The link between trauma and addiction is much stronger and more common than many people realise. While addiction often seems like a matter of choice, for many, it begins as an attempt to escape deep emotional pain — often tied to unresolved traumas.
But, What is Trauma?
Trauma can result from many difficult situations. It can arise from experiences such as physical or emotional abuse, neglect, severe accidents, violence, or even the loss of a loved one. When we go through something traumatic, our body and mind react in ways that can affect us for a long time.
When traumas are not resolved or processed, we may end up with emotional scars that impact how we see the world and cope with challenges. When these scars aren’t treated, we may end up seeking ways to soothe the pain — and this is where addiction can come in.
What is Addiction?
Addiction is a condition where a person becomes dependent on a substance or behaviour and may feel out of control to stop it or reduce it. It involves a strong and repeated need to seek something — whether a substance (like drugs or alcohol) or a behaviour (like gambling or shopping) — to feel relief or pleasure. Even though the person knows it may cause problems, they find it hard to stop.
Contrary to popular belief, addiction is not simply a lack of willpower or just a ‘bad habit’. It is linked to changes in the brain, which adapts to the addiction and starts to ‘demand’ more of the substance or behaviour. koob et al (2023) explains that addictive drugs cause a slow and worsening disruption in the brain’s circuits that manage responses to rewards, motivation, negative emotions, self-awareness, decision-making, and cognitive control. Craving compulsion is real and one of the hardest factors to deal with in addiction.
The Connection Between Trauma and Addiction
Research shows that many individuals dealing with addiction have a history of trauma. Gabor Maté, a psychiatrist and addiction expert, explores this connection in the book Evaluating the Brain Disease Model of Addiction. He suggests that the emotional pain caused by trauma can be so intense that people might turn to substances or addictive behaviours as a quick escape, despite the negative outcomes. This is because substances like alcohol or drugs can offer an immediate sense of escape or altered reality, even though they ultimately lead to further complications.
When we go through trauma, our brain enters a ‘fight or flight’ mode which is a natural stress response. However, repeated or severe traumas can cause long-term changes in the brain. The area responsible for controlling pleasure and relief — the reward system — can become disrupted. As a result, the brain starts looking for ways to feel better, and addiction may seem like a quick fix.
This concept was first introduced by psychiatrist Edward Khantzian in 2007, as the ‘self-medication hypothesis,’ that suggests that the pursuit of relief from trauma-driven distress frequently results in addiction as we try to soothe our psychological wounds.
The Path to Recovery
The good news is that, while trauma and addiction are closely connected, this cycle can be broken. However, it’s important to treat both the trauma and the addiction at the same time. Treating only the addiction, without addressing the trauma, may lead to relapse, as the emotional root of the problem remains unresolved. A study by Back et al. (2006) found that reducing symptoms of PTSD led to a decrease in substance use. However, the reverse was not true: cutting down on substance use did not result in a significant change in PTSD symptoms. This suggests that addressing PTSD may be more effective in reducing substance use than trying to decrease substance use as a way to alleviate PTSD symptoms.
Another interesting example comes from a study by the Centers for Disease Control and Prevention (CDC), which developed the concept of Adverse Childhood Experiences (ACEs). They found that the more trauma a person faces in childhood, the higher the likelihood they will develop addictions in adulthood. This study was key in showing how important childhood is for long-term mental health.
So, How Do We Break this Cycle?
Therapy can be an effective way help people deal with their traumas and resulting addiction. Approaches such as Cognitive Behavioural Therapy (CBT), can help change negative thinking patterns, or EMDR Therapy (Eye Movement Desensitisation and Reprocessing), which helps ‘reprocess’ traumatic memories making them less painful, are some of the approaches used to resolve trauma. When these therapies are combined with addiction treatments, the chances of recovery significantly improve.
There are many approaches that can be taken to deal with addiction and trauma issues, including:
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- Understanding and Processing Trauma: Therapy provides a safe space to explore and make sense of traumatic experiences. A therapist can help you process your emotions and begin to heal from past hurts. Understanding how trauma affects you can be the first step toward recovery.
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- Developing Healthy Coping Strategies: Therapy can help you develop healthier ways to cope with your pain. Instead of turning to substances or harmful behaviours, therapy offers strategies for managing stress, emotions, and triggers providing you with choices you might not even know you have.
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- Breaking the Cycle: By addressing the root causes of addiction—often linked to unresolved trauma—therapy can help you break free from the cycle of addiction. With support, you can find new ways to cope and rebuild your life.
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- Building Support Networks: Therapists often help individuals build a network of support, whether through group therapy or connecting with community resources. This network can provide ongoing support and encouragement throughout the recovery process.
Understanding the connection between trauma and addiction is an essential step in breaking this destructive cycle. Trauma can change the way the brain functions, which, in turn, can increase the chance of developing addictions. However, with the right personalised treatment and proper support, it’s possible to overcome these challenges.
If you or someone you know is dealing with trauma or addiction, know that recovery is possible. The most important thing is to recognise this connection and seek help to treat not just the symptoms but the deep emotional causes. An experienced therapist can guide you through the ups and downs of recovery and help you rebuilt a more fulfilling life.
References
Back, S. E., Brady, K. T., Jaanimägi, U., & Jackson, J. L. (2006). Cocaine dependence and PTSD: A pilot study of symptom interplay and treatment preferences. Addictive Behaviors, 31(2), 351–354. https://doi.org/10.1016/j.addbeh.2005.05.008
Gabor Mate, Heather, N., Field, M., Moss, A. C., & Satel, S. (2022). Evaluating the brain disease model of addiction. Routledge.
Khantzian, E. J. (2007). Treating addiction as a human process. Jason Aronson.
Koob, G.F., Kandel, D.B., Baler, R.D., Volkow, N.D. (2023). Neurobiology of Addiction. In: Tasman, A., et al. Tasman’s Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-42825-9_29-
