Reimagining Addiction as an Adaptive Response to Threat

Four key points:

1. Addiction is an adaptive response mediated by our autonomic nervous system.
2. The Felt Sense Polyvagal Model™ is a new paradigm for trauma and addiction treatment.
3. The Three Circle Practice is a practical harm reduction treatment framework.
4. Healing comes from establishing safety in the body.

Addictions as Adaptive

When people ask me what I do for a living I have grown to expect their look of veiled disgust. They try to hide their discomfort, but after forty years of being a trauma and addiction therapist not much escapes me. When they ask me why I do such a hard job I tell them that I love what I do. Then they look incredulous, like I have truly lost my mind.

That’s because they probably think of the addicted person as hopelessly sick, with an incurable brain disease. Or they see the ‘addict’ as weak and dependent, imbued with devilish qualities that make them do bad things. While the sick or bad explanations are tenacious, they are outdated and ineffectual as evidenced by soaring rates of addiction. We are in an escalating crisis.

Forty years ago, I began a journey to understand addiction in a new way. Fresh out of graduate school I was leading a group for young women who were incest survivors. I heard many stories of powerful and twisted ways to bring relief from unbearable pain. They were binging and purging food, cutting the body, using drugs and alcohol, and engaging in unsafe sex. They knew, but did not understand, how these self-harming/addictive behaviors would activate a numb or heightened state and sense of relief.

The sick and bad explanations didn’t reflect or respect these remarkable women’s horrific experiences.  Searching for a more sophisticated understanding led me to feminist therapists such as Judith Herman.( She wrote about these self-harming and addictive behaviors as ‘sudden jolts,’ to the body related to the autonomic nervous system (ANS), the part of the body that monitors our sense of safety. She explained how these jolts shift autonomic states to bring a numbing sense of relief, or activation, when there is no safety available.

The Felt Sense Polyvagal Model of Trauma and Addiction™

Years later I heard Stephen Porges present a new, phylogenetic based, Polyvagal model of the ANS. (2011) The theory teaches us that if we feel unsafe our ANS shifts states into flight/ fight to try to mobilize and act. If there is no escape the body shifts into a numbing state to ‘play dead.’  Porges called this numb state the Dorsal branch of the ANS. When numbing is prolonged, the body may see high risk behaviors to swing back to flight/fight. From a polyvagal perspective we appreciate how addictions act as ‘propellers’ that shift us back and forth from a flight/fight state to a numbing state in a valiant attempt to survive.

I realized I needed to find a body-based therapy that would help my clients find a connection back to their body’s wisdom. I found Gendlin’s work called Felt Sense/Focusing. (1978) Focusing is a way of deeply listening to the wisdom of the body by inviting clients to turn attention inwards. By inviting awareness inside, the whole sense of a situation, a Felt Sense, slowly forms. Accompanying the felt sense with compassion often invites a Felt Shift, a physical release that points us in the direction of healing. Through a polyvagal lens, the Felt Shift is seen as part of the neurophysiological shift in the ANS. The Felt Sense Polyvagal Model.™ (FSPM) harnesses these two embodied processes, the Felt Sense and the autonomic nervous system, to enable an integrative healing process.

Practice

We use a *graphic version of the model to teach clients about their ANS. They learn to identify what state they are in and to use their Focusing practice to invite the body into more safety.