General Trauma And Substance Abuse

SHAUN WHITTAKERDUTCH psychiatrist Bessel Van der Kolk, in his groundbreaking book ‘The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma’ (2015), asserts that it is the body – as opposed to the brain or mind – that primarily remembers trauma, and that the key issue is therefore the bodily alienation of trauma survivors.

Moreover, that foremost authority on trauma points out that those distressing memories get stuck in the brain, and are consequently expressed throughout the body, which has its own memory systems. In overcoming trauma, the centre of attention should hence be the body (sensations, intense emotions and the sense of self) rather than the mind (cognitions). In an effort to numb the bodily discomfort, the traumatised easily disconnect or dissociate from their bodies. This body-oriented paradigm therefore holds critical implications for how to approach trauma, in order to assist survivors in developing a sense of physical comfort and to embrace their bodies.

Furthermore, says Van der Kolk, chronic distress should rather be referred to as a “developmental trauma disorder”, in contrast to the limited and once-off notion of “post-traumatic stress disorder”. This is because many people are exposed to an ongoing and generally traumatic situation, and that ought to be acknowledged in the conceptualisation of trauma.

In another award-winning book ‘In the Realm of Hungry Ghosts: Close Encounters with Addiction’ (2010), Canadian physician Gabor Maté compares addicted people to hungry ghosts. Maté, who is an expert on trauma and addiction, describes such individuals as having an ‘aching emptiness’, and constantly seeking something outside themselves in order to “curb an insatiable yearning for relief or fulfilment”.

Most notably, however, for Maté, “addiction is only a symptom; it’s not the fundamental problem. The fundamental problem is trauma”. To fill the emotional void, the dependent person has to recognise that the addiction is only a consequence, and that the basic concern is really trauma.

After all, trauma is the underlying cause of addictions. And, in the final analysis, addiction is not in the genes, but an outcome of social relationships. Maté maintains that “trauma is the loss of connection to the self – to your body, your emotions, and your essence”. But this is not meant in the narrow sense in which it is used in diagnostic manuals, but in the broader or general sense of the term.

At the same time, substance abuse encompasses different forms of addiction, such as the abuse of food, pain tablets, sex, pornography, shopping, gambling, work, etc. This dependence represents temporary attempts to feel good, since such people have suffered so much. In the book, Maté refers in particular to the trauma of indigenous populations due to dispossession, the destruction of their culture, racism, patriarchy, etc. In other words, it is crucial to understand the social roots of addictions.

Alcohol and drug abuse (including cannabis) are the highest among the most distressed sections of society, while alcohol is in fact usually the real gateway drug in a traumatised society. And such substance abuse is often misinterpreted as a moral weakness of the individual or the group, without comprehending those underlying social causes. Indeed, complex or multigenerational trauma arises from a history of harmful social relationships, or ongoing toxic social conditions.

Psychologist Peter Levine, writing in his book entitled ‘In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness’ (2010), focuses on the somatic experiences of the body. He emphasises that trauma is a psychological injury, and not a disorder or disease. The pathologising of traumatic experiences unfairly discredits the survivors.

So, it is necessary to not only highlight childhood distress, but also social or community trauma in general, as there are significant limitations to an individualised diagnostic and treatment framework. The focal point cannot merely underline the behaviour of the addict, without appreciating the broader context. If general trauma is an outcome of social causes, then surely there is a huge need for social interventions, such as collective running projects or community yoga programmes.

Those community members should be enabled to escape from physical alienation and take their bodily control back. Instead of experiencing the human body as a burden, it ought to be perceived also as a source of love and happiness, and as something to take care of and to keep healthy. The challenge for all trauma survivors is to be able to restore the dignity of the self and the body.

* Shaun Whittaker is a clinical psychologist in Windhoek.

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