Integral treatment of female alcoholism and sexual trauma

This is an in-depth integral exploration of the addiction healing journey of Dana (name and personal details changed), a 35 year old female entrepreneur, interior designer and high functioning, long term alcoholic. Integrated Recovery Therapy (IRT) invites methodological pluralism to meet complex and co-arising issues and trauma.

For Dana, recognising her early unconscious childhood sexual abuse during the treatment programme was a key milestone during the 12 weeks, albeit a painful discovery. Multiple modalities were applied in an integral framework in a way that offered synergistic value and profound transformation. These included: talking therapy, inner child work, somatic and visceral healing and integration, womb alchemy and embodiment of her feminine energy, and energy medicine to reintegrate her field where parts of her consciousness had become fragmented. Click here to watch my video on soul fragmentation.

In this post I discuss how 1) Addiction as an experience involves an altered state of consciousness and why this is important to acknowledge and work with 2) Integral enactment theory and how the treatment and energetic space often evokes the enacting of wounds particularly the soul wound of shame 3) Existentialism as more than a philosophical discussion but an energetic reality through the healing and re-embodiment of the divine feminine and the womb

My unique approach to trauma healing is somatically grounded, psycho-spiritual soul based that harnesses energy medicine and is trauma informed.

Women are now drinking more heavily than ever before

Over the past two decades alcohol related deaths in women have soared by 85% compared to 35% in men (White et al 2020). This has led to outspoken public concern:

‘Alcohol is not a benign substance and there are many ways it can contribute to mortality.’ NIAAA Director Dr. George F. Koob.

Contrary to what you might think, the research shows that it's actually educated and professional women who are more likely to drink heavily and also who are less likely to seek treatment for alcohol addiction.

Perhaps drinking wine most nights has become a normalised and sophisticated coping mechanism to deal with the increasing demands of work life balancing, family and care giving and emotional stress and relationships. The truth is, women are drinking more than ever before and that's because they are under more pressure now, than ever before.

The fact is, women still shoulder the major burden of care within the family system (Power, 2020) especially where there are either elderly / sick dependents or young infants. Resistance to treatment and healing might also be a way of protecting the family's cohesiveness- especially as most alcohol addiction treatment programmes require residential stays which separates a woman from her family and her responsibilities.

Do women have a neurobiological susceptibility to alcoholism?

Some studies of addiction have found that actually, the female brain behaves differently especially with regards to the cells of the hippocampus, amygdala and neocortex. This is known as neurobiological dimorphism (Cahill, 2006). It leads to a more rapid drop in dopamine, the neurotransmitter related to reward and pleasure that is flooded through the brain during orgasm.

I mention that specifically because in this article we are following the journey of Dana, who struggled with sexual intimacy and to experience an orgasm and at the same time, had found herself drinking most nights to relax.

Dopamine affects the limbic system - the brain's emotional processing centre and also the endocrine system which of course amongst other things affects and regulates the menstrual cycle. The limbic system is affected when there is sustained trauma, chronic stress and PTSD.

Fluctuations in dopamine have cascading effects on hormonal fluctuations particularly during a woman's menstrual cycle, a sacred time of womb connection and emotional and spiritual purification and rebirth. This can further impact emotional self regulation and the nervous system. Women holding sexual trauma often report disruptions to their endocrine system and menstrual flow. Read more about why trauma is the root cause of hormonal imbalances here.

So in women, some research shows that dopamine levels fall faster than in men. This creates an urge, a need for pleasure and can affect the severity of addictive behaviour and withdrawal symptoms. (Anglin et al 1987). As you will notice, in Dana's case, hormonal rebalancing through the nervous system and limbic functioning, womb healing and releasing the root cause of trauma which was unconscious childhood sexual abuse, was all required in order to reinstate her menstrual cycles and support her recovery from alcoholism.

What does sexual trauma have to do with how women drink?

The facts are clear. Female alcoholics are more likely to have experienced both physical and sexual abuse (Ouimette et al 2008). There is also a hidden aspect of abuse which is unconscious and therefore goes unreported, which means the figures are likely to be far higher.

By the time women do agree to enter treatment they are usually in severe psychological stress and have other substance addictions or eating disorders and other layers of trauma. Sexual abuse can create PTSD symptoms including lower vagal tone, an imbalanced neuroendocrine system, structural imbalances in the pelvis and base of the spine and dissociative tendencies which if left untreated can result in chronic health conditions - often autoimmune conditions.

COVID-19 has triggered women into drinking more to cope with stress

COVID-19 has been a catalyst for heavier drinking. Not only are women more psychologically and emotionally vulnerable during pandemics (Brooks et al 2020, Taylor, 2019) but they are also more likely to drink to manage stress (Becker et al 2016, Peltier et al 2019).

With the increased isolation, work-life pressures and lack of social and emotional support, the burden of care within the family is increasing disproportionately for women (Power, 2020). During this pandemic, research shows that alcohol is actually fuelling conflict in families

(Kuntsche et al 2021) and there has been a rise in both addiction and relapse rate since the pandemic started (Dubey et al 2020).

