#MeToo Part 3: Abuse and Addiction

Over the last two weeks I have discussed the #MeToo hashtag and how abuse influences biology. I talked about how learning to ‘fight’ in response to threat changes the biology and responsiveness of the immune system. And last week I broached the subject of how the ‘freeze’ response to abuse may be, at least in part, implicated in chronic fatigue-type conditions - those in which cellular energy production/respiration is impaired, through the mechanism of an overactivated Cell Danger Response (CDR).

Today, I am going to tackle possibly the most tricky area of all. Not because it is rare, but because it is such an emotive topic. Today, perhaps obviously, I broach the subject of how ‘flight’ patterning in response to trauma can directly alter behaviour and an individual’s response to life.

I am going to talk about how experiences, behaviours or substances can be used to change biochemistry as a means of self-protection. I am going to cover the subject of how we use these external agents to change the way we feel, often to cover up the way we feel. In trying to escape abuse or trauma history, fleeing into the use of substances or the pursuit of damaging behaviours is a way to change our state. This strategy can become a compulsive escape method.

I am, of course, talking about Addiction.

As with the last two weeks, today’s article comes with a caveat. I am not - in any way - stating that all addictions emanate out of abuse histories - nor do all Cell Danger Response or immune dysregulation conditions have their origins in abuse or trauma. Within healthcare, particularly in Functional Medicine, we know that all the ‘end results’ (such as immune dysfunction, chronic fatigue or addiction) are NOT always caused by the same thing.

Instead, my starting point in all of these articles has been abuse, and the #MeToo hashtag… my aim with this series has been to elucidate how abuse can create the biochemical shifts which cause the chronic illnesses that I have discussed.

So, with the provisos out of the way, let’s discuss how addiction can result from #MeToo moments…

A Primer on Addiction

When you look at the research into addiction you quickly learn that it is a difficult area to study. Opinions about it have changed in recent decades as mental health has become less stigmatised and our understanding of neurochemistry has advanced. The literature now reflects the concept that addictive behaviours are built upon brain chemistry and neurotransmitters, rather than simply occurring as a result of ‘character flaws’ in the individual. We now look at addictions through the lens of seeking a chemical reward and we believe that most addiction is associated with the neurotransmitter dopamine.

As we learned more about neurotransmitter function, it became clear that dopamine is not a ‘pleasure’ chemical. Instead, it is a neurotransmitter released in the brain after pursuing a goal and upon attainment of that goal. This is what is known as “reward” - and reward is the sensation that you get from having worked towards something that you then achieve. We now know that the looking forward, the seeking and the yearning for the end result is as much a part of the addictive process as the release of dopamine itself which comes when the goal is achieved.

But when I bring this into the realm of my practice, this high-level neurotransmitter explanation is about as useless as the serotonin-model of depression. There are far more grey areas than absolutes when it comes to addiction - and even if we fully elucidate the pathways of dopamine involved, this still doesn’t answer the age old questions of “why”, or “who gets addicted”. We all have similar circuitry - but we don’t all become addicts in pursuit of dopamine highs. There may be structural and genetic differences at play, but still these do not offer sufficient explanation for the myriad nuances inherent in addictive behaviour patterns.

Moreover, there are differences in what people become addicted to. Addictions to substances hold a different pull than behavioural addictions because they involve the consumption of compounds which fundamentally change the chemistry (including the neurochemistry) of the addict. Behavioural addictions may “just” involve the dopamine-reward pathway, but these too carry collateral chemical damage because of the impact on the nervous system.

So addictions aren’t simple. But moreover, they aren’t just chemical - and they aren’t all the same thing. So instead of examining the mechanics of addiction - I take a step back and try to really look into “why”.

What all addictions offer as a payoff, irrespective of the specifics of the addiction itself, is escape.

Addictions are to substances or experiences which change our biochemistry in such a way that it alters our emotional and/or our physical state and, in so doing, provides relief from the pain that we are experiencing. Whatever the substance or behaviour involved in the addiction - the goal is to change one’s state. And when you look at ‘why’ someone might want to change their state… here we find our link to abuse, invasion … and #MeToo moments.

