a total stranger one black day
knocked living the hell out of me-

who found forgiveness hard because
my(as it happened) self he was

-but now that fiend and I are such
immortal friends the other’s each     e.e. cummings

Perls, the founder of Gestalt Therapy, writes that addiction treatment phases must embrace all aspects of life for the individual to become who he wants to be and  “no cure can have lasting effect or be more than a suppression of impulses unless the alcoholic (‘adult’ suckling) progresses to the stage of biting and chewing” the unassimilated life experiences.

To this end, I have developed an MPTP approach for the treatment of addictions that is phasic, overlapping, and gender neutral. It is I/Thou relationship based, non-judgmental and stresses empowerment to transform one’s life in the desired direction. This treatment model initiates and honors awareness of “what is” in the personal, familial, and social realm. Abstinence of addictive-type behaviors is not dictated as they are considered attempts at maintaining contact with self/other/substance and as such are meaningful expressions of self-assertion. Rather, this approach exemplifies respect for the integrity of the individual and voluntary adherence to the treatment process and as such facilitates an emerging awareness of personal participation in creating destructive habits and self-defeating lifestyles and necessary emotional motivation to change. (Beisser (1970) writes that “change occurs when one becomes what he is, not when he tries to be what he is not”- the Gestalt paradoxical theory of change.

Freud recognized that the creation of defenses leading to the compulsion to repeat behaviors is an attempt to gain organismic equilibrium. When the “Self” cannot function and develop optimally, this fluid transformation of energy in the service of the individual is called a creative adjustment in Gestalt therapy, and emerges organically from the experience. Its continuation depends on environmental support and may eventually become rigidified, a habit, possibly leading into addictions. Freud called this organismic state “Seelenkrankheit”, literally translated, “soul sickness”. Adler, Horney later interpreted this concept “Seelenkrankheit” as an individual’s need to manipulate the environment to gain an illusion of control over others to maintain personal integrity and a sense of “Self” in the struggle for survival.  In this spirit, addiction becomes the means in the search for a “Self”.

I have suggested that many substance overusers suffer from stunted emotional development resulting from early deprivation, neglect and other traumas. Equally often, developmental stuckness occurs at a very early age accounting for unhelpful attitudes and behaviors so prevalent in addicted adolescents and adults. Whatever the reason, they have intimate knowledge, possibly unaware, of an existence filled with pain, rage, and an inability to self-care healthily. Drug taking becomes a welcome avenue to numb pain or bring about a sense of aliveness. Thus addictive practices provide an illusion of being in control of one’s life and managing chaos while actively participating in the creation of more chaos. I often hear statements such as “If only…  I could have one more binge, a better job, and a more understanding wife… then…. Or…when I have a certain income, when my back feels better, when I kill myself… then… in spite of their experiences to the contrary and the reality that these wished-for conditions are a lie.

The coach/therapist relationship has particular significance when in the presence of an addicted person struggling in the search to find his way.  (For ease of writing I shall use the pronoun “he” throughout; women are of course very much included.) Not only will the client feel like “one of them”, the addict,  against “us (me, Clinician)”- the I/it phenomenon, a perception many learned during previous treatment attempts, but he also feels dread given the hint of a possibility of a longed-for relationship with a caring other. This is frightening at best and a daunting commitment for both clinician/client. However, from the perspective of the MPTP with its sub-theme of “Addiction: In Search for a Self” the coach/therapist brings into the therapeutic encounter an attitude of I/Thou allowing for meeting the client without judgment of where and how he is and without pretense of having superior knowledge and the ability to “fix” him. This being “with” is not a technique, a method to be practiced on…but rather it emanates from authentic caring and a conviction of the worth and sanctity of each individual struggling in the process of finding his unique self. My encounter with S. exemplifies the awesome power inherent in this self-less therapeutic approach:

An Employee Assistant Program referred S. to me for addiction treatment evaluation.

