What’s Addiction Got to do with PTSD

Q & A

Question: When someone says they are addicted to some substance, etc, or that they feel out of their body, is that the same thing as PTSD?

Paul: Addictions and the pain underneath them are almost always related to some kind of PTSD, in other words, an emotional wound or a past life-threatening experience. Some may think they their life was just fine until they got addicted, or that their addictions are purely genetic or physiological. I suspect that is someone who does not yet realize the significance of what has happened to them.

An addiction serves as a short-term remedy for pain, emotional or physical. The addictive substance or process takes a person out of their body to some extent, which reduces the pain. Usually that is not some dramatic “out of the body” experience, but simply not being as present in the body, removed a few steps away from their experience of the pain.  In common language, the person is “stoned”, or “out of it”, meaning they are not responsive as much as usual to their external environment.

Question: Is PTSD, with its dramatic and severe symptoms, an entity of its own? Are not addictions part of this spectrum of PTSD?  I was talking with someone who had an addiction, and I told them I had PTSD symptoms, and they said that they are the same thing taking drugs to not deal with it vs. the PTSD symptoms of dissociation, freeze, etc, and I really was not sure of the answer.

Paul: In severe cases of trauma, various kinds of psychological dissociation may occur which allow the mind to distance itself from the overwhelming fear or pain. The most severe forms of dissociation include amnesia and multiple personality disorder. Considerably more common forms of dissociation include a lack of focus, difficulty experiencing intimacy, and minimal awareness of emotions or sensations in the body. These happen spontaneously, meaning that the person didn’t make a decision to withdraw or avoid facing their issues. Their nervous system just did it, because of the overwhelm.

With addiction, a person discovers that some substance or process does something similar for them, i.e. distances them from their pain, so they are naturally attracted to use and re-use that. When they have symptoms of unresolved trauma, they tend to be instinctively drawn to a substance or process which offers relief, however temporary. If they feel down, they want to come up (uppers). If they feel up (anxiety), they want to come down (alcohol & others). If they feel numb, rigid, or inhibited, they are drawn to something that lets them feel more alive in their body (e.g. addictive sex). All of these are merely temporary solutions, and many cause harm in the long run, but they do offer some relief from the pain.

Sometimes it seems that the medical establishment does not fully grasp the connection between addiction and PTSD, though many health practitioners certainly do. PTSD occurs in all gradations and variations, but the “official” medical definition focuses only on the most severe afflictions and symptoms. For example, someone who is depressed several years after losing their mate might not have severe enough symptoms to qualify for an official medical diagnosis of PTSD.  However, their prolonged lethargy and depression years later began with that loss and its effect on their physiology. It is useful to the healing process to see the connections between the overwhelming experiences one has had and the symptoms they developed.

I believe our society does not fully grasp how easily scarred children are, how much real cruelty routinely occurs in the upbringing of very many children, and how much more support, tenderness and love we all need at any age, lest we be damaged in our abilities to function. If society were to see this clearly, without denial, then it would be forced to change to reorganize along entirely different lines and values.  Society as a whole is not yet ready to do that, so there is a failure to recognize these connections, a denial which supports the status quo. A belief system is built upon the assumptions, however false, that our culture provides well for its citizens and that PTSD, depression, neuroses, and unhappiness are mere anomalies to be explained away without seeing the whole pattern.

When it comes to recovery from addiction, of course, recovery work, such as rehab and 12-step work, play important roles. But if one wants to avoid relapse, they dare not neglect the “inner work”, the deeper process of introspection which takes patience, courage, and often professional support. The real solution, in my opinion, is to do this work with an approach such as Somatic Experiencing, to address the way the nervous system has gotten out of balance, dys-regulated, and thereby less resilient to present-day life. If this work is done, the pull of the addiction is considerably lessened.

Not everyone with trauma becomes an addict, but most people with trauma have learned some strategy of distancing from the pain, a strategy which diminishes the potential or quality of their life. Such a person wanting to heal can ask “how am I avoiding being fully present to myself, to my life, to my body, to my pain?  Am I willing to quit doing that?”.

It can seem scary to turn around and face what we have run from, but the rewards are huge  getting your life and your joy back!

Your comments, questions, and stories are welcome below. I will respond.

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Paul Chubbuck is a practicing psychotherapist in Fort Collins, CO, using Somatic Experiencing to help people release trauma, abuse, and loss. He may be reached at 970-493-2958 or through his website at www.releasingthepast.com.

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