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Chemical Dependency-Caused 
Trauma Etiology

This chapter:
  1. discusses ETM theory and overviews its application in the treatment of chemical dependency-caused psychological trauma (see Clinical/ Chemical Dependency for a thorough treatment of the same subject.
  2. does not address comorbity, dual presentations of chemical dependency and other trauma-causing events (like childhood or combat trauma). You can find that discussion in About/ Theory/ Multiple Sources and About/ Comparison - Contrast/ Multiple Sources/ Chemical Dependency, Clinical/ Chemical Dependency.
  3. reviews differences between clinical modalities in the treatment of chemical dependency. However, the differences are not presented within a theoretical-analytical model, but are instead summarized from my experience as the principal writer and audit officer (of six psychological trauma and chemical dependency treatment facilities) who was required to and did routinely explain the clinical differences within the parameters of formal government and other agency licensing compliance processes governing the facilities' operations. I've elected this approach for the sake of saving time, and with the understanding that legitimate exceptions may be taken of my interpretations of the various differences existing between the clinical models described.

Four Psychological Trauma Patterns

Like other psychological trauma, that caused by chemical dependency is also maintained in memory within 4 patterns. Etiology 1 comprises pattern 1 and etiology 2 comprises pattern 3. But chemical dependency initiated patterns are also different. The patterns with highlighted differences follow.
  1. The experience of the physical damage resulting from the drug use and the person's own toxic and often asocial behaviors (as opposed to someone or something else's activities providing an exogenously introduced trauma-causing variable) contradict the pre-drug use values, beliefs, images, and realities. Etiology 1 forms as a consequence of the two contradictions.
  2. The loss from the contradictions and associated emotional outcomes are retained in conscious and unconscious memories.
  3. The contradicting toxic behaviors and the physically caused psychological damage, combined with the retention in memory of the emotional elements resulting from the contradictions, create the need for survival protective measures: thoughts and behaviors that serve to dissociate the person from the reality of both the contradictions and the emotional repression; in the process of that dissociation further contradictions occur to the existential identity. That is, behaviors that cover-up for those manifested when toxic also contradict existential identity. The contradictions form etiology 2.
  4. Additional experiences of loss and emotion, this time related to the consequences of the dissociative activity, are retained in memory.
Where the contradicted values, beliefs, images and realities described in "1" and "3" represent the etiology of psychological trauma caused by chemically dependency, this etiology in this kind of trauma is compounded by the neurological and hepatic cellular changes that represent adaptation to the use and that in the process require additional use to stabilize the adaptations: the molecular elements and biological processes of chemical addiction. The ETM view is that the psychological trauma etiology is unrelated from a causal perspective to the molecular adaptation process fostering the addictive condition, or where there is a relationship, it is mostly inconsequential when compared to the influences of the molecular adaptation process itself.

Paradoxical System of Control: 
The Survivor

The paradoxical system of control for chemically dependent people is the same as for other trauma victims, with the exception that the molecular addiction also supports the retention of the etiology caused by the pathological chemical use. This support has treatment implications. The addiction must be intervened upon before the paradox's defense of the etiology can be neutralized and the etiology reversed.

ETM Theory Application: Etiology Reversal 
of Chemical Dependency Caused Trauma

TRT resolves the drug use-induced psychological trauma by reversing its etiology attending patterns 1 and 3. Before this reversal can take place, however, the chemically dependent person must achieve between 6 - 10 months of sustained sobriety. In late-stage chemical dependency, like gamma alcoholism, 14 months of sobriety may be required before the trauma can be resolved. See About/ Comparison - Contrast/ Multiple Sources/ Chemical Dependency). It describes the neurological and hepatic changes resulting from chemical dependency that effect the delays in resolving the trauma. The delays provide time for neurological and hepatic damages to, at least in part, reverse themselves.

Applying TRT with other Therapies Used 
to Combat the Chemical Addiction

During the waiting period, the chemically dependent person participates in an assiduous effort to maintain sobriety, which effort includes the use of therapies that are different from TRT. While these other therapies are helping the person to maintain sobriety, they also influence the trauma resolution process that is to eventually be attempted: nosotropically-based (behavioral methods intended to stop the drug use) therapies, although necessary, can also adversely affect etiotropic/etiology reversal efforts (see Clinical/ Treatment Facility Operations). Consequently, application of TRT must be preceded by a system of blended therapies that have the effect of maintaining sobriety (through the application of behavioral techniques) and at the same time lead the way to the application of TRT for the purpose of reversing the etiology attending the psychological trauma resulting from the drug use.

ETM application to chemical dependency is also systemic in its orientation. This systemic component is explained in the family treatment chapter (Clinical/ Family). Because the systemic and intrapsychic elements for chemically dependent people overlap, you may find it beneficial to read that chapter in concert (before or after) with this one (also see About/ Development/ Individual and Family)

TRT's Application to Chemically Dependent People

The application of all 5 phases of TRT to chemically dependent people occurs as follows.
  1. TRT Phase One assists the CDP in identifying specific trauma-causing behaviors occurring during toxic periods. Emotions felt while recording the specifics of the events are also included in the descriptions.
  2. TRT Phase Two provides for a summary of the events, a reconsideration and thus in-depth identification of the emotional responses to the events, the identification of specific aspects of existential identity contradicted by the toxic behaviors, specific losses to existential and operational identity resulting from the contradictions, and specific survival responses to the damage and the fact that the contradicting behaviors occurred.
  3. TRT Phase Three provides for the identification of survival responses and associated emotional experiences, but within the context of the identifications' purpose being that they provided for the identification of additional contradictions to existential identity. Such survival responses include the delineation of repetitive attempts to cover-up for the initial trauma-causing behaviors and the damage sustained as a consequence thereof.
  4. TRT Phase Four assists the CDP in identifying and reconciling the survival response-induced damages to existential and operational aspects of identity.
  5. Phase Five provides a review of who the person was prior to the trauma (prior to the pathological drug use), what happened to that person as a consequence of the trauma (the use), what the person had to do to survive vs. who he or she was as a person, and who the person is once the psychological trauma resulting from the chemical use is resolved.
Eight to twelve months is usually required to complete all 5 phases of TRT. The person then exits either to the family treatment processes (see Clinical/ Family) or from the ETM program altogether.

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