The last two years of pandemic life have resulted in a state of global trauma and soaring rates of addiction. For example, 92,000 drug overdose deaths occurred in the United States from November 2019 to October 2020, the highest number of overdose deaths recorded in 12 months. Experts also report a dramatic increase in behavioral addictions such as online gambling and compulsive overeating.
How addiction is understood has changed over the years. In the past, we viewed addiction as a moral failing. Our current model understands addiction as a disease, yet many aspects of the failing moral view persist. While we send people off to the hospital, we also send them off to jail. We can't seem to come to terms with how we view addiction. My book, "Treating Trauma and Addiction with the Felt Sense Polyvagal Model," frees us of the sick or bad debate. In the context of addiction, I have essentially integrated the ground-breaking work of Stephen Porges (Polyvagal Theory) and Eugene Gendlin (Felt Sense and Focusing).
Polyvagal Theory (Stephen Porges) offers a new way of understanding addiction as an adaptive response in our autonomic nervous system (ANS). This body system monitors our flight or fight shutdown responses to threats based on how safe we feel. Our ANS shifts us into different states to protect us. Addictive behaviors are the body's way of helping us survive in difficult circumstances, protecting us from unbearable pain. Polyvagal Theory provides scientific validation of clinical observations observed by trauma therapists for decades. I see addictive behaviors as "propellers" that shift us from flight or fight to shut down or vice versa. When we cannot calm ourselves in the face of threat, addictions wake us up or numb us. And in many ways, calming ourselves has become a global challenge.
My working definition of addiction is something that helps you in the short term, hurts you in the long term, and you can't stop doing it.
The basic ideas in my model can be broken down into three processes that revolutionize addiction treatment.
Working With Your Autonomic Nervous System: Finding your Physiological State
Based on Polyvagal Theory, I help clients identify their characteristic physiological responses to threats/ triggers usually established at a young age in response to trauma. Our state determines how we experience the world. Our job as therapists is to teach our clients how to create more safety in the body to shift into a grounded state. As we ground, addictions slip away. Viewing addictive behaviors as adaptive and understandable in the context of trauma is revolutionary. This changes how we help clients construct the story of their lives. We aren't bad, and we aren't sick. We are wired to survive in any way we can.
Honoring the Body's Wisdom: Felt Sensing
Our society values cognition over bodily knowing. "It's all in your mind," we say. Indeed, it is not so. Our body is continually registering how we are experiencing life through our autonomic nervous system. In contrast to traditional cognitive approaches to addiction treatment, our healing journey begins in recognizing the body's wisdom. Our 'felt sense,' a term coined by psychologist Eugene Gendlin, is the intuitive knowing that we tap into when we allow ourselves to pause, feeling down into the center of the body. Like when we are wound tight and finally allow ourselves to slow down, hear the kind words, and surrender to the tightness. Paradoxically, the surrendering allows the tightness to soften, often activating an ANS state shift into a more grounded sense of safety. This physical release brings an aha moment of acknowledgment, a new perspective. Gendlin called this process 'Focusing.' His research indicated that clients who experience these shifts do well in life. He created six steps to teach the Focusing process. Slowly, I encourage clients to reconnect with and trust their bodies' wisdom. This is the most important step.
Brains Can Change: Neuroplasticity
Our current model of addiction, for example, "Once an Addict, Always an Addict," is based on an outdated notion of brain development. Brains continue to change and regenerate throughout life (neuroplasticity). The capacity to change creates opportunities to rewire addictive pathways through activities like mindfulness meditation, focusing, yoga, embodied psychotherapies, dance, and being with friends and family. With awareness, we can choose to engage in socially connected and grounding practices that reinforce safe states.
A Felt Sense Polyvagal lens on addiction challenges society to shift paradigms from a pathologizing model to a strength-based model based on the body's wisdom. A trauma-informed approach to treating addiction helps us appreciate the power of our autonomic nervous system in protecting us from overwhelming experiences. New treatment methods are targeting our ANS, enhancing our capacity for healing. Addictions slip away as we promote health, growth, and restoration.