Root Causes of Addiction: Part 1


In my life there have been many times when I felt isolated, disconnected, and alone. These times have never  been pleasant, and in the absence of nurturing relationships, close friends to call on, or a tribe of my own, I coped by engaging in substitute relationships with work, money, entertainment, food, hobbies, and exercise – just to name a few).

For every thousand hacking at the leaves of evil, there is one striking at the root
Thoreau

For years I felt shame about many of my behaviors, and my inability to connect in deep ways with others. Now I understand that so much of my adaptive behaviors were a response to underlying root problems, problems that needed resolving and hampered in significant ways my ability to initiate, develop, and maintain intimate and nurturing relationships with people. I also believe that now, more than ever, those who struggle with addiction share similar root causes that need to be addressed if successful longterm outcomes are to materialize.

The roots of addiction go much deeper than the adaptive behaviors that so often are the focus of intervention efforts. This is because dealing with the symptoms (addictions) are easier than dealing with the root causes. I have long believed that addiction is a problem best managed over time like other chronic illnesses. But successful management necessitates addressing what drives the addictive behavior in the first place.

It requires knowing how to turn down the flame, dig out the roots, and resolve problems that are solvable. These underlying roots come in many shapes and sizes, but there are two forms that I believe are the primary drivers of addiction today.

Adverse Childhood Experiences

In the mid 1980′s, physicians from Kaiser Permanente’s Department of Preventative Medicine in San Diego made an interesting discovery. Those who were losing the most weight and succeeding in the weight loss program were the ones most likely to drop out and quit. Was it because they no longer needed the program? Nope.

Further investigation revealed that the majority of dropouts did not maintain their weight loss and went back to struggling with problems of overeating and obesity. Why did they quit if they were succeeding in the program?

A deeper look revealed that overeating and obesity were used as tools to cope with unresolved adverse childhood experiences (ACE’s). In most cases, overeating was an unconscious behavior utilized as a protective solution to these unresolved childhood problems.

How was it unconsciously protective?

In many cases, the ACEs involved sexual, physical or emotional abuse. Developing a relationship with food was safer than developing intimate or nurturing relationships with people who might abuse again. Being obese unconsciously deterred romantic interests and physically enhanced protection of the body.

The finding that most of the participants in the weight loss program had prior ACEs led Kaiser to collaborate with the Centers for Disease Control (CDC) to explore the link between ACEs and general health outcomes.

The study involved over 17,000 middle-class Americans and has produced over 50 scholarly research journal articles. Among the most significant findings in the study was that two-thirds of the participants reported at least one ACE, and more than one in five reported three or more ACEs.

In addition, the higher a person’s ACE score, the more addictive behavior was utilized as a coping response as outlined in the graph below (graph source: The Origins of Addiction by Vincent Felitti).

adult-alcoholism-graph-ace-score

Here you can see that as the number of ACE scores increase, so too does the percent who meet criteria for alcoholism. This finding is detailed in an insightful paper titled The Origins of Addiction by the lead researcher of the study, Vincent Felitti.

What the ACE study helps us to understand is that the roots of addiction are real, diverse, and if left unaddressed, will continue to fuel the behavior we are so badly trying to manage (or end).

Roots of Addiction: Part 2

Comments

  1. Rachel Wood says

    You really changed the way I think about addiction and opened my eyes to many concepts that I’ve never thought about. My brother is 24 years old, and has been sober for 2 years, no relapses. I thought a lot about him and when I got home I called him to tell him to go to your website right away. He was also very impressed. Addiction is socially constructed. That statement alone is so incredible! I have never thought of that but it is! So many teens in this country start drinking, smoking or doing drugs simply because their friends do, or it’s what they see on tv and in movies. Many things we deal with in adulthood are due to things that happened in our childhood. I want to work with children as a profession. I have always known that how children are treated growing up has a huge effect on their adulthood. Hearing it from you, only makes me want to help children in the US that much more.

  2. admin says

    Rachel, appreciate the kind words! It is great you want to work with children, they need all the help us adults can provide. May I suggest one of my favorite reads specific to helping children, and a wonderful example of the tenacity of a child’s spirit in the face of extreme trauma: The Boy Who Was Raised as a Dog by Bruce Perry. Let me know what you think.

    J

  3. Jerry says

    Another great article, John. I believe that ACEs generate a variety of maladaptive coping mechanisms including substance abuse. One look at the population of our prison system and mental health clinics clearly points out the correlation between ACEs and poor outcomes as adults. Perhaps this points to a need for more counseling in our schools in order to halt the problem as early in development as possible.

  4. admin says

    Yes, I absolutely agree that intervening as early as possible is key! Thanks for the feedback, always good to hear from you.

    J

  5. Fran R says

    I’m a 38 year old high functioning addict. My addictions have taken many forms over the years.
    First Bullimia in my teens
    This ended like a switch was thrown when I had my addictive relationship fix (love)
    This relationship ended and I moved on to marujhuana
    Another ralationship fix saw an end to dope (more love)
    After that relationship ended alcohol replaced it.

    I’m currently off the alcohol and off relationships. I have realised these are not solutions they are all short term, destructive “fixes” to my deep rooted shame

    Having noticed a very prevalent pattern I’m digging into the shame that I have carried all my life as the result of having two physically and emotionally abusive alcoholic parents.

    AA failed to address this for me, for me AA increased my life long sense of powerlessness over the pain and the band aid measures I had been applying over one MIGHTY gaping wound.

    I have since been reading articles like yours, owning the root cause of my feelings of emptiness and sorrow and for the first time feeling that there is a way of life for me where addiction isn’t a necessary or actual part of who I am.

    Releasing addiction and entering into the shame was like throwing open a door, the pain and tears all came flooding out, I was able to finally look at the wound and see it for what it was. Rather than trying to avoid looking by running to the fridge or the comfort of another person or the bottom of a bottle.