This is his story:

He reports that he spent his youth in several foster homes having been abandoned by both his mother and father. He described some of these homes adequate but a third extremely brutal. He was beaten, sexually abused, starved, to keep him in line. Eventually, at the age of 14, he escaped and attempted to make it on his own. He did so with the help of daily, non-stop marijuana smoking. He became a bicycle repairman to earn some money. In addition to smoking pot non-stop, riding his bicycle kept him somewhat sane.  My being with him non-judgmentally and interested in his experiences, finding inherent strengths and connections in his story to find purpose in his 15-year substance overuse; not immediately proposing a treatment plan and to expect him to stop use of the illegal substance, so impacted him that he abruptly terminated after three sessions. Years later, I received a bouquet of roses with a long letter, stating among many things, that the three sessions literally saved and changed his life. He stopped, because my warm, positive attitude toward him was more than he could bear even though he always longed for that kind of understanding. Subsequently, he had entered other treatment programs always being keenly aware that something was deeply missing. He wanted to return for “a little” more therapy with me, to which I agreed. We slowly developed a mutually satisfying I/Thou relationship. Initially feeling like an “it” object, with loving therapeutic support and patience, he was eventually able to develop an “I” and a” we-us” and begin genuine healing. A year into the therapy, he disappeared again as quickly as he reappeared. This is his process and can be none other.

Multi-Phasic Transformation Awareness Statement. (MPTASÓ)

The MPTAS are elaborations on the awareness and growth continuum in an individual’s transformation process from pre-addicted existence, to an eventually confluent relationship with suffering and addictive life style to a lively existence with “Self” and others and the world. Therapy, a microcosmic laboratory for learning, raises individuals’ awareness to the “what” and the “how” of their process in their search for meaning and in finding the “ Self”. The awareness statements are summary statements of accomplished growth as it emerges organically out of the coaching/therapeutic process. I believe organically, because progression toward a healthier life style in relationship with others proceeds sequentially. Developmental lags are mediated and self-care/being cared-for eases early deprivation. This is always a uniquely individual process not a recipe-type prescription for health. Every individual requires different attention in differing degrees, at different times. That is the reason for the general tenor, even vagueness of the awareness statements/ summary statements. As such, they allow for the greatest variability in expressing individuals’ unique needs, wants and achievements.

I have been asked what the purpose of the statements is and what they add to the process. My immediate answer is “a lot”, addicted individuals truly enjoy working in this format because within it, they can envision and experience their own life process for change. I am always amazed with what ease and absence of shame and guilt clients are able to point out where their awareness necessitates deepening.  The choice to and how to continue is always with the client even though, most are learning for the first time the complexities inherent in the process of choosing). Certain MPTAS may require more time and effort; others can be accomplished with relative ease. There is also significant overlap. Coaching/therapy must begin where the client experiences earliest disruption in the client’s healthy development occurs. It is not a coach/therapist’s responsibility to get the person to where they want to be in life, but to be available in every possibly way to support his unfolding. This is in essence what Laura Perls’ basic belief expresses: “provide only enough support to enable the client to help himself”.

If you would like more information on the Multi-Phasic Transformation Process™, check out my ebook, Multi-Phasic Transformation Process.

Who would have thought that my meanderings over “What is Addiction” in my last blog would lead me to an Ezine article by Melanie Solomon, July 11, 2010 and her amazing book AA-Not the Only Way — Your One Stop Resource Guide to 12-Step Alternatives–Second Edition? In it she cites many statistics based on government research and other reputable institutions that validated my experience working in the treatment field for 30 years. I felt happy for my clients gratified given the many programs for recovery and beyond that I have designed and taught with passion, conviction, and results.

