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Addiction and Trauma

by Mark Robinett, MFT

Most present day addiction therapists and researchers believe that trauma is at the root of most addictions. There are two basic types of trauma. The first is developmental trauma. This is where crucial developmental needs are not met or are thwarted so that crucial development does not happen, or happens in a skewed way. An example of where developmental needs are not met is the case where a teenage boy or girl is basically ignored and neglected with the sexual and romantic struggles of adolescence so that healthy sexual development does not happen or happens in an unhealthy direction. Some examples of thwarted developmental needs include situations where a parent is too repressive, too critical, or too encouraging of an adolescence's sexuality so that normal sexual development is interfered with and either does not happen, or happens in an unhealthy direction.

The second type of trauma is event trauma or shock trauma. One example of this kind of trauma is sexual abuse, which usually causes a state of traumatic shock within a person. This type of trauma can cause many problems - such as unhealthy sexual development, symptoms of unregulated emotions, or over stimulation of the nervous system to name a few. For example, if a person has an inner state of traumatic shock, they are usually at a great disadvantage to deal effectively with the stresses of living or the needs of healthy sexual development. This is because the trauma usually interferes dramatically with normal healthy functioning. It can in fact be disruptive in many ways to a person's physical, emotional and psychological processes. This is why an addiction may come into play - because a person tries to use the addiction to "medicate" or handle the state of traumatic shock to better deal with the challenges of life, or move on with development that needs to happen.

When a person has developmental trauma the situation is somewhat different from shock trauma, but this kind of trauma can also lead to an addiction. A person who does not have a healthy sexual development on board because of certain needs not met (or needs that were thwarted), may turn to an addiction not necessarily to try to medicate a state of traumatic shock within, but instead because their development went in an unhealthy direction and that is what they "know". The addiction in this case is an attempt to get healthy needs met, but in an unhealthy way simply because their development happened in an unhealthy way. To illustrate this I will use an example of a person addicted to masturbation with pornography. A person could get into this type of addiction because their sexual development was derailed during adolescence and they turned to this type of sex at that time, instead of moving towards beginning to be sexual with other peers during adolescence.

Either type of trauma can interfere with healthy sexual development and can lead to sexual addictions (and/or other addictions) in an attempt to cope with the trauma and its symptoms. The healing work with these two types of trauma is somewhat different. With delayed or with unhealthy development due developmental trauma, a person needs support and assistance in changing the unhealthy development into healthy development, or help in getting the development going and on track if it did not happen at all. Regular psychotherapy is usually very good in facilitating this kind of work. In the case of shock trauma, a person usually needs help in healing the trauma to their emotions, mental states and their body, and this can require psychotherapy along with a certain other kind of work that deals more directly with the trauma itself.

One type of therapy that I use in my therapy work can be effective at working with and healing a state of traumatic shock. It is called Somatic Trauma Therapy, or Hakomi Somatic Trauma Therapy. This type of work focuses directly on the state of the trauma within a person's body. It is particularly good at working with disruptions to one's physiology. The theory is that when there is a traumatic shock, a person's physiological systems that regulate normal physiological stability in addition to one's emotional and mental states have been disrupted. This style of work has the advantage of working with all three states within a person - the physiological, the emotional and the mental. Most psychotherapy works only on the emotional and mental levels and often does a very good job on healing these levels. However, when a person has a state of traumatic shock within, they often need healing work also focused on the physical/physiological level. In other words, a person who has traumatic shock might do several years of traditional psychotherapy but might still have a lot of problems due to disruptions to their physical/physiological systems which are compromised from the trauma. If this is the case, Somatic work can be effective in doing the same kind of healing work on a person's disrupted physiology as traditional therapy does for healing a person's emotions and mental states.

Another healing mode that I use for working with shock trauma is called EMDR or Eye Movement Desensitization and Reprocessing.   It is a form of psychotherapy that was developed to resolve symptoms resulting from life trauma. It works with past, present, and future aspects of trauma memories. It was developed to resolve the development of trauma-related disorders resulting from exposure to a traumatic or distressing event, such as rape or sexual abuse. Clinical trials have demonstrated EMDR's efficacy in the treatment of posttraumatic stress disorder (PTSD).  EMDR is an integrative therapy, which combines elements of cognitive behavioral and psychodynamic therapies to desensitize traumatic memories.  Recent studies have examined the effects of eye movements and have found that eye movements in EMDR decrease the vividness and/or negative emotions associated with autobiographical memories, enhance the retrieval of episodic memories, increase cognitive flexibility, and correlate with decreases in heart rate, skin conductance, and an increased finger temperature.    

A third mode of therapy that I use for treating trauma is called Internal Family Systems Theory (IFS).  This is a method for working with the different parts of a person.  In psychotherapy it can be very helpful to work with a part or several parts of a person that are wounded or cut off from the other parts.  Sometimes a tremendous amount of healing can occur as a part of a person is allowed to express itself and given empathy and assistance for its traumas.  I primarily use IFS to work with a part of a person that appears to be cut off from the rest of the person and is either in great distress and/or the cause of some dangerous or problematic behavior - such as a sexual addiction behavior.  At the center of this theory is the part called the Self, which is the spiritual center of a person.  This part can help heal other parts and help integrate all the parts into much more of a working whole.  Just learning about the Self can help a person begin to learn to integrate themselves into a much more powerful working whole as they learn to identify more and more with this part as who they really are and use it to bring other parts towards it. 

In conclusion it seems that the best combination of work in psychotherapy focuses on all three levels of healing - the physical, the emotional and the mental. Somatic work has the weakness of mostly focusing on the physical and perhaps somewhat neglecting the mental and emotional levels, whereas traditional therapy's weakness is a focus on the emotional and mental levels, while neglecting (almost completely) the physical level.  EMDR is a type of healing work that focuses primarily on trauma and can be very effective at resolving it while benefiting the physical and physiological levels.  And Internal Family Systems Theory (IFS) can work on all three levels depending on how skilled a therapist is with the model. 


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