Trauma and Alcohol Dependency

There is a big drive these days to say that trauma is at the root of all addiction. I seem to be the only person out there saying this: but it isn’t.

Let me explain.

What proponents of the trauma/addiction model are saying is not that you cannot get addicted to a drug unless you have trauma. That would be ridiculous. That means we could take a human being who has no trauma, feed them a diet of cigarettes and heroin for a couple of decades, and they could stop, day one, with no issue at all. Clearly, this isn’t the case. What is really being asked is ‘what is it that makes an individual take a drug in the first place, in fact not just to take once as an experiment, but to take it several times such that they become addicted to it?

The argument is that they have some kind of deep-rooted trauma that causes them to pick up the drug in the first place, and to use it repeatedly until they are addicted to it.

When talking about inner city heroin addiction, I can see the sense in that argument. Personally, if I wanted to try heroin I wouldn’t even know how to go about getting my hands on any. Heroin has got a very bad reputation, so I can (kind of) see the sense in the argument that being motivated to take it in the first place is symptomatic of there being something wrong at a fairly deep level.

So I can at least see the sense in the argument that for heroin addiction there may well be a very high level of addicts with trauma at the centre of their addiction.

But does the same dynamic apply to alcohol? I don’t think it does.

Don’t forget that what we’re looking at here is the reason people have for taking a drug on a regular enough basis for them to get addicted to it. After all, to be in a position where you take heroin, not once but several times, things may have already gone wrong, and the plan of ‘work hard at school, do well, get a decent qualification and a good, stable job, then live a happy and fulfilled life isn’t going quite according to plan.

Alcohol however is completely different. Things don’t have to have gone badly wrong in order to start drinking and to keep drinking on a regular basis. On the contrary, drinking is the norm and the opposite is often the case; when things are all going well we drink quite merrily, it’s usually only when the wheels start coming off that people look to quit.

Let me put it another way if I went to a dinner party, and I took out a battered leather case, removed a syringe and started injecting myself with heroin, there would be furor. But if I wanted to go and drink some alcohol, no one would bat an eyelid. In fact, I generally come under abuse because I don’t want to drink. ‘But surely you can have one, ‘leave the car and get a cab’, ‘you mean you don’t drink at all?!?!’ and all the other comments that we who don’t drink have to face on a regular basis.

We may be happy, healthy, and successful, with the key to a bright future. But every time we meet friends, every time we go out with colleagues, every time we have a meal, every time we sit down after a tough day, we have a drink. Why? Well, it’s certainly not because we’re all riddled with trauma, for most of us it’s just because it’s what we do in the West, in the same way, we keep our forks on our left and our knives on the right, and we wear a suit when we want to look smart, we have a drink when we’re out with friends, or when celebrating, or after a hard day. It’s part of our culture. It’s part of who we are.

My point is that all things being equal, we drink. And we drink. And we drink. And what happens? Several things, in fact, some physiological, some psychological. Let’s look at the physiological first.

Alcohol is a sedative; it’s a chemical depressant, which means it decreases or inhibits nerve activity. In other words, it calms things down. This isn’t really the problem, the problem is that the human brain is reactive and it works by way of a delicate chemical balance that it is always striving to maintain. So when we take alcohol which is a sedative, our brain tries to counter it. It does this in several intricate and not fully understood ways, but what it amounts to is that it becomes hypersensitive so it can work under the sedating effects of the alcohol. When this alcohol wears off, this hypersensitivity remains for a period. In minor cases (say, a small glass of wine) this will manifest itself as a slight, almost imperceptible feeling of unease, feeling slightly uptight, and maybe slightly less restful sleep than usual.

Take a bit more, say a bottle or two of wine, and that post-drinking oversensitivity gets worse. After all, the more you drink, the more your brain has to recalibrate, and the worse you feel after. After a bottle or two, it’s no longer a slight, almost imperceptible feeling. It’s a very definite feeling of anxiety, of feeling uptight, of feeling out of sorts and unable to sleep (which is why so many drinkers wake up in the middle of the night unable to sleep). It’s what is colloquially known as ‘hangxiety’, that unpleasant feeling or worry you get the day after drinking. In fact, let’s call a spade a spade. This unpleasant feeling is alcohol withdrawal. After all, it’s an unpleasant feeling that’s caused by a chemical imbalance in the brain, that is itself caused by the original dose of the drug.

