Trauma And Addiction with Dr. Natalie Feinblatt

Trauma doesn’t always look like one catastrophic event and addiction doesn’t always start as “bad choices.” We sit down with licensed clinical psychologist Dr. Natalie Feinblatt to connect the dots between trauma, complex PTSD, and substance use in a way that feels honest, compassionate, and practical. When the nervous system has been pushed past its limits, reaching for alcohol or drugs can become a form of self-medication that works for a while, until it starts taking more than it gives. 

We also get concrete about what trauma-informed addiction treatment actually looks like: thorough assessment, careful pacing, and a plan that respects where someone is in sobriety before diving into intense trauma processing. Natalie explains why language matters, especially for survivors who have been harmed while intoxicated, and why certain interpretations of “what was your part?” can backfire when trauma is involved. If you’ve ever felt stuck in shame, this conversation offers a different frame that keeps accountability without blaming the victim. 

Then we dig into EMDR therapy and the neuroscience of healing. Natalie breaks down bilateral stimulation, why trauma treatment has to include the body and the nervous system, and how neuroplasticity helps us build new pathways over time. We close with a powerful metaphor for realistic recovery: turning down the PTSD “radio” so life becomes livable again, even if the past still exists. 

If this resonated, subscribe, share the episode with someone who needs it, and leave a review so more people can find trauma-informed recovery resources.

Connect with Dr. Fleinblatt directly: https://telewellnesshub.com/directory/dr-natalie-feinblatt

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Transcript

Welcome And Guest Introduction

Speaker 2 0:04

Welcome, friends, to the Telewellness Hobby Hub podcast. I'm your host, Sunya Nagabushan. Today I'm joined by Dr. Natalie Feinblatt. Dr. Natalie is a licensed clinical psychologist specializing in trauma and addiction recovery. She works with adults who are navigating complex PTSD, substance use, and the long-term impact of painful life experiences. Her approach is compassionate, trauma-informed, and deeply affirming, helping people heal the root causes beneath addictive behaviors and reconnecting with themselves in a meaningful, sustainable way. I'm so glad she's here to talk today with us about recovery, trauma, and addictions. Welcome, Dr. Natalie.

Dr. Natalie Feinblatt 0:57

Hi, thank you so much for having me. I really appreciate it.

Why Dr. Natalie Feinblatt Does This Work

Speaker 2 1:00

Thank you for being on the show. We're really excited to have you on the show with us today. So I would like to start off, um, Dr. Natalie, with a um very pertinent question. Why do you do the wellness work that you do?

Dr. Natalie Feinblatt 1:15

Oh gosh, that feels like that could be a very long answer. Um, I would say that I do the wellness work that I do because I think like many people who end up getting into healthcare and mental health care, um, that I just find a lot of meaning and purpose in helping other people. Um and more specifically beyond that, I think that many, possibly most, I won't say every therapist, but many therapists um get into this line of work because we've had our own, you know, struggles along the way, and therapy or mental health care really helped us. And and I would definitely fall into that category that you know I've had my own struggles, and that, you know, going into the field of mental health was not only, you know, a way to make a living and help other people, but it was also kind of just a continuation of a lot of the work that I had been doing, kind of, you know, personally.

Why Trauma And Addiction Overlap

Speaker 2 2:20

Thank you. I actually can concur with that. I'm a licensed professional counselor and I also specialize in substance use work. And uh just being candid, I've had family afflicted with addictions, which kind of paved the way for me to want to learn how to help others in my family heal, but on a bigger, much uh larger scale, help others heal in their journey. So thank you for that um introduction. Lovely. So, Dr. Feindlet, I would like to start off with uh just asking a generic question about why do trauma and addictions go hand in hand? Why do they together? From your perspective, what's the connection between trauma and substance use or addictive behaviors?

