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Compassion for Survivors of Trauma – a New View of Substance Use Disorder/Addiction!

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I remember being assigned to read the book by Dr. Gabor Maté, In the Realm of Hungry Ghosts, while in graduate school and simply feeling gratitude, compassion and validation afterwards.  I never believed in the medical model of addiction that describes the symptom of addiction as a chronic disease of the brain, even suggesting a genetic component to the disease, implying that if my parent(s) had addictions, most likely I would too.  Now, don’t get me wrong, the brains of people who struggle with addiction are different, yet those changes are created as a response to the adverse childhood experiences (AKA TRAUMA) these people survived.  And if your parents suffered from addictions when you were growing up, that experience is traumatic to a child!

I’ve written before about the impact of adverse childhood experiences, especially on physical health later in life as well as addiction; however, I felt compelled to revisit it again when I learned of research that found over 96% of the study participants suffering from substance use disorders, including prescription opioids, nicotine, and cocaine, had trauma histories.  When comparing the groups based upon their drug of choice, the prescription opiate group reported more traumatic childhood experiences than the other groups and a younger age of their first adverse childhood event.  So, when you learn about the underlying dynamics associated with substance use, the thought of “Just Say No” to drugs seems crazy!

Trauma comes in many packages and I’m grateful that the new California Surgeon General (Dr. Nadine Burke Harris) is focusing on early childhood, health equity and Adverse Childhood Experiences and toxic stress as her key priorities. (For more information on the ACEs Aware initiative, visit www.ACEsAware.org.)  It is time to stop blaming the victims and participate in bringing this information forward in order to educate.  What we don’t know, we don’t know.  However, once we know better, we can do better.  With this knowledge, we can bring more empathy and compassion in our interactions with people that struggle with substances.  We can take extra steps to explain this new research to them, validating their experiences and bringing them hope that they can heal from these past traumatic experiences and release their attachment to something that is harmful to them.  We can empower them to explore various healing modalities, such as psychotherapy, neurofeedback, meditation, hypnosis, guided imagery, and expressive arts, such as yoga, writing and drawing, all of which have been shown to support post-traumatic growth.

To read more about this research, click on the box below:

ACEs and Substance Use Disorder

What will it really take to reduce drug abuse in the world?

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No, not more law enforcement efforts to reduce the production and transportation of illegal drugs.  This question has a basic economic component – as long as the demand is greater than the supply, the war on drugs will be lost.  So, how do we reduce the demand for drugs?  We must learn why people turn to drugs in the first place and we must stop buying into the belief that drug addiction is a disease and one that affects only the weak!

I have always felt that more compassion and understanding were needed for people who found themselves addicted to drugs or alcohol, not punishment, and yet, I wasn’t aware of the research that might support my feelings.  Then I read Dr. Gabor Maté’s book In the Realm of Hungry Ghosts: Close Encounters With Addiction, and I felt so validated in my view of this deeply concerning human experience.  This book opened my eyes and my heart to the underlying reasons that someone might turn to substances to soothe a painful internal landscape.  What Dr. Maté highlights is that addiction is a normal, natural response to emotional loss which is traumatizing to the human spirit. In other words, addiction soothes the pain of trauma.  So, drugs work – even if only to temporarily separate, or dissociate from the internal emotional pain of our traumatizing experiences.  And sometimes drugs may be the only reliable source of comfort that is available.  Sad, but true and I know many people find this fact hard to believe, especially when they have not walked in the shoes of the people they judge.  Then, when it happens in our own families, it becomes even harder to accept because we must take some accountability and responsibility for the depth of the pain that our loved ones feel.

Now, not all individuals that experience early childhood trauma will turn to drugs, so further research is needed to better understand the relationship between adverse childhood events and dissociation through addiction to manage overwhelming, painful emotions.  What some more recent research has shown is that there is another factor to consider in the equation, alexithymia.  A normal part of our development as children is learning how to understand and express emotions in order to regulate our emotional environment and we learn this by observing and exchanging emotions with our caregivers.  However, when children experience developmental trauma this lesson is impossible to learn, impairing our ability to deal with our emotional experiences and alexithymia develops, which is simply the difficulty to identify, describe, and feel our emotional states.

Early research suggested that men may experience alexithymia more than women, possibly due to the underlying beliefs found in a patriarchal societal culture that values logic and reason over intuition and emotion.  However, with the emerging research that is looking at the association between trauma, alexithymia and dissociation in the role of addiction, it appears that trauma disrupts the ability to process emotions in both genders equally.  Patriarchy only adds another layer of complexity, as this culture informs men – and thus women trying to succeed in a man’s world – that emotions are not valued and reflect some weakness in character.

