• David Hampton

A Call to Empathy in Addiction Treatment


Empathy in Addiction Treatment


When I began my certification training in the field of addiction and recovery, I was told to think of substance use disorder and compulsive behaviors as something like a stool supported by four legs, the four legs being trauma, shame, anxiety, and connection or connection disorder. These four primary issues work together to perpetuate our unwanted and often shameful behaviors making relapse almost inevitable unless they are specifically addressed as part of the recovery process.

In this post we will focus primarily on trauma and empathy, but in future posts we will cover all four legs of the stool.

For many, trauma sounds like a dramatic overstatement to something in our personal history.  After all, most would say that they have never had to run through a minefield in a war zone or witnessed a car bomb being detonated.  They simply had the “usual” family drama, alcoholic parent, bullied at the bus stop kind of upbringing.  Nothing nearly as serious as trauma!

I’d like for us to consider for a moment that trauma isn’t necessarily us experiencing the kind of tragic, or dramatic events that would land us on the evening news.  It is simply any time we feel that there was no empathetic witness to our pain.  It is the times that we hurt and feel most alone in the experience.  When trauma is experienced and those alienating, isolating fears of being dismissed, diminished, or minimized in our pain occur, we begin to reinforce a message that our feelings and experiences don’t really matter – that we don’t matter.  We then begin to try to minimize the events and episodes and deny the pain we experience.  What we can’t minimize, we will medicate, and thus begins the cycle.


As our culture continues to struggle with things like substance use disorder or how to embrace the hurting people who deal with these issues, we must first learn to be an empathetic witness to someone’s pain. It can be as simple as a “me too” response that helps an addict embark on the long road back learning to trust others.

But what if we as a culture are moving away from the ability to empathize?  What if what is being modeled to society now is a way of relating that says we don’t have to listen and understand someone who might be telling a different story from our own, or demonstrate understanding instead of blame?  What if the population is shifting more to a faultfinding community where blame shifting and standoffs are the norm rather than the exception?  How do these cultural shifts impact recovering people and our ability to engage them?

I believe those of us in recovery communities can lead out in the swim against the tide of careless labeling or the tendency to disregard the why behind the what.  In this era of untimely death upon untimely death due to substances we need empathy! We must emphasize that this disease is not a moral issue, a “sin” issue, or a lack of intelligence issue.  It is a pain issue.  If we as a culture can learn to ask our fellow suffering friends, “Why the pain?” instead of, “Why the behavior?” we will model something beautiful for an entire society that might otherwise interpret caring, empathy, and nurture as weakness and impassioned discourse as a waste of time and energy.

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