The problem is not the problem
While the presenting problems that have brought people into my therapy office over the years vary, the one thing that is common are experiences of unresolved pain and suffering. I have come to see that whether it is ‘depression,’ ‘anxiety,’ or ‘marital troubles’ there is often a root to the issue that has never been addressed or healed. And, where there is unresolved pain, there are often behaviors aimed at soothing that pain. And often those are compulsive and can inadvertently cause more pain and suffering.
“Addiction begins with solving a problem, and the problem is that of human pain, emotional pain. The first question is not why the addiction; it’s why the pain? And from my perspective, it’s always rooted in childhood trauma, either overt or covert.” – Dr. Gabor Mate
From 1995-1997, CDC-Kaiser Permanente conducted one the of the largest studies of looking at the impact of childhood abuse and neglect and household challenges on later-life health and well-being. Over 17,000 HMO members completed physical exams and surveys of their childhood experiences, current health and behaviors.
The types of experiences that were evaluated are:
- Physical abuse by a parent
- Emotional abuse by a parent
- Sexual abuse by anyone
- Growing up with an alcohol and/or drug abuser in the household
- Experiencing the incarceration of a household member
- Living with a family member experiencing mental illness
- Domestic violence
- Loss of a parent
- Emotional neglect
- Physical neglect
The findings indicated a very strong correlation between high ACE scores and adult onset of substance use problems, chronic disease, incarceration, and employment challenges. The more ACEs one has experienced, the higher the occurrence of negative health outcomes. More information available at https://www.cdc.gov/violenceprevention/aces/index.html
This data is startling as well as affirming my experiences as a mental health therapist. A developing nervous system is vulnerable to the conditions in the environment, their parent’s ability to regulate their own nervous system, ability to meet their child’s needs and to create a sense of safety/predictability in the world. If these things do not occur, this creates a nervous system that is constantly on high-alert, unable to self-sooth or regulate.
In the absence of these internal mechanisms for soothing, the individual looks outside oneself to find substances that at least momentarily provide the soothing that is needed. Alcohol and drugs are very effective in providing this type of relief. In order to successfully treat the substance, use problems for good, it becomes necessary to heal the pain/trauma and rewire the nervous system for safety and connection such that the need for the substance is decreased. The good news is that there are truly effective models that address the root cause of the emotional pain and can literally rewire the structures in the brain. With a trained trauma therapist, relief and healing is possible.