What is Trauma

Anyone born after 1993 can remember where they were on September 11th, 2001. While the effects of this event were felt stronger by some than others, it still resonates with almost all Americans today. This is a traumatic event felt across the nation. 

For those of us not directly impacted by the events of 9/11, while the memory still rings clear, we have learned to adapt and cope, clearly because over 800 flights arrive in JFK each day. While an event like 9/11 resonates with all of us, personal traumatic events can take a much greater toll on our physical, emotional, and mental health. For instance, if you’ve ever been in a car accident, chances are you’ve experienced some form of trauma. Whatever the conditions were on that day, you may be hesitant to drive during those times; for instance, if you were in an accident at night, you now might only drive during the day. 

Trauma is the response to a deeply distressing or disturbing event that overwhelms an individual’s ability to cope, causes feelings of helplessness, diminishes their sense of self and their ability to feel the full range of emotions and experiences. 

Evolutionary, trauma was suppose to help us survive. Here’s an example: let’s pretend you are alive 15,000 year ago when humans were a part of the food chain. If for instance you walked past a bush and were suddenly attacked by a lion, your fight or flight responses would kick in – pumping your body with stress response hormones like adrenaline to help you think fast and move quicker. Chances are you’d instinctively choose the flight response and escape the dangers of the lion. Now, next time you are next to a bush, you think about that lion experience and chances are, bushes aren’t going to be a part of your daily walking trail. For this reason, this traumatic event has helped you survive and stay away from the ghost and the darkness. 

Effects of Trauma Today

Now fast forward a couple years, we still experience traumatic events, but why? We aren’t being constantly hunted by lions anymore. Unfortunately the world is still filled with another kind of darkness, but this time, adapting to these traumatic experiences (like avoiding the bush) won’t help us but will veritably hinder our life’s experiences, sometimes indefinitely.

Take for example Jamie who was bullied through a social media platform like Facebook. Jamie might quit Facebook altogether to avoid this unwanted attack. While this seems like a fix, it is only temporary. No matter your stance on Facebook, not being a part of a large social media platform can create a sense of F.O.M.O and eventually social disconnect – especially at a young age. 

The same hormonal responses you feel when you see a lion in a bush will be the same responses Jamie feels every time she turns on her computer. Every assignment she must submit online, every social gathering, every time she tries to sleep – she’s reminded of what the bully said. 

Over the course of the day, the stress hormone response that was intended to help us avoid lions is now being used over and over. One of these hormones is cortisol. Cortisol is the chemical hormone used in our fight-or-flight response system. Cortisol uses inflammation to help regulate our brain to control our mood, motivation, and fear. When used normally, cortisol helps us get into the zone and overcome stressful situations. When these cylinders are firing all day, it causes in increased inflammation in the brain causing depression, anxiety, and a variety of other disorders. 

What Trauma Looks Like in America

According to SAMHSA, “In the United States, 61 percent of men and 51 percent of women report exposure to at least one lifetime traumatic event, and 90 percent of clients in public behavioral health care settings have experienced trauma.”

The effects of traumatic experiences can differ from person to person. For instance, in a car accident, the person driving might have a much greater fear of driving while the person in the passenger seat may now fear riding.

Additionally, people with minor traumatic experiences early in life may be better at coping with bigger experiences later in life. A common example of this is the death of a parent. Often times this is a very common traumatic experience – but affects different people in different ways depending on their coping skills, the strength of their relationship, and at what point in their life this occurred. 

As you can see, dissecting trauma is a complicated process but crucial in understanding the root cause of the vast majority of substance use disorders. Below you will find out symptoms of trauma, the varying degrees of trauma, and how trauma correlates to substance use disorders, and lastly the specialized therapies used to treat the different kinds of trauma. 

