Chapter 1: Addiction and Trauma

© Dori Digenti. 2021. All rights reserved.

“Not all traumatized people become addicted, but all addicted people, including those addicted to opioids, were traumatized in some way. That is the reality of our culture, where addiction, like trauma, is so commonplace that most people also don’t recognize its presence.” – Gabor Mate

“As long as their map of the world is based on trauma, abuse, and neglect, people are likely to seek shortcuts to oblivion.” – Bessel Van Der Kolk

In this chapter, we will delve into the connections between addiction and trauma. It is well-known that people with addictions come from all family backgrounds, economic classes, educational levels, and ethnicities. It is a false belief that addiction disproportionately affects any particular class or race. While Latinos, Native Americans, and African-Americans have been the target of profiling and mass incarceration, and have been less able to avoid the legal consequences of drug use, those with resources and privilege are able to hide their addictions and avoid legal jeopardy much more easily.

If you have suffered trauma in your life, the next sections may be difficult. Know that this information is intended as a necessary background to understand why yoga is particularly well-suited to ease and provide healing from addiction. 

 

What is Addiction?

A concise definition of addiction given by Dr. Judson Brewer is “continued to use a substance or to behave in a repeated manner, despite negative consequences.”[i] Why would someone engage in something repeatedly, knowing that the result will be bad for them? It boils down to the reward centers in our brain, and how they can be hijacked to drive us to behaviors and actions that overcome our own control, common sense, and even our reality.

In Brewer’s model, the steps that lead to addiction can be viewed as a simple behavioral cycle termed the “habit loop”: Trigger – Behavior – Reward.[ii] Something initiates our need to seek resolution: the trigger. In most cases, what triggers us is a negative experience, something that is painful. Common examples of triggers are traumatic events (see in detail below), disappointment, anxiety/worry, sadness, or lack of self-worth. When we are triggered, we act to resolve the effect of that trigger. From a yoga perspective, we would say that the behavior, while it might be harmful over time, is our way to return our system to balance, safety, and well-being. We might choose a variety of behaviors to respond to a trigger. But if we tend to resolve triggering events through substances or repetitive habitual behaviors for the reasons outlined below, we might drink, take a pill, overeat, or gamble, among other options. Our rewards would most often consist of relief, numbness, or euphoria. Then, in the addictive cycle, another trigger comes along (which could be the fading of the feeling of the reward), and the behavior is repeated.

Note that the reward could also be what we would perceive as a negative. How can this be? Let’s take this example: if our sense of self is based on believing that we are unworthy of love, then we may seek behaviors unconsciously that will reward and reinforce that sense of unworthiness through always finding unrequited relationships. Strangely, that conditioning to feeling unloved or unworthy may feel familiar, and the familiarity in itself may provide relief and reinforce a sense of safety. In other words, our misery can become our comfort.

As we continue to perform the habit loop, we end up addicted to it. But what if we don’t perceive the negative consequences of the repeated behavior? Most likely, we are ignoring or rationalizing the negative consequences of the addiction. We may be a high-functioning person with addictions, and even believe our addictive behavior makes us better. We might surround ourselves (and probably do surround ourselves) with people who reinforce that perception. We might live our entire lives “handling” our addictions and the underlying conditions that led to addiction. Or, one day we may have a conversation, health event, skilled counselor, relationship breakup, or yoga class that reveals the negative role of addictive behavior in our lives. That is the start of a recovery journey.

Are There Really Behavioral Addictions?

Beyond the headlines of the opioid and other current drug crises, there are other, more hidden addictions. Addiction can also occur in relation to a habitual behavior or activity. For example, as we further understand the role of technology in modern life, there are new studies emerging that are ringing alarms about technology addictions.[iii] We are aware of video gaming addictions, to which young males seem to be particularly vulnerable, leading to extreme cases of not eating, not sleeping, and withdrawing from daily life. This is the far reach of technology addiction. More common are those who spend many hours per day glued to social media, and literally panic when their cell phones are misplaced. Or the friend who has their phone always in hand, and is immediately ready with an answer from Google or a comment from social media about everything.  These instruments and their software are designed to be highly addictive, and the free use model makes it so easy to allow our attention, time,  and emotions to be manipulated for profit.

