in another that never occurred in early childhood.
When treating trauma the emphasis is not to be on assigning blame to anyone, but rather to encourage discovery and understanding of one’s life through safely guided self-exploration. Making some sense out of what happened without re-visiting the details and changing negative cognitions into positive cognitions is a part of trauma recovery. Shame reduction work in any context to replace the unhealthy and untrue self-beliefs one acquires from trauma exposure is necessary.
Processing meta-cognitions which is an individual’s personal interpretation of their own thoughts assists in changing the brain as well. Relevant to trauma, a survivor often will develop maladaptive thinking patterns in an effort to keep themselves safe from future similar experiences. An example of a maladaptive response to trauma is a woman attacked by a dog while walking in her neighborhood making the decision to never take walks anywhere. The thought will seem rational and smart to the survivor but ultimately harms her as she loses opportunities for enjoyment, exploration of new environments, exercise, and perhaps social connections.
I consider an integrated approach to trauma treatment as most effective. What model or models used must be based upon the individual’s presentation. The one-size fi ts all approach does not consider the unique learning styles, histories, and strengths of an individual. Many successful trauma modalities are currently used such as Eye Movement Desensitization Reprocessing (EMDR), somatic therapies such as Somatic Experiencing and Somatic Trauma Therapy. Sensorimotor Psychotherapy is a method of assimilating the body’s destructive response to sensory stimuli from the trauma and by doing so improve emotional and cognitive impairments. Other modalities include Trauma Focused Cognitive Behavioral Therapy, Neuropsychodrama, Neurofeedback, Interpersonal Neurobiology, and Internal Family Systems Therapy. This list is not exhaustive.
I have found equine assisted psychotherapy to be very effective as a brief therapy that supports an individual in staying in their body and maintaining focus. I also support the use of both Allopathic medicine and Naturopathic medicine. Again, it depends on an individual’s presentation. Nutrition, exercise, and the experience of taking healthy risks are all critical components of well-rounded treatment.
Below are some additional alternative healing methods that can enhance a treatment plan. All are methods that if accessed consistently over time, will work to build new and healthy neural pathways in the brain.
Music is Therapy – Research has shown that slow music with a repetitive 10-second cycle calms a listener because it matches the body’s natural 10-second wave of blood pressure control.
We know music is capable of eliciting the deepest emotions from humans. Music and how we hear and interpret the sounds are consistent across all cultures. If we gather a group of people with a diverse range of background and culture and play music, most all will agree on the emotions the music produces. We know some of the brain structures associated with how we hear music are those that are also connected to the limbic system. Listening to music accesses multiple brain areas that can assist us in relaxation; energize us, access memories, emotions, and the desire to move our bodies in a natural way.
Sound healing is gaining more attention in recent times. Resonance is a phenomenon in physics that is the condition when one object with a relatively weak vibration can cause a strong vibration in another object. Sound healing may involve the belief that our body parts are in a state of vibration but when we are not healthy there can be disharmony in our systems. There are sound healing modalities designed to resolve energetic blocks within our bodies to help move individuals towards well-being. Sound healing is a non-invasive treatment that uses sound waves from vibrations of a variety of sound tools that may be held on the body where acupuncture points exist or behind the ears. The sound waves access energy pathways in the body and work to heal our physiology.
Sound has been used for thousands of years in the forms of mantras, chanting, melody repetition, drumbeats, and song. These techniques have been effective in moving one from a state of imbalance to a more grounded or balanced state. Sound can facilitate shifts in human brain waves.
Yoga and activities like Chi Gong work to neutralize and balance our nervous systems and our physiology. Activities that combine both a neutralizing beat and prosodic sound or music are most effective and also reduce depressive symptoms.
Outdoor Activity – Blue light from the sun is a part of the visible spectrum in the solar rays. Blue light helps keep us awake and energized during the day as it suppresses the release of melatonin. Melatonin is a hormone that causes sleepiness and naturally rises when the sun goes down to help us sleep. If we stay indoors most of the day our eyes fail to take in the appropriate amount of light needed to provide us an internal signal as to when to sleep or be awake. We need to spend time in the outdoors so our melatonin levels will change providing us the signals for when to rest and when to stay awake. It is significant to also recreate the environment for natural sleep/awake cycles to occur. We know that sunlight decreases symptoms of depression and the expansiveness of a beautiful, natural environment helps us to feel more stable and grounded. Blue Light from the sun enhances mood and energy through the release of endorphins. Endorphins are neuro-transmitters or hormones that are released in the brain and elevate mood.
Affirmation – helps to replace negative, damaging thoughts, and self-beliefs with new positive and productive ones.
