abusive childhoods

There is a map of Emotional Responding Tattooed on my Heart.

Posted on by alcoholicsguide

When I was doing my step four inventory as part of my 12 step programme of recovery  I did it pretty much as suggested in the Big Book.

My sponsor at the time asked me to do an additional part that is not explicitly mentioned in the Big Book.

He said to list all the negative emotions (or defects of character) that I had been in the grip of and exhibiting in relation to my various misdemeanors and the resentments I had held against various people and institutions over the preceding decades.

This turned out to be a brilliant idea for two reasons.

First it showed me that  I held a multitude of resentments because I had a problem of emotion regulation.

I did not realise that the engine driving this emotion dysregulation was chronic shame.

I realised when doing my step 4 that that I had not previously been able to leave various supposed slights and abuses from my past in the past because I did not have the emotional maturity to look at these episodes reasonably and objectively.

In other words, I had not processed these episodes emotionally and embedded these events in my long term memory like healthy more emotionally mature people do.

Hence when I came into recovery I had hundreds and hundreds of resentments swirling around my mind, poisoning my thoughts and sending constant emotional daggers into my heart.

My past constantly assailed me emotionally, randomly attacking my mind.

My step 4 and then 5 showed me that I did  not have the natural ability to deal with my negative emotions.

Secondly, listing all the negative emotions I had when I held a resentment against someone was very revealing in that when I held a resentment, any resentment, and against a wide variety of people, the negative emotions listed where generally the same! In fact they were all interlinking in a pattern of emotional reacting, one activating the other. It was like a emotion web that ensnared one in increasingly frustrating states of emotional distress and inappropriate responding.

This was quite a revelation!? That I respond in exactly the same way to my sense of self being threatened?

That there was a map of emotional responding tattooed on my heart.

I was drawing up a web of my emotional dysregulation, a route map of all the wrong ways to go, to emotional cul de sacs.

It was a list of the negative emotions which appear always when I felt anger and resentment against someone for hurting me and my feelings.

Just as revealing where the negative emotions listed which clearly showed how  I react, and can still react to people who I believe have caused my hurt or rejection.

In fact it seems now that I treat all insult, intentional or otherwise, in a very similar way.

I have spent years trying to work our why?

I got as far as deciding it was an inherent problem with processing negative emotions, which it is.

However, there seems to be a problem specifically with a patterned mesh of negative emotions which are activated when someone upsets me.

In fact I think this pattern of interlinked negative emotions occurs simply because of inability to identify, label and share the simple fact that I have been upset  by what someone has said or acted towards me.

“Shame is a fear-based internal state being, accompanied by beliefs of being unworthy and basically unlovable. Shame is a primary emotion that conjures up brief, intense painful feelings and a fundamental sense of inadequacy. Shame experiences bring forth beliefs of “I am a failure” and “I am bad” which are a threat to the integrity of the self. This perceived deficit of being bad is so humiliating and disgraceful that there is a need to protect and hide the flawed self from others. Fears of being vulnerable, found out, exposed and further humiliated are paramount. Feelings of shame shut people down so that they can distance from the internal painful state of hopelessness.”

“… unacknowledged thoughts and feelings become repressed and surface later through substitute emotions and dysfunctional behavior. Other emotions are substituted to hide the shame and maintain self esteem. Anger, exaggerated pride, anxiety and helplessness are substituted to keep from feeling the total blackness of being bad. The buried shame is expressed through defense mechanisms that shield negative unconscious material from surfacing.

Anger responses are modeled and learned in some families. The anger response is more comfortable than feeling the shame for some individuals. Families where coercive and humiliating methods of discipline are used develop children who are shame prone. Behavior become driven by defenses that function to keep from feeling bad. Reality becomes distorted to further protect the self from poor self esteem. The transfer of blame to someone else is an indicator of internal shame.

Children who live with constant hostility and criticism learn to defend against the bad feelings inside and externalize blame on others. External assignment of blame is a defense against shame. People who are super critical have a heavy shame core inside.”

I was working with someone last year and we had a disagreement and this guy said to me “I am upset” and “You have hurt my feelings” I was taken aback. I thought I never say things like that. This guy was an Olympic champion at expressing how he feels compared to me. I never say I am upset because it also seems to be an undifferentiated emotion that I have trouble accessing, mentalising and expressing.

