Addiction to Trauma and the Piranha Theory

Victims who return to their abuser or who do not leave a dangerous situation are often referred to as being “addicted to their abuser” or “addicted to trauma.”  The concern with using this statement is that given the stigma connected with addiction to substances this description of a survivor of abuse can appear to be victim blaming.  The victim is seen as seeking out the abuse as a means of feeding some sort of need rather than placing the blame on the perpetrator or perpetrators who have significantly impacted the brain chemistry of the victim in a way that resembles the addiction process.

According to Bessel van der Kolk quoted in Sandra Bloom’s article Trauma Theory Abbreviated, ”one hypothesis is that people can become ‘addicted”’ to their own internal endorphins and as a result only feel calm when they are under stress while feeling fearful, irritable and hyperaroused when the stress is relieved, much like someone who is withdrawing from heroin.  This has been called ‘addiction to trauma.’”

The important distinction to make is that this “addiction” is a physiological response caused by the actions of another individual as a means of power and control.  The victim does not seek out the pain.  Instead the victim is seeking relief from the tension that builds when an atmosphere is calm.  In fact, it may be important to recognize that calm and safe surroundings can feel threatening to a trauma survivor and this creates a greater risk of returning to the abuser.

Although the addiction hypothesis explains the physiological origins of the behavior, it may also be helpful to look at what is happening emotionally and psychologically.  Admittedly, this is becoming harder to differentiate as we learn more about the brain, but it can be helpful to our understanding of victim/survivors.

The Piranha Theory - When a person grows up in an environment that is dangerous physically and/or emotionally, it results in the physiological responses noted above.  In addition, skills are learned in order to cope with the environment.  These may include the physiological response of dissociation and other responses such as lying, manipulation, running away, withdrawal and isolation, or over achieving and enhanced competence.  In other words, when a person grows up in fish bowl of piranhas a great number of responses are developed in order to stay safe in that environment.

Now imagine that a person with the skills to manage piranhas is moved to safety.  Rather than feeling safe, the person is going to be looking for the hidden piranhas.  She/he does not believe that there are no piranhas so she may feel ambivalent about giving up the behaviors that controlled the environment in the past.  The survivor may be looking for danger at every corner because that is what she is used to.  This is causing and is caused by a physiological response that is a reaction to perceived danger, real and imagined, and experienced previously. 

Being trauma responsive in our work with survivors includes providing safety and stabilization in addition to refraining from actions that could re-victimize the person.   Physiological stability cannot be achieved as long as the person is on an emotional roller coaster of stimulus and response (Bloom, 1999).   Once a person feels stable physiologically, she can then start the work of changing behaviors that correspond to the new environment.  This takes work and giving up old behaviors when there is constant fear and worry that the perpetrator is still around the corner.  Our acknowledgment of this struggle and assistance with stabilization is infinitely more productive than labeling a person with an “addiction to trauma.”

Using Right Brain Activity to Build Resilience and Assist Recovery from Trauma

I went to a conference this past week and was reading Sandra Bloom’s book, Creating Sanctuary – Toward the Evolution of Sane Societies, on the plane and became a little discouraged as I was reading her chapter on Trauma Theory. I was particularly impacted by the following paragraph on pages 28 and 29:


“Evidence also exists that the massive secretion of neurohormones at the time of the trauma may deeply imprint the traumatic memory (Van der Kolk 1994, 1996c). The neuroscientist Le Doux (1992) has termed this ‘emotional memory.’ In studying the influence of fear in particular, he has shown that emotional memory appears to be permanent and quite difficult, if not impossible, to eliminate although it can be suppressed by higher centers in the brain (Le Doux 1992; 1994). This ‘engraving’ of trauma has been noted by many researchers studying various survivors (Van der Kolk 1994; Van der Kolt and Van der Hart 19931).”

This imprinting of the traumatic memory and the flooding of chemicals into the amygdale (doing center of the brain) appears to make it almost impossible for a survivor of trauma to be able regulate their emotions and they will continue to respond to life events and relationships as if the trauma is ongoing. If this is so, how can advocates possibly hope to be able to work with and assist survivors in making positive changes in their life?

Fortunately, the Self and Family Conference provided some answers so that I was able to return feeling less discouraged and more empowered.


Using Right Brain Activity

There were a number of speakers, including Stephanie Covington, Judy Crane of the Refuge, and Cardwell Nuckols who spoke on using right brain activities to calm down the spin cycle of the amygdale, move away from the constant interpretive cycle of the left brain, and empower the survivor by engaging them in activities in which they can gain some competence and make meaning out of their experience.

The left brain is responsible for trying to make sense of the world and the perception of self. For trauma survivors, trying to make sense out of trauma can keep them in a cycle of constantly responding to the world as if the trauma is ongoing. By engaging in right brain activities, i.e. art work (collages, painting, drawing), music (drumming, dancing), exercise (yoga, Tai Chi or Qi Gong) and writing (poetry and short stories), a person is able to engage the brain in other activities that generate competency, slow down the left brain activity that keeps them in constant hyperarousal.

Judy Crane of the Refuge (see links to the left) gave a couple of dramatic examples. She told the story of a woman who had been severely sexually abused by her grandmother when she was three years old. This woman was given the materials and support to create a figure out of soda cans and Marlboro cigarette packs (her grandmother smoked Marlboros and drank a lot of diet coke). The woman put pieces of paper in the cans that described how she felt. She was given permission to show her work and then she used Judy’s golf cart to flatten the cans. The work that went into the can sculpture enabled her to be able to create, move out of the left brain, and feel empowered.


Another client of Judy’s was using self cutting as a coping mechanism. She was given red and black paint and was encouraged to use this as a way to focus her pain rather than causing self injury as the self harm was disrupting to the other inpatients. Within a few weeks, the client had gone from cutting herself to creating significant art that showed her progression from hurting to healing.

There is a lot of research out there about the calming effects of yoga, Tai Chi, and even aromatherapy. I was also given information on Soul Collages (see link to the left) and integrative medicine (I hope to expand on this in the future).


The Healing Relationship

There is more and more evidence in the mental health field that the primary catalyst for healing in trauma survivors has little to do with the mode of treatment. It is the “therapeutic relationship.” In domestic violence and sexual assault work we can refer to it as the “healing relationship.” Being as genuine, empathic, and knowledgeable of the impact of trauma on survivors as we can, we can assist them in beginning the road to recovery. This is difficult to do in situations when the survivor is still being impacted by the activities of the abuser, but can open the gateway to slowing down the hyper activity in the left brain and increases their sense of safety and trust in the advocate.

Another note: Anyone Can Provide Trauma Informed Services

Stephanie Covington, PhD. was quick to discuss how any provider can be trauma informed. In addition to speaking around the country about her programs for women, trauma and recovery, she also has talked to other providers about how to be trauma informed. She has even met with her dentist’s office to discuss how they can be more trauma informed i.e. explaining to the patient in advance each move and being responsive to how the weight of the apron worn during x-rays could be triggering. The dental office changed their procedures to be more trauma informed and uses these procedures for everyone so there is no need to question patients about their trauma history.



The conference was very informative and I hope to write more over the next few weeks about what I learned from experts in the areas of trauma, substance abuse, and mental health.