I recently finished a remarkable book, In the Realm of Hungry Ghosts by Dr. Gabor Mate’. Dr. Mate’ writes with deep compassion and insight about the addicts of the Downtown Eastside neighborhood of Vancouver, B.C. What really struck me was the subtle but profound genesis of most if not all addictions; the presence of trauma in early life and the patterns of response that formed as a result. As an extension of these traumas Dr. Mate’ found that the need for connection led to the poor choices that resulted in addiction.
This reminds me of my youth: when I was in middle school I discovered cannabis for the first time. It was not the substance itself that I found appealing, it was the acceptance that came as a result of simply joining in with others in getting high. Acceptance… The sad thing is that acceptance can be found in a multitude of environments but the price of admission to the group of stoners is so low; all you have to do to gain acceptance is to get high. No achievement, no character, not a thing. Just hit the joint and you’re “cool.” This continued through my early university years. I found belonging in the group that smoked pot, not with the drinkers. I don’t much care for alcohol, or more accurately I don’t enjoy throwing up (the almost certain outcome of my interactions with booze of any kind.) I actually think that cannabis should be legal and controlled. It’s just not for me.
I recently completed an intensive training in DBT-PE, or the prolonged exposure protocol for treating PTSD. And it was intense. Watching videos of patients undergoing the imaginal portions of the treatment were very difficult. This is where they recall out loud, over and over again, the trauma. And while this does not “cure” trauma it puts it in its place – in the past. The infectious nature of the memory is eradicated but not the memory itself.
One thing that came up in the training that really resonated with me was the often subtle nature of trauma. While most people think of trauma as rape or violence or combat, it often takes the form of serial and pervasive invalidation, repeated exposure to the anxiety or depression of others (most notably our parents) and even a lack of attachment in infancy. Dr. Mate’ believes that trauma can even happen prenatally; the anxiety or other suffering our mothers experience informs our neural development and coping mechanisms (aka somatic markers for you neuro geeks.)
As an adoptee I can certainly relate to the lack of attachment. And when you add in my other outlying factors it is no wonder that I sought connection the easiest way I could. The idea of lack of attachment was further validated in one of my patients, a 21 year old recovering heroin addict. She was adopted at 7 months; her mother and father were (are?) both addicts, so one can only imagine the vacuum of deep bonding she experienced. We explored this recently and it was quite the revelation to her. It was also very validating – she is NOT an addict by choice. Her deep programming or pattern would have her be no other way.
In a recent conversation with my 93 year old mom we talked about why certain AA groups (and their counterparts such as Celebrate Recovery) can be so effective while others are “less than optimal” (my euphemism for suck.) My conclusion was (with her concurrence) was the depth of connection that those in recovery so desperately need can only be found when like-minded others gather together and work together, forming real relationship. The ineffective groups are comprised mostly of “box-checkers” as I call them, those people who are not really interested in a better life but are just going through the motions in order to appease an external directive (like the court.)
The worst traumas are often subtle, resulting in a sense of otherness that cannot find meaningful connection with people and so, sadly, lead to attachments that diminish us – often to the point of death – and that reinforce our false belief that we have little or no value. And we are so afraid of more rejection that we run like hell from vulnerability. We run from the very thing that can save us.