When you hear the word ‘trauma’ it is common to think of many different things. Some may imagine violence and life-threatening situations, some may picture sexual violence, others may remember emotional volatility in your household when growing up. All of these examples are common and impactful trauma histories that can drastically shape someone’s views on life and people.
Traumatic events in one’s life can alter your sense of safety, trust in other people, and basic coping. The younger you were when experiencing the trauma, the deeper the impact. A common diagnosis connected to prior experiences of trauma is Post-Traumatic Stress Disorder (PTSD). People diagnosed with this condition will experience nightmares, flashbacks, and constant guardedness in life which is called ‘hypervigilance.’ A good way to think of this is that people with PTSD will walk through life in a constant Fight-or-Flight state of being. This constantly weighs on relationships and drains away a sense of hope and safety in life. Drug use or alcoholism commonly come with this condition as a way to numb out the overwhelming and chaotic fear.
To better understand trauma, we will start by breaking this into two core types of trauma: simple trauma and complex trauma. Simple trauma refers to specific events that we commonly associate with PTSD. Examples could include a terrible car wreck, sexual assault, or armed robbery. Just because the term for this is ‘simple’ doesn’t mean this is anyway less harmful to you than complex trauma. If you have experienced a significant traumatic event in your past, a treatment approach can be designed to help your wound from this event heal into a scar.
‘Simple trauma’ therapy often involves grounding and relaxation techniques combined with what we would call the ‘narrative’ of the event. This means walking through, while in a safe physical and emotional space, the details of the traumatic event so as to package the narrative into something less triggering and disruptive. By repeatedly talking and feeling through the trauma, you become less afraid of the details of the story and feel empowered to hold the story in your mind, rather than flee away from it.
Complex trauma refers to repeated impactful events over a period of time which distort your overall sense of safety and trust in life. Examples of complex trauma would include serving a long tour of duty in the armed forces with repeated exposures to bombs and threats, being in an ongoing domestic violence relationship, or growing up in a household in which you witness your mom suffering from alcoholism and making repeated suicide attempts. Because complex trauma develops over a longer period of time than does simple trauma, the treatment cannot be as based on a specific narrative.
Complex trauma therapy will involve more of an emphasis on daily coping skills, mindfulness, and repetitive patterns within relationships. It is common that a victim of complex trauma such as domestic violence will find themselves in repeat scenarios with continued domestic violence. An emphasis on boundaries and interpersonal awareness is necessary to break free from the cycle of complex trauma.
If you feel that you have experienced either simple trauma or complex trauma in your history, this is incredibly important to address for your recovery. Relapse risk is very high if significant trauma is not dealt with. When this happens, the person often feels incredibly shameful and like a failure to themselves. It is also common that these people experience a ‘blind-sided’ relapse in that they seemed to be doing very well and then everything fell apart quickly.
The timing of addressing trauma in recovery is also important. If you are in an early stage of addiction treatment with repeated relapses, you should not explore the triggering narrative of your trauma until you can reach some basic sobriety. This is because the telling of your story often is hurtful, dysregulating, and triggering for more Fight-or-Flight responses.
Another way of thinking about this is that people who enter any form of trauma therapy often feel worse for a time before they get better. We need you to feel pretty secure in abstaining from drug use when engaging in trauma therapy such that you don’t immediately fall back into your addiction as the therapy is just starting.
There are evidence-based models of care to help you heal from trauma and addiction. One treatment program is called Seeking Safety by Lisa Najavits. This is a workbook-approach to trauma which involves healthy coping skills, boundary-setting, understanding triggers for trauma responses, and substance-refusal skills. It is commonly used by the Department of Veterans’ Affairs to help combat veterans with substance abuse and PTSD concurrently.
Another form of trauma therapy is called Eye Movement Desensitization and Reprocessing (EMDR). It involves specialized techniques in which the person will focus on past events while using bilateral stimulation approaches. These could include a light which moves back and forth or the use of touch moving from right hand to left hand. The bilateral approach is helpful in allowing the mind to hold the memories and restructure them in healthier ways.
Please review this with your provider if you feel that a structured trauma-focused program is needed for you. There are many clinicians available to you to help work through a program for healing, and an evidence-based program with good research backing it is definitely the best approach. Our curriculum at CeDAR provides an introduction to trauma healing and can help you begin your journey from an open wound towards a stable scar.