Dr. Natalie Feinblatt 3:07

And you can just call me Natalie, you have to call me Dr. Heimlet. Thank you. Um yeah, of course. So, I mean, the the the thing that I usually say at first when when people ask about this is, you know, I initially got my start in addiction treatment, um, that you know, here in LA, there is a a preponderance of addiction treatment centers. And if you're you know becoming a therapist in LA, it's almost impossible for you to not end up at one of those places of somewhere on the line. Um, and that I started out there, but that from my point of view, that you can't really specialize in addiction without also specializing in trauma because the the Venn diagrams of those two populations uh overlop so so heavily. You know, I at this point in my career, I don't even know how many people I've worked with who've have addiction issues, but the number of them who legitimately seemed to have no trauma history whatsoever, you know, I can count on my fingers. Like it's it's such a small minority of of the folks that I've worked with. And so I suspect, just based on my experience, that that a big part of the connection is the trauma and self-medicating for post-traumatic stress. Um, I think that you know, a lot of people who uh experience trauma will not know how to handle it. Um, because we don't we certainly don't really learn how to handle it in in our society, at least here in America. Um and if they go on to then develop post-traumatic stress, it it just makes sense that one of our ways to try and deal with that, albeit it becomes its own problem, but is to over-rely on substances, whether it's alcohol or drugs or whatever it might be, right? And so I think that are there plenty of people who don't go in that direction? Sure, they go in other directions to try to, you know, um survive dealing with post-traumatic stress. But I think an awful lot of people go for substances because especially when we're talking about like, you know, alcohol or marijuana, like they're so readily available, they're not they're not necessarily expensive, um, and they work for a while, right? Unfortunately, you know, they they don't work forever, um, and uh they usually tend to end up causing more harm than good the longer it goes on. But um to me it makes sense that that folks would go in that direction if they have a trauma history.

Defining Trauma Beyond Big Events

Speaker 2 6:00

Absolutely. And to that point, um, you know, trauma, the word trauma is thrown around a lot, uh, big T, little T. Um, can you speak on or expand a little bit about what is trauma? Um and perhaps what are the signs of symptoms? Say a potential client comes to you and says, How do I know if I have a traumatic history? Or how do I know um what are the symptoms of signs of trauma?

Dr. Natalie Feinblatt 6:31

Sure. Well, I know that this is this has become a real point of conversation in the mental health field and just in popular culture in the last five or ten years, because I think that we have are coming to expand our definition of trauma, which I I personally think is a good thing. Um, and I know that there are I've you know heard and read some people who are concerned that we're like over-diagnosing trauma. And I don't know, my own personal opinion is like I would much rather go in the over-diagnosed direction than the underdiagnosed direction when it comes to trauma. Um, and I really, I don't really think that there's that many therapists running around saying that like because you skinned your knee when you were five, that was trauma. Like I don't, you know, I I think we generally reserve that definition for things that left a negative mark on somebody. Um so what I will say about my own thoughts on defining trauma is that you know it it can be kind of the quote unquote classic stuff, like you know, um, you know, almost dying or becoming incredibly injured, uh being being in a situation where you watch somebody die or get you know hugely injured, um, you know, getting into a car accident or you know, something like being physically abused, sexually abused, sexually assaulted, all of that stuff. And then I would also say that there's also the you know um developmental relationship trauma that can happen in highly dysfunctional or abusive families where you know maybe there was no physical abuse, maybe there was no sexual abuse, but there was you know years and years of um repeated, you know, negative interactions, um, emotional uh dependency, codependency, uh, you know, um people having you know angry outbursts, violent outbursts, um things of that nature, because I work with a lot of folks who have CPTSD, you know, when when you have experienced like chronic trauma in relationships over years and years, that can be like the big T stuff, but often it's also you know more kind of insidious and and uh you know emotional or or uh adjacent to like coercive control and things like that. And to me, that stuff is definitely also trauma because I I see people dealing with the after effects of it every day, and it certainly impacts them uh as a trauma would impact somebody.