Other examples of behavioral addictions that are rife in modern societies:

  • Workaholism is often lauded as “ambition,” “dedication,” and “drive,” but overworking (karoshi) is an official cause of death in Japan.[iv]
  • Disordered eating, or food addiction, straddles the line between substance misuse and a range of mental health disorders.
  • Sex/love addiction can co-occur with other mental health disorders like stalking or domestic violence.
  • Gambling, shopping, and spending addictions speak to the reward system of money in our society.
  • Even music can be addictive. Gabor Mate spends pages in this book In the Realm of the Hungry Ghosts[v] exploring his addiction to purchasing, researching, hunting for, and listening to classical music.

And the list goes on. These are just a few of the patterns of harmful behaviors that do not necessarily involve a “substance.” These difficult addictions may seem intractable. It is understandable if we feel hopeless or simply overwhelmed at the thought of overcoming all the various forms of addiction that seem part and parcel of life. But there are new approaches coming to light, and they bring with them ancient wisdom that has stood the test of time.

Trauma as the Root Cause of Addiction

“Trauma is not a flaw or a weakness. It is a highly effective tool of safety and survival. Trauma is also not an event. Trauma is the body’s protective response to an event—or a series of events—that it perceives as potentially dangerous.” – Resmaa Menakem, My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies

We often talk about peeling back the layers of the onion when we’re trying to understand a complicated system. When it comes to trauma and addiction, then, we will start with the individual, and then expand to bring in the impacts of collective trauma under systems of oppression, and finally move to a discussion of intergenerational trauma.

There are “big T” traumas – war, violence, natural disasters, accidents, sexual abuse; and “little t” traumas – the accumulated experiences of neglect, abandonment, co-dependency, caregivers’ addiction/mental health issues, racism, poverty, and emotional abuse. With a traumatic experience, we can be thrust into a fundamental rupture in expectations or, at the extreme, a threat to survival. Psychologists name this rupture “dissociation.” Dissociation can result from big T trauma, or an accumulation of little t traumas. Parts of ourselves can end up split off and rendered into silence, can manifest as physical illness or numbing, or are merely forgotten.

We may choose to seek relief from trauma with habitual responses or addiction, which can take mild or severe forms. We respond to traumatic life circumstance by secretly and silently attempting to maintain “normal” social function, all the while developing unskillful coping mechanisms and ignoring what we can. Those of us who have trauma histories, according to Van Der Kolk, can feel “chronically out of sync with the people around them.”[vi] Rather than risk experimenting with new options, we might stay stuck in the responses we know, even though they may result over and over in recreating dangerous and painful situations.

Adverse Childhood Experiences (ACEs)

The Kaiser-Permanente ACE study was a breakthrough in understanding childhood trauma. The study has provided strong evidence for the connection between childhood trauma and susceptibility to addiction. There is much to explore in the ACE report and a host of trainings and follow-on studies that shed further light on the ACE-addiction connection. We can see a strong correlation between age of first drug or alcohol use, and the potential for damaging addiction to set in: “Compared to a child with no ACEs, one with six or more [ACEs] is nearly three times more likely to be a smoker as an adult. A child with four or more is five times more likely to become an alcoholic and 60% more likely to become obese. And a boy with four or more ACEs is a whopping 46 times more likely to become an IV drug user later in life than one who has had no severe adverse childhood experiences.”[vii] And further and most importantly: The higher the ACE score, in a dose-response ratio, the higher the risk for alcoholism and drug addiction.[viii]

Figure: The Truth About ACEs Infographic. Used with permission.[ix]

In drawing a causal connection between trauma and addiction,[x] the connection could be rendered invisible because of the differing types of trauma experiences. Little “t” traumas can accumulate over time but fall under the radar of conscious remembering. Or, a child who is raised in a resource-poor community may experience mistreatment whose source is unclear to them (for example, the idea of being from “the wrong side of the tracks”). Invisible trauma can include the possibility of epigenetic trauma across generations, prebirth trauma, and early attachment issues in infancy. In all these cases, it is very possible that a person could exhibit a low ACE score and potentially have no known (to them) history of trauma.

