In 1996 it became very clear to me that chronic relapse in alcohol and substance abuse had a more profound cause than just the substances themselves. I looked at the core issues, the family system, and the trauma events that impacted addicts. Often sober people were angry and dry drunks. Often addicts picked up other behaviors, sober from substances but in sex or relationship addiction, self-harming, eating disorders, gambling, gaming, pornography, or a multitude of other behaviors. Or they had many years in recovery but were ready to commit suicide. That was my impetus to start a program that addressed trauma along with addiction. As you read The Trauma Heart you’ll understand how excellent visceral, cellular, trauma treatment can break the cycle of chronic relapse in all addictions, and mood disorders and behavior.
I speak at and attend many conferences and often attend the presentations of my colleagues. However, I have absolutely become a groupie of Dr. Gabor Maté. For years I trumpeted our belief that trauma work needed to be done along with addiction work, and that 90 percent of addicts and many other people have trauma. It was hard to make that case with hard-core addiction professionals who had focused solely on the addiction and perhaps a dual diagnosis. I walked into Dr. Maté’s presentation one fateful day and, for the first time, heard a professional assert with grace and compassion that trauma is core, and relapse is to be expected if the trauma is not resolved. I went to every presentation of Dr. Maté’s that day and have read his work. What also impressed me was that he had been doing his own trauma work, and as a result he recognized in utero and intergenerational trauma, that addiction was a disease of broken or dysfunctional relationships, and that building relationships and healthy attachment assisted in the healing process.
I felt so joyful for our industry that we were being validated by such a prestigious yet humble man. He worked in the trenches in Canada with street addicts, many plagued with HIV/AIDS, hepatitis, and a myriad of health issues. Dr. Maté’s belief in compassionate care and the healing process, his ability to identify with addicts with his own behaviors, his recognition that addiction is so much more than substances, and his understanding of the role of neurotransmitters in trauma and addiction are vital to understanding and healing this brain disease.
Others in our industry believe as I do, including pioneers whom I respect and admire such as Dr. Patrick Carnes, Judith L. Herman MD, Dr. Peter A. Levine, and Bessel van der Kolk, MD, but no one has given the message as passionately and as in sync with what I know.
Trauma can be identified and healed no matter what your survival/coping behaviors are, if you are willing to do the very deep work and to do it in tandem: trauma and addiction, trauma and behaviors, trauma and mood disorders. I believe these are interdependent.
When I was in treatment in August 1987 my counselor told our group, “Look to the right of you, and look to the left of you, only one of you will make it.” The odds were not good. That didn’t engender a lot of hope! Out of a community of fifty, only three of us were clean and sober after a year. I was one of the fortunate committed threesome, and we stayed connected. So I paid attention. I was always self-willed, too bright for my own good, but this disease brought me to my knees over and over again until finally I could no longer get high. My tolerance was so monumental, I could only maintain so I would not get sick. The ghosts of my past would come. My children—sixteen, eighteen, and nineteen—had given up hope. My mother had raised my youngest, my middle daughter left the house for her own journey, and my son was in and out. One time he returned home to this scene: I had broken a mirror and was holding a sharp edge to my wrist. I threatened that if he didn’t help me to get some alcohol or drugs, I would kill myself. With great disgust he said, “Go ahead,” and walked out the door. That was my bottom. I called my sister and begged for another trip to detox. With her children on board she stopped and got me a fifth of VO that I drank on the way. I was already in withdrawal.
I called myself the “Detox Queen of the Western World," a self-effacing remark that just dripped with the poison of guilt, shame, and remorse. I had been to detox many times over the years and Camden detox did not want to see my face again. One of the mental health techs scoffed at me and said I was never going to get sober, I was one of those, “constitutionally incapable” of finding recovery. I was devastated, but deep down I agreed with her that I was a hopeless case. I was in detox six times in six weeks that summer when my sister came “just one more time.”
This was a different, new detox. The staff were kind and compassionate, and I was a wreck. I had such shame, guilt, and remorse. I truly believed I was a horrendous person because of the things that were done to me and the things I had been capable of in my addiction. Those things haunted me and frightened me.
