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The Role of Emotional Trauma in Addiction

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Medically Reviewed By: Diana Vo, LMFT

November 28, 2023

Table of Contents

Understanding addiction is a complex matter with various factors at play. In some cases, addiction develops in the emotional trauma survivor’s attempt to self-medicate.

The American Society of Addiction Medicine (ASAM) defines addiction as a brain disease characterized by a complicated interplay between brain circuitry, the environment, genetics, and a person’s life.

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The National Institute of Drug Addiction classifies addiction as a brain disease that implicates reward, stress, and self-control.

Addiction doesn’t necessarily have to involve substances or alcohol. A person can also be addicted to behaviors such as shopping, gambling, or skin-picking.

Despite decades of research, understanding the root cause of addiction is still somewhat mystifying. Breaking free from addiction requires a full understanding of yourself.

The need to understand addiction is getting desperate as the opioid crisis continues to ravage the US and Canada. 81,000 people died of an overdose between June 2019 and May 2020. This is the highest number of overdose deaths in US history.

Also, “deaths of despair” are surging as a result of social distancing measures meaning increased isolation, economic insecurity, less access to healthcare, and treatment.

Addiction research is continually evolving and progressing. Research has found that:

  • Addictive behavior starts with feelings of pleasure we get from a substance or behavior
  • Addiction changes the neural pathways in the brain
  • We use addictive substances and behaviors to change the way we feel

Brain scan imaging studies of people with addictions show that over time, addiction reduces the prefrontal cortex in the brain. The prefrontal cortex controls decision-making, memory and learning, judgment, and control of behavior.

What causes some people to become addicted to substances, though?

Factors That Cause Addiction

The chances of someone becoming addicted to something vary from person to person. We often hear people say that they have “an addictive personality”.

The more risk factors a young person is exposed to, the more likely they are to become addicted. Additionally, the more protective factors that surround a person, the less likely they are to develop an addiction.

Risk Factors

  • Poverty and inequality
  • Access to drugs at school
  • Easily pressured by peers
  • Lack of parental involvement
  • Abuse

Protective Factors

  • Ability to exercise self-control
  • Positive relationships
  • Good grades at school
  • School anti-drug policies
  • Parental support

Biological Factors

Genetics plays a part in the likelihood of addiction to an extent. How much genetics influences addictive behavior is unsure, some research says that genetics has between 40% and 60% influence. Other doctors believe that it is more nurture than nature. Very often instanced where someone is in the same environment but want to seek out recovery they will need rehab to reach that lasting recovery goal.

Environmental Factors

The environment can be a huge factor at play in addiction. Some scientists believe environment is more influential on a person’s likelihood to develop an addiction than biological factors.

A young person is vulnerable to developing an addiction depending on their home environment, peers, and school environment.

If a young person’s parents drink or use drugs, then they will be more likely to adopt this behavior. And, if a person is struggling at school or has poor social skills, they’re more at risk of buckling to peer pressure to try cigarettes, drink, or drugs with their peers.

Early Use of Drink and Drugs

While a person can develop an addiction at any time in their life, early use can cause more severe addiction as the brain is still developing.

Method of Drug Taking

If a drug is injected or smoked, this increases the likelihood of addiction due to the intense rush of pleasure. When this powerful dopamine response subsides, it leaves the person craving more. The huge contrast between the high and the low is believed to increase the addictive potential of a drug.

Adverse Childhood Experiences

As we mentioned earlier, addiction medicine is constantly evolving. Some addiction experts are more convinced that all addiction is rooted in traumatic episodes that a person experiences as a child.

40% to 60% of people who struggle with addiction have experienced an Adverse Childhood Experience (ACE).

A boy holds a skateboard, appearing pensive, depicting emotional trauma in addiction

Adverse Childhood Experiences are experiences that a child aged between 0 and 17 finds potentially traumatic. These experiences can include:

  • A violent home
  • Violence in the community
  • Emotional, sexual, or physical abuse
  • Death or suicide in the family

ACEs can also occur when a child doesn’t feel safe in their environment, or if their environment doesn’t enable them to bond with others and provide stability. This can be the case when:

  • There is a mental illness in the family
  • Fighting or divorce
  • Substance misuse

Sadly, children who are exposed to chronically stressful home environments suffer from cognitive dysfunction. This disruption affects a person’s ability to cope with stressful emotions later in life. When a person does not have the means to cope with life’s stresses in healthier ways, the likelihood of developing an addiction increases.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), research shows there is a strong correlation between ACEs and substance use disorders such as:

  • Underage drinking (which is more likely if a person comes from a stressful or abusive home).
  • People with substance use disorders aged 50 are more likely to have suffered emotional trauma as a child.
  • Higher ACE scores are a strong indicator of long-term nicotine addiction
  • The number of prescription drugs used increases by 62% for each ACE.

High ACE scores are also associated with:

  • Suicide attempts
  • Risky sexual behavior
  • Poor dental health
  • Depression
  • Sleep disorders
  • Fetal mortality
  • Poor physical health

Mental Health Disorders and Addiction

Many people who are addicted to substances or drink are living with silent anxieties that they’re not necessarily aware of.

Self-limiting beliefs rooted in negative experiences from childhood can trigger painful emotions. So a person may turn to drink or drugs to stop feeling sadness, depression, or anxiety. The substance produces a dopamine response until the effects wear off. The person again feels bad until they have more of the substance.

It is now standard practice for a high-quality drug treatment center to screen their clients for any mental health disorders before they give any consideration to a person’s addiction.

Drug or alcohol treatment is pointless unless a person’s mental health is accurately assessed and appropriately treated if necessary.

