Anyone who’s ever been to a 12-step meeting has heard at least one or two recovering addicts say something like, “I got high because I had a crappy day at work and things got worse when I got home and I just got tired of feeling miserable.” That statement is very much in line with the commonly accepted idea of addictive behaviors as maladaptive coping responses used to deal with unwanted emotional discomfort. Essentially, addicts don’t want to feel stress, anxiety, sadness, and the like, so they “escape” and “numb out” by using a pleasurable and therefore emotionally distracting substance or behavior.
Generally, addicts develop this escapist response pattern early in life thanks to living in a dysfunctional home filled with inconsistent, neglectful, and perhaps even abusive caregivers. Essentially, as children they assume that these problems are their fault rather than the fault of their parents and/or others who should be caring for them. As a result, they develop a shame-based sense of self, where they believe they are defective and just plain not good enough to deserve the love and consistent care that they want/need. Over time, rather than turning to their unreliable and/or abusive caregivers, they learn to self-soothe their unmet emotional needs by ingesting a pleasurable substance or engaging in a pleasurable behavior. Eventually, that pleasurable (and therefore potentially addictive) substance or behavior becomes their go-to coping mechanism.
Later in life, as adults, they continue to use that or a similar coping mechanism. They think, “I could never trust anyone to be there for me when I was little and needed help or affection or someone to just listen to me, and I still can’t. As a kid, my mom was busy eating herself into an early grave, and my dad was busy drinking and cheating on my mom. Every time I reached out to one of them, they just shot me back down and I ended up feeling worse. So now, as an adult, when I have feelings that others might be able to help me with, I just can’t seem to reach out to them. I can’t bring myself to trust them, even if I intellectually know they’ll be there for me in a healthy way. So I reach out to a substance or a behavior instead, just as I did when I was little. That’s my coping mechanism for when I’m suffering.”
Of course, anyone who’s ever been around an addict for any length of time knows that addicts also use when they’re not suffering emotionally (or in any other way). In fact, addicts can be having a perfectly wonderful time and they’ll still turn to their addiction because that’s what they do no matter what. Yes, addicts use when they have a bad day, but they also use when they have a good day. They use because the sun came up. They use because the weather is nice. They use because election season is finally over. They use because they use. Period.
Of course, this idea puts a bit of a damper on the idea of addictions as maladaptive coping responses to unresolved childhood trauma and in-the-moment emotional discomfort—until one fully understands the ways in which traumatic early-life development and addictive substances and behaviors affect our neurobiological wiring.
Before getting into that, however, I think it might be wise to elucidate a bit on the role of early-life trauma in the formation of addictions. For starters, a considerable amount of research shows a direct link between childhood trauma, especially chronic (repeated and/or ongoing) trauma, and a wide variety of later life issues, including addictions. One significant and relatively well-known study tells us that people with chronic early-life trauma are:
- 8 times as likely to smoke cigarettes
- 9 times as likely to become obese
- 4 times as likely to experience ongoing anxiety
- 5 times as likely to experience panic reactions
- 6 times as likely to be depressed
- 6 times as likely to qualify as promiscuous
- 6 times as likely to engage in early-life sexual intercourse
- 2 times as likely to become alcoholic
- 1 times as likely to become intravenous drug users
Does this point to a strong connection between early-life trauma and addiction? You decide.
From my perspective, those of us who struggle with addiction and similar psychological issues typically learned early and well how to cope with abuse, neglect, and other forms of family dysfunction. We spaced out, we dissociated, and we found stimulation through substances, touching, and/or fantasy. That was our coping mechanism. It’s how we survived.
While other kids were bouncing on dad’s knee, we worried that he might hit us because he was drunk again. And thanks to this and other chronic abuse, neglect, fear, and caregiver unreliability, we came to believe that we were unworthy of proper love and care. That resulted, over time, in a distorted and highly negative sense of self, with every adverse experience simply reinforcing our deleterious self-image—defective, not good enough, unlovable. And with that as the general message bouncing around in our heads, it’s understandable that we might choose to escape through use of an addictive substance or behavior.
But what about the aforementioned addict who uses because the sun came up? Having a need/desire to self-soothe and emotionally self-regulate isn’t always this person’s motivation for picking up. In fact, this addict, like most true addicts, uses no matter what—even when life is just peachy, thank you very much. So what gives?
This is where neurochemistry and associative learning (also referred to as Hebbian Theory) come into play. Neurochemically speaking:
- Addictive substances and behaviors uniformly evoke an intense pleasure response in the brain. This response is pretty much the same regardless of the substance or behavior that triggers it. (Dopamine, adrenaline, serotonin, and a few other pleasure-related neurochemicals are released into the brain and received by receptor neurons located in the nucleus accumbens—the brain’s rewards center.)
- Thus activated, we start to feel pretty great, and anything that may have been bothering us a short while ago blissfully (though temporarily) fades away.
- At the same time, the rewards center transmits information about how good we’re feeling to the memory and decision-making centers of our brain. In this respect, our neurons are a bit like adolescent girls texting information back and forth during an unusually tedious algebra lecture. They’re just downright gossipy.
- Over time, this neurochemical exchange of information “teaches” our brains that using a particular addictive substance or behavior is a great way to not feel crummy. And this knowledge encourages us to repeat the usage as needed and/or desired.
Thus, it is relatively easy to understand why some people might consciously choose to use alcohol, drugs, or an addictive behavior (eating, gambling, video gaming, being sexual, etc.) as means of generating short-term relief from emotional turmoil, and why they might make this choice over and over. This does not, however, explain why an addict uses even when he or she is feeling fine. You know, “The birds are chirping so I think I’ll get high.” That sort of thing.
This is where associative learning comes into play. If you’re unfamiliar with the concept, watch a toddler who’s learning to walk, and then watch a child or an adult who’s mastered the process. The toddler must simultaneously and very consciously think about all sorts of things while he or she is figuring it out. “If I lift up this foot, I need to move it forward and put it back on the ground or I’ll fall. Whoops, I just fell. Let’s try that again.” But once the process is learned that same toddler can run around the house wreaking havoc with nary a conscious thought. This is associative learning at its best. We do something over and over and eventually we no longer have to think about it, because the methodology for doing it becomes hardwired into our brain.
Stated another way: Neurons that repeatedly fire together will eventually wire together.
This is as true with addiction as any other process. Basically, a traumatized person returns over and over to an addictive substance or behavior whenever he or she feels a twinge of emotional discomfort. Eventually, after this has occurred often enough, that person’s “using” neurons wire together, turning the choice to get high into an ingrained habit that is no easier to forget than learning how to walk. In this way, a conscious though maladaptive response to unresolved early-life trauma and later-life emotional discomfort becomes a habit (an automatic response) that, in certain circumstances, we might also refer to as an addiction.
This is why addicts don’t just use because they’re having a bad day. They use because that’s what the wiring in their brain tells them to do. They use no matter what.