One of the staff gave me a book, Adult Children of Alcoholics by Janet G. Woititz. In the beginning of the book is a “Laundry List” of signs and symptoms. I read it over and over and fell apart. I wailed and snotted and cried for a very long time.
Some of the characteristics of an adult child of alcoholics are:
1) We become isolated and afraid of people and authority figures.
2) We become approval seekers and lose our identity in the process. I always described myself as a chameleon, for example, “Tell me who you want me to be.”
3) We are frightened by angry people and any personal criticism.
4) We have an overdeveloped sense of responsibility and it is easier for us to be concerned with others rather than ourselves; this enables us not to look too closely at our own faults.
5) We have “stuffed” our feelings from our traumatic childhood and have lost the ability to feel or express our feelings because it hurts so much (denial).
At ten years old, I found a dead man at a construction site near our home. He had fallen asleep or was drunk, and had frozen to death. It was in the newspaper but no one ever talked to me about the horror and terror I felt, and I never talked about it. These “secrets” are very common in the families of trauma survivors, and are part of addiction and coping behaviors. There were many traumatic events that I just didn’t talk about; instead, I medicated the feelings and the pain. The secrets I held kept me sick and wounded. The list went on and I was stunned to think it wasn’t just that I was a bad seed or black sheep; maybe it was more than that. This Laundry List is not just for alcoholics. Dysfunction and trauma in any family system can produce these characteristics.
The staff was trying to convince me to go to treatment after detox and I resisted. After all, I’d been to treatment and it “didn’t work.” That evening they showed a video, Soft Is the Heart of a Child. The film was about an alcoholic father, out of control and angry, the mother very co-dependent and focused on him, and three children. The youngest was a little girl, terrified and hiding. The middle boy was angry, distant, and acting out. The oldest boy was trying to care for and protect his siblings, an adult before his time.
When the lights went on, tears were streaming down my face. In that film, I saw myself as the little adult-child whose job was to hold the family together; my acting-out sister; and my two other sisters needing my protection. At the same time, I saw the cycle extending to my own children; they were lost in the morass of my addiction and taking on the necessary roles. It was time to break the generational cycle. I went to my counselor, agreed to treatment, and began my very early trauma work.
For the very first time in my life I followed directions and did everything I was told. I was very broken, could no longer read at any length, stumbled a lot, and could not make a decision to save my soul. I had to call my sponsor and ask very simple questions like blue shoes or red, shower or bath, and what am I feeling? Oh, that’s what anger feels like; that’s what sadness feels like! I had no idea about emotions because they had been driven down so deep for so long.
The good news is that, after eighteen months, I regained all of my cognitive functioning, my memory, my physical well-being, was able to make decisions, and I was finally very connected to my emotions. My relationships were healthier and deeper.
Healing my “trauma heart” has been the greatest gift and I continue that work today with my own therapist because as long as I live, life brings challenges. I face them in the here and now and if I don’t, I pay the price of deeper pain. I hope this book brings you the gift of hope.
I believe in the healing properties of love, compassion, witnessing, genuineness, and, most of all, hope.
As you move forward through The Trauma Heart, I think you will identify and find answers. I believe you will experience hope and great possibilities for healing, living the life you choose, and, most of all, dreaming big.
Before we get to the story of a young man named Zac, I want to introduce a poem by the Persian poet Rumi called “The Guest House.” The Guest House is the name of my newly opened treatment center in Ocala, Florida. Like the poem, trauma treatment ultimately invites “the guest” to be aware of it all. Be aware of everything that surrounds the trauma, makes up the trauma, makes up you, and then invite it all in so that you may embrace it. We must invite in all of the elements of our life, and yes, that means inviting in the pain, breathing in all that is presented, feeling and experiencing life to its fullest. Through reading this book you’ll come to realize what I mean. Welcome!
“The Guest House”
This being human is a guest house.
Every morning a new arrival.
A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.
Welcome and entertain them all!
Even if they are a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.
The dark thought, the shame, the malice.
meet them at the door laughing and invite them in
Be grateful for whatever comes
because each has been sent
as a guide from beyond.
