Addiction is more than a harmful habit—it’s often a response to unresolved trauma. Whether it’s substance use (like alcohol, opioids, or cocaine) or behavioral addictions (such as gambling, eating disorders, or compulsive sex), addiction reflects a deeper emotional wound that demands attention.
Renowned physician Dr. Gabor Maté, who spent over a decade working with people struggling with addiction, urges us to shift the question from “Why the addiction?” to “Why the pain?” This compassionate perspective reframes addiction as an attempt to find relief from inner suffering—often rooted in trauma.
What Is Addiction?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), addiction is a maladaptive pattern of substance or behavior use that leads to clinically significant distress. Symptoms may include:
- Neglecting responsibilities at work, school, or home
- Using in risky situations (e.g., driving)
- Legal or interpersonal problems
- Building tolerance and experiencing withdrawal
- Spending excessive time or money on the substance or behavior
Addiction affects the brain’s reward system, often hijacking it in a way that overrides logic, relationships, and health. But to truly treat addiction, we must also examine its root cause: trauma.
Understanding Trauma
Trauma refers to an overwhelming experience that shatters an individual’s sense of safety or control. It can result from:
- Sudden events: accidents, illness, bereavement
- Chronic abuse: sexual abuse, neglect, domestic violence
- Collective experiences: war, genocide, systemic discrimination
When trauma is unresolved, it often manifests in both body and mind. Common trauma symptoms include:
Physiological:
- Rapid heartbeat, shallow breathing, insomnia
- Lowered immune function, digestive issues
Emotional and Psychological:
- Flashbacks, nightmares, anxiety, depression
- Shame, guilt, emotional numbness
The Trauma-Addiction Connection
Addiction can serve as a coping mechanism for trauma survivors. It provides temporary relief from deep emotional pain, especially when a person has no healthier coping strategies or support system.
Dr. Gabor Maté explains:
“Addiction is not the problem. Addiction is an attempt to solve a problem, namely, unbearable psychic pain.”
This view recognizes that many people with addiction histories come from environments marked by neglect, abuse, or emotional disconnection—conditions that shape the brain and nervous system from early life.
Nervous System and Trauma
The body’s sympathetic nervous system (SNS) kicks into gear during traumatic events, triggering the “fight-or-flight” response. Over time, repeated trauma can dysregulate this system, leading to chronic stress, hyperarousal, or dissociation (freeze response).
Trauma-informed addiction treatment must involve nervous system regulation. This includes:
- Breathwork and grounding
- Creating safety through therapeutic relationships
- Supporting the parasympathetic nervous system (rest and digest)
Resourcing and Empowerment in Recovery
Trauma recovery involves resourcing—helping individuals build emotional, relational, and bodily tools to manage stress and emotions. Healing involves:
- Reclaiming agency and self-worth
- Grieving losses in a safe and supported way
- Shifting from reaction to response
A trauma-informed therapist helps guide this process by being attuned, non-judgmental, and grounded.
Therapeutic Approaches to Trauma and Addiction
Multiple therapeutic frameworks help us understand and treat trauma-related addiction:
1. Internal Family Systems (IFS) – Richard Schwartz
IFS posits that the psyche contains sub-personalities (“parts”), including:
- Exiles: carry trauma and pain
- Managers: control to avoid discomfort
- Firefighters: act impulsively to suppress pain (often through addiction)
IFS aims to help these parts integrate under the guidance of the “Self”—the calm, compassionate inner leader.
2. Schema Therapy
This model identifies maladaptive “modes” formed in childhood, such as:
- The vulnerable child
- The angry child
- The punitive parent
- The healthy adult
Healing comes through nurturing the vulnerable self and developing a supportive inner adult.
3. Polyvagal Theory – Stephen Porges
Focuses on how the vagus nerve affects emotional regulation, social connection, and trauma response. Understanding this can help restore nervous system balance.
4. Franz Ruppert’s Trauma Model
Outlines parts of the self split off during trauma:
- Traumatized part
- Surviving part
- Healthy part
Therapy aims to integrate these parts for full emotional healing.
5. Karpman Drama Triangle
A systemic model that explores how people shift between victim, rescuer, and persecutor roles—often rooted in family dynamics.
From Surviving to Thriving
Trauma often leaves people feeling invisible and powerless. Effective therapy helps:
- Validate pain and experiences
- Create safety to explore trauma without retraumatizing
- Build capacity for self-regulation
- Develop new, life-affirming narratives
Tools like Tara Brach’s RAIN method—Recognize, Allow, Investigate, and Nurture—offer practical steps for emotional healing.
Final Thoughts: A Call for Compassionate Care
Addiction and trauma are deeply intertwined, and healing requires more than abstinence. It requires compassion, nervous system regulation, emotional support, and meaning-making. Therapists must work slowly, with care, respecting the client’s pace, story, and nervous system state.
As trauma expert Bert Ulsamer states:
“It is important to take care of the client, the group, and the counselor.”
True healing is a journey from isolation to connection—from surviving to reclaiming ownership over one’s life.
Further Reading & References
Ulsamer, B. (2023). Family Constellations and Trauma
Maté, G. (2003). When the Body Says No
van der Kolk, B. (2014). The Body Keeps the Score
Schwartz, R. (2021). No Bad Parts
Porges, S. (2011). The Polyvagal Theory
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