If you’re close to someone who is addicted to alcohol or other substances, then you know how chaotic and stormy it can be. For instance, if you’re living with someone and he or she comes home drunk, there might be violence, arguments, stealing, risky driving, injury, or even death.
Finding safety should always be the first priority. Perhaps that means you lock your bedroom door after 9pm or call the police if you’re housemate or friend comes home late. In drug treatment, the primary priority for a new recovering addict is safety. According to Lisa M. Najavits, author of Seeking Safety: A Treatment Manual for PTSD and Substance Abuse, safety “signifies various elements: discontinuing substance abuse, reducing suicidality, minimizing exposure to HIV risk, letting go of dangerous relationships (such as domestic violence and drug-using friends), gaining control over extreme symptoms (such as symptoms), and stopping self harm behaviors (such as cutting)”. In other words, safety touches upon a wide variety of life areas. Essentially a focus on safety alone can help an addict find some stability.
For this reason, residential treatment centers for drug addiction provide a safe place to heal. In order to facilitate healing, a residential treatment center needs to provide a safe place, and they do that by ensuring structure and stability. In order to create that structure and stability, certain rules are necessary. Although rules may vary from one drug treatment center to another, there are some basic ones that are common to almost all residential treatment centers. They are:
- Remain clean and sober during your stay.
- Submit to periodic drug tests.
- No romantic involvement.
- Follow community etiquettes, such as remaining quiet in the morning and late evening.
- Follow rules regarding having visitors – for some drug rehab centers this might be not having visitors at all.
Suffering From PTSD
In much the same way, if you’re living with someone or close to someone who has an addiction, you might want to establish your own set of rules and boundaries, if not only for your friend’s safety, but at least for yours. In fact, Najavits points out that just as violations of safety are life-destroying (such as abusing drugs and alcohol) so the means of establishing safety are life-enhancing. Najavits also acknowledges that a large percentage of addicts are also those who suffer from Post Traumatic Stress Disorder (PTSD).
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), Post-Traumatic Stress Disorder (PTSD) is a mental illness experienced by someone who has experienced a traumatic event, and who is experiencing symptoms of anxiety as a result. The DSM outlines symptoms that include flashbacks, bad dreams, and frightening thoughts. An individual might also exhibit symptoms of avoidance, such as staying away from certain places to avoid reliving the traumatic experience or forgetting the experience entirely. Symptoms of PTSD usually continue until a safe, therapeutic investigation of the traumatic event takes place and the individual is able to process and integrate the intense feelings associated with the trauma.
Because there is such a close connection to substance abuse and PTSD, Najavits mentions the author Judith Herman in her book. Herman is a clinical psychology professor at Harvard University and wrote one of the most meaningful books on Post Traumatic Stress Disorder (PTSD), Trauma and Recovery. Najavits points out that Herman’s focus for PTSD treatment is safety, and the same should be true for substance abuse treatment. In fact, the three stages of PTSD treatment, which also apply to substance abuse treatment, are:
Healing From Substances
Finding safety is an essential part to the entire process of healing from substances. Not only is it important to find safety at the beginning, even before a friend or relative has begun substance abuse treatment, but safety should be a primary focus through drug treatment and drug treatment aftercare.
If you have a friend who is suffering from an addiction, you can help him or her by creating boundaries and safety guidelines for the both of you.