I have not been taught as a child or since to simply say I am upset.

Instead of acting on my upset by saying to someone,  you have hurt my feelings  I do the opposite,   I react and attack them in my head, my thoughts, my words and sometimes in my actions. Sometimes I “get them back” somehow. I make them pay in some way.

Honesty is the heart of recovery and I am being honest. The years of recovery reveal many different things, some of them not so palatable.

I grew up in a family that did not express emotions like the ones I had mentioned. We reacted via anger and put downs hence I have grown up to be dismissive.

My dismissiveness and my arrogance are parts of defence mechanism against rejection, they guard my inherent sense of shame. I am full of shame, more so than fear, although these two overlap. Shame is in fact fear evoking.

I hide my shame away under an anger of emotional hostility, stay away or else! I will get you back somehow. Sometimes I am in shame and offend via my attitudes.

I also have other ways of reacting in an emotionally unhealthy way that my step 4 showed.

If someone hurts me, according to my step 4, my angry resentment of what they have said or done makes me ashamed. This can quickly prick my sense of self pity (uselessness and hopelessness) which is something I have always rage against (rage is an essential part of shame plus I rally against this feeling of powerlessness) and I retaliated via excessive pride (I am better than you, I will put you down and see how you like it!) I put you down in my mind or through the words uttered from my mouth by arrogance, dismissiveness, impatience and intolerance.

I do so because I am being dishonest and fearful.

I do some because I am self centred and selfish.

These are all parts of my emotionally entangled web that is spun when I react to some sense of rejection.

Sometimes the shame persists for some time and I try to relieve it by behavioral addictions, too much shopping, too much eating, too much objectification of the opposite sex.

Not enough action, or effort to change my feelings in a healthy manner.

My step 4  showed me this is the unhealthy fruit of my greed, gluttony, my lust, my sloth.

My spiritual malady.

Add in perfectionism because that is the quick way to do nothing, a fear of failure  that paralyses.

These are my main negative emotional  reactions to the world that often scare me and make me feel ashamed.

I have felt powerless via your comments so try to to steal some power back by making my self seem more powerful over you.

I respond to feelings of humiliation by humiliating you, I react to my chronic shame by attempting to created shame in you.

Some days I react more adversely than others.

For example, this family have just moved into my neighbourhood, they seem wild and out of control.

I am not only fearful (leading to dishonesty in my thinking, catastrophizing, intolerance of uncertainty about how they will behave etc) I have reacted to their arrival via shame based defence mechanisms and reactions. I am shamed and disgusted that my neighourhood has come to this. I am dismissive of them, intolerant, impatient and arrogant towards them. All shame based reactions.

Last night the police were called to their home and one of them was handcuffed and put in the back of the police van.

My head went “I told you so!”

It was a very shameful scene for the whole family.

When things had died  down and calm restored I spent the evening not in my fear or shame but in empathy and compassion.

How embarrassing for them how shameful.

I relate to them as they are out of control, my family was at varying times completely out of control too, traumatic and this is what has created a chronic shame in me, even still now after 10 years of recovery!

My shame responded and related to their shame.

Nobody wants to be out of control, to be teetering on the verge of the next disaster, the next moving of home, the next calling of the police,  the next swirling carousel of unmanageabiilty.

No one.

I related and all my negative emotions retreated to source like a evening tide on a beach.

I relate to my fellow human beings when I am not in fear or shame.

When I am in fear and shame the same pattern of negative reactions entrap my heart in its’ poisonous grip and I react in a way I would not choose to, if more reasonable.

This is what the heart of my alcholism looks like. Not a pretty sight some days.

The most beautiful thing about me most days is the fruits of my recovery.

Now at least I can see how I react and can take steps to deal with it.

I have a spiritual tool kit that deals with this emotional disease.

Whether  I stay in fear or shame is now my choice. A choice I once did not seem to have.

This is what recovery has given to me.

I do not have to cultivate my own misery through blind reaction.

Via an Amazing Grace I can now see what ails me.

Via AA I now have the tools, never taught to me in my family or in my troubled home environment.

I have gone home in AA. I learnt an attachment to those in AA and others.

I share my feelings of shame with those who know what that feels like.

Together we share our pain and we recover.