Why are women so resistant to treatment?

Of course there are individual factors involved but generally women are less likely to seek treatment for alcoholism than men (Schmidt et al 1995) and are more likely to report stigma as a barrier to entry- especially if they are married (Stringer et al 2015). This suggests there are many dynamics at play, pertaining to sense of self, identity, role and responsibility etc.

Whilst child care support has helped women access and stay in treatment (Brady et al, 2005) figures show that most women who go into recovery programmes are a very different demographic: they are poorer, younger, less educated with multiple substance addictions and often in severe psychological distress (McCrady 2020).

If alcohol is a coping mechanism and refuge for women, why do treatment approaches and research figures still reflect a patriarchal paradigm? Given women’s dual roles as both caregiver and professional, do treatment programmes need to support the broader context, cultural, social and ancestral, in which alcoholism exists?


Case history: Let's get to know Dana

Dana was a 35 year old American female who ran a successful design consulting firm in LA. Her parents of Lebanese origin were forced to flee Lebanon during the civil war. Dana’s relationship with her parents was difficult; she felt that they were critical of her and unsupportive. Her father was an alcoholic and was abusive physically and emotionally towards her mother. She rarely spoke to them now, but in some ways longed for a closer relationship.

A year before arriving in therapy Dana’s marriage ended after she experienced a miscarriage. She felt lost, confused and alone and began drinking more often and then moving onto stronger drinks to numb the pain of her husband becoming more emotionally distant and avoidant.

The first time Dana ever drank was at a party when she was 16. She downed a mix of vodka and ketamine and dissociated in the bathroom for several hours. During this time she reported that she ‘couldn’t feel the pain of her body or life anymore.’ She didn't consider it a frightening experience.

Physically Dana experienced chronic fatigue, pain and migraines. Her womb felt heavy and blocked and she no longer had periods. She talked about her body with a sense of disgust and disappointment. It had always let her down. Despite of her achievements, she couldn't shake the feeling that she just wasn't good enough. Click here to read more about the inner belief systems and somatic sensations that arise in people who have suffered childhood sexual abuse.

Dana had no memory of being sexually abused. She had some suspicions that 'something may have happened' to her.

She told me of a recurring nightmare that left her feeling paralysed at night and in a cold sweat; she would see a naked baby being abused by a man's hand. Then she was shown the ring of the man's finger. It reminded her of her father's wedding ring. But she dismissed the thoughts, and proceeded to believe there was something wrong with her for having such nightmares and thoughts. When I asked Dana if she wanted to find out if something had happened to her she announced that she did, she was ready to find out. Maybe, she said, it could held her understand why she had always felt disgusted with her own body.

Quadrants assessment at the start of therapy

Below are aspects of Dana’s inner, outer, individual and collective reality. Quadrants serve as a map of the client's experience and non reducible phenomena. Rather than being static they are subject to constant evolution along lines of development from pre personal to transpersonal. As Dana’s adrenals and nervous system were re-integrated she felt her deeper emotions and the root of shame- sexual abuse. She re-integrated her inner child and reclaimed the lost innocence. Recognising her ancestral history of alcoholism and abuse she forgave her father and herself. Her stage of development progressed rapidly. She began to seek wisdom through her womb, feeling empowered and excited by this source of safe and reliable access to a higher consciousness.

Psycho spiritual somatic integration through deep energy work and visceral healing enabled a rapid mind-body-spirit integration. It brought forth the core issue of shame as a result of childhood sexual abuse. This allowed a new divine feminine identity to be realised.

Embodied self empowerment is key to elevating the stage of development and state of consciousness because it increases the frequency of embodied light, the depth of self healing and realisation and enhances spiritual intelligence and feeling of connection.

Addiction as an altered state of consciousness

Theories of addiction as an altered state of consciousness suggest that Dana’s alcoholism was a quest for a self transcendent state.

States are described as temporary occurrences of aspects of reality (Esbjörn-Hargens, 2010). According to Metzner, consciousness is a spherical field of awareness (Metzner, 1994) and addiction creates a contraction in the field leading to repetitive and restricted behaviour and views. In this paradigm, addiction is an innate drive to experience an altered state (Siegal, 1984 and Weil, 1972).

Whilst addiction is said to wreak havoc in the addict’s inner phenomenology (Du Pleiss, 2014) no taxonomy exists to map the consciousness landscape in addicts; this is inherently a vibrational one.

Methods to allow addicts to access slower alpha or theta brainwaves involved in parasympathetic rest and digest states are seen as beneficial by Du Pleiss because they address the Reward Deficiency Syndrome and Feel Good Response model (Blum, 1995), the Altered-State Fulfillment model (McPeake et al, 1991), the Natural Mind models (Weils, 1972), and the Tension Reduction and Stress-related hypothesis. However, brainwave alteration is based on the medical paradigm of consciousness as a neurological process. The truth is, trauma is also transmitted at an energetic and cellular level particularly pre neurological development (Emerson, 2002). The latest findings in quantum mechanics also demonstrate how consciousness is beyond the brain.

