The following are excerpts from an article by Robert W.
For a very long time in the world of psychology, when clients manifested symptoms of trauma and sought help to understand their feelings and behaviors, they were “diagnosed” as weak-willed and inherently emotionally unhealthy. Therapists of this particular era had little to no training or understanding of trauma and its wide-ranging, long-lasting effects, so they mostly avoided the issue, providing neither resolution nor hope.
This began to change when countless Vietnam War veterans returned manifesting profound emotional, psychological, and behavioral problems (including addiction). And it wasn’t just the soldiers who identified this change; their friends and families also noticed a huge difference. Psychologists finally took a serious look at the ways in which past traumas can impact a person’s current thinking and behavior—an idea that immediately resonated with both mental health professionals and the people who’d experienced severe trauma.
Can the symptoms we see with combat veterans also manifest in the general population in response to other forms of trauma? The answer was an undeniable yes.Research has made it clear that trauma as seen in war veterans are no different, in terms of later-life manifestations, than trauma experienced by victims of sexual abuse, domestic violence, racial intolerance, homophobia, gender discrimination, violent crime, misogyny, bullying, neglect, chronic family dysfunction (including addiction and mental illness), and intimate betrayal. In 1980, the American Psychiatric Association added its first trauma-focused diagnosis, Post-Traumatic Stress Disorder (PTSD). The new diagnosis identified three primary symptoms:
- Re-experiencing trauma—in flashbacks, nightmares, and even in response to loud noises and stressful situations
- Numbed response, including depression and abuse of addictive substances and behaviors, as a way of coping with the pain of re-experiencing
- Hypervigilance, including anxiety, psychological arousal, jumpiness, overreactions, etc.
One study looking at the long-term effects of unresolved early-life trauma found that survivors are:
- 1.8 times as likely to smoke cigarettes.
- 1.9 times as likely to become obese.
- 2.4 times as likely to experience ongoing anxiety.
- 3.6 times as likely to be depressed.
- 3.6 times as likely to qualify as promiscuous.
- 7.2 times as likely to become alcoholic.
- 11.1 times as likely to become an intravenous drug use
In time, we began to look at family-wide issues wrought by global traumas, such as how addiction affects everyone close to the addict. About the impact of trauma, secrets about trauma, and shame. This is the basic idea of trauma. It happens to us and it happens to those we love. And if we don’t find a way to recognize it, call it out, and find better ways to cope with it, it will color our thinking and behavior indefinitely. Also prior to this, addiction was considered by most to be a moral failing, a lack of self-will, or a deep psychological flaw (a personality disorder), rather than an emotional illness. Part and parcel with implementation of the disease model was recognition that addicts are nearly always survivors of severe or chronic trauma. It is clear from both research and clinical observation that addictions are not about feeling good; they’re about feeling less. Addicts turn to addictive substances and behaviors not because they want to have a good time, but to self-medicate and self-regulate their emotions. Their primary goal is to escape from life and not feel stress, anxiety, depression, fear, and other forms of discomfort. And they continue to do so even as their clearly (to an external observer) out-of-control behavior creates significant problems: relationship issues, trouble at work or in school, declining physical and/or emotional health, financial turmoil, legal concerns, mood disorders, and more. Addicts cope with stress, depression, anxiety, loneliness, boredom, attachment deficits, and unresolved trauma by getting high (via a substance or behavior) instead of turning to other people who might emotionally support them. As they do this repeatedly, this choice becomes a pattern, and then an addiction.
Addicts are almost universally traumatized as children, which affects their ability to attach in healthy ways as adolescents and adults. Thus, they learn to use fantasy and dissociation via substances and behaviors for emotional regulation, rather than relying on intimate family, friends, and community for emotional support as a healthier person might. In time, they become compulsive and obsessed with this substance or behavior, using it as their primary emotional and psychological coping mechanism. Today, both the disease model and the role of trauma, especially unresolved early-life trauma,are well-accepted. The “Minnesota Model” of viewing and treating alcoholism as a disease rather than a moral failing took root. Addiction programs (heavily based on the experience of sober members of Alcoholics Anonymous) began to be developed. These treatment programs chose to view addiction as a primary disorder (rather than a symptom of some other psychological disorder) best treated with long-term abstinence and sobriety-focused social supports.