Alcohol and Other Drugs and Addiction
In my experience from working with many people who have an unhealthy relationship with alcohol and other drugs, substances, damaging behaviours, or mental health and addictions more broadly I have found that the cause of the issue is not an overuse based on enjoyment, indulgence, weak or so-called ‘addictive personality’ or some other negative fault with the person. Quite the contrary - people who develop addiction and unhealthy habits often have a very high care factor. Most often the addiction did not occur as a direct cause of the substance or behaviour, but rather from an underlying and often hidden issue that I believe we can identify and address together.
I work with many people who are highly successful overall, often scoring goals, responsible and dependable towards others, with both intelligence and a caring nature. The addiction may be the current version (usually problematic by the time I meet the person) of a behaviour that may have been ‘the second lever’, the adaptable survival mechanism, the ‘off switch’, the enabler of X and Y, or some other useful coping strategy. But now, the lever or coping skill has been over-used, causing havoc and mayhem in life, and perhaps grown to be a much bigger problem than the one experienced in the first place.
If problems have yet to emerge, the person may already predict the coming disaster should they continue their path. Addictive disorders are not just based on the amount consumed, too much alcohol or hours or money spent, but rather on factors such as failed attempts to stop, impact on work and study, internal feelings leading up to using or doing, as well as conflict with others.
Harm minimisation versus Abstinence
Early in our therapy together I provide information and education about mental health and addictions and in particular two separate approaches – abstinence versus harm minimisation. For some people they have decided that they never again want to touch alcohol and other drugs, or do the addictive behaviour (e.g. gambling, gaming, spending, etc.) which is the foundation for the abstinence model (such as AA). For others, in particular young people who may be ambivalent about giving up or stopping, it may be more suitable and realistic to consider the harm minimisation approach. In this model, we conduct ongoing risk assessments and design strategies together that are aimed to reduce and minimise potential and real harm to the person and to others.
Through my work and study I became a SMART Recovery facilitator, a harm minimisation approach suitable for anyone who would like to change their relationship with alcohol, substances, or behaviours that may be damaging. Regardless of which approach that may be most suitable, my work process always starts with a thorough assessment for us to develop a shared understanding (formulation). We will use this understanding to collaboratively work out a plan (treatment planning) of action together to guide our therapy and recovery.