5 Misconceptions About Treating Trauma in Drug Rehab
#1 Only a small number of people with addiction also need to address trauma.
Fact: Studies show a strong correlation between trauma and addiction: trauma increases the risk of substance abuse, and substance abuse makes it more likely people will put themselves in a risky situation that leads to trauma, such as drunk driving. In fact, two-thirds of people seeking treatment for substance abuse report having experienced at least one traumatic event. Among men with post-traumatic stress disorder (PTSD), alcohol abuse is the most common co-occurring disorder. For women with PTSD, alcohol abuse follows right behind depression and anxiety.
Some people find that alcohol and drug abuse (as well as behavioral addictions like gambling and sex) temporarily numb the feelings of anxiety, fear and helplessness that can result from trauma. Although it inevitably backfires, drug use can be a type of survival mechanism, a way to feel better when the stress feels unmanageable. Research shows the best way to develop healthier coping skills and stay sober is to work through the addiction and underlying causes such as trauma at the same time.
#2 I haven’t experienced anything like combat or abuse so I don’t have trauma.
Fact: When people think of trauma, they often think of war, natural disaster, abuse, rape or torture. While those experiences are undoubtedly traumatic, there are many others that can cause trauma as well. Whether or not you think it’s “bad enough,” any event that overwhelms your ability to cope can be traumatic. It can be one event or many. And it’s different for everyone — what’s traumatic for one person isn’t necessarily traumatic for another.
“Many experiences that people wouldn’t necessarily describe as trauma can be traumatic,” says Frank Florence, LPC, LCADC, MA, ATR-BC, a senior therapist at Park Bench drug rehab. For example, children who witness domestic violence can be as traumatized by those experiences as they would if they experienced abuse themselves. Experiences that make children feel profoundly different or insignificant or unworthy can be traumatizing, even if the child doesn’t remember a specific event. During treatment, it’s important to be open to exploring the underlying issues that fuel self-destructive behaviors like substance abuse so you can heal fully.
#3 In treatment you have to disclose every detail of your traumatic experience.
Fact: Trauma treatment has evolved from a “relive it to recover from it” method to a much gentler, more effective approach. Today, experienced trauma therapists know they don’t need to know the painful details to help someone heal. In fact, the seemingly simple act of trying to explain what happened can further violate the individual’s sense of safety, re-traumatize them and make recovery more difficult. The terrifying memories feel like they’re happening again, in the current moment, and can reactivate the “fight or flight” response in the brain.
“With clients who have experienced trauma, our focus is on establishing safety, control and trust,” says Florence. “Sometimes clients want to disclose everything about their past experiences, but in ethical trauma treatment we cannot always indulge all of the details. I let clients know ‘I’m here for you and I want to hear everything you have to say, but going over every detail isn’t going to help you right now.’”
So what is ethical trauma treatment? If you work with a trauma therapist who does anything to violate your trust — for example, pushing you too hard too fast, bringing up your trauma before you bring it up to them, or disclosing their own trauma at length — keep searching. It’s important to find the right therapist match, especially when working toward trauma recovery.
#4 Trauma therapy is just like treatment for any other mental health issue.
Fact: Traumatic memories can get stored in an area of the brain that can’t be reached by traditional talk therapy. Fortunately, there are a number of well-researched approaches that address trauma without having to talk it out.
Eye Movement Desensitization and Reprocessing (EMDR), for example, involves recalling a traumatic event while focusing on an external stimulus such as moving your eyes from side to side. Another trauma therapy, Somatic Experiencing, uses guided exploration of body sensations that arise from traumatic memories. Using these approaches, clients are able to enhance self-awareness, develop new insights and regulate their responses.
People recovering from trauma may also find healing in creative therapies such as music or art therapy, journaling or psychodramatic role-play that don’t require them to verbalize their story but allow for gentle awareness and processing. Relaxation and centering techniques such as meditation and yoga also can reduce anxiety, improve your ability to manage your feelings, and help reconnect mind and body. Since each individual is unique, deciding which therapies are appropriate should be a collaborative effort between therapist and patient.
#5 After a stay in drug rehab, I’ll be free from addiction and trauma issues.
Fact: Like other chronic illnesses, there is no quick cure for addiction or a mental health issue like trauma. But these conditions can be successfully treated and managed.
In his first session with a client, Florence makes it clear that addiction and trauma recovery is a slow process. For some, it takes years. “The only way to heal is to go through the pain with trust, compassion, safety and guidance,” he says. “Many clients cope by avoiding disclosing these traumatic events. This maladaptive coping skill often leads to relapse.”
He works with clients to develop a discharge plan that may include outpatient substance abuse treatment and ongoing trauma therapy. “I let clients know I’m not the therapist they’ll finish this work with,” he says. “It’ll get better, but recovery requires ongoing care.”
Change is possible. If difficult experiences have changed your life for the worse, know that treatment can change your life for the better, especially if you’re willing to delve under the surface and gently, compassionately face whatever it is you find there.
By Meghan Vivo