Does Childhood Trauma Cause Addiction?

The Good, Hopeful + Controversial Work of Dr. Gabor Maté.

It was very quick. Nearly imperceptible. It was the way the woman in class said: 

“Well, mom is severely addicted.”

There was a tone in her voice that betrayed what she thought of mom. That she was a lost cause, at fault, not able to function, lost forever. Hopeless. 

The lady in my CASA (Court Appointed Special Advocate) class was talking about a case we were working through. In the case, the mom was in active addiction and we were debating different scenarios for advocating for the children. But I paused at the tone of her voice. 

Obvioulsy mom wouldn’t be able to parent right then. But her inflection felt like she was handing down a death sentence. A finite thing. This person is addicted, story done. Ending told. Case closed. Remove the kids.

I get it. I felt similarly about people in active addiction at one time. What changed was meeting Charlie and his wife Tessie from my book, The Meth Lunches. They taught me: People can come back from the darkest recesses of life.

For me, after counting Charlie out, the meth-addled handy man who fixed our house and ate lunch with us every day, who I thought was a zombie, the undead, ruined by drugs, ended up saving himself and his wife and their baby daughter. They found the right rehabs, endured relapses, but they stayed on track. Now, they are living clean; a suburban life in Texas with school drop offs, soccer games and family meals around the kitchen table in the house they now own.

That I had given up on them was a lesson in never giving up.

This led me to the work of Gabor Maté, a physician who is fairly controversial in the field of neurodivergence. He believes, incorrectly some say, that all neurological challenges are the result of trauma, even ADHD and autism. There is some evidence that some forms of neurodivergence can be the result of trauma - PTSD is considered a neurodivergence, for example - but many people believe that the forces at play are more complex than just environment.

But his work around addiction is especially interesting. 

Maté believes - straight up - that addiction is the direct result of childhood trauma, including legacies of inter-generational family and cultural trauma, like living through a pandemic, genocide or war. For Maté the definition of addiction has nothing to do with the substance; meth, heroin, sugar, food, sex, porn, shopping.

It’s the act itself. He says:

Addiction is any behavior in which a person finds relief and therefore craves in the short-term, but suffers negative consequences in the long term and doesn’t give it up despite the negative consequences. 

In my own piece, For the People Doing Dry January: I See You, about my own drinking which became excessive and hobbling, I wrote about sitting on the toilet at 3 in the morning shitting out the effects of the multiple tequila cocktails I was drinking every night and rocking back and forth, holding myself, thinking: I am killing myself. But then I would get up the next day and do it all over again. I pushed away any promises to curb myself. It was humbling to know how much control the drink had over me and what I could endure to continue numbing myself.

…doesn’t give it up despite the negative consequences.

Maté pushes back on the idea that addiction is a brain thing passed to us through genetics. Or that it is a choice someone makes, even though our legal system treats addicts as if their addictions were a choice and punishment somehow deters and corrects it - it doesn’t.

Instead, he believes that addiction is the result of:

1) A problem with attachment in early life.

This can happen if there is neglect or abuse, domestic violence, post partum depression, or the co-morbitidies of being poor. Maybe the parents are not as doting or attentive because the family is managing a crisis, like an eviction or job loss. It can happen when family is separated, like when a child is removed and put in a shelter or group home.

I’ve talked a lot about attachment in my work because I think a lot of issues we have in our communities come to us because we are not supporting kids in the earliest stages of development. We do not support attachment. If we did, there would be more support for young parents.

I know I have attachment schisms as a result of being in foster care and then being adopted. And my adopted kids also do from being in foster care, the loss of their mother to addiction and overdose, and living in multiple homes with multiple caregivers.

The Fosters live in a broken attachment world.

The idea, simplified, goes like this: Kids who have less attachment in early life to their caregivers, have brains that make fewer endorphins. Endorphins are critical to how we feel, because they are hormones that help relieve pain, manage stress, improve moods and just make people feel okay and stable. If a child does not make healthy attachments or there is a schism in attachment, they have fewer endorphins circulating naturally and can often seek out activities that stimluate those feelings of calm and numbing. They might shoplift for a high, or do drugs to feel calm, or watch porn incessantly to keep the good feelings flowing.

Maté says that the addictive act is so powerful for these folks because this might be the first time they experience a kind of “love and connection” that has never happened before. Endorphin release feels like being tethered to something. It’s a brain-calm. It’s everything they have been craving in real life from other people, but they have to create it for themselves artificially.

Attachment in early life is a requirement for functioning.

2) The need to feel authenticity which is"a connection to ourselves.”

Authenticity, for Maté, is an evolutional requirement too. We cannot survive unless we trust our feelings, our guts. But if we grew up in homes where our feelings were threatening to our parents or they wanted us to be the good, quiet kid all the time, and not express how we felt, then we might stuggle with trusting our feelings. Our sense of having an authentic and trusted self is compromised.