    I have done a lot of crying and made a realisation that rather than being the battle hardened, tough nut I always pretended I was to myself, I am in fact a very vulnerable, wounded grown up with an immense amount of slow careful healing to do.

    This work neccesitates that I take care of me and parent myself very gently the same way I do my son It means I cannot seek temporary measures or fixes to swab up the pain or block it out. Its a very difficult thing to stay focussed in the root and not seek to deal with the immediate shock. After so many years of band aid addiction I am having to be very foccused on what I am doing and how I am feeling.

    Getting off the addiction roller coaster is a really easy decision to take, working with the deep inner pain and shame and facing it is that much more difficult.
    I find that reminding myself I am helping the terrified child that I WAS to a safe place NOW helps enormously. It empowers me past the temptation to do self destructive things

    When I have a bad moment I try to reach out to that part of myself that is melting down with calm and love as I would my son if he was frightened or hysterical. Which is how I always felt inside in the grips of an addictive drive, emotionally hysterical inside.

    I found your piece very reflective of the discoveries I have made on my journey through life and addiction. Thank you

    I

  6. Fran R says

    I just noticed on another part of the site a paragraph about managing overwhelming emotions and I wanted to add something.

    Part of my childhood experience was not being allowed to register emotional discomfort, I had to not cry, not sing, not make a noise. Be happy when I was sad, tell lies to my teachers and extended family. Essentially I was taught to repress any normal outward demonstration of inside feeling. So was my brother.

    This left us like prisoners in a locked cell with a build up of emotional energy that was not being discharged anywhere. My brothers solution aged seven was to dig a foot sized crater out of the plaster behind a poster on his bedroom wall, he did this little by little each night it grew and he hid the plaster dust in the back of his cupboard.

    I had a belt that I would tie to the bannister of the landing as I listened to our parents screaming downsatirs I would rock backwards and forwards pretending that I was on a horse riding away. I did this nightly for months and months.

    The hole my brother dug nightly became the drugs he smoked nightly.

    The horse I rode nightly became nightly binges and bulimia

    We grew from being children who weren’t allowed to express our pain adequately into adults who couldn’t face the amount of pain we still had.
    We were full of it, and so grotesquely bent out of shape when it did escape we hid it, normal people don’t have monstrous emotions boiling inside them and survival meant fitting in and acting normal, so we carried on digging the little holes hidden behind posters and riding our secret horses for comfort.

    But as we got older my brothers little hole became a great abyss and my horses were out of control and dragging me limply in their wake.

    But it began in childhood with a secret hole and a pretend horse and the desire to escape the pain of holding pain and other emotion tight inside for fear of abusive reprisal.

  7. admin says

    Appreciate greatly your feedback and willingness to share your story. Addictions do take many forms, but as you have discovered, they are adaptive behaviors to underlying, unresolved ACEs. Managing addictive behaviors is important, but your emotional healing work is the key to longterm successful outcomes. You are also very right, the emotional work is challenging, but doing it pays dividends the rest of your life. Your son is lucky to have you as his mother.

    J

  8. admin says

    Your feedback reminds me of the U2 song Running to Stand Still (“you got to cry without weaping, talk without speaking, scream without raising your voice”). You are very good writer, I would encourage you to use it as a tool for ongoing healing. There is even sold emperical support that writing about past pains can significantly help heal old wounds. Godspeed.

    J

  9. Fall 2010 Student says

    My idea of addiction has been transformed since I heard about the roots of addiction and the potential Adverse Childs Experiences (ACE’s). The focus of ones addiction should pin point the experiences that got them to using a substance and how they view that relationship. Focusing on ones adaptive behaviors almost seems like a set up for failure when it comes to recovery; and ultimately, it skips the heart and core of the matter.
    I have considered this research and understanding when it comes to my close friends and family who have addictive relationships with substances and behaviors. These ACE’s may be part their unconscious, yet if they were encouraged to take a deeper look at these experiences their entire problem might unfold. It’s all about them being willing and open to seeing these roots in order for them to see changes. It is refreshing to hear that there is new perspective out there. It gives me hope that maybe the ones close to me can be freed from their addiction imprisonment. It may be simple for me to see that the root of their addictions is what’s devouring them, but it is them who have to deal with it.

  10. Aine says

    Two things come to mind in reading this piece: (1) how does seeing overeating as an addiction shift the way we see under eating? or should it? and (2) what can the Kaiser ACE’s study tell us about culturally specific research on eating disorders and the potential for co-occurring substance abuse?

    One thing that struck me about both your piece here and Orford (2001) article that criticized gender specific research on eating disorders by calling them “arbitrary and superficial differences”, that in fact getting feminist clinicians and theorists in the same room with addiction counselors from other perspectives might make for even more nuanced discussion of both behaviors and substance abuse overall. As you say here overeating is a “protective solution” to “unresolved childhood problems” and the same argument has been made about under-eating (anorexia, bulimia, disordered eating that involves some form of control of what is eaten and how, etc.) While not always, clear links have been made between sexual trauma and/or gender policing and under-eating, so that control of food becomes an adaptive behavior to both original trauma and current or ongoing stress, anxiety, or feelings of inadequacy. It seems then that shifting the way one thinks about overeating based on similar underlining reasons for the behavior could/would shift thinking on the entire spectrum of eating disorders. Given that that both women and gay teens maintain numerical significance as groups affected by these disorders it seems that research on their psychological connections to food and the underlining causes would help the field of addiction and that addiction research may better help people working with specific populations look for additional addictions, make case plans that minimized hopping, etc.

