Multiple studies have long established the link between substance abuse and traumatic events in a user’s life. It’s not unusual for people to drown their sorrows in alcohol, be it the result of a bad day at work or a terrible episode in life. However, it puts the person in a vicious cycle; the more they intake abusable substances, the more miserable they’ll feel and prompt them to intake more.

In light of this, therapists understand the need to be aware of trauma and its impact on the human brain. So, they employ approaches that assure the patient’s safety, empower them to take action, and promote a sense of self-worth within them. All of these objectives fall within the scope of trauma-focused addiction treatment.

The trauma-fueled cycle

To understand how this form of treatment works, a look into trauma and how it undermines a person’s psyche is in order. In this context, the term ‘trauma’ will focus on the mental aspect more than the physical (called medical trauma). 

The American Psychological Association (APA) has a relatively simple definition for trauma: ‘an emotional response to a terrible event like an accident, rape, or natural disaster.’ A person may feel shocked or be stunned in disbelief in the immediate aftermath, with effects like terrible flashbacks and some physical ailments occurring in the long term. (1)

Not everyone manages to get over a traumatic experience altogether; such thoughts linger long enough in some people that they slowly take their toll. Chronic symptoms like insomnia, loss of concentration, and muscle pain warrant the expertise of treatment centers, like HEAL Behavioral Health and others, to help them cope and change.

However, access to adequate care has been a long-standing issue, at least in the U.S. In a recent study of over 50,000 adults, more than a tenth said they don’t have or know any viable source of mental health care in their area. The rest of the respondents that have access refuse or are hesitant to get help, mainly because they worry that they can’t afford it. (2)

As a result, most people resort to self-medication, a term psychology experts use to refer to acts like ‘drowning one’s sorrows in alcohol.’ The problem with this is that people whose abrupt turns in their lives rendered them gloomy will drink alcohol, which is a depressant, to their heart’s content. More alcohol may result in more endorphins released, but it’ll lead to an unhealthy dependence.

As mentioned at the beginning of this piece, the result is a vicious cycle—and the human body is the biggest loser. Studies have linked alcohol misuse and abuse to more than 200 known diseases and health conditions––ranging from high blood pressure to various types of cancer. All this and the affected individual won’t feel any closer to getting any better emotionally.

Recover, not relive

Trauma-focused addiction treatment goes by several names, although the Substance Abuse and Mental Health Services Administration (SAMHSA) refers to it as a trauma-informed approach. Regardless of the name, it has a shared goal of understanding the events and experiences that induced trauma and restoring a person’s self-esteem and confidence using their strengths.

As SAMHSA only released its framework in 2014, trauma-focused treatment is relatively new to the scene. Any program or system that wishes to employ trauma-focused treatment must possess the following crucial assumptions:

• A basic understanding of trauma and its effects on individuals and their social circles
• Explicit recognition of the signs of trauma, not just in the person but in friends/family
• A support mechanism that utilizes all the relevant principles and ideas
• Specific measures to avoid reopening the individual’s traumatic wounds in the process. (3)

Despite its name, a trauma-informed approach to treatment doesn’t necessarily concentrate on the trauma itself. According to the Oregon State Hospital, the experience resulting from said trauma carries the most weight. Two individuals may go through the same traumatic event, but one might not necessarily consider it traumatic. (4)

A trauma-informed approach hinges on six fundamental principles. 

• Safety – Ensure the overall well-being of the individual
• Trust – Make the individual at ease during the process
• Support – Arrange peer support mechanisms for individuals
• Collaboration – Clarify the responsibilities of every member
• Empowerment – Promote recovery through a strengths-based methodology
• Culture – Devise a treatment that disregards stereotypes and prejudices. (3) 

Trauma-informed models

Since it’s relatively new, trauma-informed approaches require more studies to determine whether it’s truly effective. However, two empirically-supported models exist to date.

The first is Seeking Safety, developed by researchers at Harvard Medical School and McLean Hospital with financial backing from the National Institute on Drug Abuse. This model consists of 25 topics that discuss coping skills, though an individual doesn’t need to complete all of them. It’s flexible enough to be used in any trauma, not only the kind that involves substance use. (5)

Another model with federal support is Trauma, Addictions, Mental Health, and Recovery (TAMAR). Initially made for incarcerated females in Maryland, TAMAR has since seen extensive use in justice systems for both males and females across the U.S. The model consists of 15 modules, each with two sessions, spread across ten weeks. 

Other models use existing treatments, such as prolonged exposure therapy and trauma-specific cognitive behavioral therapy (CBT). The former may sound antithetical, given the approach’s requirement of avoiding reigniting the trauma. Still, experts say some exposure is necessary as a lack thereof will only reinforce the trauma.

Conclusion

Despite the necessity for further research, trauma-informed care is poised to take a more active role in this day and age. In a way, current psychological techniques are gradually undergoing a shift. The question therapists should ask should no longer be ‘What’s wrong?’ but ‘What happened?’ Not only can it yield better results, but it’ll also do so for a lower cost. 

Whether by alcohol or any other substance, trauma-informed treatments have a unique way of helping individuals. By empowering people to view their sources of trauma differently, these treatments can help them open their eyes to crucial realizations. For programs and systems to make the most out of this model, it must be applied to clinical and institutional perspectives.

References

1. “Trauma”, Source: https://www.apa.org/topics/trauma
2. “Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study”, Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8214217/
3. “SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach”, Source: https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf
4. “Trauma Informed Care”, Source: https://www.oregon.gov/oha/HSD/BH-Child-Family/Documents/Presentation%20-%20Trauma-Informed%20Care.pdf
5. “About Seeking Safety”, Source: https://www.treatment-innovations.org/ss-description.html