Over 21 million Americans have battled with substance abuse and drug addiction over the past year and that number is rising. Since the appearance of fentanyl in the mix of various street drugs, the number of overdoses and deaths is exponentially increasing every year as a result. Whether it’s a problem with alcohol, opioids or another substance, drug abuse severely impacts millions of lives.
More than ever, the growing prevalence of addiction needs to be addressed. Let’s start by looking at some of the most common myths that have been common in our society. First, we considered addiction to be a behavioural problem, manifesting in individuals with a lack of self discipline and will power. In a sense, we saw it as a choice, assuming that an individual can just choose to stop using. Through the decades, we have progressed as a society in our understanding of what addiction actually is. To this day, many still consider it to be a disease, something one could be genetically predisposed to, an affliction you can inherit. Last but not least, many view it as a chronic mental health condition, the cause of which needs to be determined on an individual basis. Although more humane, this approach can still be misleading.
This article is to explore the point of view that addiction is not a disease or a behavioural problem, but rather a solution to a problem. That problem is unresolved trauma. More precisely, we are to explore the work of Dr Gabor Mate and his bio-psychosocial perspective on the influences of early childhood development on addiction.
Empathize, Don’t Ostracize
Dr. Gabor Mate is a retired medical doctor from Vancouver, BC. He s renowned for developing a compassionate approach towards addiction. Society has ostracized drug addicts for as long as they have existed, and the work of Dr. Mate focuses on empathy and compassion instead. This approach recognizes that trauma is the common template under addictions and it needs to be properly addressed if healing is to take place. Just think, how uncomfortable does a human need to feel in their own skin that they need to escape themselves, even at the risk of self-harm? His work lies in compassionate exploration of what drives people to take dangerous drugs, and there is almost a direct correlation between childhood trauma and addiction. A desire to escape distress and regulate one’s body and mind is what drives the repetition of the harmful behaviour.
Rather than choice, chance or genetic predetermination, it is childhood adversity that creates the susceptibility for addiction.
The Influence of Early Childhood
Humans as well as animals require nurturing from a caregiver in order to survive. Authentic and attuned emotional interactions with parents stimulate a release of natural opioids in an infant’s brain which promotes a secure attachment to the parent and positively affects further development. When a newborn or younger child does not receive consistent and secure interactions, or experiences interactions that are stressful, maldevelopment is the result. Various stressors experienced in early childhood have been shown to affect the development and functioning of different areas of the brain. Stress primarily reduces the numbers of both opiate and dopamine receptors in the brain. Healthy development of these neural systems is crucial as they are responsible for essential human drives such as love, connection, pain relief, pleasure, incentive and motivation. When circumstances do not allow the infant and young child to experience secure interactions on a consistent basis or, worse, exposure to many painfully stressing ones, trauma occurs.
Lack of Authenticity
First let's look at what trauma is. It is a misconception that for something to be a traumatic experience that it has to be a major negative event. Instead trauma can result from repeated events such as emotional neglect, lack of connection, feeling alone without anyone to talk to, having to suppress your authenticity and gut feelings, etc. Trauma isn’t so much about what happened to you, rather what happens inside of you as a result.
Early childhood trauma affects how human beings respond to stress. Trauma in children, such as sexual, physical or emotional abuse as well as abandonment alter the child’s development and the child is more reactive to stress throughout their adult life. Studies of drug addicts find high percentages patients have experienced childhood trauma of various sorts, including physical, sexual and emotional abuse.
A brain that is conditioned to be easily triggered into stress is likely to assign a high value to activities and situations that provide short-term relief and less interest in long-term consequences, such as substance abuse. In contrast situations or activities that for the average person are likely to bring satisfaction are undervalued because they often have not been rewarding, such as enjoying intimate connections with family. This is an outcome of early trauma and stress.
The Missing Link
Many people likely believe that addicts invent or exaggerate their stories in order to gain sympathy or make an excuse for their behaviour. However, many addicts will tell their stories reluctantly, only when asked and only after trust has been established, and this may take months, even years. Often they see no link between childhood experiences and their tendency toward self-harm. If they do acknowledge it, they do so in a distanced manner that still protects them against the full emotional impact of their past.
In conclusion, most individuals that seek help for substance abuse in behavioural health setting have a history of trauma. These individuals often don’t recognize the role that trauma has played in their own life and life events, and studies say that they are often avoidant of the topic altogether. What’s worse is that the majority of medical health professionals that they deal with also don’t recognize trauma as the significant underlying thread that links them together. Dr. Gabor Maté says that the amount of hours of trauma informed study that medical doctors are required to take is zero. By recognizing that traumatic experiences tie so closely to behavioural health problems, medical and community professionals can begin to build a trauma informed healing environment for affected individuals, with the key being meeting the individual in a compassionate manner. Helping people to heal past previous painful experiences and form new meaningful connections is the way forward if we have any chance of rehabilitating today’s already dysfunctional society that is on the verge of a massive collective breakdown. Learning how to connect whole-heartedly to others, to form compassionate and caring communities where individuals can thrive together is the future and trauma-informed compassionate inquiry is the path.
To learn more about compassionate inquiry and Dr. Gabor Maté watch The Wisdom of Trauma on Mangu.tv.
Links & Resources:
Journal of Restorative Medicine