Addiction and Psychological Pain

Dr. Gabor Maté, renowned addiction expert, calls for a compassionate approach toward addiction. He believes that the source of addictions is not to be found in genes but in the early childhood environment.

During the many years I spent working in the addiction and mental health field, first as a neuroscientist and later helping empower people to facilitate their recovery (healing), I rarely heard the word ‘trauma’ being used. I would often visit addiction treatment services in the UK and very few practitioners would mention ‘trauma’. They would assume that the person presenting to them with a drug or alcohol use problem was too wrapped up in the positive effects of the substance to stop using. Or the person had a brain disease, arising from a chemical imbalance which may have a genetic influence. Or they continued to use (a) substance(s) to avoid the unpleasant effects of withdrawal.

Few practitioners mentioned that the person with the substance use problem might be self-medicating to ameliorate psychological pain. And yet in society, there were plenty of people visiting their doctor and obtaining a prescription of benzodiazepines such as librium, which are highly addictive substances, or antidepressants, which also produce problems, to help them deal with unpleasant psychological states of anxiety or depression.

When I sat down and talked to people who were on their journey to recovery from substance use problems, they would sometimes mention problems in their life that pre-dated their excessive use of substances and often were the reason they started to use the substance in question. This was particularly the case with former heroin users.

This drug is commonly used in hospitals as a painkiller—it is called diamorphine or diacetyl-morphine—and is just as effective in ameliorating psychological pain. Some of these people would mention to me that they rarely talked about their earlier problems, e.g. sexual or physical abuse, because of the shame they felt and/or because their treatment service was not a place ‘where people would understand such things’.

When I came to Australia in late-2008, I again rarely heard the word ‘trauma’ used, even by addiction treatment services. I didn’t think a great deal about this matter until I read Judy Atkinson’s book Trauma Trails: Recreating SonglinesThe Transgenerational Effects of Trauma in Indigenous Australia, which just blew me away. I didn’t just learn about trauma and how so many Aboriginal people were traumatised as a result of colonisation, but also that trauma could be passed down the generations. I learnt a whole new approach to healing.

I was particularly struck by the following statement which Judy quoted from Bringing Them Home, the report of the National Inquiry into the Separation of Aboriginal and Torres Islander Children From Their Families (1997).

The report details “multiple and profoundly disabling” layers of abuse in the lives of those affected, causing “a cycle of damage from which it is difficult to escape unaided (p. 177):

  • Separation from primary carer
  • Effects of institutionalisation
  • Repeated sexual violations
  • Psychological and emotional maltreatment
  • Loss of cultural and spiritual knowledge and identity (pp. 177—228).

The results are a profoundly hurt people living with multiple layers of distress, chronic anxiety, physical ill-health, mental distress, fears, depressions, substance abuse, and high imprisonment rates. For many, alcohol and other drugs have become treatment of choice, because there is no other treatment available. “If they hadn’t used alcohol they probably would have committed suicide…” [my bold]

I started to read everything I could about trauma, including the following classics:

Trauma and Recovery: The aftermath of violence—from domestic abuse to political terror by Judith Herman, M.D.

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk

The Boy Who Was Raised As A Dog And Other Stories From A Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love, and Healing by Bruce Perry

In the Realm of Hungry Ghosts by Gabor Maté

After reading these books and others, it was clear to me that most people presenting with a serious substance use problem have suffered some form of abuse (sexual, physical, psychological) in their earlier life, often as children. This is certainly the opinion of leading practitioners such as Gabor Maté and Bessel van der Kolk.

Which made me think: no wonder there were addiction problems amongst Aboriginal people, since they had been suffering trauma and its associated pain for generation upon generation. To me, given all this trauma, it was surprising that there was not a lot more addiction amongst Aboriginal people. Aboriginal people of Australia are clearly a resilient race.

Although I rarely heard non-Aboriginal people talk about ‘trauma’, plenty of Aboriginal people did so. There was a general feeling that there were few trauma-informed practices amongst mainstream services. Sadly, many non-Aboriginal people have said to me, in relation to Aboriginal people, ‘Why don’t they just get over it?’

Trauma is very difficult to just get over!

Gabor Maté is quite an extraordinary man, one of my favourite people. His website is well worth visiting.

Dr. Maté, renowned addiction expert, calls for a compassionate approach toward addiction, whether in ourselves or in others. Dr. Maté believes that the source of addictions is not to be found in genes but in the early childhood environment. In The Realm Of Hungry Ghosts, his most recent best-selling book, draws on cutting-edge science and real-life stories to show that all addictions originate in trauma and emotional loss.

I’ll leave you with a short film where Gabor talks about the roots of addiction. The text introduction to this film clip starts:

It is critical to understand that although addiction is a problem it is also an attempt to solve a graver problem that is, unbearable psychic pain. To understand addiction we need to understand human pain and that takes us to focus on childhood experiences. One of the outcomes of childhood distress is addiction and the more adversity an individual experiences in his or her childhood the higher their risk of resorting to addictive behaviour to sooth their pain, even temporarily…


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