When people come to Maple Mountain Recovery seeking treatment from substance use disorder and co-occurring mental illnesses, many of them are also dealing with some level of trauma. Some have experienced a lifetime of trauma beginning in early childhood, while for others the actions caused by their addiction have left them with trauma.
“Most people with substance use disorder have some trauma associated with the substance use, because they’re not acting in accordance with their own values when they’re in the midst of the substance abuse,” says Jodi Lycett, a clinical mental health counselor and the primary therapist at Maple Mountain, a trauma-informed addiction treatment center outside Salt Lake City.
People who have been living in active addiction might feel traumatized by the ways that they have harmed themselves or their loved ones, or they may have experienced trauma while living on the streets or interacting with the criminal justice system. At the very least, many people who are getting sober are also confronting actions they took that they are deeply uncomfortable with.
“We at least have to do that much with them even if they don’t have past trauma as well,” Lycett says.
In order to help clients heal and have greater success in sobriety in both the short and long-term, counselors at Maple Mountain help clients understand trauma, its physical and psychological effects, and how it can interact with substance use disorder.
What is trauma?
Trauma has become a word that is used frequently, so it’s important to have a set definition to understand what clinicians mean by trauma.
“Trauma is an event that is so upsetting that it overwhelms a person’s mind, body and spirit so that they’re unable to make sense of it,” Lycett explains.
When someone experiences trauma, their amygdala—the primitive part of the brain that controls memory, emotions and survival instincts—becomes overactive.
“It’s like an antenna is always up and the brain is constantly looking for and perceiving threats,” Lycett says. This can trap people in a loop of anxiety, fear and vulnerability, which characterizes post-traumatic stress disorder (PTSD).
The response makes sense for people who are under constant threat — like those living in a war zone. However, for people who experienced an event and now lead a generally safe life, being constantly on edge becomes a hindrance. They are less able to focus on the future and may avoid certain situations because of their trauma response.
“That part of your brain that is searching for danger doesn’t make very good decisions,” Lycett says. “It’s that part’s job just to keep you alive, so you may not be able to focus on other things. It would be like asking a soldier in battle to make decisions about retirement, when he’s just trying to stay alive.”
How is trauma treated in the short and long term?
Although living with trauma or PSTD can be debilitating, there are ways to effectively treat trauma, including cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR) and other modalities. The goal of any treatment is to reprocess the traumatic memory in a way that makes a person able to deal with it.
“People who have experienced trauma have to work through all of those traumatic events to tell the brain to calm down. There’s a lot to refocus,” Lycett says.
Many times, the body is already trying to process trauma through nightmares or intrusive memories, but therapy allows an outlet to effectively process in a safe space.
“We try to process it through even without therapy,” Lycett says. “It’s just that usually when its something that was traumatic we’re so frightened that we try to push it away rather than letting it flow through and process. Therapy helps a person feel safe and calm enough to process their experiences that in a way that makes sense to them.”
How long it takes to complete this reprocessing depends on the individual, the traumatic event, and how long ago it occurred. However, it is possible for many people to make a full recovery.
Despite this, many people still experience “traumaversaries,” or days that are particularly hard for them each year. This might be when the event occurred, or a vulnerable day like a birthday. Even after a trauma has been addressed, these days are often accompanied by physical or psychological distress.
“For a lot of people it’s really significant,” Lycett says. “It’s a really powerful thing.”
Working in a hospital, she even saw people who would need care on the same day year after year, without realizing the pattern.
Lycett encourages clients to be aware of what dates are difficult for them, whether it is the anniversary of a loss or another significant date. At those times, accept that you might struggle, and build in a bit of extra self-care, she recommends, whether that means taking a day off work or going to an extra fellowship meeting.
“Just be aware that it’s coming,” she says.