Seeking Safety

In-Depth Explanation

Seeking Safety

Seeking Safety, developed by Dr. Lisa Najavits, is an evidence-based treatment designed specifically for people dealing with both trauma (or PTSD) and substance use disorders. The model recognizes what research has confirmed: trauma and addiction are deeply intertwined, with up to 75% of people in substance abuse treatment reporting trauma histories. Rather than treating these issues separately, Seeking Safety addresses both together through a present-focused approach that prioritizes establishing safety—safety from substances, unsafe relationships, and extreme symptoms—before any trauma processing begins.

The Trauma-Addiction Connection

Trauma and addiction are deeply connected:

Self-Medication: Many people use substances to cope with trauma symptoms—numbing painful emotions, reducing hypervigilance, escaping flashbacks, or achieving sleep.

High-Risk Environment: Addiction can lead to situations that cause new trauma—violence, assault, accidents, dangerous relationships.

Shame Overlap: Both trauma and addiction carry intense shame, which can keep people stuck and isolated.

Nervous System: Trauma dysregulates the nervous system. Substances temporarily regulate it—but make the underlying dysregulation worse over time.

Why Treat Together: Treating only addiction without addressing trauma often leads to relapse (the underlying pain remains). Treating only trauma while actively using can be retraumatizing (not enough stability). Seeking Safety addresses both.

Core Principles of Seeking Safety

1. Safety First: The priority is establishing safety in all areas of life—from substances, from dangerous situations and relationships, from self-harm, from extreme symptoms. This must come before processing trauma memories.

2. Integrated Treatment: Trauma and addiction are addressed together in every session, recognizing they interact with each other.

3. Present-Focused: Unlike some trauma treatments, Seeking Safety doesn't require discussing trauma details or reliving the past. It focuses on coping skills for the present.

4. Ideals: Each topic includes an "ideal" to strive toward—positive, achievable goals that counter the negative patterns of trauma and addiction.

5. Compassion: The approach is deeply compassionate, replacing shame and blame with understanding. You developed these patterns for survival reasons.

6. Hope: Recovery is possible. The path involves building skills, one step at a time.

What Does "Safety" Mean?

In Seeking Safety, safety encompasses multiple domains:

Safety from Substances: Abstinence or significant reduction in use. Being free from the chaos, danger, and self-harm of active addiction.

Safety in Relationships: Being in relationships that are supportive, not abusive or exploitative. Learning to recognize red flags and set boundaries.

Safety from Self-Harm: Not hurting yourself through substances, cutting, dangerous behavior, or neglect of basic needs.

Safety from Extreme Symptoms: Having coping skills to manage flashbacks, dissociation, panic, and other overwhelming symptoms without falling apart.

Physical Safety: Having stable housing, meeting basic needs, not being in dangerous environments.

Ask Yourself: Where am I unsafe right now? What area of safety needs the most attention?

The 25 Topics of Seeking Safety

Seeking Safety covers 25 topics across cognitive, behavioral, and interpersonal domains:

Cognitive Topics (What You Think):

Safety — The meaning of safety and where you need it
PTSD: Taking Back Your Power — Understanding trauma responses
When Substances Control You — Understanding addiction
Honesty — Truth versus secrecy and denial
Compassion — Self-kindness versus self-punishment
Creating Meaning — Finding purpose after trauma
Discovery — Learning new ways of being

Behavioral Topics (What You Do):

Taking Good Care of Yourself — Basic self-care
Red and Green Flags — Recognizing safe and unsafe people/situations
Detaching from Emotional Pain — Creating distance from overwhelming feelings
Grounding — Staying present when triggered
Coping with Triggers — Managing things that set you off
Self-Nurturing — Treating yourself kindly

Interpersonal Topics (How You Relate):

Asking for Help — Reaching out to safe supports
Setting Boundaries in Relationships — Protecting yourself
Healthy Relationships — What safe connections look like
Getting Others to Support Your Recovery — Building your team

Grounding: A Core Skill

Grounding is the ability to stay present when triggered by trauma or cravings. It's essential for both trauma and addiction recovery:

The 5-4-3-2-1 Technique:

Name 5 things you can SEE right now
Name 4 things you can TOUCH right now
Name 3 things you can HEAR right now
Name 2 things you can SMELL right now
Name 1 thing you can TASTE right now

