Addiction is a disease that is rife in our society. Although most people
think of addiction as being centered around substance abuse, such as
Alcohol, Marijuana, Cocaine or other narcotics, hallucinogens or
stimulants, it can also include things like over-eating, over-working,
over-exercising, and sex addiction. Addiction can be seen as any type of
behavior that we use to numb ourselves (self-medication) or bolster low
self-esteem (external self-esteem regulation).
The self-medication type ususally takes the form of alcohol or other drugs such as marijuana, cocaine, amphetemines, although it can also include the abuse of prescription medication, or things like over-eating and compulsive sexual behavior (visits to prostitutes, pornography, internet sex etc). I am of the school of thought that it is not the substances themselves that are the problem, but our relationship to the use of them. Simply put, if we are dependent on a substance, as in feeling an adverse effect from stopping the use of said substance, or use that substance to numb from/avoid feelings/emotions, then we have a problem.
External self-esteem regulation takes the form of behaviors that involve seeking ego boosts to maintain our sense of self. Such behaviors include over-working to achieve success financially or greater prestige, sexual conquest behavior, and abuse of power (such as physical abuse/wife battering). And also included in this catagory would be dependency on relationship ( as in only feeling worthy because one is loved and being unable to sustain being on one?s own for any length of time). Once again, none of these behaviors in themselves are unhealthy, unless we are dependent on them to maintain our self-esteem.
And it is often the case that we fool ourselves into believing we are not addicted, by stopping one kind of addictive behavior, only to then begin another (as in the person who gives up cocaine only to begin drinking more alcohol). What also makes dealing with addictions so difficult is that many of them are socially condoned or even actively encouraged in our society (such as over-achieving or over-working).
Most approaches to dealing with addiction focus on cutting out the addictive behavior. I prefer to work on the underlying causes that lead to addiction, such as unresolved trauma, depression, self-loathing/hatred, a fierce inner critic/judge, feelings of shame, insecurity, inadequacy or a host of other reasons. From this viewpoint, addiction is simply a symptom of an underlying problem, not the problem itself. My experience is that once these underlying problems begin to get addressed and treated, the addictive behavior will cease to have such a pull on the individual, and will be much easier to break free from. And as the individual becomes healthier and happier, the addictive behavior will simply cease, since the need for it has gone.
There is another aspect to addiction that is almost totally unaddressed in our culture, in our medical and psychological approaches to healing addiction, and it is this: The reason most people engage in addictive behaviors is quite simply to get high. In my opinion, there is nothing wrong with wanting to get high, or wanting the high that certain substances or behaviors can bring us. Rather, my view is that we are seeking to get high in the wrong ways.
The healthiest and best high in my experience comes from intimacy, from the open, honest and authentic sharing of true feelings, emotions and experience between people. When we can come to learn how to relate to each other in this way, then the need to find high's through addictive behaviors simply vanishes, since the artificial substitutes have been replaced by the natural way.
Therefore i prefer to work by helping to guide the client to healthy ways of getting their needs met first, and then the addiction will simply fade way. But i do want to make clear that here I am referring to what would be called functional addicts: This means those who are addicted in some way, but manage to continue keeping their lives more or less together (holding down a job, being in a relationship). But in certain cases where the addictive behavior is out of control, and threatening to destroy the person's life, then it is necessary to work the other way around, in terms of having the individual stop the addictive behavior and then developing treatment plans and goals accordingly. It certain cases this is absolutely necessary to avoid serious negative consequences an out of control addiction can cause.
For me no one approach is ever the right approach in all situations. We are all individuals and although we share many commonalities, each of us needs to be treated according to our uniqueness. And I do encourage those dealing with addictions to join twelve step/and or recovery programs, especially since these programs enable people to find support, help, encouragement and community around their recovery process. But I do not insist on their joining recovery programs.
What feels vital to me is that those I work with know that they can come and seek help to deal with the addiction without having to face the often terrifying prospect of letting go of the addictive behavior first.