Reference

1. http://www.angriesout.com/teach8.htm

 

The Discordant Echoes of the Past

Posted on by alcoholicsguide

The last six years of research has been dedicated to trying to understand a fundamental part of my illness of addiction, of me.  People often say there is more to you than addiction.

To which I normally answer yes, there is also recovery.

I don’t mean to be smart arsed by this but I view recovery not only as a healing in many ways, physiologically, physically, emotionally, cognitively and spiritually but also as a ongoing process of learning about me, the various strands that have contributed to my illness and the various aspects of my recovery which also give insight into what was wrong in the first instance.

If certain aspects improve in recovery there is a fair chance these were impaired in the addiction cycle. I believe there is a lot more to addiction that the end product of addiction, namely chronic pathological addictive behaviour.

Various aspects have contributed to the need to externally manage troublesome and painful internal feeling states.

Recovery according to my wife has made me a nicer person, more loving and considerate and easier to live with. Better company,  more mature in my emotional reactions and more responsible. I hasten to add that I have some way to go still in some respects. In simple speak, I have become less selfish, self centred and less me, me me!

These to me seem like the traits of addiction, this self obsession.

Other factors have fed into this manifest self obsession too however.

Recovery has been a continual process of learning how to do life in a more healthy, emotionally mature way, in simple terms. I have had to learn so many things, the things  more healthy people take for granted and learnt years ago.

Somehow I never learnt how to do some basics, was never properly taught these basics or always had inherently difficulties with certain basic, developmental skills.

For example my emotional life was a complete failure, continually running away from my feelings, avoiding them as if they were actually injurious to the self!

I have spent years trying to work out why I ran away from my feelings and from a very early age. I have that type of curious head.

In early recovery I was astounded that I could not feel what emotions I was having, could not generate a mental perspective on what emotions I was experiencing, could  not identify and label and thus use as a way to make effective decisions. My decisions were always based on the “distress” of not knowing exactly what I was feeling, actions were taken simply to escape this distress.

I had in effect an emotional disorder and that this emotional disorder seemed to precede, initiate and propel by addictions.

Addictions were the place I went to in fleeing me and my negative emotions. They were the tools I used to regulate my negative moods, emotions and negative sense of self.

Me overwhelmed Me – I appeared to need help regulating Me so I chose and used stuff outside of me which seemed to work originally in provide escape but increasingly contributed to this escalating problem of my inability to live with me.

Someone described the spiritual awakening which results from doing the the 12 steps of AA as fundamentally changing how we think and feel about the world and our place in it!

So what do I think and feel about the world and my place in it?

And has this changed in recovery?

Generally I would say I have had a revolution in how I relate to the world, it no longer scares me like it did, I am no longer to ashamed take my rightful place in it.

That does not mean I no longer struggle with fear and shame. In fact the longer I am in recovery I see these two factors as contributing most of the distress I can feel in recovery.

Fear I have always been aware of – we have a fear-based illness it is often shared in AA meetings but shame?

Six years of academic research has clearly shown me that this fear based illness is a distress based disorder. Neuropsychology has shown that the experiential wisdom and insight of 12 step groups has always been correct.

Fear/distress causes me problems via certain avenues such as catastrophic thinking, fear of an uncertain future, distorted /dishonest thinking.

Fear can lead to a wide range of other negative emotions. But honesty is often the first port of call for fear.  I find fear leads immediately to distorted dishonest thinking. Honesty comes from the ancient Greek “to be in (one with) God” so I guess dishonesty is not being in God which is the opposite to being in fear. Interestingly the Christian Bible refers to the Devil as the Father of All Lies!

I had not however realise that shame creates just as many emotional difficulties and emotional pain as fear!

Shame and fear certainly effect each other but both can take the lead.

Fear is referred to in the Big Book of AA “This short word somehow touches about every aspect of our lives. It is an evil and corroding thread; the fabric of our existence was shot through with it.” but shame is rarely mentioned!

This is not surprising as there was little research into the effects of shame of illness back then in the 1930s, in fact research into shame is relatively recent, in the last 25 years. Interest in shame came form an academic article which called shame the “master emotion!” which can effect and amplify all other negative emotions. Thus it has just a profound effect on emotional well being as fear!

I was delighted to come across this research recently as I have always been looking for answer to a vexing question, ever since early recovery in fact.

In early recovery, and since, I have always wondered when someone hurts my feelings, intentionally or otherwise,  I suddenly have this warm sensation, this spreading dendritic/branching type feeling in my heart which when activated captures my heart and pollutes my head with negative thoughts about me.

