A qualitative analysis of trauma narratives among people in treatment for PTSD and substance use disorders

Abstract

Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) are highly comorbid yet PTSD treatment is seldom offered in residential SUD treatment facilities. Written Exposure Therapy (WET) was introduced as a brief PTSD intervention to a clinical sample of participants with comorbid PTSD-SUD. As part of this treatment, patients wrote accounts about the traumatic events that they experienced and the impact of the trauma on their lives. This master's thesis presents a qualitative analysis of trauma narratives among individuals (N = 38) undergoing treatment for PTSD and SUD. There is limited qualitative data on traumatic experiences and reactions of people with comorbid PTSD-SUD. Through thematic analysis, the researcher investigated the intricate connections between trauma, emotional expression, physiological expression, and substance use, aiming to gain insights into the unique challenges and coping mechanisms of this sample. Participants' accounts explore the significant impact of trauma on emotional well-being, relationships, and perspective shift, providing potential implications for trauma-informed interventions in dual-diagnosis treatment settings. The findings shed light on the complex interplay between traumatic experiences, PTSD symptomatology, and patterns of substance use. Four themes emerged from Session 1 accounts: (1) My Heart Dropped, (2) The Pain was Unbearable, (3) All My Fault, and (4) I Started Using. Two themes emerged from Session 5 accounts: (1) My Life has Been Changed and (2) The Future Holds Promise. This study further contributes to the existing literature on trauma and substance use, providing a deeper understanding of the subjective experiences of individuals in residential SUD care with co-occurring PTSD.