Five Ways the Body Keeps the Score: Understanding the Link Between Trauma and Addiction

For many people struggling with addiction, the path that got them there isn’t in any way linear or straightforward.

These behaviours are not fueled by boredom (although this can be a factor in relapse), or because someone needs to fill in the gaps during a stressful day, substance use (or any addiction) is often a way to cope, to numb, distract or escape something. 

It’s craving connection but avoiding it all at the same time. It’s wanting what ‘functional’, healthy people have, but not knowing how to get it.

And it’s almost always due to some form of unresolved trauma. 

The kind that is buried so deep in the mind and body, it’s impossible to make the connection between your current behaviours and whatever events befell you in your past.

The mind tries to forget, it wants to flee, fight, stay frozen, whatever helps to numb out the pain of early neglect, loss, severed attachments, financial worries, you get the point.  

However, the point is that the body doesn’t forget.

In fact, the body acts as a container for all lived experience, whether good or bad, illustrating how trauma can be stored physically and influence addiction. 

Many scientists and other incredibly smart people, like Bessel van der Kolk, believe the body keeps a precise tally of life events – the body is the memory.

And no matter how much we drink, take drugs, gamble, play video games, or whatever other behaviours spike your dopamine – the body is silently keeping a record of all major life events, creating its own storage file in case you need it for protection later on.

Five ways the body keeps the score

Modern neuroscience and trauma research, including Dr. Bessel van der Kolk’s work, show that trauma leaves a physical imprint on the body, making it more than just an experience or memory.

It’s a physiological imprint. 

An emotional scar that remains on the nervous system, and until the somatic imprint of your past is resolved, the struggle you have with addiction (or other mental health challenges) will persist.

Below are some ways the body keeps the score, along with helpful insights on why trauma healing (which includes a multifaceted approach) is vital for sustainable addiction recovery.

1. Trauma dysregulates the nervous system 

The first rule of understanding the connection between trauma and addiction is that adversity, particularly when it becomes chronic or occurs early in life, dysregulates the nervous system.

This, in turn, causes a whole range of unpleasant symptoms, such as anxiety, depression, flashbacks, avoidance, and shame, to name just a few, leading many to self-medicate as a way to’ cope’ or escape these symptoms.

When someone experiences a sudden loss, betrayal, or overwhelming stress or violence, the nervous system, which we call our ‘internal security guard’ here at our treatment centre in 

South Africa, becomes ‘stuck’ in survival mode.

So, alongside depression, anxiety, flashbacks, and shame, the individual will more than likely experience other symptoms such as:

• Feeling flat or emotionally numb.
• Sleep disturbances.
• Profound irritability or overwhelm.
• Disconnection from the self and others.

These symptoms all point to a dysregulated nervous system, which can push many people toward substances, i.e., they may turn to alcohol to relax or stimulants to feel more alive, all in the name of escapism or coping.

For many, substance use (or any other type of addiction) becomes the ‘solution’, not the problem, or as the experts put it:

‘Addiction is an unconscious attempt to regulate a highly dysregulated nervous system.’

Remember, the body keeps the score of all lived experiences, good or bad. Naturally, this can feel really pleasant or not, depending on which side the coin lands. 

When it flips on the not-so-pleasant side, which it often does in trauma, and keeps on turning that way, this is usually the point where people start seeking external resources, often in the form of substance abuse or other destructive behaviours.

2. Trauma creates emotional flashbacks

If you’ve ever experienced an emotional flashback, you’ll know how frightening they can be. One minute, all is well, and the next, you are back in time – reliving an experience that you’ve likely tried everything you can to forget.

This is a good example of how the body keeps tally of your past- it’s the vehicle, albeit a very smart one, that doesn’t let you forget.

Unlike visual flashbacks, emotional flashbacks are felt experiences, such as sudden fear, shame, or emptiness that seem to come out of nowhere.

These symptoms tend to occur without an obvious trigger.

Note the keyword here – ‘obvious’. Many people don’t realise or connect these experiences to trauma. 

Instead, many accuse themselves of being ‘too sensitive,’ ‘unable to cope, ‘ or ‘irreparably broken. ‘

Which, in turn, causes them to pick up another drink or take another line, whatever substance leads to the quickest route of feeling better, or simply feeling anything at all – instead of the economy-sized emptiness of feeling too much of nothing.

At White River Manor, we help you identify emotional flashbacks, enabling you to build sustainable tools and resources to help you manage these intense states without turning to substances or other destructive coping patterns.

If you’d like to learn more about our addiction or trauma treatment programmes, contact our specialist rehab centre in South Africa today and speak to a member of our team in confidence.

3. Trauma distorts memory, beliefs, and identity

Another way the body keeps the score is through distortion, particularly in childhood trauma, where the young nervous system is still developing and thus becomes easily overwhelmed and activated.

