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How can I process trauma without substance use? · Wellbeing Solutions - Ask A Counsellor

• 0:00
  SPEAKER_00: So when we talk about trauma and substance misuse, it's important that we start with compassion rather than judgment.
• 0:07
  SPEAKER_00: And I think we find this a little bit difficult as a society because of the stigma around addiction, but also we hear compassion and we think that erases accountability and that's not the case at all.
• 0:19
  SPEAKER_00: For many people, substance can become a way of coping with overwhelming emotions or a nervous system that feels constantly on alert.
• 0:28
  SPEAKER_00: It may have started as a way of getting through something difficult.
• 0:32
  SPEAKER_00: So rather than kind of stigmatizing that and asking what is wrong with you, a trauma-informed approach would then ask, What happened to you and is this what helps you survive?
• 0:42
  SPEAKER_00: How do we move beyond that while recognising the consequences that that causes?
• 0:47
  SPEAKER_00: Processing trauma alongside substance misuse needs to happen at a pace that feels safe enough for the person, and they need to be safe as well, because if that substance has been all that has kept somebody alive, then not feeling safe, and that needs to come first.
• 1:05
  SPEAKER_00: We don't want to push someone to talk in detail about traumatic experiences before they have the tools and the stability to manage what comes up.
• 1:14
  SPEAKER_00: So a useful starting point, as just said, is safety.
• 1:18
  SPEAKER_00: This can mean creating like a safe relationship in therapy, developing predictable routines, making that person's world bigger than the substance, and learning to regulate the nervous system.
• 1:29
  SPEAKER_00: Simple techniques such as slow breathing, noticing your surroundings, grounding yourself through your senses, and things like that can bring somebody back into the present moment.
• 1:40
  SPEAKER_00: Another important skill is developing awareness of what happens before substance misuse.
• 1:45
  SPEAKER_00: Instead of judging the behaviour, we can become curious about it, which I feel is a little bit of a theme.
• 1:52
  SPEAKER_00: So we can think about what was happening just before the age happened, what emotion was present, what did that person need in that moment.
• 2:01
  SPEAKER_00: This can help somebody understand the function of the substance use without excusing the harm that it may be causing.
• 2:09
  SPEAKER_00: Trauma-informed counselling also focuses on choice and control.
• 2:13
  SPEAKER_00: We can offer options rather than taking control away from the person.
• 2:17
  SPEAKER_00: For example, asking, would you like to talk about what happened or would it be safer just to focus on your immediate needs today?
• 2:24
  SPEAKER_00: And that small question can help restore a sense of control.
• 2:28
  SPEAKER_00: It doesn't sound like much, but it really is where it all starts.
• 2:31
  SPEAKER_00: As stability develops, trauma processing may become possible, and this should be done carefully and appropriately with professional support.
• 2:42
  SPEAKER_00: The goal isn't to force somebody to relive the trauma and it's also not to erase it.
• 2:47
  SPEAKER_00: It's to help them make sense of what happened, reduce its power in the present, and develop safer ways of responding to it.
• 2:54
  SPEAKER_00: When we're responding to a trauma, we're still responding to the incident that happened as though it's in the moment.
• 3:06
  SPEAKER_00: There may be progress and setbacks and difficult days and moments where old coping strategies return.
• 3:12
  SPEAKER_00: These moments again can be approached with curiosity and we can look at well, what needs to work differently?
• 3:18
  SPEAKER_00: When are you more vulnerable to that?
• 3:21
  SPEAKER_00: If somebody is struggling with trauma and substance misuse, they don't have to process it alone, but addressing it is the first step to starting to process things without that as a crutch.