One other possible factor in addiction is indicated in understanding the highly sensitive person (HSP, also called Sensory Processing Sensitivity, SPS.) In her book The Highly Sensitive Person: How To Thrive When The World Overwhelms You,[xi] author Dr. Elaine Aron states that “the highly sensitive person (HSP) has a sensitive nervous system, is aware of subtleties in his/her surroundings, and is more easily overwhelmed when in a highly stimulating environment…. they process everything around them much more—reflect on it, elaborate on it, make associations.” She continues “It also means you are more easily overwhelmed when you have been out in a highly stimulating environment for too long, bombarded by sights and sounds until you are exhausted.” While I couldn’t find specific research on the connection between HSP and addiction, there is a logical connection between the need to downregulate (reducing the response to a stimulus – “chilling out”) the overactive nervous system and addictions). Whether HSP is just a flavor of being more introverted than is either typical or socially acceptable is a valid question. Or could the development of highly sensitive responses be an effect of early childhood trauma?

To sum up, many experts agree that trauma and addiction have a strong cause-effect linkage. If we wish to reduce the terrible impacts of addiction, we need to understand all the causes of trauma that affect us. And further, we need to deepen our knowledge of how trauma impacts the mind/body/emotions through the nervous system’s response mechanisms.

 

The Polyvagal Theory

Our knowledge of the Autonomic Nervous System (ANS) is growing and changing with the advancement of scientific knowledge. For many years, the ANS was considered a binary response system, consisting of the “aroused” state: the sympathetic nervous system (SNS), and the “resting” state: the parasympathetic nervous system (PNS).

In the older, binary view, the SNS is engaged when we are presented with excitement, fear, danger, or threat. Adrenaline and stress hormones (especially cortisol) are released. When the arousal of the SNS is a response to danger or fear, we experience the “fight or flight” response for escape or defense. Respiration, heart rate, and muscular and brain signals all increase in responsiveness. When the arousal event ends, we experience an automatic re-engagement of the PNS. The system slows down and our maintenance activities take over (for example: sleep and digestion).

With the Polyvagal Theory,[xii] Dr. Stephen Porges expanded on this binary model. He proposed that the PNS, which is controlled by the Vagus nerve, actually has two branches, rather than a single branch, with two different response mechanisms. What is the Vagus nerve? The Vagus (thus PolyVagal) nerve is the 10th cranial nerve. The Vagus nerve extends from the base of the skull down through the lungs, heart, diaphragm, and stomach and up to connect with nerves in the neck, throat, eyes, and ears. The Vagus regulates the engagement of the PNS system.

Porges calls these two PNS branches the Dorsal Vagal, which is the controller of the immobilize response, and the Ventral Vagal, which controls Social Engagement. The table below outlines this Polyvagal system.

Branch

 

Ventral Vagal

Sympathetic

Dorsal Vagal

Neuroception (Perception of)

Safety

Danger

Life Threat

Activity

·  Social Engagement

·  Play (hybrid with Sympathetic)

·  Intimacy (hybrid with Dorsal)

·  Fight-Flight

·  Freeze (hybrid with Dorsal)

Shutdown

Affect

Connected, calm

High energy, polarized

Collapsed, numb

Location

Face, head, senses

Spine, legs, adrenals

Torso, gut

Table. The Autonomic Nervous System as seen by the Polyvagal Theory

Porges sees the Ventral Vagal as the most recent development in mammals, including humans. In normal conditions of safety, the social engagement system is active and allows play, creativity, intimacy, and socialization. Social engagement develops in the infant to connect with the mother/care provider through hearing, vocal tone, facial expression, and speech. When the social engagement function is working well, creative and playful connection, activation, and rest and calm are balanced, and responses flow naturally.