I have long been a supporter of views and research by people like Stanton Peele, Herbert Fingarette, and Thomas Szasz, Gordon Marlatt as well as George Vaillant, Edward J Khantzian and other more traditional researchers and writers. Their work has brought an important counterpoint to what appears a one-sided view of addictions and treatment. Why is this crucial? Because I believe we human beings are much too complex, creative, strengths and value based to be defined by a simple disease label, Addiction, and AA attendance that promise success. Perhaps some of the behaviors when under the influence can be lumped into categories but not the human being who engages in these behaviors. Hence we need treatment programs (is treatment the right word?) who see individuals as unique and respected for who and how they are in the moment and that their being where they are has meaning and purpose even if we don’t understand that. I do not imply that anything goes or works – to the contrary – choice, responsibility, and consequences are musts to gain freedom and often require learning many long-forgotten developmental skills. However, how to make it happen? The answer lies deep within each individual. In Gestalt we call this an interdependent, co-created process in the ongoing present in a I/Thou dialogical relationship.

Now to the above question – what is the answer, the right approach? The client has the answers, clinicians do not. We may have hopes, wants, and dreams for our clients, we may be well-trained with all kinds of degrees but a client will render us helpless if we attempt to know better. Our presence serves to support, listen, and assist birthing the long-forgotten “I” and never work harder than the client will or do more than s/he is able to process. As a Gestalt Clinician, I work from a relational, dialogical perspective and have the flexibility to approach a client’s present needs from almost any perspective i.e. I can work with the Bodymind, emotions, feelings cognitions, perceptions which are all interconnected as long as the focus is the client and not my agenda.

Given that treatment outcomes are rather low no matter what treatment is offered, the question remains, what makes the concept that many roads lead to Rome so unacceptable? Is this a competition; if one approach works why would another approach be excluded? Is it not possible that just as individuals from different cultures may have their own ways of problem solving that those in the addicted population may have their own preferences for getting beyond sobriety? Before we all take ourselves too seriously let’s not forget that 77 – 82% cure themselves (Solomon 7.11.2010) without using formalized treatment.

My belief has always been and still is. If it works, great, if it does not meet your needs, look for another approach – and don’t forget to consider your Self in the equation.

Let’s celebrate the many men and women who dedicate their lives to find answers to the elusive questions posed by addiction and human nature and are willing to create innovative programs.

As for myself, I want to celebrate my clients, their stamina and determination to create a life worth living because or in spite of their overuse of substances. There is no better remedy to gain freedom from addiction and dreaded relapse than to fulfill one’s potential as a human Being. I hope that alll find a program that speaks to their heart and soul – one human being to another. You are not

“Once an Addict, always an Addict”
rather you are
“Once a Human being always a Human being”
always in the process of becoming

References:

Fingarette, Herbert. Heavy Drinking. ISBN 0-520-06754-1
Khantzian, Edward J. Addiction and the Vulnerable Self. ISBN 0-89862-172-0
Langer, Ellen J. Mind-Fulness. ISBN 0-201-09502-5; ISBN 0-201-52341-8
Szasz, Thomas. Ceremonial Chemistry. ISBN 1-55691-0193
Vaillant, George E. Spiritual Evolution. ISBN 978-07679-2657-7



When I began working in the field of addiction 30 years ago, most clients were automatically labeled addicts, (yes, shocking but true) just as most clinicians were either recovered individuals or members of addiction-troubled families. Of course, the field has evolved and what was once held to be gospel truth has been modified and re-labeled. The purpose of this brief paper serves to highlight the confusion and complexities inherent when assigning the label “Addiction”.

Addiction may be:

• Disease/illness; Disorder DSM-IV-TR, (insurance reimbursement)
• Not illness but can create lots of physical illnesses
• Myth of Alcoholism (Herbert Fingarette; scientific data)
• Concept, not illness (Jellinek)
• Spiritual depravity, character defects – AA fellowship only salvation (AA)
• Hedonism – following the pleasure principle – feels good (our limbic system)
• Everyone is addicted (Andrew Weil, Harvard Conference presentation)
• Genetically programmed (unproven, research not universally validated)
• Big multi-billion dollar business
• Treatment and discomfort depends on the healthcare providers’ projection (Ellen Langer, Harvard)
• Resulting from abuse and trauma
• Life-style issues
• Once an addict – always an addict vs. once a human being – always a human being
• Organismic self-regulation, creative adjustment to what is
• My theory is better than yours philosophy !