    Your piece also made me think about an article I chose for publication in my upcoming anthology. The article, written by L. Liburd does original research on black women and excessive eating. She maps cultural attitudes about the body in Southern Black communities through literature and cultural cues but then deals specifically with the epidemiological impacts of excessive eating on black women’s health, their own beliefs about these impacts (shame, self-blame, intellectualizing, etc.), and finally what drives them to continue eating after diagnosis like Diabetes or “sugar”. She makes a complex argument that echoes the ACEs study; basically, black women in her study have developed a relationship to food as a result of childhood traumas that then further isolate them from developing other positive interpersonal skills, creating a cycle of dependence that superseded medical knowledge. Community acceptance of larger bodies and the import of food at social gatherings further serves to normalize excessive eating and thus render stories of trauma or isolation invisible. This seems to reinforce the ideas presented here and in class and her work may have benefited from a further understanding of addiction literature as well as coding for substance abuse in her analysis as this shows up once or twice in the narrative but is not part of theoretical framework of the article.

  11. mistymave says

    I really connected with one thought that Fran shared : “Releasing addiction and entering into the shame was like throwing open a door, the pain and tears all came flooding out, I was able to finally look at the wound and see it for what it was. Rather than trying to avoid looking by running to the fridge or the comfort of another person or the bottom of a bottle.”
    Shame for me had to do with my relationship with God as a Christian. I felt that the romantic relationship I was in and out of for 8 years was not good for me and prevented me from living out my faith authentically. Part of giving up that relationship involved coming to terms with God’s love for me despite the actions of my past. I had been trying for years to fix things on my own terms and finally reached a point of full submission. I was so tired of the vicious cycle. In my mind, I thought if I got rid of the relationship, everything would be miraculously better. Through counseling and group work, I was able to uncover all the issues that this relationship had been covering up. I found that my childhood was about separating myself from emotional moments. I became totally engrossed in school and dance, that relationships (other than the romantic one) were neglected. And most of all, there were areas of my early childhood that I had always pushed away. I was finally able to dwell on those darker areas and search for healing and closure.
    I have heard the various reasons for looking forward and forgetting your past, especially within the Christian community. I find that the way I interact with others and the way I deal with stress and emotions today continue to be very much tied to the past. I continue to seek out a better awareness of how I became who I am.
    In regards to counseling youth who are experiencing trauma in their lives, it can be a very complex process. I spent two years as a skills trainer working with mostly foster youth and others who had experienced trauma. It is hard to work with deep issues while a child is still living in a chaotic environment. They need to get their basic needs met before they can really come to terms with trauma. Meanwhile, building a relationship with a caring adult, having good social support systems and learning skills to navigate their way through childhood continues to be a good direction to go in helping these children. Many times addressing a child’s trauma is going to have to involve the whole family because this has most likely affected them in some way as well. I know that in my own experience, my parents refused my plea for seeking counseling as a 5th grader. Some families are in denial of the desperate state their child or their family is in.

  12. Kellie says

    I definitely can relate to this entry. I feel that I have often used food as a coping mechanism for unresolved issues that I have for years now. I believe that adverse childhood experiences (ACE’s) can cause people to develop problems with addiction. Before taking any graduate courses in drug and alcohol addiction, I had always wondered what exactly causes addiction. I now know that it can be many factors, but ACE’s seem to play a valuable role in fueling an addictive behavior. The results of this Kaiser study are startling. Two thirds of the 17,000 participants reported at least one ACE. That seems like a very large number. It makes sense to me that addictive behaviors are kind of like a coping mechanism for deep seeded pain and trauma. In this sense, as Dr. Fitzgerald stated in this post, those traumas need to be addressed if someone is going to have long term recovery from addictions. I personally have sought therapy for some addictive-type behaviors in the past, and I have to say that it was usually the behavior itself that was the focus of therapy and we rarely went into my past or stories from childhood. I know realize that those memories and experiences are very important to address and I may have had better therapeutic outcomes if we would have talked more in depth about those things. I know that ACE’s will be something that I will want to address with future clients and have a safe place for exploration of those in my practice.

  13. Brandeis says

    As Kellie stated she has, I too have used food to deal with my ACE’s. It was never an issue weight wise as I was an athlete my entire life until I became pregnant with my son. I was diagnosed with pre eclampsia and was on bed rest for 6 months. I was pretty careful with what I ate when I was pregnant and on bedrest, but with all the swelling and other issues I ended up gaining 80lbs in the last four months of my pregnancy. After a very difficult birth, I was 50lbs heavier than I had been and exhausted as new mothers often are. That is when the food really impacted me. Now that I am no longer the same athlete I was, it has been difficult for me to get back to the level of fitness that used to be the norm for me. I never made the correlation between that and my ACE’s… Not until I read this blog was I aware that there was a correlation for me.
    I did know that there was a correlation for my son. I have noticed how my son uses food to cope with the stress of my ex husband and I getting divorced. I noticed on days he was to visit his father, his eating increased. He went from being an active toddler who was too busy to be bothered to sit down for long to eat, to being a boy who eats to fill himself up. I know he is hurt, angry, and disillusioned. He has been better since we have moved and he is in an environment free of the divorce, where he can go outside and play.
    I know that children of divorce have increased odds of addiction, but I had never associated the food with potential for other addictions. My son is already in therapy, but now I know I will need to make his therapist aware of this food portion as well.
    As Rachel Wood said above, you have changed my perspective on addiction and to qoute G.I. Joe the great American hero “knowing, is half the battle.”
    Now, I know a little more how to help my son and myself.

  14. zzz says

    I can completely agree that unresolved ACE’s vastly contribute to one’s addictive behaviors whether it be food or alcohol. I wonder how closely ACE’s and trauma as a child closely relate. Are they the same? And would trauma therapy work on someone who has had an adverse childhood experience vs. a child who experienced extreme trauma. Regardless, getting to the root of issue most likely always lies in a ACE or early childhood trauma. And once you discover this you can begin to heal.

