Addiction

In this article, we’ll be exploring the topic of past childhood trauma. While we always intend to be helpful when presenting information, we only encourage you to proceed if you recognize how this could affect you. Only you know best if it’s something you want to continue with. Please remember that if you have experienced past childhood trauma personally, we want to encourage you to take breaks while reading, especially if you are feeling uncomfortable or strongly react to what we’re sharing. We’ve included some resources near the end of the article that you may want to consult.

Many of us have experienced challenging moments in our lives. Memories of past childhood trauma may not be immediately obvious or apparent. They are often repressed in our minds or we may make a conscious effort to avoid thinking about these memories because they cause such a strong emotional response in us. While scientists are still researching and determining the complexity of connections between traumatic experiences and memories, “experts in child psychology argue that the memories formed from infancy to the age of 2 or 3 are very unlikely to be recovered.” (1)

We will look at how to recognize childhood trauma, find out how commonplace it is, and learn about some of the trauma people might have experienced that they have held on to and how it is affecting their adult lives. Then, we will talk about how repressed trauma may appear in adulthood and what our reactions to discovering it might involve. It’s important to understand that trauma is unresolved stress and does not become your identity. With the right understanding, practical coping tools, and a framework resolution, you can move forward and heal from these events to live well and feel better.

What is childhood trauma?

Childhood trauma is stressful experiences, such as abuse, neglect and household dysfunction, that occur before age 18. Traumatic experiences usually involve situations where children feel threatened either physically, emotionally or both. Trauma is highly individualized because not everyone is affected by the same things or in the same ways. That makes it quite challenging to determine the exact causes. However, studies show that childhood trauma can affect a person’s mental and physical health over time because our memories store both the events and the associated feelings/reactions.

What is a trigger for negative reactions?

When we don’t have an immediate frame of reference for something, our brains (whose primary purpose is to help us survive) may turn to memories of traumatic events. It can create an unexpected reaction. What’s happening is that we haven’t found a way to process and let go of the associated trauma. Our bodies, in turn, respond in several different ways:

• nightmares
• flashbacks
• confusion
• sleep disorders
• anxiety and panic attacks
• depression
• grief
• guilt
• shame
• nervousness in everyday situations

Attempts to try to address the trauma may lead to behaviours that are associated with a range of mental health conditions that could include:

• substance use
• self-harm
• eating disorders
• personality
• mood disorders

How common is childhood trauma, and how often does it occur? Are certain groups or people affected more than others?

Dr. Gabor Maté is a physician who has studied trauma’s connection to our health in a biopsychosocial context – how our health is affected by events we have experienced throughout our lives. He asserts that we need to acknowledge trauma because the interconnectivity between our psychology and physiology cannot be denied. (2)

Historically and currently, childhood abuse and neglect are often underreported for many different reasons ranging from children being generally unaware that what is happening to them is wrong, to being afraid to tell someone they trust what is going on. (3) In 2014, a General Social Survey conducted in Canada included questions about “maltreatment during childhood” for anyone over 15 to answer. It was ground-breaking because this study was the first-time data about childhood trauma and abuse had been collected nationally from adults. Here are some of the results: (4)

a.Those between the ages of 35 and 64 years of age at the time of the survey were the most common segment reporting abuse.

b.33% experienced physical or sexual abuse by someone over 18 or witnessed violence between known adults.

• More males (27%) than females (19%) experienced it and were almost twice as likely to report it. However, females were 3x more likely to have experienced sexual abuse before age 15.
• 65% of abused people reported occurrences between 1 and 6 times; 20% reported being abused between 7 and 21 times; and 15% reported abuse of at least 22 times,
• For 61% of respondents, parents and step-parents were responsible for the most severe physical abuse; but sexual abuse most often happened by someone outside of the family.
• 67% of victims never told anyone about the abuse.

c.40% of Indigenous people have experienced abuse compared to 29% of non-indigenous, and 42% of indigenous women have, compared to 27% of non-indigenous women.

d.48% of respondents who identified as members of the LGBTQ2 community reported having experienced abuse compared to 30% of heterosexuals.

e.Immigrants were less likely than non-immigrants to report a history of abuse as children. When abuse occurred, someone outside their family most often perpetrated it.

f.Drug and alcohol use were twice as common for people who had experienced childhood abuse.

g.There were negligible differences between people who had experienced childhood abuse when it came to education, employment, or income as adults.

