How counselling can support people with addiction

To any reader, I hope this article encourages you to carry on seeking the help that will aid your recovery. You are, I believe, likely to be suffering from a disease - a disease that may cause you to feel shame and guilt. But we would not shame a cancer sufferer, for example, so nor is addiction something to feel ashamed about. It can happen to anyone and is not by choice.

To those who may be close to someone with an addiction, I commend you for caring enough to search for help. I am a recovering addict and alcoholic and, by writing this article, I hope to be of some use in another person's recovery.

As an alcoholic and addict in recovery (five years+), I am fortunate enough to be in a position where I have walked the walk. As a counsellor, I am seeing the issue from the other side. The side of the professional who has earned the privilege of seeing clients who are in the grip of addiction.

It is difficult to write about addiction objectively but I feel I am able to offer my own experiences, which include my work as a counsellor, and also maintain a professional and objective view.

The prevalence of addiction

Addiction is not limited to one substance and does not discriminate against who becomes addicted. The behaviour can range from collecting classical music CDs (Gabor Mate), food, exercise, alcohol, sex, smoking, dieting and drugs (prescription and illegal). On my journey in recovery, I have seen addicts who range from financial directors to sex workers and pretty much every gradation between.

Research has shown somewhere between 17% and 40% of any population are likely to experience addiction. The stated long-term recovery rates are dismally low – between 1% and 5%. Allowing for the inaccuracy of statistics and the problems associated with defining addicts and long-term recovery, these figures shocked me. I have come to believe that anyone can recover but recovery comes from effort and cannot be given.

Sometimes it is kinder to allow someone with an addiction to behave that way while making their choice as safe as possible. Here I am referring, amongst others, to the Baltic method, the Portugese way, the Swiss way, the Netherlands way.

To some degree, the English way of methadone prescription is a reflection of these ways, but I am mindful of Professor David Nutt (neuropsychpharmocologist) and Keith Hellawell (drug czar under Prime Minister Tony Blair) and their experience of speaking the truth about drugs to power. Without digressing into Harry Ainslinger and the American war on drugs, "just saying no" is not enough.

As a counsellor, I am able to offer support and encouragement.

My journey into recovery was with the help of 12-step fellowships (AA and NA) and I am deeply grateful for the help and wisdom I was shown. Grateful fxor the wisdom I have been able to acquire and use on a daily basis. Interestingly, a lot of rehabilitation providers (cost not being a factor) send their clients to 12-step meetings or include them in their programmes. Speaking of cost, I could not afford any cost and AA does not charge!

Why might addictions develop? 

I have become very much convinced that addiction is a symptom of a deeper-routed problem. Yes, the addiction is serious, harmful and detrimental but, in recovery, I have needed to look at what purpose the addiction served. Not easy but I feel it is very necessary to do so.

For me, the addiction eased the feelings of difference, not belonging, not feeling happy in my own skin, feeling worthless and also some significant trauma. Out of respect for the people who were around me in addiction, I am going to keep their identities and roles anonymous. They have no right to reply and the problem was mine and not inflicted by them!

With clients, I very much see the addiction as a way of coping. Coping with society and its relentless pressure (and failure) to asses and describe success. Coping with life and all that has entailed. Sometimes it is about "Am I the right shape, do I earn enough, have I learned enough, is my partner pretty enough? etc.". This is I feel a demonstration of our herd instinct. To exclude someone from the herd or group is very powerful. The advertising industry is very much aware of this.

Then there are clients who have been treated in a way that has caused them to not want to, or not be able to deal with the events and consequent pain of their lived experience i.e. parental domestic violence, care system upbringing, addicted parents, inadequate education and housing, abusive caregivers – to list a few.

Another group are those who have been afflicted with mental ill health. As with all addicts, this group are very good at self-medicating – with varying degrees of success. Here, I think of the surgeon who is able to function despite being addicted to Class-A drugs and the street addict who trades up their prescription medication for a drug that works better for them.

So what appears to be a multi-faceted problem has, I believe, at its core some commonality. We cannot deal with life without some way of alleviating the pain, the memories and the consequences of lived experiences, without a way of soothing the pain. Our way of dealing with life has either ceased to work or the costs are too high.

This presents a paradox i.e. if we cannot deal with life then how do we deal with addiction?

This seeming paradox can be approached when the addict is ready to face their issues, their demons. Not when they are told to or are required to do so. Required by the criminal justice system, the family, the employer et al.

Unapologetically lapsing into AA terminology, when a rock bottom is reached, we are ready to start our recovery. When we are sick and tired of being sick and tired. When we have the gift of desperation.

Painful as it might be for the addict and difficult as it may be for the counsellor, I feel that a holding pattern of counselling is the most effective until this point has been reached. We can lead a horse to water but we cannot make it drink. We can show an addict the benefits and methods of recovery but only they can recover, when they are ready. Unfortunately, no one amongst us is powerful enough to make someone recover.

All is not doom and gloom though. There is hope.

How can counselling help? 

By providing a space, a relationship, where the addict can feel comfortable and secure enough to describe their addiction. A space where they feel safe enough to try (and often fail) to recover, by staying close to the client and supporting them, then recovery becomes more possible. When the client is in recovery (days, weeks or many months) being willing, and trusted enough, then they can look to the causes of their addiction. Work that I feel Carl Rodgers (Rogers.C. Client Centered Therapy.1951.Constable and Co.Ltd.London) described as self-actualisation.