Typically, the sessions are 60 to 120 minutes, approximately once a week for 4 to 10 weeks. For example, she reexperienced her sexual abuse through frequent nightmares and intrusive, distressing thoughts and images of the event whenever she encountered men who physically resembled alcoholism and anger her father or when she was in closed spaces, such as closets or basements. Emotionally, she alternated between feeling apathetic, numb, and alienated from others and feeling “on edge,” hypervigilant, and anxious.
How Can Anger After a Trauma Become a Problem?
Many survivors who disclose their assault to others experience secondary victimization. Secondary trauma occurs when survivors seek assistance from medical, legal or healthcare professionals, but these professionals often exhibit and use victim-blaming behaviours (42). Contact with many services especially those which do not specialize in sexual assault traumatization, can increase survivors’ psychological and physical distress (43). Many hormones and receptors in the glutamatergic, serotonergic, and adrenergic systems have been identified as key factors in memory and perception, one of which is the gamma-aminobutyric acid receptor (GABA-R) (11). Following sexual abuse and the development of PTSD, the dysregulation of the HPA axis can stimulate the adrenergic system, activating GABA-R (15). The multifaceted interactions between these systems may explain the connections of emotions with factual memory.
Prolonged exposure
- A reduced responsiveness to CRH is observed and the negative feedback by cortisol on the hypothalamus and pituitary is disturbed.
- Three studies evaluated the Food and Drug Administration (FDA)-approved medication naltrexone; one of these studies also included disulfiram, which is also FDA approved for treating AUD.
- Some experts think that the eye movements themselves help with desensitization, but EMDR probably works mainly because of the exposure, not the eye movements.
- PTSD often is not diagnosed because it causes such varied and complex symptoms.
- The Simpson et al. (2017) article extends prior reviews of behavioral treatments for AUD/PTSD by considering whether comparison treatment conditions are matched to the experimental treatment condition on time and attention, and by reporting on alcohol and drug use outcomes separately when possible.
The findings were explained by emphasizing that concern for the future involves greater prefrontal cortex resources that help inhibit the excessive impact of alcohol. Research has shown that thought suppression may contribute to alcohol-related aggression. One study supporting this finding enlisted 245 men with a history of heavy episodic alcohol use (Berke et al., 2020). They completed surveys assessing their endorsement of traditional masculine norms, use of thought suppression, and both trait and alcohol-related aggression. It was found that thought suppression mediated the association between the toughness masculine norm and alcohol-related aggression.
Is There a Relationship Between Complex Trauma and Alcohol Use Disorder?
Human studies have also shown that traumatic events can increase endorphin activity. For example, patients with PTSD will experience numbness or analgesia when simply exposed to reminders of the trauma (Pitman et al. 1990). We know the analgesia is attributable to a release of endorphins because drugs that block endorphins (opioid blockers) also block the analgesia in PTSD patients. In one study, Vietnam veterans with PTSD were shown a videotape of combat and asked to rate the pain intensity of a hot stimulus. After viewing the videotape the hot stimulus was less painful (i.e., the trauma reminder produced analgesia). However, when the opioid receptors were blocked with naloxone, an injectable opioid receptor blocker, there was no analgesia (van der Kolk et al. 1989).
Biology of the Stress Response
- Up to three quarters of people who survived abuse or violent traumatic events report drinking problems.
- Werner and colleagues (2016) utilized a large dataset of almost 4,000 women to examine comparative differences in alcohol use patterns, AUD prevalence, and the relationship between trauma and AUD among European American (EA) and African American (AA) women.
- It also is possible that victims of childhood abuse feel that their experiences make them “different” from other children and lead them to withdraw from healthier social circles toward fringe groups, where alcohol use is more accepted.
- A high percentage (42.9 percent) of the study participants had PTSD, although data analysis for specific disorders was not conducted.
The behavioral and physiological similarities between learned helplessness in animals and patients with PTSD suggest that learned helplessness is a good model to understand PTSD (see Foa et al. 1992 for a review). Anger management and alcohol treatment programs must recognize and educate participants about the relationships between alcohol and anger. It’s equally important that psychotherapists highlight this interaction both with clients who consume alcohol and those in relationships with them.