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Who Can You Turn To When AA is Not Enough?

The 12 steps may help many if us us to stay sober and live healthier lives, but they can't always heal trauma from our past. So what can?

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AA can help penetrate the pain. But solving it? That's another matter. ThinkStock

By Kristen McGuiness

10/05/11

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Michelle, a 29-year-old teacher with long blonde hair and three years of sobriety, relates: “The first time I was raped, I was 19. I was already drinking at that point, but after the rape, it got significantly worse.” She pauses for a moment before continuing, “When I was raped again just two years later, that’s when the complete shutdown occurred. What I realized later was that I was suffering from post-traumatic stress disorder (PTSD) and the trauma and the addiction were just feeding off each other. I couldn’t leave the house without drinking or using, but then it only increased the fear and anxiety that I was already experiencing.”

According to Los-Angeles based psychologist and trauma expert Dr. Deborah Sweet, “When people are traumatized, they lose the ability to self-regulate or self-soothe themselves. They reach out for self-medications to deal with what has happened to them. The addiction is a way to keep trauma at bay. Drugs and alcohol are natural painkillers after all.” 

Dr. Sweet explains that trauma can look different for different people: “We can be talking about childhood trauma, where someone was criticized or grew up in an unpredictable, confused, or alcoholic home. There can be shock trauma: stemming from an attack or an accident. There is physical trauma, sexual trauma, emotional trauma. The condition can take on a lot of different forms, and what people have to remember is that what is traumatic for one person might not be for another.”

People need to understand that the 12 steps are about our reactions—“What did I do?”—and therapy is about what happened to us.

For Jackie, a fashion designer whose punk rock style and addiction—she's now eight years sober—are both expressions of her past, growing up in an alcoholic home has had enduring effects on her life. “I’m an adult child of two alcoholics, which meant that I had to learn to take care of myself really young,” she explains. “I would be putting my mother to bed at the age that she should’ve been putting me to bed.”

As Jackie explains, the damage from her parents’ alcoholism really reared its head once she became a teenager. “In my adolescence, because I was so traumatized, I constantly had a need to escape myself and that’s where my addiction came into play,” she says. “After a while, I couldn’t really separate whether it was the trauma or the alcoholism that was making my life so unmanageable. At that time, I didn’t have a program to look back at my life, as we do in the 4th step, where I could go and observe the source of my fear. I think the only time trauma and addiction get separated is when you hit bottom and can see that they are distinct things.” 

Dr. Joe Kort, a psychotherapist and author who specializes in sex and relationship therapy and who has worked with numerous patients suffering from trauma, explains that when trauma sufferers are getting sober, they need to make careful choices to protect themselves. “When people are doing drugs and alcohol, the trauma doesn’t get treated so when they finally get the addiction under control, they are connecting to it for the first time. It’s not a bad thing, but they do need to be cautious about who they’re telling. If handled improperly, it could be re-wounding to the person with the trauma. That’s why they should be seeing someone who is trained in understanding the intricacies of trauma, and even specialized in EMDR (Eye Movement Desensitization and Reprocessing, a form of therapy that retrains the cognitive system damaged by trauma).”

Michelle realized early on that she had to be careful how she approached her trauma with sponsors. She recalls, “My first sponsor was a Scientologist and she didn’t agree with my being on medication for my PTSD. That [not being on meds] wasn’t going to be an option for me. I don’t have health insurance so seeing a qualified therapist is kind of hard for me right now, but I’ve been on medication for a while and it has really started to work.” Explaining the role the 12 steps have had in her growth,  she adds, “Though working the steps were huge for me, they haven’t treated my trauma. I know that without the medication, I would return to the old anxiety.”

According to Dr. Sweet, who not only works in the field of addiction and trauma but also has been sober over 20 years herself, “The 12 steps are not a cure for trauma; they are a cure for alcoholism and addiction. That doesn’t mean that the 12 steps aren’t important. They are crucial as a framework before or while doing the trauma work, but I think people need to understand that the 12 steps are about our reactions—“What did I do?”—and therapy is about what happened to us.” 

For Paul, a 45-year-old bookseller with graying good looks who experienced extreme physical violence as a child, recovery has been the first step, but not the last, in healing the wounds from a physically and emotionally traumatic childhood. “When I was drinking and using, I used the trauma as an excuse,” he confesses. “It was like, ‘You’d drink too if you had this done to you.’ But then I did the steps and I worked through those resentments. Unfortunately, I’ve begun to see the trauma come up more and more the longer I stay sober, and it makes me really think that I need to get some outside help to address it even after 15 years of sobriety.”

Dr. Kort explains that without resolving the trauma, people risk repeating the cycle. “What happens,” he says, “is that they have unresolved and untreated trauma and as an adult, they reenact it in various ways—returning to the scene of the crime or repeating what happened to them as children.” 

Paul understands. “My stepfather was horribly abusive to my brother and me, and for years I had this resentment against him,” he says. “But then as I grew older, it shifted to a resentment against my mom for not protecting us. And now I have seen it shift into my relationships with women. I’ve been having a lot of issues around trust, and though I have done the work around my mother and stepfather—I still pray for them every day—I need to start doing the work on the relationships in my life today.”

Dr. Sweet suggests that those who have suffered trauma pick a good sponsor “and that means one who can also realize what is beyond their scope. When we’re dealing with abuse, assault, rape or incest—really heavy-duty things—I believe that sponsors should always refer people to professional care. For people who can’t afford trauma therapy, one of the ways we heal trauma is through relationships, so don’t give up. We can always be healing from trauma.”

For Jackie, that healing has been not just about receiving help but also about offering it. “By the time I got sober, I was in so much pain, I just had to sit on my hands for the first six months,” she says. “I didn’t have the capacity to confront my trauma issues until I could get more comfortable with my feelings. What has helped me the most is helping other girls with similar pasts, connecting with woman who share my story, and realizing that together, using both the 12 steps and therapy, we can help each other heal.”

Kristen McGuiness is a freelance writer and regular contributor to The Fix who wrote previously about the 13th step and dreaming about drinking, among other topics. She is the author of 51/50: The Magical Adventures of a Single Life

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