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`Introduction
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`Introduction
The addict, addiction and the family involved can be likened to the spider, its web, and its prey.
The web of illusion and disillusionment that weaves the addict's body, mind and spirit together catches almost everyone inextricably in its sphere and makes it one of the most challenging and complicated issues facing today's clinician. Just as a web may be at once inviting, invisible and deadly for the unsuspecting, a lack of knowledge regarding addiction can be time consuming, frustrating and ultimately destructive in the therapeutic setting. Due to the interwoven symptomology throughout the body, mind, and spirit of the addict, our treatment approach must also be multidimensional and interconnected.There is currently much debate over whether chemical dependency is genetic or environmental. Nature or nurture? In fact, as you take this course, you will see that the etiology of addiction really does not matter. Addiction creates its own constellation of symptoms, and treatment initially must focus on the addiction.
Dr. C was in analysis for twelve years. He spent hours and hours looking at his dreams, free associating, and exploring his intrapsychic material. His skilled analyst helped Dr. C look at his painful childhood, the lack of consistent parenting and the loneliness this sensitive man often felt as a boy. They explored his time in the war and his subsequent post traumatic stress disorder, including the neglect in childhood which made Dr. C perhaps more vulnerable in the war. Together, they worked on the transference, looking at its interpersonal and archetypal aspects. It was a successful analysis except that Dr. C's binge drinking and abuse of prescription drugs were never addressed in the analysis as a problem. When Dr. C would bring his shame and guilt over his drug use to the sessions, they were discussed as symptoms of a dysfunctional childhood or sequelae to acts committed in the war. Dr. C died at the age of 46 in an accident in which his judgement had been impaired by combining alcohol and prescribed pain killers.It is the intention of this course to introduce the issues of differing opinion and treatment approaches through our own personal and professional experience, as well as links through the web to articles from other researchers and professionals. We have also included referral sources at the end of this text. Although the use of mind and body altering substances is documented throughout history, addiction to drugs, alcohol, people, food or sex appears more prevalent in todays' societies.
A standard working definition of addiction is the use of anything that is habitual, compulsive and interferes with the individual's physical, emotional and spiritual well-being.We will be introducing you to TheACCEPT©Model of treating substance abuse.Developed by Phoenix Helm Simpson LMFT and Kate Amatruda MFCC, this model involves:
We as clinicians must be aware that our preferred theory and practice of psychotherapy or counseling is not enough to facilitate the recovery of addiction unless we actually address the addiction itself. Chemically dependent people have repeatedly shown everyone around them that in spite of the best intentions and the purest will, the mental obsession and physical craving for their drug or behavior of choice will destroy in days what they have taken months, years or a lifetime to create.
To
believe that one therapist, as a single individual and source of intervention,
can counteract such a powerful force as addiction is foolish, misleading and
no different from the rest of the well meaning and loved individuals who have
watched this client's struggle. We must accept and acknowledge the power
of the disease before us. It is tricky as addiction walks in under many different
guises or symptoms such as job dissatisfaction, the inability to hold a job,
loneliness, inadequate relationships, isolation from family and friends, entitlement,
insecurity and many others. For more information on current drug use in the
United States, go now to 
1997
National Household Survey on Drug Abuse.
In Phoenix's informal poll of young adult clients the most frequent age of beginning use (85%) was 8 years old. As a clinician she was shocked since the prevailing wisdom in treatment says that a person's problem-solving abilities stagnate at the age when use begins due to the choice of getting high superceding the process of struggling through an issue. It was one thing to work with adults struggling with issues of adolescence; however, going back to elementary school problem solving skills put a recovering addict at a tremendous disadvantage.
Where
does this all begin? To learn about the neurobiology of drug addiction go to
the National
Institute on Drug Abuse. Clearly, while there are circumstances that predispose
a person to addiction, including heredity, biochemical vulnerability, trauma,
stress, or a
history of child abuse, it is crucial to address the addiction itself, as
a separate clinical issue.
How do we help ourselves and our clients navigate these murky waters? Through our own experience and the current articles included in this course we aim to provide the starting point to understanding and dealing with addiction in your practice. To wrestle with it in other parts of your life do not hesitate to make yourself available to the widespread resources you may also suggest for a client. Many twelve step meetings have open sessions where you do not have to be an addict or alcoholic to attend. Understanding of the journey that your client is embarking on towards healing is crucial.
Denial is the primary defense in the disease of addiction and coaddiction. Knowledge and the ability to confront the truth are the ultimate undoing of denial. It is important to recognize that recovery is a lifelong process. Addiction is never cured, but rather attended to throughout the life of the individual.
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