  15. Sharron Clemons says

    Appreciate greatly your feedback and willingness to share your story. Addictions do take many forms, but as you have discovered, they are adaptive behaviors to underlying, unresolved ACEs. Managing addictive behaviors is important, but your emotional healing work is the key to longterm successful outcomes. You are also very right, the emotional work is challenging, but doing it pays dividends the rest of your life. Your son is lucky to have you as his mother. J

  16. Aspen W. says

    There is no doubt that ACE’s are a huge factor in an addict’s life. I have seen it time and time again in addicts around me and I have seen people affected by these experiences their entire lives. It always makes me wonder though. I mean we all had adverse experiences in childhood. I don’t think I know a single person, even those raised in “ideal” situations, that didn’t have some pretty crappy things happen to them as a child. Personally I saw and experienced things that I would never, ever want my son to be exposed to. My mother had a terrible childhood and she battled addiction for years only to become a selfless, giving, marathon running, mountain climbing, all out awesome person! Her brother on the other hand, who experienced these same-I keep wanting to say it so I will-shitty circumstances, has spent his entire life in and out of prison, always to return to the drugs. His excuse, or rationale, or whatever it is at the time, is always the same; resentments and an inability to face the people who did him wrong and who owe him so much. So why is it that there are people like my mother and I who use our adverse experiences to fuel our positive drive for success in life and why is it that other people deal (don’t deal is more appropriate) with these experiences in negative, life threatening ways like drug addiction? I totally get that these experiences play a tremendous role in our lives but it’s hard to be empathetic to certain individuals when I see others, including myself, making a conscious (and often times what feels like constant) effort to be better people because of the adverse situations that life likes to throw at us all.

  17. admin says

    I think it comes down to the fact that there exist a wide range of risk and protective factors that interact over time to produce very different outcomes in people. We know that all it takes is one caring individual at the right development time to make a HUGE difference. We compare people all the time, that is the culture we live it, and I do it myself. But I believe understanding all the factors that produce the life trajectory of individuals is not so easy, particularly because often the most shaming factors are concealed. No question your mother’s brother had very different life experiences than your mother, and some we may never know about. I honor those like your mother who have struggled with addiction and overcome it, and have compassion for those like your mother’s brother who still struggle. Thanks for sharing.

    J

  18. Samantha Geddes says

    You really opened my eyes to how addiction starts at such a young age. It is hard to believe that aspects of our childhood stick with people and cause problems late into adulthood. I truly believe that people– parents truly need to be educated on what to look for in their children. If we can see symptoms of at risk kids, then we can help them while they are still young. Once they reach adulthood and their problems fester into addiction, for example, it is much harder to treat.

  19. admin says

    Thanks much for the comment! It is amazing that early childhood events can impact so many health outcomes even 50 years later. A great book about childhood trauma, resiliency, and prevention is Bruce Perry’s book “The boy who was raised as a dog.”

    J

  20. Oshar says

    Thank you so much for this article, here is my story, Im addicted to sex since i was 13 years old, also social alcoholic since i was 14 years old. Now im 37 years old and my life is completely destroyed.

    I also have to mention that when i was 7 years old until i was 8 years old i was sexually abuse by a neighbor. and then suffered emotional neglect by my mother.

    I always wondered why i always suffer from depression, anxiety, social phobia,and i cant have intimate relationships etc. My life was really sad and totally failed.

    When i get my first job finally i can afford a therapist , who help me to explore in my inner world and finally 10 years ago at the age of 27 be able to talk to someone about my abuse.

    At the same time i still struggled with my sexual compulsion with pornography. I was really ashamed with my behavoir because i always promise to stop it but i fall over and over in the same cycle.

    Aditionally i always got drunk always when i was at a party or simply to be able to talked to a girl.

    Finally 10 years ago my sexual compulsion turned me to run for prostitutes and then I decided that i had a real big problem and thats how i found the 12-step programs, i felt good at the time because i dont felt alone anymore, and began to work the program but didnt work for me, because i felt that something was missing in the story, the 12-step programs are based on sefl-guilty, and character deffects, so this programs made me felt more guilty and over and over again get back in my addictions. And this programs are not interest in looking for the real root of the addictions.

    But sometimes my mind bring me back memories of my sexual abuse. and deeper in my mind im beginning to felt that my sexual abuse has something to do with my adult addictions. I did some search in the internet and 7 years ago there are few pages that began to talk about this issue, but i noticed im in the rigth way, besides there are few.

    I found some trauma therapist, but i only have one appointment with her. Because she told me to treat my addiction first and then my childhood trauma. I didnt like that position.

    Finallly thanks God, and the internet ( jeje ), In recent years there is more evidence of people like us who has suffered abuse of many kind as a child and then as a consecuence of that, severe depression, anxiety disorders, and as a way of copy or defense mechanism we develop some kind of addiction.

    I really hope that this articles help more people like me and finally find a light at the end of the road.

    There is also a doctor called Gabor Mate in you tube who has also a clear vision of the issue too.

    thank you for let me share my story.

    Im also Sorry about the grammar but im not english native, lol.

  21. admin says

    Thank you for sharing your story! You are not alone, and I am glad to hear you are putting the pieces of your life together in a way that is helping you to see the big picture. At 37 it may feel as if your life is completely destroyed, but it is through pain and suffering that we come to understand some of the deepest truths about life – which ultimately can set us free. Your sexual abuse, addiction to porn/prostitutes, drinking, and depression/anxiety all link together as you know (and have known for a long time). I am sorry to hear about your experience with the trauma therapist, as it is important to treat all the conditions concurrently. If you search my site for Gabor Mate you will find I have a couple of recent posts about him. I agree he understands well the issues of addiction and underlying traumas. Keep working it, seek out a therapist that can work with all your issues, and don’t give up! The gold is relationships, that become deep, nurturing, and loving when you heal from the past and manage the unhealthy behaviors in the present.

    Thanks again for visiting my site!

    J

  22. Kylee says

    I found this post to be very helpful and informative. I have dealt with addiction in my family and how it has effected me and my family is something I never really grasped. I tend to keep that part of my life closed off and hidden, not really sharing the past with anyone. I know that I shoved many of my childhood memories away because of the subject in them. This post made me realize that opening myself up to the past and taking notice of what happened in it will benefit me and not harm me.

