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, discovery and healing of early childhood sexual abuse during treatment was a key milestone during the 12 weeks. An integral framework allowed Dana’s addiction to be treated in its entirety by harnessing modalities that offered synergistic benefit and existential renewal: dialogical therapy, somatic and visceral integration, womb alchemy and energy medicine.


I discuss: 1) Addiction as an altered state of consciousness 2) Integral enactment theory and soul wound of shame 3) Existentialism and divine feminine re-embodiment through womb (void of creation)


I suggest an integral healing programme focused on psycho spiritual somatically integrated trauma work through an existential transpersonal lens of divine feminine womb embodiment is needed.



How do women like their drink?


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.


Research shows that educated and professional women are more likely to drink heavily and less likely to seek treatment. It seems as though drinking wine most nights has become almost normalised - perhaps it’s deemed an acceptable coping mechanism to meet the increasing demands of work and life and the frequent pressures that can arise.


Educated and professional women are more likely to drink heavily and less likely to seek treatment.

Women still shoulder the burden of care in the family system (Power, 2020) especially where there are either elderly dependents or young infants. Reluctance to enter treatment could therefore be a way of avoiding disruption to the entire family’s sense of cohesiveness.




Do women have a neurobiological susceptibility to alcoholism?


Neurobiological studies of addiction show that 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).

In women, dopamine drops faster so the urge to seek reward is activated more quickly and felt more intensely. Dopamine plays an important role in the mesolimbic pathway. This connects the nucleus accumbens to the frontal lobes and allows a sense of reward to be felt. This is why women often become addicted to alcohol faster than men (Anglin et al 1987) and experience more severe withdrawal symptoms.


Fluctuations in dopamine have cascading effects on hormonal fluctuations during a woman's menstrual cycle. This can further impact emotional self regulation and the nervous system. Whilst biological factors alone are insufficient to explain the causes of addiction, they are necessary considerations when it comes to integrative treatment. In Dana’s case, hormonal rebalancing, healing the womb, increasing vagal tone and gut-brain axis connection, recovering her regular menstrual cycles as well as releasing fear imprinted in her nervous system was required.



How does trauma present in female alcoholics?


Research shows that female alcoholics are more likely to have experienced both physical and sexual abuse (Ouimette et al 2008).


By the time they are in treatment they are usually in severe psychological stress and have other addictions and mental health conditions.


Links between early childhood abuse and alcoholism can result in PTSD type symptoms such as lower vagal tone, impeded emotional regulation and dissociative tendencies (Lotzin, 2019).


In teenage years girls are more likely to use alcohol to cope with stress than boys (Kuntsche et al 2015). In my clinical practice I have yet to work with an alcoholic or heavy drinker who did not experience considerable childhood trauma - including in utero and birth trauma.




How has the pandemic affected women's drinking behaviour?


COVID-19 has been a catalyst for heavy 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 in response to 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, alcohol use has been found to be correlated with work-family conflict (Kuntsche et al 2021) and we have seen a rapid rise in both addiction and relapse rates since the pandemic began (Dubey et al 2020).



Why are female alcoholics are less likely to seek treatment?


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: Dana's background and trauma experiences

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. She described her father as an alcoholic who was physically and verbally abusive towards her mother. She rarely spoke to them but in some ways longed for a closer relationship.


A year before arriving in therapy Dana’s marriage ended after she experienced a miscarriage. This she said, had led to heavier and more frequent drinking - whisky instead of wine. Dana’s relationship with alcohol began at 16 years old when she drank vodka and ketamine at a party and dissociated for several hours. During this altered state of consciousness she reported that she, ‘couldn’t feel the pain of her body or life anymore.’ Since then, Dana recalls drinking almost every night both socially and alone.


Physically Dana complained of feeling fatigued and disconnected with lower back pain and frequent migraines. She reported feeling blocked and heavy in her womb. Emotionally she spoke of a sense of shame and self disgust particularly with her body. Psychologically she couldn’t shake the belief that she was not good enough regardless of her education and career success.

