Abstract
This article is about why children and adolescents with traumatic experiences are particularly at risk of becoming severely addicted. It addresses the question of why it is so difficult for them to feel safe in therapeutic relationships. It will be examined to what extent the epidemiology of addiction, trauma, and attachment disorder provides evidence as to whether there is a significant relationship among the disorders that contributes to the complicated and lengthy nature of therapy for adolescents who have become severely addicted. It will describe how the reward system, attachment system, and anxiety-stress system (limbic system) interact at the neurobiological level. As a result of the study, it is shown that the role of the reward system in understanding the development of dependence cannot be understood neurophysiologically without the role of attachment and anxiety-stress. One conclusion from this is that this relationship should be taken into account therapeutically in order to be able to expand the spectrum of therapeutic intervention options and to be able to make the therapy of severe dependence disorders in adolescence more successful. Methodologically, two levels of description are compared here: On the first level, the neurobiological research findings are presented as the connection between addiction, trauma and attachment; on the second level, the significance of the research findings for therapeutic practice is concretely described and empirically demonstrated on the basis of a case report. In conclusion, it is shown that understanding the neurobiological function of the implicit memory systems of reward, attachment, and anxiety/stress has a central importance for the further development of addiction therapy for dependent adolescents.
Highlights
Why Dependent Young People Seek and Find Little HelpAdolescents with addictive disorders still have a hard time in child and adolescent psychiatry; they don't find a place there
Melanie's example clearly shows how important it is for addiction-trauma-bonding work with structurally dissociatively disturbed and severely dependent adolescents to recognize all parts in their respective protective function
Three major conclusions emerge, which can be summarized as follows: First, it becomes clear that the relationship between addiction, trauma, and attachment should definitely be taken into account therapeutically in order to be able to expand the spectrum of therapeutic intervention possibilities and to make the therapy of severe addiction disorders in adolescence more successful
Summary
Adolescents with addictive disorders still have a hard time in child and adolescent psychiatry; they don't find a place there. These adolescents do not understand themselves and have no language for the stress and inner emptiness that they try to numb in addiction What they do not know: The neurobiological and dynamic mechanisms of addiction, trauma, and attachment disorders are similar and reinforce each other as vicious cycles. They are helpless to this "programming" of implicit memory of reward, attachment, and anxiety/stress because the experiences are inaccessible linguistically, mnestically, and cognitively. An example is used to show that the methods of addiction and trauma treatment complement each other and that attachment theory is the unifying concept
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