Anyone who has been caught in the vicious cycle of addiction can appreciate the term “vortex” as a description of their experience. Addiction leaves a trail of carnage in its wake – the immense damage in physical and mental health, relationships, finances, career prospects, and even one’s sense of self.
Many people who struggle with addiction are often baffled by their behaviour. An honest desire to stop harmful patterns doesn’t always lead to lasting change – no matter how strong the desire for change is.
The Vortex Model of Addiction demonstrates how circumstances and life events, as well as responses to overwhelming events, contributes to the transition into addiction. It also provides information about how our brains and bodies are wired – information that is invaluable in addressing the process of addiction.
I'm excited to share a model of trauma and addiction I have developed over my 20 years as a clinical counsellor working in this field.
Before explaining the model, it’s important to set the groundwork. Many of my previous posts have focused on the connection between trauma and addiction. My 4-part series, The Trauma & Addiction Link, explores different connections between a history of traumatic experiences and the use of substances and behaviours to self-medicate.
Research shows that someone with PTSD is four times more like to also have a problem with substance misuse than someone without PTSD.
While trauma isn't always a contributing factor for everyone with addiction, painful life experiences are known to contribute. The Adverse Childhood Experience (ACE) Study reveals a strong correlation between traumatic childhood experiences and addiction.
For anyone with a history of trauma and addiction, if these two issues are not addressed together, it leads to greater struggles for both problems.
Substance use often starts as a way of managing the overwhelming symptoms of trauma including anxiety, shame, uncomfortable physical sensation, and intrusive thoughts.
This model of addiction draws from the work of many well-known researchers and clinicians in the fields of trauma, neurobiology (how our brain functions), and neurophysiology (how our nervous system functions). Some of the work that strongly influences my understanding of trauma and addiction include:
Research including the Adverse Childhood Experiences Study by Drs. Felitti and Anda that demonstrates the powerful link between a history of childhood trauma and the development of addiction.
Somatic approaches to trauma therapy including the work of Peter Levine (Waking the Tiger) and Bessel van der Kolk (The Body Keeps the Score).
Stephen Porges’ Polyvagal Theory, a complex theory about the human nervous system, our biological responses to safety and danger.
The “Window of Tolerance” introduced by Daniel J. Siegal that describes how we function best when we’re able to remain in a zone of nervous system activation that is optimal.
Even though there is so much more to be said about the theoretical underpinnings of my model, here is a brief introduction to The Vortex Model of Addiction:
A State of Calm
As humans, we function best when most aspects of our lives are manageable, and when we can demonstrate self-regulation across all major domains of life: physical, emotional, relational, cognitive, and behavioural.
Individuals who can easily access a state of calm actively address issues in their lives. They typically take good care of themselves. They participate in meaningful relationships, social, academic, or vocational endeavours. They tend to possess a healthy repertoire of coping skills and are good at reaching out for support when they need to. In fact, supportive relationships are crucial. Bessel van der Kolk, a leading expert in trauma says this:
“Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.”
Most people who misuse substances or engage in mood-altering behaviours as a way of coping tend to find it difficult to engage in life and relationships in these healthy ways. They rarely enjoy a true sense of calm.
A Little Stress
We all know life does not remain in a blissful state of calm. Our modern lives are far too complicated for that. There are numerous sources of increased stress or anxiety: deadlines, traffic delays, minor illnesses, or a quarrel with a loved one. There are daily situations that place higher demands on our self-regulatory processes. Frustration, work pressure, excitement, and performance all require a higher output of physical, emotional, or cognitive energy. It’s important to note that not all stress or activation is negative. Delivering a speech, training for a marathon, or falling in love all increase the demands on our system but are not necessarily unwanted or unpleasant experiences.
People who are well-regulated find ways of engaging in activities that are more challenging or taxing but are not overwhelmed by these demands.
At the end of a more stressful situation, they can decompress and find a way back to a state of calm. Perhaps a good meal, connection with a loved one, exercise, or a good sleep helps “reset” their nervous system enabling them to return to a state of calm and manageability.
Overwhelmed & Shutdown
If only life remained in such general states of manageability – but it clearly doesn’t. For most who struggle with addiction, there are some aspects of their lives that have become overwhelming or unmanageable. Traumatic and stressful circumstances are painful and inevitable: accidents, illness, violence, abuse, natural disasters, death, and broken relationships are all too common in the human experience. Even when these painful situations occur, there can be healing when someone has access to the supports and resources they need to recover.
In this previous post, I discussed the two categories of trauma symptoms: hyper-arousal and hypo-arousal symptoms. The hyper-arousal category includes those symptoms where there is “too much” occurring: flashbacks, nightmares, overwhelming emotions, and physical distress. Hypo-arousal refers to experiences where there is “too little” going on – relational isolation, emotional numbness, feeling disconnected from reality, and disconnected from self. These two broad types of trauma symptoms form the basis for the next two stages of the Vortex Model: Overwhelmed and Shutdown.
The hyper-arousal symptoms include fear, anger, intrusive reminders of the trauma, and the high activation in the nervous system that remains following stressful and traumatic experiences. This ongoing activation of the fight or flight response can continue long after the threat or trauma has ended – this is what contributes to the experience of a state of chronic “overwhelmed”.
But people who have experienced trauma will also have an entirely different set of symptoms – those belonging to the hypo-arousal cluster. Rather than a state of high activation experienced through hyper-arousal, hypo-arousal shows up as a state of “shutdown” that results when trauma and traumatic stress become overwhelming, and the nervous system moves into dissociative and disconnected responses.
Patterns of harmful substance use as well as mood-altering behaviours begin to take root in these two stages, often because they serve specific purposes in helping clients manage the symptoms of trauma. This leads to the next stage …
It isn’t difficult to see what happens when people disconnect from overwhelming and painful symptoms of unresolved trauma with mood-altering substances or compulsive behaviours. It creates a fast-track into addiction and all the painful negative consequences that result from addiction: self-destruction, loss of control, loss of self, suicidal thoughts and action, substance-induced psychosis, and all the profound impacts on health, relationships, and overall functioning.
Although “Oblivion” isn’t a clinical term, it’s a good description of the detachment someone feels when addiction has taken over their lives – when they feel disconnected from themselves, others, their future, and even reality.
Summing It Up
There you have it: a quick summary of the Vortex Model of Addiction. It’s a model that helps us understand how our nervous system responds to traumatic and stressful experiences as well as the process of addiction. It also speaks to the journey of healing and the process of recovery.
In the next posts, I take a look at the Overwhelmed and the Shutdown stage in much greater detail. And the post after that will cover Oblivion. I hope you stay tuned. Feel free to sign up if you’d like to receive the updates in your inbox.