Addictions can come in so many different forms that it is impossible to name them all but they all have something in common. All addictions developed as a coping skill, whether it is alcohol, weed, opioids, sexual addiction, eating disorders, gambling, shopping addiction, etc. As people travel through their lives, we pick up different coping skills in different situations. Some work well and some don’t. Some may seem crazy, some are conscious and intentional while others are not but we all have them. All people who struggle with addiction stumbled across the substance or behavior and noticed how well it worked for coping with whatever adversity they had, or more accurately, forget the difficulty temporarily. Addictions have a tendency to work so well that people will use the addiction to cope with everything and then no other coping skills are needed. Of course they have to continue the addiction because there is only short term relief. While people who do not have an addiction are developing new coping skills all the time, people with addictions stop learning new ones because they don’t need to. As a result, one of the biggest challenges in working with addictions is understanding when the addiction is gone, the person is left with no means to cope with challenges.
Just like any other challenge, some additions can be debilitating while in other situations people may be able to continue their normal life. We have all heard the phrases, “hitting bottom” and “functional alcoholic”. The first implies the individual has gotten so overwhelmed by their addiction that they can no longer hold their life together while the second is self-explanatory. Both are dysfunctional. There are also different phases of addiction treatment. Often family and friends are worried for the individual before they are worried for themselves. Remember, they are getting something from the addiction, so wanting someone to stop and that person being ready to stop are often far apart. For treatment to work, the individual has to want to change their behavior and the motivation cannot be to appease someone in their life. “You can take a horse to water but you can’t make him drink ''. This can be extremely upsetting and frustrating to loved ones who want the addiction to stop and can see that if the person would just stop, life would improve.
There are a number of options for addiction treatment. Individuals who are alcoholic need to be evaluated by a doctor to determine if they need a medical detox. Opioid addiction causes the person to become very ill when they stop using so again, a doctor should be consulted. For some people, inpatient treatment should be the first step in treatment. It provides 24/7 support and also takes them away from all triggers and friends who may unintentionally cause harm. The hope is that once inpatient treatment is completed, they have developed other ways to cope so the addiction is not the only option. Reinterring life can be difficult so there needs to be aftercare, usually groups and individual therapy. Some people do not need or cannot take the time for inpatient treatment. In those situations, there are some day treatment options that provide a higher level of care than just groups and individual therapy. Ongoing groups and individual therapy are usually the longest phase of treatment and sometimes the only treatment but are always very important to maintain “sobriety”. Groups provide a venue to learn from others, stay mindful of the reasons they stopped the addiction and provide “sober” social options. Individual therapy helps patients replace the needed coping skills and understanding why they became an addict originally. Through therapy, triggers can be identified and even matched with adaptive coping techniques which helps people feel more in control of their lives and behaviors. Cognitive Behavioral Therapy (CBT) is useful to enable people to identify negative thoughts which lead to negative feelings and help people identify what they need in order to feel their best. Thoughts, feelings and triggers are tightly connected and special care needs to be focused here. Mindfulness techniques help people learn to relax, stay focused on what is important, and improve self-awareness.
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Dr. Sara Denman, Lic #Psy 19808