Take even more than that, say 2 or three bottles of spirits, and the withdrawal is the full soup and fish; shakes, total insomnia, inability to eat, panic, and even seizures and DTs.

The natural tendency is to drink more and more because the brain becomes increasingly proficient at countering the sedating effects of the alcohol, and as it does so three things happen:

Firstly we are able to drink more (this is what tolerance is).

Secondly, we want to drink more (after all we need to drink more to get the same effect).

Thirdly, the withdrawal gets worse.

It’s what happens to us when we are in the withdrawal phase that is key.

When we are in that withdrawal phase (or post-drinking oversensitivity) we don’t feel right. Our usual mental resilience is substantially reduced. Little things that would ordinarily not bother us can start to concern us, and even become overwhelming. In short ‘life’ (whatever that word means to us) looks a bit more intimidating, a bit more insurmountable, a bit more unpleasant all around.

There are two ways to get rid of this withdrawal.

One is time. After a few days, your brain chemistry gets back to normal. But it does take a few days, and who wants to wait a few days to feel good? You want to feel good now! So how do you go back to feeling good RIGHT NOW?

Well, that’s simple enough, you can just take another drink. After all, the whole reason you feel so anxious and intimidated and overwhelmed is because your brain is geared up to work under the sedating effect of the alcohol, but the alcohol isn’t there, so it’s tearing ahead, going mad, overthinking and over-worrying. Think about driving a vehicle at a good, steady, 30 mph pace. It’s a perfect speed. You’re moving ahead nicely, but totally safe and in control. Your foot is applying consistent pressure on the accelerator. But then the tarmac road ends and you’re driving on wet, muddy grass. The vehicle slows down drastically. Now you’re going far too slowly. So you push down on the accelerator harder, and harder and harder. You eventually get back up to that 30 mph pace, then suddenly the muddy grass ends and you’re back on a tarmac road. The tires bite the tarmac and the vehicle leaps ahead, totally out of control. That’s what happens when you drink alcohol. For every action there is an equal and opposite reaction, there’s no free ride when it comes to drugs (and particularly not with alcohol).

So when you feel awful, anxious, out of sorts, and overwhelmed due to drinking, the quickest way to get rid of that feeling is to have a nice large glass of sedative. If you do so you immediately correct that chemical imbalance and revert back to your usual confident, capable self. And doesn’t that feel just great?

The trouble is that when we are in that withdrawal phase everything looks bad. Stephen King once wrote that the hungover mind will find the most disturbing part of any panorama and focus in on it. Won’t it just. And therein lies the problem. Let’s take an example. Say you had an argument with your Dad on your 21st birthday. It upset you and bugged you at the time, but you know what? It wasn’t a big thing, you made it up afterward, and it’s all good. But when you’re in alcohol withdrawal, when you are feeling anxious and out of sorts, when your brain is racing ahead out of control, you may keep coming back to that argument. You may keep thinking about it and worrying over it. The same way when you get a sore in your mouth you can’t stop constantly running your tongue over it. That argument may worry you and be on your mind constantly. Then you have a drink and your normal confidence and resilience returns and that argument goes back to being what it always was; an irrelevance.

In this situation, you can very easily fall into the trap of thinking that the argument with your Dad affected you very deeply, and the reason you drink is to mask the pain of it. After all, that’s exactly what seems to be going on. So the myth that your addiction is tied to a traumatic event in your past is one that is very easy to believe. But it’s not true. It’s not the event that was traumatic, but the warping effect of the withdrawal that makes it seem so.

