Trauma, Addiction, and the Flight from Intimacy

In today’s hectic, fragmented world almost everyone wants more emotional connection and physical intimacy to help balance our increasingly technological lifestyles. In intimate relationships we feel safe to talk about our deepest and most personal feelings, thoughts, and problems without judgment, criticism, ridicule, or betrayal of confidence. Authentic intimacy supports an inner journey, allowing a soul-to-soul connections with others within which we can share both our wounds and our divinity.

Yes, technology and busy-ness do discourage intimacy, but Barry—my husband and professional partner—and I began asking, “Why do people flee from intimacy when it’s available?” This is a question we have been asking for the past thirty-three years, beginning with a deep examination of our own struggles with intimacy. We have also asked this question of the hundreds of couples in our counseling practice. Our conclusion is that the flight from intimacy is triggered by hidden and unhealed experiences of childhood trauma that emerge when people reach a certain level of safety and closeness in their relationship.

Barry and I discovered early in our relationship that we each had lot of trauma during the first three years of life. What we did not anticipate was how much it would affect us as personal and professional partners. Over the years, we have laughingly talked about how our backgrounds make us highly qualified to research, teach, write, and talk about childhood trauma.

When signs of childhood trauma surfaced in our marriage, we decided to make meaning from it by converting our relationship into a heuristic research “laboratory.” For over thirty years, we have been engaged in a subjective process of reflecting, exploring, sifting, clarifying, healing, and writing about the meaning and effects of early childhood trauma on human development.
To learn more about why people flee intimacy, we created a systemic model of optimal human development and immersed ourselves in fleshing it out. We began by describing an individual model of optimal development. We then used this model as a template for mapping the optimal development of larger systems like couples, families, organizations, nation-states, and the evolution of the human species. We also integrated many theories from the field of developmental psychology and identified four stages of human development that all human systems ideally should move through: codependent, counterdependent, independent, and interdependent.

First, we established a base of optimal individual development by identifying the developmental processes for each stage. Completing these processes is essential for becoming fully individuated adults who are capable of creating and sustaining intimacy. Our research on the optimal track of development began by studying secure attachment during the codependent stage through the work of John Bowlby (1988), his protégé Mary Ainsworth (Bowlby & Ainsworth, 1965), and Ainsworth’s protégé Mary Main (Main & Solomon, 1986).

We also studied the optimal experience of separation and individuation during the counterdependent stage of development, drawing on the research of Margaret Mahler (Mahler & Furer, 1969; Mahler, Pine, & Bergman, 1975; Mahler, 1980) and Louise Kaplan (1978). We sought to identify the specific behavioral interactions between parents and children during the first three years of life that help create secure, self-reflective human beings capable of experiencing intimacy, autonomy, self-correction, and self-direction. Great thinkers such as Carl Rogers (1961), Abraham Maslow (1962), Erik Erickson (1994), Viktor Frankl (1963), Carl Jung (1933), and Jean Houston (1982) influenced our model of the optimal human being. Drawing from the biblical axiom, “without a vision, the people perish,” our four-stage model of optimal human development offers an uplifting and inspiring vision of the possible human.

Then we researched the trauma track of human development and the impact of adverse childhood experiences (ACEs) on individual development. They included prenatal, birth, and attachment trauma during the codependent stage, and separation trauma during the counterdependent stage. We also looked at the effect of these traumas on long-term mental and physical health.

At this point we sought to determine where things break down in the behavioral interactions between parents and children during the first three years of life. We wanted to know why people flee from intimacy and what happens that moves people away from love and connection and towards pain, suffering, and disease.

We returned to the work of John Bowlby and Mary Ainsworth. Their research on insecure attachment identified two subcategories: ambivalent and avoidant. Mary Main’s later research identified a third category of insecure attachment: disorganized. Disorganized attachment is the result of unintentionally inconsistent, unpredictable, and disorganized caregiving during the first year of life. It involves a connect-disconnect pattern of social and emotional interactions that not only damages people’s ability to experience and sustain intimacy, but has long-term mental, physical, and emotional consequences.

