Is addiction linked to trauma or stress?
We can link addiction to to stress or trauma, although addiction can develop without either. People arrive at addiction through different routes, and understanding what a substance or behaviour does for a particular person can help us understand why they keep returning to it.
I have worked therapeutically with addiction for many years, and one of the questions I find most useful is surprisingly simple:
Book your initial consultation
What does the addiction give you?
You might initially struggle to answer that question – perhaps you know what alcohol, drugs, smoking, gambling or another compulsive behaviour takes from your life, perhaps you can even list the consequences. You’ve probably spent years thinking about the consequences and telling yourself you should stop. But understanding what keeps drawing you back requires you to look at the other side of the relationship.
A cigarette might provide five minutes outside during an overwhelming working day. Alcohol might change how you feel when you arrive home in the evening. Gambling might absorb your attention so completely that, for a while, everything else disappears, and a drug may alter an internal state that you find difficult to tolerate.
Once we understand the function of the addictive behaviour, its persistence can begin to make more sense.
How are stress and addiction connected?
When we feel stressed, the body prepares us to deal with whatever is happening. Our heart may beat faster, breathing can change, muscles tense, and stress hormones such as adrenaline and cortisol run through the body. We become more alert, and our attention shifts towards whatever seems most important in that moment. Once the situation has passed, these changes would usually begin to settle. This system helps us respond to the challenges of life but we run into problems when stress becomes intense, repeated or difficult to resolve.
Research has linked chronic and repeated stress with greater vulnerability to substance-use disorders – stress can also influence craving and relapse in people who already have an addiction. If stress leaves you feeling uncomfortable, and a substance or behaviour changes that feeling, your brain and body will learn it’s the answer to the difficult feeling. If you regularly experience distress and discover something that reliably changes how you feel, your brain has good reason to remember it. You may drink and feel more relaxed, you may smoke and experience a moment of space, you may use a drug and feel temporarily different inside your body. As you continue to repeat the behaviour, your survival system learns to strengthen the relationship.
Book your initial consultation
Is addiction always caused by trauma?
No. Trauma is one possible part of somebody’s story. Research has found an association between traumatic experiences and substance-use problems, particularly where adversity occurs during childhood. This does not mean that everybody who experiences trauma will develop an addiction, or that everybody with an addiction has experienced trauma.
People start using substances or repeating potentially addictive behaviours for many reasons. You may have started smoking because your friends smoked, you might begin drinking socially and forget how to socialise without alcohol, a prescribed medication may initially have a legitimate medical purpose, but then your body craves it when you no longer need it. A innocent behaviour at first can acquire another role during a difficult period of life. You then discover that it helps you switch off, escape an uncomfortable feeling, or get through something they currently find difficult to manage, and it completely changes your relationship with the behaviour. This is why I express caution about assuming we need to uncover a major trauma whenever somebody comes to therapy for addiction. I want to understand your story and the role the addiction plays within it.
What does trauma have to do with addiction?
Trauma is the resulting feelings after a distressing experience and can continue long after the original experience. For some people, this includes intrusive memories or a persistent sense of threat. You may experience strong emotional or physical reactions to reminders of what happened. These reactions can affect sleep and some feelings or sensations may feel hard to tolerate. A substance or behaviour that changes those experiences can understandably become appealing. Alcohol may temporarily reduce anxiety, drugs can alter awareness, emotion or bodily sensation. And repetitive behaviours can provide absorption or escape. When something repeatedly provides relief from distress, the brain remembers this, it doesn’t make trauma a universal explanation for addiction, but it helps explain one of the routes through which an addictive relationship can develop.
Book your initial consultation
Why can chronic stress matter even without trauma?
I think this is an important part of the conversation, because people sometimes dismiss their own stress when they cannot identify a traumatic event. You do not need a dramatic story for life to become difficult to manage. Chronic stress can build through ongoing pressure, relationship difficulties, financial insecurity, loneliness, caring responsibilities or an environment that continually asks more of you than you currently have capacity for. If your days repeatedly leave you searching for relief, anything that reliably provides that relief can become increasingly valuable.
