Substance Use Disorder and Trauma

Photo by Susan Wilkinson on Unsplash

As a woman in long-term recovery and a regular contributor to The Phoenix Spirit, I have written about my experience finding sobriety, struggling with and addressing cross-addiction, and being a part of a 12-step program. What I have not yet shared is that I am a trauma survivor, and how addressing my trauma has been an integral part to addressing my substance use.

I am a survivor of childhood trauma and, like many women, a survivor of sexual assault. After I found recovery and continued to work a recovery program, the ongoing effects that my trauma had on my physical and mental health became more apparent. Without substances to “self-medicate,” I struggled to find ways to cope. In recovery, life was certainly better, but I was surviving, rather than thriving.

Eventually I read The Body Keeps the Score by Bessel Van Der Kolk, M.D., and learned about Polyvagal Theory, which explains, in part, how our bodies store trauma, and how our nervous system may become dysregulated as a result of traumatic experiences. Trauma survivors can find themselves in a constant state of “fight or flight,” even when there is no crisis or threat. Dr. Van Der Kolk’s work further expounds that traumatic events from the past often fuel addictive behavior – even when such events are not cognitively remembered. Subsequently, addressing substance use disorder and/or addiction often requires work to resolve past trauma events.

Numerous studies have shown the correlation between substance use disorder and trauma and/or post-traumatic stress disorder (PTSD) to be significant. One U.S. study found correlations between the severity of substance use and levels of childhood physical, sexual, and emotional abuse, as well as PTSD.[ii]  Alcohol abuse has also been associated with physical and emotional abuse.[iii] The consequences of trauma can lead survivors to anxiety, numbing, and rage and affect their capacity to concentrate, to remember, to form trusting relationships, and even feel at home in their own bodies. Coping with dissociative and/or numbing substances is a common result but, when those substances are removed, the consequences of trauma remain.

When it comes to “fight or flight,” I found myself always turning to flight. Even as a child, I read books almost constantly – mentally escaping into the worlds created by the pages. I was an over-achiever who stayed busy with school and extracurricular activities, escaping into the next goal or achievement I was working towards. Eventually, substances became a dissociative tool I would use that succeeded in helping me flee from reality and the feelings of crisis that I could not control. So did over-working, eating excess amounts of sugar, working out compulsively and many other cross-addictions that I struggled to address solely using a 12-step program approach. It wasn’t until I received treatment and support in addressing the underlying trauma, in conjunction with 12-step work, that I truly began to thrive.

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Ultimately, exploring the role of unresolved past trauma was the missing key that allowed me to turn a corner in my recovery from substance use disorder.Even though I found, and maintained, sobriety I still suffered from being in a constant state of trauma response. In situations where others seemed to be able to navigate successfully, my nervous system went into a state of “fight or flight.” Things like interpersonal conflict, challenges at work, and holiday gatherings with family. Even situations where I felt like I was trapped where there no was no present threat sent me into panic – flights, standstill traffic, and professional public speaking in a room when the door was closed.

Prior to finding recovery I would manage these situations with alcohol or prescribed benzodiazepines.  After recovery, I found myself in these situations without adequate tools to successfully navigate them.  I would either suffer through the overwhelm, avoid the situations entirely, or find another means of checking out – distracting myself with work, television, or daydreaming, eating sugar, staying constantly busy…the list goes on.

12 step meetings and working the steps with a sponsor provided a reprieve and helped to manage these symptoms to an extent. It also helped get to the point of health and self-awareness to start seeking other avenues to address my trauma history. Things such as working with a trauma therapist who also specialized in somatic experiencing and experiential therapy. I addressed mental health concerns and challenges with a mental health professional. Other types of treatment that I have become aware of that can support trauma recovery include residential trauma treatment, outpatient trauma treatment, psychodrama therapy, eye movement desensitization and reprocessing (EMDR), acupuncture, massage, yoga, rolfing, and homeopathy.

Addressing my trauma included talking about the traumatic experiences and processing the emotions I was not able to process at the time as a child. In this process, new memories surfaced which was incredibly challenging, but ultimately helped me move towards further healing. It also included addressing my past substance use and cross-addiction behaviors by focusing more on what emotions were coming up in the situations which I felt the need to dissociate from, as well as how they were rooted in the traumatic events. I was provided with support to identify and develop new coping and self-soothing tools – things like meditation, breath work, grounding techniques, and self-awareness on a physical, mental, and emotional level.

With a magnifying glass on the emotional and traumatic responses, I worked to become more self-aware of when those same feelings or responses arose and practiced applying new coping tools which allowed me to stay present and grounded. I became better able to navigate situations and memories that used to overwhelm me entirely – I could respond in a way that was intentional, purposeful and in line with my values and ideals for myself. I finally started to thrive in my recovery! I no longer felt like I was treading water or playing an on-going game of “whack-a-mole” with cross-addictions. I found confidence in my recovery and in myself. Ultimately, exploring the role of unresolved past trauma was the missing key that allowed me to turn a corner in my recovery from substance use disorder.

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Like any sort of recovery, my trauma recovery is ongoing, and I am sure it will continue to change and evolve. It is something I work to maintain and build upon – much like a 12 step program addresses substance use disorder, alcoholism, and addiction. Recovery, for me, is a lifelong journey that gets more beautiful with every step.

As always, I share my experience, strength, and hope with the intention of encouraging others with their own recovery and healing. Afterall, I have found my own path in recovery continuously lit by the vulnerability, authenticity, and honesty of others. I often find myself in awe of human resiliency and how relationships with other people can have the power to heal. I am grateful for the opportunity to share a part of my journey as we all continue to “trudge the Road of Happy Destiny”[iv] together.

References
  • [i] Van der Kolk, B.A. (2014). The body keeps the score: Brain, mind and body in the healing of trauma. Viking.
  • [ii] Fullilove MT, Fullilove III RE, Smith M, et al. Violence trauma, and post-traumatic stress disorder among women drug users. J. Traumatic Stress, 1993: 6: 533-543.
  • [iii] Schwandt, M. L., Heilig, M., Homer, D. W., George, D. T., & Ramchandani, V.A. (2013) Childhood trauma exposure and alcohol dependence severity in adulthood: Mediation by emotional abuse severity and neuroticism.  Alcoholism: Clinical & Experimental Research, 37(6), 982-992.
  • [iv] W., Bill. (1976) Alcoholics Anonymous: the story of how many thousands of men and women have recovered from alcoholism, 164.  New York: Alcoholics Anonymous World Services.

Rachel T. Schromen is an estate planning attorney and owner of Schromen Law, LLC in St. Paul, MN (www.schromenlaw.com). Ms. Schromen speaks frequently on the topic of Addiction Trust Planning, including providing training on the topic to attorneys in the Metro Area.

Last Updated on September 8, 2021

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