Understanding Traumas and How Wellbridge Treats

First, it is important to understand what trauma is, a quote by Dr. Gabor Mate states that “Trauma is not what happens to you. Trauma is what happens inside of you because of what happened to you”. So if you are “triggered” by something, this could be a smell, an anniversary, a photo, a sound, a place and so much more; but if something reminds you of that past traumatic event, then the feelings of that event that are stored within you get reactivated and you feel as if it’s happening in real time all over again, when in fact it may have happened, five, ten, or twenty years ago. If this happens to someone then they are stuck, the wound is still open and there has never been any healing process.

There are three types of traumas; there is ACUTE trauma, a single significant traumatic experience (ex:  car accident, 9-11, sexual assault), CHRONIC trauma, repeated prolonged (ex: domestic violence, bullying, homelessness, prolonged medical issues) and COMPLEX trauma. Complex trauma is what most patients have and don’t even recognize or understand that they have it, and thus never identify themselves as someone with trauma. Complex trauma is confusing to most people because it is not what happened to you but rather what has NOT happened to you, what you were neglected and deprived of.

This brings us back to childhood trauma; there is no species on the planet that’s newborn babies and many years thereafter into late teenage years, that is more dependent on attachment, nurturing, role modeling, support and so much more from its primary caretaker than the human child. If this child is neglected, has no attachment, not nurtured, avoided, not of primary concern, blamed, and witness to maladaptive behavior by its caretakers amongst other behaviors, this child then goes past fight or flight mode and goes into isolation mode. Here, this child’s negative self-image and negative view of the world around them is built on lies. This child has shame and a negative identity, thus avoiding the world around them; while this works for a short period of time and helps them cope and survive, this pattern builds on itself, they eventually find that they have no coping skills for the outside world, thus finding new ways to isolate including drugs and alcohol, sex, stealing, gaming, gambling, hoarding, eating disorders, the list goes on and on. Then the child learns no coping/life skills on how to deal with anger, anxiety, shame, bereavement, self-pity, depression, and other challenges. The child develops a self-identity that I am not good, I am not safe and it’s me against the big bad world.

At Wellbridge, once a week there is a Trauma group named “The Phoenix Group” (Rebirth), it is in this group that we present to the full patient community education and awareness about trauma; to allow for them to start to process how their trauma and how primarily their childhood trauma has affected them throughout their lives. It is in this group that we start to look at how their substance abuse issues and/or process addictions and mental health issues have affected them and is directly linked to their childhood trauma, which came first. It is also here the patient can start a healthier journey of finally starting to allow the wound(s) within them to start healing. We look at several trauma experts and their teachings in how to present this to the patients so they can start to process what may be going on within them and their trauma history; trauma expert resources utilized in group and sessions include Dr. Gabor Mate, Dr. Bessel Van Der Kolk, Dr. Peter Levine, Dr. Jon Connelly, and Tim Fletcher amongst others.

With the education and awareness that the patients gain in “The Phoenix Group”, they can begin to identify their personal trauma and trigger points. It is at this point that patients are vetted according to their interest and motivation into working on their trauma. It is important to point out that all patients new to early recovery and the many changes going on in their lives are not ready for trauma therapy and are not able to process their trauma at this point in their recovery process; it just may be too early and fearful for them at that point. Early exposure can be beneficial for them, for when they are ready to address their trauma.   The patients that are ready to work on their trauma get set up with individual trauma session(s).

At Wellbridge, we recognize the importance of trauma work as most of our patients have experienced some type of trauma in their lifetime. As trauma therapists, we work diligently to provide individualized patient-focused care based on a case-by-case basis. Patients engage in groups as well as individual therapy in a supportive and safe environment where they can feel heard and accepted without fear of judgment. Our work with patients aims to help them reshape their view of themselves and work towards healing through radical acceptance of the hardships in their lives they cannot change or control, as Rick Warren once said, “We are products of our past, but we don’t have to be prisoners to it.” Through engaging in treatment and beginning the healing process, the patient recognizes their strength and resiliency which supports their recovery as recovery is a process of change through which they improve their health and wellness, live self-directed lives, and strive to reach their full potential.

As a therapist working in the field of addiction and specializing in work with victims of trauma, I recognize that for us to properly treat the individual we must provide a sense of safety and security for individuals to feel comfortable engaging in the therapeutic process. The number one priority in mental health and substance use treatment is safety. Patients who walk in through the doors of Wellbridge are met with care, compassion, empathy, and security. Entering treatment can be a scary experience for anyone seeking help due to the fear of the unknown as many correlate comforts with substance use as it has been their primary coping mechanism as their substance of choice has become their friend, confidant, and primary support. Our goal at Wellbridge is to provide a sense of security and safety in which patients can feel comfortable exploring the underlying issues that have impacted their current substance abuse. It is helpful to understand that substance abuse is like an iceberg, we see the substance abuse at the surface but underneath that is trauma, mental health struggles, interpersonal relationship conflicts, impaired view of self, and other unresolved stressors. As many individuals in the recovery world have identified trauma is often the gateway to negative coping mechanisms such as substance abuse. Trying to avoid the pain of trauma becomes a habit and that’s how compulsions and addictions are created. Each patient who enters treatment is provided psychoeducation on trauma which provides the patients the time to examine and identify trauma impacting their current struggles with addictive behaviors and self-worth while in treatment, as many have normalized or avoided the trauma they have experienced while in active addiction.

