PTSD, Addiction and Self-Esteem
In my own recovery from posttrauamtic stress disorder (PTSD), I came to see PTSD symptoms as a trauma addiction and this affected my self-esteeem. Let me explain.
Technically, addiction, in the negative sense, is an inability to stop a behavior even though you know it will bring adverse effects. In my PTSD experience I came to see intrusive thoughts, nightmares, hypervigilance, mood disturbances, insomnia, etc., as behaviors I couldn't stop -- even though I so desperately wanted to.
That was all back in the 1990s before we so deeply began to understand and explore how trauma affects the brain. Even though now we have concrete proof that many PTSD behaviors are often involuntary (and due to chemical and other changes in the body and brain following trauma) I still see PTSD as the body and brain's "addiction" to trauma. We want to stop going back to, or being driven by, the past and yet we can't.
How Addiction Affects Self-Esteem
A trauma addiction drives us to PTSD behaviors bent on relieving the pain, stress, anxiety and discomfort that we feel. Drug, alcohol, sex and food addictions (to name a few) are common in the PTSD world as we all seek to soothe the post-trauma ache. The problem, of course, is that while symptoms of posttraumatic stress disorder are tough enough to bear alone, addictions add another layer of disturbance: They bring on even more guilt and shame than we may already be carrying.
My client, Claire, struggles with alcoholism. She tries and tries to break the addiction and the habits it has formed but again and again reverts back to bingeing and engaging in drinking behavior that threatens her job, family and, many times, her life. She says:
I feel so guilty and ashamed that I have no self-esteem whatsoever. I hate myself.
That's a normal reaction to feeling out of control and embarrassed by not being able to choose your actions and implement changes. Those feelings of guilt and shame also clue you into something important: you have a desire to be different. While this may seem like a silly idea to highlight, it's actually crucial. The more you are aware of things that are good about you (like wanting to change) the more you can develop a sense of self-esteem. It starts with such a simple gesture as recognizing your desire to be a better person.
What is Self-Esteem?
Technically, self-esteem is "confidence in one's own worth or abilities . . ." Self-esteem takes a dive (and so does resilience since they are linked) when your focus becomes imbalanced toward only seeing the negative in who you are. While it's true that PTSD symptoms are a part of who you are today it is also true that there is much more to you than PTSD alone.
Increasing your self-esteem can increase your resilience, strength and ability to more confidently make different choices and take different actions. Try this 3-step process to slowly get started:
- Acknowledge what you are confident that you can do. Make a list of actions in which you know you can count on yourself to engage. For example, take care of the dog or the kids, show up for work every day, etc.
- Identify the value that drives these behaviors. Behind the things you can depend on yourself to do are values that are important to you. To add on to the example above, consistency is a value you would be embodying if you were to count on yourself to do something every day.
- Generalize that value into other areas of your life. Find ways to use the value you named above in new opportunities. For example, identify how you can be consistent in your PTSD recovery work or support of a friend or other meaningful activity.
Like the picture in this post, you are a full circle. While it may feel like PTSD consumes the entire inner space of the circle it is really only a black dot within it. You are larger than your symptoms. Your identity is about more than just this moment. Explore the bigger you that you are. Discover the rest of yourself in ways that engage the good in you so that you introduce more balance into your recovery, plus jumpstart behaviors that make the trauma addiction easier to interrupt and redirect.
Rosenthal, M. (2014, December 25). PTSD, Addiction and Self-Esteem, HealthyPlace. Retrieved on 2021, August 3 from https://www.healthyplace.com/blogs/traumaptsdblog/2014/12/ptsd-addiction-and-self-esteem
Author: Michele Rosenthal
Your articles are so reassuring and intelligent. Maybe I a just ready to listen or maybe you have saved me some therapy but I want to thank you.
@LisaMarie -- Thanks so much for sharing your thoughts with me. So much of healing has to do with be ready and open to new ideas, possibilities and approaches. It's very exciting that you're in that spece right now. Here's to your forward motion....
This is a valuable column that clarifies a lot of things about the way PTSD plays out in one's inner life, and how PTSD recovery depends on strengthening self-esteem. BUT "trauma addiction" is a terrible name for what you're getting at! It's inaccurate and inflammatory. Gaining control of your PTSD symptoms is just not the same thing as gaining control of your drinking. I find it insulting, and suspect you are using it as click-bait.
Hi, Kathy, thanks for sharing your thoughts. Actually, no, the term "trauma addiction" comes purely from my experience of PTSD. I first used it in my award-nominated PTSD memoir, Before The World Intruded: Conquering the Past and Creating the Future.