“What causes addiction?”, is one of the most deeply explored and researched questions. Why would someone persistently engage in behaviours that inevitably lead to suffering in the long term? Clearly, there is no one answer to it. However, a growing body of research and clinical evidence suggests that addiction is often intertwined with experiences of trauma. Trauma, whether stemming from childhood adversity, interpersonal violence, or other traumatic events, can profoundly impact an individual’s susceptibility to addiction and their journey towards recovery.

Addiction has long been viewed through the lens of “bad choices,” subsequently ostracising those struggling with any form of addictive behaviours. In truth, no one wants to be an addict. Dr. Gabor Maté, a distinguished expert in addiction, challenges this perspective, asserting that the notion of addiction stemming from “bad choices” is profoundly shortsighted. He elucidates that addiction is a coping mechanism aimed at alleviating the pain inflicted by childhood trauma. It’s an attempt at self-medication, seeking temporary relief from overwhelming emotions and distressing memories.

During early childhood, a pivotal developmental phase where the brain is malleable, every experience leaves its mark, shaping neural circuits. When a child experiences neglect or abuse—whether physical, emotional, or sexual—it significantly impacts brain development, potentially predisposing them to addiction. These adverse childhood experiences can disrupt the formation of secure attachments and healthy coping mechanisms. They can also affect the neural pathways involved in regulating stress, emotions, and decision-making, contributing to dysregulation and impeding an individual’s capacity for self-regulation, thus perpetuating the cycle of addiction.

Moreover, trauma can significantly impact an individual’s brain reward system, driving them to seek solace in substances. Trauma can lead to deficiencies in the processing of endorphins and dopamine—neurochemicals crucial for pleasure and pain relief—prompting individuals with addiction to self-medicate in an effort to compensate for their diminished neurostimulation. In essence, individuals become addicted to substances as a substitute for the brain chemicals their bodies struggle to process.

For decades, addiction has been perceived as a “disease” or a consequence of poor choices, overlooking its underlying root causes. In his seminal work, “In the Realm of Hungry Ghosts,” Dr. Maté advocates for a compassionate approach, urging us to inquire not into “why addiction,” but rather “why the pain.” It is imperative to adopt a compassionate perspective towards addiction. By reframing addiction through the lens of trauma and compassion, individuals can embark on a journey of healing and growth.

Trauma-informed approaches to addiction treatment recognise the underlying role of trauma in shaping addictive behaviours and prioritise healing and recovery. These approaches aim to create safe and supportive environments where individuals can address past trauma, develop healthy coping skills, and rebuild their lives free from addiction. Integrating trauma-informed care into addiction treatment can pave the way for sustainable recovery, empowering individuals to reclaim agency over their lives.

(Inputs from an article by Pragati Goyal, Lead Clinical Psychologist at Lissun)