Once a week, patients engage in Seeking Safety to examine the correlation between trauma and substance abuse. Seeking Safety helps patients recover from their traumatic past so they can regain the foundation they need to move forward in life. However, unlike other trauma-focused therapies, Seeking Safety does not ask the client to delve deep into the memories and details of the trauma. The goal is to examine how differing traumatic experiences have affected their current maladaptive coping mechanisms. Seeking Safety allows patients to explore different experiences bringing awareness to trauma that impact their current struggles to cope. Seeking Safety focuses on skills that apply to both trauma and addiction simultaneously. This includes learning how to set boundaries in relationships, honesty, compassion, healing from anger/resentments, and recovery thinking. The main aim of these skills is to help patients attain safety in their relationships, thinking, behavior, and emotions.

We have seen an increase in domestic violence victims seeking treatment, therefore providing necessary support in treatment is essential. Domestic violence and substance abuse are strongly connected, in that substance abuse is involved in approximately 60% of reported intimate partner violence cases. For some patients who are victims of domestic violence, seeking treatment is a way to get out of their current situation and find support.  Victims of domestic violence often use substances to cope with the abuse they experience, as patients often report using substances to avoid trauma responses and cope with verbal, emotional, psychological, and physical abuse. Statistically over 1 in 3 women (35.6%) and 1 in 4 men (28.5%) in the US have experienced rape, physical violence, and/or stalking by an intimate partner in their lifetime.  Domestic violence is highly prevalent in the LGBTQ community. As per the National Coalition Against Domestic Violence, 43.8% of lesbian women and 61.1% of bisexual women have experienced rape, physical violence, and/or stalking by an intimate partner at some point in their lifetime, as opposed to 35% of heterosexual women. For males, 26% of gay men and 37.3% of bisexual men have experienced rape, physical violence, and/or stalking by an intimate partner in their lifetime, in comparison to 29% of heterosexual men.  We provide LGBTQ groups weekly so patients of the LGBTQ community can have a safe place to discuss and process trauma, and shared experiences such as issues with identity, discrimination, rejection from family/peers, and shame.

Patients who have been victimized require therapeutic support to feel heard and validated due to their normalization of the abuse they have encountered. With my years of experience working with victims of domestic violence, sexual violence, and sex trafficking, I recognize a priority for treatment is assisting patients in feeling safe and secure both while in treatment and after through providing resources and supports they can utilize to provide a sense of security. Individuals identified as victims of domestic violence engage in individual trauma-focused therapy sessions in which they complete a safety plan before discharge. Through their therapy work, the individual learns they cannot control their partner’s abusive behavior, but through developing an improved sense of autonomy, they can take steps to protect themselves from future harm. A safety plan is a personalized and practical plan that helps identify things a victim can do to better protect themselves and to help reduce the risk of being hurt. This includes coping strategies, resources for professional and community support, social support, and an exit plan.

The main goal for individuals coping with trauma is to improve their sense of autonomy through improving their self-worth, developing coping skills to navigate self-defeating thoughts, identifying unhealthy relationship patterns such as codependency and trauma bonds, and healthy boundaries. I provide weekly trauma-based topic groups aimed at addressing these specific topics to begin the healing process. There are three stages of healing from trauma: victim, survivor, and thriver. The victim stage is when the individual feels as though they are still in a traumatic incident which is not dependent on the amount of time that has passed, they correlate the trauma they’ve experienced with their identity and sense of self. At this stage, the individual often avoids emotions due to feeling overwhelmed by the many emotions’ trauma can evoke. This is where addictive behaviors occur as the individual engages in self-medicating behaviors including substance use to cope. When an individual is abusing substances, they may feel they are healing from their trauma, but they are avoiding and stuffing their emotions down which then are displaced in varying places of their lives. In the survival stage, individuals seek help, see themselves as deserving of help, begin to identify and grieve past trauma, learn how to protect themselves through learning coping skills to navigate emotions, become hopeful and begin work on compassion towards themselves. The goal for these individuals is to help to move from the survivor stage to work toward the thriver stage. For individuals coping with substance abuse, they have felt they have been in survival mode and struggle to see the light at the end of the tunnel, which is why individuals benefit from gratitude, compassion, and hope in each day; as the recovery community refers to it as “taking it one day at a time.” In the thriving stage, patients find gratitude in life and live in the present. They understand that their emotional pain will pass and bring new insights. They can utilize healthy coping skills, show improved boundaries and sense of self, and live in the present.