Symptoms of Trauma


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Wonderful! Coalition is the best of the best! The staff are not only professional, educated, and welcoming, but extremely passionate about loving and treating people who battle the disease of addiction. What makes Coaltion stand out from the rest is their aftercare program, where you'll be supported and counseled by the same staff who worked with you while you were inpatient. A "coalition" is an alliance for combined action, but this treatment facility is more than that: it's a family.
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The opportunity to go to Coalition recovery is the best gift my mother has ever given me. From the moment I walked in the front door I felt a huge weight lift and I knew that if I put in the work my life was about to improve exponentially. Every staff member that works there has a huge heart and I felt more than comfortable sharing my inner most secrets with them and asking for help and advice. They have helped me overcome extreme anxiety and depression issues, have helped grow my feeling of self worth, they have led me in the right direction to have a fulfilling life and have made me truly excited for my future. I took advantage of every opportunity they gave me. They even have a program that will get you on track to pursue a degree! I was fearful that I would never be able to succeed in college and I am thrilled to tell them about all of my successes! Dr. Val is my personal therapist and I can not say enough nice things about how she has helped me. I truly value her opinions and how she challenges me. I do not know where I would be or how I would be doing without her. If you are truly ready to change your life and willing to do the work and stay open minded Coalition will be the place that turns your life around. Every clinitian and staff member is completely dedicated and invested in my well being and I am excited to stay in contact and be one (of their many) success stories! Thank you Coalition Recovery!
Amanda Cilento
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Coalition Recovery in Tampa is an excellent addiction treatment center. I love their admissions team & clinical staff. They use evidence-based methods and create custom individualized treatment plans to provide the best care for their clients. I have referred clients here many times and they all talk about the excellent care they received by the staff at Coalition Recovery. Great work!
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Coalition Recovery is a top notch drug & alcohol rehab facility! Their staff does a great job and genuinely cares for their patients. I highly recommend them to anyone struggling with substance abuse problems.
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Coalition provides amazing treatment and aftercare for those struggling with addictions. The staff and executives are top notch and focus on client care first before anything else. Their approach to addiction treatment and the Renaissance program are unlike any I’ve seen. They are not solely concerned on the client remaining substance free, but also with having a high quality of living and living life to their fullest potential.
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14:21 15 Jun 18
Top-notch treatment center! A friend of mine went to treatment here for help with his drinking problem. He tells me all the time that Coalition Recovery saved his life! It's great seeing my buddy back to his old self. Glad he found exactly what he needed at CR.
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Patrick Sneed
22:00 21 Jan 19

Types of Trauma

Acute Stress Disorder vs. Post-Traumatic Stress Disorder (PTSD)

When a person develops traumatic symptoms, but disappear away after a few weeks, it is considered acute stress disorder. Acute Stress Disorders are typically associated with minor traumatic events like the break-up or an embarrassing event at work. 

A person may be suffering from Post-Traumatic Stress Disorder (PTSD) if their symptoms last more than a month and severely affect the person’s ability to function. Contributory effects of PTSD can include depression, panic attacks, suicidal thoughts, feelings of being isolated, not being able to complete daily tasks, and drug abuse. 

Small ‘t’ vs. Large ‘T’ Traumas

We can place traumatic events into two categories – small ‘t’ and large ‘T’.

Small ‘t’ traumas are events in which one’s bodily safety or life is not threatened, but symptoms of trauma exist nonetheless. These types of events can include things like financial troubles, legal battles, work stress, moving or a new job, divorce, infidelity, or an upsetting personal conflict. 

Large ‘T’ traumas, on the other hand, are extraordinary experiences that bring about severe distress and helplessness. They can be one-time events like acts of terrorism, or prolonged stressors like war, and child abuse/neglect. Other examples of large ‘T’ traumas include:

  • Bullying
  • Community Violence
  • Complex Trauma
  • Disasters
  • Early Childhood Trauma
  • Intimate Partner Violence
  • Medical Trauma
  • Physical Abuse
  • Refugee Trauma
  • Sexual Abuse
  • Terrorism and Violence
  • Traumatic Grief

Small ‘t’ events are more likely to cause acute distress disorder, whereas large ‘T’ events will commonly cause Post-Traumatic Stress Disorder. The treatments for each will vary depending on the severity of how much the event(s) affect the person and how long after the event the person is seeking therapy. 

