When Childhood Trauma Causes Addiction, Trauma-Focused Therapy Can Help Prevent Relapse
Childhood trauma can have lasting effects that continue to inform your emotions, thoughts, and behaviors well into adulthood, including your substance use. By exploring what childhood trauma is and how it increases the risk of addiction, you can begin to better understand your own experiences. Because childhood trauma can cause addiction in some individuals, it is now recognized that addressing these experiences is an essential part of the addiction treatment process.
For some, childhood trauma creates a sharp dividing line in life—a before, an after. That’s how it was for Laura, a 32-year-old computer engineer from the Bay Area. “I would remember my life before the sexual abuse and it felt like a dream I wanted to return to,” she says. “I remembered what it was like to feel safe, to not feel angry, sad, and alone, and I want to return to that place. When I got older, I discovered that alcohol could temporarily give me refuge.” Although her abuse had begun when she was seven years old, Laura was 14 when she started drinking. It numbed her sadness and her anger, giving her solace for a few hours. “Drinking made me forget. It made me feel normal. It made me social. For a little bit, I could be free.”
Brad, on the other hand, does not remember a before. Instead, the emotional abuse and neglect inflicted by his parents was the only kind of life he had known. “I have scattered memories of good times,” he explains. “But the prevailing narrative was always abuse. If we had a few good weeks it was a nice break, but I knew it would all start up again soon enough.” While Brad’s experience of childhood trauma was different than Laura’s, his solution for coping was the same, even if he did not recognize it at the time. “I didn’t start drinking until late in high school, but when I did it opened up the floodgates to all kinds of substance use,” he remembers. “Anything that would make me feel good, I would do. MDMA, cocaine, Oxy—put something in front of me that could make me escape and I would snort it, swallow it, and, eventually, inject it.”
Brad, however, did not immediately connect his ever-growing substance use to the trauma he experienced as a child. “It wasn’t like I was alone in doing these things. All my friends were experimenting with drinking and drugs. I wasn’t calling my dealer thinking, ‘I’m doing this because my parents abused me.’” As he grew older, however, his friends began to slow down their substance use. “But for me, it didn’t stop. It was the only way to feel the way I wanted to feel. And it took me a long time to connect that to what happened when I was a kid.”
Childhood trauma is experienced differently by everyone; the circumstances of trauma and reactions to it are often deeply individual. However, there are certain common threads that permeate many narratives of survivors, including substance use. Now, research confirms that childhood trauma causes addiction in some survivors, acting both as the impetus for use and complicating the recovery process. Unfortunately, many survivors find that getting and staying off drugs of abuse is a more complex endeavor due to the lasting impact of their traumatic histories, putting them at greater risk of relapse. In order to prevent your own relapse and find lasting recovery, it is therefore essential to seek out true dual diagnosis treatment in which your childhood trauma is addressed.
What is Childhood Trauma?
Childhood trauma comes in many forms, some of which are immediately recognizable as trauma. However, many people who have experienced trauma live with its repercussions but do not identify themselves as having traumatic histories, making it impossible for them to connect their subsequent emotions, thoughts, and behaviors to childhood trauma. Having a full understanding of what constitutes trauma is therefore essential to correctly categorizing your experiences.
According to the Substance Abuse and Mental Health Services Association:
Individual trauma results from an event, a series of events, or a set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.
This trauma can include:
- Sexual violence
- Physical violence
- Emotional abuse
- Major accidents, illnesses, or medical procedures
- Witnessing violence, including intimate partner violence
- Historical trauma
- School violence
- Natural disasters
- War or terrorism
- Forced displacement
- Traumatic grief, particularly following the death of a family member, separation from a parent, or divorce of parents
Some of these events are unfortunately so commonplace that their traumatic nature becomes invisible to those who experience it. Events such as the divorce of parents or childhood bullying, for example, can have a deep and lasting psychological impact, but are too often not understood as trauma the way sexual or physical abuse is. In other cases, growing up in an emotionally neglectful household can keep the trauma hidden from you if you have never experienced anything else and do not realize the harmful nature of this type of parenting. Recognizing your experiences for what they are is the first step to understanding how your childhood experiences have shaped you and how they connect to your substance use.
The Increased Risk of Addiction Amongst Childhood Trauma Survivors
The connections between childhood trauma and disorders such as depression, anxiety, and post-traumatic stress disorder have been firmly established for decades. Today, however, there is increasing awareness of the fact that childhood trauma causes addiction as well, creating a fuller picture of the etiology of substance abuse. In some ways, these links appear obvious. As Raychelle Cassada, author of The Anger Workbook for Teens, writes, “Substance use is often used as a means to cope with the painful traumatic memories.” Substance use may also help you deal with the feelings of isolation, depression, and low self-worth that so often result from childhood trauma, making drugs and alcohol highly attractive even at dangerous levels.
