Effective addiction treatment – fighting with symptoms or cause?

One of the most common statements says that addiction is a disease. Many people, including specialists, still think that first you have to deal with addiction, and only then you can solve the rest of the problems.

At the first meeting, I often hear from patients:

“I went to AA meetings, but the only thing that mattered was whether I was drinking, when and how much. And I don’t understand how come that for five years I managed not to drink, and then it started all over again.”

“I was trapped in a vicious cycle of depression and addiction, from which I cannot get out. The relationship I was hoping for didn’t work out. I know it’s stupid to break down because of this.”

“I signed up for a visit to a psychotherapist, but for half of the conversation, I only heard that first I had to deal with my addiction. Can it really be separated? First one and then the other?”

I admit that I used to think similarly. Until I met Bożena Maciek-Haściło * with her psychodynamic understanding and approach to treat addicts on the basis of the theory of bonding.

According to this approach, the addiction symptom is only the tip of the iceberg. Thus, the attempt to eliminate it, even if effective, will not eliminate the source of its formation. The symptom will come back, another symptom will appear, or one will accept living in misery. This is why it is so difficult for patients to begin living in abstinence. When they hear that they need to be completely clean to take the therapy, they either do not start the treatment at all, or they give up quickly.

The main burden for addicts is interpersonal relations. These difficulties arose in childhood and due to the contact with the first guardians, who were unable to look after them in a way that allows them to deal with emotions. Most addicts experienced the trauma of lesser or greater severity. We are talking about “lack of” trauma (i.e. neglect or abandon) or “excess” trauma (i.e. physical violence, abuse). This is why they do not know how to experience feelings in a good way. They felt the need to retreat in some way in order to protect themselves and be able to survive in relationships with people. At some point, they reached for a substance (e.g. alcohol, drugs) or an activity (e.g. gambling, computer games, shopping) and felt that it is the source of relief and peace that people do not give. The primary function of reaching for a substance or activity is the need to soothe and relieve tension. The person does so because of the need of self-healing. An addictive substance or activity is the most available form of dealing with difficulty and has a calming role.

Philip Flores ** writes that a person’s attachment to a substance or activity is so strong because it is reliable and easier to control than uncertain and unpredictable contact with another person. Addiction alleviates and reduces loneliness, pain, and suffering, as well as (deluded) feeling of repairing a wounded, weakened “I”.

Therefore, what helps patients is learning how to build relationships in a safe way. This can occur both in the therapeutic group and in individual contact. Thanks to this, patients begin to understand themselves and the fact that resentments and fear of relationship are the main causes of their suffering. When the patient tries to build a bond with other people, the recovery progress begins.

Only the experience of intimacy with another person and being accepted, may result in an independent decision of the patient on the limitation or even complete abstinence. Thanks to the sense of safe dependence, the patient can give up the trust in the substance, and begin to trust the other person. Sometimes for the first time in one’s life.

1 marca 2019

tekst: Barbara Sławik zdjęcie: pinska

* Bożena Maciek – Haściło – psychologist, certified PTP psychotherapist, supervisor of addiction psychotherapy. She works in the Psycho-educational Laboratory team, conducts classes at the addiction care school Care Bro. The head of the Poradnia Leczenia Uzależnień i Współuzależnienia (Addition and Codependence Treatment Center) in Śrem.

** Philip Flores – author of “Addiction as an Attachment Disorder”