What Trauma-Informed Addiction Care Looks Like

Speaker 2 9:24

I'm really um glad that you distinguish those ideas or those constructs because, like you said, I think many people hear the word complex PTSD or trauma um and they think you know, war veterans, which are absolutely giving them breath and breath. But I also feel and I mirror your sentiments, there are those silent ones that uh maybe go without um having been able to express themselves, growing in an invalidating environment at home, maybe having an early attachment disorder or attachment style. So I think that's a really important distinction distinction that you pointed out there that um our awareness or our recollection in society um may jump to think it has to be um something uh like you said, uh physical, like uh years and years of physical or sexual assault or abuse. But sometimes the more insidious ones, as you pointed out, that distinction are the ones that are gone left unsaid and are left unheard, um, have not having a voice. Um so thank you for clarifying that. I think that was a really important point to make um in the world of uh healing in terms of trauma and how people maybe sort to unhealthy coping mechanisms. Um tell me a little bit, Natalie. Um what would a trauma-informed addiction treatment look like in a practice for someone maybe thinking about starting therapy and needing to see a specialist like yourself? Can you give us a little insight about what that treatment may look like?

Dr. Natalie Feinblatt 11:07

Sure. I would say, you know, first and foremost, it would be a thorough assessment to see if a person who is coming to therapy due to you know having an addiction has a trauma history, right? And and looking at all the different kinds of trauma like we just discussed, right? Not just the the big stuff or the classic stuff, but like the other stuff as well. Because, like I said, in my experience anyway, the odds that they will are like very, very high. Um, so making sure to assess for that, get get you know a history on that. Um, and then I would say also um working with the person to plan to possibly do some more intensive trauma work, depending on where they are in their recovery, right? If they're like trying to get sober or very newly sober, it might not be the time to like dive into all that trauma stuff, but um to to know that there is definitely a plan for getting there once they've stabilized with their addiction more. Um, so stuff like EMDR or brain spotting or internal family systems work, you know, thing things of that nature. Um, and then I would also say that a part of trauma-informed addiction uh therapy would be um a couple things that that I run into with a lot of folks is first of all, um, and this can be the case for anybody, I mean it's frequently women, but it doesn't have to only be women, but you know, going back and seeing if if they do have anything in their history where they were, you know, assaulted or taken advantage of when they were intoxicated, um, making sure that they know that that was not their fault. And it wasn't like, oh, well, I set myself up for that by being so drunk or so high or whatever, right? Letting them know that, okay, do you do you have a role to play in your substance use? Of course. And that doesn't mean that when somebody sees you intoxicated, that gives them the right to do things to you that you're not consenting to, right? Correct. Um, so so making sure that they know that, and also making sure that if they are going the route of 12-step programs, which I am generally in favor of 12-step programs, but I don't ever like you know force them on clients who just aren't interested. Um, but if they're doing that and they are working the steps and they, you know, come to step four, which is making an inventory, you know, one of the one of the places where, in my opinion, AA, you know, alcoholics anonymous and narcotics anonymous still need to do a little catching up, is that you know, you will often get a sponsor who you know, you will put your trauma on your inventory and they will say, Well, what was your part in that?

unknown 14:11

Right?

Dr. Natalie Feinblatt 14:12

And it's like, oh, like you know that that is not, in my opinion, a very trauma-informed approach to that. I am a fan of doing an inventory, I think it can be incredibly helpful. And at the same time, there are certain things in a person's history that they did not play a role in, whether it was abuse they experienced when they were a child and they were literally powerless to do anything about it, or things that they experienced while they were intoxicated, if, like, you know, we're just talking about if they were sexually assaulted or something like that, they don't have a part in that either. That is all on the perpetrator, right? Um, and so I I think that making that clear to people who are going through that process um can also be very helpful in terms of making sure things are trauma-informed.