These research findings bring much awareness to how the human spirit needs emotional connection with others who can nurture both our rational and intuitive intelligence, both our ability to feel and to understand our emotions, and ultimately express our emotions so that our actions can be guided, and not driven by them.  I found this research quite calming to my own spirit, not only because it validated my personal experience but because it validates a new approach to healing addiction, one that comes from a place of compassion and great appreciation for the resiliency of the human spirit instead of through further traumatization supported by the current, failing war on drugs.  This new approach is growing from a broader and deeper understanding of what is considered developmental trauma, which I will write more about in my next Talk Therapy reflection, and the need to help people put words to their powerful, sometimes overwhelming, emotional experiences of the past in order to face the pain and fear head on, because if you can’t feel it, you can’t heal it.

We all can make a difference in reducing the demand for drugs and decrease the incidence of addiction.  My recommendation in doing so is to look into the research that supports that addiction is a symptom, not a disease.  From this deeper understanding, embrace the idea that we are all born with emotions and emotions are a significant part of our intelligence.  Once there, commit to being a better role model to the people in your life by openly expressing your emotions and not just the “positive” ones – all of them, including disappointment, rage, guilt, shame – as all emotions are vital parts of our wholeness and well-being.

If you want to take the first step on the path of deeper understanding of addiction, click on the link below to read a recent study that explores the relationship between developmental trauma, dissociation, and alexithymia:

Addiction Predictions: Trauma, Alexithymia, and Dissociation

Yoga helps improve mental health at any age!

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For my 40th birthday, I ventured to a spa in the Catskills of NY with a dear friend of mine for a long weekend to relax and celebrate this milestone in my life. Little did I know at the time how much this trip would change my life!

I decided to keep an open mind and try every class they offered along with the ‘vegetarian’ food being served while restricting my intake of salt, sugar, and caffeine. There were no TVs or radios in the rooms and it was before ‘smart phones’ so we were pretty cut off from the rest of the world, yet surrounded by so much of Mother Nature calling us to connect with her beauty.

Now as I reflect back, I find myself smiling because it felt so disorienting yet so comforting at the same time. I was at a point in my life where I spent a great deal of time at work, with very little time for me. I was most familiar with putting everyone else’s needs in front of mine, and believed that I could only ‘be done’ when everyone else was taken care of, which reinforced an unconscious belief that my value or worth came from taking care of others. I was exhausted emotionally, physically, mentally, and spiritually and didn’t even realize it! Little did my brain know how much my body craved to slow down and nurture it, instead of feeding it a constant diet of stress caused by a deep need to please others.

My mind-body connection was turned off until that weekend in NY. After trying the step-aerobics class (and creating a moat around my step from my own sweat), I found my way to my first ever yoga class. Immediately upon settling onto my mat, something shifted inside of me. I don’t necessarily remember the teacher or the poses, but I do remember FEELING and thinking that what I was experiencing seemed vaguely familiar yet foreign at the same time. When I left that class, I felt a sense of peace and somehow a bit lighter than when I walked into it, although it was NOT a power yoga class and I didn’t even break a sweat.

On the drive home from that weekend away, I was determined to find a local yoga class where I could test out if I could replicate the results of that one yoga class. I found a small one-room yoga studio one town over and when I walked in, I was amazed that it felt like ‘home’ and not any house I had ever lived in. The sense of peace and calm was palpable and irresistible. I found myself called back day after day for over two years. My felt experience in that yoga class in NY was not a one-time event!

Although initially I continued to work long hours, my addiction slowly shifted towards spending more time on my mat in those group yoga classes, where no one knew my name and no one expected anything from me. I could simply be in my own inner world while surrounded by others doing the same thing. The first specific learning I remember is that I was breathing incorrectly. I would hold my stomach in on my inhale and let my belly out on my exhale. No wonder my mind and body were in a constant battle! As I learned to synchronize my breath with the movement of my body, I was able to start to notice sensations in my body, be guided by them to avoid any physical pain, and begin to trust the emotional intelligence of my body.

And that was where I came face-to-face with my anxiety. It was in that safe, sacred space in those group yoga classes where I realized how my mind worked very hard to distract me from the wisdom – and pain – that my body held, encouraging me to keep moving in order to avoid the stillness, because it was in the stillness that the underlying fears would rear their ugly heads. And yet, what I discovered was that by inviting those fears to join me on my mat, sitting with them while I breathed deeply, and asking them how they came to be, I was able to gain a new appreciation for how my fears had been serving me. As my awareness and gratitude grew, my fears began to fade. Don’t get me wrong, my fears still exist, along side of a full palette of other powerful emotions, yet they no longer control me or constrict my world. When my fear greets me now, I remember that they are trying to communicate something to me, so I create time and space for them, honoring their protective nature.

That trip to NY was many years ago, before much of the clinical research to demonstrate the benefits of yoga was conducted, but my personal experience hooked me from that very first class. Now it seems new research is being published every month from around the world supporting the claims that yoga is not only a viable treatment for physical and mental health challenges but also a way to prevent illness by integrating it into a self-care program to promote overall well-being. So, if you don’t want to take my word for it – click on the link below to check out some recent research from Japan published in the International Journal of Yoga that suggests that yoga reduces anxiety, improving mental health, at any age!

Recent research from Japan