How Trauma is Linked to Addiction and Mental Health

March 13th, 2023

By P. Casey Arrillaga, LCSW, LCDC

How Is Trauma Linked to Addiction and Mental Health?

There is an undeniable connection between trauma, addiction,
and other mental health issues, yet the nature and depth of that connection is
still poorly understood by many people. This is in part due to lack of
information, but also perhaps because not everyone understands the nature of
trauma itself and how pervasive it can be.

The Nature of Trauma

Trauma can come in many forms, some very obvious and others
more subtle. Some trauma researchers call the most obvious traumatic events
“big T” events, and smaller, less obvious events “little t” events. For
example, a horrible car crash in which someone you love dies in front of you
would be an obviously traumatic event. No one would be surprised that you would
have a long-term trauma reaction, although they might not know exactly what to
expect that reaction to be and how long it might go on. On the other hand, the
less-obvious traumas can be small, often repeated events that erode a person’s
sense of safety in the world, most destructively by chipping away at their
sense of who they are. Such repeated small hurts are the “little t” traumas.
Examples include ongoing bullying or being repeatedly told your needs don’t
matter. These events aren’t called “little” because they don’t have much
effect. They are called “little” because they fly under that radar. In
fact, sometimes the traumatic effect is exacerbated by those around them
saying, “That’s no big deal. You’re being too sensitive.” This can reinforce
the negative self-talk that is the real culprit in making the event traumatic.

In his book, “The Body Keeps the Score”, well-known trauma
researcher Bessel van der Kolk makes the point that it is our reactions and the
way we talk to ourselves afterward that create and perpetuate the trauma. For
instance, if we grow up being neglected, we may start telling themselves that
this is happening because we aren’t good enough. Because people like to be
right, we will then look for anything that confirms our beliefs and discount
anything that goes against them. Thus, anything that seems to confirm our
belief that we aren’t good enough will be given special attention, and then
over time we will take for granted that such things are our lot in life because
of our imagined flaws.

To make things worse, people often perpetuate their traumas
by unconsciously seeking out situations that remind them of the trauma, or
out-and-out replay it. This may be because we find such things familiar even if
we don’t like them, or it may be in an effort to “get it right this time.” Some
people may do this because the negative beliefs about themselves imply that
they deserve no better. Regardless of the reason, replaying the old scenes and
dynamics results in people retraumatizing themselves, and further spiraling
downward into feeling less and less worthy and thus less and less safe.

How this impacts addiction and other mental health
conditions

Research shows strong links between traumatic events and
addiction. Trauma is so prevalent in people with addictions, that many
therapists who work in the field consider addiction to be a response to trauma.
While it would be impossible to verify that everyone with an addiction was only
in this position because they suffered trauma first, it is safe to say that
most of the people in treatment have been through trauma. It even seems
reasonable to hypothesize that it is the addition of trauma that may make the
difference between someone who might recover from their addiction without
needing treatment and someone who will recover no other way.

People in addiction treatment often reveal traumas they have
never addressed sufficiently or at all. Some discover traumatic memories that
had been obscured by subconscious protective mechanisms or years of addiction.
Even if someone had no trauma from childhood, there are many traumatic events
that happen in the course of addiction, including some that are harder to
recognize, such as loss of self-esteem over and over, or the trauma that comes
from hurting loved ones.

In similar ways, trauma has been shown to exacerbate almost
any other mental health condition. The more traumatic the event and the earlier
in life it happens, the more profound the effect tends to be. For instance,
people who have experienced trauma as children are more likely to suffer from
depression, anxiety, ADHD, and are more vulnerable to less common conditions
such as bipolar and schizophrenia. Just as with addiction, this can become a
self-perpetuating cycle, as both “big T” and “little t” traumas are more likely
to occur to someone who struggles with mental health, thus creating greater
risk and worse outcomes.

What can be done?

First and foremost,
if you or a loved one has experienced trauma, seek help. This may start with
telling someone who seems safe, but our most trusted people do not always have
the skills to help heal beyond holding the space or lending an accepting ear.
As helpful a start as these things can be, there is no substitute for
professional help by a therapist who is trained and experienced in healing
trauma. There are variety of proven techniques practiced by experienced
professionals, such as CBT, EMDR, and IFS. While the many acronyms may seem
like alphabet soup at first, there are plenty of good articles written on each,
and a therapist can help explain the techniques they use in terms that are easy
to understand. If the addiction or mental health issue is causing serious
problems, the healing is best done in a treatment center where there is 24-hour
support available and there are many others who are also healing. This type of
environment becomes part of the process within itself, giving support and
encouragement so that inner freedom and outward success can be found.

About The Author

P. Casey Arrillaga is the Team Leader for Education at
Windmill Wellness Ranch, and he is the author of books including “Realistic
Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.
His books, podcast, videos, etc. can be found at CaseyAuthor.com