
Dealing with past trauma may be the key to breaking addiction - camtarn
https://www.theguardian.com/lifeandstyle/2018/nov/24/joanna-moorhead-gabriel-mate-trauma-addiction-treat
======
andai
I tried breaking an addiction earlier today, but I could only make it a few
hours before the withdrawal overwhelmed me.

I've been practicing mindfulness lately, noticing the "shape" of sensations in
the body, and it struck me that, physically, the withdrawal symptoms felt a
lot like how I feel when I'm working through trauma.

I had the sense that, if I could work up the courage to face it and work
through it (specifically, to practice mindfulness on the extremely unpleasant
sensations), the addiction would eventually dissolve.

So I did a double take, when I saw my own thoughts at the top of HN!

~~~
all2
One thing that really, really helped me was being told that 'it is ok to feel
bad'.

No one had ever told me that before, and I always did my best to avoid
discomfort and pain. Now, I have a much different story.

~~~
yosito
The biggest thing I've learned from breaking addiction is that addiction
thrives with a maladaptive relationship to pain. Developing a new relationship
to pain, embracing it as a path to growth, has been a key for me in overcoming
addictive behavior. So many people I know who continue to struggle with their
addictions do so because they're avoiding pain.

~~~
coleifer
I know, it sounds almost silly but its like being in addiction you're just so
preoccupied with how you think you're going to feel.

------
wenc
Since this HN, folks might be interested in a contrary view of Mate's ideas:

The Seductive (But Dangerous) Allure of Gabor Maté. "Gabor Maté is admirable,
but leads us down the wrong road"

[https://www.psychologytoday.com/us/blog/addiction-in-
society...](https://www.psychologytoday.com/us/blog/addiction-in-
society/201112/the-seductive-dangerous-allure-gabor-mat)

------
mindgam3
Yeah, this is pretty much the most matter-of-fact (and accurate) headline I've
seen on hacker news all week.

What's funny (funny strange, not funny ha-ha) is that there even need to be
headlines about this. In my mid twenties I struggled with some of the various
addictions that were quite fashionable among the SV tech elite (work,
Facebook, Burning Man, psychedelics, in that order). Thankfully I survived
that period and was able to reflect on it, at which point a boatload of
repressed childhood trauma began surfacing. After a number of years of working
through that, the connection between trauma and addictive tendencies is so
painfully obvious. Feeling bad + never learned healthy self-soothing rituals
==> take a hit of something to feel better ==> rinse and repeat.

I've known enough other people who struggled with similar issues to understand
that my experience is hardly unique. I would go so far as to say that anyone
who ever experienced addiction will understand at some intuitive level that
their dysfunctional behaviors are connected to past trauma. The question is,
why is mainstream psychiatry still so obsessed with "curing" addiction via
chemical means, as opposed to through psychology/trauma recovery?

~~~
phren0logy
> The question is, why is mainstream psychiatry still so obsessed with
> "curing" addiction via chemical means, as opposed to through
> psychology/trauma recovery?

I'm a psychiatrist, and at the risk of sounding defensive, I'm not sure where
you are getting this from. I have never worked at any addiction program where
psychological and behavioral interventions weren't the primary mode of
treatment. There are medications that can help with diagnoses related to
trauma or other contributors to addiction (PTSD, depression, etc), and a
handful of medications that can address some limited facets of chemical
addiction, but the bulk of treatment is non-pharamcologic.

The same is true when I got to national and international addiction
conferences: medications are a side-dish, not the main course.

~~~
S-E-P
That is great, I don't exactly know where you are located. But as someone in
California I can tell you that the amount of (at risk) kids that I've worked
with throughout the years tells me over half of them were strung out on a
solely medication based treatment. We were the first exposure to actual
"therapy" that they've ever had, and it is by far the most effective thing
many of them have ever been exposed to. Maybe it's a regional thing, probably
a Californian thing.

~~~
akiselev
I think you're conflating multiple factors here, mainly psychiatry and
parenting. Child psychiatry is an extreme because the patient is most often
not the one making decisions (which they're often not capable of anyway). Much
of the time, the patient hasn't even really figured out what their "normal" is
before their parents stick them with a professional.