  23. admin says

    Thanks for the feedback. It is true that our past does influence a great deal of our present (and future) behavior. The Kaiser study helps to understand this and suggests that ignoring it can have a number of consequences. We all have stuff in our pasts that we don’t want to look at, or that make us feel shame, it’s part of being human. It is also human to not want to share these parts of ourselves and do the best we can to put on a front that hides aspects of who we really are. This is why engaging in therapy can be so beneficial. Having someone as a guide to your internal world, and someone who can help you explore the pain of the past in a safe way is invaluable. Taking notice of the past pains is a good first step, but processing the pain in way that resolves the emotional wounds is what frees you to move forward in life constructively. It takes courage to engage our shadow side, and delve into the parts of ourselves that we like to keep hidden and closed off. But that is also where the gold and healing come from.

    J

  24. andrew godinet says

    I can definately relate to this post. I have had many situations in my life where I used money and hobbies as ways of coping with unresolved issues. I had a rough past and I thought that I was able to move foward from those situations, but now I see that I my way of coping was just a repsonse to my root problem. I think that the comment from Fall student 2010 was really getting somewhere, “The focus of ones addiction should pin point the experiences that got them to using a substance and how they view that relationship.” With the rise of technology we have lost the importance of intimate relationships. That brings me to the point that ACEs play a huge role in the lives of addicts of all sorts. it is crazy that a study of 17,000 people was done and over two-thirds of the participants reported atleast one ACE. This study only made it clearer that ACEs really do have an effect on the lives of these individuals. The step now that we must take is to help these individuals identify these ACEs and resolve these problems.

  25. Caitlin Brown says

    This topic hits close to home for me and really helps me understand more about what drives addictions. I’ve always had difficulty understanding why a person would abuse drugs, but I am coming to realize it is no different than the coping mechanisms I use myself. Particularly the example of the people who failed to lose weight makes a lot of sense to me. I’ve always known that I turn to food, sex or shopping for comfort far more often than I turn to people. The reactions of these things are predictable, and have less potential for emotional harm than a human interaction. I also know that I don’t lose weight not because I can’t but because I feel safer this way. These thought processes are not so different from what drives substance addictions. I think the difference for me is personality; I have a very high aversion to risk. Otherwise, there but for the grace of God go I.

  26. admin says

    Appreciate your feedback and agree with your personal insights. We do a lot of things in life to stay safe, but often we overshoot the mark in an effort to ensure that early adverse childhood experiences never happen again. The end result is that the cost to stay safe continues to rise as we cheat ourselves of important life experiences. The greatest risk is not risking making the changes we need in order to live life to the fullest.

    J

  27. Jaqueline B. says

    Dr. John Fitzgerald,
    I really agree with your research and the way you explain that to add as many protective factors in
    a child’s life is the best way to try to reduce the chances of having a problematic teen in the future. To
    be an involved parent and to talk to the child as much as possible, in conjunction with giving the child
    many different cultural and athletic opportunities is definitely the way to go. Not forgetting of course to
    pay attention to who our children peers are and what they are doing with their free time. Many times
    parents assume that children already know what they should or should not do; however, parent-child
    conversations about choices are never too much. I also totally agree that to fight against drug
    dependency one must use all strategies available, because like you said most of the time this is a chronic
    problem, not just something that may be fixed in a week or two. The government definitely must see
    this problem as any other chronic disease and fight against it in a multi-diversified way, also taking into
    consideration the cultural aspects of the problem.
    Thank you for all that you are doing for the community!
    Jaqueline B.

  28. Jaqueline B. says

    Dr. John Fitzgerald,

    I really agree with your research and the way you explain that to add

    as many protective factors in a child’s life is the best way to try to reduce

    the chances of having a problematic teen in the future. To be an involved

    parent and to talk to the child as much as possible, in conjunction with giving

    the child many different cultural and athletic opportunities is definitely the

    way to go. Not forgetting of course to pay attention to who our children

    peers are and what they are doing with their free time.

    Many times parents assume that children already know what they

    should or should not do; however, parent-child conversations about choices

    are never too much. I also totally agree that to fight against drug

    dependency one must use all strategies available, because like you said

    most of the time this is a chronic problem, not just something that may be

    fixed in a week or two.

    The government definitely must see this problem as any other chronic

    disease and fight against it in a multi-diversified way, also taking into

    consideration the cultural aspects of the problem.

    Thank you for all that you are doing for the community!

    Jaqueline B.

  29. Nick Hubler says

    I appreciate the point of view of Dr Fitzgerald’s approach on addiction. After taking a summer class on drug awareness and being fortunate enough to hear one of Dr Fitzgerald’s lectures, I took the liberty of highlighting a few new components of addiction that I was not aware of before.

    Addiction as a mindset is one of the most prevailing problems worldwide; there is a definite correlation coefficient in being in a single parent family and addiction. One primary reason is probably due to fact that one parent would have less resources to balance the needs of the child than a two parent family.

    Poverty can be particularly insidious because it can intensify addiction and addiction can intensify poverty. Having an addiction can be very good in lessening unpleasant feelings and can appear to be a short term solution to a multitude of serious problems.

    Lastly, one of the largest factors in determining addiction is having the experience of being abused as a child. Children have numerous challenges growing; however the added component of physical, verbal or sexual abuse can pose a drag on learning how to deal with emotions constructively. I was unaware before Fitzgarald’s lecture the role that abuse can play.

  30. Kimberly E says

    I have heard before that using drugs and alcohol is a symptom of a much bigger problem, so this definitely makes sense. I think a lot of addicts use to cover up feelings and problems from the past. Using becomes a coping mechanism. If only the addiction is treated, the underlying causes of that addiction are still there. The study done on the Adverse Childhood Experiences was interesting because it shows the negative effects these experiences have on everything from over-eating to alcoholism.
    Kimberly E

  31. Liz F says

    I have played the weight yo-yo game for 20 years now and always thought that there was a psychological reason to why I would seemingly sabotage my weight loss successes. At first people would notice the weight loss and I would be proud and enjoy the attention. After losing significant amounts of weight (usually the same weight I would reach each time), I would start getting uncomfortable about the changes to my body. Eventually, I would start to binge again and before I knew it I gained all the weight back and then some. Every time I would start to get some control back over my eating habits, I would tell myself that “this is it, this is going to stick.” But, it never does.