When we perceive danger, though, we send out a call to the systems of the ANS, and the responses to that call cascade down through the three parts of the system according to the level of threat. According to Porges,[xiii] Social Engagement (Ventral Vagal) is the first to respond. We use the physical, sensory system to check for safety through vocal tone, facial expression, and eye contact with whatever or whomever is approaching. In other words, we first check to see if there is any real danger through sensory cues, and whether there is a support system present – parent, family, or tribe. If social engagement fails, if we perceive that the danger is real, then the defensive system (Sympathetic) kicks in and our body prepares for action – running away or fighting. Finally, if we perceive life-threatening danger, then the most primitive system engages to immobilize us and we shut down (Dorsal Vagal). This cascade of responses is shown in the “Autonomic Ladder.”[xiv]

Figure. The Autonomic Ladder. ©2018 Deb Dana, from The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation. Used with permission of the publisher, W. W. Norton.

Window of Tolerance

When we have unresolved trauma, we can become stuck in a response mode of either Sympathetic fight/flight (anxiety, disorientation, agitation – the “gas pedal,”) or shutdown (depression, dissociation, withdrawal – the “brake pedal”). Our ability to cope with life shrinks, and input–even positive or well-intended input–can feel painful and unwanted. We may experience jumping between these two defended modes unexpectedly: we inadvertently engage the gas pedal and brake pedal simultaneously. It’s easy to see how if we have an over-sensitized nervous system, we seek to cope through substance abuse or other addictive behaviors.

For the trauma survivor, in the middle of the two extremes of fight/flight and checked out, lies a narrowed “window of tolerance,” the place where we can interact is a nurturing and healthful way.

Figure: Hogan, Jacqueline. “Living in Your Window of Tolerance.” @Jacquelin Hogan, Counsellor and Coach. https://www.jacquelinehogan.com/window-of-tolerance/ Used with permission.

How can we expand our “window of tolerance” to build resiliency when uncertainty or anxiety appear, and lessen the risk of harmful addiction? Trauma therapists use various techniques to help open the window of tolerance by touching into states of hyper-arousal or hypo-arousal slowly, over time, and in small doses. The goal is to restore and rebuild healthy social engagement. They do this by guiding us to consciously explore eye contact, familiarity (“tribe” or “herd”), collaboration, teamwork, support groups, and other behaviors[xv] when we encounter uncertainty or potential threat. We can also speak of this expanded window as the development of vagal tone. We will return to connection between vagal tone and yoga in later chapters.

As I mentioned in the Introduction, Bessel Van Der Kolk presents top down and bottom up approaches to trauma healing. How do these square with Polyvagal theory and the nervous system’s response to traumatic events?

The top down, cognitive or talk therapy approaches, can help us to release stress by using logic to unwind emotions. The thinking mind, however, tends to shut down when we sense danger or threat. We also often find it difficult to express through words the details of what has occurred during trauma. Porges has found that some treatment models are–intentionally or not—meant to encourage us to “get over it” by tamping down feedback from the body, where trauma may be held or trapped.[xvi]

In the bottom-up approach, we work to allow “the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that result from trauma.”[xvii] The bottom-up approach starts with the release of stress that is held in the body. When that release happens, it has a positive effect on emotions and thought patterns. Working with bottom-up approaches over time, the physical impact of trauma is both the potential source of healing and the path to a return to wholeness. Porges outlines that return to wholeness as a process of restoring social engagement as the default, rather than being stuck in defensiveness, escape, or shutdown.

One last point to bring in here: If we look at the last row of the Table above on the Polyvagal theory, we can see that each part of the ANS is located in a different area of the body. Ventral Vagal engagement takes place at the face and throat; Sympathetic engagement at the spine, limbs, and adrenals; and Dorsal Vagal engagement at the torso and gut. The activities that occur during perception of safety – those that promote care, compassion, connection, play and intimacy, in other words prosocial behaviors – engage all three aspects of the ANS. In other words, these prosocial, positive behaviors engage and link the whole body.

