In previous post, I’ve talked about some of the links between addiction concepts like cravings and trauma disorders like PTSD (see here). The reality is that there is a closer link between addiction and trauma that is often overlooked.

I spend a lot of time on this site covering some of the neuroscience that explains why the repeated use of addictive substances can lead to the kind of behavior that is so common in addiction. Still, most of that neuroscience ignores the portions of a person’s life that come before the actual drug use. The one exception would have to be all my writing on impulsivity, and some work on the relationship between early life stress (or trauma) and depression, which is known to be associated with drug abuse.

The way I see it, there are at least 3 distinct stages to addiction :

• What happens before drug use.
• What happens once chronic drug use begins.
• What happens once a person stops using.

Though we often like to pretend otherwise, trauma is a common part of the first stage.

How do we define trauma?

In this context, trauma is any event that affects a person in a way that can be seen to have caused a substantial, long term, psychological disturbance. The key to this way of looking at trauma is its subjective nature.

Things like divorce, bullying, rejection, or physical injury can all be considered traumatic if the subjective experience can be thought to conform to this definition. Anything counts as long as it leaves a painful emotional mark.

While we’re all pretty adapt at covering up such trauma, the emotional pain often needs to be soothed and a good way to soothe it is with drugs that make it temporarily go away. The first drink of alcohol, or hit of some other drug, will often take care of that.

The reality of early trauma and addiction

Some call the experience of covering up the pain of trauma with drugs “self-medication” (though the term also applies to other situations), some dislike the term, but I think the fact remains that often, emotional pain can begin a search that often leads to risky behaviors and drugs.

I’m nowhere near calling self-medication the only reason for drug abuse as some others do, but I think it’s an important factor and one that can’t be ignored. As the stigma of emotional pain, or emotional responding in general, is reduced, people’s ability to deal with such pain in a healthy way should lead to a reduction in seemingly helpful, but ultimately self-destructive behaviors.

One of the most useful roles of psychotherapy for addicts is in dealing with the trauma in a healthy, constructive manner. This way the shame, guilt, and other negative emotions associated with it stop guiding the person’s behavior. While this is rarely enough to stop the need for self-medication by itself, it can be a very useful part of a comprehensive treatment plan. It’s important to remember that once someone has entered the realm of chronic drug use, there are brain and body changes that can often trump whatever the reason for beginning drug use was.

The ignored reality about addiction is that it often has an origin in behavior and unfortunately, trauma is often that starting point.