She mentioned a recurring nightmare of a naked baby being abused by a man’s hand. The ring on the man’s finger reminded her of her father’s wedding ring. When asked if she experienced sexual abuse Dana was unable to confirm but announced that she wanted to find out if she had, maybe that would help her understand why she felt disgusted with her own body for as long as she could remember.



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.

For female addicts to access their own womb consciousness as a source of inner power is a profound, ancient and safe way to heal. At its deepest level, the womb is void, a space of destruction and rebirth that facilitates healing through new identity emergence. This is reflective of that feminine typology that integral theory mentions but does not offer details about.

Alcohol as a depressant is often considered a feminine drug because of its role in slowing down or muffling the nervous system. However, I suggest that actually alcoholism is a search for the divine masculine - the space that holds all movement because of its ever present stillness.


Dana’s attempts to quieten the inner fluctuations of her own heart and nervous system reflect her longing to experience stillness; a ground in which her body could feel safe enough to rest in, to slow down and surrender into.


Womb alchemy is a practice of grounded embodiment in the womb, a place of primordial wisdom and knowing, with many gates and layers. At its deepest, the womb is void, empty nothingness, capable of transmuting all that is full.


Dana’s journey of connecting with the womb began with healing the movement and ended in accessing the stillness, through which her emotional feelings and flux could be recognised and held, within herself. As such, reinforcing not just her inherent feminine, but her innocence in the emptiness which was taken at such a young age, and also her capacity to connect to her own divine feminine source of wisdom.

Feminine womb as a centre of void (destruction) and rebirth (creation) soon became Dana’s way to meet the shame of her existence in a more profound and healing way - she was able to recognise her own power to create guilt and heavy emotions and her own power to transmute them.



Conclusion


An integral framework allows a therapist to harness methodological pluralism. In this case, a psycho spiritual, existential lens was combined with somatic integration and energy medicine. It enacted Dana’s suppressed shame caused by sexual abuse and re-ignited a deeper sense of embodiment and feminine identity that was more aligned with Dana’s soul calling.

Women still face many barriers to entry when it comes to addiction treatment. Most integrative care requires a residential stay. Few practitioners have the necessary tools and resources to truly facilitate mind-body-spirit integration at an existential level. Educated and professional female patients rarely come to therapy for addiction but addiction is often enacted in their trauma cases. For those that do seek addiction treatment, earlier traumas are often enacted. Therapist and patient must therefore both be clear on healing goals and the nature of existential rebirth as central to recovery.


Women still face many barriers to entry when it comes to addiction treatment and few treatment programmes truly facilitate mind-body-spirit integration at an existential level.

There is a need for traditional addiction therapies and services to consider somatic trauma work and consciousness based energy medicine to provide clients with the best chance of authentic self connection, direct inner insight and progression in their stage of development and state of consciousness. For the female alcoholic, this inherently requires re-connecting to the womb as the seat of primordial wisdom, safety and nourishment.


The future of this world depends on the embodiment of the feminine, it’s cycles of destruction and creation, its flowing waters and thunderous storms and capacity to renew as the feminine womb does, each month. When we teach women to access the void of the womb, to embrace divine deconstruction, we also teach them how to create themselves again, in a higher frequency of light and embodied consciousness.


P.S. If you’re ready to dive deeper than ever before, here are 5 ways I can help you heal, grow and awaken your inner alchemist

1. Work with me privately in a transformational 6 week journey to heal the root causes of trauma and pain. Just drop me an email and put 'Private Alchemy' in the subject line, tell me what you'd like to heal.


2. Learn how to heal trauma using energy medicine in my latest course- an initiation for experienced practitioners. I will be sharing techniques that have been revealed to me through sacred alchemy work that I use in practice.


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4. Learn healing alchemy at the School of Healing Alchemy, online in depth courses that you can take in your own time 5. Join my monthly group healing sessions which are attended by people around the world