Addiction and PTSD: The Pleasure-Pain Dilemma
From birth, if not earlier, we are forced to learn how to deal with and find ways of soothing pain.
When we are hungry or distressed as babies, we cry to get our mother’s attention so that she will care for us, help us regulate ourselves, and fulfill our needs. When we are stressed on a neurochemical level, our body releases nor-adrenaline, adrenaline, and cortisol into our bloodstream. When these levels rise too much– in other words, if the level ruptures our emotional threshold– we overflow. When we are not able to contain our emotions, our excess of stress-hormones in our system, we look for ways to pacify ourselves.
In healthy attunement, our parents or primary carers help us to regulate our emotional imbalance when we are babies, then through childhood. Through healthy attunement and care, we become more independent, resilient and able to self-regulate our internal environment, thereby giving ourselves the capacity to face the challenges of life.
The release of dopamine hormones into our bloodstream and on our nerve-receptors takes the edge off our internal suffering and helps us to regain a sense of containment. Through attunement and social interaction, we learn what healthy boundaries and containment are.
Unfortunately, for many of us, a picture perfect life of attunement just doesn’t happen. Misattunement caused by our carers is extremely prevalent in our current demanding society. Furthermore, there’s a need to mention abuse and neglect and what it does to our developing nervous system and our internal regulating mechanisms of pain and pleasure.
When care is not provided at critical moments, and when the lack thereof continues, we look for ways of coping. As children we may become obnoxious and aggressive or shut down altogether; we could turn to self-harm or start behaving in repetitive, disturbing ways. These are attempts to be noticed, and listened to; attempts to help us regulate our internal stress.
By the time we are adults, we will have put into place patterns that will give us some sense of control. What these patterns do is to help us release dopamine in our system in an unnatural way or, when we use substances, replace our natural dopamine hormones by opiates. These are necessary survival strategies that we have put in place in times of need, but when we continue to rely on them, they become destructive.
Addictive behavior, or addiction to substances, alters our relation to our pain-pleasure centers in the brain and creates the additional problem of craving. It masks and perpetuates the underlying Post-Traumatic Stress which is often at the root of all this.
Addictions vary a lot from person to person. They can include alcohol or drugs; binge eating or abstaining from eating; preoccupation with hygiene or self-image; over-organizing or being a workaholic; the need for shopping or sexual occupation, the need for a partner or acceptance through power, money or prestige. Basically, it could be anything. I have encountered people who are obsessively into yoga, cleansing, mountain hiking or are high-fliers in well-positioned jobs, and they suffer.
Repetitive addictive behavior is often related to unmet essential needs in childhood.
To work through addiction is to address the underlying Post-Traumatic Stress. It is only when this has been contained and processed that the impulse to escape into addictive patterns of behavior can be curbed, and this will continue to be a challenge.
Trauma, as well as addiction, creates strong brain circuits or may result in the absence of healthy brain wiring and development. To curb impulses and face trauma that has been there since childhood needs dedicated, committed work. Given the neuroplasticity of our brain, however, it can be done!