Case Study: Supporting Emotional Trauma and Addiction in Therapy

Client Background and Presenting Concerns

Larry was a single man in his early 30s who worked as a marketing coordinator for a regional tech company. During much of the first phase of his three-year, twice-weekly psychotherapy, Larry was defensive, irritable, and prone to pushing boundaries. His main concern was a persistent sense of emptiness and low mood, which he described as a gnawing, hollow ache in his chest—“like a bottle that’s been drained dry and forgotten in the back of the cupboard.”

History of Addiction and Emotional Struggles

Complicating his struggles, Larry had a history of alcohol misuse, which he admitted he sometimes relied on to numb the intensity of his emotions. He recalled nights in college when he would binge drink alone, trying to quiet the restlessness he felt after arguments with his father, leaving him both physically drained and emotionally hollow the next day. Despite having sought therapy intermittently over the years for both depression and addiction, Larry had never found lasting relief—until he began to confront not only the emptiness itself but the ways he had tried to escape it.

Therapeutic Approach and Interventions

In therapy, Larry and his psychotherapist experimented with mindfulness-based interventions combined with narrative reflection. Larry was encouraged to sit with the emptiness, naming and describing the sensations without trying to suppress them with alcohol or distractions. Together, they traced patterns in his life—particularly times when feelings of rejection or inadequacy had triggered his drinking. Larry began to journal these moments immediately, noting thoughts, urges, and the physical sensations that accompanied them. Over time, he learned to tolerate the discomfort without acting on it, gradually replacing old coping mechanisms with healthier ones, like brief walks, grounding exercises, or phone calls to supportive friends.

Mindfulness-Based Techniques

Larry practiced observing his emotions and bodily sensations as they arose, without judgment or immediate reaction. When he felt the familiar pull toward alcohol, he paused, acknowledged the craving, and allowed himself to experience the discomfort fully. Over weeks, these mindfulness exercises helped him break automatic patterns of avoidance and create space to choose healthier responses.

Narrative Reflection and Journaling

Through journaling, Larry identified recurring themes of rejection, self-criticism, and loneliness. Writing these experiences down helped him see connections between his early life experiences and present behaviors, particularly his use of alcohol as a coping tool. Reflecting on these patterns in therapy sessions allowed him to develop new strategies for self-soothing and emotional regulation.

Progress and Outcomes

By the end of therapy, Larry reported that the hollow ache in his chest had softened. While he still experienced moments of loneliness or craving, he felt empowered to respond intentionally rather than react impulsively. His alcohol use diminished significantly, and he described a new sense of “quiet strength,” a capacity to feel fully without immediately seeking escape. Through the combination of insight, practice, and consistent therapeutic presence, Larry had begun to fill the empty well within, not with avoidance, but with self-awareness, resilience, and connection.

Key Takeaways

This case study illustrates the importance of combining presence, empathy, and structured therapeutic techniques when supporting individuals struggling with emotional trauma and addiction. Mindfulness, narrative reflection, and consistent therapeutic guidance can empower clients to tolerate difficult emotions, break unhelpful coping patterns, and cultivate lasting emotional resilience.