The above bullet points are not inclusive and perhaps none speak to each reader. My heart goes out to clients and clinicians for both are, one might say forced, to give a diagnosis that pretty much will stay with an individual for life i.e. failed attempts to purchase life or health insurance etc. Are any of our noble attempts really helpful? Statistics vary hugely; it all depends on who provides them – each program is the best on the web.  The questions really become: Can a label alone define anything? Who is the client? What is his/her experience; a good question because some will say addicted individuals can’t think clear enough for recall or have warped perceptions. Others will claim that there is no cure; what does that mean? Why bother? Who is the individual who has learned to overuse substances? Are they embodied in their drinking, drug-using activities?

In conclusion, my professional belief is that what is, is and whatever works, works. I see each individual as a wonderful, complex, highly unique individual who trusts or learns to trust me that s/he is deserving. Kierkegaard wrote that “if you label me you negate me”; a powerful statement that invites all professionals to have an open mind, an open heart, to see and experience the client/professional relationship not as two separate, isolated human beings but in an I/Thou co-created dialogical relationship. This is how we both experience our working together. Believe me, it isn’t always easy. You may see it differently and I would really love to hear your experience and position on the issue of “Addiction.”

You may find more information on my website www.GestaltRI.com; LinkedIn and Facebook.

References:

Alcoholics Anonymous (2001) Alcoholics Anonymous World Services. Fourth edition. Inc. New York City.

Diagnostic and Statistical Manual of Mental Disorders (2000). Fourth edition. American Psychiatric Association.

Fingerette, Herbert (1988) Heavy Drinking. The Myth of Alcoholism as a Disease. University of California press.

Jellinek E.M. (1960). The Disease Concept of Alcoholism. College and University Press. New Haven, Ct.

Langer Ellen J. (1989) Mindfulness. A Merloyd Lawrence Book. Lifelong Books. Da Capo Press.

Vaillant M.D. George E. (2008). Spiritual Evolution. A Scientific Defense of Faith. Broadway Books, New york.

The above is a very limited selection of references that contributed to the shaping of my philosophy. For more information and my own publications, please visit my website www.GestaltRI.com

Carpe Diem

I took six vacation days and with my husband went to visit our daughter and her family in Florida. They had moved there only a few months ago. I was wondering how we would like it because the first and only time we had visited Florida we liked nothing about it. All we saw was “old” people playing shuffle board. In defense of my ignorance I must tell you that I do not recall the year of our visit but having been interested in purchasing an Audi, they cost a glorious $12,500.—at that time, will attest that it was many years ago.

Well, this time was very different. We loved it, seeing my family of course, how happy they were, the sun, the houses the pool, the very friendly people – it was almost scary, everyone on the road smiled and gave some kind of greeting. We enjoyed encountering the bicyclists, the golfers, boaters, the grocery stores’ personnel. Could it be that they didn’t suffer from SAD (Seasonal Affective Disorder)? Can’t be, they, too, had a very harsh winter; a different life style perhaps? It seems that every country has a south where the pace of living is different. Floridian life style appeared definitely different from our frenetic way of being on the East coast – at least from my perspective and experience.

Personal Reflections

Unfortunately, I had only one glorious day basking in the sunshine and sight seeing. Then I began to be very ill for the rest of the time and was fortunate to be able to travel on the plane to return home. I must add that even the treating M.D. and nurses were sweethearts.

