Existentialist theory and working with addiction

In my work with clients suffering from addiction, a conversation about purpose and meaning is part of almost every client's therapeutic journey. Alongside the areas of trauma, self-image and behavioural, the existential is just as ubiquitous when working with a client towards a successful recovery.  

I have the work of Irvin D. Yalom and Victor E. Frankl to thank for helping frame these client conversations about meaning and purpose. 

Both are legendary figures in therapy. Dr Yalom for his development of existential psychotherapy. His most revered work is perhaps Loves Executioner, (though my favourite is The Gift of Therapy, written for therapists and clients of therapy) Frankl is revered for developing his own approach, logotherapy, advanced in the best-selling Man’s Search for Meaning.

Yalom frames the core paradox of meaning and being human in his book, Loves Executioner in brilliantly stark terms.

“If death is inevitable, if all of our accomplishments, indeed our entire solar system, shall one day lie in ruins, if the world is contingent (that is, everything could as well have been otherwise), if human beings must construct the world and the human design within that world, then what enduring meaning can there be in life?”

And yet. “We are meaning-seeking creatures. Biologically, our nervous systems are organized in such a way that the brain automatically clusters incoming stimuli into configurations.”

And… “Even more important, meaning gives birth to values and, hence, to a code of behaviour: thus, the answer to why questions (Why do I live?) supplies an answer to how questions (How do I live?)” 

Frankl’s book, Man’s Search for Meaning, tells the incredibly moving story of how he survived the Holocaust. Logotherapy, his therapeutic approach, was based on the premise that man’s underlying motivator in life is a “will to meaning” even in the most difficult of circumstances.

In the pursuit of meaning, Frankl recommends three different kinds of experience: through deeds, the experience of values through some kind of medium (e.g. beauty through art, love through a relationship) and finally through the response to suffering (a crisis or adversity)

For Frankl, happiness could never be an end to itself, it was an important byproduct of finding meaning in life.

“What man actually needs is not a tensionless state but rather the striving and struggling for some goal worthy of him. What he needs is not the discharge of tension at any cost, but the call of a potential meaning waiting to be fulfilled by him.”

Core to my own approach is identifying, through therapy, not just the potential causes of an addiction, but also the barriers to recovery. And “What’s the point of my life?” And “I don’t have any purpose” are heartfelt refrains I often hear from my clients. The sense of purpose is important in the process of recovering from addiction for two reasons. 

Firstly, in order to cease an addictive behaviour it helps if the client feels something more than “I’m helping myself”. They may feel that’s not enough. They may not feel that they, alone, are worth it.

Secondly, giving up an addictive behaviour leaves a vacuum. Filling that vacuum is hugely important to not stepping back into addiction, and filling that vacuum with what is important, is best after exploring exactly what is meaningful to each client. 

When I talk to clients about their sense of purpose I tend to paraphrase Frankl by working with them to find meaning in three areas. 

1. Who do you love, what do you love and who loves you?
2. What do you do and what do you believe in?
3. How are you going respond to (this) crisis and/or adversity in your life in general?

The change part of my programme is geared to change which makes returning to addictive behaviour much more difficult.

Some of the changes that I’ve worked on with clients, after exploring through therapy what is meaningful to them, have included:

• Re-claiming relationships with people they love (family and friends) that were in abeyance or had ended.
• Re-starting activities and interests that were loved but that were perhaps shelved.
• Turning political or ideological passions into activism.
• Bringing what they are passionate about into their work or changing their work to match their passions.
• Helping others respond to crises and adversity in their life.
• Giving back to society in line with the passions and interests that they rejuvenate.

I believe that meaning and purpose can be as critical to recovering from addiction as identifying, for example, trauma, as its cause. And I have Yalom and Frankl to thank for giving me the words, and the theoretical framework, to embark on these conversations, and to spur tangible, meaningful change.