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Helping Families Understand a Substance-Using Loved One’s Trauma

“Trauma” is a word thrown around so much these days that it’s lost most of its meaning.

According to Dr. Peter Levine,1 one of the world’s foremost experts, trauma is, “the often debilitating symptoms that many people suffer from in the aftermath of perceived life-threatening or overwhelming experiences.”2

Trauma occurs when a situation is perceived as life-threatening or overwhelming.  Scratch the surface of many people who use substances problematically, and you will find trauma.  Sexual assault, childhood abuse, loss of a love one, war, a car accident, the chronic stress of racism, homophobia and transphobia or poverty, all can cause trauma.  It doesn’t matter what happened: it matters that a person has experienced something that has left internal thinking about trauma and substance abuse

But Wait: Families Are Traumatized Too!

Absolutely.  The emotional and financial havoc addiction wreaks on a family is a traumatic event.  Families often experience the same symptoms of trauma that addicted persons do, such as hyper-vigilance, or constantly being on the alert for danger.  A family member may feel they have to monitor their loved one’s every move to make sure they don’t use again.  This can create a vicious cycle: a family member’s monitoring, such as walking into a person’s bedroom unannounced, can trigger a traumatized person’s own hyper-vigilant response, causing them to scream or jump and not feel safe at home.

“You’re Just Using This as An Excuse!”

Many a frustrated family member has heard themselves say, “You’re just using that as an excuse to keep drinking/using!”

The family’s frustration is understandable.  Obviously, dangerous substance use makes the situation worse, not better.  Yet until an individual has other coping skills and is in a safe environment, the effects of trauma, such as panic attacks, severe/suicidal depression, agoraphobia (a fear of being outside in crowds or open spaces that can leave some homebound), will persist even if the substance use stops.  The idea that the only problem is drinking or using, and that everything will be fine if the person can just “get sober,” is simply false.

Possible Family Discussions

The more that conversations can be approached with a “we’re all in this together” attitude versus “us vs. you” the better.  “Family” means everyone: the person recovering and everyone they are close to.

-Everyone has the right to feel safe at home.

Families may wish to talk about what makes all members feel safe, such as no violence, including screaming and yelling, allowed.

barriers for dealing with trauma

-Setting boundaries can make everyone feel more comfortable.

You may want to discuss privacy, such as not listening in on each others’ phone calls or reading each others’ email.  An adult who has a substance problem will not benefit from being treated like a child.  And other family members have the right to their own space and privacy too!

-Family members have often dropped everything.

Their friends, their work, their own health, to help a loved one in crisis. The whole family may want to find ways to get back into their own routines, doing what makes them feel “normal.”

-Family members face emotional complexity too.

Family members and people in recovery often find themselves trying to help each other deal with complex emotions, when they can barely handle their own! Traumatized people sometimes need to talk endlessly, and that can drive a family member crazy.  Family members sometimes want to talk about the damage of the past, and that can be too painful for people in early recovery.  You may want to discuss limits on what you talk about for now, and other ways to get support.  For instance, a rape survivor may find a 24 hour rape crisis hotline to be a good source of support when they are having middle of the night flashbacks.  A family member may find therapy or a support group helpful.

-House rules against drug use are acceptable.

It is perfectly reasonable not to allow drug use in the home and to expect a recovering person to stop engaging in dangerous behaviors. But we’ve found that approaching these discussions as making agreements, not threats, makes everyone feel safer and more likely to succeed.  These discussions are exceedingly difficult when emotions are raw due to family-wide trauma. Barry Lessin, M.Ed., CAADC, a psychologist specializing in families impacted by substance use,  encourages discussions with input from the recovering person to establish groundrules based on physical/emotional safety for everyone. Family members don’t need to agree with loved one’s requests, but acknowledging their input injects compassion into any discussion and goes a long way into having them more likely agree to basic groundrules. [The book “Beyond Addiction” is an excellent resource for guidance in improving communication.]

-Everyone involved in early recovery fears a relapse.

If families can talk about the talking about trauma and substance abusepossibility of slips without resorting to threats, the person may be able to be more honest and get help to prevent a slip from becoming a full-blown relapse.   Trauma survivors already live in constant fear: adding to that fear by saying that one slip will result in homelessness or being cut off from family will make a slip more, not less likely.

-While Abstinence is an admirable goal, there are alternatives.

While permanent abstinence is often the goal, it is not the only safe and healthy outcome possible.According to the National Institute on Alcohol Abuse and Alcoholism, more than half of those who were once alcohol dependent eventually drink in moderation.3  Abstinence may be the best choice for now, but it does not have to be a permanent condition of either an individual’s health or a family’s well-being.

Trauma is NOT a Life Sentence

As Dr. Peter Levine says, “Trauma is a fact of life.  It does not have to be a life sentence.”  Neither does substance use disorder, for individuals or families.  Healing together with love, compassion and patience is not only possible: it’s the only thing that works.


1 Somatic Experiencing Trauma Institute.

Levine, PA.  (2005)  Healing Trauma.  Boulder, Colorado: Sounds True, Inc.

3 NIAAA Spectrum.  Alcoholism Isn’t What It Used to Be.


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