I suddenly feel hurt, upset, less than, smaller, weaker, hunched over, feeble, and then I get these other voices suggesting the person who upset me is right, I am worthless helpless, useless. Who the hell was I thinking I was, sure I was kidding myself?

I feel that I have been assailed, my head swoons, I lose my bearings. I am under some seemingly grievous emotional attack!

These feeling and thoughts multiply against the audio soundtrack of my tormenter’s voice which then blends into orchestra with my own and other voices of negative self perception.

I am suddenly strangely paralyzed by this emotional avalanche.

Other negative emotions are detonated such as self pity, the ever present sense of “poor me”.

Eventually other emotions may get activated too like fear and dishonest thinking.

I can work myself into quite a emotional state replaying the scene of my supposed insults via resentment and the re-sending of situations, feeling and thoughts from this and other previous episodes in my  life. Other negative mood congruent memory is activated and soon there are other similar memories of similar insults supporting this insult and my increasingly sense of low self esteem and self worth.

I found it impossible for years to stop this spreading emotional feeling and distorted thinking after it was first activated.  It simply continued  against my will. When activated it takes ages to reduce. In fact the intensity of the emotion always seems to get worse before any hope of it getting any better!

I usually need the help of a loved other to help me through it.

It feels as if there has been an emotion explosion in my heart?

One emotion explodes and it then detonates other emotions is the best way I can explain it.

These leads to increased negative thoughts about self and the reinforcing of a negative self schema ingrained in memory from childhood on.

It seems to confirm all the worse things about myself.

Chastises me for having thought any differently!

All because I took a slight at what someone may have said to me!

Often I have found out afterwards that I had misheard and misinterpreted the words and that no insult was intentionally given in the first instance!

My fear-based misinterpretation led to all these negative emotional reactions and cognitive distortions which all then ran away with themselves.

Now in recovery I feel that shame has just as profound an effect on my negative emotions as fear – in fact shame can lead to fear and vice versa. But to me now, it seems that shame is that negative emotion that detonates the other emotions that spread dendritically across my heart.

I have finally found out what has been at the heart of my emotion dysregulation –  shame.

Shame and fear also have similar parents – namely trauma /abuse, insecure attachment as a child to a primary caregiver.

Addiction doesn’t exactly help with shame either!

The trauma incidents I experienced in childhood have led to a fear based responding to the world and what I would call chronic or toxic shame.

A knawing feeling of being less than, not good enough.

An emotional achilles heel.

The above feeling of shame and the resultant negative emotions and thoughts that it detonates are the result of what is perceived  as insult and rejection. It is often said in recovery that the recovering person fears nothing more than rejection, as it brings that damning emotion of shame.

At least fear can activates action, shame always paralyses. Fear can embolden, shames weakens.

We sufferers of toxic shame thus very vulnerable to this type of “putting us down” or the feeling of being rejected or even “found out”.

We spend our lives constantly guarding against it, although we are often unconscious of this.

I sometimes wonder if the “hole in my soul” was shame-shaped?

This is why shame inspires the constant use of defense mechanisms, the myriad of self defence mechanisms that we use against shame, rejection and which I will discuss next time around.

As for the solution to the above perceived insult, pray for forgiveness or simply forgive the person who allegedly insulted you as it exonerates him/her of being a imperfect human being while doing the same thing for you at the same time.

Accept the gift of our communal and very human imperfection when you can.

 

 

 

Childhood Maltreatment and later Alcoholism/Addiction

Posted on by alcoholicsguide

One old timer I know often says two things that I often take issue with – 1. there are as many alcoholisms as alcoholics and that 2. we all come to AA in different boats but end up in the same dock.

Thanks to having a wife in Al Anon I have had the benefit of her insight and from other al-anons who state how remarkably similar we alcoholics are in our behaviour, particularly in dealing/coping with distress and stress, our emotional reactivity and at times immaturity (or so-called defects of character), I disagree that we are so different in our addictive behaviours.

All addictive behaviours from alcoholism, substance addiction, eating disorders to hypersexual disorder seem to be based on an inherent problem with emotion and stress dysregulation.

I believe I have a distress based condition. It results in what appear to be distress based reactions such as perfectionism, distress intolerance and frustration intolerance, normally exemplified in my shouting at my PC when it doesn’t work quickly enough or crashes!