The Codependent Stage

We concluded from Main’s findings that the flight from intimacy originates in the codependent stage of development due to disorganized parental caregiving. Our research on the trauma track yielded several important discoveries.

Downer Addictions

Disorganized caregiving during the codependent stage forms the foundation for “downer” addictions that are mostly oral in nature. As children mature, pacifiers, baby bottles, and thumb or finger sucking morph into nail biting and addictions to food, alcohol, smoking, marijuana, pornography, and dependencies on other people. All downer addictions serve as substitutes for missing experiences of nurturing, protection, comforting, and consistent emotional contact. While these addictive substitutes may bring temporary relaxation, they do not satisfy because they are missing the love connection and feelings of comfort and safety. We see addiction as any ritualized, compulsive, comfort-seeking behaviors designed to avoid emotional pain.

Coping Patterns

Main identified three specific coping patterns associated with disorganized attachment, which we have named the “Lost Child,” the “Solicitous Caregiver,” and the “Little General.” At the core of these three sets of behavior patterns we discovered something very interesting: it was not so much that people feared experiencing intimacy, they primarily feared losing it. We concluded that the earlier and the more frequent the disturbances in attachment during the first year of life, the more likely people were to flee intimacy as adults.

The Psychological Immune System

We discovered a strong connection between the mother-child attachment system and the immune system, and between the trauma and long-term health. Karlen Lyons-Ruth identified disorganized caregiving and disorganized attachment as the primary cause of stress in young children (2002, pp. 107–19). She describes the attachment system as “a psychological version of the immune system” that combats and reduces stress much like the immune system is the biological structure for fighting physical disease.

Cortisol

The chronic-stress-associated disorganized caregiving during the first year of life causes long-term exposure to high levels of cortisol. This seriously affects children’s developing brains and nervous systems, leaving them frayed and overly sensitive. It also impacts the endocrine system—particularly the hypothalamic-pituitary-adrenal (HPA) axis—and leads to long-term HPA-axis dysfunction, a major cause of chronic and degenerative diseases later in life.

The Counterdependent Stage

Our second area of heuristic research focused on the counterdependent stage. While there is an abundance of information about codependency and the codependent stage of development, we found very little information about counterdependency and the counterdependent stage of development. During this stage, children gradually become psychologically and emotionally separate from their parents, primarily their mothers. The optimal completion of the counterdependent stage of development leads to what Carl Jung called “individuation” (1923), and what Margaret Mahler describes as the “psychological birth” (Mahler et al., 1975).

In an effort to understand individuation, Barry and I immersed ourselves in studying both the optimal and trauma tracks of development during the very complicated and little understood counterdependent stage. We made the following important discoveries about trauma, individuation, and intimacy.

Abusive Experiences

The most common causes of trauma during the counterdependent stage are abusive relational experiences inflicted by parents and other adult caregivers. They include emotional abuse, such as shaming and judgment, and physical abuse designed to restrict toddlers’ exploratory behavior. Parents and other caregivers use punitive tactics in an effort to reduce children’s natural narcissistic behaviors (Weinhold & Weinhold, 2008, p. 57).

The Drama Triangle

Separation trauma during the counterdependent stage also corrupts the separation process, and creates a dysfunctional relational dynamic known as the drama triangle (Karpman, 1968). The persecutor, rescuer, and victim roles in this dynamic emerge during the separation process for two reasons. The first is due to disorganized caregiving, and the second is due to parents and other adult caregivers having not successfully completed their own individuation process.

The Splitting Stage

The “terrible twos,” a period typically filled with ambivalence and contradictions, involves a split into good/bad and all/nothing thinking. Toddlers need specific kinds of parental support to become fully individuated and self-directed. Without this support, they learn dysfunctional social and relational patterns based on the pseudointimacy characteristics of the drama triangle. The good/bad split in thinking naturally creates a flight from intimacy behavior pattern that makes authentic intimacy virtually impossible.