Sponsor Message Legal Med 180

Speaker 2 15:05

Yes, Natalie, I think that's so important to point out those um those different silos and levels of treatment that happen when a patient first walks in the door and then and is looking for help if there's something due to trauma history. And one of the key things that you pointed out that I really um agree in the mirror, in fact, I I do the same work with my patients is assessing where they're at and what space they're in, correct? The idea that um let's not push uh too heavy um EMDR or um too early on because they may not have the toolbox to self-so-regulate themselves, and then that may just turn them back to their substances, right? Yeah, and that other point that you pointed out, and I I really do think this is a powerful language that you use, is the language that we are using when we're talking about trauma-informed um treatment and substance use work, because as you mentioned very clearly, and and I'm glad that you pointed it out, the 12-step program is is wonderful and has many, many um wonderful places in in terms of recovery. However, I I start to also want to point out that you know, as a child, if you were sexually assaulted or if there or if you were a survivor, um there's no space in in trying to blame or to use language in blaming the survivor, right? Yeah, yeah. Maybe someone could be thinking, oh, well, I think may something may have happened to me in the past. I'm not sure. Was it my fault? I was drinking. So that's so important for you to point that out and and empower uh people to understand um there's not a space to there should be no space in blame, um, and blaming the survivor.

Marta Hamilton 17:05

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How Long Healing Can Take

Speaker 2 17:37

I I want to often um we often hear people talking about um how long does this journey take? And I I hear it from my own clients, my own patients, I hear it from um friends of mine that are in recovery. What does the timeline, you know, uh where you live in a very fast-paced world, a capitalistic society, people are, you know, need to get back to work. I mean, what what do you speak to that? What can you say when someone asks you, well, well, Dr. Natalie, how long is this gonna take? What's the healing process like?

unknown 18:12

Yeah.

Dr. Natalie Feinblatt 18:14

I do my best to be as honest with people as I can around that. And and I'll say, like, you know, I I know this might not be what you want to hear um in terms of like, oh, we're gonna get through this in a couple months, you know. Um, but what what I will typically say to people is, you know, if if they are coming to me for a single incident trauma, right? Where it was one thing, you know, I I've I worked with somebody who, you know, was present locally unharmed at like a mass shooting, but like that was literally the the only thing in their life that would really kind of qualify or count as as a significant trauma, right? If that's the case, you know, we could conceivably, depending on what kind of work we're doing, whether it's ENDR or something else, we could conceivably get through that in like you know, a matter of months, you know, three, four, five months or something like that, depending on how often we're working together and you know, all of that stuff. However, when we're dealing with something that's more complicated, like you know, a history of multiple traumas or you know, growing up in an abusive or dysfunctional family and trying to work through all of that, you know, that that can take uh years sometimes. And obviously, there are things that people can do to try to speed it up, like you know, working on stuff in their own way between therapy sessions and you know, maybe going to support groups and whatever else. But you know, even when we're doing something like EMDR, where you know a lot of people will say, like, oh, this is so much faster than traditional talk therapy, I'm always kind of like, yeah, I don't know that I totally agree with that. Um I think sometimes it can be, um, but other times I think it it it can take a significant amount of time still. Um the good news is that hopefully, you know, using that in therapy or whatever will will really make a huge difference, and the person possibly won't need, you know, regular therapy down the line um because it was thoroughly reprocessed, but I would say it really depends on what we're dealing with. And I would also say that I recognize that being able to be in therapy for for months and years is a privilege, and it is not available to everybody, especially not in the United States. Um, and so I think that there are other options in terms of support groups, books, podcasts, you know, all that stuff. That therapy is one way to work through this stuff, but it doesn't have to be the only option, especially if you know somebody is just not in the position of being able to afford that financially or in terms of time or things like that.

EMDR Explained In Plain Language

Speaker 2 21:17

You mentioned eye movement desensitization reprocessing. Um, I love EMDR, it's the bread and butter of what I do with my work. Um for our listeners, can you give maybe a brief snapshot or synopsis of what EMDR is and how does it play out in treatment?