This really reached out to me because growing up, my family was angry a lot. Always. Sometimes quiet and stifled, taught and tense, sometimes boiling over and raging. My family could go from normal to unhinged in ways that often surprised and left me unable to anticipate how people would react. I was always stressed, reactive, worried - then relieved when every one was calm and happy. Creating negative scenarios in my head to ruminate about became a hobby.

It took me years to find myself again.

And 3) Add to this, traumatic events called ACES (Adverse Childhood Experiences).

ACES can be divorce, death of a family member, sexual abuse, witnessing violence in the home, family separation, poverty, eviction, mental illness, bullying or addiction in the family. ACES pile up, causing trauma. For Maté, they create disconnection from ourselves and other people.

A study in Front Psychiatry in 2022, showed conclusively that the greater the severity and number of ACES, the more likely a person was to take drugs. They also found that abuse, neglect, and family dysfunction were significant predictors of drug addiction. And this underscores Mate’s work. It turns out when we aren’t 1) properly connected to our people and 2) we are not properly connected to our own feelings, and 3) life deals us traumatic blows, this creates an equation for addiction.

Maté says what develops is….” difficulty being in the present moment, and you develop a negative view of your world, and a negative view of yourself, and a defensive view of other people” And ultimately, the addiction is an attempt to solve a problem that you can barely name, but also is so all encompassing that mystifies, sublimates and colors everything you do or think.

This is where therapy - really really good therapy - can be a literal life-saver, because it reconnects you back to your whole self, your body, how you are in relation to your people, to the world. I often say that therapy saved my life when I was in my early 30’s. I was broken by a lot of things that had created a pile on top of me. The day I saw my therapist for the first time, I felt NOTHING. Absolutely nothing. I told her that all of me was inside a tiny ball, a pebble really, in the depths of my belly, and I couldn’t access it.

What followed for the next five years of my therapy, two times a week, was what Maté calls recovery, which is really “recovering yourself.” The tiny ball got bigger and bigger until I filled myself up with my self.

And this makes me consider and reconsider the lived experiences of the people in The Meth Lunches, who almost always, across the board, managed addiction and substance abuse disorders and also had childhoods filled with these three features. I know that isn’t entirely scientific, but anectodotally, it all feels spot-on to me.

And let’s be honest, I want Maté’s message to be fact.

I want this equation to be true. Because the more we can humanize the causes of addiction, the more we can meet people where they are and help them. The more we won’t give up on other humans, thinking they are wretches, worthless and beneath us. We can stop seeing people with addictions as zombies, tweakers, pill heads and junkies. (The ultimate in disconneced language, mirroring their disconnection from the world and themselves.) The more we can create policies that support young families and babies, so the ACES don’t accrue. The less we can use drug court and police to punish people for acting out the things about themselves they can’t control anyway.

Lastly, one of the phrases that helps David and I a lot parenting kids who come from developmental trauma and attachment challenges is this: Kids do better when they can. That means if one of our kids isn’t handling themselves well, it’s probably not a choice. They probably can’t do better at that moment.

I believe the same with adult humans. People do better when they can. So if someone is deep into addiction, it’s because they can’t do better right now. That isn’t cause for alarm, as much as it is a starting point, to help them find themselves again.

The only way out is to rebuild. The only way out is to recover the self, literally.

_________________

End Notes:

The judge and I have a lot of bottle blond going on.

It’s official. I am a CASA (Court-Appointed Special Advocate). For those of you who don’t know about CASA, I am now an officer of the court who advocates for kids in the foster care and criminal justice systems. It’s a volunteer position and I have been considering doing this for awhile, since we closed our fostercare license.

On to new adventures.

If you would like to see the entire Gabor Maté video that I reference above, go here. It was given to us as part of the homework assignments in our CASA classes and I couldn’t stop thinking about it. What if Maté is right?

The classes also really opened my eyes to how our own personal experiences create all kinds of subjective bias when we are faced with a challenge. The way I believed Charlie and Tessie were hopelessly locked in their addictions. The guy in class who was raised in a bar where his mom worked, who has a a different take than the person in class, who was beaten as a child, and different from the woman in class who was lucky and had a comparatively seamless life.

That lady who was dismissive of the mom who was addicted to heroin? She hadn’t known anyone, had never loved anyone in active addiction. How could she not be dissmissive? What in her experience would lead her to think differently?

It is stunning to me that every decision we make is bathed in our lived experiences. Who do we help? Who do we believe deserves our help or doesn’t? Who deserves to parent their children and who doesn’t? Who deserves to be seen as a human instead of a tweaker?

These are the questions on my mind now…