The Impact of Childhood Trauma on the Formation of Addiction

Identifying the Connection Between Trauma & Relapse

There is a strong connection between trauma and relapse in individuals recovering from substance use disorders.

Connections Between Trauma & Relapse Include:

• Triggering Traumatic Memories—Trauma can evoke distressing emotions and memories that can lead to intense cravings and the risk of turning back to self-medication as a means of escape.
• Emotional Dysregulation—Unresolved trauma can lead to heightened emotional reactivity, impulsivity, and difficulty tolerating distress. This can increase the risk of returning to substance use as a way to regulate emotions or find temporary relief.
• Self-Destructive Tendencies—Traumatic experiences can contribute to self-destructive behaviors, including substance misuse. (5) Individuals who have experienced trauma may engage in self-sabotaging behaviors or have a negative self-perception, which can undermine their recovery efforts.
• Co-Occurring Mental Health Disorders—Ongoing mental health issues, such as post-traumatic stress disorder (PTSD), can increase the risk of relapse by intensifying emotional distress, impairing coping mechanisms, and increasing the desire to self-medicate.
• Coping Deficits and Lack of Effective Strategies—Trauma can disrupt the development of healthy coping mechanisms, and individuals who have experienced trauma may have limited adaptive strategies for managing stress, triggers, and cravings.

Revictimization and Environmental Factors—Individuals may find themselves in environments or relationships that reinforce trauma and increase stress levels, which can create additional triggers, increase the risk of revictimization, and undermine the recovery process. (6)

The Impact of Emotional Neglect on Substance Use Disorders

Emotional neglect can have a significant impact on the development of substance use disorders in individuals who may struggle to express their emotions appropriately and effectively cope with stress. This can lead to substance use to numb emotional pain or escape from the difficult feelings associated with neglect.

Low self-esteem and self-worth can lead to self-destructive or self-sabotaging substance-using behaviors to escape from negative self-perceptions. In addition, attachment difficulties, such as struggles with trust, intimacy, and forming meaningful connections, can compel a person to use substances as a way to cope with the lack of support resulting from attachment issues.

Trauma-Informed Care in Addiction Treatment Programs

Trauma-informed care recognizes and addresses the impact of trauma on individuals seeking recovery from substance use disorders. (7)

Key Components of Trauma-Informed Care Include:

• Safety and Trust—This involves ensuring physical and emotional safety, establishing clear boundaries, being sensitive to potential triggers, and fostering an atmosphere of trust and respect.
• Trauma Screening and Assessment—This is conducted to understand the impact of an individual’s traumatic experiences and to inform personalized treatment plans and trauma-specific interventions.
• Psychoeducation—Individuals are provided with education about the connections between trauma and addiction to develop a better understanding of their experiences and foster empowerment and self-awareness.
• Promoting Emotion Regulation and Coping Skills—This includes providing individuals with tools and strategies to manage unpleasant emotions, stress, triggers, and cravings without turning to substances. Skills training may involve mindfulness techniques, relaxation exercises, and healthy coping mechanisms.
• Peer Support—Peer support groups, such as 12-step programs, can provide individuals with a supportive network of peers who have experienced similar challenges. Peer support promotes empathy and a sense of belonging, which are crucial for trauma recovery.

Staff Training—Staff members must receive specialized training on trauma and its impact on individuals. This training helps staff develop the necessary skills to provide compassionate and trauma-informed care. (8)

Resolving Trauma Through Evidence-Based Therapies in Addiction Treatment

Resolving trauma is a critical aspect of addiction treatment, and evidence-based therapies have been developed to address both trauma and addiction concurrently.

Commonly Used Therapies for Trauma Include:

• Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)—This intervention is a widely recognized therapy specifically designed for those who have experienced trauma. It aims to help individuals process their traumatic experiences, develop coping skills, and challenge negative thoughts and beliefs associated with the trauma.
• Eye Movement Desensitization and Reprocessing (EMDR)—This therapy focuses on processing traumatic memories and reducing their negative impact using guided eye movements while individuals recall distressing memories.

Dialectical Behavior Therapy (DBT)—This is a comprehensive therapy that incorporates elements of cognitive-behavioral therapy with mindfulness-based techniques. DBT helps individuals develop emotion regulation skills, distress tolerance, and interpersonal effectiveness.