It has become apparent that there is a higher concentration of individuals who have suffered from some form of trauma in their lives, and coincidentally find themselves in a residential treatment facility for substance dependence, than one might find in the general population. Understandably, trauma survivors may well have engaged in substance abuse as well as other types of maladaptive/dependent behaviors (process addictions such as gambling, sex, shopping, etc.) in an attempt to adapt to the overwhelming disruption that trauma causes. By self-medicating the associated symptoms, there is an agenda of coping, albeit and ironically, one that is ultimately self-harming. Addressing trauma in the context of a residential treatment environment is paramount to reducing/eliminating triggers for continued dependence. Moving forward towards trauma resolution in a supportive social environment establishes a much stronger positive prognosis for successful recovery.
Trauma can be an event witnessed (9/11, Katrina, the Northridge, California Earthquake, mass shootings, etc.) or one personally experienced (various forms of child/adolescent abuse, assault, threats to life, etc.) which bring on various disruptive symptoms: bad dreams and nightmares, depression, anxiety, attentional difficulties, disrupted relationships, shame and self-harm behaviors. When hurtful events have compounded over time, and in different contexts, the possibility of more deeply effected mental health concerns increases and the need to address such history becomes even more compelling for future mental health and stability, something that is often seen when one may have experienced emotional childhood trauma in the form of parental verbal, emotional, physical and sexual abuse.
When the sexual abuse is experienced by a young boy, the issues of harm are compounded by the various entanglements that are brought about by the contextual environment of his society and community, making disclosure even more difficult. Not any worse, but certainly different in terms of upbringing and societal expectations. A young boy who has experienced sexual abuse endures an array of compromised self-esteem and self-worth issues as he moves into puberty and teenage years. Fearing critical indictments by those around him, the young male victim of sexual abuse is far more reluctant to discuss the issues of sexual abuse trauma, and confusion and fear set in. The film, Spotlight, last year’s drama about the incidence of sexual abuse perpetrated upon boys by members of the Catholic clergy, brings these issues out wonderfully. Additionally, a very well written book by Mike Lew, “Victims No Longer” speaks at length about all of the various issues that befall the young male victim and is an original resource manual for adult male survivors of sexual abuse.
Certainly, when sexual abuse has likely occurred, clinical experience and specific training makes for solid therapeutic change; and a wonderful paradigm shift in regards to one’s sense of self and personal identity. The good news is that the prognosis for quality change through the work accomplished in trauma therapy is very good. The difficult news is that one has to talk about it, and though one may have to walk where angels fear to tread, in the right environment with the right people by one’s side, healing happens and hope is regenerated.
Dr. Mark Stahlhuth is a Doctor of Clinical Psychology and is the Clinical Director at Rise in Malibu. He has a private practice working with teens as well as adults and their families in the areas of addiction and trauma. For more than three decades Dr. Stahlhuth has conducted psychological assessments on an in-patient basis as well as in residential and outpatient settings; the foundation for this work includes several years of graduate study in psycho-diagnostic assessment, graduate teaching assistantships, and internships and work at agencies specializing in psycho-diagnostic assessment. www.riseinmalibu.com