What Is The Relationship Between Trauma And Addictions?
Since psychotherapy has worked with addictions, there has always been a suspicion that the experience of trauma during childhood is one of the predisposing factors to suffering from addictions as an adult.
There are many people who were sexually abused or were victims of parental neglect who, when they reach adulthood, have a severe substance abuse problem or have fallen into behavioral addictions such as gambling, sex or food.
The relationship between trauma and addictions has been especially addressed and researched over the last 20 years.reaching a few very valuable conclusions in this regard.
It has long been suspected that childhood trauma predisposes people to addictions as adults, something that has ended up being confirmed by science. Numerous studies have established a relationship between suffering traumatic experiences during childhood and presenting addictive behavior in adulthood, a topic that has been arousing the interest of the specialized community for 20 years.
One of the most notable studies that confirmed this relationship was the research by Felitti and colleagues (1998). In their work they referred to trauma as “Adverse Childhood Experiences” (AIE), defined as traumatic experiences experienced before reaching the age of 18. Among these EAIs would be physical, emotional and sexual abuse, parental neglect, loss of a parent, witnessing intimate partner violence and/or living with a family member with a mental disorder.
The work of Felitti et al. is already a classic and in it they explained that, as the number of AIS increased, the risk of consuming substances in adulthood also increased. During the more than 20 years since this work, research based on the idea of IAS has found a strong relationship between having multiple childhood traumatic experiences and developing addiction in adulthood. Whatever type of addiction the focus is on, everything indicates that the more EAI, greater risk of suffering from addiction as an adult.
Dysregulation of the stress system
Suffering traumatic experiences during childhood can impact the individual in multiple ways. The effects vary from person to person, depending on factors such as the type of trauma, duration of the traumatic experience, age at which the trauma occurred, gender, and the presence or absence of a supportive caregiver. Heredity also plays a role, with individual differences in how genetically predisposed one is to show resilience in the face of unpleasant events.
The specific impact of childhood trauma is complex and is experienced by each individual uniquely; however, yes it is possible to find a common effect in the form of deregulation of the stress system. This system is largely governed by the hypothalamic-pituitary-adrenal (HPA) axis, a set of structures whose mission is to prepare the body to respond effectively to situations experienced as threatening.
When we are presented with a danger or stressor, the HPA axis and other associated systems prepare us to carry out fight or flight behavior. To do this, different stress hormones are released, including adrenaline and glucocorticoids, which induce changes at a physiological level: blood pressure increases, heart rate increases, breathing accelerates, there is hyperactivity and, ultimately, produces a feeling of alarm.
These physiological changes also include sending blood and energy to muscles and brain areas that may be useful for fight or flight. Brain structures that can offer immediate assistance and facilitate quick and poorly thought-out actions are prioritized., unlike the slower prefrontal cortex, which controls executive functioning and self-regulation. It is automatic responses, not deeply considered ones, that help us respond quickly to a situation in which seconds can make the difference between living and dying.
The problem is that the stress system acts against us if it is constantly activated, as is the case in persistent traumatic situations in which the threat is never resolved (for example, sexual abuse for years). The individual is constantly exposed to an unpleasant situation, a prolonged childhood trauma that causes chronic stress. This ends up causing deregulation of the stress system.
If the HPA axis is constantly activated, it means that there will also be a prolonged increase in stress hormones and the accompanying neurophysiological effects. This means that children who suffer situations of abuse and other forms of trauma end up presenting very high levels of anxiety, hypervigilance, excitement and continuous alertness.
Childhood is a period of development, a few years in which the child’s body is still forming. Therefore, dysregulation of the stress system due to trauma is especially critical during childhood. This dysfunctional situation can cause extremely detrimental effects on the immune system, emotional regulation skills, cognitive development and executive functioning and, if that were not enough, it also increases the risk of suffering from neurodegenerative diseases.
Trauma at an early age can alter the regulation of the hormones oxytocin and serotonin. The first is involved in attachment and emotional intimacy, while the second influences the mood, making it more positive. An alteration in the release of these hormones during childhood translates into attachment problems and an increased risk of suffering from depression.
The core of the link between trauma and addictive disorder
The main reason people, with or without psychopathology or a history of trauma, take drugs is due to their immediate psychological effects.. When we take drugs or perform rewarding behaviors, one of the first effects we notice is that they cause us pleasure and, subsequently, reduce our discomfort. The first effect can be understood as positive reinforcement, while the second is negative reinforcement.
In search of calm
For people with a history of trauma, with dysregulated stress systems, drugs offer relief from their chronic hyperactivity and anxiety. In simpler words, they calm their nerves. Neurodepressant substances such as alcohol, opioids, benzodiazepines, and cannabis have calming effects and even have the ability to slow down the central nervous system.
Also we should talk about gambling, especially slot machines. These devices have colorful lights and striking sounds, hypnotic stimuli that induce their players into a kind of trance that helps them forget their discomfort and ignore the people around them. Gamblers, when they play, forget about everything other than the machine.
People with a history of trauma are more vulnerable to addiction because using substances and engaging in certain behaviors helps them regulate their mood. Taking drugs prevents intrusive thoughts, reduces anxiety and lowers the level of arousal. By consuming substances and engaging in certain types of addictive behaviors, they enter a state of numbness and apparent calm, a temporary state that does not solve the underlying problem that makes them feel bad.
But not all people with trauma take the same drugs or for the same reason. Many have a different reaction and, instead of hyperactivation, end up dissociating or using depersonalization strategies. This people they feel chronically numb, disconnected from reality. They may even not feel any emotion, as if they were turned off.
These people do not want to calm down, quite the opposite. They want to feel an increase in energy and alertness, to stop being in OFF mode. For this reason they would take drugs with stimulant effects, such as cocaine, amphetamines, nicotine or synthetic drugs. Furthermore, behaviors such as non-suicidal self-harm, sex and gambling can take these types of people out of states of numbness and allow them to experience sensations, although it does not help them solve the underlying problem either.
Conclusion
Thus, people with a history of trauma are more vulnerable to addiction mainly because drugs and rewarding behaviors modify mood, varying whether they are consumed to calm the nerves or to feel something. Addictive behaviors may be an individual’s best attempt to cope with the biological and neurobiological consequences of childhood trauma.whether it is hyperactivation or depersonalization.
Taking this into account, the treatment of addiction will require, first of all, knowing what effect the experience of a past trauma has had on the patient. The patient will take drugs or do rewarding behaviors to feel good, something also shared with people who are not addicted. The key issue is knowing what type of drug you consume or what addictive behavior you engage in, knowing whether you do it to reduce your anxiety or to have sensations, and relate it to the childhood traumas that have caused you, once an adult, to present this type of pathological behavior. .
