Barriers to recovery: PTSD symptomatology in affluent addicts
In Pain Part II, we continue to explore the question: “Why am I destroying myself with alcohol and drugs?” Answering this question requires much more than simply identifying painful situations, attitudes, and events common in wealthy families – it requires accessing the associated emotions and understanding how they are related to using. Unfortunately, this proves very difficult to put into practice. Many of us are truly baffled as to why we keep relapsing and often succumb to a pattern of continued use and dysfunctional behavior, due to what can best be characterized as post-traumatic stress disorder (PTSD).
PTSD as manifested in the affluent
You might say, “Wait a minute. How can we, wealthy people, have PTSD, when we have it so easy?” Well, the degree of absent, neglectful, destructive parenting – combined with societal hatred of the wealthy (wealthism) – often inflicts major damage during childhood. The damage continues into adulthood, although sometimes in more subtle forms. These experiences alone can lead to PTSD. Add in actual abuse in its many forms or the unexpected loss of loved ones, and it’s almost a guarantee.
In Part I, we identified causes of suppressed pain in childhood and how that pain impacts us in adulthood by keeping us detached from our feelings and from others while seeking ways to mask the pain and fill the void (often with drugs, alcohol, and other compulsive behaviors).
The combination of bad parenting, societal resentment, and trauma (i.e., abuse, death, etc.) often results in our adopting “survival roles,” where personal identity is significantly changed or lost.
Survival roles allow us to get by as best we can when we’re struggling to effectively handle everyday life. We often live a double life, either secretly drinking or using pills or keeping dual sets of friends. Working too much or other “isms” are common as well. Money helps keep the façade intact – we’re trying to look good on the outside, while dying inside. We block the cognitive, physical, and psychological meaning to these painful events and experiences.
Drinking: My solution to losing my son
To use my personal experience as an example, drinking was my ultimate way of coping with the loss of my beloved son. Born with Down syndrome, he died from an inoperable heart condition at age six. I had also lost my 10-year-old brother from a similar condition when I was nine. I knew alcohol wouldn’t fix my pain, but it did provide some relief … until it took over my life.
While I could talk about their deaths, I had great difficulty showing feelings when doing so. I could cry when Lassie was lost, but not over my brother or son, which was very confusing to me. This is a common experience for many others as well, who either can’t connect feelings of pain and unease to experiences or can’t give themselves permission to explore the implications on our substance use and recovery.
Internalized self-oppression and loss of identity
When we can’t access or make sense of our experiences and emotions, the resulting depression, chronic anxiety, and anger are often turned inward. We belittle ourselves for our inability to cope with life. This self-oppression becomes internalized with loss of esteem and increasing shame, leading to a weak sense of personal identity and alienation from our core values of family and culture. Many chronic substances users – even those with lots of money – have toxic shame, hating themselves on some level but unable to figure out why.
Treatment as trauma
In the context of affluence, it’s hard for us even to accept a PTSD diagnosis – let alone accept outsiders, including those in the helping profession. But I know many individuals from wealthy and prominent families who fit the definition, based on childhood experiences and mistreatment due to exploitation and resentment. In response, we become paralyzed – unable to take positive steps toward healing, with treatment becoming an additional source of trauma.
We come into therapeutic settings such as treatment scared, mistrustful, and reserved – evaluating whether it is a safe space and whether staff or patients can be trusted. Will our life experiences and feelings be heard and respected? Or will we be told not to talk about money (“It has no place in treatment!”) or labeled grandiose? The phrase “I’m not going there!” is so much more than fear of exploring feelings. It’s about being mistrustful – if not re-traumatized – by damaging therapeutic experiences.
Negative messages about the danger of feeling
Many of the childhood hurts are hidden but sending powerful messages about self-worth and the danger of feelings, because no listened to us as children. If we feel, we might get out of control, and who knows what might happen? As a result, we fail to experience appropriate emotions and to trust “the process.”
The isolation trap
We believe: If I talk, people will resent me, take advantage of me, or hurt me. If I don’t talk, people will see me as unresponsive, aloof, and withholding.
We don’t feel connected to others and, in fact, fear connection to others. When our emotions are frozen or unavailable on a conscious level, simply being asked to describe our feelings puts us on the spot – we don’t know what to say.
We feel shame, including the shame of being different. Our differences become particularly difficult when we try to relate to others in treatment and don’t fit in.
We feel sorry for ourselves and tell ourselves, “No one wants to know the real me. They only want to know me for my money/body/public image.”
Staying in the image
We prioritize maintaining the public persona as a rich, famous, important, or professional person to avoid introspection and to protect ourselves from further resentment and exploitation.
Becoming a survivor
The ultimate goal is to shed our survivor roles and become survivors in the true sense of the word – “thrivers” – flourishing in our new life. But once the drugs are gone, all these feelings come up: fear, overwhelming sadness, anger, and despair. As Terry Hunt suggests, pain can be a source of helpful information from our “engine room.” It’s firing up, but can we embrace our pain and use it as motivation for a different life? Can we gain enough understanding about what happened to us to realize how it affects our efforts at quitting and staying quit?
How suppressed pain impacts recovery
Negative messages about us or our families
After internalizing all of the bad things that the world has to say about us, we struggle to develop enough self-esteem to want to recover. Am I worthy of recovery?
Parental pressure to be perfect
It is hard to feel OK about ourselves as addicts or our relationships with others if we expect perfection or think others expect perfection. Am I OK with being good enough? Or am I marching to another’s drum?
The molded child
When we follow the path our parents have laid out for us and use it to identify ourselves, the focus is only on externals. This leads to little insight into addiction. Growing up protected and sheltered, we have very few resources to deal with addiction. And we refuse extended care to learn these tools because we must go home to the people and place that form our identity. Finding my own identity is scary. What if I don’t like who I am?
Parents relate to us on their terms and ignore our wishes
Our own feelings aren’t acknowledged or considered, so we learn to deny them. “What I feel doesn’t matter.” We also feel we can’t change things because we were unable to do so as a child. So, we feel powerless – stuck in the situation. Can I learn to self-actualize? Can I learn from a 12-step program?
Parents absent, raised by servants
This abandonment leads to lack of connection to ourselves, meaning we cannot get in touch with our feelings or the feelings of others – not in treatment or through A.A. fellowship. How can I find the courage to join in?
Turnover of (hired) primary care giver
The inconsistency results in distrust and feelings of powerlessness. “You, too (counselor), will not be there for me.” Yes, it’s difficult finding good treatment and therapists.
Parents confuse being present in the home with having a relationship with children
Pseudo-parenting can lead to pseudo-recovery (only fixing what shows, not working on what’s inside). If our anxiety and fears can be addressed, it feels so good to rejoin humanity.
The awareness of us versus them
The effect of this separateness is isolation for those who believe their background and resources make them unique, with crippling fear around having to do what everyone else does. We have little experience in doing so. “Who are we if we are not different – better than?” For those of us trying to blend in, we harbor the fear of being outed – of getting honest. I can chose to stay stuck or chose to try something different.
The healing process
Assuming we can overcome these hurdles and find welcoming therapists and safe spaces, in my experience, honest, open, truthful communications from the heart are a good beginning. Just being able to talk to someone with similar experiences was life-changing. No matter how embarrassing or painful the subject, the deadly stresses and desire to use – born of multiple traumas – can begin to be released and healed.
Essentially, the healing process begins with learning to accept the consequences of our life and our actions and developing the maturity to bear our feelings – whether joy, sorrow, anger, or fear. In future blogs, we will elaborate on recovery settings and practices allowing us to understand and manage our experiences and emotions.