Anna Runkle, a writer and coach specializing in trauma, developed adult-onset post-traumatic stress disorder (PTSD) from witnessing the death of a friend. In the same week, her mother also died, she was attacked on the street, and a romantic relationship ended. Afterwards, she found herself in a massive repetitive fight-or-flight reaction for 18 months because she couldn’t stop thinking about those events. Upon recovery, though, she made it her mission to help people suffering from trauma and addiction by teaching techniques that benefit the mind and body simultaneously.
How are the mind and body connected?
The body and mind share a special connection and role in health. Anxiety and depression from stress are associated with both psychological and physiological conditions, such as diabetes, mental illnesses, and addiction.
This bond exists between the physical aspect of health, and its emotional, mental, spiritual, social, and behavioural counterparts. Studies on this mind-body relationship have spawned complementary therapies, which have since been combined with traditional medicine in the treatment of mental health disorders and addiction. One physician who practices both is Dr. Christiane Northrup, a renowned OB-GYN and author of Women’s Bodies, Women’s Wisdom. The blending of traditional and complementary modalities is called a ‘holistic approach’.
Intertwined from birth
Dr. Northrup claims that we are born with innate acceptance of our bodies. But as we mature, our bodies and health are molded by habitual thoughts and beliefs that guide our behaviour. To improve our well-being, we must acknowledge that our beliefs, behaviours, and physical bodies are unified. Then we must examine and change destructive beliefs and assumptions that we have unconsciously inherited from our parents and our culture.
Western civilization alludes to the intellect as being superior to emotions, and that mind and spirit are superior to—and entirely separate—from the body. Dr. Northrup counters that our thoughts, emotions, and brains communicate directly with our immune, nervous, and endocrine systems, and with our bodies’ organs. Clinicians conventionally studied these as separate entities, when really, they belong to the same system.
Dr. Northrup recommends considerably expanding our entire concept of the mind. It shouldn’t be confined to the brain for the intellect because it exists in all our bodies’ cells. Every thought, every emotion has a biochemical equivalent.
Negative thoughts and emotions make us sick
A thought held and repeated long enough becomes a belief. This belief becomes a biology— the physical basis of our health. Our beliefs are heavily influenced by our culture. Fortunately, we can change our minds as we mature.
Destructive thoughts and suppressed emotions lead to physical distress because of the biochemical effect that emotions have on our immune and endocrine systems. Scientific studies show that inescapable stress is associated with a form of immunosuppression (suppression of the immune system response). Autoimmune diseases, such as multiple sclerosis, cause the immune system to attack healthy cells if it gets destructive messages from within the body. Depression has been associated with self-harm behaviours and the malfunctioning of the immune system. Many with autoimmune disorders (80% of which occur in women) suffer from depression—also a risk factor for heart disease and osteoporosis.
Treating the whole person
Holistic therapy recognizes the mind-body link with traditional and complementary methods. Traditional treatments, aka ‘talk’ therapies, help recovering addicts change dysfunctional thought and behaviour patterns.
The National Institute on Drug Abuse confirms that holistic addiction treatment is effective in treating substance abuse disorders (SUDs) and mind-body-spirit ailments. It addresses physical, mental, and emotional health issues by developing skills for recovery. It decreases the need for substance use and boosts self-esteem.
On anger, sadness, and avoidance
Dr. Marsha Linehan is the creator of dialectical behaviour therapy (DBT), a branch of cognitive behaviour therapy (CBT), the gold standard in treatment modalities for behaviour and addiction-related conditions.
She says, “Anger is often justified, but not effective. Sometimes, anger functions to avoid sadness, which is one of the main emotions avoided in conditions like borderline personality disorder (BPD). The inability or the struggle to do something is the inability to tolerate sadness without help. Avoidance behaviour is avoidance of sadness. Most BPD patients are afraid that if they experience sadness, they will fall into an abyss and not be able to get out.” During a crisis, it’s hard to think clearly, control emotions, and not react in destructive ways. So coping strategies are important during severe distress.
This is where DBT comes in. It is effective for addictive behaviour, but not so much for trauma- related cases. Dr. Linehan originally developed DBT for high-risk patients with suicide and self- harm ideation, but it’s not a suicide prevention program. It’s a ‘life worth living’ program. The main life skill taught is radical acceptance. Patients learn to accept withdrawal symptoms, cravings, relapses, stressful thoughts, feelings, and behaviours instead of rejecting them. Therapists help them find a balance between acceptance and change to overcome problems. DBT-SUD (substance use disorder), an updated approach to DBT, addresses alcohol and drug addiction. Some treatment programs combine DBT with hypnotherapy in cases of extreme emotional surges and chronic sleep disturbances like insomnia.
Here are some DBT techniques to regain physical and emotional control in moments of crisis
One of the best ways to tolerate distress is to distract. This is Extraordinarily valuable when patients have urges to kill or hurt themselves, or to use substances. Dr. Linehan uses psychological methods of changing biology—rapid interventions to bring arousal down—when patients are so upset that they can’t process information or use coping skills. Often, a distraction plan helps. Patients are urged to write this plan on a card, or record it on their phones, and bring it everywhere.
