Trauma and Its Role in Addiction Recovery: An Interview With Jamie Marich
Jamie Marich, Ph.D., LPCC-S, LICDC-CS, REAT, RMT travels internationally, speaking on topics related to Eye Movement Desensitization and Reprocessing (EMDR) therapy, trauma, addiction, expressive arts and mindfulness, while maintaining a private practice in her home base of Warren, OH. She is the developer of the Dancing Mindfulness practice and delivered a TEDx talk on trauma in 2015.
Jamie is the author of EMDR Made Simple: 4 Approaches for Using EMDR with Every Client (2011), Trauma and the Twelve Steps: A Complete Guide for Recovery Enhancement (2012), Trauma Made Simple: Competencies in Assessment, Treatment, and Working with Survivors, Dancing Mindfulness: A Creative Path to Healing and Transformation (2015). Her latest book (in collaboration with Dr. Stephen Dansiger) is EMDR Therapy and Mindfulness for Trauma Focused Care (Springer Publishing Company, November 2017).
Insights on Trauma, Addiction, and Recovery
I recently spoke to Jamie about trauma and its role in addiction recovery. Here’s what she had to say.
Liv: In the introductory chapter of your book, Trauma and the Twelve Steps, you explain the problem with “they’re just addicts” mentality. Tell me about the prevalence of trauma in those seeking substance use treatment? And how might that mentality affect those seeking treatment?
Jamie: No matter how you slice the numbers, prevalence is high. We’ve established that untreated post-traumatic stress disorder is a factor in addiction relapse, and whenever we see individuals coming back for multiple engagements in treatment, we must examine whether or not their trauma was adequately treated as a clue in what may have blocked them from lasting recovery. In addition to PTSD, experts are now recognizing that trauma, which simple means any unhealed wound (physical, emotional, sexual, spiritual) that can keep a person stuck at the limbic level of their brain, can manifest as more than just classic post-traumatic stress disorder (PTSD). Many forms of depression, anxiety, adjustment disorders, and even substance use disorders, eating disorders, and behavioral compulsivity can have their roots in unhealed trauma.
Liv: You explain that the Greek word for trauma is wound and that each and every one of us experience wounds (physical and emotional) differently. Left untreated, healing can become complicated and protracted, not to mention the occurrence of re-wounding. Tell me about the importance of understanding the individual nature of trauma in addiction treatment?
Jamie: Trauma and trauma healing is a fundamentally subjective experience; there are so many variables at play that determine what kind of care a person may need to process their experience after an experience or series of experiences, first of which is their existing ability to cope. There are too many variable at play to go into in a short article, so I would suggest your readers go to my TEDx talk if they want even more on this concept. Bottom line, if you work in treatment, avoid the one-size-fits all mentality in treating your wounded clients. That’s not the reality of how wounds heal.
Liv: And how important is treatment of trauma in terms of sustained recovery?
Jamie: How important is treating a physical wound that an individual experiences? It’s that important. All wounds need care. Sometimes that care, in the sense of emotional wounding, may imply simple validation of the person’s experience and giving the person breathing room to let their own brain and body do its thing while the person feels supported. Sometimes more drastic interventions are needed. All wounds need care; ignoring them and hoping they’ll go away on their own is not an option anymore.
Liv: You go on to raise the important need to be trauma-sensitive and trauma-informed in our execution of twelve-step recovery principles, that a rigid application of the steps can do more harm than good. How can someone who isn’t professionally trained, psychologically, be trauma-sensitive in their application of the 12 steps? For example, a sponsor relationship?
Jamie: I go into a lot of details about this in my book Trauma and the Twelve Steps; sponsors were a primary audience for that book, in addition to professionals. Any sponsor can get some education on the basics of trauma and learn how certain behaviors that have been long endorsed by many other sponsors and meetings can be counterproductive to the recovering individuals. A few examples:
- NEVER tell a sponsee to just go off psych meds, that professional counseling isn’t helpful, or that they just have to “avoid drinking, go to meetings, and work the steps.”
- Remember that your job as a sponsor is to help a person work the steps, not to be a professional counsellor of any kind, specifically if you lack the training.
- Recognize how tough love/hot seat style strategies may do more harm than good. Instead, consider how you can validate a person’s struggle and challenge them into action without tapping in to their existing shame scripts.