I also believe I have distress based impulsivity, I want that thing, whatever it is, NOW. That anything!

In fact I have noticed when I want something, anything, I end up pathological wanting it in no time at all! It seems then like I NEED it. I too think this is based on distress and heighten stress reactivity.

In fact it is through this pathological wanting that my so-called defects of character that my examples  of emotional dysregulation appear.

If I can’t get what I want, all range of negative emotions spill forth such as intolerance, impatience, arrogance, pride, shame, selfishness etc .  They only appear when I want something and you are getting in the way of me having it!!

So there is a link between my motivation (which is dysregulated due to the effects of chronic stress which turns simple wanting into something more akin to “needing”) and my subsequent emotional dysregulation.

So where does this distress come from? Is it purely the effects of chronic stress dysregulation caused by years of neuro toxic brain damage or does it go back further, into childhood?

I do not think we all have separate alcoholisms, I feel we have remarkably similar reactions to life and these centre on an inherent difficulty regulating stress and emotion.

I also believe we have come to recovery in similar boats. In fact the majority of us have come to recovery in a remarkable similar boat so much so that it would resemble a gigantic ship rather than a boat. That boat is the ship of childhood maltreatment.

Child maltreatment has been frequently identified in the life histories of adolescents and adults in treatment for substance use disorders, as well as in epidemiological studies of risk factors for substance use and abuse.

 Child Maltreatment

One study (1) suggests there is ample evidence exists for higher rates of substance abuse and dependence among maltreated individuals.

In clinical samples undergoing treatment for substance use disorders, between one third and two thirds evince child abuse and neglect histories (Dembo, Dertke, Borders, Washburn, & Schmeidler, 1988; Edwall, Hoffman, & Harrison, 1989; Pribor & DiWiddie, 1992; Schaefer, Sobieragi, & Hollyfield, 1988).

In the US a survey of over 100,000 youth in 6th though 12th grade, Harrison, Fulkerson, and Beebe (1997) Harrison, Fulkerson, and Beebe (1997) found that those reporting either physical or sexual abuse in childhood were from 2 to 4 times more likely to be using drugs than those not reporting abuse; the rates were even higher for youth reporting multiple forms of child maltreatment. Similar findings have been reported by Rodgers et al. (2004) and Moran, Vuchinich, and Hall (2004).

Among youth with Child Protective Services documented maltreatment, Kelly, Thornberry, and Smith (1999) reported one-third higher risk for drug use among those with an abuse history. In a large epidemiological study, Fergusson, Boden, and Horwood (2008) have shown physical abuse and particularly sexual abuse to be related to illicit drug use, as well as abuse and dependence.

Another Study (2) study would suggest the figures are much higher –   data were collected on 178 patients–101 in the United States and 77 in Australia–in treatment for drug/alcohol addiction. The purpose of the study was to determine the degree to which a correlation exists between child abuse/neglect and the later onset of drug/alcohol addiction patterns in the abuse victims. The questionnaire explored such issues as family intactness, parental violence/abuse/neglect, parental drug abuse, sibling relationships and personal physical/sexual abuse histories, including incest and rape. The study determined that 84% of the sample reported a history of child abuse/neglect.

A third study (1) stated that, using the Childhood Trauma Questionnaire-Short Form (CTQ-SF; Bernstein & Fink, 1998; Bernstein et al., 2003) to assess childhood maltreatment in a community sample of active drug users, Medrano, Hatch, Zule, and Desmond (2002) found that 53% of women and 23% of men were sexually abused, 53% of women and 43% of men were physically abused, 58% of women and 39% of men were emotionally abused, 52% of women and 50% of men were physically neglected, and 65% of women and 52% of men were emotionally neglected.

Substance abusers, in addition to having higher rates of childhood maltreatment than members of the general population, have been found to have levels of psychological distress that increase with increasing severity of all types of childhood maltreatment (Medrano et al., 2002). This association is important considering that stress increases an individual’s vulnerability to addiction and addiction relapse (Goeders, 2003; Sinha, 2001;Wills & Hirky, 1996).