DBT distraction techniques:
- Use safe alternatives to self-harm behaviours, like screaming into pillows or writing unsent letters to people who have caused harm.
- Indulge in pleasurable activities, like going to the movies or text messaging friends.
- Think about others. Help someone.
- Divert thoughts. Reflect on a past happy event. Recite mantras.
- Leave! Walk away from an argument. Avoid self-harm items.
- Convert negative energy into positive by doing chores.
2) Paced breathing
Dr. Linehan explains that meditation works because patients change their biology when they practice intentional breathing. When they breathe in, their sympathetic nervous system fires and arousal pulls up. When they breathe out, the parasympathetic system (part of the automatic nervous system that counterbalances the action of the sympathetic nerves) kicks in and arousal goes down.
The opposite of a stressed and wandering mind is a mindful one. Mindfulness means paying attention to the present moment without any kind of emotional reactivity to what’s happening. This is the first skill module taught in DBT and the most critical part of the entire treatment. DBT was the first therapy to put mindfulness into psychotherapy. For patients who couldn’t tolerate meditation or focus on their breath, Dr. Linehan translated mindfulness practice into behavioural language.
Videos and apps
The average cost of a one-year DBT program is $6,000+. Those who can’t afford it may opt for free apps or YouTube videos that teach breathing and mindfulness techniques. Some practitioners offer free or discounted classes on Udemy. Breath Pacing is a breathing regulation app. Examples of meditation apps are Headspace and Stop, Breathe, and Think.
Mindfulness is broken down into different skill sets:
- Observation—Patients pay attention to what they’re currently experiencing internally and externally. This is central to all contemplative practices.
- Description of what they observe.
- Participation—The skill of letting go and going with the flow.
- Action—Non-judgmentally doing what works and acting intuitively.
We are all born with intuition – the ability to make good decisions even without enough information. By age seven, though, our brain’s frontal lobe reasoning centres kick in, suppressing the intuitive voice. In Western culture, the more educated we get, the less we trust our intuition. Society upholds logical, rational left-brain thinking and dismisses other forms of knowing as primitive or ignorant. Addictions keep us out of touch with our knowledge, feelings, and intuition. So, our intuitive capacity is underused. But it can be relearned as we become more in touch with our inner guidance system.
Intuitive guidance is the ability to read our own or another’s energy field. Part of many ancient healing and counselling systems, it can help detect energy blockages before they become physical.
Why medication needs backup
Most patients suffering from addiction and trauma experience depression and anxiety, so they are usually prescribed antidepressant and/or anti-anxiety medication. This kind of medicine often has adverse side effects, including suicidal and homicidal thinking, sexual dysfunction, numbness, and impairment in communication or decision-making.
Doctors push medication in cases involving traumatic experiences (like physical abuse) because adrenal overload can break down the immune system, leading to more serious illnesses. Medication-assisted treatment plans can be helpful in complex trauma, but in many cases, it can delay recovery by reducing awareness, leading to brain fog. Medication often takes care of symptoms but can’t offer a cure. Worse, when medication is stopped, its benefits (and side effects) cease. Still, any intervention is better than nothing.
So therapy, especially traditional talk therapy, is added to the mix. This focuses on aspects of trauma, such as memories, triggers, and emotion regulation.
Forms of talk therapy:
- Cognitive behaviour therapy (CBT)—an effective treatment for 65- 70% of people suffering from depression and anxiety. It addresses the mind-body connection by identifying thoughts, emotions, and beliefs that influence behaviour.
- Dialectical behaviour therapy (DBT)—this offshoot of CBT teaches emotional and interpersonal coping skills.
- Rational Emotive Behaviour Therapy (REBT)—a branch of CBT, REBT examines the root causes of specific behaviours and beliefs.
- Cognitive processing therapy—challenges patients’ thoughts about trauma to make them less upsetting.
- Exposure therapy—rewires the brain by encouraging patients to gradually face their fears.
- Acceptance and commitment therapy—teaches psychological flexibility. Effective for treating mental disorders associated with drug and alcohol addiction.
- Motivational enhancement therapy—gets rid of blocks that impede recovery.
- Family therapy—identifies family members’ dysfunctional thought and behaviour patterns from their loved one’s addiction, rebuilds trust, and resolves interpersonal problems.
- Group therapy—sessions with fellow residents usually in early recovery.
With certain conditions, though, like childhood/chronic post-traumatic stress disorder (CPTSD), talking about the past can be paralyzing or triggering. As CPTSD is neurological—meaning it develops in relation to slowed and altered brain changes caused by early adversity, abuse, neglect, and other stressful conditions—these changes leave patients prone to dysregulation when growing up.
This is an abnormality or impairment in the regulation of a metabolic, physiological, or psychological process . This occurs when patients lose their train of thought or are unable to find the right words. They feel lost or numb or become clumsy. Because of it, patients make grave social mistakes, emotionally overreact, or miss danger signals.