Liv: You talk of a number of 12 Step slogans, which can be problematic for recovering individuals struggling with unresolved trauma. What are the two most unhelpful and why?
Jamie: ‘Take the cotton out of your ears and put it in your mouth.’ I can’t stand this slogan for multiple reasons. The intent of it is that recovering folks must learn to listen. Yet this slogan implies that what you have to say isn’t important. And so many folks entering into recovery come from alcoholic homes where “don’t talk, don’t trust, and don’t feel” are the unwritten rules of behaviour. All three of these rules prevent the healthy processing of trauma and adverse life experiences and this slogan communicates the same brutality of shutting someone down. Not to mention that a lot of survivals of assault were forced into situations by having their mouth restrained, gagged, etc.
‘Our secrets keep us sick.’ This is another one where the intention is good: that what we “stuff” will cause us problems in the long run. However, for many survivors of childhood trauma, keeping the secret was literally a life-or-death matter (e.g., abusers often say things like, “I’ll kill you if you tell anyone”). Learning to move from the pattern of secret keeping can me a long and arduous road and hearing something like this early on can feel shaming and belittling. Moreover, many newcomers hear this and, not realizing what it means, begin sharing too much, too soon with people in their fellowships who may not be safe witnesses to the information. Working on releasing the things we bury never means you have to broadcast your stuff to the world; it’s about finding a small group of trusted people in your support group and/or professional circles who can appropriately assist you.
Liv: While a sponsor relationship can be as trauma-informed and sensitive as possible, what other professional healing should a recovering person with unresolved trauma take?
Jamie: Obviously I am a big advocate of professional counseling with a clinician (e.g., psychologist, social worker, counsellor, marriage/family therapist) who has some training in trauma, preferably training in a specialized modality for treating trauma like EMDR therapy, trauma-focused CBT, brain-spotting, Somatic Experiencing ®, Sensorimotor Psychotherapy ®, or hypnotherapy. Additionally, adjunctive care providers like body workers, energy workers, yoga therapists/trauma-informed yoga teachers, martial arts instructors, and a variety of other healing arts that help a person more deeply sense into and work with embodiment can be tremendously valuable. In an ideal context, collaboration can exist amongst the providers to create the most integrated experience possible for healing.
Liv: In your private practice, you use the elements of your experience to bring healing to others. What are the components of your trauma-focused healing, and what have you found to be most effective outside of the 12 steps?
Jamie: After getting sober in a 12-step program, I completed EMDR therapy as a client, which helped tremendously in eradicating suicidal impulses caused by unhealed traumatic experiences. EMDR enhanced my love of the performing arts, namely singing and song writing, and I’ve deepened my exploration into fine arts and expressive arts practices throughout my recovery. I’ve also benefitted from mindfulness meditation, yoga (both grounded and aerial practice), conscious dance, and martial arts, not to mention a wide array of bodywork and energy work. For me, there has never been that one, magic bullet that has fixed me; it’s required an integrated approach and I find that most everyone needs some degree of this “all of the above” approach to healing.
Liv: In your new book, EMDR Therapy & Mindfulness for Trauma-Focused Care, you talk about the importance of redefining the paradigm for trauma-focused care, specifically the use of mindfulness. Tell me how mindfulness might impact the treatment of trauma?
Jamie: Mindfulness is the practice of coming back to awareness; it’s not some instant state of calm that we expect people to be able to achieve immediately. In fact, practicing mindfulness can be quite difficult at first if you’ve been traumatized. However, learning to engage the practices in small pieces over time can teach folks how to more effectively work with their resources, like breath and embodiment, to return to the present moment whenever life pulls them away from it. The discipline required from cultivating these practices can be healing in its own right. Moreover, mindfulness can teach us how to breathe with or “ride out” emotions or life stressors as they come, similar to riding a wave they may have once threatened to engulf you.
As the great mindfulness teacher Jon Kabat-Zinn suggests, mindfulness is not about making the waves go away, it’s about learning how to surf. And long-term recovery, especially deep healing work, will require you to feel some feels and ride some waves. Mindfulness is not a cure-all, yet mindfulness skills and cultivating mindfulness as a way of life is an invaluable companion for the healing journey.
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