The title of this article may shock you, especially when you realize that I am considered a trauma expert in many circles, traveling the country educating other professionals on trauma competency, especially within the context of addiction services. But really, I mean it: trauma isn’t the problem.
Trauma, in its simplest definition, derives from the Greek word meaning wound. Trauma is a subjective human experience, colored by an individual’s perception, life experience, and healing style. My general assumption is that if an experience is wounding to a person, we should validate it as traumatic. Many people I’ve trained and professionals with whom I work get nervous when we start talking about trauma as more than just diagnosable PTSD.
As one mentioned, “Well, if we say that everything can count as a trauma, aren’t we impugning what people who go through really major stuff, like wars and genocide, experience? I mean, so much of these other things like divorce and bullying and losing a job are just life – deal with it!”
This criticism takes on a new dimension in working with substance abuse professionals, especially those who are more traditional in their orientations. There is a pervasive fear that in working on trauma, we may be giving people an excuse to keep using (e.g. “But I’m not an alcoholic, my trauma made me do it!”), or that working on trauma may destabilize a person before he or she is really ready to commit to recovery.
My answer to this sort of criticism is that the trauma itself isn’t the problem that manifests clinically. After all, there are people who go through war or get raped – things we might traditionally associate with PTSD – and are able to heal because they’ve been given the time, space, and emotional resources that they need to heal. Yet there are people who go through something that may not be so obvious, like growing up in an alcoholic home, who are seriously wounded because they’ve never been allowed to heal.
Avoid looking at the magnitude of the original trauma; rather, assess whether or not the traumatized person has been given adequate time, space, and support to heal. When a person has not been able to heal from his or her emotional wounding, then complications ensue that can affect quality of life, personality development, and emotional regulation skills. Not being allowed to heal…that is the problem. Thus, as clinicians, helpers, family members, and those working in service, we must rise to the challenge of creating the most healing environment possible for the people who seek us out for care. We must take into consideration that even a small wound that’s been left to fester can be a serious matter in need of our attention.
Addressing trauma in the addiction professions does not mean that we abandon everything we’ve learned about addiction in the last 50 years and turn addiction treatment centers into mental health clinics. I’ve sadly seen many programs go this route, and I don’t believe that the answer in working with traumatized addicts is to just treat the trauma. Even if there may be a strong traumatic etiology contributing to the manifestation of chemical or behavioral addiction, the basics of lifestyle change that we cover in initial addiction treatment must be communicated on some level before cathartic-level trauma work can happen. However, these initial addiction treatment interventions can be delivered in a more trauma-sensitive way.
I address many strategies for how we can deliver these services more trauma-competently in my 2012 book, Trauma and the Twelve Steps: A Complete Guide to Enhancing Recovery. For the purposes of this article, I will sum it up as such: incorporating the body into initial addiction treatment is imperative. Initial addiction treatment traditionally does a fabulous job of helping recovery individuals work on spiritual and cognitive components of the disease, yet many programs continue to ignore the importance of the body. Instead of sitting around in group talking about problems all day, recovering individuals are better served if some of these groups would incorporate training in breath strategies, how to recognize triggers at the somatic level (i.e. body awareness), and how to use body-based coping skills such as exercise, yoga, dance, and work with animals to manage craving and tolerate intense emotion. Many addiction treatment centers are doing a much better job with such interventions, especially in recent years, yet more work still needs to be done in order for the addiction field to truly be more trauma-competent.
Trauma is nothing to be afraid of. When the word trauma gets uttered in many addiction and even mental health treatment centers, too many professionals continue to wince, usually out of fear or misunderstanding. If that happens, go back to the word origin: trauma is a wound. Wounds come in all shapes and sizes, and not all manifest at the intensity of PTSD. At the end of the day, in treating trauma, we are simply treating human wounding, more specifically, the wounds that have festered over time without a real chance to heal. To more fully grasp this concept, I often challenge professionals to think back to the worst period of wounding that they experienced in their own lives: What did you get that really helped you to heal? What, perhaps, did you wish you would have gotten that could have helped the healing process happen more fully? Answering questions like these are a few of the key ways that we can work on better understanding our role in helping others heal.
Jamie Marich, Ph.D., LPCC-S, LICDC is the author of Trauma Made Simple; EMDR Made Simple; and Trauma and the Twelve Steps. The creator of the practice Dancing Mindfulness, Marich travels the country offering trainings and retreats on trauma, addiction, and mindfulness topics. For more information, go to www.mindfulohio.com, www.traumatwelve.com, and www.dancingmindfulness.com.