How Trauma influences Addiction

In 1995, the U.S. health maintenance organization Kaiser Permanente and the Center for Disease Control and Prevention performed a study known as the Adverse Childhood Experience Study or (ACE). They took over 17,000 participants and asked them a series of questions regarding their childhood background. They found a direct correlation with childhood trauma and adverse effects later in life – including addiction. 

Participants were asked about different types of childhood trauma that had been identified in earlier research literature:

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Physical neglect
  • Emotional neglect
  • Exposure to domestic violence
  • Household substance abuse
  • Household mental illness
  • Parental separation or divorce
  • Incarcerated household member

The questions used can be found published as the NPR ACE quiz.

The Adverse Childhood Experience Study (ACES) found that compared to an ACE score of zero, having 4 adverse childhood experiences was associated with a seven-fold (700%) increase in alcoholism, a doubling of risk of being diagnosed with cancer, and a four-fold increase in emphysema; an ACE score above six was associated with a 30-fold (3000%) increase in attempted suicide.

When we hear the word “trauma” we almost always think of a singular event – a car crash, family death – but what the Adverse Childhood Experience study shows is that trauma is also complex, or related to multiple experiences as shared beliefs. Sometimes psychiatrists will refer to this as complex PTSD. Many of the common examples of CPTSD are found in the ACE questionnaire like childhood neglect.

The ACE study has helped us understand more clearly why addiction surfaces in some and not others. 

Therapy Options for Trauma

We know that addiction is a supplementary effect on another underlying symptom. These underlying disorders can be chronic stress, severe anxiety disorder, or chronic depression among others. But generally, these mental health disorders are often side-effects from previous traumatic experiences. To fully treat all of these subsidiary symptoms (or causes) of addiction, we must address trauma first.

Fortunately, there is hope of recovering from traumatic events. Through talk therapy, individuals can slowly start to dissect these experiences and eventually come to terms with them. Over time, talk therapy can help individuals not only overcome their traumatic experiences but reverse many of the mental and physical damages caused by trauma. 

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Cognitive Behavioral Therapy (CBT) teaches the person to become more aware of their thoughts and beliefs about their trauma and gives them skills to help them react to emotional triggers in a healthier way. 

Exposure Therapy (also called Vivo Exposure Therapy) is a form of cognitive-behavioral therapy that helps reduce the fear associated with the emotional triggers caused by the trauma. 

Talk therapy (psychodynamic psychotherapy) is a method of verbal communication helping a person find relief from emotional pain and strengthen the adaptive ways of problem management that the individual already possesses. 

Accelerated Resolution Therapy (ART) is a form of psychotherapy with roots in existing evidence-based therapies but achieves benefits much more rapidly (usually within 1-5 sessions). 

At Coalition Recovery, we utilize each of these therapies to help people overcome their traumatic experiences and move on with their life. By healing these underlying disorders, we can effectively treat addiction for the long-term limiting relapse.

If you are looking into addiction treatment, ensure your facility is a dual-diagnosis facility, meaning they are able to treat both substance use disorders and mental health disorders like depression, anxiety. Coalition Recovery is a dual-diagnosis facility, but also specializes in trauma care in addition to mental health disorders. We believe that in order to effectively treat one you must treat the other. 


If you are experiencing any of the symptoms of trauma and are looking for help and information, the following organizations may be able to help:

National Center for Post-Traumatic Stress Disorder (NCPTSD)

The NCPTSD is part of the Department of Veterans Affairs. They work to improve the clinical care and welfare of America’s veterans. Their website is an educational resource for PTSC and the consequences of traumatic stress.

American Red Cross

Post-traumatic Stress Disorder (PTSD) Alliance

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