Physical Grounding:

Feel your feet firmly on the floor
Feel your back against the chair
Hold something cold (ice cube, cold water)
Squeeze a stress ball or clench and release fists
Splash cold water on your face

Mental Grounding:

Say: "My name is [name]. I am [age] years old. I am safe right now. Today is [date]."
Count backward from 100 by 7s
Name categories: states, animals, movies, colors
Describe the room you're in, in detail

Detaching from Emotional Pain

When emotions feel overwhelming, these techniques create healthy distance:

Imagery Techniques:

Imagine putting the feeling in a container (box, safe, jar) and setting it aside
Visualize the feeling as a wave—it rises, peaks, and falls
Picture yourself in a safe place (real or imagined)
Imagine a protective shield around you

Cognitive Techniques:

"This feeling is temporary. It will pass."
"I've survived this before. I can survive it again."
"This is a reaction to the past. I am safe now."
"I don't have to act on this feeling."

Important: Detaching is not suppression or denial. It's creating enough distance to cope without being overwhelmed. You can return to process feelings later when you have more resources.

Red and Green Flags in Relationships

Trauma often impairs ability to recognize safe vs. unsafe people. Learning to identify red and green flags is essential:

Red Flags (Warning Signs):

They pressure you to use substances
They dismiss, minimize, or mock your feelings
They violate boundaries you've set
You feel worse about yourself after being with them
They're unpredictable, volatile, or intimidating
They isolate you from other supports
Something feels "off" even if you can't name it

Green Flags (Signs of Safety):

They support your recovery
They listen and validate your feelings
They respect boundaries
You feel safe and yourself around them
They're consistent and reliable
They take responsibility for their mistakes
They encourage your growth and connections with others

The Role of Compassion

Both trauma and addiction thrive on shame. Seeking Safety replaces shame with compassion:

Understanding Your Patterns: You didn't develop trauma symptoms or addiction because you're weak or bad. These developed as attempts to cope with overwhelming experiences. They made sense at the time, even if they cause problems now.

The Compassion Statements:

"I did the best I could with what I knew at the time."
"Having these struggles doesn't make me bad—it makes me human."
"I can understand my patterns without excusing harm."
"I deserve help and support, just like anyone else."

Self-Talk Practice: Notice your self-talk. Would you say these things to a friend? If not, practice speaking to yourself the way you would speak to someone you care about.

Asking for Help

Trauma often teaches that others can't be trusted or that asking for help is weakness. Seeking Safety challenges this:

Why It's Hard:

Past experiences of being let down or hurt
Shame about needing help
Fear of being a burden
Not knowing how to ask
Belief that you should handle everything alone

Why It Matters: Recovery from both trauma and addiction is extremely difficult alone. Connection is a fundamental human need and a powerful healing factor.

How to Practice:

Start small—ask for minor things first
Be specific about what you need
Choose safe people (green flags)
Remember: asking for help is a sign of strength, not weakness

Going Deeper

For more on Seeking Safety:

Seeking Safety by Lisa Najavits — The original treatment manual (also available as a client workbook)
A Woman's Addiction Workbook by Lisa Najavits — Addresses unique issues for women
The PTSD Workbook by Mary Beth Williams — Practical trauma coping exercises
In the Realm of Hungry Ghosts by Gabor Maté — Understanding addiction through a trauma lens
Seeking Safety groups — Many treatment centers offer Seeking Safety groups. Ask your provider.

Important Considerations

Safety First—Really: If you're not safe (still actively using heavily, in abusive relationship, homeless, in crisis), the priority is establishing safety. Skills and processing come later.

Not Processing Trauma: Seeking Safety is specifically designed to NOT process trauma memories. If you want to do trauma processing (like EMDR or prolonged exposure), that comes after you've established stability.

Professional Support Recommended: While you can apply these concepts yourself, working with a therapist trained in Seeking Safety is ideal, especially if your symptoms are severe.

It Takes Time: Recovery from trauma and addiction is a long process. Be patient with yourself. Progress isn't linear.

Crisis Resources: If you're in crisis, reach out to a crisis line (988 Suicide & Crisis Lifeline), go to an emergency room, or contact your treatment provider.

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