Addiction is often understood as a behavioral response to a craving. But beneath the urge to use, something else is happening: A person is trying to change how they feel.
Trauma can fundamentally alter our sense of safety in the world. When we don’t feel safe, the nervous system activates its innate defenses, which can leave us feeling anxious and hypervigilant, or emotionally numb and shut down. Over time, the nervous system adapts to this defensive state until dysregulation becomes the new “normal.”
These uncomfortable internal states are one reason trauma can increase vulnerability to substance use and addiction. In the absence of other coping strategies, substances can provide a powerful and immediate way to relieve the discomfort and change how a person feels. They can calm anxious feelings, numb emotional pain, generate energy, or offer temporary relief from stress and overwhelm. In this way, substance use can be a means of regulating a nervous system that is struggling to regulate itself.
The problem is that the relief is temporary, and comes at a cost. Many people who struggle with addiction face significant challenges at home, at work, and in their relationships. As stress accumulates, and the nervous system remains in a defensive state, the symptoms of dysregulation intensify, showing up as sleep problems, digestive issues, or chronic pain. These symptoms can add more stress to a person’s life, which further increases the desire for relief. When substance use becomes a primary way of relieving that discomfort, a perpetual cycle ensues.
Real physician voices, twice a week
Free, and one click to unsubscribe.
That cycle also helps explain why the moments leading up to a relapse deserve attention. There may be a trigger, followed by escalating stress, difficult emotions, physical sensations, and an increasingly urgent desire for relief. When a person can recognize those signals earlier, there is an opportunity to interrupt the cycle.
Learning to self-regulate can create space between the symptoms of dysregulation and substance use, where a person can choose a different response. At the HeartMath Institute, we use emotional regulation techniques and heart rate variability (HRV) coherence biofeedback as complementary tools that can support addiction recovery by helping people change how they feel. HRV reflects changes in the time intervals between heartbeats and provides information about the state of the nervous system. With coherence training, people can practice shifting their state toward greater emotional and physiological regulation while developing skills for managing stress and difficult emotions.
When people support their recovery with these tools, they not only feel better, but they find that the skills they learned in a 12-step program become more accessible and easier to implement. Learning to regulate themselves from the inside can reduce their reliance on outside substances for relief.
The brain and nervous system are adaptable, and “nerves that fire together, wire together.” The more we repeat an action or behavior, particularly one that makes us feel good, the stronger that neural pathway becomes.
People who struggle with addiction often have well-worn pathways that reinforce behaviors that help them feel better. Each time they break the cycle of using a substance to feel better, they are building a new path. While change isn’t easy, tools that provide relief during moments of craving, upset, or distress can help reinforce healthier responses.
Over time, repeated practice can build greater capacity to experience stress, tolerate difficult emotions, and manage cravings without reaching for a substance. As the nervous system becomes more regulated through practicing coherence and maintaining abstinence, responding differently can become easier.
This perspective also matters after a relapse. Recovery doesn’t happen in a straight line. When we’re under stress, the brain naturally falls back on pathways that are familiar, especially those that have provided relief in the past. That doesn’t mean a person is back where they started.
Instead of responding to a relapse with shame, we can approach it with curiosity. What was happening beforehand? Was the person overwhelmed, lonely, exhausted, or triggered? What was the nervous system trying to manage in that moment? Those questions can help reveal what support might be needed the next time a similar situation arises.
Every time a person recognizes a trigger, practices regulating themselves, reaches out for support, or makes a different choice, they are strengthening a new pathway. When recovery includes regulating one’s emotional state and physiology, people develop a greater capacity to respond differently when difficult moments arise.
Over time, this capacity can extend beyond managing cravings. People can begin to rebuild their lives with more emotional balance, more stability, and a greater capacity for managing life’s challenges.
That is what resilience can look like in recovery: having more ways to meet a difficult moment, more ability to regulate the nervous system, and more freedom to choose what happens next.
Jorina Elbers is a neurologist.
