Published March 25, 2024 · Reviewed by Sergey Litvinov, MD · ~1248 words

A lot of people arrive at detox having never told anyone what happened to them. The drinking or the using is the part everyone can see. The thing underneath it is older and harder to say out loud. Trauma comes in physical, emotional and psychological forms, and it changes how a person uses a substance. Resilience is the part that can be rebuilt, and it is learned, in the same way any other skill is learned.

How trauma feeds substance use

Trauma is an experience bad enough to overwhelm your ability to cope with it. Childhood abuse. Neglect. An accident, a natural disaster, combat, violence from someone close to you. What follows is usually a way of coping, and for a lot of people the way of coping is a substance that makes the memory quieter for a few hours.

Trauma often sits at the start of substance use and keeps it going afterwards. People medicate the anxiety, the depression, the constant scanning for the next bad thing. It works for a few hours. Then the underlying problem is worse than it was, and the amount it takes to quiet it goes up. That loop is how the addiction forms.

Coping with triggers and cravings

Resilience is the ability to take a hit and come back from it. In treatment it is not a personality trait you either have or do not have. It is built out of specific skills and specific people, and both of those can be added.

What we use at Pines Recovery Life to build it:

1. Cognitive-Behavioral Therapy (CBT)

CBT works on the thoughts that run ahead of a drink. You learn to catch the thought, check whether it is accurate, and answer it with something else. Most of the time it is not accurate, and naming that takes some of the force out of the craving.

We use CBT in both individual and group sessions. The point is that you leave with something you can do when a craving arrives. An explanation on its own does not help at the time.

2. Mindfulness and meditation

Mindfulness practice teaches you to notice what you are feeling without immediately acting on it. We teach it as a skill. Sit with the craving, watch it, let it pass without doing anything about it. Cravings do pass.

Done daily, it puts a gap between the trigger and the response, and that gap is where the decision gets made.

3. Managing stress

Stress is one of the most common triggers there is. We teach deep breathing, progressive muscle relaxation and guided imagery, which all sound small until you are standing in your own kitchen at the end of a bad day with nothing else to reach for.

They bring the body down out of the alarm state, and a body that is not in alarm argues with you a lot less.

4. Sleep, food and movement

The unglamorous parts of recovery do most of the work. Regular exercise, real food, enough sleep, and people around you who are on your side.

Exercise releases endorphins and lifts mood on its own. A balanced diet gives the brain nutrients it has been running short of. Sleep is when the repair actually happens. And friends and family who know what you are doing give you encouragement and somebody to answer to.

5. Relapse prevention

Relapse worries everyone in recovery, and a plan written down beforehand is what makes it less likely. We build one with each patient. What your triggers are, what your early warning signs look like, and what you do when a craving hits.

The plan names the high-risk situations, the routines that hold a week together, and the people you call before you do anything else.

6. Expressive arts therapy

Some things do not come out in a sentence. Painting, drawing, writing, music and movement give people a way to put the experience somewhere outside their own head first.

We run expressive arts therapy alongside the clinical work. For patients who have never been able to say what happened to them, it is often the first thing that moves.

7. Time outdoors

Time outdoors settles people. It lowers stress and it breaks up the indoor sameness of a treatment week, and both of those matter more than they sound. We build it into the program on purpose.

Being outside is also where the mindfulness practice tends to stick, and where people get some perspective on where they are and what they are doing about it.

8. Spiritual practice

For some people, faith carries a lot of the weight in recovery. It gives the whole thing a purpose beyond getting through the day, and a sense of being connected to something larger. We make room for whatever a patient already believes, and it sits alongside the clinical work.

Meditation, prayer, yoga. Whatever form it takes, it gives people somewhere steady to stand while everything else is moving.

9. Body-based therapies

Alongside the standard therapies, we use treatments that work on the body: acupuncture, massage therapy, chiropractic care and aromatherapy.

Detox is hard on the body, and a body that hurts less is an easier body to do therapy in. That is the reason these are in the program at all.

10. Other people in the same position

Almost nobody does this alone. We run peer support groups, and the people in them are the ones who know exactly what your week has been like, because they are in it too. Encouragement is part of it. So is having somebody who will notice if you go quiet.

In a group you say the thing out loud, hear it come back from somebody who has been there, and find out you are not the only one it happened to. Relationships built that way tend to outlast the treatment itself.

Trauma changes how a person uses a substance, and treating the addiction without touching the trauma leaves half of it in place. Pines Recovery Life runs physician-led medical detox and residential inpatient treatment in Pembroke Pines, Florida, and the trauma work happens alongside it with the same clinical team, so you are not starting the story over with a stranger halfway through. If you or someone you love is dealing with both, call and talk it through with a counselor.