Numbing out. Taking the edge off. Feeling no pain. There is a reason that so many references to substance misuse demonstrate a desire to change a painful or uncomfortable experience: it works. And many of those who struggle with addiction are proof of that, especially if trauma has been a contributing factor.
People with addiction often medicate trauma symptoms.
We have come to understand something important about trauma and the impact it has on us. Trauma isn’t so much about what occurred – trauma is more about how our nervous system responded to that event or experience. It is also about how our nervous system keeps responding, even years after something overwhelming happened.
When we experience the threat of a traumatic situation, our nervous system activates our threat response system (often referred to as our fight or flight response). Trauma rattles most aspects of who we are: our physical bodies, our emotions, our thought processes, and our connections with other people. And these impacts are often felt long after the event has passed.
Even if we were too young to remember the trauma, our nervous system still remembers.
Trauma and adverse experiences can trigger excessive fear or anxiety long after the original threat of the trauma is over. It can lead to overwhelming anger, shame or other painful emotions. Trauma activates our nervous system so that we become more “on guard” or have difficulty sleeping. Overwhelming events can also create intrusive thoughts and disturbing memories. It is these symptoms (and many others) that motivate people to use alcohol and drugs in an attempt to medicate these painful symptoms that continue following a trauma.
The Connection Between Trauma and Addiction
One of the best studies to highlight the impacts that unresolved trauma has on substance misuse and addiction is the Adverse Childhood Experiences Study (ACE Study). This groundbreaking study shows that the effects of a wide variety of traumatic experiences are cumulative and they can lead to significant adverse outcomes, including mental health issues and substance misuse.
The ACE Study shows that substance misuse, as well as other compulsive behaviours, can become a way of managing the overwhelming experiences of childhood trauma and adverse experiences. (See more about the ACE Study here) If you experienced painful childhood experiences and also have problems with substance misuse, you may have starting mood-altering with substances as a way of coping with symptoms related to those painful experiences.
The use of drugs and alcohol can be a very effective way of stopping intrusive memories, self-soothing, managing anxiety, shame, or anger as well as offering ways to numb out.
Two Categories of Trauma Symptoms
There are many different ways that trauma leaves it “fingerprints” on who we are and how we function. These after-effects are easier to identify if we view trauma as being more about how a traumatic experience continues to impact us after the event has passed rather than just thinking about trauma as an event that occurred. And these symptoms are also easier to understand if we think about them in terms of how trauma may have rattled our nervous system.
The impacts or symptoms of trauma can be divided into two groups. One category is referred to as “hyper-arousal” – it is related to the increased activation of the fight or flight response following trauma or stress. The other category is referred to as “hypo-arousal” – it is more related to the freeze response of trauma and includes such experiences as numbing and dissociation.
1. Hyper-arousal: High Activation, Intrusive Experiences, and Fear
The term “hyper-arousal” is used to describe the high level of activation that remains in the nervous system and the physical body following a traumatic experience. It is essentially an ongoing activation of the fight or flight response even after the threat or the trauma has ended. If you continue to live in this state of high trauma activation, it alters your experience of yourself and the world around you. When this high activation of the nervous system remains following a trauma, it contributes to the development of these trauma symptoms:
Your nervous system remains on high alert: You might be more jittery or startle easily. You might be more emotionally reactive and experience greater irritability, aggressiveness, or impulsivity. Perhaps you are hypervigilant – always watchful for any sign of potential threat. Insomnia can also be a common problem if our nervous system is continually scanning for possible danger.
Physical Symptoms: When our nervous system remains on “high alert” our body also remains on high alert. Overwhelming physical sensations can continue to be experienced following a trauma – it means that the fight or flight response has remained activated long after the danger has passed. Symptoms can include tension, digestive problems, excessive sweating, and elevated heart rate.
Re-experiencing Symptoms: These intrusive experiences are the ways you continue to relive your original trauma through disturbing trauma-based flashbacks, nightmares, and intrusive images.
Emotional Reactivity: There are several painful emotions that come from unresolved trauma: heightened anxiety, fear, shame, and anger. There are all normal reactions to trauma, but if these powerful emotions create significant problems in your life, it may be a sign of unresolved trauma.
Self-Destructive Behaviours: Trauma also leads to self-destructive behaviours that can be an attempt to manage the overwhelming experience of trauma symptoms – self-harm, disordered eating, compulsive sexual activity, and substance abuse are much more common among people with a history of traumatic experiences.
2. Hypo-arousal: Avoidance, Numbing, Disconnection and Dissociation
The term “hypo-arousal” is used to describe another (and different) nervous system state that results from the high level of activation that remains in the nervous system and the physical body following a traumatic experience. Rather than a state of high activation experienced through the symptoms of hyper-arousal as listed above, the hypo-arousal symptoms show up as a state of disconnection or shutdown that results when trauma and traumatic stress become overwhelming. “Dissociation” is the clinical word that is often used to describe this state of overload.
If the hyper-arousal state is the “fight or flight” response, the hypo-arousal state is the “freeze” response.
This experience of dissociation or disconnection helps make a painful experience more tolerable in some ways. This type of reaction occurs without conscious thought – it is an instinctive response to an overwhelming experience. And it occurs, in part, as a way of protecting us from the painful experiences of trauma symptoms.
When this high level of trauma activation in the nervous system results in a “freeze” response, it contributes to the development of trauma symptoms that fall into the hypo-arousal category including:
Physical, Emotional, and Relational Experiences: There is a sense of being emotionally numb, detached, or empty. You might feel out of touch with your emotions or your body. There may be challenges with being forgetful or “spaced out”. Traumatic experiences can also create a tendency to withdraw and isolate. Unresolved trauma can make you more comfortable avoiding intimacy or connection with other people.
Behavioural Symptoms: If you learned to cope with trauma by dissociating or shutting down, you might continue to respond in a similar way when face stressful situations today. Hypo-arousal and dissociation also contribute to substance abuse and addiction – when people live in a constant state of numbness and detachment, there can be an increased desire to engage in high-risk behaviours or sensation-seeking in dramatic ways including high-risk substance abuse and behavioural addictions such as sexual acting out and excessive gambling.
Substance Misuse and the Symptoms of Trauma
Substance misuse and compulsive behaviours are common among those who have been through traumatic experiences and who continue to suffer from ongoing trauma symptoms. For those who live in a chronic state of hyper-arousal and high activation of their fight or flight response, it is no wonder they seek out options to help them shut down or numb out. For others, they use substances as a way of countering the numbness and emotional flatness they experience in the hypo-arousal state.
For those who’ve had trauma, substance use is a way to dampen the pain - the pain of constant trauma activation or the pain of living life disconnected from some of the important aspects of who they are.
Thank you for your interest in “Trauma and Addiction: The Link Can’t Be Ignored”. Stay tuned for more posts on trauma, addiction, self-regulation, mental health, and the process of recovery.
Here are all the posts in the "Trauma and Addiction: The Link Can't Be Ignored" series:
Introduction to Trauma Addiction Link
Part 1: The Problem is the Problem
Part 2: How Ignoring This Hurts Your Recovery
Part 3: Why People Abuse Substances
Part 4: Feeling No Pain