Indeed, research has found that those who have experienced childhood abuse are 1.5 times more likely to use illicit drugs each year compared to adults who have not experienced childhood abuse. Some studies suggest the number is even higher and increases with the severity of abuse. For example, a study on “highly traumatized” individuals found that a full 39% of participants reported dependence on alcohol and 34.1% reported dependence on cocaine. Survivors of childhood abuse are also more likely to start using earlier than their non-abused peers; one study found that childhood sexual abuse survivors begin using a full year before individuals who have not experienced sexual abuse. The same study found that rates of drug and alcohol use amongst young people who are survivors of childhood trauma are rising while rates of use in the general young population are declining. These results are part of a growing body of literature demonstrating important links between childhood trauma and addiction, helping us better understand the vulnerabilities of survivors.
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Why Childhood Trauma Causes Addiction
The reasons for increased susceptibility to substance abuse amongst survivors of childhood sexual abuse are complex and undoubtedly include the desire to deal with feelings of anger, sadness, depression, worthlessness, and loneliness. However, there are many ways to cope with those feelings aside from substance abuse. So what makes drugs and alcohol so particularly attractive to survivors of childhood trauma? Many now believe that it has to do with the impact of such trauma on the brain. In the case of parental abuse or neglect, for example, Canadian physician Dr. Gabor Maté says:
A child has certain fundamental needs for emotional development and also for brain development. If you look at the human brain, it develops under the impact of the environment. So for example, in the case of addiction, the brain’s reward circuitry is impaired. Those circuits need the support of the environment to help them in their development, and the essential quality of the environment is a mutually responsive relationship with the parent or caregiver. [When families are neglectful or abusive], the children will look for reward elsewhere. So [when we’re looking at] the brain physiology side of addiction, which is the underdeveloped reward circuits in the brain, we’re looking at the impact of addiction.
However, childhood trauma impacts the brain in more ways than just modulating the reward circuitry. According to brain imaging studies, survivors may have diminished white and grey matter, potentially impacting a host of critical processes, and a number of neural networks appear to be affected. A 2012 study found that “kids who had been maltreated showed connectivity problems in several brain areas, including the superior longitudinal fasciculus (SLF), which is involved in planning behavior.” Additionally, they found white matter loss in the right cingulum-hippocampus projection (CGH-R), which is associated with emotional processing and abstract thought. Significantly, these changes were found to correlate directly to the development of substance use disorders as well as depression. Combined with currently emerging research, this suggests that childhood trauma causes addiction in part by interfering with important emotional and logistical processes, including emotional regulation and impulse control, that would otherwise offer protection against substance abuse.
The Need to Address Childhood Trauma in Addiction Treatment
The addiction treatment process is designed to help you break through your dependence on drugs of abuse by identifying triggers, disrupting negative patterns of thought, emotion, and behavior, and creating new, healthy patterns that will help you stay sober. However, as our understanding of addiction has grown, it has become clear that simply focusing on the addiction in isolation is unlikely to produce durable healing. Without addressing the underlying issues, the impetus for drug abuse will remain, heightening the risk of relapse. Instead, addiction treatment is more effective when it focuses on the needs of the whole person and targets the psychological and neurological underpinnings of addictive behaviors. For people who have experienced childhood trauma, this includes addressing those traumatic experiences through trauma-focused therapies in the context of a dual diagnosis treatment program.
Trauma-focused therapies are designed to help you explore trauma with the support of therapists who have the training and experience necessary to guide you through the therapeutic process safely, collaboratively, and productively. This may include a variety of individual, group, and experiential therapies modified to your comfort level and needs in order to avoid re-traumatization. You will never be forced to talk about your traumatic memories until you are ready to do so, and there is a broad range of non-verbal modalities that may be used to allow you to stay safe during the therapeutic process if necessary.
By investigating your experiences and understanding the link to your addiction, you can begin to forge deeper self-knowledge while challenging the destructive narratives trauma has created. Here, you can learn how to express your sadness, your anger, and your fear in non-destructive ways and process those feelings in a way that allows you to move forward. Because childhood trauma is known to impact the brain in ways that create known challenges, you and your therapist can pay particular attention to these potential deficits in order to encourage healthy new neural connections and compensate for areas of struggle. At the same time, you can create practical strategies to cope with the complex effects of childhood trauma in positive ways. This includes treating any co-occurring mental health disorders that may be connected to your traumatic experiences, such as depression, anxiety, and post-traumatic stress disorder. Addressing these issues is essential in order to minimize the risk of relapse and giving you the insight and skills necessary to forge a future without substance abuse.
High-quality dual diagnosis treatment, of course, isn’t just about looking back and focusing on addiction and trauma. Rather, it is a chance to discover who you can be without substance abuse and what you can do when you are no longer locked in a traumatic state. With the support of compassionate clinicians and peers, you can explore your potential, your passions, your hopes, and your dreams. You can learn how to access rewarding experiences without the use of drugs and alcohol and move toward increased confidence, joy, resilience, and connection with the world around you. You can break free from the cycle of pain and addiction and become who you truly want to be. Your trauma and addiction do not define you. You do. And with the right care, you will discover the empowering possibilities that lie ahead.
Alta Mira offers comprehensive treatment for people struggling with addiction and co-occurring mental health disorders and process addictions. Contact us to learn more about our renowned Bay Area programs and how we can help you or your loved one start the journey toward recovery.