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.
The Opposite Of Addiction is Connection
Do Stronger Human Connections Immunize Us Against Emotional Distress?
Right now an exciting new perspective on addiction is emerging. Johann Harri, author of Chasing The Scream, recently captured widespread public interest with his Ted talk Everything You Know About Addiction Is Wrong, where he concluded with this powerful statement:
The opposite of addiction is not sobriety. The opposite of addiction is connection. - Johann Harri
These sentiments are augmented by a growing number of experts, including addiction specialist Dr Gabor Maté, who cites 'emotional loss and trauma' as the core of addiction. Compare this 'emotional loss' to Johan Harri's idea about lack of connection and it is clear they're talking about a similar emotional condition.
If connection is the opposite of addiction, then an examination of the neuroscience of human connection is in order. Published in 2000, A General Theory Of Love is collaboration between three professors of psychiatry at the University of California in San Francisco. A General Theory Of Love reveals that humans require social connection for optimal brain development, and that babies cared for in a loving environment are psychological and neurologically 'immunized' by love. When things get difficult in adult life, the neural wiring developed from a love-filled childhood leads to increased emotional resilience in adult life. Conversely, those who grow up in an environment where loving care is unstable or absent are less likely to be resilient in the face of emotional distress.
How does this relate to addiction? Gabor Maté observes an extremely high rate of childhood trauma in the addicts he works with and trauma is the extreme opposite of growing up in a consistently safe and loving environment. He asserts that it is extremely common for people with addictions to have a reduced capacity for dealing with emotional distress, hence an increased risk of drug-dependency."Humans require social connection"
How Our Ability To Connect Is Impaired By Trauma
Trauma is well known to cause interruption to healthy neural wiring, in both the developing and mature brain. A deeper issue here is that people who have suffered trauma, particularly children, can be left with an underlying sense that the world is no longer safe, or that people can no longer be trusted. This erosion (or complete destruction) of a sense of trust, that our family, community and society will keep us safe, results in isolation - leading to the very lack of connection Johann Harri suggests is the opposite of addiction. People who use drugs compulsively do so to avoid the pain of past trauma and to replace the absence of connection in their life.
Social Solutions To Addiction
The solution to the problem of addiction on a societal level is both simple and fairly easy to implement. If a person is born into a life that is lacking in love and support on a family level, or if due to some other trauma they have become isolated and suffer from addiction, there must be a cultural response to make sure that person knows that they are valued by their society (even if they don't feel valued by their family). Portugal has demonstrated this with a 50% drop in addiction thanks to programs that are specifically designed to re-create connection between the addict and their community. "Human connection is crucial in in the immediate task of clearing trauma"
Personal Solutions To Addiction
"Ask not why the addiction, but why the pain."
- Gabor Maté
Recreating bonds is essential in the long term, but human connection is crucial in in the immediate task of clearing trauma. When a person decides to finally face and feel the pain that they may have been avoiding for years or decades, the first steps cannot be done alone.
"You have to be with that pain, but you have to have support."
- Gabor Maté
This support is essentially the reintroduction of the care and support which is so important in creating the neural structure of emotional-resilience in early life. By doing so, we begin to replace what was missing, and thanks to the revelations of neuroplasticity we now know that you can in fact teach an old dog new tricks; neural rewiring is possible in adult life. Though it is essential for addicts to feel supported in order to finally face and feel the pain they have been trying to avoid, this is ultimately an inner journey that must be taken by the individual.
"Whatever you do, don't try and escape from your pain, but be with it. Because the attempt to escape from pain creates more pain."
- The Tibetan Book Of Living And Dying
The Roots Of Healing
When we are young, our parents care for us until we are able to do it for ourselves, after all they won't be there to do it for us forever. Perhaps, on an emotional level this is also true: our parents love us so that we may learn to do it for ourselves. The programs in Portugal have demonstrated that addicts do remarkably well when they feel valued by their community. Whether they realize it or not, the Portuguese are creating positive limbic modeling by valuing the addicts so they can learn to value themselves. When people are there to provide loving support for an addict wishing to face the emotional pain they carry, they are loving them and caring for them until they can learn do love themselves. With this in mind, perhaps the neural-wiring of emotional resilience developed through the loving reflection of another, once fully developed, could simply be called self-love.
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