The “trauma of recovery”

unexpected-road1Bill White with Stephanie Brown on the unexpected  “trauma of recovery”:

Bill White: Yes, you used the phrase “trauma of recovery” that just stunned me when I first read it.

Stephanie Brown: By 1994/95, we were well into analyzing family data and clearly saw that the experience of trauma, so starkly evident during active addiction, continues in the beginnings of recovery. Most people expect that when the drinking stops, everything is going to be fine, and it isn’t. It isn’t for the individual, and it definitely isn’t for the family. New kinds of problems actually emerge with recovery, totally unexpected because no one knows what to expect with abstinence, and the family members do not know how to operate without the drinking. The family system in active addiction achieves homeostasis by adapting to the pathology of addiction. The family system works during active addiction to maintain the status quo, but when you enter active recovery, those mechanisms no longer work. And, there are no family system mechanisms yet developed to support healthy living or healthy relationships. That leaves the family in the beginnings of recovery without structure to nurture and support the health of family members or the family as a whole. There’s a vacuum in the system, which often creates more trauma—new trauma—which we labeled the “trauma of recovery.” Clearly, this vacuum is a time when the family needs much greater external support to help “hold” them in their new recovery process. The transition from exiting formal treatment to achieving stable family functioning is still a huge vacuum for many families.

Seeking safety vs. treatment-as-usual for male veterans

Seeking Safety appears to improve attendance, satisfaction and coping, but makes no difference in drug use:

Findings: Seeking Safety (SS) compared to Treatment As Usual (TAU) was associated with better drug use outcomes, but alcohol use and PTSD severity decreased equally under both treatments. SS versus TAU was associated with increased treatment attendance, client satisfaction and active coping. However, neither these factors nor decreases in PTSD severity mediated the effect of treatment on drug use.

Grief, love and addiction

On Being‘s blog draws a link between “complicated grief ” (a potential new DSM-V diagnosis) and addiction.

UCLA researchers found that grief over losing a loved one can take an extreme form of bereavement, stimulating the part of the brain normally associated with reward and addiction. This is called “complicated grief” and the name alone gives more weight and depth to our varied experiences of loss.

I’m more and more convinced that addiction is the result of multiple neurobiological factors and trauma shares some of those factors. There are so many parallels when listening to an addict discuss their first experience with their primary drug and trauma survivors describe their traumatic experience—multisensory details, their instrusive nature, the emotional arousal and its resistance to cognitive challenges.