13. Better understanding of addiction helps recovery

By Tom O'Connell

In an age of complicated theories that lead to confusion, it's good to hear some simple, straightforward statements about psychotherapy and recovering addicts. Clear and useful insights for therapists were provided at the Albert Einstein College of Medicine's 18th Cape Cod Institute by Joseph Weiss, M.D., who is co-author of The Psychoanalytic Process and How Psychotherapy Works (Guilford Press). .

Discussing "more severely disturbed people," which obviously includes addicts, he noted that it's important for them to "understand why it happened, and how it affects the rest of one's life." Weiss, who is in private practice in San Francisco, also says that each person has particular needs about how he or she can be helped.

Although there are some common factors in addiction, each human being is a distinct personality with a unique history and needs to be treated that way. Generic slogans are helpful, but each of us has had a slightly different journey through life.

Weiss, an eminent researcher, suggests that addiction is a way of "trying to connect." Citing a case in which a man had experienced neglect in his family, Weiss said, "Addiction took care of the attention he didn't receive."

On addiction relapse, Weiss said it can happen for a wide number of reasons. He cited an especially difficult case in which the patient had been using Xanax and alcohol, along with speed. The man's mother had been too busy to give the young man a sense of continuity. And the father, who was always working, was prone to lecturing the son during visits to the boarding school.

It took a year and half to resolve the Xanax addiction, when the patient finally began to feel that he was connecting with the therapist. In situations where parents are very controlling, Weiss says a person will often respond by choosing addiction to create a situation where they are out of control.

He also discussed "survivor guilt" in recovery. When a person chooses to abstain from alcohol, it may lead to guilt about not drinking with the family anymore, and about feeling superior to other family members. Such guilt can set a person up for relapse.

Grief and loss are factors too. "When a person gives up a symptom it gets lonely out there in empty space," said Weiss. He told of a woman raised in a teasing family. Hating to be teased, she finally stopped the teasing in her marriage, but then she became very lonely. She was feeling a loss because the familiar situation was gone.

In addiction recovery, when the tobacco is stopped, or the drink, or the drug, it leaves a deep feeling of emptiness. It's a major loss, and after loss we go into grief. When we finally reach acceptance we move on with our lives.

A key item for Weiss is teaching the patient to be "authentic." But in teaching, he  cautions against lecturing during therapy. He also warns against treating relapse as a negative thing. He believes the focus should be on the positive, including an understanding of why the relapse happened, and how recovery from the relapse is taking place. 

A key theme for Dr. Weiss is found in the word "connect." And 12 Step recovery programs provide a way to connect. When the process is combined with skilled psychotherapy the chance for quality recovery is excellent. After all, to connect is to live.

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