Polyvagal theory used to guide bottom up approaches can lead to resolution and healing, on the individual and personal level. We will be limited in our success, though, without also exploring the sources and consequences of trauma beyond ourselves. The root causes of trauma, that in many cases lead to addiction, must also include looking at the systems that result in trauma.

Collective Trauma

 

People in addiction struggle with personal trauma histories that are unique to their life circumstance, and likely led them to seek relief through addictive substances and behaviors. However, we are also impacted by collective trauma. By collective trauma, we mean the shared psychological impact of an event, history, or treatment of a group or society where everyone is impacted. Common examples of collective trauma are war, racism, authoritarianism, genocide, sexism, and natural disasters.

To understand the impacts of collective trauma, we have to look back in US history and its colonizing systems. One of those systems is what Joanna Macy as termed the Industrial Growth model. The Industrial Growth model that arose in Europe and then in the US was prevalent starting with the Industrial Revolution of the late 1800s. New studies, though, such as the 1619 Project, Stamped from the Beginning, Caste, My Grandmother’s Hands, and others,[xviii] continue to extend our understanding of the origin of Industrial Growth capitalism back to the first arrival of slave ships in the American colonies. The 17th-19th century time period in the US marked the forming stages of a white supremacy culture that originated and was reinforced by industrial capitalism. White supremacy culture is “the idea (ideology) that white people and the ideas, thoughts, beliefs, and actions of white people are superior to people of color and their ideas, thoughts, beliefs, and actions.”[xix] Though the Emancipation Proclamation dealt a strong blow to slavery in the US, discrimination continued in waves of racist ideology throughout this time period, so that African-Americans were prevented from full participation in the reward systems of US industrialization.

By mid-19th century, the spread of steam-powered engines that allowed extraction of resources, textile processing, rapid cross-Atlantic travel, and the railroads, led to ever-expanding profits for trading companies and industrial “captains of industry.” Large-scale agriculture and mass-production factories, supported by slave, indentured, and immigrant labor in the US, were propped up by financial systems that allowed the few to profit from the work of many.

Initially, the waves of 19-20th century immigration from Europe included white groups from Ireland, Italy, and Eastern Europe, who were also kept out of the reward systems. Over time, though, these groups were integrated into dominant cultural norms centered on whiteness, and bias against these groups faded. Not so for others.

Moving forward through the 20th century, the spread of electricity, telephones, gas engines, and air travel accelerated industrial growth, and led to a mid-century era of prosperity (for some) and a sense of unlimited potential. On a parallel track, waves of racially discriminatory laws and practices continued to exclude, marginalize, and kill Blacks, Native Americans, and other people of color. The owner class was crystalizing, now clearly consisting of European-origin, largely Christian white males controlling most resources and continuing to disenfranchise newer waves of immigrants from southern hemisphere countries.

By the late 20th century, the expansion of industrial globalization was rapid and was seen as further progress. Owners could now expand operations to low-labor cost countries and produce goods anywhere to support the lifestyles of those in developed countries. Those on top talked of a “trickle down” effect, and promoted the idea that soon wages and standards of living would rise worldwide. Yet, the reality is that despite real social progress in some areas, the Industrial Growth model has resulted in more racism, exclusion, inequity, unrelenting wars, and environmental damage than ever. In short, those who have been excluded from resource acquisition over generations (African-Americans, Latinos, Asian-Americans, Native peoples, the poor, women) have been impacted most by the collective trauma of industrial growth capitalism.

But no one group alone has experienced the collective trauma and harms of oppressive systems. While those with the least power take the brunt of the traumatic circumstances, we can see in oppressive systems that survivors, bystanders, and oppressors alike may turn to addictive actions for relief.

In Mary Watkins and Helene Shulman’s breakthrough study Toward Psychologies of Liberation,[xx] the authors point us to a consideration of the impacts of collective trauma. They believe that we can only find healing by freeing each other from oppressive systems. Liberation psychology asks us to interpret symptoms in relation to community and cultural life. In the authors’ view, we must be able to connect healing with social and cultural transformation, rather than by only helping the individual one-on-one. Liberation psychology defines a “need for psychological practices that can repair the bonds among people as well as the narrative threads of an individual life history.”[xxi]

Survivors. Those who survive or are raised in the midst of collective traumatic events take the brunt of the system in feelings of hopelessness, numbness, lack of agency, and despair. In a state of traumatization, those affected come to feel a “gradual realization that the community no longer exists as an effective source of support.” Survivors experience marginalization at the seeming “edges” of society, through inadequate healthcare, racism, poverty or violence, and through the experience of ongoing numbness and isolation.

