Gabor Mate’ Key Points - Trauma and the Bio Psycho Social Model of SUD
Training - January 27, 2017
Trauma defined: Limitation of one’s capacity to respond
When people feel safe:
- Ventral Vagal
- Parasympathetic activation
- Social/engagement mode
When people feel danger:
- Sympathetic activation
- Rage, panic, increased heart rate
- fight/flight
When people feel their life is threatened:
- Dorsal Vagal and elevated endorphins
- Freeze state, checked out/disassociation
- Opposing systems or neurology running at same time – hyper arousal and intense numbing
Goal of treatment: Help person to connect (re-connect) with the self.
- Help them identify what they know and solidify that
- They need to start with noticing their internal state – NOT with relating to other people (makes group work difficult)
- Ask the client - What happened to you? Why the pain?
- Therapists need to work out their own stuff so they can show up with confidence and hope to the therapeutic relationship
- The most important thing we can offer our clients is “who we are in relationship”
- Client must sense safety before they can enter into social/engagement mode (eye contact can trigger anxiety – do not push this)
- People in long-term freeze state (unable to connect with emotion: psychopathology) showed transformation after meditation training
Misc. information:
- Hippocampus not developed until age 4 or 5, so early trauma is stored in sensory centers
- 5-7% is genetics not 50-70% as NIDA states
- Trauma/stress source of most SUD, medical issues, MH issues
- All substance use is self-medicating
- 4 systems involved in addiction – endorphins (love, bonding, pain mgmt.), stimulants (elevated dopamine, reward, elation, desire, learning, survival), stress (cortisol, adrenaline, glucose), self-regulation or impulse control (generated from source of appetite, mirrors ADHD, inability to say no)
- Endorphins – molecules of emotion, pleasure, pain relief, love, drive to attach
- Oxytocin – chemical apparatus for love – protecting and nurturing life
- ACC – active with both physical and emotional pain – lots of opioid receptors
- VTA – Center for elation/desire - VTA releases dopamine into NA. Connect to forebrain where memory gets reinforced. (Dopamine tags)
- OFC – Decision making and cravings. Abnormal in drug users.