As a result of this unwelcome interruption of our plans, I had lots of time to reflect on how I was living my life and the frailty of being human. Fritz Perls, the co-creator of Gestalt Therapy once wrote that if you want to know how a person lives life, just observe them eating a meal. Well, even at my age of 77, I still eat and drink fast, one might even say gulp at times, I work long hours and I prefer to have things done yesterday.

It’s not all bad, however, I love life and everything in nature, I am curious about everything, I can lose myself listening to opera and classical music, enjoy theater, gardening, and savor my time being with family and friends; but for the most part I am on automatic pilot. I asked myself is it out of habit, to avoid experiencing restlessness, is it because I have a passion for living and for my work and I can’t – won’t let go? Or, is it possible that this is simply who I am? What is of value to me is that I have choices here; it would be unfair to put responsibility on anything or anyone. So the question is how do I stop myself doing what would be more healthful. Perhaps much of it is habits?

Habits are a funny thing. They certainly can make life easier as we can’t possibly reflect on everything prior to doing it. But many times, I have the impression that the habits have us. It’s certainly devilishly difficult to change them, especially if, after much reflection, we discover that they actually serve a purpose or evolved and developed from something innocent that once worked. Brushing my teeth three times a day – or more – doesn’t get in the way, working twelve hours a day, I discovered in my meanderings, really does. Consider my Mother’s admonishments in the prayer book she gave me with much love in her heart when I left for America as an innocent 18 year old – “Arbeite und Bete” – work and pray. It is certainly the German way. Perhaps I followed this advice because, because, because? Nonsense! It’s my task to figure it out and change it to what? That’s the exciting prospect – oh, the possibilities. We’ll discuss more about habits in the next few newsletters.

So, how about you?

Do you have habits you do not like? Silly question perhaps because we all have them. I would encourage you to choose one, not a particularly troublesome one and

* Write it down and give it some thought
* Don’t change anything yet
* Ask yourself what possibilities you see replacing the habit
* Notice your body posture and visceral experience as you are contemplating this
* Don’t do any more for now, simply raise your awareness

Gestalt Theory states that “Change happens when one becomes who he really is, not when he tries to become what he is not” (Beisser, p. 77, 1970). This principle of change implies that in the process of maturation an individual introjects familial and societal attitudes and beliefs about himself that may eventually interfere with healthy organismic self-regulation. Messages (Gremlins) such as: “You’ll never amount to anything,” “You are just like your father,” “Girls don’t do that,” “You should be nice to your mother,” “You are so selfish,” “You shouldn’t be such a sissy,” “Don’t tell,” abound in difficult family or social systems and are believed and absorbed as truths by healthily egocentric children. The inherent potential for developing is often truncated and the capacity to realize one’s inherent strengths is diminished.

Children who internalize these parental messages often feel conflicted, unnatural, and bad as they are maturing. Eventually, self-alienation becomes the foreground and may be expressed in addictive behaviors and poor mental health during and after adolescence. They feel disconnected from their actions and statements such as the following abound: “That’s not like me.” “I can’t believe I did that.” “I don’t know where this was coming from?” “I’ll never amount to anything no matter what I try.” “I am not fit to live!” These unhealthy internalized beliefs are visibly supported and observed in a client’s posture, tone of voice, and unhelpful repetitive behaviors.

Therapist/Coaches provide clients the opportunity to explore experientially and question the validity of their belief systems and behaviors for their usefulness in the present context. With this process clients can experiment with new possibilities and discover opportunities to modify or replace parts, or all, of a given belief with a synthesized, more ego-syntonic alternative that can be assimilated and eventually integrated.

John had been told all his life that he was a lazy bum just like his father. When ready to graduate from high school, he wanted to take advantage of a job opportunity that started at 8 A.M. John didn’t want to get up that early and wanted different hours but was denied the request. Initially, with his usual “I want what I want and how and when I want it” attitude, he laughingly dismissed the job offer. His therapist/coach explored the wisdom of his polarized decision-making attitude and invited him to a two-chair experiment with the goal of exploring his contradictory attitudes. One position really wanted a good job, the other, the “but” side was afraid of failing, as he discovered. Working this process, John was able to say that he really wanted a job AND that he was afraid of failing – a very deep fear that he learned early and throughout his childhood. He said that he could still hear his drunken father yelling at him that he’ll never amount to anything in life and that he’ll become just like him (the father).