Many parents, especially when looking at-risk demographics, look to psychiatry
as an easy fix so that's what the doctors give them. The parents often can't
afford to take time to drive their child to a psychiatrist twice a month let
alone pay for the sessions. The end result is that psychiatry stuck in a
terrible ethical spot, where their duty to treat not just symptoms but causes
clashes with the realities where the parents are at the end of their rope. Are
doctors stewards of health, responsible for the patient? Or are they
professionals that have to meet their _clients_ half way? I don't think there
is an easy answer to that question.

Obviously there are many unethical and incompetent psychiatrists but my
experience in California (as an adult) stands in stark contrast to all the
horror stories I hear about child psychiatry from school administrators. As
usual, there is a massive wealth gap and your mileage will vary.

~~~
S-E-P
A lot of the kids we've dealt with parents are typically incarcerated, dead,
or no longer have custody of their children.

In our area sexual abuse is one of the main issues, usually these kids live
with relatives(after the conviction) who are usually the most well off in the
family. They still by in large get the short end of the stick even though the
relatives/guardians try to work with psychiatrists, but we've heard how that
goes. That's often how they end up with us, they (the relatives/guardians)
bring their troubled kids to us for actual help, not just medication.

But hey I don't mind, we do better work (at least in our area), bring 'em all.
Gets more kids off of substance abuse, gets them connected to people who care
about them, and more times than not equips them to help their families and
community by in large. And we don't even get paid (all voluntary), and that's
how I prefer it.

~~~
akiselev
Is your org more of a last resort for these guardians so they go to
psychiatrists first or is it a discoverability problem in general?

Since you're all volunteering, I'm curious if the simple removal of the profit
motive is enough to change the way all parties involved approach treatment or
if its a matter of just having more time to devote per person (because the
limit becomes your time and patience instead of their checkbook).

~~~
S-E-P
No, it's for any at risk kid, and many do come first. Most likely discovery
since that would take a lot more energy and money.

Since there isn't really any motive to reach a solution, and no harm no foul
if it doesn't work out. No one's going to really hold us to anything since it
doesn't cost them anything more (sometimes less since we will pay for what
they need when they are with us, none of that gets reimbursed).

------
talltimtom
I get people saying “Well of cause”. But this is just a fluff piece. I
honestly would love to see a scientific breakdown of just how often we are
actually seeing people become addicted due to purely psycological or
environmental factors. I come from a family that has seen all to many cases of
addiction so I am absolutely certain that there is a genetic component to it,
and as a result I have consciously stayed away from anything addictive short
of caffeine, to which I honestly feel I have an unhealthy addiction that I
just cannot cut. I’d love to see someone break down the science. And I truely
think that if the consensus became that addiction was most often due to past
trauma, then we would see a revolution in how fundamental where distributed
and in treatment.

~~~
phren0logy
"Trauma is Just One Risk Factor Out of Many Possible Contributors to Addiction
Disorders" doesn't quite have the same ring to it.

But to your point, there are well-described genetic risk factors. And
socioeconomic, environmental, etc. risk factors. Like any complex behavior,
there's no "one weird trick" that explains it all. But that doesn't get
clicks. (I am an MD who treats addiction)

~~~
bernardlunn
Yes, but also trauma is treatable without Pharma drugs eg by meditation,
hypnotherapy

~~~
tcj_phx
"Stress" experienced by people who are traumatized (fresh trauma or PTSD) has
effects on the physical body. There are some good prescriptions that can help
with the biological effects of stress: MAOI's [0], various supplements, etc.
Sometimes "depressed" patients really just need thyroid medications.

MAOIs are good for getting people out of bed while their team figures out what
other sorts of interventions they'd benefit from:

    
    
      [...] New research into MAOIs indicates 
      that much of the concern over their 
      supposed dangerous dietary side 
      effects stems from misconceptions 
      and misinformation, and that it is 
      still underutilized despite 
      demonstrated efficacy.[4] New 
      research also questions the 
      validity of the perceived severity 
      of dietary reactions, which has 
      been based on outdated research.
    

[0]
[https://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor](https://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor)

Later anti-depressants (Tri-cyclics, SSRIs, etc) tended to be less-effective
than the MAOIs, but the MAOI's patents had expired.

B-vitamins can boost the metabolism. There's a prescription version of Methyl-
Folate that's approved as an add-on for depression treatment (imho, this
vitamin should really be a primary treatment).