Any trauma, but particularly earlier experiences of adversity, can interfere with:

• Self-worth.
• Memory formation.
• Brain development.
• Relational trust.
• Core beliefs about safety.
• Decision making.

Young children don’t look at an angry parent and think, “Oh, boy. I don’t like mum or dad when they behave like this.“

Instead, they internalise the emotional experience, which gradually turns into what we call ‘core beliefs’. Here’s what this can look and sound like:

• ‘I am not safe.’
• ‘I am not enough. ‘
• ‘I can’t rely on anyone.’
• ‘I have to please others to be liked or loved.’
• ‘I deserve whatever pain comes my way.’

Despite being innocent and faultless, the child rarely blames their parents for any neglect or abandonment that takes place; they blame themselves.

In later life, addiction becomes a way to fill the internal void of childhood, to quieten the shame and self-judgement of previously internalised experiences.

Again, the body keeps the score. 

4. The body holds trauma in physical form

As we’ve already established, trauma is not just an emotional experience.

It’s very much a physical one too.

In fact, studies show that only approximately 10% of our experiences and emotions are processed in the mind; the remaining 90% are either processed or ‘held’ in the body.

It is very often the case that traumatic events or experiences are ‘stored’ in the body rather than processed.

For instance, when something frightening or traumatic happens, like a car accident or mugging, the brain doesn’t have the capacity to process the experience in the moment.

Why?

Because it prioritises survival over memory completion.

You may have heard us say this a few times in previous articles: our nervous systems are not geared toward joy, connection, or even processing; our internal security guard’s only job is to keep us safe.

And, more often than not, it does its job well. Sometimes too well, which usually looks like either a highly activated nervous system state (fight-or-flight) or a profoundly deactivated state (freeze or shut down).

What’s more, unresolved trauma fuels stress hormones like adrenaline and cortisol, which drive impulsivity and cravings.

So, you may see how easily traumatised people can become addicted.

Trauma is a felt experience that seeks relief in any way it can find. Substances are often the most useful way to achieve this.

Our issues are in our tissues

As mentioned above, the body physically keeps the score, manifesting through illness, injury susceptibility, and other diseases.

This can include:

• Migraine.
• Digestive issues.
• Chronic pain.
• Fatigue.
• Muscle tension.
• Immune system disruption.

Our issues are literally in our tissues.

At our rehab centre in South Africa, we support clients using evidence-based integrated approaches that help treat both addiction and trauma, including:

• Behavioural therapies such as CBT and DBT to help address unhelpful emotions, behaviours, and beliefs that may cause or worsen substance use.
• Experiential approaches such as yoga, mindfulness, breathwork and other somatic approaches to help you safely reconnect with your body and reprocess trauma in new, more empowering ways.
• Peer support allows you to connect and share your experiences with others who may have walked a similar path. The power of sharing stories in safe environments can help reduce shame, blame, disconnection, and unhelpful coping.
• Comprehensive addiction treatment programmes that include supervised medical detox to help rid your body of substances in a safe, supportive environment.
• Aftercare programmes that provide ongoing therapeutic support and care after inpatient treatment ends, helping you stay sober and well.

The body may keep the score – but once it releases the traumatic charge from the past, the need for substances reduces naturally.

5. Trauma creates a need for relief – addiction becomes the shortcut

Since trauma changes the neural pathways of the brain, individuals who have experienced chronic trauma specifically often have:

• Altered stress responses compared to non-traumatised people, i.e., more hypervigilant or more shut down, depending on the person’s nervous system capacity.
• Reduced dopamine.
• Trouble feeling joy or calm.
• A higher risk of addiction due to all of the above.

The bottom line

Drugs and alcohol can become significant temptations for someone living in chronic dysregulation. It’s like carrying a heavy backpack for years and finally setting it down – the relief is immediate and profound.

Substances can offer this fleeting respite, allowing a person to escape their internal chaos for a moment. But as welcome as that relief may feel, it is almost always short-lived.

The problem with temporary relief is that it often leads to lasting consequences. Substances may provide a shortcut to bliss, but once the high fades, the underlying pain, sadness, and emptiness return – sometimes even more intensely than before.

True recovery requires a fundamental shift: moving from artificially medicating the nervous system to genuinely teaching it how to self-regulate, feel safe, and connect with others. 

Addiction itself is rarely the core problem; more often, it’s a symptom of a much deeper wound your body has been keeping a score of for years.

If you or someone you love is struggling with trauma or addiction, our compassionate, multidisciplinary team is here to help.

We offer comprehensive, personalised trauma and addiction treatment programmes tailored to each individual—their unique struggles, lived experiences, and hopes for recovery.

Remember: Healing begins when the body feels safe enough to recover. We’re here to walk alongside you, one gentle step at a time, throughout this transformative process and beyond.

Contact our treatment centre in South Africa today to learn more about your treatment options and how we can support you.