A Clinical Case Vignette on State Dependency, Nervous System Regulation, and Identity Restoration by Cherry Farrow
Abstract
This case vignette explores the resolution of alcohol reliance in a client for whom substance use functioned not as addiction, but as a nervous system regulation strategy following cumulative trauma. The work demonstrates how indirect hypnosis, regression, somatic anchoring, and identity-level reframing can restore innate safety, sovereignty, and self-regulation without aversive interventions or behavioural control. The case highlights the importance of distinguishing state dependency from addiction and illustrates how trauma-related loss of internal safety may be misattributed to external figures or substances.
Introduction
Alcohol misuse is frequently conceptualised within addiction frameworks that prioritise behavioural modification and abstinence. However, emerging trauma-informed and somatic models suggest that for some individuals, substance use serves primarily as a compensatory strategy for nervous system regulation rather than compulsive dependency.
This case presents a client whose alcohol use emerged following severe trauma and relational rupture, and whose resolution occurred not through cessation-focused strategies, but through the restoration of innate safety, identity coherence, and embodied sovereignty.
Client Background
The client (female, adult) presented with distress related to her reliance on alcohol to manage anxiety, fear, and nervous system dysregulation. She reported intense resistance to the idea of giving up alcohol, describing it as her “only safety plan.”
Her history included:
- a severe poisoning event involving repeated near-death experiences
- subsequent post-traumatic stress
- a period of intense dependency on her spouse for survival and care
- the sudden arrest and disappearance of her spouse, resulting in shock and emotional collapse
Following these events, alcohol use escalated as a means of calming her nervous system and restoring a sense of safety. The client also reported that the presence of a masculine figure—romantic or otherwise—eliminated her desire for alcohol entirely, while absence triggered panic and craving.
Importantly, the client had a prior history of independence, fearlessness, extensive solo travel, and deep spiritual trust, indicating that the presenting symptoms represented a departure from her baseline identity rather than a lifelong pattern.
Clinical Conceptualisation
Rather than framing the issue as addiction, the clinician conceptualised the problem as state dependency—a reliance on external cues (alcohol or masculine presence) to access internal states of safety, grounding, and regulation.
Several unconscious equations were identified:
- Alcohol = Safety
- Masculine Presence = Survival
- Being Alone = Threat
- Safety Exists Outside the Self
These associations were understood as adaptive responses formed during trauma, rather than pathological traits.
Therapeutic Approach
The session utilised an integrative framework drawing from:
- Ericksonian conversational hypnosis
- regression and time-based resource elicitation
- somatic awareness and anchoring
- identity-level belief resolution
- future pacing and probability-based reframing
The work was intentionally non-protocol-driven, allowing the client’s unconscious processes to guide the sequence and depth of interventions.
Key Interventions and Process
Deconstruction of the Alcohol–Safety Association
Rather than challenging alcohol use directly, the clinician elicited the precise internal states alcohol provided: presence, relaxation, clarity, groundedness, and safety. The client was guided to recognise that if alcohol could evoke these states, they must already exist within her nervous system.
This reframing reduced alcohol from a “source” of safety to a conditioned trigger.
Regression to Pre-Trauma Safety States
Through hypnotic regression, the client revisited multiple developmental periods (early childhood, adolescence, early adulthood) in which she experienced profound safety, trust, and confidence—often while alone and without reliance on others.
Across all memories, safety was experienced as:
- embodied
- internally generated
- connected to nature, purpose, and self-trust
- independent of masculine presence
This disrupted the belief that safety required external containment.
Somatic Anchoring and Embodiment
States of safety and confidence were anchored somatically in different regions of the body (hips, feet, elbows, whole-body groundedness). This allowed safety to be accessed as a felt sense rather than a cognitive insight, facilitating nervous system integration.
Identification and Resolution of a Core Identity Decision
A pivotal moment emerged in which the client recognised an unconscious decision made during a romantic relationship: the belief that love required relinquishing personal power and sovereignty.
This decision was examined and resolved through identity-level reframing, leading to key insights:
- she never lacked alignment, power, or connection
- information can be received from others without self-abandonment
- no external figure holds authority over her life force
The client reported a felt restoration of “essence” following this resolution.
Future Pacing and Integration
The client was guided to project forward in time, observing her nervous system response to:
- being alone
- future stressors
- potential uncertainty
She reported calm, grounded responses and a clear internal strategy for self-regulation (nature, centring, internal resourcing), without reliance on substances or external figures.
Alcohol was described as emotionally neutral and largely irrelevant.
Outcome
By the conclusion of the session, the client demonstrated:
- absence of craving or emotional attachment to alcohol
- restored sense of safety while alone
- improved nervous system regulation
- embodied confidence and sovereignty
- coherent future orientation
Notably, no directive abstinence or behavioural control strategies were employed. Resolution occurred through identity restoration rather than symptom suppression.
Discussion
This case illustrates several clinically significant points:
- Substance reliance may function as state regulation, not addiction, particularly following trauma.
- Safety must be restored somatically and at the identity level, not solely through cognitive insight.
- Trauma can temporarily collapse sovereignty even in highly resilient individuals.
- Healing accelerates when therapy restores what existed before trauma rather than constructing new traits.
- Indirect, client-led hypnosis can produce profound change without confrontation or force.
Conclusion
This vignette demonstrates how trauma-related alcohol reliance can resolve rapidly when the underlying loss of internal safety and sovereignty is addressed. By restoring access to innate regulatory states and correcting identity-level decisions formed during trauma, the client reclaimed self-leadership and resilience without engaging in addiction-based treatment models.
The case supports a paradigm in which therapy functions not to remove behaviours, but to reintegrate the self that never required them.
Ethical Statement
This case vignette has been de-identified and is shared with informed consent for educational and professional purposes.