—Rumi
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In the trauma/addictions arena, we use the word “trigger” to describe what may happen viscerally, sensorially, and cellularly to a person when something creates an emotional response that can often be uncomfortable or even cause memories, flashbacks or a physical response. So this is a trigger warning!
The stories in this book are about some of the deepest and painful traumas. The stories are about the triumph and victory over trauma that has immobilized and kept our storytellers prisoners in many ways.
In order to get to the rewriting of our story, however, we must tell the story.
You, the reader, may be triggered because of your own history. We invite you to use the Reflections after each chapter to describe and release the emotions that may come up for you. Also, go to page 127 and use the “healthy soothing” behaviors recommended and continue to journal your experiences.
There are resources available for you, and at the end of the book you will find websites for appropriate therapists in your area, and a way to contact The Guest House for additional resources.
I invite you to read the story below. It’s about Zac, a delightful, strong, bright, and handsome young man, often with a beautiful bright smile on his face. Zac is a staff member at The Guest House Ocala, and he earned that position the hard way—through life experiences and running from, stumbling through, and doing battle with his own trauma story. Zac’s body bears the evidence of his battle. Self-harming behaviors have left physical scars. Trauma has also left emotional scars.
Zac had been in multiple treatments, but inevitably the memories and flashbacks would overwhelm his ability to bear the emotional pain, and his body would bear the brunt as he sought relief.
Zac’s Story:
SCARS THAT HEAL
My name is Zac. I am an alcoholic, a drug addict, a love and sex addict. Most noticeably, as the photos on the following pages show, I am a cutter. I self-harm. I do these things to escape life, to escape the pain that I have lived with for so long. My story begins when I was around eight years old. This was when I started being sexually molested. I didn’t know what was right or wrong, I just learned that this is how I was desirable. Sometime later, when the molestation stopped, I no longer felt loved and desired. I hated this feeling and didn’t know how to cope. I’m not sure where I learned the action but I started to cut myself up on my shoulders. I didn’t do it often, or deep. The feeling gave me relief from my pain of no longer feeling desired, an outside pain to hide the inside one.
As time went on, I started drinking and having sex at a young age. To me I felt I had to have as much sex as possible to prove I was a man. At the time, I didn’t realize I was also using sex to run from my feelings. I always needed to feel desired, loved, validated. Women did that for me, only I could never have a healthy relationship and cheated on all my girlfriends. I needed everyone to want me, because my molester no longer did. Alcohol did the same for me. When I drank I felt warm inside, like I belonged and was needed. It helped me relax and be part of the group with other people; only I could never control my drinking. Once I started, I could not stop. I would drink until I could no longer feel, no longer remember what I had done while intoxicated.
I somehow managed to graduate high school, always just doing enough to pass my classes. I was a football star and I loved the feeling of being on the field, with a thousand people watching me, wanting me to tackle the opposing team. I’ve always been a calm, nonaggressive person, but when I put that helmet on, I knew I could actually hurt someone and get away with it. I loved when I could make someone bleed, and even more so I loved when I made myself bleed. When I hit so hard, and played so strongly I got hurt. I felt tough and manly, all the while getting some release from my pain inside. I started community college after high school, though I was usually too drunk to remember what was discussed in class. My molester went to college, so I didn’t want to. I went to make my
parents happy. By this time, I didn’t even want to live. I had made some minor suicide attempts before this point, and was now just passing time until I died. I didn’t care what happened to me, as long as it could just be over.
I started playing rugby, and soon after found myself playing in Australia, far away from my parents, my dog, and my few friends who still put up with my drunkenness. I was an outsider, but all eyes were on me. Wherever I went in town people recognized me as the American. I felt desired, but not enough so to keep me from drinking, and now it was an almost everyday occurrence. I remember on my twentieth birthday I finally admitted I had a drinking problem and called my mom long-distance and cried and cried to her for a while. I didn’t want to drink any longer, but a few days later I was, and as always, I couldn’t stop. When I got back to the States I spiraled into an even bigger depression; it was almost like I picked up right where I left off. Not caring anymore, just waiting to die. I had no direction, and felt I had no purpose.
