Primal Therapy and Substance Abuse
Updated: Nov 6, 2020
The Cave You Fear To Enter Holds The Treasure You Seek................Joseph Campbell
It is known that there is a correlation between trauma and later problems with anxiety and substance abuse.
This means that the substance abusers who once endured trauma may be suffering from post-traumatic stress disorder. Stress disorders manifest themselves, and are managed, in different ways. Addicts use substances to manage theirs.
PTSD experts know that healing REQUIRES working with the body. Is it time to apply their knowledge to the healing of the abused addict. I’ve not yet heard such discussion. Medication? Yes. Behavior modification? Yes. Intellectual-style Counseling? Yes. But, what are the results of these methods? There is a very high recidivist rate. This suggests that the current methods of symptom management do little or nothing to solve the stress disorder that is driving abuse-related addictions.
What could addiction counselors learn from the field of PTSD? To understand, we must know this about ourselves:
1. We’re all constantly motivated by a steady flow of (mostly unconscious) body signals that originate in our nervous system’s reaction to environmental cues. Danger cues result in signals that activate the sympathetic nervous system, whose job it is to prepare us to deal with the danger. Traumatic experiences such as childhood abuse generate such signals.
When a cue overwhelms our nervous system…when it represents a life or death situation over which we have no control, our nervous system instantly assembles a complex of highly stress-filled, unconscious, defensive physical reactions. If we survive the danger, our nervous system stores this complex for future use. This results in a survival advantage, since a more efficient response to the danger in the future increases our chances of survival.
This sensorimotor memory of prior trauma is a product of fear conditioning. These memories are physically expressed (embodied). To re-member them is to re-feel them.
Embodied memories are made up of “…some combination of any and all of the following: muscle tensions, proprioceptive sensations, an organized sequence of muscle movements, and the homeostatic settings of internal organs as regulated by the autonomic nervous system”
2. Our nervous systems process our experiences in two, sequential steps. We first unconsciously react to that experience. Only AFTER this happens, does the information pass to the cortex for further, more precise processing. When this secondary processing occurs, we are said to have become conscious of the subcortical information. The term “conscious”, as used here, only means that subcortical information has become cortically processed. Cortical information processing involves associating the newly received information with all other stored information, matching it to current environmental conditions, and adjusting the unconscious primitive reactions to better fit the present situation. This is something that the cortex does automatically. And, it doesn’t require awareness.
The adjustment of primitive reactions to match current environmental situations is mediated by the medial prefrontal cortex:
“the medial prefrontal cortex …has been hypothesized to play a role in the extinction of conditioned fear responses.” “By exerting inhibitory influences over the limbic system, including the amygdala, the medial prefrontal cortex thereby regulates the generalization of fear and overall increase in the fearful behavior mediated by the amygdala.”
But, the cortex and its medial prefrontal area can only perform this high level analysis and adjustment of lower-level responses if it receives the information that those signals contain.
3. Because of the nervous system’s ability to manage information overload, traumatic information never makes it to the brain’s cortex. It gets trapped in the subcortical structures. That would be the end of things, if the encapsulated information stayed put. Instead, since a natural process has been disturbed, a constant pressure forces this information toward the cortex (the second half of its journey). This phenomenon can be easily understood if we study ANY natural process that has been blocked. For example, whenever water is diverted from its natural course (by a dam) what happens? The trapped water begins to exert a pressure against the dam. This pressure will never go away until the trapped water makes it back into its natural course once again.
Similarly, pressure drives trapped traumatic information toward consciousness. As it approaches consciousness, we experience a generalized feeling of anxiety. That is, the sympathetic nervous system begins to ramp up to defend against danger…only, this time, there is none (because a memory is driving the event). But, that anxiety still compels us to do something to get rid of it. So we behave in some way. However, this time, there is nothing to react to (except a private memory). Because of this, the behavior appears neurotic.…it’s behavior that has no apparent cause.
Through the process of operant conditioning, we learn behaviors that help us to moderate our anxiety. These learned behaviors, pain relievers, and substances are used to dull the anxiety. To dull anxiety is to keep the danger signals from approaching consciousness. However, these and all learned adaptive neurotic behaviors, only treat the symptoms of the problem. Once the pain relieving substances/behaviors begin to wear off, the danger signals rise toward consciousness once again…..and anxiety returns. So, more substances/behaviors are required to dull the anxiety. We see, then, that symptom relief is not healing. Rather, it can easily lead to a lifetime of dependance on pain relievers, support groups, and chronic acting out/in.
Why are we not addressing the cause of the anxiety that is driving drug addiction and the other disorders? We have understood fear conditioning and its relationship to anxiety for over 100 years now. Why are we not using this information to mitigate the cause of anxiety…the chronically experienced fear conditioned memory.
It is understood that the danger signals can be so overwhelming in some individuals that it is a humane act to administer something that will diminish the anxiety signaling. But, this should only be a temporary act, because it is not treating anxiety’s cause. As such, continual use of opioids will lead to more addiction, illness, and even death.
Instead, something should be done to address anxiety’s cause…the trauma-related conditioned fear memories. What would happen if, instead of numbing the danger signals that are pushing toward consciousness, we helped them gain access to consciousness? This can be done. It’s not easy and it’s not comfortable. But, it results in a permanent reduction of the defense-related signals. Why? Because this process helps trapped danger signals get to where they are supposed to go….the cortex. The medial prefrontal cortex now gains access to trauma-related information that it can exert control over. This means a reduction in our anxiety. And it means a weakening of the compulsion to act in neurotic ways. And, because there are fewer signals to “push down”, depression begins to dissipate.
This movement toward health happens slowly, incrementally, and with lasting results.
It's precisely what is being done in PTSD-related therapies such as Sensorimotor Psychotherapy, Somatic Experiencing, Fear Memory Integration, Primal Therapy, Soul Retrieval, Yoga, sweat lodges, etc.
All of these trauma-related modalities invite us on a personal journey, to find the lost sensorimotor artifacts of our past trauma. Slowly and steadily bringing them into consciousness will re-establish our emotional health….permanently. The journey requires a strong intention, hard work, discomfort, and curiosity. But then….so do all things that result in lasting self-improvement.