But this isn’t as simple as trying to escape a bad memory, or trying to forget a trauma. This isn’t a behavioural choice as an attempt to ‘run away’. It runs far deeper than that - because whilst an addiction might look like a very surface-level, conscious choice to try and blot out or forget things, there are far, far deeper biochemical roots to these behaviours. These biochemical roots take hold at the point of trauma or stress.

The Locking Mechanism Of Trauma & The Surprisingly Low Incidence of Addiction

All studies into those who have experienced extreme abuse or trauma in their history suggest that, on some level, though the trauma is long-passed, the sufferer continues to relive the chemical processes of trauma in their neural networks as if it were currently being experienced. Moreover, their bodies are stuck in the adrenalised, highly alert state into which they were pushed at the original moments of trauma.

The work of Bessel Van Der Kolk in “The Body Keeps The Score” is illuminating here - demonstrating how brain scans (fMRIs) show us how the areas of the brain that are activated as someone is reminded of their trauma are those which also get activated whilst present memories are formed. This means that when someone who has experienced trauma is reminded of it, they see the images as vividly as if it were taking place right now.

Simultaneously, the area of the brain which confers language ability loses neural activity when a trauma patient is reminded of their history. This suggests that whilst experiencing high alert in highly active, ‘fight’ areas of their brain, they simultaneously experience powerlessness - and inability to speak or to rationalise.

And again, when someone is reminded of historic trauma, they relive BOTH the high alert AND the powerlessness that occured at the moment of their trauma or abuse. These two experiences - alertness and powerlessness - are not only remembered each time someone thinks of their past pain - they are neurochemically and neurologically repeated.

All of this ties to dopamine. Dopamine is a chemical which, along with priming us for reward-seeking behaviour, helps to encode memories. Whilst teaching us what to seek and what to avoid, dopamine helps us to lay down experiential memories which guide future choices and behaviours.

Remembered trauma locks up brain synapses and fires dopaminergic pathways. In this situation, the consumption of a chemical substance or pursuit of behaviours which can directly hijack this dopaminergic system can feel like a viable escape solution to resolve the continual replay of trauma memories which haunt the addict’s brain. The pursuit of the addiction and the craving of the dopamine release on consumption of the addictive substance can help the feeling of being frozen in trauma to dissipate. Pursuing the release of dopamine can numb the historic sensations of trauma and hurt.

In many ways, the use of substances to alleviate pain isn’t at all surprising - it’s actually a really rational, common-sense solution to the deep-seated pain from which someone is trying to escape. The work of Gabor Maté also helps to bring enormous depth to this world of addiction:

The whole process of becoming hooked on a substance, or attracted to compulsively repeat a destructive behaviour, is typically an escape valve. Whilst it might seem that the addict is exacting upon themselves ultimate harm, in truth - for them - their addiction is saving them from a deeper pain.

So, whenever we are in a state of trauma, the body steps into ‘high alert’ mode. This doesn’t have to be major trauma, though it certainly can be. But biochemically the result of threat is an adrenalised state of inner chaos and a brain that wires the body for panic and stress responses. The inner chaos isn’t the problem here - the ‘inner chaos’ state is completely biologically appropriate given what the body thinks is happening.

Instead, the damning part in modern society - and years after trauma is experienced - is that the rational brain, in moments of calm, cannot see the need for this stress response. We can tell we’re anxious, on high alert, panicking - but the self-reflected conscious awareness can only see that this adrenalised state is “irrational” (we don’t know what’s being triggered, and by what).

Moreover, our rational mind can distinguish between threats - real, imagined and perceived. But that distinguishing rationalisation happens in the part of the brain which is turned DOWN in a state of stress. The body and the limbic part of our brain - those parts that get activated in times of stress - doesn’t distinguish between threats. Attack first, ask questions later.

And, as neural scans show, when trauma memories are triggered the brain and body live through the experience as if it was happening now. And when the inner chaos feels irrational though inescapable, life becomes the battle between the chaos and controlling that chaos.

When it comes to addiction, life can start to resemble a battle between internal chaos and the desire to stop or escape that chaos. If, in response to the hijacking of our neurons by trauma history, we can hijack our neurons in return utilising addictions … this is actually a very good salve for our distress.