    In therapy we discussed what it meant to be thin and I had always equated it with being more sexually appealing. I realized over time that it meant being noticed and having people pay attention to you. As much as I may have wanted that, I was not ready for it and actively stopped the attention by eating and gaining the weight back.

    Adverse Childhood Experiences explained in the study really illuminated my behaviors and what I need to do to get past this. Thank you for posting this blog. Also, thank you for all the work you do to help people.

  32. admin says

    Thanks for the comment. Check out: Carnes, P., R. Murray, et al. (2005). “Bargains With Chaos: Sex Addicts and Addiction Interaction Disorder.” Sexual Addiction & Compulsivity: The Journal of Treatment and Prevention 12(2-3): 79-120. This will illuminate your situation even more.

    Best,

    J

  33. Taylor says

    Thank you so much for sharing this perspective of addiction. I have had many experiences with loved ones living with multiple types of addictions, and I, too, fully agree that these behaviors come from a deeper-rooted problem…A problem that no one really pays attention to in the midst of their struggles because so many are centered in on the addiction itself.

    I think it is so important to know that these issues are coming from a deeper center because addicts are receiving the short-end of the stick and being proclaimed as individuals who simply can’t handle a certain substance in a “normal” way, or someone who is attracted to a drug because they like the high. What if we focused on these individuals needing a “high” because of a rooted problem that is consciously AND subconsciously eating away at them.

    Thank you for your insight, Dr. Fitzgerald!

  34. Neil says

    This is a very interesting discovery. When people think of alcoholics or drug addicts, they blame them for the way they ended up — I’m no different. But this isn’t always the case. I have a brother who was addicted to prescription pills. Our relationship has been strained ever since. I always blamed him for the choices he made in life and how it affected the family. It has always been hard to forgive him since I feel like everything was his fault. But I think I’m wrong for looking at the situation in 2-dimensions. There’s much more to take into account. Looking back, my brother had experienced one or two ACEs. I can only imagine that my lack of empathy worsened the situation. I know it wasn’t easy for him to experience ACEs, become addicted, and negatively affect everyone in his life. Nothing is as simple as it seems. It wasn’t his intention to hurt everyone. In the end, I cannot change what happened in the past, but I can change what happens here and now. I always wanted to forgive him, but it was hard to find reason to. Now, I realize the reason was there all along.

  35. Jenna says

    I appreciate that you have this information easily accessible for anyone who wants to explore what exactly Adverse Childhood Experiences can do. I have two sisters, one of which is currently incarcerated due to addiction related offenses. My other sister battles alcoholism. I know my triggers, and have sought treatment in the past. I spent years in therapy, both while in foster care and afterward. My adulthood therapist introduced me to ACEs and after working together for 5 years we parted ways both thinking that I had achieved sustainable rehabilitation.

    My identified addictions were all “thrill-seeking” in nature, so while I never experienced a substance abuse problem, I was addicted to adrenaline…and didn’t care if it cost me my life. I probably need to explain that a little better. I sought out dangerous activities and engaged in deviant behaviors. While I was never actively suicidal, I simply had no commitment to staying alive. Slowly, by identifying all the ACEs that had happened to me and working through them, I started to realize that inside me there was a worthwhile human being after all, and that I could contribute to society.

    Fast forward a few years. I developed a healthy relationship, got married, had a child, began furthering my education…and then my husband was hit by a car as a pedestrian. The traumatic brain injury I am told is what altered his whole being. He went from being kind and caring, loving and supportive…to violent and withdrawn, abusive and reckless. He became an alcoholic and somehow got turned on to crystal meth.

    We attempted marriage counseling, he went into rehab a couple of different times and he was seeking individual counseling as well. Things continued to spiral downward. I recognized that the domestic violence aspect was affecting my children and so I left.

    I watch my son and daughter struggle daily. Their schooling is difficult, they have lost interest in all extra-curricular activities and I worry that there is not enough love or services available to keep them from developing an addiction. I understand the ACEs modeling, and have accessed all available services that I’m aware of for my children.

    Is there any way to assuredly prevent them from having an addiction issue? Any feedback you have would be greatly appreciated.

  36. admin says

    Jenna,

    Thanks much for the feedback and voicing your own experiences with aces. The simple answer is there is no assured method for preventing addiction, it is a complex problem with many moving parts. The longer answer is that addiction develops from an interplay between risk and protective factors, so to prevent it one must reduce the risks and increase the protections. Still no guarantee, but it’s the best we have. Another part of the answer is realizing that most ACEs are about trauma. So understanding the nature of trauma and how to heal it is critical to addressing addiction.

    A final comment is that what links ACEs, trauma, and addiction is emotional development. All of these problems cause constrictions and deficits in emotional growth that impact ones ability to initiate, develop and maintain healthy relationships with others. So key is finding a therapist that knows how to do developmentally-based psychotherapy.

    Hope this helps

    J

  37. Brian says

    It is my opinion that the source of addictions, while pointing to a reason for the addiction, it cannot excuse the addiction. More and more drug counselors are using Adverse Childs Experiences (ACE’s) to try pin point an exact moment or experience that caused the person to begin their drug abuse. They focus on certain adaptive behaviors that person possesses, or lacks, and uses that as an excuse for being an addict and their failures in recovery. That passes over the crux of the issue, a person still choses to take drugs instead of deal with their life. It takes aways the personal responsibility that a person has for their actions. Some of my close friends and family have struggled with addiction to one thing or another. Be it relationships, objects, substances, or hobbies. Each one of them chose to engage their addiction. Each of them had to chose to stop the destructive behavior before they could stop. I believe that when we excuse the addiction by giving it reason. When we are saying that humans are not strong enough mentally to force their will control themselves. I admit that the root and the reason people seek addiction is valuable for showing the person why they are prone to addiction. However, once the person is aware of why they are doing something, it should be easier for them to stop. If they are willing to see the root of their problem as simple information and not as an excuse, they can stop the behavior of addiction. Then they can start to make real changes. If someone is driving a car and it makes a loud noise, then veers hard, leans to one side, and is difficult to keep straight, it’s probably a flat tire. That’s the root of the problem. Now that the driver knows the root of the problem, they can fix it. Of course the driver must decide to fix the tire, and that is the personal choice that needs to be made if they want the car to go straight.