Triggers (loud noises, critical remarks, feeling left out, embarrassing events) can launch an emotional explosion inside, like an outburst of rage or shame (flooding), often followed by dissociation (checking out emotionally).
This is why relationships or school can be a challenge, why addicts find it hard to quit from substance abuse, and therapy takes a long time to work.
Treatments for dysregulation
Dr. Bessel Van der Kolk, a Harvard psychiatrist, recommends the following :
- Eye movement desensitization and reprocessing (EMDR) – Endorsed by the US Veterans Administration, this involves the use of controlled side-to-side eye movements or vibrating hand-held paddles or other tools that alternately stimulate the left and right brain. Practitioners help patients visit traumatic memories and reprocess them into normal ones. EMDR effects are long-lasting and astonishingly effective at treating adult-onset trauma.
- Neurofeedback – Practitioners attach electrodes to patients’ faces and scalps to measure brain activity. Patients watch videos or listen to sounds or other stimuli that change with their brain states. Our brains use chemicals called neurotransmitters to communicate. Brains can learn from biofeedback to reach a relaxed alert state.
- Tapping arms, face, head, and torso along acupressure points or meridians of the body calm anxiety and harsh emotions.
- Self-expression through writing is effective in re-regulating and a better choice for those who dislike talking about problems. It comes from a different part of the brain than speaking. Some studies suggest that the physical act of writing gives patients something manageable to process. Some forms include free association and journalling.
- Checklist – Doing a personal inventory of fears and resentments twice a day, followed by meditation, works to alleviate emotional difficulties or attention problems.
- Meditation – Different forms include mindfulness, Vipassana (the oldest Buddhist meditation practice that uses a codified system of mind training), passage meditation (combines literature with spirituality practice), and Vedic meditation (aka transcendental meditation). The last one is easy. It uses a mantra to focus on for 20 minutes twice a day. One doesn’t have to sit in a special way. It can be done anywhere, even in bed.
- Physical and movement therapies – This treatment category helps with dysregulation, heals the nervous system, and integrates awareness of the self and the environment through movement. It includes yoga, dance, martial arts, touch, massage therapy, somatic  bodywork, acupuncture, reiki, t’ai chi, and the Feldenkrais Method. The last one is a powerful revolutionary approach that uses gentle, mindful movement to bring new awareness. Traumatic memory is stored in the body. It can be accessed, triggered, or soothed through physical means, like vigorous exercise. Some yoga practices are specifically designed for treating trauma. Runkle found that running 45 minutes a day and reduction of sugar from her diet reduced symptoms by about 60% in the first week.
- Expressive therapies – Also known as experiential therapies, these include music and art therapy. Patients with difficulty asserting themselves use alternative forms of expression in place of talking.
- Somatic techniques – According to Ruth Buczynski, president of the National Institute for the Clinical Application of Behavioral Medicine, “When the nervous system has been hijacked by trauma, it’s crucial to resource patients with body-oriented techniques. These tools make patients feel safe, not just when they’re with therapists, but also between sessions.”
- Changing brain chemistry without medication – Two old ideas in psychology claim that when we hit adulthood, our brains stop changing, and that we can separate psychological disorders from biological ones. Global neuroscientist Daniel Siegel, a psychiatry professor at the University of California-Los Angeles and Executive Director of the Mindsight Institute, refutes these. He claims that through neuroplasticity (a branch of neuroscience), our brains continue to develop throughout our lives. He says, “We can stream energy and information through the brain and differentiate the right brain from the left side, then link them.” Marriage and family therapist Emma McAdam concurs with Siegel, referring to modern imaging technology that allows researchers to look into the brain in ways not possible before. This means we can change our brain structure, function, and chemistry by changing how we think and act. Psychotherapy, sans medication, helps us achieve this.
- Epigenetics – This emerging field claims that even though our genetic makeup influences our brains, the way we respond to our experiences can impact which of our genes are turned on and which are passed down to future generations .
Stress is a major factor that drives people to addiction. Dr. Northrup emphasizes, however, that stress itself doesn’t create immune system problems, but the perception that the stress is inescapable—the belief that the sufferer can’t do anything to prevent or change it. Perception can always be changed, however, with the help of treatments discussed here.
The Substance Abuse and Mental Health Services Administration (SAMHSA) emphasizes that there are many routes to healing, so treatment centres develop individualized plans. When conventional treatments have failed, a holistic approach is the key to long-term recovery, fulfilment in abstinence, optimum wellness, prime overall health, and a renewed sense of purpose.
 New Oxford American Dictionary
 Van der Kolk, Bessel. “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma”. Penguin Books. 2014.
 Relating to the body, especially as distinct from the mind (New Oxford).
 “Epigenetics: The Science of Change”. Environmental Health Perspectives, 114(3), A160– A167.
Photo credit: Mark Morgan. This picture has a Creative Commons attribution license.