A comprehensive approach to addiction
We are usually very willing to describe ourselves as addicted to biscuits, cake, Downton Abbey or Twitter. However, we find it harder to admit that we are drinking more than we would like or have recourse to pornography, drugs, or gambling to an extent that it impairs our relationships, work or our lives in general.
This article is for people who are wondering whether this description fits them or someone they know. There are various options for you, all of which have advantages. You can see your GP, go to meetings of AA or similar, attend a specialist drug or alcohol centre, or go into rehab or a clinic.
If you choose AA, you will find that the first two steps in AA is to acknowledge that you have lost control over your drinking and to call upon a higher power for help. These ideas help many, but there are others who prefer to take responsibility for all of their actions, who are atheists or agnostics, and who want to work psychologically.
Such people can gain control over their addictions by increasing the effectiveness of their thinking, by dealing with the issues the addictions are enabling them to avoid, and by seeking to give themselves more interesting and fulfilling lives. You can think more powerfully by focusing on issues, by consciously using psychological principles, by emerging from denial, by anticipating difficulties, and by using techniques which have evolved within specific addiction work.
Addiction work, to be at its most effective, sees addiction within a framework which combines the social, the biological and the psychological. On the one hand, it is a learned behaviour; we have recourse to drugs and alcohol because they work on a stimulus-reward model. The person who has always been shy and awkward around people goes to a party, drinks, and suddenly everything seems so much simpler and more enjoyable. After a stressful day, a few whiskies work wonders. There is also an element of learning by association: what psychologists call "operant conditioning". We get off the train near to home, and we associate this with drinking, and so we head for the pub across the road. One of the first stages in working with addiction is to help people become aware of what has been learned, and then to put into practice the key finding that what has been learned can be unlearned.
Quite early on it can be important to make a personal assessment of the effects on you and others of your use of alcohol or drugs. In light of this, you can make a decision about how you intend to handle these substances in the future.
I believe that mobile phone technology offers extraordinary new opportunities for people who want to change their thinking or their behaviour in a new direction of their own choice. For example, it is useful to keep a diary of your drinking while you are drinking. This was almost impossible in pen and paper days. But it is very easy to make a record on your mobile phone. You can also use your phone as a way of listening to yourself. You can write texts to yourself or record voice messages to yourself. You can use the reminder system. You can take photographs which can motivate you, and, as you gain new insights into yourself, you can record them on your phone. You can use Excel or similar to record the progress you are making.
You can become aware of the excuses you use to drink or take drugs, and you can understand how you make seemingly irrelevant decisions which inevitably lead you into danger. For example, you can, apparently innocently, decide to visit a particular pub, while knowing that you are bound to meet there a friend who will offer you cocaine.
Therapy can also help you to uncover the issues around shame which can underly addiction. You may be sceptical about this but it is amazing how often addicts suffer from shame, not only because they are ashamed of the addiction and of what they do under its influence, but also because of perhaps half-remembered incidents from their past. Sometimes, working on this sense of shame seems able to dislodge the engine which drives the addiction.
Addictions are often a way of dealing with other emotions. Alcohol, in small quantities, reduces adrenaline production, and so is attractive to people who are nervous, shy and suffer from insecurity and low self-esteem. Drugs such as cocaine produce highs which contrast with depression, though later, they aggravate it. A therapy against addiction is most likely to have a lasting effect if it also addresses these emotional issues.
Lastly, there is also evidence that people are much more likely to drink less if they have more satisfying lives. People who are lonely and bored, and who hate their jobs and lives are more likely to revert to their addictions.
For these reasons, there is a place in addiction work for a comprehensive approach. It may be that such work could enable you, not only to be in control but also lead on to achieving a much better life for you and others.
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About Richard Thomas
I am a psychotherapist and psychosexual therapist who also has a psychology qualification. I work in Central London in Harley Street and in Bexhill on the Sussex Coast. Psychotherapy is a marvellous profession because you can see how determined, brave and creative people can be; it really is true that people "move towards the light."… Read more
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