#MeToo and Addiction

#MeToo wasn’t about overt sexual abuses - it was more about microaggressions and the inconsiderate infringements of personal boundaries and space that occur in the workplace. In this way, it might seem far-fetched to suggest that #MeToo moments lead to serious addictive behaviours.

But here is where that ‘addiction grey area’ comes up again. And it is also where a subjective threat becomes layered within the social norms and expectations. The nuance within the #MeToo movement was that this was workplace abuse - the kind of infringements which could (and did) affect career progression, relationships with colleagues, roles and opportunities.

Here, #MeToo was akin to prostitution, in that, in order to be valued as a human being (within the workplace, in particular), the expectation was for abuses to be ignored, sanctioned - in fact, necessary in order to allow for personal/professional success and acceptance.

In this way, whilst the actual abuse may seem minor, it bears all of the hallmarks of the most terrible abuses: the inability to escape.

What makes a trauma more indelible, speaking neurochemically and of the nervous-system, is the prolonged release of stress hormones and high-alert chemicals. Being allowed to feel ‘fight/flight/freeze’ - and then act on that instinct - is a highly sophisticated and successful safety mechanism. Being trapped, however - whether literally or by inference and choicelessness - is what creates prolonged release of stress chemicals and imprints the fear patterning.

This is why living in an environment of unmentionable microaggressions and advances which are supposed to be ignored can lead to the same neurochemical state as major traumas. The whole point of the #MeToo hashtag was to expose something that has not been able to be spoken about for decades. The very fact that this hashtag was even necessary demonstrates how powerless people have felt within their own lives.

Powerlessness affects biology. And when biology becomes affected - especially when fear and ‘internal chaos’ are the result - seeking solace, avoidance and to shift one’s chemistry utilising substances can become seriously addictive. When your body becomes locked into feeling fear - and yet you cannot physically escape the situation - the substances or behaviours which can change the way your body feels become deeply attractive. Pursuing them eventually becomes impossible to live without.

The Legitimisation of Avoidance

When I work with addiction I have enormous empathy for my clients. I can see the rationale behind finding a behaviour which takes pain away. When that behaviour includes imbibing a substance that powerfully alters the chemistry of our bodies - which can feel like such places of pain when they are holding onto the biochemistry of threat - staying addicted to that substance (and the behaviour of acquiring it) can feel like the only option.

Moreover, escape into addictions - whether to behaviours, substances or both - is easier than facing challenges. And, quite frankly, it feels better. Facing challenges, dealing with stress, threats and trauma is hard.

Avoidance is one of the best safety strategies there is. When we cannot escape, it is human nature to find myriad ways to halt experience. We block memories, we shut down sensory perception - and we utilise substances to allow us to feel something different. We all do this at times - from using caffeine to stop us feeling tired, to having that glass of wine to help us unwind.

But Addictions are extreme versions, usually founded on a more extreme need to run away or change state. As such, addictions are tricky to tackle because they provide security and solace - whether that’s in an addiction to the gym, to running or other activities, into over-activity or over-achievement… or whether addiction takes someone towards the bottle, or to gambling, stealing or sex.

Small infringements of space, power and career progression may seem minor. But, in truth, they can provide the breadcrumbs for many ‘minor’ addictive behaviours. If we feel sufficiently threatened or powerless, this is enough motivation for the body to lock down, to change the biochemistry and, eventually, to contribute directly to addictive behaviours.

The complicated part of dealing with addictions is finding the motivation to let go of the addiction itself. It’s easy to want to be rid of autoimmunity or immune hyperactivity, chronic fatigue or mitochondrial issues. It’s less easy to want to let go of your security blanket and your ‘safe place’. Yes, the old adage is true that you have to want the alternative more than you want the security of the addiction - but how do you get there? How do you stop running away?

It is this topic that I will cover next week. After all of the pathways and the biochemistry of distress are laid out, as I have done over the last three weeks, how do we change the hardwired patterning that becomes imprinted as a result of abuse or #MeToo moments? It’s a big topic, and it won’t provide all the answers, but it will start a conversation about releasing the chemistry of abuse to allow for true freedom, as opposed to the “freedom” of escape which comes from addiction.

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