Dr. Natalie Feinblatt 21:36

Yes, and and I can certainly try. I I really struggle to have like an elevator pitch for EMDR because it there's as you know, there's just so much to it. Yes. Um, so I will try my best, but feel free to add things if if you want to. So I move with desensitization and reprocessing is a specific kind of Form of therapy that that follows a protocol of using bilateral stimulation, which is just a fancy way of saying, like alternating left, right, you know, usually it's eye movements, but you know, it can also be auditory or tactile or whatever. Um, using that as a tool to help someone reprocess past trauma in a more thorough and complete way. Um and as opposed to talk therapy, where we're mostly focusing on thoughts and emotions, um, EMDR also brings the body into the picture, um, which is very valuable because trauma has a huge impact on the nervous system and the body. Um, and it's a way of tuning into your thoughts, feelings, and body while reprocessing trauma with the bilateral stimulation, um, in such a way that you're able to kind of move from it being something that intrudes onto your day-to-day life to just another experience that you've been through that you still have your feelings about, but that isn't causing you symptoms of post-traumatic stress.

Speaker 2 23:14

That was a lovely explanation. To be honest, it was really well explained because I think um, like you said, there there's not a it's such great work we do with EMDR. And typically um people hear EMDR and and they're like, is it hypnosis? Am I in control? What exactly is going on? So it's important to point out that the patient is always in control of the session. Um yeah. Yes, and um the beautiful part of EMDR is that it gives the power back to them, right? It gives them the onus, the autonomy, the agency to take. And like you said, um, through the reprocessing and the dual uh the dual attention stimulations or bilateral stimulations, I've heard my patients say, and and please chime in here, I've heard them say, you know what, Dr. Sharma? It it the story is still there, the narrative is there, but it's almost like a distant, distant, they feel removed from it. Almost like a storyline or a movie that's that's passing on on a train. Uh so I think that's powerful language that um I've heard my own patients tell me, and I I've I've heard other people explain it. Um and the other part that I would agree with you is uh EMDR is one of many tools, right? So yeah, the work is making sure that after our session with EMDR, they have the tools, um, their coping skills, emotional regulation, all of those really good things that are gonna help them stay baseline. Um, because it's not easy work to talk about trauma, right? It's very um uh it can it can be very destabilizing. You mentioned I'm sorry, go ahead.

Dr. Natalie Feinblatt 25:01

No, no, I was just agreeing with you. Yes, it can be destabilizing, so it's important to get the coping skills part of it as well.

Speaker 2 25:07

And you mentioned the piece about um the central nervous system and how the body um the body feels trauma or holds on to trauma. Can you help us learn? And this part I'm actually fascinated with, Dr. Natalie, um is the the neuroscience piece. Can you help us explain what goes on in the brain? Um, what does neuroplasticity look like? This is you know a big wave of where everything is going right now in in terms of you know things we hear on podcasts and things we hear in in the medical literature. Can you help us learn a little bit about what what happens in the brain, the neuroplasticity piece and the neuroscience part?

Neuroplasticity And The PTSD Radio

Dr. Natalie Feinblatt 25:52

Sure. So, you know, when we are talking about trauma um and mostly in our thoughts about it, we're in the prefrontal cortex, which is just the part of your brain that's right behind your forehead. Um, and it's where we do most of our thinking. It's like the the planning, strategizing, thinking, right? And that part is very important, like we use it all day, every day. Um, but it's not the full picture, right? We also need to get into kind of the the middle of our brain, which is you know the limbic system, which is where uh the emotions come up. Um that part is also important, which is why it's good to not just talk about feelings, but try and feel feelings, you know, even during the session or during um, you know, EMDR or whatever technique we're using. And then we've also got to get into the the nervous system, right? Which is runs throughout our entire body and and is you know affecting our body every minute of every day. Um so to to be able to utilize all three of those areas in trauma treatment is very important because trauma impacts all three of those areas, and only really going into one of them, and you know, in therapy, I think we're guilty of of going too much into the thought area. Um, that that's only part of the picture, right? Um, and then in terms of neuroplasticity, you know, this is a talk I have with most of my clients at some point or another, is that you know, we we now understand that the brain is capable of changing throughout the lifespan, which is awesome. Like that's it's not like oh you're you've hit 40, like you're stuck with your brain the way that it is, right? Um luckily the answer is no. Um, and that we're still able to change our brains. Um, the only downside is that the older we get, the more work it takes to do that, right? Like when we're young and our brain is very, you know, squishy and moldable, um, you know, our brain doesn't take as much effort to change. But the older we get, the more we really need to, you know, focus on repetition and and practicing new things in order to create new neural pathways. And you know, EMDR is one of the ways that we do that, but even honestly, just practicing your coping skills when you you might not have thought to do that in the past is a is a form of neuroplasticity and and working to change your brain, right? Um so it takes effort, um, which is and and repetition, which is not fun and time, but it is possible, which to me is the the hopeful thing. It's just gonna take work.