My father is a marine biologist and travels the world saving coral reefs. He started taking me on trips with him, showing me how good life can be, how everything on the planet had a purpose, even the smallest of creatures. I love the ocean, and my father, but they were not enough to lessen my pain. At the age of twenty-one I started doing pills, then quickly turned to heroin. Alcohol was no longer even a thought for me. Heroin numbed my pain like never before.
My life soon turned into what one would expect from a heroin junkie: stealing, lying, cheating. I was arrested a couple times, and started my run with treatment centers. After my first treatment, I stayed sober for just a month or two, quickly reverting back to the drugs to run from my pain. I had yet to tell anyone what had happened to me as a boy, and didn’t understand how much this affected me. When I went to my third rehab I found myself back in South Florida, near where I was born. I did really well in treatment, and actually, for the first time in almost twelve years, told someone about the molestation. They wanted to send me off to another facility. I said no, that I didn’t want that, it didn’t affect me. I got kicked out of that facility for having sex with a woman, and was sent to their partner facility in that town. I graduated there and soon was living at a halfway house. I started working and life was going well for about eight months. Then again, I relapsed and was soon living out of my truck, using public restrooms, and showering on the beach to stay clean. I remember my mom driving the three hours to where I was to chase me and try to help me. She got me a hotel room and into another halfway house. I was kicked out only a few days later. After some time, I called her, willing to go into yet another treatment facility for help. Only this time, it was one where I would have to talk about what happened as a boy.
I arrived at Judy’s treatment facility in Central Florida and started working on trauma. I did therapy about being molested, and about my drug and alcohol usage. I was willing to live without those two crutches, only I wasn’t willing to live without women. I still hadn’t realized my need to be desired. I fell in love with a girl at the rehab and soon got wrapped up in everything that I shouldn’t have. I again attempted suicide, and was readmitted into treatment. I was still unwilling to let go of the girl, but I cheated on her in treatment.
I didn’t take things seriously and was honestly just staying there because I promised my parents I would. I planned on leaving and killing myself. This is exactly what I did; I ran away and attempted to take my own life. Luckily, I failed at my attempt and decided I needed to try something different.
During this time, my father was in a place called Saipan. It’s a small island about 800 miles from Japan. It was the location of a major World War II battle; several thousand Japanese soldiers and civilians committed suicide there to avoid capture when Allied Forces took control. I called my father to once again ask for his help. He told me how he had been in Saipan, that all over the island there are signs for Suicide Cliff, the place where those thousands went and jumped to their deaths. He told me he was plagued with thoughts of losing a son, that maybe I will never find peace. He was willing to do anything to help me, to give me a life of happiness. He made me promise to go back, and not to leave until the therapists said I should.
So this is what I did. I went back and took things more seriously. I started doing what I was suggested to do, and work on assignments to heal myself. I took away the drugs, the alcohol, and now the women. I started cutting again; I took razors to my chest, to my arms, to my leg, even my face. I wanted the world to see how ugly I felt inside, how full of pain I was. Only now I couldn’t get away with the little cuts I had done when younger; I needed bigger, deeper cuts to get the release I craved. As with all that I do, I started cutting addictively. I couldn’t stop, nor did I really want to. I needed the feeling of my skin opening up at my hand, to watch the blood pour out and drip on the floor. I needed to feel the punishment for my actions, for not being good enough for my abuser. At one point I was sent to the psychiatric ward for observation because they were worried I was going to kill myself. Only they didn’t understand I was doing this because I was trying to learn not to want to kill myself.
My therapist then, Tom Pecca, threatened to quit if they did not allow me back. I came back and did the work. I tried my hardest to show I was serious and to get better. I learned all sorts of techniques to not cut, healthier outlets to get through the pain I had inside. He finally told me I was ready to go and I was terrified. I still had open wounds from my cutting and didn’t know how to even live in the real world. He told me I knew what to do, and had the tools to continue on a healthy path, but it was up to me to continue to do the work and keep healing myself.
Two weeks after leaving treatment, I found myself on a plane with my father heading to Saipan. I had the ocean, my dad, and a purpose for now. I didn’t cut the entire time I was there and started to feel better about life. I believe it was around two weeks into our stay there when my dad took me up Suicide Cliff. During the drive, he told me how he had come up here and prayed for me, hoping that I would find peace. He told me he had accepted the fact that I might not live longer than him. He told me how there has been nothing worse in his life than the fear of my death. We got to the top and out of the car. We walked over to the edge of the cliff and I leaned over the railing, looking down to where so many had perished. I began thinking of how much pain I had caused him and my mother. How much I’ve done to them that no parent should ever have to go through.
