More often than not, substance abuse recovery involves an impossibly complex and painful process—one fraught with physical, emotional and spiritual perils, and one which invariably causes an addict or substance abuser to come to terms with a great many uncomfortable truths about self, severity of condition, and one’s prospects for actually maintaining sobriety (Lewis, Dana & Blevins, 2009).
Addiction and abusive consumption pathologies are rooted in the soil of imbalance, be it biochemical, behavioral, emotional, or psychosocial. Accordingly, the reasons that an individual might begin consumption of any substance are myriad, but are rapidly eclipsed by the reasons why he or she continues to consume (Beck, Wright, Newman & Liese, 1993; Czuchta & Johnson, 1998). The author believes that it is here--in the transitory area between a client’s simple use of a substance and their full-blown dependence upon it--where a therapist can find the greatest clues to how a person will approach and process recovery.
This concept begs several simple questions: What were the catalysts and are they still relevant today? What were the emotional, social and physical conditions associated with early consumption and continued use? What can the therapist learn about motivation in the client? The author believes that asking these questions about the client’s state of being as addiction initially grew is the most effective way to understand the physical, psychological, behavioral, social, interpersonal, family and spiritual issues he or she will face in recovery. Knowing as much of the cause of client’s addiction can allow the therapist--in many instances--to learn about what recovery will look like (Beck et al., 1993; Czuchta & Johnson, 1998).
Perhaps the best place to start when framing these issues is to first understand how they are typically manifest in people. As previously mentioned, addiction finds its beginnings in imbalance and disproportionate responses and behaviors. Physically, this is primarily an issue of altered brain chemistry. In order to sustain a constant sensation of euphoria (and in late-stage addiction to keep from experiencing withdrawal) an addict or abuser will consume ever-increasing amounts of a given substance. In terms of emotional stability, an imbalance can be the result of childhood neglect or abuse, where an abuser or addict self-medicates as a means to quell a deep-seated pain. Behaviorally, an addict or abuser frequently seeks to level out imbalances that are the result of unhealthy interpersonal interactions or simple social learning, with addiction taking hold as the result of a lifestyle patterning and conscious choices.
The issues that one will face in recovery are--in the author’s opinion--directly related to the issues which led to the development of an addiction or abusive pathology, and in learning how the client sought to address those issues--to set right the imbalances that he or she experienced in life--a helping professional can begin to strategically anticipate the issues that will need to be addressed. Of critical importance for the therapist is to understand that wherever an issue (psychic, physical, spiritual, emotional, or otherwise) previously existed in a client’s life--but was addressed through consumption instead of targeted therapy or cognitive change--that issue will need to be visited once the “balancing” variable of the substance is removed from the equation (Czuchta & Johnson, 1998).
For people in recovery this translates rather simply into the client facing his or her major life issues without substances--many for the first time (Czuchta & Johnson, 1998; Lewis, Dana & Blevins, 2009). Typically, the physical, emotional and spiritual elements of a client’s life will be interconnected, each affecting the other in varied ways. Physical changes brought about by continued substance abuse can change every aspect of a client’s perceptions about family, religion and self, and more often than not this will generate both fear and reluctance during initial phases of recovery. When physical systems are not functioning properly the net impact on a person’s other life areas can be profound. Conversely, if a client is disenfranchised emotionally or spiritually, behaviors and physical symptoms can move to the fore as the client subconsciously works toward stability.
The author believes that because of the inter-connectivity between different areas of every human being’s life, all the major areas must be examined in in a way that honors the role each area plays. Viewing everything in flux--observing the push and pull of life’s major components--is the surest way to determine what issues a client must emphasize as they move through therapy.
To the author, addiction is less a tangible “thing” and more a place. In this place a client’s issues are the simple expression of the manner in which they respond to stress, pain, sadness, anger, anxiety, and myriad other issues. Instead of healthy management of these issues, addicts and abusers begin to respond to them with the typical behaviors of addiction: taking a drink, a hit, or a pill. To develop a healthy and sustainable approach to living--which happens in therapy and is continued in recovery--clients must learn to replace responsive habits with appropriate behaviors.
abuse. New York: Guilford Press.
Lewis, J.A., Dana, R.Q., & Blevins, G.A. (2009). Substance abuse counseling (4th ed.). Belmont, CA: Brooks/Cole.