  38. admin says

    Brian, what about people who get heart disease from eating fried chicken? No one ever sets out to get heart disease, they just like eating chicken. Those who experiment with alcohol, drugs, gambling, food, sex….don’t plan on getting addicted. No one chooses addiction, it is an outcome resulting from many factors, not just ACEs. Genetics, environment, and yes, free will all play a role. Thanks for your feedback!

    J

  39. Ali says

    Brian

    On a fundamental level, yes, it is a choice.

    But until someone who goes through addiction has the chance ( through therapy) to change their World view, and thus their core beliefs, then addiction seems like the only choice.
    Even getting addicts into therapy is difficult, because the need for therapy simply reinforces their view that they are flawed individuals.

    I was addicted to alcohol..and from a young age too.

    I discovered something that I could simply “drink”…and the emptiness and numbness, would just evaporate for a while..Imagine that!

    I knew that I would be beaten and belittled and told that I was a failure….but at the weekend i could make it go away!

    Of course we all know this, but for those who suffer addictions, those “dicoveries” were/are profound, they were/are a credible means to an end..whereas before that person suffered in silence, being stripped of any self confidence, belief and any hope and having negative core beliefs replace those that were once positive…now,that person has a “friend” who takes them away from the bad lands for a while…and that “friend” never lets them down.

    One has to replace the bad habits with good ones, the negative core beliefs with positive, and start to grow that emotional muscle..but this has to happen with help, patience, understanding…from the addict, to those who are close to that person.

    One has to remember that a person who is trying to stop their addictions is, in essence, giving up their religion…and we know how people can feel about their fundamental belief systems.

    I dont think we “excuse” the addiction by giving it reason, On a basic level the addict is somehow aware that there is a “choice” being made…however the addict is not aware that there are other choices…this is often why the addict will feel guilt and shame after indulging their habit, thus contributing to the continuation of a cyclic process.

    I still suffer from addictive tendencies in times, but I am learning.
    I am not emotionally attached to alcohol anymore…but once in a while I can go out and drink too much on a Saturday night…
    The obvious conclusion for me is to abstain altogether..and maybe that is my personal litmus test!!!
    Or is abstinence, simply denial?..there are more colours to a bruise than just black and blue.

  40. Kathleen says

    This really made me look into my own life and compare this to people around me I know. My unlce is an alcoholic. I for so long have wanted to know what happened, my mom is so successful and my uncle was thriving at one point too. He was living in New York working on Broadway. Out of nowhere he just stopped, said he was done. He decided to try and produce but lost his job and the market crashed. I always just blamed him losing his job as to why he started to drink but this article makes me look back at his childhood. He wasn’t physically or sexually abused, but he might have been abused emotionally. He was always comparing himself to my mom who was not only excelled academically but also on stage. My uncle also did well in plays but that wasn’t the typical scene for boys his age. I wouldn’t be surprised if he was made fun of. My mom also married young and got a job right out of school not needing to rely on parents. My uncle however had to do a little searching and get some help. He also has been single for a long time. Maybe having a constant comparison to his sister and having pressure from his parents (who have high expectations) are underlining causes of his drinking problems today.
    This really changed the way I think about addiction and I am honestly starting to understand my uncle more and feel kind of bad about this. I want to show him more love now. How can I help him? What can I do to make him happier with himself?

  41. admin says

    Kathleen, I think you are on target with investigating the roots of your uncle’s drinking problems. There is always more to the story than meets the eye. What can you do for him? If possible, spend time with him and listen to his story unfold. Listen empathetically, and help him see that he is so much more than his drinking behavior. Often people who have struggled with addiction confuse who they are with their behavior. Let him know the essence of who he is, is different than his drinking behavior. Also encourage him to seek help, it is never too late to change.

    J

  42. Fayley says

    Yes there are so many underlineing causes for addection it is not only the drug. Using the case of food addection is great because its shows that addiction can happen in many ways not related to drug use. By addressing addection with treatment programs that are on going we can treat this as a chronic disease which it is. I would also like to add that addiction can becaused by not only adverse child hood issues but also probally connects with attachment, family setting and resorces avaible to children. With proper outlets and supervision many children might avoid addection.

  43. Bahar says

    I really appreciate this article because it is so crucial for people to be aware of the fact that addiction is not a “simple-fix” type issue. There are so many factors that may lead to one becoming addicted to drugs. I have seen first hand how adverse childhood experiences have caused people to make bad choices which do affect how they handle relationships, etc. How can we expect people that have a weak foundation in crucial aspects of their lives to be able to cure their drug addiction? We must first target the underlying issues, as mentioned in this post, because knowing the cause of the issue would make its treatment much more targeted and more likely effective. Hopefully drug treatment will start to become more integrative and will look at the patient from 360 degrees for the benefit of the patient; it will also save time and money.

  44. Heather says

    I am reading through – Your comments all seem to make complete sense -confusing and a bit scary for me a first time reader… I have a series of addictions, gambling being my top one- drinking, smoking and overeating, yes I am one big bag of issues -however on the outside no one would ever know- I am a high paid professional- well dressed beautiful family lovely husband- in the eyes of others I have it all, and feel the need to destroy myself internally on a daily basis, as self worth has always been an issue, my question is why? I have thought long and hard where did it all go wrong so I can go back and fix it – I have nothing but I am scared to think that maybe something did happen to me as a child that I am not allowing to be let out.. I need alot of help but feel as though I cannot get it in fear of blowing my cover and letting others think of me the way I feel about me.. I am stuck in a world of wanting to run- ( I always picture myself running when trying to cope with my issues) I don’t know where to start- I have come to a bit of a realization lately that this is my fate – being 41 years old and I cannot be fixed at this point.

