The Harsh Reality of Addiction Recovery from a Substance Use Therapist.

“Addicts experience something breathtaking when they can stretch their vision of themselves from the immediate present back to the past that shaped them and forward to a future that’s attainable and satisfying”

– Marc Lewis

The most frustrating part of addiction is the desperation to get clean when using, but also the desperation to get high when clean. Where does someone turn when stuck in a persistent state of hopelessness...always knowing where they want to be, but never being where they are? How do you convince someone that their decision making is altered by a part of their brain that is influencing decisions before they are even made?

This phenomenon becomes more apparent on a daily basis when working with those who are suffering with substance use disorders. This conflict arises when an individual believes they have complete control over the decisions they make since they believe they are consciously making them. To them, their decision making is with their best interest in mind and fully grounded in rational thinking and reason. However, many times these decisions have the capacity to deliver self-destructive consequences. This is especially true for the individual suffering from a troubled past or previous trauma.

Memory has an integral role in decision making. If an individual has experienced significant forms of distress and trauma, their memory is going to ensure that their decisions are protective in nature.

Since memory systems utilize past experiences to understand the present and anticipate the future, decisions are geared towards the avoidance of pain, discomfort, stress, and ultimately, the avoidance of change.

As a therapist working to explore and identify healthy life changes that will improve one’s quality of life, this is often where the challenge can arise. Ideally, with time, someone can gain deeper insight and harness the motivation needed to change and make positive life adjustments. The thing is, this does not always work out because something stops that individual from drawing power from their insight and turning it into behaviors that are conducive to a new way of life.

This leads to frustration, shame, guilt, and eventually depression as someone who has all of the desire to make changes simply cannot put it together to make a difference. This may be because the unconscious mind often has a completely different agenda than the conscious individual. One may learn that there is comfort in the familiarity of chaos, even if the chaos leads to complete social, physical and emotional isolation.

When looking at the benefits of using alcohol or substances, one should not ignore the powerful feelings of safety and security that the effects of the high produce. No matter the severity of pain the individual encounters, the experience of the high provides a safe shield, protecting them from the full impact of reality.

Although it is impossible to isolate addiction to one event in time, the experience of trauma and different forms of it seem to be a common trait that many of my clients share. I have learned that addiction always begins with pain and always ends with pain.

The high feels like a surge of warmth that comes with the experience of love. It may feel like the warm embrace of a loved one or for many, the love that that they never had the opportunity to experience. It is no surprise that opioids are the endorphins that are released in the human body when a mother holds and soothes her distressed infant. However, the high inevitably turns on the user as they become even more trapped in the walls of isolation, further reinforced by bricks of shame, fear and despair. Unfortunately for many, this state of existence is still a desirable alternative to the overwhelming and unbearable experience of life on life’s terms.

The effects of an environment on the individual are significant. Fortunately, this is something that can be utilized to foster change. I have heard that the goal of psychotherapy should always be security. When working with individuals who may have grown up in toxic environments, often coupled with abuse and neglect, fostering security can be very challenging. For them, their own bodies have learned to prevent them from feelings of security and safety as a

consequence of their repeated trauma(s).

I have seen and explored this problem through my work and through my own experience. The answer has to be connection. Connection to a person, who provides unconditional positive regard. This person can be anyone capable of providing stability, unconditional support and who can convey the message that, “I am here with you no matter what your feelings or emotions tell you.” This person may even be the therapist. The person has to show the individual through their support that they can be the safety net the person needs. By sending consistent signs and cues of safety, one can help a person begin to turn off their “fight or flight” and/or withdrawal response system(s).

This is not an easy process but through consistent support it can be accomplished. If an environment caused an individual to adapt by making protective decisions, an environment can also be fostered to illustrate how that they don’t have to work so hard to protect themselves and that there is so much power in vulnerability. Through this process, a person can learn how to tell their body to “calm down, we are not in danger,” and allow themselves to experience the freedoms that connection can offer.

Through co-regulation (learning how to manage emotional states with someone else), a person can eventually learn self- regulation (how to self-soothe). They can learn how to manage the pain that is inevitable in life. People will always experience pain in life, that is a reality. The growth begins when one can learn that they do not have to face the pain alone. Through connections with other people, those suffering with substance use disorders can learn that they do not need use drugs or alcohol to get their needs met as they can get them met naturally, through others. Change will always be hard, but it does not have to include suffering. Through connection and support, change can ultimately lead one to new meaning.

-Christopher J. Brown