What are the roots of addiction? In this article, we’ll discuss the link between childhood trauma and addiction. Why does trauma lead to dependency and what can we do about it?
The question of why some people become addicted to substances and others do not has been a major topic of study in the field of substance use disorders. It is certainly curious that many people who use drugs or alcohol repeatedly never develop an addiction.
Over the years, a number of factors have come to our attention as raising the risk of addiction. Research has shown that genetics play a role, as does the presence of other mental health issues. Developmental disorders like ADHD are also linked to a stronger likelihood of struggling with addiction.
One factor that has been receiving increasing attention is the impact of childhood trauma on the risk of addiction. Experts have recognized that people who grew up in more difficult environments, or with the added stress of societal prejudice, are significantly more likely to abuse substances.
Why and how does childhood trauma increase the risk of addiction? To answer this question, we will need to define trauma, examine its impact on the brain, and discuss the perspective of the experts on its connection to addiction.
What is Childhood Trauma?
The word trauma can mean different things depending on the context. Author and physician Gabor Maté, who has written extensively on the link between trauma and addiction, speaks of two types of trauma: Trauma (with a capital T) and trauma.
Capital-T Trauma refers to the big events like accidents, deaths, injury, and physical or sexual abuse.
Small-t trauma refers to emotional injuries that are often overlooked, including neglect, rejection from parents or lack of attachment, chronic criticism, shaming, and growing up in a home where love was conditional. These traumas can be more insidious, as they are all-too-often normalized.
Adverse Childhood Experiences (ACEs)
Many of the most common traumas, both big-T and small-T, have been categorized as adverse childhood experiences (ACEs). ACES include:
- physical/emotional/sexual abuse
- neglect
- household dysfunction, e.g.
- substance abuse
- domestic violence
- incarcerated family members
- divorce
- caregivers with mental illness
- persistent sense of an unsafe environment
An influential study carried out by the CDC with Kaiser Permanente found a high correlation between ACEs and certain illnesses in adulthood, including addiction. The context and results of this study are extremely important, both to understand the commonality of ACEs and how they are related to substance use.
Carried out between 1995 and 1997, over 17,000 adult patients were studied. They were mostly middle-class, white, insured individuals – in other words, they had a higher chance of having grown up in stable environments unimpacted by poverty and prejudice. Nonetheless, about 67% of participants reported having experienced at least one ACE during childhood.
This backs up Maté’s assertion that childhood trauma is incredibly common in modern society. In a household with one or both parents employed full time, and in a world in which community is given less and less priority, a sense of emotional neglect, in particular, is an understandable outcome.
The number of participants who had experienced more ACEs was, of course, much lower. Still, 20% of participants reported experiencing 3 or more ACEs.
The more ACEs a person experienced, the more likely they were to develop in addiction. Someone who experienced 4 or more ACEs was 5 times more likely to have an addiction to alcohol and 10 times more likely to have injected street drugs!
Other Significant Traumas
Some ‘small-t’ traumas, such as neglect, are considered ACEs. However, there are many others outside of that category that nonetheless have a significant impact on a person’s life. Many of these traumas are very common.
For example, chronic criticism is something many children experience. This can be an indirect consequence of a parent’s personal struggles or a purposeful parenting choice. Although it is less common nowadays, many parents still believe that a child needs to be criticized and shamed in order to work hard or follow the rules. Unfortunately, not only do we lack evidence for the efficacy of this style of discipline, but research increasingly suggests that it has negative consequences for the child, even after they reach adulthood.
The psychological scars that remain increase the risk of mental health struggles, including substance use disorders.
Why Does Trauma Lead to Dependency?
The link between trauma and dependency is clear, but why should this be the case? Addiction is complex, after all, and there are not just psychological but also physical factors at play.
Both of these realms are relevant when looking at the correlation.
Trauma and the Brain
There is ample evidence that trauma impacts the brain, going so far as to cause changes to its structure. This is due to a number of factors.
The most prominent reason for this lies in the role of the body’s stress response, which involves the nervous system. As a crucial part of the human self-preservation instinct, the body naturally reacts to threats, using approaches like fight, flight, and freeze. Due to the urgency of many threats, this response needs to be automatic and potent. The body and brain are quick to adapt to the circumstances, putting the person in a heightened state of awareness.
But context matters. The same responses that can save your life in the face of danger are maladaptive in normal day-to-day circumstances. If the brain begins to adapt to a trauma response, it can remain reactive even when there is no direct threat. The structural changes make a person more likely to act in a way that prioritizes countering threats and, without actual danger, this often leads to the instinct to numb or distract oneself.
In short, a person who is continuously hyperaware and hyperreactive is then drawn to substances that give them a temporary reprieve. A person whose system underreacts in order to avoid perceived threats may seek out substances that provide a temporary boost of energy or pleasure.
Trauma and the Psyche
How does the person’s psyche impact their likelihood of addiction? Someone who experiences trauma, especially during childhood, focuses on what may go wrong, becoming avoidant and struggling to appreciate the good things in life. They struggle with attachment, meaning, emotional regulation, and self-esteem.
This leaves them with a void – the sense that something is missing. What a healthy person would find in relationships and personal pursuits, they search for in other avenues. Substances seem attractive, as they temporarily fill the void, or at least distract from it.
The combination of a physical predisposition to dependency and a psychological search for relief powerfully increase the likelihood of attraction to and, subsequently, addiction to substances.
Modern Addiction Rehab: Treating Trauma
Our growing understanding of how trauma is linked to addiction has provided important insights into how to treat it. Rather than focusing on the symptoms of the problem, including the physical dependency and psychological cravings, experts now know to look at the root causes of addiction.
This has led to the emergence of dual-diagnosis treatment centers. Dual diagnosis treatment recognizes that, due to the effects of past experience, there are usually underlying issues. In many cases, these are expressed not just in run of the mill struggles but in co-occurring mental illnesses as well. For instance, depression, anxiety, insomnia, OCD, and other disorders all commonly co-occur with addiction.
Dual diagnosis treatment ensures that the person’s entire context is explored. This is achieved through the following treatment modules:
Individual Therapy
Addiction treatment goes far beyond learning to avoid triggers and resist cravings. In individual therapy, the person delves into their psyche with the help of a mental health professional. They explore childhood experiences, relationships, and patterns of thought and behavior.
It is in individual therapy that trauma is often uncovered. Experiences that have been pushed to the back of the mind, minimized, or even forgotten, are given space for discussion. Their link to the person’s struggle with addiction is brought to light. The experiences are then processed and the person learns to cope with associated struggles in healthy ways.
Mindfulness
Holistic approaches to treatment are also important when addressing the roots of the addiction. Mindfulness, including the underlying philosophy and meditation practices, is proven to improve outcomes by gradually changing the way the person views life.
Mindfulness is not about seeing things in a persistently positive light or pretending that pain does not exist. On the contrary, it is about recognizing that both ups and downs are part of the fullness of life. By learning to experience them without attempting to get rid of them or distract oneself, difficult emotions are easier to regulate and simply being alive becomes more meaningful.
Conclusion
The link between trauma and addiction has been demonstrated time and again. Addiction experts now incorporate this understanding into treatment, with the dual-diagnosis approach taken by all the best rehab centers.
Trauma often lies at the root of addiction. The good news is that it can be addressed, leading to a more sustainable and complete recovery.
Get in touch with Seasons in Malibu today for the best dual-diagnosis rehab treatment.
References
CDC: About the CDC-Kaiser ACE Study