There's lots of space for the medical perspective on a treatment team.

------
nicolashahn
I really like Gabor Mate. I recently watched a video in which he discusses the
connection between addiction, ADD, and trauma. Extremely eye-opening for me,
as someone who's witnessed and experienced a bit of the three. I'm not going
to attempt to paraphrase, but here's the video:

[https://youtu.be/x2YdpvnwtGc](https://youtu.be/x2YdpvnwtGc)

~~~
schoen
That video was discussed a bit on HN two days ago:

[https://news.ycombinator.com/item?id=18497985](https://news.ycombinator.com/item?id=18497985)

------
elchief
Dr. Maté's Scattered Minds is an excellent book for those dealing with ADHD

I've read it, and it blew my mind how it described my various quirks, which I
thought were unique to me, but are common to those that suffer ADHD

------
pasbesoin
I'll RTFA, but you know what else helps? Changing the physical environment.

Getting away from severe, chronic stressors. Getting to a community that
provides services and allows for mobility.

"By your bootstraps" doesn't work so well, when you don't have boots. Or when
someone keeps "stealing them from you" (metaphorically).

------
Nav_Panel
Is this not what Freud, Fromm, &c have been saying for about a century?

Psychoanalysis is designed as a therapy through which the patient "deals with
their past trauma".

------
rblion
Psychedelics helped me a lot but I'm in a good place today where I only vape a
little weed. No drinking or smoking. Cutting down on porn a LOT! Still hard to
completely avoid to be honest until I have a steady again.

I am starting to just lay out everything in front of me as a CHOICE. I can
feed the side of me that is a world-class designer and a sincere servant to
society OR feed the hedonistic self-destructive megalomaniac that will
probably die unfulfilled.

Pretty easy choice when I lay it out like that...

~~~
maxhallinan
Did you take psychedelics in a clinical setting?

~~~
rblion
Nope. Just knew the right people at the right time, pure intentions and an
open mind.

All a person needs to have a good experience.

------
andai
Are there any techniques to release or resolve trauma of which there are no
clear memories? Not to say repressed, but which occurred at a very young age
before clear memories could form. Being born, for example.

~~~
penagwin
Being born I consider a little odd, I doubt its encoded at all.

But I do agree about unclear memories. Being physically beaten is rather cut
and dry. Being emotionally abused becomes super unclear as to what is and
isn't abuse.

------
cheez
I broke an addiction successfully by relocating and leaving everything behind.
The addiction came back after I returned. Very sad. For now, I'm stuck here,
but I know I have to leave.

~~~
coleifer
Doesn't sound like you broke it successfully. Hit me up if you want to talk,
I've been there.

~~~
cheez
I appreciate the offer and you are of course right. I broke it but I did not
get enough time in the "addiction-free" state before I returned to the
circumstances that caused the addiction. Something like 1% of the time. I
think I would need to be in at least 20-30% of the time to break the
addiction.

------
josephjrobison
My wife is a neuropsychologist and the core part of their treatment for PTSD
is CBT, and bringing up the traumas of the past until it becomes boring and
normal.

------
ermir
Sam Harris recently released a podcast episode titled Addiction, Depression,
and a Meaningful Life that goes exactly in this topic. I found it to be one of
his best episodes, and I am sure you will find it useful too. Link here:

[https://samharris.org/podcasts/142-addiction-depression-
mean...](https://samharris.org/podcasts/142-addiction-depression-meaningful-
life/)

Also, the connection between responsibility and a meaningful life is one of
the recurring themes of Jordan Peterson's work, a message which is sadly
lacking in the modern culture. No wonder he has gotten so popular so fast.

------
random878
As a reader from the world of medicine, and not tech, I'd like to request that
readers approach medical topics with an equal amount of criticism they'd
reserve for their own field.

Politely put, this is a short opinion piece in a newspaper. Cynically put,
this is a paid for advertisement hidden in a newspaper to sell a book.

------
newname2018
Lifelong sufferer of various addictions here. I've kicked most but one thing I
want to say is most addicts I've known. (myself included) are so worried about
" how they feel" It's very helpful to an addict to just put those " feelings"
aside and get on with your life. Not trying to sound like Nancy Reagan but
stop being such a pussycat and grab ahold of life Just say no Edit, your
feelings aren't that important. Get a life, Without an addiction