Some people do genuinely have trauma, and I absolutely believe that they are more likely to end up addicted to alcohol, in the same way, that those with mental health issues are more likely to end up with alcohol dependency. After all, if we don’t feel good, if we suffer from anxiety or depression or a sleep disorder, if we have ADHT/ADHD or bipolar or suffer from obsessive compulsive disorder, or suffer from trauma, then we don’t feel good. And if we don’t feel good a sedative may well make us feel a whole world better, after all, it’s going to anesthetise that bad feeling. And what’s the most readily accessible sedative out there? What sedative is available without prescription, from our nearest supermarket or convenience store? What’s the strongest sedative that we can obtain in almost unlimited quantities (in fact that is only limited by how much we can afford, beg or steal)? Our old pal alcohol of course.

So I totally get that someone with trauma (or indeed an underlying mental health condition) is more likely to drink and to drink more, and therefore to become addicted to alcohol. So you can expect a higher percentage of people with trauma or mental health issues to be represented in the alcohol-dependent population than in the population as a whole but, THIS ISN’T THE CASE FOR EVERYONE. There are people out there who drink regularly enough, and in enough quantities, to become addicted to alcohol who have no such underlying issues. They drink for one reason and one reason alone; it’s because it’s what we in the West do. It’s fun, it’s sociable, it’s an integral part of weddings, holidays, social occasions, celebrations and commiserations. Many people have jobs that require them to entertain clients, and the way we do that in the West is with alcohol. So their job actually requires them to drink daily and heavily. So all these people out there drink, and they drink, and they drink, and so become dependent on it, without any underlying trauma.

Many people claim that many of us drink, but only some of us become addicted, and the reason for that is trauma. Again I take issue with this. Firstly I’m not clear that there are lots of drinkers out there who aren’t addicted to it. The majority of people I know drink, and the majority of them drink more than the recommended daily amounts. The majority of them struggle to do dry January and don’t enjoy social events without drinking. If you cannot enjoy something without a drug then there is a level of addiction there (psychological if not physical). Children don’t need alcohol to enjoy social occasions, and nor did any drinker before they started drinking. Needing a drug in order to cope with or enjoy life is a form of psychological dependency.

Secondly, I don’t believe in any event that trauma is the sole reason why some people become addicted to alcohol when others seemingly don’t. I believe that there is a much simpler explanation; some people drink more than others on more occasions. That may be to do with trauma, but equally, it may not be. Some people are brought up in a household where it’s normal to drink every day. Some people have jobs that require them to entertain clients so feel obliged to drink every day (I’ve heard many times from people who work in the City of London of the days when they’d be drinking over 100 drinks a week, and all of them on the company credit card). Consume enough alcohol and you WILL get addicted. Period.

There will be people out there who will say that trauma doesn’t have to be some huge, dreadful, overwhelming event. Trauma can come about from much smaller things, like not having your emotional needs met as a child. Which is another thing that I think is dreadfully wrong with the world of recovery at the moment; its current inability to differentiate between ‘trauma’ and ‘life’.

No life is perfect.

Every life has its ups and downs. But we humans can on the whole cope with these ups and downs providing they’re not too extreme and not in too great a number (and providing our brain chemistry is as it should be and hasn’t been disrupted in some way). A lot of what is currently being chalked up to trauma isn’t trauma. It’s just life. And yes, I get that some people are more sensitive than others and may be traumatised by something that may not traumatise the next person. But for the vast majority of people, not having your emotional needs met is not traumatic, it’s just life, and we are adequately capable of coping with it. Trying to make it out as traumatic in order to fit an incorrect theory (after all if we want to say that all addiction is the result of trauma then we have to open up the definition of trauma massively to make that theory fit) is not only incorrect, it is also incredibly insulting to those with genuine trauma. To say that not having your emotional needs met is traumatic in the same way that being raped is, or being sexually abused as a child is, or going out on a patrol and coming back having to scrub your best friend’s blood and brains off you is, totally belittles true trauma.

Even for those with genuine trauma, there is not an unbroken link between that and addiction. The fact is that there is an intervening step between the two, a break in the chain of causation if you like. And that is how we look to manage things when they aren’t going well. When we feel bad, depressed, miserable, overwhelmed, there are a lot of things we can do to try to manage that, some good, some not so good. We can seek counselling, we can see a psychiatrist or a doctor, we can exercise, read, lose ourselves in a hobby, try meditation, yoga, homeopathic remedies, we can speak to friends, we can hide ourselves away from the world, we can spiral down and down, and we can take drugs. Taking drugs is just one of many responses to trauma, After all, there are a lot of people out there with genuine trauma who don’t become addicted to drugs at all.

