As a part of the Cherokee County DUI/Drug Court team, I attended the National Association of Drug Court Professionals Training in Washington, DC in July of 2013.  I arrived at the training with barely 3 hours of sleep after attending a family wedding in Cleveland, Georgia.  I rented a car that was way too big for me to maneuver on 3 hours sleep.  I scrubbed every inch of concrete in the entire airport parking deck, narrowly missing a metal crossbeam which I had mistaken for an alleyway and scarring my team members for life, before we reached the “overflow hotel” for the conference.  It was not traumatic; it was an adventure!  During the conference, the city government cut the water  off in the main hotel which housed events for our 4000 attendees and 4000 middle aged women(all dressed in red) celebrating 100 years of their sorority.  It was not traumatic. Each day we had to get ourselves to and from the main hotel, by boat, a thousand dollar taxi ride or a trolley with 16 changes but it cost a buck forty five.  It was not traumatic.  On the way home on the airplane, an unidentified male sitting in the tiny seats directly behind the judge and DUI Court Coordinator, threw up all over the airplane.  That was semi-traumatic!

So, when I noticed the word “Trauma” printed in 11 titles of the training sessions for the conference, I was on alert.  You see, I have been practicing Social Work in the state of Georgia since March 16, 1981. Since I have been around, we the professionals, have designated” buzz diagnoses” which define most of our clients.  These buzz words change about every decade or so, with new research on different illnesses and with new social problems.  The current “diagnosis de jour” is Post Traumatic Stress Disorder. Right or wrong, that’s the deal.

When I first came into the business of counseling, we didn’t use the word “trauma”  much.  When we did use it, we were referring to Vietnam Vets, especially POWs.  Later, the term “trauma” was stretched to include children who had been physically abused.  In the 1990s, we widened that term to include battered women.  The circle of the trauma definition has grown.  And that is fine.  So, now the big earth shattering news is that previous trauma in a patient’s life is being associated with their possibility of recovery.  Well, no shit!

There is of course, trauma associated with recovery itself.  No one stops drinking or shooting heroin because they had one incident that they think might be dysfunctional, but it’s kind of on the line.  No, people don’t make a change in their substance use unless something terrible, something traumatic happens.  Duh!  Trauma for our field is defined as feeling helpless and hopeless in a situation beyond your control.  Well, when you work in the field of substance abuse, our patients lives could easily be written as a made for TV movie.  Car wrecks, relatives who have inbred, having a bondsman on the Christmas card list are routine.  I had  a guy look me in the eye and say “Grace, do you mean that no one has ever gotten stabbed at your house on Thanksgiving before?” He was serious.

It doesn’t seem like a big stretch to surmise that a person who experienced trauma earlier in their lives might self medicate with alcohol or drugs.  Self medicating is a coping skill that may work for a while. When it stops working, then counselors enter the picture.   So, what do you do?  How do you treat this patient?  What do you do first?  1) Get them sober first, period.  Get them good and clean and sober.  After a minimum of six months of continuous sobriety, then work on the mental health issue, the trauma.  2) Some stuff needs to be left alone.   I am of the mind that some patients may have trauma that just needs to stay buried in the back yard.  3) Some of these folks will be ok, with or without our latest research on trauma and the impact on recovery.  They are genetically mutants, tougher than a John Deere Tractor and they will survive; you need to tell them that.  4) We need to encourage and challenge these folks to be as healthy as they can be.

Sometimes, I believe that we label too much stuff.  Not every move we make or don’t make has to have a diagnosis, list of symptoms, dysfunctional code.  Sometimes we get so into living the diagnosis, that we make it a lifestyle.  Now that is dysfunctional.  We need a code for that one, by golly!

So, in summary, I do not want to ignore trauma and the impact it can have on a person forever.  There is some really bad stuff that happens to people, in war, in accidents, in life.  And those people may have difficulty in the recovery process.  It’s like having another layer on a cake, more to deal with.  But, people are stronger than they think.  I see miracles almost every day; I see people who live through horrific events and manage to build healthy lives.  That’s what I’m talking about!