The Problem With Treating Trauma and Addiction as Two Separate Struggles

Several months ago, I started the blog “72 Hour Hold” out of desperation to save my own life. My experience as a childhood sexual abuse victim had caught up with me. I thought I could outrun it. I was wrong.

• What is PTSD?

There seems to be a half-life for abuse — for the men I’ve been around, it explodes out of them in their 40s or 50s. I was 45.

Two years on, life has drastically improved. Thankfully. But there’s more to discover about trauma. A lot more.

If you’ve read my blog, you know I was kidnapped and sexually abused when I was 4. You can read that story here. One of the things we know about a traumatic event such as abduction and sexual abuse is that it rewires the human brain. When you’re as young as I was, mental health professionals tack on the word “developmental” to describe your condition.

That word is important because it means that the trauma affects, impacts and inflects the victim’s childhood development. It’s a disability.

Why am I sharing all this? Because the most severe effect trauma had on me was to make me believe that something was already wrong with me before that man kidnapped me. Indeed, my core belief is that he kidnapped and abused me because I was defective.

The notion of “being defective” is a difficult one to explain. That’s precisely the point, however. There is no sense-making of what happened to me, and it’s that beyond-making-sense element to the abuse that I’m trying to articulate. Trauma affected me at a cellular level. At a soul level. Everything I did and said from that day was drenched in the self-belief that I was broken. And whenever anything went wrong, or I made a mistake, I felt like it was what I deserved.

When my friend handed me a mini bottle of rum in seventh grade, I took it. Alcohol was the only thing that did anything to relieve my defective brain. For 20 years, I would use alcohol and drugs to treat my post-traumatic stress disorder (PTSD) symptoms.

And they worked beautifully. But as any addict knows, the drugs eventually turn on you. For me, at 32 years old, I simply couldn’t get drunk anymore. And the pain pills became too difficult to get (plus they made me wicked constipated). I got really depressed and ended up in rehab. Thankfully, I got sober, and getting rid of the drugs and alcohol saved my life.

Since that time, I’ve attended Alcoholics Anonymous (AA) meetings several times a week. It saved my life, and everything good in my life is because of AA. Still, living with addiction is difficult. What’s most difficult about being an addict, in my opinion, is the way addiction can turn on you in an instant. This often requires a doubling down on recovery — more meetings, more work with a sponsor, that sort of thing.

When my PTSD symptoms became severe in 2017, I doubled down on AA as I was taught to do. It was the first time AA didn’t work, and I felt the bottom drop out of my life. What’s worse, I felt defective for this. I felt like I wasn’t doing it right, that something was really wrong with me. Thankfully, I met some amazing people who had also experienced trauma, and they pointed me in the right direction.

Later, after I got into trauma therapy, I found myself in an awkward position: AA didn’t work on my trauma, and trauma therapy didn’t work on addiction. The two communities — recovery and trauma therapy — have trouble talking to each other. The recovery community’s answer to trauma: “work the program harder.” The trauma therapy’s answer to addiction: “maybe try not doing that addictive behavior? It’s clearly not working for you.” The gap between trauma and recovery leaves someone like me in a tricky, even dangerous position. Things are changing, however. I’m lucky to currently have an AA sponsor and a therapist who are both helping me. They support the work I’m doing in both places, and we talk about how the two kinds of work come together.

What I’m struggling to get at is how trauma affects everything that comes after it. And the really nasty trick is that trauma makes you think that the traumatic event is your fault, that you’re defective. And that feeling of being defective, unfortunately, is reinforced by the siloed understanding we have of trauma and addiction. It’s difficult to put your trust into a therapeutic modality that fundamentally misunderstands something so obviously connected to your condition. How can you trust an AA sponsor who is not trauma-informed? How can you trust a trauma therapist who really doesn’t understand addiction?

For me, I know my addiction comes out of my trauma. Sure, I have a genetic predisposition toward addiction, given my family tree, but my life happened the way my life happened. I was abused at 4 years old. That abuse affected everything that would come after. That abuse undermined my self-belief. That abuse made me believe I did something wrong. That abuse made me believe I was defective. Of course, I drank. Of course, I used drugs. You cannot ignore the correlation between the two. (I should say that not all addicts have experienced trauma, and not all trauma survivors experience addiction.)

Things are changing, getting better. We’re learning. But we need to treat both addiction and trauma as correlative medical problems, and we need to get those who struggle with them medical help. I’m mindful of how fortunate I’ve been to get the help I need. So many people don’t get help through no fault of their own.

We have a system that makes it impossible for many people to get the help they need. And people who have no idea what it’s like to live with trauma and addiction get to decide who gets what, and for how much, when it comes to help.

Our voices are only going to get louder.