Types of trauma

There are many different types of trauma that people have experienced.

Neglect

Neglect is where a child’s or teen’s needs are not attended to, exploited, pushed aside, or greatly resented. It can have immediate, short-term, and long-term consequences.

Neglect can be considered a general unawareness or systematic failure of a caregiver to respond to a child’s needs because they were overwhelmed or preoccupied. It’s often unintentional, perhaps reflecting low awareness and emotional intelligence or even a remnant of intergeneration trauma. In some instances, basic needs could be provided by caregivers, but it’s the emotional and psychological needs that are not. Sometimes it’s a case of caregivers “mishand[ling] one key area of support.” (5) For example, a child could be experiencing a lack of:

• comfort
• nourishment
• shelter
• medical care
• emotional support
• education
• caregiving (leaving a child alone or in the care of a third party who cannot provide adequate care)
• general resources such as food and clothing or even love when they are part of a large family

Neglect can be a “failure to act or notice a child’s emotional needs,” which results in chronic emotional and psychological crises that can affect brain development. (6)

From the caregiver’s behaviour, a child learns that their needs are unimportant and that seeking adult support is often futile. In households with strict rules – such as no crying, no sadness, or no loud voices – the adults discourage natural, spontaneous responses from the child or teen. Instead, they should acknowledge that the child is likely instinctively expressing a need to feel close and share their emotions. By denying them the opportunity to process their feelings, these children grow up learning that mentioning these natural responses is something to fear. In the child’s adult relationships, this can manifest as mental and physical difficulties where they:

• feel low self-worth
• have low self-esteem
• display low confidence
• have trouble with loneliness
• are focused on perfectionism or avoidance, and
• find comfort in self-deprecation

Children also learn from caregiver behaviours such as being emotionally detached, anxious, or constantly worried.

Abuse

Abuse can be viewed as an intentional, conscious action or decision by a caregiver to deny a child care or harm them. In many circumstances, the abuse is physical or sexual. The abuse creates trauma.

Children who have experienced neglect and abuse are vulnerable to other traumatic events that are offshoots of the original trauma. It could be that they are threatened by, become involved in, or witness an event such as (7):

• bullying
• community violence
• multiple complex traumatic events
• natural disasters
• early childhood trauma that occurs before age 6
• intimate partner violence
• traumatic medical stress
• refugee trauma
• traumatic grief such as the loss of a parent or close caregiver, or family member
• the end of a relationship (divorce)
• having a learning disability
• having a caregiver with untreated mental illness

Recognizing the signs of unresolved trauma

Symptoms of unresolved trauma start when adults experience stress or when experiences remind us about something that happened when we were children. Adults who have experienced childhood trauma aren’t always able to recognize their own trauma because they have usually developed strong self-reliance and have often been the ones to build a solution to cope with these experiences independently.

As a result, it may be challenging to consider that symptoms of unresolved trauma may look like somewhat ordinary things. But these are often the body and mind’s ways of alerting us to problems that originated in childhood:

• Chronic pain – migraines, joint and nerve pain, back pain, fibromyalgia, etc.
• Fatigue – constant low energy, weakness, brain fog, sleepiness, etc.
• Digestive issues – nausea, diarrhea, constipation, IBS, etc.
• Hypersensitivity/Hypervigilance – awareness of sensations to sounds, lights, environments, etc.
• Anxiousness – increased heart rate, panic disorders, fears, etc.
• Depression – low moods, lacking motivation, feeling hopeless, etc.

