Trauma profoundly disrupts the body’s capacity to self-regulate, both psychologically and somatically. This psychophysiological dysregulation interferes with perception, cognition, affect tolerance, complex and basic bodily functions, and identity formation.
In the face of chronic dysregulation, we learn to adapt and cope in a myriad of ways. The strategies we develop to deal with trauma symptoms are often referred to as adaptive or maladaptive coping mechanisms. These strategies often use the body as a way of shifting or discharging tension, discomfort or pain. Attempts to alleviate the symptoms of trauma can fuel high-risk behaviours from self-injury and eating disorders, to substance use and many types of self-sabotage.
Adult survivors adeptly develop compensatory strategies for self-regulation long before seeking professional help, with some strategies rooted in the lessons – or subjective truth – a person has taken from a traumatic experience. From self-injury to eating disorders, these strategies capitalise on using the body as a means to shift or discharge tension, fueling high-risk behaviours that attempt to keep at bay the symptoms they aim to alleviate.[1]
By acknowledging addiction as another attempt at self-regulation and coping we can approach addictive behaviours as those that begin as survival strategies, and gradually escalate into disruptive patterns. It is important to understand how addictive substances contribute to trauma coping.
What are Compensatory Strategies and Coping Mechanisms?
Coping mechanisms can be understood as the ways people deal with stress. They can potentially cause more problems later on, although they appear to help in the short-term:
Avoidant Coping
Avoidant coping is a way of handling difficult emotions and situations by creating mental or emotional distance. It involves consciously or unconsciously steering clear of the issue, either by denying its impact or distracting oneself to avoid confronting the stressor directly.
While it may offer a temporary sense of relief, it often hinders the process of facing and understanding the underlying problems.
Maladaptive Coping
While providing temporary relief, maladaptive coping mechanisms may lead to long-term challenges or exacerbate existing situations. Examples include using substances like alcohol or drugs, overeating, or engaging in self-harming behaviours.
Alcohol misuse often coexists with post-traumatic stress disorder (PTSD). While alcohol may temporarily alleviate symptoms such as hyperarousal and social discomfort, its stimulant effects are short-lived. At higher doses, alcohol acts as a depressant, numbing and even providing memory loss, while often contributing to interpersonal issues.
Some trauma survivors also resort to self-medication using stimulants and psychoactive drugs to manage alertness and block distressing thoughts and memories. Although substance use offers temporary relief, it hinders effective trauma processing.[2]
Seeking Social Support
Acknowledging the significance of human connection, seeking social support involves reaching out to others for emotional, informational, or practical assistance. This may include sharing feelings with a trusted friend, seeking advice from a mentor, or participating in a supportive community.
This can be incredibly challenging, as for many people the thought of sharing their feelings is overwhelming, risky and seems too exposing. There are a wide range of reasons that seeking social support seems inaccessible, and for many of those in society, there are tangible structural barriers to support.
While encouragement and advice to open up and share is readily available, the approaches to doing so are not as clear. Many of those who are opposed and hesitant to seek social support have reached out to trusted figures in the past and been let down, influencing their readiness to do so again.
Recognising Compensatory Strategies in Response to Trauma
To support those struggling with trauma, while not undermining their independence, choice, and personal sense of control, it is important to understand why they turn to compensatory strategies in the first place. Dr Janina Fisher suggests that we first identify symptoms common to trauma survivors, and then look at the specific psychoactive impacts of various drugs and align them with the corresponding symptoms:1
- Re-enactment Symptoms: These include risky behaviours and self-sabotage. Substances like alcohol and cocaine can mimic these behaviours, providing a temporary escape from shame and guilt.
- Persistent Expectation of Danger: Feeling on edge or fearing danger is common after trauma. Alcohol and marijuana might help reduce this hypervigilance, making it easier to navigate daily life.
- Hyperarousal Symptoms: Trauma survivors often struggle with intrusive symptoms that make them feel constantly on edge. Alcohol and marijuana can be used to relax and numb these overwhelming feelings.
- Numbing or Hyperarousal Symptoms: Some turn to stimulants like cocaine to counteract feelings of numbness, seeking a sense of well-being and aliveness. While some substances and changes in eating habits induce a numbing effect, substances like speed, cocaine, and even self-injury work against numbness. They not only increase hypervigilance but also enhance the sense of well-being and feeling truly alive, countering the compromised sensations caused by numbing trauma symptoms.
Finding Coping Strategies For Trauma
The aftermath of trauma can linger, resurfacing unexpectedly or emerging long after the event. Unsettling feelings linked to the trauma may arise spontaneously. Knowing strategies to cope with trauma symptoms can help avoid problematic compensatory strategies which are likely to cause further issues in the long-term:
Grounding Exercises
- Remind yourself of your safety in the present moment.
- Hold or touch an object symbolising the current reality, this could be anything from a mug to a plant.
- Verbally describe your surroundings, or count footsteps or raindrops for distraction.
Understanding Your Triggers
- Identify experiences, situations, or individuals triggering reactions.
- Triggers may include reminders of past trauma like smells, sounds, words, places, books, or films.
- Significant dates and challenging seasons can intensify reactions.
- Understanding triggers helps in preparedness and effective management.
- Keep a mood diary to spot patterns and detect early signs of changing feelings.
Practise Slow, Counted Breathing
- Modifying breathing patterns influences the body’s physiology and behavioural responses via the vagal pathways.
- Take extended, deep breaths for a calming effect on the heart rate and cortisol levels.
- Inhale and exhale slowly, with each breath lasting at least five seconds.
Applying Cold Water to the Body
- Applying cold water by standing in a cold shower or splashing cold water on the face for 30 seconds can stimulate the vagus nerve.
- Other options include holding an ice cube on your face if you can’t access running water.
- Meanwhile visualise a place evoking a sense of safety.
Vocalisations
- Vocalisations like humming, singing, and gargling can directly stimulate the vagus nerve, which is connected to the body’s relaxation response.
- Hum or sing softly while focusing on the gentle vibrations in your vocal cords.
- Gargling with water can stimulate the vagus nerve through vibrations in the vocal cords and eardrums.
Nightmares
- Reassure yourself of your current safety.
- Engage in calming activities before returning to sleep, such as a muscle contraction body scan. This involves breathing in, contracting a small muscle group such as the toes, then breathing out and relaxing the muscles. Next contract the feet and ankles, breathe in, relax the muscles and breathe out. Continue like this all the way up to the face and head.
Take Away
For trauma survivors who use self-injury or harmful substances, it is essential to know that the behaviour began as an attempt at mastery, not self-destruction. There is hope for everyone to find the resources to recover from trauma without the “help” of substances or self-injury.
Resources
[1] Fisher, J. (2000). Addictions and trauma recovery – Janina Fisher. https://janinafisher.com/wp-content/uploads/2023/03/addictions.pdf
[2] Campbell, K. (2011). Eastern Trauma Advisory Panel Trauma, alcohol and drug comorbidity: https://www.semanticscholar.org/paper/Eastern-Trauma-Advisory-Panel-Trauma%2C-Alcohol-and-Campbell/64012d6fe9dc3ee4013e502febefdb0c8bac520d
