Trauma is a common cause and symptom of substance use disorders and mental health conditions. The correlation between trauma and these disorders is so strong that the treatment of trauma has become one of the most significant advances in the field of addiction treatment. Traumatic life experiences and the way we internalize their effects can fundamentally change the way we think and behave. Trauma is a personal experience. The same experience may be considered highly traumatic to one person, but non-traumatic to another. A multifaceted set of personal beliefs, experiences, and environmental conditions determine whether we perceive experiences as traumatic or not. Trauma is also perceived as a matter of degrees. Events, like armed conflict experiences, assaults, major accidents, and sexual violence produce a significant traumatic response from most people. However, many everyday negative experiences can also cause people to experience trauma. People may suffer from unaddressed trauma without ever having experienced a single major physical event.
Trauma does not discriminate. People from all walks of life—different ages, genders, socioeconomic groups, race, ethnicity, geographic location, and sexuality—can and do experience trauma.
TYPES OF TRAUMA
There are many types of trauma that a person can experience. Some of these events would result in trauma for most all, however, there are also some experiences that may be traumatic for one person but not another.
Events that are generally considered to be traumatic for most are:
• Childhood neglect
• Emotional, physical, sexual abuse
• A family member with a mental health issue
• A family member with an alcohol or substance use disorder
• Sudden death of a loved one or separation from a loved one or family member
• Community violence
• Natural and human-driven disasters
• Poverty and discrimination
TRAUMA’S IMPACT ON SUBSTANCE USE AND MENTAL HEALTH CONDITIONS
Trauma plays a foundational role in the development of addictive behaviors and co-occurring mental health conditions because untreated traumatic events can create negative self-perceptions from which we feel the need to escape through self-medication. Whether a combat veteran unable to process her negative experiences, or a father who has not acknowledged his own childhood sexual assault and is now experiencing symptoms while raising his own child; one’s inability to address, process, and treat the impressions of negative experience can perpetuate profoundly negative and persistent thinking about one’s safety and worldview. Identifying and treating the traumatic life experiences that may trigger self-medication and mental illness is an essential part of effective treatment.
WHO SUFFERS FROM TRAUMA
Like substance use disorders and mental health conditions, anyone can suffer from trauma and it can affect everyone in different ways. Anyone can also lead a seemingly normal and productive life while suffering from undiagnosed and unaddressed trauma. Someone can be exposed to a single-related traumatic event like a car accident or endure ongoing exposure to several events starting in childhood through adulthood. Ensuring that individuals that are exposed to trauma are able to acknowledge, understand, and process their trauma is essential to good mental health.
Specialized trauma treatment at Futures is designed to help patients for whom trauma plays a major role in dual-diagnosis conditions. Patients with trauma receive all core medical, clinical, and wellness services, but with an intensified and specialized focus on trauma-specific therapies. Specialized trauma therapies include eye movement desensitization and reprocessing (EMDR), dialectical behavioral therapy, and a trauma-specific program called Seeking Safety.
Seeking Safety is an evidenced-based treatment model that treats co-occurring issues to include PTSD and substance use. Like DBT, Seeking Safety focuses on the present so they can move forward versus traditional modalities used to treat trauma where they focus on the past. The goal is to create coping skills that they can use in the present moment to create a safe space. Seeking Safety is effective in both individual and group settings.
Reduce trauma and/or substance use symptoms and increase safe coping skills in their relationships, their thinking, their behavior and emotions.
Topics covered in Seeking Safety:
• Self-Awareness in Recovery
• Red Flags / Green flags
• Compassion vs Harshness
• Skills, Drill and Coping Skills
• Asking for Help
DIALECTICAL BEHAVIOR THERAPY (DBT)
DBT is an evidence-based approach which focuses on someone developing a life worth living by learning skills and tools to deal with interpersonal issues, emotional dysregulation and stress. Effects of trauma can show up in several forms: low-self-esteem, increased depression and anxiety, substance use issues, impulsivity and self-harm, difficulty sleeping, flashbacks, guilt, shame and self-blame. DBT work maintains a treatment hierarchy of addressing: high risk behaviors to include suicidal thoughts and intent, self-harm, substance use, behavior affecting engagement with therapy and reviews current behaviors that affect the quality of life.
• DBT is an effective treatment for people who have difficulty controlling their emotions and behaviors.
• DBT aims to reduce problem behavior and increase skillful behavior.
• DBT helps people learn how to understand and value themselves and others.
Art Therapy is a counseling modality and profession based on the belief that the creative process involved in the making of art has the power to be healing, to aid in processing emotion, and to be life-enhancing. Art Therapy can achieve short-term goals which can relieve acute symptoms and provide stabilization. It can achieve intermediate goals which can support functioning and address immediate problems such as existential issues of isolation, productivity, and daily functioning. Finally, Art Therapy can be customized to meet the needs of the population.
Clinical Art Therapy at Futures is offered in a group setting and follows a curriculum designed to help patients further process some potentially difficult and/or abstract concepts as they move through their treatment. Topics include: Envisioning my addiction as a monster, Exploring how I present myself on the outside vs. what I tend to keep inside, Expressing and communicating the layers of my feelings (anger, depression, fear, guilt, etc.), Examining my “road to recovery,” and creating my “safe space,” among others.
Hypnosis is used to create a state of focused attention and increased suggestibility during which positive suggestions and guided imagery are used to help individuals deal with emotional dysregulation, symptoms of addiction (including post-acute withdrawal), and other mental health conditions to include trauma. In the hypnotic state an individual can easily make positive changes because the self-conscious mind is more open to suggestions.
EMDR is a trauma based treatment modality that focuses on opening up neurotransmitters in the brain to address past and current issues. The goals are to target past experiences, current triggers and future potential challenges. EMDR is used in the treatment of trauma, as well as those with chronic pain. EMDR is typically offered in a 1:1 setting to help promote safety of reprocessing memories, however certain EMDR principles can be brought into the group setting such as: The Four Elements which helps promote grounding when in the Fight of Flight mode, feeling anxious, dealing with stress triggers.