Czuchta, D.M., & Johnson, B.A. (1998). Reconstructing a sense of self in patients with chronic
mental illness. Perspectives in psychiatric care, 34(3), 31-36.
Addiction and abusive consumption pathologies are rooted in the soil of imbalance, be it biochemical, behavioral, emotional, or psychosocial. Accordingly, the reasons that an individual might begin consumption of any substance are myriad, but are rapidly eclipsed by the reasons why he or she continues to consume (Beck, Wright, Newman & Liese, 1993; Czuchta & Johnson, 1998). The author believes that it is here--in the transitory area between a client’s simple use of a substance and their full-blown dependence upon it--where a therapist can find the greatest clues to how a person will approach and process recovery.
This concept begs several simple questions: What were the catalysts and are they still relevant today? What were the emotional, social and physical conditions associated with early consumption and continued use? What can the therapist learn about motivation in the client? The author believes that asking these questions about the client’s state of being as addiction initially grew is the most effective way to understand the physical, psychological, behavioral, social, interpersonal, family and spiritual issues he or she will face in recovery. Knowing as much of the cause of client’s addiction can allow the therapist--in many instances--to learn about what recovery will look like (Beck et al., 1993; Czuchta & Johnson, 1998).
Perhaps the best place to start when framing these issues is to first understand how they are typically manifest in people. As previously mentioned, addiction finds its beginnings in imbalance and disproportionate responses and behaviors. Physically, this is primarily an issue of altered brain chemistry. In order to sustain a constant sensation of euphoria (and in late-stage addiction to keep from experiencing withdrawal) an addict or abuser will consume ever-increasing amounts of a given substance. In terms of emotional stability, an imbalance can be the result of childhood neglect or abuse, where an abuser or addict self-medicates as a means to quell a deep-seated pain. Behaviorally, an addict or abuser frequently seeks to level out imbalances that are the result of unhealthy interpersonal interactions or simple social learning, with addiction taking hold as the result of a lifestyle patterning and conscious choices.
The issues that one will face in recovery are--in the author’s opinion--directly related to the issues which led to the development of an addiction or abusive pathology, and in learning how the client sought to address those issues--to set right the imbalances that he or she experienced in life--a helping professional can begin to strategically anticipate the issues that will need to be addressed. Of critical importance for the therapist is to understand that wherever an issue (psychic, physical, spiritual, emotional, or otherwise) previously existed in a client’s life--but was addressed through consumption instead of targeted therapy or cognitive change--that issue will need to be visited once the “balancing” variable of the substance is removed from the equation (Czuchta & Johnson, 1998).
For people in recovery this translates rather simply into the client facing his or her major life issues without substances--many for the first time (Czuchta & Johnson, 1998; Lewis, Dana & Blevins, 2009). Typically, the physical, emotional and spiritual elements of a client’s life will be interconnected, each affecting the other in varied ways. Physical changes brought about by continued substance abuse can change every aspect of a client’s perceptions about family, religion and self, and more often than not this will generate both fear and reluctance during initial phases of recovery. When physical systems are not functioning properly the net impact on a person’s other life areas can be profound. Conversely, if a client is disenfranchised emotionally or spiritually, behaviors and physical symptoms can move to the fore as the client subconsciously works toward stability.
The author believes that because of the inter-connectivity between different areas of every human being’s life, all the major areas must be examined in in a way that honors the role each area plays. Viewing everything in flux--observing the push and pull of life’s major components--is the surest way to determine what issues a client must emphasize as they move through therapy.
To the author, addiction is less a tangible “thing” and more a place. In this place a client’s issues are the simple expression of the manner in which they respond to stress, pain, sadness, anger, anxiety, and myriad other issues. Instead of healthy management of these issues, addicts and abusers begin to respond to them with the typical behaviors of addiction: taking a drink, a hit, or a pill. To develop a healthy and sustainable approach to living--which happens in therapy and is continued in recovery--clients must learn to replace responsive habits with appropriate behaviors.
References
Beck, A.T., Wright, F.D., Newman, C.F., & Liese, B.S. (1993). Cognitive therapy of substanceabuse. New York: Guilford Press.
Lewis, J.A., Dana, R.Q., & Blevins, G.A. (2009). Substance abuse counseling (4th ed.). Belmont, CA: Brooks/Cole.
Czuchta, D.M., & Johnson, B.A. (1998). Reconstructing a sense of self in patients with chronic
mental illness. Perspectives in psychiatric care, 34(3), 31-36.
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