Adverse Childhood Experiences (ACE)

Adverse Childhood Experiences (ACE) is “used to describe all types of abuse, neglect, and other potentially traumatic experiences that occur to people under the age of 18 years.” (8) ACE scoring is a methodology to help adults reflect on situations that may have affected their development. ACEs have the potential to uncover symptoms of childhood trauma because an adult can better articulate whether they feel they’ve been able to deal effectively with the ACE. In fact, “one in every six adults experience at least four ACEs, according to the CDC. These experiences can be particularly harmful because they occur at such a vulnerable phase of growth. In early childhood, brain development and social-emotional growth are at a critical stage.” (9)

How to recognize if childhood trauma is affecting you as an adult

It’s important to realize that not all trauma is due to mistreatment or abuse. Children can experience frightening events in their lives, such as accidentally getting separated from their caregiver in a store or being startled and uncomfortable because of loud noises in their environment. They can also experience trauma when they experience something new or, for the first time, like visiting a doctor or dentist. These events can create memories associated with trauma, but the cause was not neglect or abuse.

Some professionals help people sort through types of traumas by helping determine whether they have experienced what they are referring to as Big T Trauma or Little t Trauma, which attempts to explore them in the context of how the event affected someone’s physical safety to produce the traumatic response. This approach can help someone determine if these experiences are affecting our innate sympathetic nervous reactions, also known as fight, flight and freeze.

Big T traumas are “generally related to a life-threatening event or situation…[like] a natural disaster, a violent crime, a school shooting, or a serious car accident,” but “chronic (ongoing) trauma, such as repeated abuse, can also qualify as big T trauma.” (10)

Little t traumas are “events that typically don’t involve violence or disaster but do create significant distress… [such as] a breakup, death of a pet, losing a job, getting bullied, being rejected by a friend group.” (11)

Common reactions to trauma

Framing childhood trauma may be difficult because we tend to discount the impact of events that happened to us in childhood. After all, they happened at a time in our lives when we didn’t have the evaluative tools, control, and self-determination that adults do to process situations.

Our adult perspective and viewpoints can also cloud or invalidate the child’s reaction to the trauma. For example, uncharacteristic responses from adult figures that may have been frightening to you as a child and perceived as threatening may not be viewed the same way today. There’s also a tendency to internalize responsibility for the caregiver’s actions, taking on blame for a situation and excusing the caregiver. It can be because, as a child, you were told you were responsible for that adult’s behavioural choices at the time.

Many adults also experience disassociations where they strategically avoid certain situations. Generally, it’s because they cause them discomfort as adults. An example of disassociation would be how as an adult, you can never be late, or it can cause you to panic. The root cause may be a childhood experience where a caregiver was late to pick you up. The emotions that the event made you feel may have influenced your development so that you unknowingly relive an unresolved traumatic experience from your childhood.

Ways to heal from childhood trauma

Now that we have looked at what trauma is, and unveiled how people may have experienced trauma, as well as abuse, it is time to look at ways which we can heal from childhood trauma. The following gives some strategies for healing.

• Learn to approach memories calmly and recognize and be curious about our automatic reactions. It is fundamental to learning about what triggers us, which can help process those triggers, removing their intensity over time.
• Try to fill in the blanks/gaps in memories by approaching them with storytelling. This method can help gently bring memories forward because it allows us to be more mindful as adults. We can leverage more emotional regulation tools that we have learned to understand these situations and process the experiences from a different perspective. It also helps us release the fearful associations and acknowledge how we can choose to remove the trauma, so it doesn’t continue to have a hold on our current lives.
• Explore a wide range of treatment options:
• CBT – cognitive behavioural therapy helps people re-think their thoughts and beliefs about traumatic events and activate healthy coping skills.
• DBT – dialectical behavioural therapy helps to build skills in responding to stressors and emotional regulation.
• EMDR – eye movement desensitization and reprocessing helps retrain areas of the brain that hold traumatic experiences by following a series of specific eye movements performed under the direction and guidance of an EMDR therapist.
• Somatic Experiencing (or similar types of therapy) – create positive mind/body connections that help reset the nervous system. These could include treatments such as:

– Meditation

– Deep breathing

– Yoga

• Clinical EFT (Emotional Freedom Technique) focuses on stimulating acupressure points in the body with a repeated light touch.
• Clinical Myofascial Release focuses on specific guided motions to expand and contract tissues that relax and release tension and trauma.