Dual Diagnosis

When a person has an addiction as well as mental health illness it is referred to as dual diagnosis or co-occurring morbidity.

It is more difficult to treat a person who has a dual diagnosis. That’s why a skilled mental health professional should do an initial assessment before any treatment program is assigned or commenced. Clinicians know what pharmaceutical combinations can treat dual diagnosis situations. For example, the antipsychotic drug clozapine is effective at reducing the desire to smoke nicotine.

Medical evidence also suggests that sertraline and naltrexone are effective in people with alcohol use disorder and depression. But, it needs the skill and experience of a medical professional to assess the nature of a person’s mental health condition aside from the addiction so it can be treated appropriately.

If a person’s mental health is misdiagnosed, they may get the wrong treatment which could make a person’s problem even worse.

Emotional Trauma and Mental Health Disorders

An image of an individual in distress, showing the role of emotional trauma in addiction

The evidence that childhood emotional trauma is linked to serious mental health disorders is strong. Severe mental health disorders can include:

  • Schizophrenia
  • Major depression
  • Bipolar disorder
  • Manic depressive disorder
  • Autism
  • Panic disorder
  • Obsessive-compulsive disorder

Research also shows that when a traumatic situation ends, symptoms of severe mental health disorders subside. If you remove a person’s exposure to trauma, they become happier, well-adjusted people.

Dual Diagnosis and Environment

Dr. Gabor Mate is an addiction specialist who worked in Vancouver’s Downtown East Side for over 10 years. This region of Vancouver has one of the highest populations of drug addicts in the world and is considered the ground zero of opioid use disorder.

During his time working with Vancouver addicts, he noticed a prominent trend. Every person with an addiction has experienced emotional childhood trauma.

Dr. Mate has an interesting take on addiction. He disagrees that addiction is a brain disease or that genetics has a part to play. Based on his experience of treating opioid addicts, he believes that people use substances, drink alcohol, or engage in addictive behaviors because they are escaping negative thoughts and feelings.

He believes that if you deal with negative thoughts and feelings you are less likely to abuse substances.

Dr. Mate also believes that addiction is rooted in childhood trauma. He also believes that addiction is not the problem, rather it is the solution to a problem.

Healing the emotional trauma of a person is a vital step to becoming fully substance-free in the long-term.

Treating Emotional Trauma and Addiction

The main treatment for emotional trauma is cognitive behavioral therapy. This therapy is evidence-based which means it has been clinically proven to help people to heal from deep-seated emotional trauma.

What Is Cognitive Behavioral Therapy?

Cognitive behavioral therapy is a talking therapy that aims to change a person’s way of thinking. The therapy helps a person to challenge their negative thought processes and replace them with more positive thoughts and feelings.

CBT follows three main principles:

  • Psychological issues are based on ways of thinking that are unhelpful.
  • Psychological problems are based on patterns of behavior that are learned.
  • People can learn to manage their mental health healthier and lead a happier life.

To change a person’s thinking patterns, CBT uses several strategies such as:

  • Learning to identify patterns of distorted thinking that is making situations awkward. Then reevaluating situations that are more healthy and realistic.
  • Understand the motivations and behavior of others for a more balanced view of the world.
  • Learn to cope with challenging situations with problem-solving.
  • Develop self-confidence and self-belief.

CBT also helps a person to alter their behavioral patterns such as:

  • Facing fears
  • Preparing for difficult situations through role-play
  • Learning to relax and stay calm

CBT aims to get the person to be their therapist and solve problems themselves. A Cognitive-behavioral therapist works with the client collaboratively to forge a treatment solution together.

Trauma-Focused Cognitive Behavioral Therapy

Trauma-focused cognitive behavioral therapy can benefit anyone who might have experienced a repeated or single experience of physical, sexual, or mental abuse and have developed symptoms of Post-traumatic stress disorder.

Post-traumatic stress disorder (PTSD) symptoms include:

  • Reliving the traumatic experience through flashbacks and intrusive thoughts
  • Avoidance of people, things, places
  • Feeling jumpy
  • Inability to relax
  • Difficulty concentrating

Healing From Trauma

Recovering from trauma means being able to live fully without being plagued or haunted by memories of the past. Trauma recovery needs to happen intentionally and in stages over time.

One interesting observation Dr. Gabor makes is that once a person’s life and environment improve, i.e. more connected with others and in a stable and comfortable home, symptoms of trauma subside and the person is less likely to use or drink.


Connectedness, acceptance, and non-judgment are what a person needs to heal from emotional trauma. Isolation is the enemy of healing for people with a substance use disorder.

When isolated, people are more likely to turn to substances to evade the negative emotions and thoughts that come to them.

A photo of a video conference session, showing the importance of staying connected in addiction recovery

Peer support groups aim to keep people connected. 12-step programs provide a safe place free of judgment with like-minded people who can share their stories. Talking about problems such as cravings, money worries, or homelessness can relieve negative thought patterns. Other members of the group can help to brainstorm for solutions to problems.

The COVID-19 situation is a problem as social distancing measures are forcing people into isolation when they need connectedness. This is why it is vital to take advantage of the online meetings via mobile phone or computer if possible.

Final Thoughts

Addiction is treatable and emotional trauma can be healed. The trick is being able to identify the traumas that create the need to abuse drink or drugs in the first place.

A good quality treatment center with qualified staff such as Renaissance Recovery can assist people to process the trauma that’s stored in their memories. With the right program of cognitive-behavioral therapy, family therapy, and group bonding activities it is possible to move on from those past experiences and leave them there where they belong.

Call us today at 866.330.9449 to kickstart your lifelong recovery. We’re here to help you every step of the way!866.330.9449



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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