Trauma, addiction and coming home…

Very early in my career, working in the field of addiction, I learned the true nature of the disease I was treating was not simply substance use, but, in fact, trauma and early childhood adversity (ACES). Although addiction has a biological and genetic component, certainly some people are more vulnerable and at risk, it is important not to underestimate how we use our addictions to modulate the nervous system. When we feel bad, they help us feel better, that’s why we use them, and why they are so ubiquitous in our culture. We desperately want to numb out and feel something other than what feels uncomfortable and difficult in the present moment.

I remember a vivid illustration of this, I was meeting with a young woman for a clinical assessment who was seeking help after losing custody of her daughter due to safety concerns related to her substance use disorder and she desperately wanted to have her back home. She was a IV heroin user who had numerous overdoses in the few years prior to our meeting. On at least five occasions she required Narcan to save her life and despite the numerous brushes with death, continued to engage in her destructive drug use.

During our initial meeting, I asked her some standard questions, gathering basic data which included who she would like to have as her emergency contact. She became quiet for a time and finally said she did not have an emergency contact. She proceeded to share with me that when she was eight years old her mother died of a drug overdose and a few years later her father took his own life. She had very little family and the family she did have did not want her. She moved frequently and grew up without any secure attachments and no sense of belonging. Heartbreakingly, she tearfully told me that the only time she ever felt safe and like she was at “home” was when she used heroin. Her problems began long before the drug use.

Childhood trauma rewires the brain and hijacks the system. Early, chronic activation of the fight/flight system or collapse/freeze response create adaptive changes that have a lifelong impact on our health and wellbeing. Our addictions are a temporary solution to a complex problem. A desperate attempt to bring our bodies back into homeostasis and relieve our suffering.

Addiction changes brain function by providing a shortcut to the brains reward system by flooding the nucleus accumbens with dopamine. Dopamine is the neurotransmitter that is involved in the experience of pleasure. This short cut allows us to briefly circumvent the devastating effects trauma has left behind in our bodies. Addictions have a way of cutting us off from our felt experience, but there is no path to healing that does not include revisiting our wounded places and reclaiming our embodied selves. We must go through the body to heal trauma.

Learning to softly dip into sensation and into our experience in the body can feel frightening and overwhelming. This is especially true when we have used our various addictions to escape and avoid the held material in the body. But when we close ourselves off to the emotional states we find challenging and difficult, then we inadvertently close ourselves off from the rest of our human experience including joy and happiness. Life is experienced through the body and the gifts of doing this important work can lead to a deeper sense of meaning and purpose and rekindle a zest for life that we may have lost somewhere along the way.

Gentleness and kindness should always be our compass by which we are guided on this journey. Giving ourselves permission to vacillate between those old neural networks and imprints of trauma left behind and coming into the softness and safety we are learning to recreate inside ourselves in the present moment. The feelings of safety and connection we all seek can never been in found in the things we use to numb, avoid or bury within. Instead, it is on this journey back into our heart and body that offers the surest hope of coming “home” again.

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