Childhood trauma resources

You may want to review some of the most innovative thinking about childhood trauma from people who have extensively studied links between it and health as adults. They advocate for different approaches for physicians to acknowledge and address trauma’s effects on our lives.

• Dr. Gabor Maté has written several books on the topic, including the recent release “The Return to Ourselves: Trauma, Healing and the Myth of Normal”
• Dr. Bessel van der Kolk created the National Child Traumatic Stress Network https://www.nctsn.org and has published a book about trauma titled “The Body Keeps the Score”
• Dr. Nadine Burke Harris gave a TED talk: “How childhood trauma affects health across a lifetime, “where she discussed studies prepared by the Centres for Disease Control (CDC) and Kaiser Permanente. She has published a book titled, “The Deepest Well: Healing the Long-Term Effects of Childhood Adversity”

We have also included links to some Adverse Child Experience (ACE) Questionnaires that you may be able to explore as you begin working on healing from childhood trauma.

• ACE Questionnaire from The Canadian Association for Mental Health, CAMH.
• Finding your ACE score from the National Centre for Juvenile Justice, Family Violence and Domestic Relations, and Child Welfare and Juvenile Law NCJFCJ

Above all, please be gentle with yourself as you explore your childhood trauma. It can be a difficult, lengthy, and complicated process to work through as an adult, and you may find that you are not ready to talk about it. Remember that you don’t need to figure everything out alone. Taking time and space to heal is one of the most significant gifts you can give yourself.

References:

1. Positive Kids n.d). The Child Psychology of Abuse and Repressed Memories. PositiveKids.ca. Retrieved February 10, 2023 from https://positivekids.ca/2017/01/09/the-child-psych…

2. Maté, G. (2023 February 22). George Stroumboulopoulos in conversation with Dr. Gabor Maté Live on Instagram. Instagram @strombo, @gabormatemd.

3. Burczycka, M. (n.d.). Family Violence in Canada: A statistical profile, 2015, Section 1: Profile of Canadian adults who experienced childhood maltreatment. Statistics Canada. Retrieved February 10, 2023 from https://www150.statcan.gc.ca/n1/pub/85-002-x/20170…

4. Ibid.

5. Holland, K. (Medically reviewed by Legg, T.J., PhD, PsyD.) (2021 October 21). Childhood Emotional Neglect: How It Can Impact You Now and Later. Healthline.com. Retrieved February 10, 2023 from https://www.healthline.com/health/mental-health/ch…

6.Ibid.

7. The National Child Traumatic Stress Network. (n.d.). What is childhood trauma? Trauma Types. The National Child Traumatic Stress Network (NCTSN.org). Retrieved on February 10, 2023 from https://www.nctsn.org/what-is-child-trauma/trauma-…

8. Su, Wei-May & Stone, Louise. (2020 July). Adult survivors of childhood trauma: Complex trauma, complex needs. Australian Journal of General Practice (AJGP). Volume 49, Issue 7. Retrieved on February 10, 2023 from https://www1.racgp.org.au/ajgp/2020/july/adult-sur…

9. Newport Institute. (n.d). Big T vs. Little t Trauma in Young Adults: Is There a Difference? Newport Institute.com. Retrieved on February 10, 2023 from https://www.newportinstitute.com/resources/mental-…

10. Ibid.

11. Ibid.

One of the often-overlooked challenges with addiction is that the addicted individual is not the only person impacted by the disease. Family and friends may encounter difficulty with the individual’s pattern of behaviour, potentially escalating financial and legal problems, and even just the daily struggle of providing positive reinforcement and support.

It is complicated and typically overwhelming for those impacted when the disease takes hold. Often, family members are unable to observe or note the signs and behaviours that signal addiction. This article offers advice on supporting someone you care about who is struggling with an addiction, no matter where they are in their recovery journey.

What are some indicators to watch for that might reveal addictions?