Separation and Bonding

Individuals can only can complete their psychological births to the extent that they are securely attached and bonded with their parents. Separation primarily begins with toddlers exploring the world around them, and then moving away from their mothers. If bonds with their mothers are weak because of an disorganized attachment, children do not feel safe enough to explore.

Secondary Caregivers

The presence of supportive fathers or second bonded caregivers is essential in successfully completing the individuation process. Their role is to support children’s mixed feelings about separating from their mothers and leading the children away by creating safe exploration experiences. We identified very specific things that secondary caregivers must do to help children become psychologically separate, and the most important is overcoming the splitting stage’s good/bad thinking by helping toddlers develop both/and thinking.

Overcoming the splitting stage is very challenging, as it stirs any unhealed separation trauma in adult caregivers. It requires they stay neutral and objective during rounds of conflict, turbulence, ambivalence, and contradiction without getting triggered or using punitive parenting tactics.

Upper Addictions

Disorganized caregiving during the counterdependent stage forms the foundations for “upper” addictions that are driven by adrenaline, the most addictive substance to the human body. Running; failing to eat, sleep, or rest; and hyperactivity of all kinds serve as defenses against emotional intimacy and the great fear of losing it. These childhood defenses morph into adult addictions such as managing other people’s lives; excessive shopping, sexual hookups; exercising, working, and traveling; and a host of avoidant activities that support the flight from intimacy.

The Flight from Intimacy

Our most important discovery, however, was about the flight from intimacy. While this behavior is anchored in the codependent stage, it typically gets reinforced during the counterdependent stage through measures designed to inhibit children’s exploratory behaviors. They learn avoidant behavior to minimize the impact of these painful relational interactions. By this time, children have also developed cognitive and language skills that help them flee from both caregivers and intimacy. They create avoidant behavior patterns that are very difficult to change later in life.

Trauma and PTSD

For more than two decades, we fine-tuned our systemic, four-stage, two-track model of human development. Our heuristic research included studying ourselves, our clients, our trainees, and our international work with large systems. We integrated the findings of our heuristic research into our counseling and consulting practices, our teaching at the university, our professional trainings, and our writing. At some point we recognized that a large number of our adult clients, students, and trainees had posttraumatic symptoms that did not fit the diagnostic criteria for posttraumatic stress disorder (PTSD). When we delved deeper into their histories, many had birth traumas, attachment traumas, separation traumas, were unwanted children, and had experienced a host of intergenerational trauma patterns that included poverty and mental illness. By the mid-1990s, we had identified developmental trauma as a set of symptoms that were distinctly different from those describing PTSD.

Developmental trauma occurs in the first three years of life in the context of intimate relationships with adult caregivers. While people typically do not remember these experiences, they leave a deep imprint on the central nervous system (CNS). This causes problems with impulse control and regulating emotions; feelings of shame; unpredictable behaviors; and fears that make them suspicious and distrusting. Most importantly, they struggle with intimacy and social isolation in ways that impact their sense of self. People typically do not remember developmental traumas, particularly if they were the result of neglect; they only emerge later in close adult relationships as addictive and dissociative behaviors, and emotional and relational triggers.

Event trauma usually happens later in life, and is most often caused by a single or an acute series of events that people can remember, such as accidents, combat experiences, terrorist attacks, and natural disasters. Event trauma experiences produce symptoms that are traditionally associated with PTSD.

Most people experience both event and developmental trauma during their lives, and learn to cope with posttraumatic reactions in two ways. The most common way is by using self-medicating addictions to calm the CNS. Another way people cope is by dissociating and by avoiding situations related to the original trauma experiences that trigger them, particularly those involving developmental trauma. Increased intimacy is the most common trigger for unresolved developmental trauma, because the original trauma occurred in the context of an intimate relationship.

