NEW YORK | TELEHEALTH | CO-OCCURRING DISORDERS
Addiction and compulsive behaviors often stem from difficult histories and neurobiology. This means the physical structure and pathways of the brain have adapted to manage traumatic or uncomfortable past experiences. Rather than viewing them as failures, we can understand them as profound, though eventually limiting, attempts to manage internal distress.
Whether you are struggling with a substance, a digital device, or a specific behavior, the core need is often the same: a familiar and proven way to achieve internal homeostasis that trauma has compromised.
Co-Occurring Disorders
The link between trauma and addiction is strongest when the trauma occurs in childhood, while the brain is still developing. Across pooled international studies, roughly a third of people with substance use disorder report each major form of childhood trauma, and many report more than one.
As you better understand the dynamic relationships among mental health, life experiences, genetics/epigenetics, and addiction, you become better equipped to overcome the challenges you may face.
Integrative therapy can also address any other possible co-occurring disorders such as depression, anxiety, borderline personality disorder, obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and bipolar disorder.
Trauma and post-traumatic stress disorder (PTSD) are often overlooked factors in addiction treatment, but the resolution of past trauma can play a major role in successful addiction recovery. While unresolved trauma may often lead to addiction, the good news is that effective and comprehensive treatment is available.
Treating Trauma and Addiction Disorders
The first step in treating trauma in the context of addiction is to identify it. We can look for signs of trauma responses or PTSD during your initial assessment phase.
If a trauma response or PTSD is identified, I will work closely with you to develop an individualized plan to integrate trauma and addiction treatment that will address your specific needs and goals.
The integrative approach to trauma and addiction recovery means treating the whole person. It entails not just working on the physical symptoms, but also the mental, behavioral, and social impacts, with the understanding that they are all interconnected. This approach empowers you to heal and improve all of these aspects of your life.
Clinical Approaches for Addiction Recovery
The path forward is rarely a straight line. Treatment adapts to what is most pressing rather than following a fixed sequence. Physical and mental steadiness comes first, with attention to the immediate urges and patterns that disrupt daily life; once that footing is in place, the deeper work of reprocessing the history behind them can proceed safely.
That is one of the first questions the assessment answers. The initial sessions look at your current use, your health and safety, and what you want from the work. From that, the appropriate level of care and the treatment alternatives are determined, from outpatient psychotherapy to medical supervision for withdrawal or a residential program, based on both your situation and your goals. The plan is built from there.
They are treated as one picture rather than in sequence. EMDR protocols adapted for urges and cravings, Internal Family Systems, and somatic methods address both, and the pacing shifts with whatever is most pressing in a given week.
Many people keep a program, a sponsor, or an outpatient group in place during this therapy, and coordination with other providers is arranged with your written consent. Individual sessions add what those settings leave to one-to-one care: resolving the trauma underneath the pattern.
A pattern that has become hard to stop is reason enough to begin, whether it involves a substance, a behavior, or a device. The assessment in the first sessions clarifies what is being treated and how.
Carole Shepherd, at every session, from assessment through the trauma processing. She has practiced for nearly 30 years, consults to other trauma therapists on exactly this kind of co-occurring work, and does not delegate any part of your care to an associate.
Arrange a brief welcome call to discuss your needs and next steps.
Copyright © 2026 Carole Shepherd, LCSW-R, LMT, RYT, SEP - All Rights Reserved.
INTEGRATIVE PSYCHOTHERAPIST
TRAUMA & ADDICTION THERAPY
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Photography and artwork: Joseph A. Rosen (aerial and black-and-white images); Jerome Harris (botanical images).
NEW YORK | TELEHEALTH | CLINICAL CONSULTATION