The Cumulative Effect of Trauma
• October 2021 •
From Juan Navarro, Executive Director
Los Angeles Centers for Alcohol and Drug Abuse
The Cumulative Effect of Trauma
One of the most prevalent issues we see among behavioral health patients is trauma. During Domestic Violence Month in October, we’re reminded of the complicated relationship between interpersonal violence, SUD (Substance Use Disorders), and trauma.
As humans, we often experience a stressful or life-threatening event as an emotional shock. The response to such a deeply distressing or disturbing incident can be trauma — and it overwhelms an individual’s ability to cope. Trauma causes feelings of helplessness. It diminishes our sense of self and our ability to feel a full range of emotions and experiences. In fact, traumatic events often produce lifelong changes in our emotions, thoughts, and our body’s stress response.
One in four American children and adolescents experiences at least one potentially traumatic event before the age of 16 — often as a result of domestic violence, parental abuse or neglect in the home. Negative experiences in foster care can add to the exisiting trauma. Additional trauma from school failure or expulsion can follow.
Studies have found that people with trauma can have high rates of lifetime dependence on various substances. In the National Survey of Adolescents, teens who experienced physical or sexual abuse were three times more likely to report past or current substance use than those without a history of trauma. In surveys of adolescents receiving treatment for SUD, more than 70% had a history of trauma exposure.
We know that traumatized youth tend to use alcohol and drugs as a coping tool to relieve anxiety or depression. Continuing substance use can put them in unsafe places with unsafe companions – adding to the risk for domestic/interpersonal violence and more trauma. This pattern may continue into adulthood – evolving into a lifetime of negative, traumatic events, including violence, abuse, arrest, incareration, and/or homelessness.
For traumatized youth and adults with substance use disorders (SUD), getting into behavioral health treatment is only a first step. This is no time for fragmented care – the many layers of trauma, mental health issues, and violence exposure must also be addressed as part of SUD treatment.
Take this chance to learn more: SUD and Trauma
“My name is Summer and I’m an alcoholic. I’m not making any excuses, but there was a lot of drinking and fighting when I grew up. I guess I was just repeating what was set for me. That’s what happened in my family — even my grandparents; drinking and fighting. My girlfriend was really aggressive, always getting into fights. Even with me. First it was my dad, now my girlfriend controlling me. Drinking numbed me up and made it easier to live with it because I just wanted to not feel. I did leave that relationship, which wasn’t easy, but I always ended up with an abusive partner, like I had a bullseye on my head. I got into treatment after I was arrested for defending myself in an attack by my boyfriend. In treatment, I learned a lot about abuse, alcoholism, and trauma. I learned it was a cycle I had the power to end. I do feel empowered by what I learned in treatment and I am determined to live a healthy life now. What do I have to say to someone in my former situation? I say, don’t go it alone like I tried. Get help now.”
SPOTLIGHT – THE EVIDENCE IS IN:
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a short-term, evidence-based treatment for children, adolescents, and their family members impacted by trauma. Research shows that TF-CBT successfully resolves a range of emotional and behavioral difficulties associated with single, multiple, and complex trauma experiences. The practice expands on traditional CBT by extending its reach to incorporate family therapy and a trauma-sensitive approach. TF-CBT seeks to give parents the resources and skills necessary to help their children cope with the psychological ramifications of abuse or other trauma.
TF-CBT helps patients to better process emotions and thoughts relating to a traumatic experience through useful tools that can alleviate overwhelming thoughts causing stress, anxiety, and depression. A secure, stable therapy environment is provided to enable patients to disclose details of trauma. Patients are then shown how perceptions may be distorted and given the tools to redesign those perceptions.
TF-CBT is a strengths-based, skills-based model — child and parent must practice at home for optimum effectiveness. Core components of TF-CBT include:
- Psychoeducation and parenting skills
- Affective regulation
- Cognitive processing of the trauma
- Trauma narrative
- In vivo mastery of trauma reminders
- Conjoint child-parent sessions
- Enhancing future safety and development