At the same time that we recognized developmental trauma as a category separate from PTSD, so were other researchers and mental health practitioners, such as Bessel van der Kolk, MD. He differentiated the symptoms of developmental trauma from those characteristic of PTSD, saying it could not be adequately defined using a DSM diagnosis of PTSD. He also recognized that both PTSD and developmental trauma leave lasting imprints on the CNS and cause posttraumatic reactions such as flashbacks, reexperiencing, and trigger sensitivities (van der Kolk, 2005).

More and more practitioners are ignoring the DSM, focusing instead on creating practice-based evidence model approaches for healing the trauma underlying client addictions and intimacy problems. In a practice-based evidence model, the complicated real-world happenings are not controlled, but are documented and measured just as they occur. It is the process of identifying, tracking, and measuring what is important in clients’ lives, rather than controlling how practices are delivered.

This contrasts with quantitative, evidence-based practices as the best method of determining which clinical services are most effective. Most psychotherapy research typically compares a specific intervention against no intervention, which does not control for placebo effects. Many people still believe that only quantitatively measured things are real.

Trauma and ACEs

Our heuristic research approach on developmental trauma has been supported by findings from the ACEs epidemiological research studies (Felitti & Anda, 2010). They confirmed our conclusions that early childhood trauma dramatically impacts people’s lives and increases the probability of the onset of chronic and degenerative physical, mental, and social diseases during adulthood.

Dr. Vincent Felitti of Kaiser Permanente and Dr. Robert Anda of the Centers for Disease Control and Prevention (CDC) designed and conducted an initial phase of the ACE studies. It was conducted at Kaiser Permanente from 1995 to 1997 and included more than seventeen thousand participants from the San Diego area. Subjects were given a standardized physical examination and asked to complete a confidential, ten-question survey about their ACEs. This information, correlated with the results of their physical examination, created baseline data for the ACE study.

The ACE score assessed the total number of adverse experiences, and the findings showed that ACEs were very common. Almost two-thirds of the study participants reported at least one ACE, and more than one in five reported three or more ACEs. They found that the short- and long-term outcomes of these ACE studies correlated with a multitude of adult physical health, mental health, and social problems (CDC, 2010).

The study showed that the higher the number of reported ACEs, the higher the risk of developing health problems in adulthood. These include poor social functioning and mental health; poor sexual habits; increased risk for addictions including smoking, alcoholism, drug use, obesity, and promiscuity; and chronic and degenerative diseases such as COPD, cancer, heart disease, and STDs.

Participants with five or more ACEs had a 550 percent greater chance of becoming alcoholics than those with no reported ACEs. Adults with four or more ACEs were twice as likely to have heart disease and women with five or more ACEs were at least four times as likely to have chronic depression. People with six or more ACEs lived about twenty years less than those with no ACEs. Since the original study in 1997, over eighty follow-up, ACE-related studies have produced similar results. However, we identified some important limitations in the ACE research:

• They did not ask those reporting ACEs if they had sought counseling or used other remedial treatment practices.
• They did not identify any resiliency factors that might have been present in the subjects’ lives.
• Most of the ten original ACE questions focused primarily on abuse rather than neglect.

We find neglect more harmful than abuse because nothing happened—there is nothing to grieve, to feel resentful or angry about, or to work through in therapy. Those with histories involving neglect are aware their lives do not work, but they do not understand why they struggle with chaos, addictions, and intimacy issues.

The Healing Process

Identifying the underlying causes of the flight from intimacy was our primary research goal, and the second was learning how to heal it. This can be a daunting task as it requires recalling, reexperiencing, and making meaning of painful traumatic memories.

We discovered—in doing our own personal healing work—that placing the healing process in a larger context helped us connect to other people, and to archetypal and mythic realms containing universal themes of transformation. Joseph Campbell’s The Hero with a Thousand Faces (1949) proved to be a very effective framework for our recovery journey. Our clients, students, and trainees reinforced this personal healing strategy, saying Campbell’s framework gave them a sense of beginning, ending, and hope during their healing process.

