This pamphlet introduces the concepts of psychological trauma and loss as they relate to chemical dependency. The pamphlet number is:
I-A
This material is for TRT participants. It also provides family members and friends information about the TRT program so that their support for the participant may be enhanced. The TRT Educational Program, including this material, is not intended for general interest reading. It is not a solicitation to engage in TRT. Neither is it authorization to provide TRT to anyone. TRT is authorized for use only under the supervision and facilitation of a Certified TRT Counselor. The authors of TRT, and or their designates, are the TRT certifying authority.
A Physical Basis for Chemical Dependency?
Recent research suggests the most important contributing factor in chemical dependency is an individual’s physical rather than psychological makeup[1]. In our experience, however, most people affected by chemical dependency view the difficult aspects of their experiences as having psychological origins. As an example, we hear from both chemically dependent people and their family members about psychological problems that they believe caused an increase in stress which led to increases in the amounts of alcohol or other drugs consumed. A lessening of control seems to have followed. The conclusions, then, are that personality deficiencies originating in childhood (psychological dependency and / or compulsive behavior disorder) directed the chemically dependent person toward alcoholism.
In contrast, we have found that as the serious problems resulting from chemical use are aleviated, the clients’ perspectives change dramatically. Most discover that drinking or drug difficulties in some form began much earlier than originally thought. In this light, psychological stress seems to be one of the ramifications of drug use. The more obvious psychological problems previously thought of as the originators of the chemical use problem, begin to be seen as the effect rather than the cause.
To understand more clearly how individual and family views become distorted by drug use, we’ve had to look at the way in which different people adjust to, and then attempt to protect themselves from, the chemical use experience. At the heart of this protection process has been the natural need to defend against trauma and loss.
Loss
The example of loss with which most of us are familiar is the death of a loved one. Such an experience clearly affects us deeply. Grieving is necessary and often lengthy until the loss becomes integrated into our continuing lives (Kubler-Ross, 1969). We experience similar profound grief at the ending of a marriage or the loss of a home or a valued job (Ramsey, 1981, Colgrove, Bloomfield and Williams, 1981).
The loss that results from chemical dependency is not always so obvious, yet it is there. For example, a person who repeatedly becomes drunk and then acts in ways completely contrary to the way that he (or she) believes he is supposed to behave loses considerable self-esteem and self-worth (Collins, Carson, 1985). The emotions that accompany these losses are usually ones of disbelief, anger, shame, guilt, sadness and hurt -the same feelings that accompany the loss of a loved one through death. However, because nothing tangible is lost, few people understand that the grief process is even present. Consequently, the assistance of others that is so important in helping us overcome the death of a loved one is not provided. The person grieves alone, pressing the grief inside, where it stays unresolved.
The spouse, child or parent of the chemical user also suffers inner losses. The behaviors of the user contradict their values as well. Losses of self-esteem and self-worth affect the spouse individually, while losses of trust in and respect for the partner affect the relationship. Children lose their parent as a role model. Parents of chemically dependent children seem to lose the child they raised even while he or she is still with them.
Trauma
When loss occurs in a way that is expected, or easily understood in terms of natural change, the experience is one that is susceptible to natural resolution through grief. For example, if a loved one dies after a long and fruitful existence, the loss is grieved and eventually accepted as essential to the process of all life. The death is seen and experienced as part of the natural order of things. The same is true of growth from one career to another or the orderly changing of homes resulting from different needs. They are seen and experienced as natural steps in life. However, when the change is radical, unanticipated, and without natural order or appropriate consent the death of a child, the abrupt loss of a valued job, or the burning down of one’s home – the loss is not seen or experienced as a part of the natural order. When such a loss occurs to the foundations of individual reality, the experience becomes psychological trauma.
Chemical Dependency, Trauma and Loss
Life with chemical dependency, whether you are in the role of the addicted person or a family member, is full of radical and unpredictable changes. Seldom do these experiences fit our expectations of “natural life.” Aside from the changes in personality due to the effects of the chemical, drug or alcohol dependency periodically produces even more bizarre events: family violence, sexual assault, suicide attempts, infidelity and deteriorating physical condition. These events contradict the values and beliefs of what “should be” that are held by both the chemically dependent person and those with whom he or she is involved. As these contradictions multiply, additional losses of self-esteem, self-worth, trust, security, innocence, and often even the sense of being a person are internalized. The experience becomes one of shock, terror, shame, guilt and loss of control – the hallmarks of trauma. Paralysis of otherwise normal psychological processes is the result.
