What Lies Beneath: Treating the Trauma Underlying Substance Use

Session Description: For many individuals suffering from substance use disorders, making the decision to enter treatment is a challenging process requiring a great degree of humility and courage. Clients often initially approach treatment with limited knowledge and perspective of what is truly required of themselves to benefit from a residential treatment setting. Not surprisingly, surrendering from their “regular lives” into an often novel and emotionally challenging therapeutic setting will elicit self-protective mechanisms. These reflexive responses can prevent both the client and the clinician from gaining meaningful access to the areas of deepest vulnerability and suffering, particularly with a trauma history. Taking a multiplicity of the self-perspective is a useful approach to assist both clients and clinicians in understanding how to collaboratively explore all aspects of what appear to be therapeutic impasses. Using the authentic therapeutic alliance and applying nuanced experiential, somatic, emotion-focused, and family systems-based approaches, can facilitate access to the “parts” of self that rely on substance use to cope. Additionally, we will discuss how more novel experiential treatment approaches including Ketamine Assisted Psychotherapy can deepen internal access to one’s self and enhance opportunities for relational intimacy and repair.