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The Role of Addiction Psychology and Recovery

What to expect in this episode:

  1.  Traditional psychology has taken a central role in recovery and treating addiction, but it may not be ideal. 
  2.  Psychotherapists often recommend AA or treatment because no progress can be made while in active addiction.
  3.  Immersing in the recovery culture to help the psychology of recovery.

 

Psychology and Recovery

Its a newer phenomenon that psychotherapy and psychology has taken a central role in the world of recovery. Part of me is rubbed a little wrong by that. It’s not that I am anti-therapy, both my parents are psychologists I actually love psychology. I’m fascinated by it.

 

But traditionally, we have an understanding that individual Psychotherapy is not a very effective way to treat addiction.

 

Addiction Needs to Be Addressed for Better Mental Health

What you’ll find most commonly is somebody’s afraid to enter into the world of recovery for a variety of reasons, so they go see a therapist – maybe an addiction specialist or maybe just a therapist – and I think the most common story is somebody will see a therapist for months or even years while still continuing to engage in their addiction maybe with some improvement maybe with no improvement.

 

Eventually, that therapist will say – maybe in months maybe in years, “hey, I can’t continue in this therapeutic process until you do something about your addiction problem and I can’t help you with your addiction problem. You need to go to treatment or Alcoholics Anonymous.”

 

It’s kind of a shame to me that somebody might be in therapy for five, six, seven, eight years I would hope that therapists out there recommend that early, and I also understand that if the clients not willing to go into treatment or to seek out some recovery that the therapist is stuck.

 

Immersing in the Recovery Culture

In general, my belief (and this is complex in nuanced) is that people have to immerse themselves in a culture of recovery and integrate recovery as part of their identity as the primary task of recovery. And that’s up front.

 

Upfront I have to challenge myself to admit that I have an addiction problem that I’ve been unable to solve. Then I have to take on the task of saying, “Okay, I’m a person who suffers from addiction and in order to treat this condition, I need to be a person in recovery.”

 

I need to be a person who identifies myself as someone in recovery from this condition just like I would if I diabetes. If I had a horrible case of diabetes then my recovery from that, or even a cancer survivor, I would identify as a cancer survivor. It almost killed me!

 

I have to know that deeply about myself and it is the first and primary core task of recovery

 

Psychology in Later Recovery

Then therapy comes along in order to help me to better understand myself and treat the underlying emotional conditions that existed, maybe prior to my addiction. In all different dramas in different ways of being different blocks I had that caused me to suffer that I then use drugs and alcohol to treat. I think of therapy as by and large the later stages of recovery.

 

At first, I have to be a person in recovery then I can work on this other stuff because if I’m not a person to recover, continue to use I’m not going to get any therapeutic work done.

 

There are exceptions. The exceptions to that are if I have trauma and it’s so severe it’s getting in the way of me being able to identify as somebody in recovery. So if the psychological problem or even psychiatric problem is so severe that I can’t engage.

 

An easy example is if I have a really hard time regulating my emotions. Incredibly impulsive. It will be impossible for me to engage in recovery because I can’t sit still, I can’t stop talking, I can’t take it in, take information and reality in, so a specialist, a therapeutic specialist would have to come in and treat my Emotion Regulation Impulse Disorder in order for me to engage in recovery.

 

But in general, I think that’s the exception

 

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dual diagnosis treatment for mental health and addiction
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Dual Diagnosis vs Multidimensionality

Some time ago, I had the opportunity to work in the Skid Row area of downtown Los Angeles. In those days (the early ’90s) the residents of the area were divided between need “mental health services” or those needing “addiction services.”  This distinction was usually the result of some odd government funding rules or just the general ignorance of the time. It must have been extremely frustrating for clients to walk back and forth between programs as both programs had strict entrance criteria. Invariably, the client would give up and end up using and just sleeping on the streets. 

 

The Dual Diagnosis revolution came about as both traditional mental health, and substance abuse programs began to realize that clients didn’t fit into these neat boxes. In my mind, this was obvious. Any Introduction to Psychology course will instruct you on understanding the complexity of human behavior. More often than not, people need help in a variety of areas. 

 

Mental health disorders and substance abuse issues are only a small part of the recovery plan Share on X

 

Services such as financial and legal planning, helping the family, and assisting clients in finding good-paying jobs and housing. More importantly, the staff needed to have a greater level of compassion and understanding as clients ranged in age, culture, and background. 

 

More recently, the Diagnostic Manual of Mental Disorders-V (DSM-V) (the psychiatric diagnostic manual) instituted new guidelines for diagnosis along a dynamic spectrum of issues (i.e., health, financial, relationship and emotional issues). This strategy of diagnosis avoided the stale one-word diagnosis (e.g. alcohol abuse) and painted instead of a richer and more clinically useful multidimensional picture.

 

The American Society of Addiction Medicine (ASAM, 2013) has developed a multidimensional assessment model that provides both clients and staff a client-friendly treatment model. The assessment model includes everything from treating withdrawal symptoms to assess the client’s risks of relapse. The ASAM Placement has also allowed a common means of communication between clinicians, recovery professionals, and third-party payors.

 

Unfortunately, rather than focus on treatment efficacy, many programs seem to offer a menu of attractive services, some of which have shown little value in establishing and maintaining the client’s sobriety. Share on X

 

However, most programs use traditional treatment models. Unfortunately, most of these models of treatment reflect the treatment the staff received in their respective recovery programs.  Rather than focus on treatment efficacy, many programs seem to offer a menu of attractive services, some of which have shown little value in establishing and maintaining the client’s sobriety. It’s almost impossible to do a Google search on substance abuse issues without going through countless slick webpages offering expertise and a pleasant rehabilitation process. 

 

The relatively recent focus on Dual Diagnosis has opened the recovery community to an earnest attempt to provide a more simplistic but helpful understanding of clients who suffer from substance abuse and mental health issues. Although both issues are indeed mental disorders, the development of the Dual Diagnosis model has started a much-needed paradigm shift for both clients and treatment professionals. Although the multidimensional approach is growing in the recovery field, it is still challenging to have the staff and client to see just how complicated this perspective is.  Typically, a simple diagnosis like “he’s just an alcoholic” or “he’s a recently divorced drug addict” is used to describe a rather complex individual in a complicated situation. 

 

Along with this development, some insurance companies have become more “savvy” in how they evaluate treatment progress and thus pay for treatment. Some have demanded that the client be discharged to a lower level of care or burdening the client and the family with the additional costs of treatment. I have seen clients lose their treatment benefits and sadly return home only to repeat the cycle of addiction. Along with more effective treatment models, funding agencies need to support our client’s in their recovery as a medical necessity and not just auxiliary service. 

 

In my own recovery, the most helpful experiences were those in which compassionate staff helped me develop a sense of hope and regain a more balanced perspective on life in general. I learned to develop a greater acceptance of my higher power and trust in myself and my support system. These and other dynamics such as compassion, humor and the ability to have fun without drugs, remain outside traditional addiction medicine, but in many ways are just as important (or more). 

 

My own personal experiences at Recover Integrity have shown just how a program can be both a treatment program, providing complex dual diagnosis treatment, and a place of healing and renewal of hope Share on X

 

My own personal experiences at  Recover Integrity have shown just how a program can be both a treatment program, providing complex dual diagnosis treatment,  and a place of healing and renewal of hope. This humanistic perspective perfectly emboldens my own work as a clinician and as an administrator of the program. [/vc_column_text][/vc_column][/vc_row]

If you think a loved one would benefit from a dual-diagnosis treatment plan, please reach out to us for a free 15-min consultation. We are here for you.

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