Addictions

Addictions comes in many forms & shapes, The common or most spoken of are: Alcohol & Drug addictions. Then follows with the very common process addictions, Gambling, Spending money, Collecting, Sex Addictions, Pornography, Relationships, love Addiction, Dating Sites, Social Media Site addiction, Facebook, Twitter, Internet Addiction.

All addictions have a common theme, avoidance & denial. Avoiding clear discernment and focusing on the object or process that perpetuates the avoidance.

Those objects in many ways serves the individual by temporarily soothing the itch, or the desire, that is seemingly intolerable and or numbs the individual satisfying their craving.

Most often the individual has very little control over these urges, in fact the body is attempting to find balance all of the time which makes it even more challenging.

The underlying urges are really feelings of desire to be liberated from the want & desire to be happy and or free of annoying thoughts & personal judgments.

The body is always attempting to gain Homeostasis or balance. In all if not most cases there are underlying feelings and thoughts that tend to move the individual to take less then constructive measures to soothe their need. The desire to seek relief and comfort is so great, that it clouds judgment.

Will power is not enough and the support from therapists & treatment centers are needed.

Levels of use: Abstinence, Experimentation, Social recreational, Abuse.

Addiction Tolerance: The body is forced to change or adapt to develop tolerance. The tolerance is the tendency to use larger and larger amounts in order to have the same effect on the system.

Dependence: Tissue dependence results from the biological adaptation of the body due to prolonged use of drugs or behavior. The body compensates by resetting normal homeostasis levels for certain drugs and behaviors which changes the body so much so that tissues and organs become dependent Psychological dependence is recognized as an important factor in the development of addictive behaviors, users begin to to rely on the psychoactive drug or behavior to deal with their challenges.

In a very strange way they have a love object that is always there as long they use or continue the behavior. It Alters and effects the behavior of an individual and can alter ones state of consciousnesses.

Withdrawal: Upon stopping use of the drug or behavior, the body attempts to re-balance itself after cessation of or prolonged use of psychoactive drug or compulsive behaviors.

Various symptoms manifest as result depending on the drug or behavior as well as length use. If you are challenged in any area of your life and finding yourself repeatedly seeking relief by the use of medication or a process addiction please seek professional support.

As a significant part of my approach I offer to my clients Motivational Interviewing which prepares them where ever they are along the continuum of Change

Changing Behavior Is The Client’s Choice, How Can I as a therapist Help The Client Come To A Place Where He/She Sees Change And Sees The
Process Of Changing As Worthwhile.

Phase 1. As A therapist I would want to avoid these traps :

1. Avoiding premature focus trap. Start broad.
2. Confrontation/denial trap. Client ends up arguing against change.
3. Labeling Trap
4. Blaming Trap. Maybe active discussion of problem makes the client feel blamed. Client feels blamed whatever the cause
5. Question/Answer Trap. Creates a passive client and controlling counseling. Never ask 3 questions in a row, especially if you
open your session with questions
6. Expert Trap. Also involves asking too many questions. Activity, energy and commitment needed for client in outside world; why not let the client be more of an active participant in counseling?

Information gathering by doctor should reinforce energy and activity, involving behavior, rather than passivity when you
expect them to actively take their medication, etc.

OPENING STRATEGIES: I might engage the client by:

1. Ask open-ended questions-can’t answer yes or no. Closed
questions can establish a passive client and are typical of intake
and many first sessions of counseling. Rethink what you need to
know.
2. Listen reflectively (empathically); follow client’s path, not
yours .. Reflect back what client tells you. More efficient. It’s the
client who needs to move. Listen to himlher. Like Roger’s idea of
being a mirror for the client. Good for gaining time when you
don’t know where you want to go or to cross cultural boundaries.
Concentrate on client’s interpretation of problem, not problem
itself. No on judgment; yes on reflection whether you agree with
client or not. Validate. Allows client to make “change talk” and
locate his/her fear and anxiety about change. Don’t react to
hearing negative information. Listen to their body language or
when client stops talking. This technique provides a safety net.

3. Summarize. Giving back to the person in a contained form. Here
is where you can be a bit directive. Person hears themselves in my reflecting
back of what they have said and then they hear your
summary, which contains your emphases to reinforce certain
aspects of what they said and not other aspects. Don’t use
needless words. “Offering a bouquet to the client.” Can serve as
an interim summary and then ask, “What else?”

4. Affirm. With “problem talk” and “problem focus,” easy to forget
positive things. Convey respect for client’s achievement,
struggles, and feelings. Reframing weaknesses into strength.
Must not be phony or contrived on counselor’s part. Must
monitor yourself to see where you see possible affirmation.

5. Eliciting self-motivating statements. The client makes the
argument for change. This is usually done by counselor, so you
change that relationship.

a. Problem recognition. The client’s realizing that there is a
need for a change and he/she articulates the costs and
benefits of change.

b. Expressed concern. Both the cognitive and emotional
aspects of their condition. Follow this by reflective
listening.

c. Intention to change. Arises more in later stages of change 1
but also can occur in crisis (like aftereffects of substance
abuse). The client needs to “own’ the change.

d. Optimism for change. Ability to change-goes beyond
intention. “I could change in chose to.” The client
articulates the ability to behave differently.

In Addition I make use of the Stages of Change Model to gage where a client is in their recovery. This model keeps me honest, from imposing my goals on them, and lets them decide where they are
and what they are ready for with respect to their recovery
Five stages of change have been conceptualized for a variety of problem behaviors.

The five stages of change are precontemplation, contemplation, preparation, action, and
maintenance.

Precontemplation is the stage at which there is no intention to change
behavior in the foreseeable future. Many individuals in this stage are unaware or
underaware oftheir problems.

Contemplation is the stage in which people are aware
that a problem exists and are seriously thinking about overcoming it but have not yet
made a commitment to take action.

Preparation is a stage that combines intention and
behavioral criteria. Individuals in this stage are intending to take action in the next
month and have unsuccessfully taken action in the past year.

Action is the stage in which individuals modify their behavior, experiences, or environment in order to
overcome their problems. Action involves the most overt behavioral changes and
requires considerable commitment oftime and energy.

Maintenance is the stage in which people work to prevent relapse and consolidate the gains attained during action.
For addictive behaviors this stage extends from six months to an indeterminate period past the initial action.

As A Therapist it is important to establish the readiness of individuals. By doing so I am better prepared to offer you
those interventions that best suite you rather than using a shot gun of approaches.

When I consider where you really are along the continuum of change, as opposed to where I think you should be, it is my view that you are best served.

Steven Shaps Marriage & Family Therapist 503.913.7295 or 310.721.1246 www.stevenshapsmft.com

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