There is also evidence that the way in which people cope with stress is related to substance use. For example, researchers have found that greater use of avoidance stress-coping strategies (i.e., disengaging from investing effort to cope with a problem) is related to a greater likelihood of drug use initiation, higher levels of ongoing drug use, and a greater probability of relapse, whereas greater use of active stress-coping strategies (i.e., taking steps to deal with a problem) most consistently functions to protect individuals from substance use initiation and relapse (Wagner, Myers, & McIninch, 1999; Wills & Hirky, 1996).

Childhood maltreatment may influence substance use behavior through its effect on stress and coping. There is emerging evidence that childhood maltreatment may negatively affect the maturation of self-regulatory systems that enable an individual to modulate and tolerate aversive emotional states (Cicchetti & Toth, 2005; Hein, Cohen, & Campbell, 2005). Childhood maltreatment may disrupt neurobiological development and elevate subjective stress by biologically altering the brain’s response to stress (Bugental, 2004;DeBellis, 2002; Heim & Nemeroff, 2001; Heim et al., 2000; Sinha, 2005; Wills & Hirky, 1996). Childhood maltreatment may also affect an individual’s characteristic style of coping with stress so that he or she may be more likely to rely upon maladaptive strategies, such as avoidance of problems, wishful thinking, and social withdrawal, rather than active strategies, such as seeking information and advice from others (Bal, Crombez, Van Oost, & Debourdeaudhuij, 2003; Futa, Nash, Hansen, & Garbin, 2003; Krause, Mendelson, & Lynch, 2003; Leitenberg, Gibson, & Novy, 2004; Thabet, Tischler, & Vostanis, 2004).

Elevated stress and maladaptive coping related to childhood maltreatment may translate to greater substance use behavior by making the coping motives of substance use appear more attractive (Wills & Hirky, 1996). Indeed, substance users commonly report using psychoactive substances such as alcohol, cannabis, and cocaine to cope with stress and regulate affect (Boys, Marsden, & Strang, 2001)

Most cocaine dependent inpatients reported multiple types of childhood maltreatment, and only 15% reported no maltreatment at all, (similar figures to study 2).

“Our findings suggest that the severity of overall childhood maltreatment experienced by recently abstinent cocaine dependent adults has a significant relationship with perceived stress and avoidance coping in adulthood.

Our findings suggest that having a more severe childhood maltreatment history may result in a greater sensitivity to stress…basic coping skills training may not be adequate in decreasing distress and avoidant coping in order to decrease substance use and relapse. Additional interventions that focus on stress tolerance, altering appraisals of stress, stress desensitization, and affect and emotion regulation skills may be of particular benefit to patients with childhood maltreatment histories.

The fact that childhood maltreatment is a preventable phenomenon that occurs early in life and affects psychological functioning well into adulthood makes our findings relevant to clinical practice with children as well. Early identification and treatment of maltreated children may help prevent stress sensitivity or the development of a less adaptive style of coping. Assessment of coping ability and the implementation of coping skills and stress tolerance training may also be indicated for maltreated children in an effort to increase their coping efficacy and decrease their vulnerability to stress later in life.”

I may have been in recovery for a number of years now but coping with stress/distress is still central to my recovery. Dealing with the effects of childhood maltreatment not only via negative self esteem and self schema but in the real sense of coping with every day stress/distress, mainly prompted in my interpersonal relationships (other people!) and with my PC!

 

References

1. Rogosch, F. A., Oshri, A., & Cicchetti, D. (2010). From child maltreatment to adolescent cannabis abuse and dependence: A developmental cascade model.Development and psychopathology, 22(04), 883-897.

2. Cohen, F. S., & Densen-Gerber, J. (1982). A study of the relationship between child abuse and drug addiction in 178 patients: Preliminary results. Child Abuse & Neglect, 6(4), 383-387.

3.  Hyman, S. M., Paliwal, P., & Sinha, R. (2007). Childhood maltreatment, perceived stress, and stress-related coping in recently abstinent cocaine dependent adults. Psychology of Addictive Behaviors, 21(2), 233.

Abusive Childhoods Increase Risk of Later Alcoholism

Posted on by alcoholicsguide

Sitting in AA meetings over a number of years I have been struck by the amount of stories I have heard about fellow AAs having had abusive childhoods and have always wondered how much this sort of maltreatment in childhood contributes to later alcoholism.

In my research I have found that child maltreatment has been frequently identified in the life histories of adolescents and adults in treatment for substance use disorders, as well as in epidemiological studies of risk factors for substance use and abuse.

