Dr. Johanna O’Flaherty: The Correlation Between Trauma and Addiction

The voices come from all directions, often harsh. Mean. Misguided. Damaging. Suck it up, buttercup. Big boys don’t cry. Are you still hung up on that?

One of the world’s preeminent voices in trauma therapy is fighting back against that messaging.

“Why don’t we just leave it alone and get on with it?” asks Dr. Johanna O’Flaherty. “Well, because trauma doesn’t leave us alone.”

Relentless, often hidden, trauma tortures people who then pretend they aren’t affected by it. They seek out activities or substances, mind-numbing, incident-forgetting behaviours, people, places, or things, all with a goal of getting over it. But, when they come down, the memories are there. When they sleep, the incidents make them scream or lash out. They still smell the smells, hear the sounds, and reactivate the terror. And that’s when O’Flaherty and experts like her are called in by mothers and fathers, by employers and colleagues.

When Pan Am flight 103 blew up over Lockerbie, Scotland in 1988, O’Flaherty was brought in to help debrief families and friends. She was called in again after 9/11. In 2017, after the Las Vegas shooting. And more recently, in Boulder, Colorado when, just last March, 10 people were senselessly murdered in a supermarket. In all these settings, O’Flaherty brought her strength, hope and expertise to families, first responders, and coroners—last responders—dealing with the trauma.

Dr. O’Flaherty and Aurora Recovery Centre

This month, she is working with Aurora Recovery Centre in Manitoba, training dozens of members of the staff over ZOOM on the correlation of trauma and recovery. It is a topic and concept much discussed in research papers and science labs around a world tired of the aftereffects of wars, overdoses, and pandemics.

“It is very futuristic of Aurora’s leadership to understand the need for their treatment centre and their staff to be trauma informed,” said O’Flaherty, who has trained clinicians in treatment centres across Canada and the United States in the past.

“[Aurora President and COO] Steve Low asked who do you think should be involved? I said everybody,” says O’Flaherty. “From the driver who picks the patient up at the airport to kitchen staff to everybody that is going to interact with the patient.”

She explained how, typically, treatment centre executives tend to invite only their clinicians to trauma training, but Low was open immediately to the notion of bringing in all who could make it for the four sessions. In Aurora’s case, that meant its own staff, but also representatives from the airlines, police services and other first responders.

The correlation between addiction and trauma is obvious to anyone in the field of addiction medicine. Why is it some folks grab onto the reins of recovery and stabilize, while others stumble and scrape themselves on the sharp edges, and even succumb to it?

“We need to begin to integrate [treatment of] sabotaging behaviour. Whatever that is,” O’Flaherty is quick to point out, when questioned about the validity of trauma being such a main factor in relapse prevention.

Trauma and Responses

“As far as I am concerned, I think 95 per cent of the population that is entering any treatment have experienced trauma. Whether it is childhood trauma, self-inflicted trauma through the use and abuse of drugs or alcohol, incident trauma, or veterans suffering from PTSD. What do we do to ourselves when we are out there in blackouts, or even greyouts. We put ourselves in dangerous situations,” she says.

There are many types of trauma and responses to it. For instance, childhood trauma can include anything from neglect, where a child does not receive the nurturing needed in their formative years, to lack of medical care, to being left alone or in the hands of incapable adults. It can grow in severity to emotional, physical, sexual, and psychological abuse.

First responders – police, military, medical professionals, paramedics, airline employees – are all high on the  list of those who have a front row seat to trauma. They exhibit symptoms, ask, or get told to get help, and show up at treatment centres looking for answers.

No matter the child or the veteran, the nurse or the constable, their responses to trauma are varied and can produce physical and emotional symptoms and unhealthy coping strategies that can last a lifetime.

There is acute trauma resulting from a single stressful or dangerous event. Chronic trauma results from repeated, prolonged exposure to stressful situations or events. Complex trauma comes from exposure to multiple traumatic events.

Again, no two humans react the same way, be it bullying in school, a firefight in Afghanistan or a terrorist attack in New York. But, when it comes to substance use issues and trauma, O’Flaherty has written the book on it.

In her 2014 book The Correlation Between Trauma and Addiction, and in her ZOOM training with Aurora, O’Flaherty uses various scientific studies and research plus her own decades in the field to show how there is a clear relationship between trauma and addiction.

Trauma and Hope

She has some powerful messages of hope to share, too.

“For people that have experienced trauma, this is not a life sentence,” O’Flaherty says in her comforting, kind voice. “The purpose of my work is liberation. Empowering liberation. I am very passionate about it and, unfortunately, in my early days, and I am sober 43 years, they didn’t have any of this. They would say, ‘Well, put it on the shelf. Put it on the shelf.’”

“The whole purpose, and my passion for working, for having trauma-informed therapists in the world, not just for substance abuse programs, is for the individuals to be able to identify the trauma and be able to integrate and begin a healing process. It doesn’t happen overnight, but it begins a healing process.”

O’Flaherty’s credentials are beyond reproach. Behind her name are the letters PhD, LADAC, CEAP, signaling just some of her expertise in clinical psychiatry, critical incidents crisis debriefing, substance use counseling, and employee assistance programs. She was a vice president of treatment services at the Betty Ford Center for six years. She was clinical director at Sierra Tucson, the CEO of the Las Vegas Recovery Center. She has worked with the FBI on Critical Incident Response training.

Trained in Depth Psychology, commonly referred to as the psychology of the soul, she sees the role of a counselor in helping people through their trauma story as almost “shamanic.”

“I love working with others. When the individual that has been so wounded and full of shame is willing to share their most innermost fears with a counselor, when I am in that place, it is a sacrosanct space. I have to be in a place where I’m going to honour that.”

The importance of an individual doing their own trauma work cannot be underestimated, says O’Flaherty.

“If they don’t tell their story, they push it down. Trauma is stored on a cellular level,” she says, referencing ideas put forward by Bessel Van Der Kolk, considered one of the world’s top experts in the field.

“So, they push down the trauma, then they get sober. They are sober a month or two or three and they see something that triggers them, and they are flooded with trauma memories. And we, in treatment centres, if we haven’t taught them just the basic elements on how to emotionally regulate, breathing, giving them different tips on how to emotionally regulate, we haven’t done them a service.”

As the great Indian social scientist Akshay Dubey once said, “Healing doesn’t mean the damage never existed, healing means the damage no longer controls our lives.”

Aurora and its partners in the professional field outside of Gimli, Manitoba, are doing their part to provide that service, to empower, liberate and facilitate healing among those who most need it.

By Jeff Vircoe

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