Here are five practical techniques that I use in my Life Process Program, which follows an empowerment model as opposed to a disease approach for addiction treatment.
Intimacy, Family, Community
A Mature Identity
All of psychological change is based on people’s belief that they are capable of changing. The principal drawback to all disease and medical theories, including those of mental illness as well as addiction, is that they convince people that their current, problem state is their natural selves. Consider the old saying, “Suicide is a permanent solution to a temporary problem.”
To diagnose someone as an addict is to, in disease terms, give the person a lifelong identity and sentence for something that is treatable. Recall people must declare that they are alcoholics or addicts as their ticket of admission to an AA or an NA meeting. We know smoking is addictive. But do former smokers, say three or four years down the road, tell everyone that they are still smokers? I never diagnose people as addicts, or even as being addicted. Instead, I review people’s problems with them, and seek to understand the source of their problems.
Of course, substance abuse can often be a source of their problems. But such behaviors occur in specific settings, under the sway of specific moods, which themselves indicate areas where effort at change will be productive. My concept in treatment is that the important things about the person’s life are changeable. An addictive problem is something that the person is encountering rather than a statement about who they are.
As Ilse Thompson and I say in Recover! think about how you regard a difficulty a child might have with one teacher at school, or in learning a key idea in a classroom. You don’t tell the child, “Teachers hate you” or “You can’t learn”!
People, you, CAN change.
When you have a disease, and no choices, your values are irrelevant. What you want, what you believe, what you care about don’t matter. But everything we know about human beings, and addiction, tells us the reverse, that what’s important to you is critical for change. People with jobs and families do better fighting addiction because they have more to lose if they don’t.
The most successful treatment method we know – utilized by even disease-based programs – is motivational interviewing (MI), which can be described as a value-sharpening effort. MI assumes that people are ambivalent about their excessive behavior, and that by focusing on and harnessing those values that work against the addiction, the therapy can enhance a person’s motivation to change. A therapeutic series of questions of this sort might begin with, “What are the important things for you in life?” (examples: family, health, work, self-respect, independence), followed by, “And how does your drinking/drug use/gambling/sexual acting out, et al. impact those values you hold?” The therapy then follows up on these discrepancies, because it assumes that people are capable of directing their behavior in line with their values – i.e., they are not powerless.
People are not static. We expect much more from teens than we do from children, more from young adults than from teens, more from mature adults than from young adults. We may even expect, in some regards, greater things—like compassion and patience—from older adults than from those in their primes. As your life improves, change results.
How do people progress successfully along this route to maturity? They develop greater experience, insight and skills, and personal resources, and they acquire more responsibilities – all of which are anti-addictive mechanisms. So, I anticipate, encourage and, yes sometimes prod people to move forward in life – to get training and education, to form more mature relationships, to join communities.
When people form better relationships and become community members, they are generally on a positive path that makes it not only easier to quit an addiction, but that sometimes rules the addiction out entirely. Consider parenthood as one example of such an anti-addictive force. In general, having children is going to make people examine their behavior and, when they see it harms their children’s lives, to be intensely motivated to change.
Of course, AA is one type of support system. The problem I find with AA and similarly insulated groups is that they limit people’s focus to be solely concentrated on their addictions. This in turn makes them less able to develop in other areas of their lives, like work or family, with different sorts of people from those they meet in a support group. Such outside non-12-step groups have different, unfamiliar rules for communicating and interacting. Although 12-step groups can be valuable as a form of understanding and support earlier in recovery, they make less sense as people wish to gain a broader identity than that of a recovering addict or alcoholic.
Family and community, which bring with them responsibility and care for others, place people in a new relationship with themselves and with the universe. That’s right, you may no longer be an addict. The possibility of creating an identity beyond your addicted one is anathema – impossible and dangerous – from the disease theory perspective. In the life process perspective, it is the goal.
Overall, readers may see a self-empowering treatment approach like my Life Process Program differs in essential ways from the disease treatment approach. I view the addicted person differently. My expectations about their ability to change is greater, both with regard to their relationships with the world, and in terms of their personal identities.
In empowerment therapy, an addicted person is seen as being at a temporary stage from which we anticipate they can, and will, move forward. We are helpers, not providers of salvation. And, in the end, we believe the person can and will find their way out of addiction due to their own power.
Stanton Peele, Ph.D., is an international addiction expert. He has been researching, writing about, and treating addiction for four decades, beginning with his seminal book (with Archie Brodsky) in 1975, Love and Addiction, and continuing most recently with his publication in 2014 of, Recover! An Empowering Program to Help You Stop Thinking Like an Addict and Reclaim Your Life (soon to be released in paperback), written with Ilse Thompson. His Life Process Program is now available online. His website is Peele.net.