Oppressors are led to deny their basic humanity in order to perform acts of violence. They adopt ideologies such as race superiority, misogyny, and xenophobia, and by doing so suppress and deny the natural human emotions of care and regard.

This toll of denial is embodied, as Watkins and Shulman discovered in their work. They recount studies of Nazi perpetrators and their offspring (more about intergenerational trauma below), where the effects of their actions became “forgotten by consciousness, but remembered in the body.” These symptoms were in some cases the remnant signals of the total suppression of empathy with survivors. “Splitting” headaches, sensory overload, inability to sleep, and often leading to substance abuse and depression. Our survival as members of a cooperative group, a tribe, a herd, are written in into our genetic code, and when we ignore these natural connections, it manifests also in the body.

Bystanders are those who witness trauma, but are not the subjects of the traumatic event or circumstance. In a society like the US that values individualism so highly, we could say that the bystander role is a habitual response when we encounter trauma. We take the reflexive response to draw back, to deny, to wall off in order to self-protect. Bystanders to trauma, however, also carry the weight of the experience, even though they may seem to benefit from avoidance. Bystanders, according to Shulman and Watson, can become “the severed self,” separating themselves into safe enclaves. We can think of several examples of this: “white flight” to the suburbs; the school voucher system that reinforces school segregation and results in defunding of public education; and anti-immigrant bias. When individuals value hyper-individualism and “grind culture”[xxii] over social good, we are left with a bystanding culture that is led to believe that there is no time to address social inequality.

“[This] individualistic self conducts itself as though its neighborhood, community, and perhaps even family do not really matter. What counts are impressive showings in the array of competitive tasks that are presented as necessary to survival and to opportunities to succeed and excel in the mainstream culture. The capacity to separate and differentiate from others is understood as a triumph of psychological development, advocated by developmental theorizing and supported by normative family and individual therapy as well as families and schools. This competitive self is rooted in visions of scarcity, a vision that leads to violence and disconnection due to struggles over resources that are deemed to be insufficient.”[xxiii]

Chronic bystanding can lead to negative health outcomes by encouraging “a striving self [that] finds itself in a cycle of exhausting pursuits and then in almost frantic efforts at recuperation.” The bystander can experience “real and symbolic losses of community, tradition, and shared meaning” leading to feelings of “personal inadequacy and struggles to fill itself in the ways offered by the culture that has produced it: conspicuous consumption and consumerism, drug and alcohol abuse and addiction, personal rituals of bearing emptiness such as anorexia, celebrity and guru fixations, gambling, passive forms of entertainment…” and other acts of “replacing being with having.”

We see in the bystander a close description of an individualistic society invested in white supremacy culture. In other words, the bystander can enact a successful lifestyle which is actually a dissociation from compassion and from neighborly concern and connection. And that lifestyle can have pernicious impacts, such as addictions, cult influences, or mental health disorders.

It takes courage to give up the privilege of being a bystander. Bystanders feel a fear of being the lone voice in the wilderness. They feel that there is a need to “go along to get along.” Habitual bystanding is harmful because of its psychological costs – the ignoring or hate of “outsiders” and the isolation of “insiders,” which is not spoken of but is felt and expressed in prejudices, gated communities, and narrow rules of engagement with others.

