What is the guiding approach of Harmony Heals to addiction and trauma?
Harmony Heals began as a holistic counseling center whose goal was to treat trauma survivors. In this journey we discovered that there were few if any clients with trauma that were not also suffering with an addiction. In fact evidence shows that many if not most clients with substance abuse issues and serious mental health issues have a history of trauma. At Harmony Heals we have always believed that we must treat the underlying trauma in order to alleviate the symptoms which increase the likelihood of addition and other mental health disorders.Clients who have suffered trauma, tend to have repeated relapse and hospitalizations hoping to decrease their symptoms. Unfortunately the programs they attend may not focus on treating the root of the trauma, just work to stabilize and release them. By utilizing trauma trained professionals working to build understanding of these symptoms, and therapies geared to move beyond the trauma, we can improve the client’s ability to thrive.
What do you define as trauma?
The Diagnostic and Statistical Manual of Mental Health DIsorders, DSM V, defines trauma as exposure to actual or threatened death, serious injury, or sexual violence; either by direct experience, witnessing it, learning about the event occurring to close friend or family, or repeated or extreme exposures to details of the event. When given this specific definition, clients often will say that in this case they do not have any trauma, although they are exhibiting the symptoms of it. In order to address trauma on a broader scale, we include adverse childhood and adulthood events that have lead to their inability to cope. Some examples of these are:childhood abuse or neglect, sexual abuse, domestic violence, traumatic deaths, life-threatening illness, accidents or natural disasters, living with any illness in yourself or a parent, assault, rape or bullying. We view trauma as Pia Mellody coined “anything less than nurturing”, thereby including loss, neglect, abandonment, lack of nurturing, or being loved, or feeling unworthy.
Relationship Difficulties with Untreated Trauma
Clients with untreated trauma usually experience relationship difficulties as they attempt to have a relationship but still contend with untreated trauma symptoms which can be very disabling. These symptoms include intrusive memories, severe anxiety, sleep difficulties due to flashbacks, easily triggered anxiety or anger, and major depressive disorder. Often the symptoms cause impaired judgment and an inability towards intimacy, impeding their relationships. All of these symptoms make it difficult for the client to have relationships, work, and or function on a day to day level. Clients who experience addiction on top of PTSD symptoms often experience the inability to hold a job and even homelessness.
Are Clients Aware of the Effects of Trauma?
Many clients do not remember or recognize the traumas they have experienced and it is common for them not to make the connection between the trauma and symptoms they struggle with. While clients will agree that they have all of the symptoms of trauma many often believe that they are going crazy. Clients are often surprised to find that the symptoms they experience are natural reactions to trauma. It is also common that clients minimize the trauma with such statements as, “Even though I was abused as a child, it wasn’t that bad as others or as bad as it could have been.” The work begins by owning that these events have occurred and are significant and must be given credence for the impact they have had on the client’s life.
Commonly Overlooked Aspects of Trauma Care
Since clients may not recognize the impact of trauma or even know they have experienced trauma, it is essential to do trauma screening. Often the trauma does not get addressed at all or clinicians dive into the trauma without doing safety and stabilization first. Following an initial assessment there will be an individual session with a clinician who will further screen for trauma. Screening involves an intensive assessment with mapping out the history of trauma and a timeline of events. The clinician is versed in asking very specific, direct, and in depth questions to reveal trauma’s which may be overlooked or not given the significance of a traumatic event. In addition measurement scales such as the DES(Dissociative Experiences Scale) and Beck’s Depression Inventory and Suicidal Scale, will be used to check the severity of symptoms. From the onset of treatment we facilitate trauma work with extensive preparation, and with some clients we may delay or opt to focus on the trauma when the symptoms become more stable.
What can be accomplished with comprehensive trauma treatment?
Clients acquire the coping strategies necessary for self-soothing and emotional regulation. By alleviating the severe symptoms of PTSD they are no longer haunted by the side-effects that the trauma created, including a reduction in intrusive memories and thoughts.They learn more effective survival strategies reducing risk to substance abuse and chronic depression. Clients begin to heal and to know themselves again. They often state “ I feel like myself for the first time in a long time” having begun to learn to nurture and support themselves to live a more fulfilling life.
Is Trauma Related to addiction?
When clients begin to experience post traumatic symptoms, it is common for them to turn to substances as a means of medicating symptoms of intrusive memories, night terrors, flashbacks, negative self thoughts, suicidal ideation, avoidance, and hypervigilance. Substance use becomes a means of coping and surviving these disturbing symptoms. As the symptoms persist and the tolerance for substances build, clients have a propensity towards addiction, needing to use more and more to diminish the intensity of symptoms. Addiction itself then becomes a traumatic event which the client now has to overcome. In the words of our Clinical DIrector, Gina Tabrizy, MFT, “addiction is trauma”.
The Adverse Childhood Experiences Study