Dr Gabor Mate is a physician who spent many years working in a harm-reduction based organization with people who were physically dependent upon illicit drugs. An infant survivor of the Holocaust, his roots have grown from traumatic soil. Perhaps it’s no surprise then, that from his point of view, people become addicted to drugs as a result of childhood trauma. In fact, his latest book “In The Realm Of Hungry Ghosts“, he has shared this perspective and offered related policy suggestions. But his understanding of addiction has been somewhat controversial. Is addiction a "disease" or is it a painful way of coping with past emotional trauma?
Like most things, the answer isn't a simple one. People are complex, as is substance use, abuse and addiction.
Evidence for a Disease-Based Model
When we think of addiction as a disease, some say it helps to remove the stigma from drug and alcohol abuse--it's not a choice, a deficit in morality--it is a biological phenomena. It also ensures that insurance companies will pay for treatment related to drug addiction. Most scientists agree that there is at least a genetic component to addiction, with studies from separated twins, each growing up in different environments, showing up to a 70% rate of heritability.
More evidence for addiction as a disease comes from the way repeated drug abuse has been shown to re-wire our brains. Because drugs mimic our brain's natural pleasure system--only much, much more intensely--our brain begins to seek out getting and using drugs above all else. Our neural circuitry is literally re-wired to seek out more drugs, and without them, our brain has difficulty feeling the incomparably weak pleasure system that we're born with. Meaning, your brain doesn't feel good without the drugs anymore.
Evidence for a Trauma-Based Model
There has also been research that shows a correlation between unresolved childhood trauma and addiction. There is also research that shows that early childhood and attachment trauma is strongly correlated with later addiction. In essence, the thought is that people use drugs as a way to self-medicate, to shut down feelings that are experienced as "too much". For a young child, a relationship with their primary caregiver may feel "too much", and the need for love may be pushed down. In this case drugs can become something of an attachment figure--a stuffed animal or "lovey" that replaces a need for healthy, mutual relationships.
Evidence for a Sociological Model
Okay, well there's alot of overlap between this one and the Trauma-Based model. Living without your basic needs met can be, in of itself, a form of trauma. But a Psychology professor from Columbia University, Dr. Carl Hart, believes that sometimes drug addiction can be a "rational choice"--that is, if there is no healthy way to experience pleasure, most people will choose an unhealthy way to experience pleasure. That, if all people had access to opportunity and hope, that they would be less likely to depend on illicit substances.
Why Does the Model Matter?
It's likely that all models have some truth to them. And it matters because you can't treat a problem if you don't understand it. Both politically and individually. At Creating Space Counseling and Wellness, if you've had a history of addiction, it will be important to understand what addiction meant for you, personally.
Recognizing that addiction is, in part, a neuro-biological condition, people usually just don't and can't stop using drugs. It's often not something that we can "will" ourselves out of. Instead, learning about how the brain works, and what is happening when you feel an urge or craving to use can help create some space between the feeling and the action of using.
Understanding that unresolved trauma may be connected to your addiction would necessarily mean that a part of recovery is healing from your experiences of past abuse.
Recognizing that untreated ADHD or other neurological disorders may have played a role in addiction, would lead to therapy incorporating ways to understand and cope with ADHD, as well as healing from the developmental trauma of being "misunderstood", as so many adults with ADHD express feeling.
It's also important to know that in order to recover from addiction, you need to have other sources of healthy pleasure in your life--a safe place to call home, hope for the future, a supportive network of friends/and or family.
Finally, regardless of your own relationship with drugs and alcohol, if you've had addiction in your family, it's especially important to learn healthy ways of coping with hard emotions--to reduce your risk of re-creating that cycle for yourself.
If you have struggled with addiction, give yourself the opportunity to understand your experience in a holistic way, to write a new, fuller story about your past and the possibilities for your future! Call Creating Space and Wellness to schedule an appointment today! 856-281-1664