This is one reason I look at the wider circumstances of somebody’s life when I work with addiction. We can explore the behaviour itself, while also looking at what surrounds it. What happens before the urge appears? What changes afterwards? When is the urge strongest? What do you need at that moment? These questions can reveal the function that an addiction has gradually taken on.
Why knowing the consequences often isn’t enough
Most people I meet with an addiction already know that it is harming them. It’s why they’ve come to see me. A smoker knows the health risks of smoking, someone drinking heavily may already see the effect on their relationships, health or work and a person gambling compulsively can understand perfectly well what they are losing, but knowledge doesn’t automatically remove the need that keeps pulling you towards the behaviour. This is why I find it useful to explore what the addiction brings into your life.
For example, cigarettes may create regular breaks in your working day, they may provide social contact with other smokers. Smoking is an acceptable reason to walk outside when everything feels too much. If we remove the cigarettes without noticing those things, you can end up losing the actual things that give you stability.
Book your initial consultation
What happens in the brain when addiction develops?
Addiction involves changes in several interacting brain systems involved in motivation, reward, learning, stress and self-control. Dopamine forms part of this picture, although describing addiction as simply a series of dopamine hits misses much of what is happening. Dopamine plays an important role in motivation and learning. When an experience becomes significant, the brain learns about the cues associated with it. Places, people, feelings and particular times of day can gradually become connected with the expectation of the substance or behaviour. This can help explain why somebody who genuinely intends to stop can experience a powerful urge when they encounter a familiar trigger. With repeated substance use, further changes can occur in reward and stress systems. At this stage, using the substance may increasingly become connected with relieving withdrawal or an unpleasant internal state.
Stress can also make an existing addiction harder to manage
Research consistently finds that stress can increase craving in people with substance-use disorders. Chronic drug and alcohol use can also affect biological systems involved in stress and reward. This can create a difficult situation when you want to stop. The substance or behaviour may have become one of the established ways you respond to distress, while stopping it can bring its own physical or emotional discomfort. When another stressful experience occurs, the familiar solution can become especially compelling. This is why I think addiction recovery needs to include more than removing the addictive behaviour.
Book your initial consultation
Understanding your own addiction
If you are trying to understand an addiction, you might find it useful to become curious about the moments when you reach for it – notice what is happening beforehand. You might feel tired after work. Something may have happened that left you unsettled. You might feel lonely or uncomfortable in your own thoughts but sometimes the trigger will simply be a familiar situation that your brain learned to associate with the behaviour.
Notice what changes afterwards. This can help you identify what the addiction does for you. You may find the answer involves stress or something traumatic from your past, you may discover unmet needs, but sometimes the pattern is simply deeply established through years of repetition. Whatever you find, understanding the function gives you useful information about what recovery needs to include.
Recovery can involve recovering yourself
I use the word recovery quite literally in my work – addiction can gradually take up an enormous amount of space in someone’s life. Decisions begin to organise themselves around drinking, drugs, cigarettes, gambling or another behaviour. People can lose touch with parts of themselves along the way. So alongside helping somebody change the addictive behaviour, I want to know the person in recovery.
What matters to you? What do you want your life to contain? Are there unmet needs in your life? What helped your addiction become necessary or valuable? How can those needs begin to find a healthier place in their life? For some people, this does include therapeutic work around trauma. For others, we need to look carefully at chronic stress and the conditions of their everyday life. We may also work with established patterns, triggers and the learned associations surrounding the addiction. The aim is to understand enough of your experiences that your behaviour starts to make sense.
From there, we have somewhere useful to begin.
Welcome to my website, a space where I try to catch your eye, and explain the heart of my practice.
My journey over 17 years has taught me that true knowledge isn’t about the letters after my name or the timeline of my academic pursuits. It’s about the stories shared, the moments of vulnerability, and the human connection that transforms both you and me. It’s holding space, listening intently, and noticing the patterns within your words and emotions.
Together, we can navigate the complexities of life, embracing both the shadow and the light. So, if you’re seeking more than just a quick fix, and ready to make lasting changes, you’re in the right place. Let’s embark on this journey together. Click and read more about my approach here.