We also used Carl Jung’s “wounded healer” archetype (Dunne, 2000) to help make meaning of our developmental trauma experiences. This framework helped us view our painful experiences as transitory and deeply transformative, recognizing that they shaped us not only personally, but professionally.

During our over thirty years of clinical practice, we created an integrative approach for healing developmental trauma that includes the following:

• Heart-centered social and relational support to address the relational aspects of developmental trauma
• Skilled bodywork therapies and trauma-specific tools to address the somatic aspects of developmental trauma
• Targeted biochemical support to repair the brain and CNS

Let us look at each of these three components.

Heart-Centered Healing

We identified two kinds of heart-centered social and relational support.

Heart-Centered Developmental Psychotherapy

This recognizes the client-therapist relationship as a primary resource for healing. It begins with empathic attunement and building a relationship with clients based on genuineness, compassion, and unconditional love. It helps clients identify unhealed developmental trauma, and uses developmental interventions for healing it. It asks, “What happened or didn’t happen to you growing up that may be causing problems in your life?”

We identified five therapeutic doorways for helping clients identify unhealed developmental traumas very quickly, and produces significant healing in six or fewer sessions. They are:

1. Identifying intractable, recycling conflicts in clients’ intimate relationships. We explore prenatal, birth, infancy, and early childhood history in search of their sources.
2. Identifying clients’ attachment strategies and any distorted parent-child relational dynamics that might be anchored in it. According to Mary Main’s research, about 90 percent of clients come to counseling with a disorganized attachment history (Siegel, 2015).
3. Working with clients’ chronic or acute health issues. Developmental trauma leaves a residue of unprocessed emotions in the brain, CNS, HPA axis, endocrine system, and physical structure of the body itself. These health issues often display themselves symbolically and metaphorically. Stomach issues, for example, can reflect situations that people “cannot stomach,” and back issues can relate to a lack of support.
4. Using self-awareness activities and inventories to identify clients’ patterns of relational trauma involving attachment and separation trauma.
5. Educating clients about the drama triangle. Clearing this dysfunctional relational dynamic, anchored in unhealed attachment and separation trauma, is often life-changing.

Heart-Centered Relationships

The second kind of relational support is creating heart-centered, conscious, committed relationships in which partners agree to help each other heal developmental trauma. They provide the safety and intimacy that are necessary for the deepest healing, particularly issues related to attachment and separation trauma.

These healing relationships can be created in psychotherapy or through personal agreements between committed partners, siblings, long-time friends, and in groups. The most important part of the healing process is that people commit to resolving their conflicts and not fleeing when intense emotions emerge. We discovered that highly motivated couple clients are able to create this kind of relationship in three to six sessions.

Trauma-Specific and Bodywork Therapies

The second component of our integrative approach for healing developmental trauma is skilled bodywork therapy and trauma-specific tools that address the somatic aspects of developmental trauma. These help repattern the CNS damaged by experiences of developmental trauma, particularly during the first year of life. Early trauma is stored as cellular memory throughout the body tissue, the CNS, and the brain. Shock and trauma often overwhelm the developing CNS, causing it to freeze and become blocked. This affects the natural flow of cerebral spinal fluid and physical movement, causing posttraumatic symptoms such as reexperiencing, flashbacks, avoidance, and hyperarousal.

We found two categories of bodywork therapy helpful in healing developmental trauma.

Trauma-Specific Therapies and the CNS

These are trauma-specific therapies that work directly with the CNS. We developed the trauma elimination technique (TET), which is a synthesis of a number of other trauma-specific therapies (Weinhold & Weinhold, 2011, p. 281). Other approaches include eye movement desensitization and reprocessing (EMDR; Shapiro, 2001) and other kinds of tapping therapies based on acupressure techniques like the emotional freedom technique (EFT; Craig, 2008) and the tapas acupressure technique (TAT; Fleming, 1999).

