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• 64% of most people have at least one ACE

• 12% of people have an ACE of 4 or more

• An ACE Score of 4 are seven times more likely to be

alcoholics and are 1200% more likely to attempt

suicide

• People with any ACE Score are 2-4 times more likely

to use alcohol or drugs and to begin using them at an

earlier age

• People with an ACE Score of 5 or higher are 7-10

times more likely to use illegal drugs and to report

injecting illegal drugs

• People with higher ACE scores are also more likely

to report chronic pain and misusing pain medications

• It does not matter what types of ACE’s

make up a score.

• An ACE Score of 4 that includes divorce,

physical abuse, an incarcerated family

member, and a depressed family member

has the same statistical consequence as an

ACE score of 4 that includes living with an

alcoholic, verbal abuse, emotional and

physical neglect.

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Developmental Trauma • Boundary Issues

• Self-Esteem Issues

• Difficulty owning one’s reality

• Difficulty with wants/needs

Addiction

Pia Mellody

I

m

p

ai

re

d

b

o

When the Inner Child Feels Less Than: • The Wounded Adult Criticizes and Attacks

• The Healed Adult re-parents by Affirming through self-

esteem

When the Inner Child Feels Out of Control: • The Wounded Adult Indulges the Addiction

• The Healed Adult re-parents by Setting Limits through

boundaries and moderation

When the Inner Child Feels Abandoned and Needy: • The Wounded Adult Neglects and Abandons

• The Healed Adult Nurtures by taking care of dependency

needs and wants appropriately and by setting boundaries

I am flawed and not good enough.

I need something outside of me to be

whole and okay

Obsession, cravings,

addiction, and acting

out.

Remorse and meta-

shame regarding

use

Life damaging consequences due to

use

Cycle of Addiction

and Shame

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Inner Addict: “Bring me your pain, I will give you

relief ”

Translation: “Bring me your pain and I will bring you

the illusion of relief ”

The Addictive Personality

by Craig Nakken

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Inner Addict: “I will set you free”

Translation: “I will come to own you”

The Addictive Personality

by Craig Nakken

“

”

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New Roads

To Forget

To Numb

To Obliterate

To Avoid

To Get Back

at Others

Anger

Lonely

Tired

Overwhelmed

Sad

Triggers Effects

New Roads

To Forget

To Numb

To Obliterate

To Avoid

To Get Back

at Others

Anger

Lonely

Tired

Overwhelmed

Sad

Triggers Effects

How Many Social Workers does it take to

change a lightbulb?

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One.

But the lightbulb has to WANT to

change.

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(Even if you are an addict who isn’t sober yet)

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Autobiography in 5 Short Chapters By Portia Nelson

Chapter 1.

I walk down the street. There is a deep hole in the sidewalk. I fall in. I am lost…I am helpless. It isn’t

my fault. It takes forever to find my way out.

Chapter 2.

I walk down the same street. There is a deep hole in the side walk. I pretend I don’t see it. I fall in

again. I cannot believe I am in the same place. But it isn’t my fault. It still takes a long time to get

out.

Chapter 3.

I walk down the same street. There is a deep hole in the sidewalk. I see it is there. I still fall in…it is

habit. But, my eyes are open. I know where I am. It is my fault and I get out immediately.

Chapter 4.

I walk down the same street. There is a deep hole in the sidewalk. I walk around it.

Chapter 5.

I walk down another street.

Cycle of Relapse Last Use

Return to

Active Use

Early Days of Sobriety

Dealing with recent consequences

Starting to Feel Better

Motivation High

Real life sets in

Struggle to cope

Deny or lack awareness of recovery

needs

Pretend everything is okay

Hit an impasse

Ignore relapse warning signs

Set-up behaviors

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Connecting to the Body

All emotions have a energy in the body

Addicts in early recovery are often:

numb

disconnected from their bodies

dissociated from feelings

Awareness of the physical sensations of feeling:

assist in recognition of emotional triggers

build the capacity to tolerate emotional distress

help clients identify what type of self-soothing

skills to use

Ask “where do you feel that in your body?”

Connecting to Community People recover when they are encouraged to choose

their own path to recovery

Present a menu of options including:

Twelve Steps

Women for Sobriety

Refuge Recovery

SMART Recovery

Therapy groups

Spiritual Communities

Volunteer work with meaning/purpose

Inner World of Trauma Survivors with

Addictions:

Everything is truly my fault (but I will act like I don’t care)

I can never forgive myself

Nobody can ever understand me

Surrender is a dirty word

Powerlessness is something dangerous

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For Survivors on the the Twelve Step recovery path

Disarm anxiety related to the words:

“powerlessness”

“surrender”

“character defects”

Help client develop a vision or mission statement with meaning. Orient to the Step 12 and the idea of giving

back. It helps them develop purpose, meaning, and create order out of chaos. Future hope can repair

hopelessness caused by trauma. Start this conversation at the same time you discuss Step 1.

Amends list should include themselves