Movement – presence in the body through focused intentional movement helps ground us in the present. Research shows that movement increases the flow of blood and oxygen, which in turn assists with learning, and physical and mental well-being. Trauma can be stored in the body and some survivors may find non-verbal expression a safer method of trauma release and recovery. Movement can help break up the freeze state (tonic immobility), which is characterized by profound motor inhibition during inescapable terror, that some trauma survivors find themselves returning to when in fear. Walking, hiking, cycling, dance, and more, all provide increased endorphin release and help elevate mood. The healthy brain seeks novelty. Trying something new involving action, movement, or activity can help build new healthy neural pathways.
Sleep – Treating sleep disturbance is critical when helping those with unresolved trauma. REM sleep is the fifth sleep stage that occurs about one hour to an hour and a half into sleep. It recurs throughout the course of a good night’s sleep and is critical in providing us the opportunity for our brain to re-boot, to cycle through the day’s events, to rest, and to refreshen for the next day. When this doesn’t happen, our ability for decision-making, healthy choices, clear memory and more is impaired. REM sleep is typically absent or minimal in people with addictions and trauma. To truly provide holistic treatment; it only makes sense to treat sleep- providing more than “sleep hygiene” lectures by referring a client to a sleep specialist who provides consults on sleep and perhaps recommend a diagnostic sleep laboratory.
Creative Expression – Activities such as poetry writing, playing music, drawing, coloring, knitting, crocheting and more can assist in creating harmony as both our logical, linear; language areas of the brain and our creative and emotional areas of the brain are activated when engaging in these activities.
Healthy Others – We also know today that we impact each other’s brain. Thus, finding other people who stimulate our thinking, excite us with new healthy interests, and who are engaged in life can help us heal. Mirror neurons are brain cells that code the behavior and actions of other people as well as our own. Although more research is needed, current research assumes these neurons act to provide our ability to simulate another person’s condition. Many of us have experienced the mood of another being contagious and when framed in positivity this can effectuate brain change that keeps us in healthy life engagement. Spending time with people who affect us in a positive way reinforces our ability to simulate their manners, actions, moods, and outlook as we in turn provide this to them. The mutuality of a healthy rewarding relationship changes our brain in a myriad of positive ways.
Re-Parenting – For some, re-parenting of those suffering by providing them what lacked in their early development; or what was later lost in adulthood such as the provision of physical and emotional safety, consistent compassion, support, kindness, and acceptance are necessary for effective trauma treatment. We
can treat the attachment failure by re-parenting people through nurturing, compassion, empathy, kindness, and the provision of a safe environment in which to experience trust in relationships.
Healing Begins with Kindness – Research shows that the most critical part in whether or not a patient heals in therapy is not the modality the therapist employs, but rather the therapeutic relationship itself. Research cites empathy as the significant factor that must exist for therapeutic success. Everything in life is relational. Relationships are at the heart of all our joy and all our sorrow. We are wounded in relationship and so to heal it makes sense to do so in the context of a safe relationship. Through consistent genuine experiences of feeling cared for over a period of time, a person can gain the safety, self-worth, connection, and trust in another that has been absent.
The therapeutic relationship can influence Neuroplasticity. The result of positive focused attention on someone that allows the person’s brain to change in response to the experiences facilitates Neuroplasticity.
The latest research on neuroscience and the brain are significant factors that can guide a patient’s treatment plan. The dysregulation of the nervous system and emotions resulting from traumatic experience once understood and attended to, serve to move those with Substance Use Disorder to a fulfilling life void of illegal substances. Coping skills to manage challenges and difficult emotions can replace the need for substances.
Recovery means to return to a normal or previous state of health. Trauma recovery must involve the entire body and move one towards full brain/body connection. Integrative experiences assist in healthy brain changes.
In past decades, it was believed that trauma recovery required the verbal sharing of traumatic experiences with a trusted, safe, and non-judgmental individual in therapy. We know today that this re-visiting of traumatic events can be detrimental to some and that PTSD in part involved the patient reliving the past in the present.
In conclusion, treating addictions and other behavioral health issues requires targeting the root trauma. Current neuroscientific findings; particularly neuroplasticity provides clinicians a guide to implement specific therapies and modalities to support positive brain change in our patients. A robust treatment program will be truly integrative, include individual, group, and family therapy and be truly customized for the individual. If we are not treating the trauma history, we are neglecting a critical need for our clients to live in long-term recovery. Using neuroplasticity as the foundation for development of a clinical program can contribute to the provision of customized treatment with a buffet of healing options.
The previous articles can be found at www.thesoberworld.com
Nancy Jarrell O’Donnell specializes in addiction and trauma treatment. She has spent most of her 25-year career working in residential and in-patient facilities. Her experience ranges
from Psychotherapist to Clinical Director to President of Clinical Services/Operations. She is a licensed therapist in Arizona currently in private practice. She developed The Sabino Model: Neuroscience Based Addiction and Trauma Treatment™
©Nancy Jarrell O’Donnell 2018