Speaker 2 28:45

So for our listeners that are hearing this um explanation on neuroplasticity and how uh trauma and healing is is impacted by um the different circuitry in our brains and neurotransmitters. Am I hearing you say that things can be reversible and and we fire off new synapses or new rewiring? Is that what I'm hearing you say? That we can actually reverse some of these things?

Dr. Natalie Feinblatt 29:12

Yes, I would say that we can. I mean, this is another question along with the the how long is this gonna take question. Um, another question, and I'm sure you get it too, is like, you know, can I can I be cured? Can I be fixed? Can this go away? Right? Um, can this be reversed, or however it is that people say it when it comes to you know, symptoms of post-traumatic stress or whatever it is? And the to me, the answer is yes, and you know, we need to make sure to have like you know, realistic expectations around this. So, like for some people, do all of the symptoms of of PTSD, you know, go away for the for the most part? Sure. But what I see happen to most people is that the way I'm I'm a you know therapist, we love metaphors and things like that. Um I the the the you one that I usually use here is like you know, your PTSD right now is like this this radio that is blaring this music that you don't like, and you you can't get rid of it and you can't turn it down or off, right? And so what what we're gonna hope for here and what I see happen is that we can get you to a place where we can turn the volume way down, and um, sometimes it might even go off for periods of time, um, and you might even be able to change the channel sometimes. Um, and so I think that is a uh a realistic portrait of what is possible. It's like, okay, this are some people able to get rid of the radio entirely, sure. But what I see more often is that you know it is chillable and reversible within you know uh a realm of reality where it's not it's not just gonna magically disappear, but it can get a hell of a lot better.

Final Takeaways And Thanks

Speaker 2 31:08

Natalie, I love that metaphor, and you're right, as therapists, we have a lot of metaphors that kind of uh came to the patient or the clients. But that's that's a lovely metaphor. I was actually visualizing that myself and and and cap encapsulating it because you're right, it's for some patients or some clients, it's not the idea of you know, they may come into therapy thinking, okay, Dr. Natalie, cure me, heal me. Well, that's a loaded um and and a loaded question right there. And so the idea is maybe for some patients it looks like this, but for some other patients it looks like a little different. Turning down that noise, you know, to where it's tolerable and using our coping skills and and and gathering our support system, reconnecting with our our um our folks, not isolating our support systems, things like that. I love that metaphor, Natalie. I have to be honest, I really think I'm gonna try to use that with some of my clients. It's a beautiful, beautiful metaphor. And I think it really symbolizes you're right, toning down some of that so that patients can implement their coping skills to continue to work on their journey of healing. Um you know what, Natalie? I think at this point I want to thank you so much because we're almost out of time today. Um, but I want to thank you so much for being on the show with us. Um, it's been an absolute pleasure. I've learned so much from you, Natalie. Um, and especially about the plants piece. I think people get really, really um intrigued by that. And you gave such an excellent explanation of that. So I want to thank you so much, Dr. Natalie Feinblatt, for sharing your insights and being part of our wellness journey today. Thank you, Doctor.

Dr. Natalie Feinblatt 32:53

Of course. Thank you for having me.