Often, when the condition is revealed, those close to the person wonder how they could have missed the signs. The fact is, addiction is not clear cut, especially if the addicted person intends to keep it secret or is genuinely unaware that they have a problem. While you should pay attention to all behavioural changes, here are three indicators that you may be able to observe that could help to reveal addictions:

• Absenteeism or avoidance. Have you noticed a decline in attendance or withdrawal from social engagements and/or family events? Within a work setting, you may notice an increased use of sick leave, or variations in arrival and departure times. Additionally, you may notice prolonged breaks or extended absences.
• Excuses. Have you noticed overly elaborate explanations being offered when you check in or reach out to see how the individual is doing or if they missed an event they were expected to attend? This may be particularly difficult to notice given the increased amount of virtual or online engagements due to COVID-19.
• Irresponsibility and recklessness. Has the individual stopped performing specific roles and accountabilities? Are they making careless mistakes or missing key tasks or responsibilities that have significant repercussions?

What is addiction and what are the different types of addictions?

Addiction is a chronic disease distinguished by compulsive engagement in rewarding stimuli despite adverse consequences.¹ Research estimates that genetics account for 40 to 60 percent of a person’s likelihood of developing a substance use problem or a compulsive habit.² An addiction heavily impacts the way a person thinks, feels and acts. When an addictive disorder has formed, people will pursue debilitating habits despite putting themselves or potentially others in harm’s way. They may be aware of their problem but have difficulty stopping on their own despite consequences that could include job loss, injury, divorce, financial hardship or worse.

While dependence on drugs and alcohol are some of the most commonly experienced types of addictions,³ the disease can include compulsive engagement in behaviours like binging and purging food (eating disorders), sex, gambling and excess screen time or social media engagement.⁴

Five ways to support those with addiction, beyond talk therapy

Supporting someone through their addiction and subsequent treatment may not come as second nature, but there are ways you can help. Be sure to start by setting boundaries to ensure you protect yourself. It’s important to remember that you can’t support a person in need if you’re not feeling stable yourself.⁵

1. Set boundaries

The boundaries you set should depend on your situation and the nature and intensity of the other person’s addiction. Here are some examples to consider:

• Disallow drug or alcohol use when they are in your home.
• Refuse to bail them out of jail if the circumstance arises.
• Walk away from and report their physical abuse if applicable.
• Refuse to give them money or to provide any means that support the addiction.
• Refuse to cover for them, at work or in front of friends and family.

2. Education about addiction, relapse, co-dependence

If you are concerned about someone’s addiction, it is best to have them assessed by an addiction medicine specialist or someone with a similar professional designation. As a starting point, you should obtain some resources for reliable information that can educate you on what your friend or family member is experiencing. While you may not be qualified to help someone with a severe disorder, you may be able to help them find the qualified and quality of addiction care needed.⁶

3. Build a support system

The support system could include friends, family, and members of a support group focused on addiction recovery.

These groups often socialize and meet regularly. You can help by joining the visits, offering to drive them to scheduled meeting, and even just sitting and talking on the phone when in-person socializing isn’t possible.

4. Build resilience

Exercising, building/maintaining financial health, self-care practices, working on emotional intelligence, and focusing on good interpersonal relationships are all great ways to build resilience so that the actions of the addicted person do not affect your emotional, financial, and social well-being.

5. Create a relapse plan

A relapse plan includes everything from relapse prevention tactics, like contacting someone from the support system or practicing disrupting dysfunctional thinking as it occurs,⁷ to more robust measures like in-patient treatment or overdose prevention.

How to help someone with addiction get the help they need

It may be helpful to get some individual counselling to assist both you and the person with the addiction. Counselling isn’t just for the person with an addiction. The more you can manage, the better you will be able to help another person. There are a variety of resources to find counsellors.

• If the person is employed, investigate whether the company offers an Employee Assistance Program or a health insurance program for easier access to counselling services.
• Ask someone who has been through addiction treatment which local and/or regional programs worked for them.
• Investigate national programs and the various resources available.⁸
• For assistance with financial concerns or legal troubles, it may be helpful to talk to an attorney.
• Some organizations provide addiction and mental health services on a sliding scale fee.
• Local churches may also offer some low or no-cost counselling and/or support groups.

