Aftercare course Session 16
PAWS-versus-trauma. Big-T and small-t. ACEs. EMDR, IFS, somatic work, prolonged exposure. And why the deeper work usually doesn't begin until the second half of year one.
What you'll learn
01
Big-T trauma is a single severe event — a car accident, an assault, combat. Small-t trauma is the slow, formative experiences that shape a nervous system over years — emotional neglect, growing up with parental addiction, chronic conflict at home. Roughly two-thirds of people in treatment for SUD have meaningful trauma history.
02
Trauma work, done well, requires a stable nervous system to do it inside of. Begun too early, it can destabilize and increase relapse risk. The standard guidance is six to twelve months of stabilization first, then deeper work — with one important exception: active flashbacks, dissociation, or trauma symptoms driving relapse risk need integrated care now.
03
EMDR, Internal Family Systems, somatic experiencing, prolonged exposure, CPT — many modalities, all evidence-based for different things. The therapist's job is to figure out what fits you. Your job is to find someone trained in both trauma and SUD. Word of mouth, in this field, is more reliable than online directories.
What healing looks like
There is a phrase that has become common in trauma-informed circles: the opposite of trauma is not the absence of bad things. The opposite of trauma is the presence of safe relationships, in which the nervous system can, slowly, learn that it is safe.
The trauma underneath your addiction was, in most cases, formed in relationships — or in the absence of safe ones. Childhood relationships. Adolescent relationships. Sometimes adult ones, layered on top. The injuries lived in the body because there was nowhere safe to put them.
The healing, when it happens, also happens in relationships. With a therapist who knows what they're doing. With a sponsor or coach who is steady. With a partner, eventually, who can be present for what surfaces. With the version of yourself that is now sober, and stable, and slowly, year by year, becoming someone safe to be with.
Your worksheet
Three low-pressure pieces of self-inquiry. The work of this session is to notice, not to resolve.
Session 16 · Worksheet
Ten quiet minutes. Answers save on this device as you type — no account, no upload.
Three reflection prompts for the week
For the quiz
Search 'ACE questionnaire' online — the CDC has a version. Ten questions about specific kinds of difficulty in your first eighteen years. Take it with a sponsor, coach, or therapist nearby if anything might surface. The score is a starting point for conversation, not a diagnosis.
For the nervous system
Twice a day for a week — late morning, before bed — pause for sixty seconds and check in with your body. Where is your nervous system? Anxious? Hypervigilant? Numb? Regulated? Write a single sentence each time. After seven days, look at the patterns.
For the next step
If something surfaced in the quiz or the check-ins, take one small action this month. Ask for a referral to a trauma-trained clinician. Read one book — Bessel van der Kolk's The Body Keeps the Score is the most widely recommended. Have one honest conversation with your sponsor. Or just sit with the question. The work waits.
Up next
What to do when you feel yourself slipping. The crisis card. The five-step protocol. The calm document built on a calm day for the night you cannot think.
Continue to session 17If this brought up more than it answered
CVR recovery coaches work with one client at a time. Private, one-on-one, no scripts. If you want to talk to someone, we can usually get back to you within a few hours.
If you need help right now
These lines are free, confidential, and open 24/7 — for you, for your person, or for anyone you love. You don't have to be in the worst moment to call.
Overdose or medical emergency
911
Signs of overdose: slow or stopped breathing, blue or gray lips or fingertips, gurgling, unresponsive. Call 911, give naloxone (Narcan) if you have it, and roll them onto their side. Stay on the line.
Suicide & Crisis Lifeline
988
Call or text 988 any time you — or someone you love — is in emotional crisis, thinking about suicide, or just can't carry it alone tonight.
SAMHSA National Helpline
1-800-662-HELP
Free, confidential treatment referral and information for individuals and families dealing with substance use. In English and Spanish.
Never Use Alone
1-800-484-3731
A person answers, stays on the line while someone uses, and calls for help if they stop responding. No judgment — harm reduction, not intervention.
Domestic Violence Hotline
1-800-799-7233
Substance use and abuse often overlap. If you're being hurt, threatened, or controlled — physically, emotionally, or financially — trained advocates can help you think through what's next.
Naloxone (Narcan)
Get it free
Naloxone reverses opioid overdose. It's available over the counter, and many programs mail it for free. Keep it in your house, your car, your bag — even if you don't think you need it.
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