He told me to turn around from the edge of the cliff and look. We could see the whole island from there. The resorts on the beach and the people in the water, the coral reef under the crystal-clear water, and even the shipwreck under the surface from the battle. The trees blowing in the wind and the birds flying around; it was beautiful. My father then told me he felt that if some of the Japanese that had marched up there to die had only turned around and seen the beauty of the island, of life, that perhaps they wouldn’t have jumped. He told me that I had focused on the negative, and if I could just turn around and focus on the positive, on the beauty of life, that everything would be okay. I remember the next morning
I woke up, and thought to myself, “What a good day to be alive.” I used to wake up and think the opposite.
This is the beginning of my story, and I don’t mean everything you just read. I mean that last thought. I don’t know what my future holds, but I know great things are in store. Today it has been over eighteen months since I cut myself, even longer since I’ve had drugs or alcohol in my body. I even work with Tom Pecca these days, and get to help others just like me heal their trauma. Today I know that I am enough, that I am loved and desired, and that I don’t have to hurt myself or others to get relief from the things that bring me pain. I am a miracle.
Suicide/Banzai Cliff
Today Zac is clean and sober, and a walking, breathing example of hope and resilience in the face of what feels like unbearable pain. Now Zac’s purpose is to help folks who read this book to know that surviving is just a step or two away from seeing your pain as a gift, as is described in the poem, “The Guest House.”
Beginning Thoughts
“At my core I am a unique and glorious being of infinite worth and potential. I am valued and loved beyond my comprehension.”
—Author unknown
We are not bad people trying to get good; we are wounded people trying to heal. The majority of people addicted to substances or process addictions such as sex/relationship, eating disorders, self-harming behaviors, gambling, pornography, money disorders, and variations of these, are trauma survivors. Relapse is inevitable without trauma resolution. Many don’t identify as trauma survivors until they are helped to look at their history: personal, family, intergenerational, and in utero. That is the “Aha” moment when puzzle pieces fall together and the behaviors make sense. Behaviors always make sense when you unravel the story.
For almost thirty years I’ve worked with clients and families who are in such great pain around addictions and behaviors gone amok, believing their loved one must be bad, wrong, defective. The “identified” client believes that to their core, when in reality the whole family is embroiled in their individual survival coping mechanisms. The identified client is often the red flag that the family needs healing. These families come from every walk of life and they/we relate to their struggle and their desire to heal that little boy and girl inside.
Trauma creates the need for soothing/coping behaviors, and those behaviors are what initially help us to survive until they turn against the individual as addictions.
Travel into The Trauma Heart with me and explore the many ways that life’s events impact each member of the family. The Trauma Heart offers the essence of trauma and addictions treatment through the stories, art, and assignments of former clients and the staff who worked with them to reveal a snapshot of their pain and healing. Then together we can change this trauma world we live in, one person, one family, at a time. In this book:
• You’ll explore the meaning of trauma, addictions, behaviors, and identify and relate to your own history.
• You’ll be given the opportunity to understand what we mean by, “We are not bad people trying to get good; we are wounded people trying to heal,” and, “Behaviors always make sense when you unravel the story.”
• And finally, you’ll walk through the process of trauma/addictions treatment through very personal stories, art, and assignments from clients and the clinicians who have done their own trauma resolution. You’ll be offered reflective sketches, and personal assignments you can do if you choose to explore your own history.
Walk through the pain and experience the joy, the courage, and the transformation of these warriors.
Reflective Sketches
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1) Why did you buy The Trauma Heart?
2) What do you need from The Trauma Heart?
3) What emotions did you feel buying The Trauma Heart?
4) Are you ready to look more deeply into your story?
5) What would be the best possible result that could come from reading this book?
6) Please make an intention to have the best possible result. Your energy will invite healing.
7) Please journal your thoughts, feelings, and complete the reflective sketches.