Trauma, Addiction, and Dissociation

Addiction and Trauma Connection

According to the self-medication hypothesis of substance abuse, many people develop addiction problems in an attempt to manage the distress associated with the effects of trauma exposure and to alleviate traumatic stress symptoms.

Signs and Symptoms of Addiction

• Using more of the substance than intended or over a long period of time.
• Having difficulty cutting down on using or quitting.
• Experiencing strong cravings to use the substance.
• Using the substance to the point that it interferes with home, school, or work responsibilities.
• Regularly using the substance despite interpersonal difficulties that are caused or worsened by the substance.
• Habitually using the substance in dangerous situations, for example, driving a vehicle.
• Requiring more and more of the substance to feel the desired effects or feeling less of a 'high' when using the same amount (tolerance).
• Experiencing withdrawal symptoms when stopping use of the substance, or continuing use of the substance to avoid withdrawal symptoms.
• Abandoning significant activities or hobbies in favor of using the substance.

If this sounds like you, I can help. With nearly 10 years of experience as an addiction counselor in clinical settings, I can teach you how to manage your cravings and learn alternative coping strategies. I also utilize an EMDR protocol known as DeTur, devised by Popky, which can help to desensitize the triggers that often lead to substance use. Additionally, I employ Dr. Robert Miller's Feeling State Addiction Protocol to break the fixation between feeling and behavior.

Trauma-Informed Care

Trauma-Informed Care/Practice is a strengths-based framework founded on five core principles:

• Safety
• Trustworthiness
• Choice
• Collaboration
• Empowerment – as well as respect to diversity

As a trauma-informed counselor, I take every precaution to do no harm or to re-traumatize the person with whom I am working. I see the survivor of trauma as a unique person who has experienced extremely abnormal situations and has managed as best they could.

Dissociation

EMDR can be useful for treating dissociative disorders. Dissociation is a healthy adaptive defense used almost universally by people in response to overwhelming stress or life-threatening danger. However, most people experience mild dissociative symptoms at times when their lives are not in immediate danger.

Dissociation can be viewed as running along a continuum; such as losing track of time when you're immersed in a good novel to avoiding distress completely by not letting anyone or anything affect you or cause you to feel your feelings.

A questionnaire is usually given at the start of therapy to screen for dissociative disorders. People with dissociative disorders don't feel integrated but instead feel somewhat fragmented because they have memories, feelings, thoughts, and behaviors that are experienced as uncharacteristic and foreign.

These divided senses of self and response patterns are called dissociative parts of the personality. People who have suffered trauma, especially when it occurs in childhood, are more likely to experience high levels of dissociation.

EMDR can be used to effectively integrate the parts of the self. However, when processing traumatic memories in a dissociative person, a good deal of preparation needs to take place in order to manage the dissociation and stabilize the person beforehand.

Ego state therapy using EMDR can be useful to improve a sense of inner connectedness so that ego states are working together instead of against each other in conflict.