Trauma and Addiction: Is it a Never Ending Cycle?

There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds.
— Laurell K. Hamilton, Mistral's Kiss

Addiction is a coping mechanism. Addiction to drugs, alcohol, prescription pills, business, work, shopping, food, gambling, sex and so on. You can become addicted to almost anything.  As Gabor Maté states, in order to treat addiction we have to first understand its purpose.

It is impossible to understand addiction without asking what relief the addict finds, or hopes to find, in the drug or the addictive behaviour.
— Gabor Maté, In the Realm of Hungry Ghosts

Addiction can run in families and research shows us that if you have immediate family members who are addicts, then you have a greater than average chance of becoming addicted as well. This is because of a genetic vulnerability that can be passed down through generations. But this is only one piece of the story.  Addiction serves a purpose, and that purpose is to reduce or numb pain. And it works… for a short time. And then the original pain comes back again and with it comes a host of new problems brought on by the addiction – financial problems, relationship problems, problems at work, or health problems. Pain and addiction are a feedback loop, each one reinforcing the other.

What causes this pain? It can be life circumstances such as a divorce or death of a loved one, or loss of a job. But more often there is a relationship between addiction and pain from childhood that has stayed with you into adulthood.  Pia Melody, author of Facing Codependence and Facing Love Addiction, founded a treatment center in Arizona called The Meadows based on the principle of addiction being caused and reinforced by trauma, including childhood abuse and neglect.

The hardcore drug addicts that I treat, are, without exception, people who have had extraordinarily difficult lives. The commonality is childhood abuse. These people all enter life under extremely adverse circumstances. Not only did they not get what they need for healthy development; they actually got negative circumstances of neglect... That’s what sets up the brain biology of addiction. In other words, the addiction is related both psychologically, in terms of emotional pain relief, and neurobiological development to early adversity.
— Gabor Maté
trauma and addiction, trauma therapy, substance abuse, ptsd

Trauma survivors self medicate away suffering, flashbacks, nightmares, insomnia, heart pounding, unexplained illness and extreme startle responses with behaviors or substances (“medications”) such as shopping, alcohol and drugs. For a short time the symptoms fade away into the background. The suffering that comes from trauma can be so intense that people are willing to accept any consequences, even the most dire, to escape the pain for a short time.  As the body builds tolerance and both body and mind become addicted, greater amounts of the medication are needed to feel “okay”.  Sooner or later the addiction takes hold, the PTSD symptoms become worse not better and lives become unmanageable. This is how the wheel of trauma and addiction spins round and round.

When you are traumatized you retreat to your animal instincts of survival. You call out for help if you can. If no one listens you may run away or fight back. Or you may freeze in your tracks while your adrenaline pumps and your heart races, like a deer caught in the headlights (freeze). If all else fails, you may collapse and almost feign death, like the gazelle in the lion’s mouth, with the instinctual hope that if the predator thinks you are dead, you may actually live through the attack. These trauma responses stay with you long after the event and when the memory is triggered, you access the place where the trauma in stored and experience the same physiological arousal – you feel helpless and unsafe, your heart races, your breath becomes short, images, smells and sensations flood your senses.  If alcohol or drugs can stop this from happening, doesn’t it make sense that you would try? And doesn’t it makes sense that you can’t just white knuckle your way through?

So if addiction and trauma are a cycle, how do you get off the merry go round? The only way that really works is to treat both at the same time. The first step in treatment is to understand the cause, the relationship between trauma and addiction. Then you can start to build compassion for yourself rather than self hatred, shame and judgment. I highly recommend reading Gabor Maté's book In the Realm of Hungry Ghosts, which is quoted several times in this article, in order to understand this cycle from a place of compassion.