I see addiction as a container that facilitates a patient to feel a certain spectrum of frequency of light that is generally lower and denser rather than more narrow. This container creates safety from painful emotions but imprints density into the field and fluids and impedes the natural biorhythms of viscera.

I see addiction as a container that facilitates feeling of a more limited spectrum of frequency of light -lower and denser. This is designed to create safety from difficult emotions (denser fields) but actually restricts the client from transmuting these imprints.

Therapy is about supporting the client to safely expand beyond their container in order to integrate it into a higher frequency of consciousness. This then becomes a permanent rather than a fleeting state. Rather than a longing for self transcendence addiction is a call to soul growth.

Addiction in the context of Integral Enactment Theory

Integral Enactment Theory suggests that addiction is a phenomenon of multiple and dynamic objects and experiences that arise along a continuum of ontological complexity (Du Plessis, 2014). Etiological models that arise during therapy are co created and are influenced by methods of therapeutic intervention.

Methodological pluralism is necessary for depth treatment of alcoholism and will enact various aspects of the addiction that can actually appear to be very different in nature. In this case, a somatic approach enacted Dana’s suppressed memories of childhood sexual abuse. This in turn, creates another enactment that calls for appropriate intervention. It is usually at this point that specialists find themselves out of their depth and treading water, because their modalities do not equip them to safely support patients at holistic depth and through profound existential deconstruction.

Enactment is a constant process that is influenced by the therapist’s depth of presence and degree of existential awareness, their integrative and synergistic skill set and the capacity to create a therapeutic relationship built on trust and embodied safety. Enactment can be revelatory and expansionary or it can be marred by lack of self disclosure and withdrawal, contracting the client back in to a state of unworthiness, whereby their inherent shame for example, leads them to feel they are ‘too much’ or ‘too broken’ and that therapy cannot help them. This increases the chance of relapse.

To me, enactment as a metaphysical reality reflects the essence of the early embryological state: the embryo begins to exist in a fluidic co-created environment, constantly being shaped and constantly emerging as amniotic waters move and imprint the developing nervous system. No sense is made here, it is beyond the brain, but feelings are generated by the heart as impulses and reflexes of the nervous system continue to create the network underlying physical form. This is why an existential approach to addiction treatment is important - we are not working with behaviour but identity. Read more about in utero healing and womb work here.

Enactment as a metaphysical reality reflects the essence of the early embryological state

The specific existential approach of somatic re-embodiment combined with womb alchemy brought important phenomena into being - childhood sexual abuse as well as a re-emergence of Dana’s divine feminine. In this way, there was what Wilber call's, true 'kosmic address' through epistemological, methodological, and ontological pluralism.

Eventually, Dana began to talk of her miscarriage and the name she had wanted to call her daughter. Layla which is the Arabic word for night. She began to understand the connection between the dark night of the soul she had endured, the void of womb and the divine feminine calling within her. She understood this call was being answered as she fell pregnant, but was shattered through the miscarriage.

Healing the divine feminine was a soul balm for Dana and she began to respond to her inner call, embodying her womb, her creator and her inner Goddess. She felt empowered to create a new identity and a new life.

“Who is She? She is your power, your Feminine source. The Goddess. The Great Mystery. The web-weaver. The life force. The first time, the twentieth time you may not recognize her. Or pretend not to hear. As she fills your body with ripples of terror and delight. But when she calls you will know you’ve been called. Then it is up to you to decide if you will answer.”― Lucy H. Pearce, Burning Woman

Addiction, shame and the call of an existential soul cure

An existential-humanistic paradigm is vital to treating addiction as it supports a patient to orientate deeper into the actual purpose of their existence and into a relationship with their inherent sense of self worth. An existential paradigm supported by psycho spiritual orientation and energy healing can support addicts to touch a deeper sense of self and fill the void that often accompanies addiction (Miller, 1998). In the case of female alcoholics and Dana in particular, womb alchemy as a psycho spiritual existential practice supported a rapid healing and stage progression. It enabled Dana to access her divine feminine energy through her own body -her womb. This was a place that had previously been dissociated from due to the abuse, and held much shame for her.

In this way, the site of her disconnection rapidly became the catalyst for her re-emergent purpose.

Shame is related to ontological aspects of self - i.e being and consciousness and perception of self (Kim, 2010, Sinha, 2017). Neurologically, shame impacts the brian, the amygdala (Roth et al 2014, Michl, 2012), frontal lobe, temporal and limbic system (Michl, 2012, Roth et al 2014). Alcoholism impacts the same structures. Thus, shame as an existential soul wound is similar to addiction; it calls for a soul cure.

Shame as an existential soul wound is similar to addiction; it calls for a soul cure.