Let’s talk addictions.

We all have them.

In his award-winning book, In the Realm of Hungry Ghosts: Close Encounters with Addiction, Dr. Gabor Maté explains the origins of addiction as being rooted in trauma and calls for a more compassionate approach toward addictions or compulsive behaviours.

At the heart of Dr. Maté’s philosophy is the belief that there’s no such thing as an addictive personality. “Addiction is not a weakness of character. It is not a failure of will. It is not an inherited brain disease.”

Instead, he says, addiction is an escape from human suffering. The ‘medication’ of choice may be alcohol, drugs or nicotine, gambling or shopping, sex or self-harming, overwork, extreme sports or computer gaming, obesity, anorexia or bulimia. “In fact, it could be anything we’ve ever craved that helped us escape emotional pain; that gave us peace of mind, a sense of control and a feeling of happiness.”

He explains addictions originate in a person’s need to solve a problem: a deep-seated problem, often from our earliest years that was to do with trauma or loss. This may include physical and emotional neglect, abandonment, violence or abuse.

The addiction or compulsive behaviour, though damaging in the medium or long term, can save a person in the short term. The primary drive is to regulate the nervous system so that we can operate in our ‘window of tolerance;’ a term coined by Dr. Dan Siegel. (Note: Sensorimotor therapist, Dr. Pat Ogden, calls this the ‘optimal arousal zone.’)

“We are all born with brains wired for happiness”, Dr. Maté argues, “but if our happiness is threatened at a deep level in childhood, we resort to addictions as a substitute for the self-soothing brain chemicals (such as endorphins and serotonin) that help make us a happy healthy human being.”

An excerpt from Bessel van der Kolk’s book, The Body Keeps the Score, goes well here: “When you have a persistent sense of heartbreak and gutwrench, the physical sensations become intolerable and we will do anything to make those feelings disappear. And that is really the origin of what happens in human pathology. People take drugs to make it disappear, and they cut themselves to make it disappear, and they starve themselves to make it disappear, and they have sex with anyone who comes along to make it disappear and once you have these horrible sensations in your body, you’ll do anything to make it go away.”

In a young child, this might look like an obsession with sugar-laden foods. But this is merely a way of regulating or soothing the nervous system. Trauma therapist, Dr. Janina Fisher backs this up: “Food is the first drug children [impacted by trauma] have access to.” Perhaps, because access to other options are not available.

Dr. Fisher goes on to state that stigma surrounding addiction is often tied into the widespread belief that addiction is a choice or a moral failing. But this is a misunderstanding of addiction. She claims this is where adoptive and foster caregivers often get it wrong.

  • Failure to understand that addictive behaviours arise not as a pleasure-seeking strategy, but as a survival strategy.
  • Failure to acknowledge the relief offered by unsafe behaviour, such as over- or under- eating, self-harming, smoking, drinking alcohol or drug use. All these behaviours release adrenalin into the body, which can help a child regulate his or her nervous system.
  • Failure to understand that the need to rely on others can be scary. As is the feeling of greater sense of safety that comes from relying on a substance or behaviour under their control.
  • Failure to understand that self-care is not a priority. The bodies role, in the trauma survivors experience, is that it is purely a vehicle for discharging tension. Its care becomes meaningless.
  • Failure to undertand that trauma-related patterns of shame and secrecy will make it impossible for a child to feel safe in disclosing the truth, especially if he or she knows the caregiver will not want to know. And so, it becomes normal to lie and evade to keep safe.
  • Becoming engaged in a struggle in which the caregiver becomes the person in favour of safety and the child for unsafe behaviour; neglecting the task of helping the child to work through strong internal opposing forces.

Dr. Maté agrees saying enhanced, sustainable treatment of addiction requires “caregivers and counsellors who get it. We need to take a less punitive and more compassionate, trauma-informed approach.” He says, “Don’t ask the question ‘why the addiction?’ but ‘why the pain?’ and ‘how does [the addictive behaviour] help?’”

© Janina Fisher

Note: Prolonged use of any of these behaviours leads to tolerance: more is needed to achieve the same result.

Dr. Fisher warns that sobriety or abstinence is not necessarily the best treatment for addicts as it will only address the addiction issue. Further, removing the ‘prop’ will cause the addict’s ‘window of tolerance’ to collapse to almost nothing. This may result in increased PTSD systems (dysregulation, impulsivity, overwhelming emotions and flashbacks); all of which predispose the addict to relapse.

Therefore, developing awareness is the bottom line: this involves tracking (and ‘noticing’) triggers and then working through traumatic memory to fully understand the role of the addictive behaviour in ‘medicating’ activation.

Dr. Fisher’s tips for caregivers:

  • Increase the ability to be mindful rather than judgmental. Mindfulness regulates arousal, wakes-up the frontal lobes, and increases self-awareness.
  • Build curiosity and compassion. This helps to regulate the nervous system and lessens the need to act out. (Experiment with reframing – “how did it help you?” and celebrate these survival resources.)
  • Become a trauma detective. Seek out connections between triggers and addictive behaviours, and gradually work at expanding the ‘optimal arousal zone.’

© Felicia Stewart, 2019