  45. admin says

    Heather, it sounds to me like things have been stirred up for you and change is occurring, although you may not realize it. Despite your professional persona, it is possible to seek out therapy, begin talking and feeling your way through your past. You can begin to put the pieces together slowly and safely, and make changes in the NOW that move you beyond addiction. Living a life of addiction may be your fate, but it doesn’t have to be. All you need to do is be open to change and have the courage to keep moving forward by taking small steps. Continue to read and study what is on this site, journal, begin meditating, exercise, and seek out positive relationships in your life. And email me if I can be of more help. Your life is far from over…trust me on this.

    J

  46. Christy Ray says

    This was a great article! It also helped me to understand why addictions are sometimes passed down from generation to generation. I come from a long line of alcoholics on both sides of my family. I had a long talk with my uncle once about why he drank and he used various excuses but one was “I learned it from my dad.” Growing up watching a parent drink and dealing with the effects is traumatic for anyone, especially a child who is not able to understand and can suffer emotional and physical abuse, like my uncle. This abuse and years of trauma as a child caused him to start his drinking at an early age and it continued throughout his life. Fortunately, he was never abusive to his wife or children, but the years of living with an alcoholic father has had effects on his children and one of his sons also struggles with alcohol addiction. It’s a vicious cycle and one that has detrimental effects for years to come.

  47. tsmith says

    I heard you speak at PSU & explored your site. I know this is an older post but I can especially identify with ACEs and how they can influence behavior.
    It reminds me that we all have issues even if others might not regard them as ‘addiction’. I was very young when trouble started, one of my maladaptive behaviors that has caused a lot of shame is onychopagia (compulsive nail biting).
    Learning to find root causes and working toward health is a place where we can all meet. Thanks for sharing the information about ACEs and all your work!

  48. Ani Avanessian says

    I’m excited to hear you speak for my class soon! I read many of your articles but the one that hit home to me was definitely this one. I have many relatives who are alcoholics and can’t admit it. My aunt will drink or have a drink anywhere she goes. She doesn’t realize it but she is so dependent on alcohol. She won’t admit it, and when it is brought up or mentioned she gets angry and defensive. It hurts me that she is this way. When you stated “the roots of addiction go much deeper than the adaptive behaviors” really made me think of her. I remember her telling me one day when she came to this country she was very alone and would occasionally go out to bars and drink. But she would not just have one drink she would have many. She felt so alone that she turned to alcohol. Even after meeting her now husband she still turned to alcohol, now more than ever. Deep down I know she doesn’t like it but she is so dependent on that feeling of being intoxicated. Working toward help is what I’m going to try to do with my family and her, I can’t stand to see her like this anymore. Thank you so much for your knowledge I’m looking forward to hearing you speak.

  49. admin says

    Thanks Ani for the nice feedback. It is never too late to help someone! Hang in there, learn about CRAFT, and have hope that things can change for your aunt.

    J

  50. bonnie says

    Dr. Fitzgerald,
    As I read these inputs I see many are talking about addictions related to food, sex, drugs, ect. But what about the clean accepted addictions that do just as much harm to our children as if we used the unaccepted one. Ones like Religion, Workaholics, Social Media, just to name a few. I have never been an addict of those that were not socially accepted but I have been the sufferer of abusive parents when it came to the socially accepted and rewarded ones.

    In the Western world we are one of the few countries that reward for over working…Many countries require you take the vacation time and some compaines completely shut down for the holiday time.

    Work — we reward those who put in the long hours at the sacrifice of the family unit. We admire those who are dedicated to their careers and do not try to understand the prices many children in these homes have sufffer.

    Religion, no I am not talking about the parent who has a balance in the family and goes to church… I am talking about the parent who can not say no to the duties and prestiege they find from being to involved in the church organization to the point the family suffers or holds unrealistic expectation that their children will be the fit the perfect mold of what they think a christian should be.

    All of these need to be addressed. Common knowledge is an addict will many times will trade one addiction for another, even with treatment. Why should a drug addict be looked down on by society any more than someone who works 3 jobs and leaves the children emotionally and physcially alone — the effects on the children are the same. You take the emotional problems of a child from a drug addicts home and list them next to one from a religion addicts and they are the same.

    We need more media coverage and understanding on the work of places like the Bridge in Bowling Green Kentucky. They will only take some one who is clean for a period of time and go beyond the chemical addition to work on the reasons for the addiction in the first place. I learned there that many times addictions as many above have stated center from a sense of Shame.

    I really enjoyed hearing a lecture your lecture you are one of the first, besides the ones at the bridge that really talked about addictions as a lifestyle change not just as addressing the drug of choice so to say. Thank you.

  51. admin says

    Bonnie, thanks for the comment. It gets to the issue of where we draw the line in what we call an addiction. If we go too broad the term at some point ceases to have useful meaning, but zoom in too tight – like a focus just on substances – and we fail to fully comprehend the phenomena. I fully agree as a society we have deep lifestyle problems with work, consumption of media, and religion, but labeling these things when they become unhealthy is not without challenges. In some instances, addiction likely fits, but in others my guess is that a developmental or trauma-based framework makes more sense.

    In the case of religion, I encourage you to read James Fowler’s seminal book, Stages of Faith, that provides some great insight into the ways religion gets played out in families.

    Appreciate much the feedback, gets me thinking!

    J

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  1. [...] Addiction Management Treatment Blog: Dr. John Fitzgerald updates this blog to help people learn about addiction and therapy. Recommended posts: "Sins and Needles: when creativity transforms addiction" and Uncovering the pervasive roots of addiction: Part 1." [...]

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