Consequences of Trauma: Survival
The problem with psychological trauma, and therefore the reason that it should be resolved, is that it has a tendency to continue itself without the person’s permission, The shock of the experience helps to repress any further emotional response. As the loss and pain are internalized, the surviving part of the individual, stimulated by the protective aspects of shock, rises out of the psych’s state of dislocation to take control. If the emotions inside are not given an opportunity for expression, then the person will function as simply trying to survive. This mode of functioning often continues long after the original trauma-causing events are forgotten.
Regrettably, there is an even sadder aspect to the trauma’s endeavors to continue itself. The predominant protective survival method used by the trauma victim is formulation of a new and inaccurate belief that he or she is to blame for the original trauma-causing events. As a result, alcoholics believe they are bad or evil people when in reality they have different brain chemistries that do not adapt to drug use the same way that other peoples’ chemistries adapt (Franklin, 1987). Spouses, children and parents of a chemically dependent person, on the one hand agree with the moral “evil” or “bad” view of the drug addicted person, and on the other hand believe they, themselves, are responsible for that person’s drug or alcohol use. Through these inappropriate assumptions of responsibility and projection through blame, almost everyone involved distorts the chemical use history. At the heart of these survival spawned distorting beliefs is the conviction that if the focus can be changed from the drinking or drug use onto other problems, then the trauma-causing events, and thus trauma itself, can be denied. The result is the trauma’s perpetuation of itself- a retention of the emotional pain that comprises its existence.
If the trauma is left unreconciled, such a system of distorted thought will grow until it dominates almost all of the individual’s perceptions as well as his or her interactions with others. In moderate cases, the distortions and subsequent affected interactions are manifested by[2] rigid and ineffective communication methods, intra-family and social isolation, increasing paranoia, dichotomous thoughts and behaviors that have contradicting purposes and counteracting outcomes, and obsessive – compulsive behavior that naturally tries to control the abuse resulting from the addiction. In more severe cases, the distortions and resulting interactions are manifested by narcissism, violence, criminal behavior, and sociopathology ,(the appearance of not caring about anyone except one’s self). We identify this condition of distortion and its accompanying behavioral responses, for both the user and family member, as a natural, predictable and expected post- traumatic stress response to psychoactive drug use.
Trauma Resolution Therapy
The purpose of TRT when applied to people affected by chemical dependency is to resolve the trauma underlying the post-traumatic stress experience- thus ending the trauma’s effects. To accomplish this task, TRT uses a specially structured process of writing and individual/group therapy to assist those who have been hurt in understanding exactly what has happened to them. Through this understanding, they simultaneously regain clear and undistorted perceptions of themselves that were lost as a result of the trauma. As the clearer perceptions become available, the person regains his or her natural problem solving (coping) capacities that were also lost in response to the trauma.
Time and Loss
A special note about time and loss. Our experience has shown that it really doesn’t matter when the trauma occurred. Time alone does not heal all wounds; time does not erase loss if that loss is left unresolved. People have a tendency to believe that if the emotional pain from the past event has not gone away after substantial time has passed, something must have been wrong with them in the first place. This is not true. What is true is that the trauma will naturally remain in any individual’s life, regardless of that individual’s personal strengths, and continue to cause emotional pain until the specific losses resulting from that trauma have been reconciled.
“It Wasn’t That Bad”
When Chemically dependent people and/or their family members enter TRT, they often hold the view that the trauma causing experiences “were not that bad.” We consider this view to be a natural (as well as universal) response to painful feelings and loss. Under circumstances of trauma, remaining strong, tough and even stoic are not only necessary to defend against the hurt, but they are also necessary in continuing with everyday life management processes. The TRT process respects these defenses and encourages you to continue to use them if they have helped you in your day to day life. We are sure that being strong is an especially valuable trait for those of you who are still exposed to drug induced behaviors of an actively using chemically dependent person.
In TRT, however, we believe that you also should be allowed to resolve feelings of hurt and loss. In this regard, viewing any trauma to which you were exposed as the hurting experience that it truly is, is not only acceptable, but also encouraged.
Appendix
Chemical Dependency: Is Its Origin Physical or Psychological?
