I want to share a story about an angry young man, late 20s, extremely bright and educated, with a history of chronic relapse, legal problems, alienation from family and friends and extreme loneliness. Drugs of choice meth, cocaine, and Adderall which had been prescribed to him as a child of 7 years old. We were titrating the Adderall, he was not happy.
We asked, “What was going on at 7 years old that you had to see a physician who prescribed you Adderall?” He replied, “I was angry, acting out, couldn’t focus, and hyper. My parents didn’t know what to do.” So we asked another question, “What happened to you when you were 7 years old?”
“I was molested by a camp counselor, I never told anyone until today. No one ever asked the question.”
This man/boy had been to treatment 5 times and no one asked the really important questions. This young man’s history from 7 onward becomes a map of layers and layers of trauma events like repeated bullying, broken relationships, domestic violence and jail.
Many clients come to us sharing their trauma events for the first time because the question has never been asked, “What happened?”
As clinicians we can provide a safe environment for our clients to begin to Unravel their trauma story. Our most important job is to hold space, witness, providing safety and an environment of trust.
My journey to understand trauma/PTSD came 25 years ago while working with two populations. Men, addicts who were frequent visitors to the criminal justice system, and women who were residents of an excellent long term woman’s program. The similarities were chronic relapse, relationship issues, hopelessness, despair, and trauma histories that had not been healed. The signs and symptoms of PTSD were very evident but not well understood then.
Many of these folks had been sober or abstinent for periods of time but memories, flashbacks and being “uncomfortable in their own skin” had sent them back to substance abuse, process addictions or other unhealthy behaviors.
I believe that when trauma/PTSD creates the impetus for such despair there are only 3 choices:
- Relapse
- “Going Crazy”
- Suicide
Relapse being the healthiest choice and I believe this is where chronic relapse occurs.
There is a 4th choice and that is Trauma Resolution. A painful but amazing journey of healing.