If we are to overcome bystanding behaviors, we must “see through or deconstruct individualism, understanding it as a relatively recent way of structuring selfhood that slowly disrupts community, the loneliness, separation, and emptiness that it breeds…” In a transition from bystander to participant in a healing process, individuals must “disrupt the processes of social amnesia,” as they move toward “mend[ing] the torn fabric of interdependence.”[xxiv]

We can see how the flawed coping mechanism of addiction happens because of the breakdown of communities where collective trauma has occurred.  We can see that each participant in oppressive systems – whether survivor, oppressor, or bystander—can end up on a very short journey to seeking relief through addiction in order to escape. The individual cannot heal themselves through personal change alone, because unjust systems affect everyone, even those who seem to benefit most from them. To overcome addiction, we must transform the oppressive systems that create collective trauma.

Intergenerational Trauma

“The ultimate test of the community recovery process is not the mass recovery of one generation, but breaking intergenerational cycles of problem transmission and embedding personal, family, and cultural resistance and resilience as an enduring intergenerational legacy within the deepest fabric of a community.” – The William White Papers[xxv]

“Trauma is routinely passed on from person to person – and from generation to generation … we need to look to the body – and to the embodied experience of trauma. All of us need to metabolize the trauma, work through it, and grow up out of it with our bodies… Only in this way will we heal at last, both individually and collectively.” – Resmaa Menakem, My Grandmother’s Hands

Within a context of collective trauma, which can affect groups of people widely and across time, is the process of relieving intergenerational trauma.[xxvi] We don’t know yet if family trauma gets passed down the generations by upbringing, or becomes encoded in the genetic material itself (known as epigenetic trauma, an area of research that is underway but not conclusive). What we do know is that parents and grandparents who undergo traumatic events in their lives–such as the survivors of the European Holocaust and their families; Africans who were kidnapped and enslaved for centuries; generations of Native Americans; the Japanese during World War II; and other peoples around the world–are much more likely to grow up in environments where further trauma may occur. And, like the house fire that quickly follows the first hints of smoke seeping under the door, where trauma is active, addictive behaviors for coping often arise.

How does trauma imprint in a community or across generations? Is there a collective nervous system response? People raised in chaotic or traumatic environments, or who have inherited “trauma coding” in their genetic makeup, often seem to “overcome” trauma in adolescence or later in life.[xxvii] Whether this is due to suppression of the effects is very hard to know. When it comes to trauma in families, and the frequent co-occurrence of mental health or addiction issues, so much is hidden, not spoken of, or made light of. We are encouraged to gut it out, because “life is hard,” “you need to roll with the punches,” and “what doesn’t kill you makes you stronger.” There is a lot of work to do before we come to understand how to work effectively with intergenerational trauma and its true impacts.

We have explored the effects of individual, collective, and intergenerational trauma in this chapter. Liberation psychologies teach us that collective traumas need to be healed with community processes, not just individualized therapies that tend to only reach those at the top of the system. We also now understand that mental and emotional trauma – whether individual, collective or intergenerational, or from survivors, bystanders, or perpetrators – affect the body and can manifest as negative physical and mental health impacts.

A final note at the close of this chapter involves bystanders and their role in the trauma-informed communities we hope to foster. The pathway to recovery requires all of us from whatever aspects of privilege we hold, to give up numbing and bystanding behaviors. We are called to reflect on whether the structure of society – our grind culture, individualism, white supremacy, and growth capitalism – is an ongoing form of collective trauma. Are we choosing to stand by as those in power pursue profit and exploit those with little power? This is the danger of a recovery is measured only by individual health, productivity, and income level. Once we emerge from addiction, do we forget others about others who are still mired in it?

Deep ecologists Joanna Macy and Molly Brown remind us that as bystanders “We are tempted to discredit feelings that arise from solidarity with our fellow beings. Conditioned to take seriously only those feelings that pertain to our personal needs and wants, we find it hard to believe that we can suffer on behalf of society itself, or on behalf of other life-forms, and that such suffering is real and valid and healthy.”[xxviii] If this is true, then bystanding itself is injurious to the individual and to society. Our suppression of the urge to help and heal in itself is suffering from which we might seek escape through substance abuse.

Could this bystanding of the pain of others itself actually be the basis of our addiction crisis? Can we survive and genuinely thrive while others are caught in cycles of self-destruction?