In a pulitzer prize winning series of articles (1987), Jon Franklin, reviews research on the bio-chemistry of behavior. He concludes that many problem causing behaviors, including those stemming from chemical dependency, result from different brain chemistries. Additional research (1986, National Institute for Alcoholism and Alcohol Abuse) has determined that when certain neurotransmitters become soluble in alcohol, they result in different behavioral responses depending on genetic coding. The behavioral responses to the neurotransmitter’s soluble states range from passive to very violent activities. Studies of neurochemistry and psychoactive substances (1987), shows the internal cellular changes undergone in response to brain cells in alcohol solution. The changes reflected are of damage to the brain chemical production facility responsible for emotion. In other words, alcohol use, whether by addicted or non addicted people, results in depletion of the person’s physical ability to experience feelings -thus altering important aspects of personality.
Genetic Factors in Chemical Dependency
It also appears that some people are predisposed by their genes to suffer from chemical dependency long before they venture to take their first drink or in other ways consume their first drug. Dr. Donald Goodwyn’s study of genetic factors in alcoholism (1976) followed the lives of identical twins separated at birth. The research found that children born of alcoholic parents – then separated from those parents at birth and raised in non alcoholic foster homes became alcoholic as readily as did the twins that remained in the alcoholic homes. In addition, the study also determined that those born of alcoholic parents, had 4 times the probability of becoming alcoholic when compared to the general population, even though they were raised in the non alcoholic foster environment. In his study of three thousand Swedish adoptees, C. Robert Cloninger drew several very important conclusions about genetics and alcoholism. First, like Goodwyn, Cloninger determined that children of alcoholics were much more prone to become alcoholic, even when separated at birth from the alcoholic environment and raised in non alcoholic foster homes. He also found that alcoholism fell into two categories. One category (representing 75 of the population studied) was made up of alcoholics who, although they had serious health problems, were still able to function socially. In this group, although the alcoholism was determined to be genetically caused, it also demonstrated that the degree of functionality of the alcoholism could be influenced by socioeconomic (environmental) factors. The other category (representing 25 of the sample of alcoholics) were considered a more disturbed group and not functioning socially because they were prone to violence. In this latter sample there was no indication of any environmental effect at all. According to Cloninger, violent alcoholics were going to be that way (as long as they were drinking) regardless of where they were raised.
Psychological Predictors of Chemical Dependency?
Potential psychological predictors (personality traits) as causal factors in alcoholism have also been addressed. In a landmark (45 year) study of alcoholism by Harvard University (Vaillant, 1982), the lives of 650 people were followed from early adolescence to mid-life. The original intent of the research was to identify psychological variables which lead or contribute to alcoholism. The children (subjects for study), parents, and their families were evaluated with psychological testing and interviews prior to the onset of drug use. Follow up interviews and testing were continued until the subjects reached their mid-fifties. Dr. Vaillant reported “surprise” that no psychological variable or trait could serve as a predictor of alcoholism. In fact the research effort determined the opposite-that people with high self-esteem, positive parental relationships and / or otherwise strong coping skills, developed alcoholism just as readily as did people who had low self-esteem, poor parent bonding and weak coping capacities. In addition, the study also concluded that most of the profiles claiming that psychological dependency and compulsive behavior disorders were causal to the alcoholism were skewed by the evaluation methods. In other words, very few researchers had considered the effects of the drug use on the respondent’s perceptions of themselves or had utilized adequate testing to account for those effects. Vaillant concluded that identifying true personality variables through the effects of alcoholism is analogous to “trying to focus on the exact location of a fish that is moving below the surface of the water – the view of the fish’s actual location is deflected by factors of light and distortions in the water” (paraphrased).
Summary
Chemical dependency is physically based and results in distorted self perceptions by those who have been affected by it.
References
Genetic Aspects of Alcoholism, Donald Goodwyn, 1976, 1979, 1982
Swedish Alcoholism Studies of 3000 Adoptees. C.
Robert Cloninger, 1976-1984.
The Natural History of Alcoholism, George Vaillant, 1982, Harvard Press.
Studies on neurochemistry and the psychoactive drug influence, “Secrets of Addiction,” American Broadcasting Company, 1987.
Molecules of the Mind, John Franklin, Dell Publishing Co., 1987.
On Death and Dying, Elizabeth Kuebler Ross, 1969, How to Survive the Loss of a Love, Colgrove, Bloomfield, and Williams, 1981.
Living With Loss, Ramsey, 1981.
“Trauma Resolution Therapy (TRT); An Experiential Approach,” Collins, Carson, 1985, Chemical Dependency, Focus on the Family.