Ample evidence exists for higher rates of substance abuse and dependence among maltreated individuals (1) so much so that alcoholism and addiction for many represent a developmental cascade.

In clinical samples undergoing treatment for substance use disorders, between one third and two thirds evince child abuse and neglect histories (2-7).

In a survey in The USA, of over 100,000 youth in 6th though 12th grade, Harrison, Fulkerson, and Beebe (1997)  found that those reporting either physical or sexual abuse in childhood were from 2 to 4 times more likely to be using drugs than those not reporting abuse; the rates were even higher for youth reporting multiple forms of child maltreatment (8).

Similar findings (9,10) have been reported by Rodgers et al. (2004) and Moran, Vuchinich, and Hall (2004). Among youth with Child Protective Services documenting maltreatment, Kelly, Thornberry, and Smith (1999) reported one-third higher risk for drug use among those with an abuse history(11).

 

Substance-abuse-effects-families-300x169

 

In a large epidemiological study, Fergusson, Boden, and Horwood (2008) showed physical abuse and particularly sexual abuse to be related to illicit drug use, as well as abuse and dependence (12).

It also appears that  extreme economic deprivation characterizes many maltreating families who are residing in impoverished areas with substantial neighborhood disorganization and ample availability of drugs in the community(13).

Hawkins, Catalano, and Miller’s (1992) highlighted poor and inconsistent family management practices, high family conflict, and poor bonding to family as risks for adolescent substance abuse, and these factors also are characteristic of the dysfunction in maltreating families in which abuse and neglect occur.

These features are consistent with the progression of developmental failures exhibited by maltreated children (14).

Consequently, compromised adaptation in the social and academic arena contributes to association with deviant peers, who escalate the access to and modeling of substance abuse, contributing to early onset of drug use.

 

For many the propensity for later alcoholism and drug addiction are determined in part by genetic inheritance but all genetic transmission also relies on environmental conditions.

It would appear that abusive childhoods and emotional deprivation provide fertile grounds.

 

References

1.  Rogosch, F. A., Oshri, A., & Cicchetti, D. (2010). From child maltreatment to adolescent cannabis abuse and dependence: A developmental cascade model.Development and psychopathology, 22(04), 883-897.

2.  Bayatpour M, Wells RD, Holford S. Physical and sexual abuse as predictors of substance abuse and suicide among pregnant teenagers. Journal of Adolescent Health. 1992;13:128–132.

3. Cavaiola AA, Schiff M. Behavioral sequelae of physical and/or sexual abuse in adolescents. Child Abuse & Neglect.1988;12:181–188.

4. Dembo R, Dertke M, Borders S, Washburn M, Schmeidler J. The relationship between physical abuse, sexual abuse and tobacco, alcohol, and illicit drug use among youths in a juvenile detention center. International Journal of the Addictions.1988;23:351–378

5. Edwall GE, Hoffman NG, Harrison PA. Psychological correlates of sexual abuse in adolescent girls in chemical dependency.Journal of Adolescent Chemical Dependency. 1989;1:53–68.

6. Pribor EF, Dinwiddie SH. Psychiatric correlates of incest in childhood. American Journal of Psychiatry. 1992;149:52–56.

7. Schaefer MR, Sobieragi K, Hollyfield RL. Prevalence of child physical abuse in adult male veteran alcoholics. Child Abuse & Neglect. 1988;12:141–150.

8. Harrison PA, Fulkerson JA, Beebe TJ. Multiple substance use among adolescent physical and sexual abuse victims. Child Abuse & Neglect. 1997;21:529–539.

9. Harrison PA, Fulkerson JA, Beebe TJ. Multiple substance use among adolescent physical and sexual abuse victims. Child Abuse & Neglect. 1997;21:529–539.

10. Moran PB, Vuchinich S, Hall NK. Associations between types of maltreatment and substance use during adolescence. Child Abuse & Neglect. 2004;28:565–574.

11. Kelly BT, Thornberry TP, Smith CA. In the wake of child maltreatment. Washington, DC: Office of Juvenile Justice and Delinquency Prevention; 1997. pp. 1–15.

12.  Fergusson DM, Boden JM, Horwood LJ. Exposure to childhood sexual and physical abuse and adjustment in early adulthood.Child Abuse & Neglect. 2008;32:607–619.

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