Drugs are a pretty poor way of managing things because the benefit is so short-lived and the aftereffects so catastrophic, in fact in the medium and long term they tend to exacerbate and exaggerate any problem multiple times over. However they do tend to be the default option for many people for one simple reason; there is an expectation, sense of entitlement if you will, that we feel good all the time. And if we don’t feel good we need to consume something to make us feel better. TV shows, films, friends, adverts, books, songs and colleagues, all perpetuating the idea that if we don’t feel good at any point we just need to shove something down our necks in order to feel better.

That is the crux of the problem. It’s not the trauma, it’s the learned but very core belief that we can use drugs to manage it. Don’t believe me? Look at TV, films, adverts, read books and listen to songs. Go on social media and look at the images. Start to count how many times a day you’re presented with an image of someone relaxed and happy with a drink in their hand. This is the message we are continuously being bombarded with; that whatever your problem is, a drink will take it away. Even though the learned desire to consume something to change how we feel is quite prolific in our society, not everyone is conditioned in this way.

There will be people who quit drinking and find that they do indeed have an underlying issue (like trauma) that is like a dark cloud hanging over them, making them feel miserable and constantly crying out to be sedated with alcohol. For those people quitting is one thing, sorting out their underlying problem is another. But for a significant number of people quitting is the only thing they need to do. After that all the rest just becomes life, but minus the alcohol they find they are very well equipped to deal with that, thank you very much.

It is this latter category of people that are being failed miserably by the current obsession with trauma. I’ve had too many people come to me and say that they have struggled with their drinking and have reached out to professional for help, only to be told that the first step is to identify the trauma that is causing them to drink. They can’t do this of course because there isn’t one. Eventually, they’re sent away having first been made to feel like they’re being obtuse and difficult for not admitting their trauma. Many people no doubt invent something or convince themselves there is something when there isn’t, just to get the help they need. Time and effort and money are then expended on this imagined ‘trauma’ instead of getting to grips with the real issue.

The link between trauma and addiction may be very high when you look at heroin addicts in an inner city. In order to take a drug with a reputation that heroin does, not just once but several times, I can see the argument that there has to be something wrong, and I understand the argument that that issue could be based on some traumatic event in the addict’s past. However, I’m not convinced that even heroin addiction has trauma as its ultimate cause in every case. Because we need more and more alcohol to get the same effect, because it drags us down more and more, because it becomes increasingly difficult to get satisfaction from drinking, and because late night drinking tends to be where other drugs seem to appear out of the woodwork, I think it entirely plausible that people can end up on heroin due to drinking, and not due to an underlying trauma. It’s a gateway drug; a drug that leads to other drugs as we’re constantly trying to get to that feeling of peace, confidence and tranquillity that we had all the time before we started taking it in the first place, and as it becomes increasingly difficult to achieve. Why spend time trying to drink your way through half a dozen drinks when you already feel sick, when you can just inject some heroin?

Be that as it may, either way, the same dynamic does not apply to alcohol, which is a socially acceptable drug that between 80% and 90% of the population consumes. Trauma is NOT at the heart of every addiction, and until the recovery industry starts to appreciate that it will continue to fail those who are seeking its help, particularly those with alcohol dependency.

When it comes to addiction, society has a very sad history of victim blaming. Society started out by simply throwing its hands in the air and declaring all addicts as insane. Then it started claiming it was a spiritual or personality disorder. Next came genetics. Now is the era of trauma. All of these things blame the individual. When are we going to take our heads out of the sand and face what has been staring us in the face of thousands of years? It’s not the individuals that are at fault, it’s the drug. If you take a drug often enough you’ll get addicted to it. If you don’t, you won’t. It really is that simple. Trauma may be a reason that someone picks up a drug and take it regularly in the first place, but it’s not the only reason. With alcohol, most people I’ve come across consume it regularly simply because it’s what we do in this society, not because they have an underlying trauma.