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Addiction

I regularly work with individuals and couples who have addiction problems. I use these therapeutic approaches:

AA (Alcoholics Anonymous), EFT (Emotionally Focused Couples Therapy) and AEDP (Accelerated Experiential Dynamic Psychotherapy).

In AA the power of 12 Step meetings is in feeling unconditionally accepted by your group and its members. This unconditional acceptance is also modeled in therapy where you are encouraged “to show up as you are” with flaws, negative thoughts and vulnerable feelings.

To get sober from any addiction (alcohol, drugs, porn) you need to find an alternative in life that replaces, and feels as good as, getting drunk, high, buzzed. Instead of addiction love, safety and respect are the only substitute I know. Underneath we all long to feel safe and accepted and to be able to turn towards our partner for this support.

In individual therapy the therapist is the safe haven and secure base, in a relationship it is each other. In couples work we need to get out of the negative pattern of criticizing, demanding and blaming. To break this negative cycle and move towards healthy “interdependency” which means feeling the true longings we all share; to be safe, close, connected and seen by our partner with love and acceptance. 

Addiction is a primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction also affects neurotransmission and interactions between cortical and hippocampal circuits and brain reward structures, such that the memory of previous exposures to rewards (such as food, sex, porn, alcohol and other drugs) leads to a biological and behavioral engagement in addictive behaviors.

Addictions are an attachment based disorder where the substance is the transitional object that serves to calm the anxiety an addict feels. Addictions allow dopamine to be released in the system and this effects the brain and provides relief from anxious or sad feelings. These compulsive behaviors almost always serve to function as self soothing and prevents the addict from turning to their partner for safety and care. An addict often feels the only way to claim their independence is by determining their own destiny, even if that means being self-destructive.

 

Dr. Gabor Mate says the effective response to help addicts would be to address the emotional pain and adverse conditions at the root of the addiction.

 
 
Johann Hari: Everything you think you know about addiction is wrong

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