Four ways to support a person during addiction treatment

There are many ways to stand by someone’s side during their addiction treatment without compromising your own well-being. Here are four of the main underpinnings for supportive actions when dealing with someone else’s addiction recovery.

1. Get information about addictions

Knowledge is power and may help you understand more about yourself and how you fit into another person’s addiction. Start by learning about the disease process of addiction and how it affects the life of the person you wish to support. You can also search for information about how addiction impacts family and friends and how they can set and maintain healthy boundaries.⁹

2. Understand the signs and symptoms of a relapse

Understanding addiction’s chronic and cyclical nature will help deal with the signs of relapse and how to deal with a crisis. Only trained professionals should handle emergencies, but there are tools like Naloxone kits and emergency contacts that will help keep a relapse from turning into a fatal event.

3. Stand your ground, with compassion

It’s not always easy to maintain healthy boundaries when your compassionate side wants you to do all you can to help someone recover from their addiction. Remember that their recovery isn’t your responsibility, but your health and well-being are. Take care of yourself first so that you can be both strong and supportive.

4. Don’t try to rescue the addict

Many addicted people cannot change until circumstances indicate they must. This often occurs when they experience the consequences of their disease. You can create several boundaries that will help, like committing to not financially supporting the addict or their addiction. Paying for things like groceries and rent may help, but it may also prolong the disease.

How to support someone during addiction recovery—building resilience and moving forward

Once a person is ready to move past addiction and into sobriety and a return to previous norms and rebuilding, they will need support in new ways. Here are a few ways to continue supporting an addict once they exhibit behaviours and patterns of recovery progress:

• Continue to maintain boundaries and hold them accountable for the expectations they made for their life and sobriety while in recovery.
• Engage in healthy, sober activities with them.
• If it is permitted, offer to attend a support group with them.
• Offer to drive them to appointments, meetings, job interviews, or social events.
• Don’t expect addicts to keep every promise they make (they may not be able to do so) and don’t respond with pity or anger when mistakes are made.
• Expect, but do not fear, that their recovery may come with relapse.
• Never lose hope for their recovery. Even if they have to return to treatment multiple times and sustain repeated relapses, if the person is willing to return to recovery they are worth your support.

Most importantly, focus on your own life and make sure that you are taken care of first. If you experience stress due to another’s issues on top of your own, it creates resentment and strain. Think about joining a support group for family members of people with addiction. In such support groups, you should be able to find and connect with other people going through similar situations. As you start to share what you’re going through, the group members should help you see that you are not alone in this and that taking care of your mental health is the best thing for building resiliency around a person with an addiction.¹⁰ By making sure you get exercise, plenty of sleep, and time to socialize and support, you are setting yourself up to help the person you care about as they progress in their recovery. Secondarily, you will serve as a role model for the person who is recovering and looking for self-care skills to implement in their own life.

References:

1. https://www.asam.org/Quality-Science/definition-of-addiction
2. http://headsup.scholastic.com/students/the-role-of-genes-in-drug-addiction
3. https://www.emcdda.europa.eu/attachements.cfm/att_213861_EN_TDXD13014ENN.pdf
4. https://www.healthline.com/health/types-of-addiction#behavioral
5. https://www.heretohelp.bc.ca/infosheet/supporting-a-friend-or-family-member-with-a-mental-illness
6. https://www.ccsa.ca/sites/default/files/2019-04/CCSA-Addiction-Care-in-Canada-Treatment-Guide-2017-en.pdf
7. https://www.mentalhelp.net/blogs/fourteen-dysfunctional-thoughts-that-can-keep-people-sick/
8. https://www.canada.ca/en/health-canada/services/substance-use/get-help/get-help-problematic-substance-use.html
9. https://psychcentral.com/blog/imperfect/2017/08/how-to-set-boundaries-with-an-alcoholic-or-addict#1
10. https://www.trihealth.com/dailyhealthwire/wellness-and-fitness/7-tips-for-helping-someone-with-an-addiction