Somatic Therapies and the CNS

Experienced somatic therapists are able to listen to the body and to help release areas of stress and congestion in the CNS. They are very gentle and work at subtle levels that honor the fragile “baby nervous system” and the old brain where the earliest memories of developmental shock are stored. They typically use a very light touch to move cranial, pelvic, and spinal bones in order to regulate the flow of cerebrospinal fluid. They include craniosacral work, somatic experiencing (Levine, 1997), trauma-informed yoga, and five elements acupuncture.

Biochemical Support

The third component of our integrative approach for healing developmental trauma is targeted biochemical support for the brain, CNS, and immune system. We added this component to our integrative approach after many years of working to heal developmental trauma in ourselves and our clients. We noticed that some only progressed so far and then stalled. Even with skilled heart-centered psychotherapy, committed relationships, and somatic therapies, there was a level of healing that did not happen. Clients with the most trauma during their first year of life seemed to struggle the most with fragile nervous systems, sustaining intimacy, and autoimmune disorders. We also had clients and students who had cycles of low-grade anxiety, depression, fluctuating moods, and addictions.

Barry and I had a lightbulb moment when we connected the dots between people’s chronic symptoms and Lyons-Ruth’s description of the attachment system as a psychological version of the immune system. We began to see her description as a real mind-body experience in developing children’s undifferentiated brains and nervous systems. When mommy kisses her baby’s boo-boo, it is “all better” if she is securely attached—her touch relieves pain because it releases endorphins.

We synchronistically encountered information from one of our students about low-dose naltrexone (LDN) therapy. LDN is a compounded drug developed to administer in high doses for treating alcohol and heroin addictions. It belongs to a class of drugs known as opiate antagonists, and must be prescribed by medical personnel after a screening. It works by blocking the signal between the brain’s opioid receptors and its endorphin producing system. This temporarily causes the body’s endorphin-producing organs to triple production and stay tripled as long it is taken. The naltrexone itself is excreted in about three hours, though the endorphin levels remain elevated all the next day. The only known side effects are vivid dreams and disturbed sleep during the initial period of use.

Research indicates that naltrexone taken in very low doses (e.g., 4.5 mg or less) is also effective in treating autoimmune disorders such as fibromyalgia, chronic fatigue syndrome, MS, and lupus. Researchers believe LDN’s anti-inflammatory effect works directly on damaged glial cells in the brain and spinal cord, the CNS’s first and most active form of immune defense (Johnson, 2013). LDN also has no toxicity, minimal side effects in either short- or long-term usage, and is inexpensive (Bihari, 2013). German research findings indicate that LDN helps people with dissociation and traumatic brain injuries, conditions that are generally considered chronic and untreatable (Pape, 2017).

The most surprising impact of LDN, however, is on clients’ mental health. Within several weeks of taking it, some users report lifelong debilitating episodes of major depressive disorder completely lifting. They felt calm, relaxed, and completely free of dread and fear. Those taking it long-term report that LDN increased their ability to cope with previously stressful relationships. Over time, their moods stabilized and they were less susceptible to getting triggered under stress. Some said that none of their efforts to heal through self-care practices such as meditation, yoga, exercise, and regular psychotherapy produced the same dramatic effects that they had with LDN (White, 2017). Most notable in those who used it long-term was a radiance that emerged as trauma’s influence disappeared, and they began living from their full potential.

After some research and deliberation, Barry and I began taking LDN, and experienced feeling calmer, more focused, and able to stay present under stress. The flight from intimacy is no longer an issue in our relationship. We also noticed similar shifts in our students, colleagues, and clients when they added LDN to their healing paradigm. We are very clear, however, that the deep healing we are experiencing and seeing in those around us is the result of the synergistic interaction of an integrated, mind-body approach to healing developmental trauma.

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