We need a fundamental change in how we relate to trauma, which has been shown to be an underlying cause of addictive behavior. To imagine that individuals can recover from trauma and addiction and live good lives while ignoring the devastations around them – in communities and in the environment – is a fantasy. Human and non-human beings live in herds, groups, flocks, packs, fields, forests, ecosystems, water systems, oceans, and so on. It’s only natural that we will root out the deeper causes of the addiction crisis we face through acknowledging our interdependence, and work together to heal the individual, collective and intergenerational trauma that leads to addiction.

[i] Brewer, Judson. The Craving Mind. Yale University Press. 2017.

[ii] Brewer, Judson. The Craving Mind.

[iii] Hazelden Betty Ford Institute. Technology Addiction. https://www.hazeldenbettyford.org/articles/fcd/teen-technology-addiction

[iv] Chris Weller. October 28, 2017. Japan is facing a ‘death by overwork’ problem — here’s what it’s all about https://www.businessinsider.com/what-is-karoshi-japanese-word-for-death-by-overwork-2017-10

[v] Mate, Gabor. 2008. In the Realm of the Hungry Ghosts. Berkeley: North Atlantic Books.

[vi] Van der Kolk. The Body Keeps the Score.

[vii] ACE Report.

[viii] Szalavitz, Maia. How Childhood Trauma Creates Life-long Adult Addicts. The Fix. September 25, 2011. https://www.thefix.com/content/trauma-and-addiction9180.

[ix] The Truth About ACEs Infographic. Copyright 2013. Robert Wood Johnson Foundation. Used with permission from the Robert Wood Johnson Foundation.

[x] Khoury L, Tang YL, Bradley B, Cubells JF, Ressler KJ. Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population. Depression and Anxiety. 2010;27(12):1077-1086. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051362/ .

[xi] Aron, Elaine N. Ph. D. The Highly Sensitive Person: How to Thrive When The World Overwhelms You. Penguin Random House. 2013.

[xii] Porges SW (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation. New York: WW Norton.

[xiii] Dykema, Ravi. “Don’t talk to me now, I’m scanning for danger.” An interview with Stephen Porges. http://stephenporges.com/images/nexus.pdf.

[xiv] Dana, Deb. The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation. New York: Norton. 2018.

[xv] Chitty, John. Dancing with Yin & Yang. Boulder: Polarity Press. 2013.

[xvi] Asprey, David. Stephen Porges: The Polyvagal Theory & The Vagal Nerve – #264. Podcast. December 1, 2015. https://blog.bulletproof.com/stephen-porges-the-polyvagal-theory-the-vagal-nerve-264/

[xvii] Van Der Kolk, Bessel. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books. 2015.

[xviii] The 1619 Project.

https://www.nytimes.com/interactive/2019/08/14/magazine/1619-america-slavery.html.Wilkerson, Isabel. Caste: The Origin of Our Discontents. Random House. 2020. Kendi, Ibram X. Stamped from the Beginning: The Definitive History of Racist Ideas in America. Nation Books. 2016. Menakem, Resmaa. My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies. Central Recovery Press. 2017.

[xix] From https://www.showingupforracialjustice.org/white-supremacy-culture.html

[xx] Watkins, Mary and Helene Shulman. Toward Psychologies of Liberation. Palgrave Macmillan. 2008

[xxi] TPOL

[xxii] https://www.rubiconline.com/the-shortcomings-of-grind-culture/

[xxiii] TPOL p. 163

[xxiv] TPOL

[xxv] http://www.williamwhitepapers.com/pr/Quotes%20from%20William%20White%20%26%20Co-authors%202015.pdf

[xxvi] Coyle, Sue. Intergenerational Trauma — Legacies of Loss. Social Work Today. May/June 2014 Vol. 14 No. 3 P. 18 https://www.socialworktoday.com/archive/051214p18.shtml,

[xxvii] Kelly E. Knight, Scott Menard and Sara B. Simmons. “Intergenerational Continuity of Substance Use.” Substance Use & Misuse, 49:221–233, 2014

[xxviii] Macy and Brown. Coming Back to Life, p. 2