John took the first steps in undoing a long-standing personal belief by accepting the reality of the complex situation. Now he could begin to explore truth from fiction, use his inherent strengths of courage and perseverance and begin differentiating what belongs to him and what does not. He may succeed only partially, or get to like starting his day early, in either case, rigidified behavior changed. This experiment required creativity and skill in establishing the appropriate Yin and Yang and to proceed with sensitivity and focus, considering the usefulness and practicality of each. AND, cognition alone does not create change; rather awareness of what is and synthesizing beliefs and wants supported by a strong emotional charge, allows for change to occur.

Clinicians must have the patience to stay with a client’s process. It bears repeating that rather than to attempt to fix a client’s problems and symptoms, staying with the client by getting out of the way and allowing the process to unfold on its own, is ultimately more helpful. Professionals must be sufficiently tuned in to know when contextual confrontation or challenges are called for. They must have the skills and confidence to be intuitively creative and flexible when attempting any experiment including the huge experiment of addiction treatment (Zinker, 1977).

A Therapist/Coach gives only as much support as is necessary and only as much as the client truly wants. The individual must be afforded the opportunity to look deep inside to find the answers while the Therapist/Coach accompanies him on his journey to realize inherent potential in his own way and in his own time.

The holistic and positive aspects of Gestalt therapy makes it ideal for the treatment of any addiction related problem.  It allows for the greatest possible treatment variables in approaching individual differences, stresses the uniqueness of each person, admires the resiliency of the human spirit, and appreciates the integrity and spirituality of any individual.

Gestalt therapy sees the whole as greater than the sum of its parts.  It bridges the gap between cognitive and behavioral therapies by including the body, emotions, senses, and the phenomenological field of the individual as a context for the decision making processes and their behavioral execution.  One of Gestalt’s major premises is that all our coping mechanisms are creative adjustments to the stresses of life depending on the developmental readiness of the individual: Creative, because they are chosen among several alternatives; and adjustments, because they alter the experience in some way.  Gestalt therapy presumes that the individual organism attempts to self-regulate, and all coping mechanisms are considered positive until they no longer serve well their intended purpose.

The Gestalt awareness/experience/contact cycle can be demonstrated as follows:

When healthy individuals are thirsty, they allow the emergence of their need for water to become figural:

through the awareness of sensations (dry throat)

through identification of need (I am thirsty)

to activation of energy (go to the water faucet)

to action (pouring water and drinking it)

to contact (cool water feels good)

to enjoying the process of need satisfaction and withdrawal, leading to organismic homeostasis (no longer thirsty).

When this natural completion of the cycle becomes blocked, dysfunction occurs and the individual becomes stuck in habitual behavior patterns.  Considering the chaotic histories of most substance abusers, a clear figure (need) cannot emerge.  Thus, the awareness-contact-withdrawal cycle is interrupted through misidentification of sensations and inappropriate need fulfillment.  Eventually behaviors become rigid, then they become addictive patters that do not allow self-regulation and homeostasis to occur.

Examining the interruptions

In addiction treatment it is imperative that this cycle and its interruptions be examined in the context of the individuals’ problems, relationships, and environmental field.

The Gestalt 10-Step Program for Addiction and Trauma Recovery organizes the evaluation of the client’s lifestyle in the context of the awareness-experience cycle and the recovery stages from addictions or related problems (See table 1).  They also serve to make individuals co-responsible for their lives, stress decisions and choices, relationships, and the person’s phenomenological world.

The first three steps stress the personal decision/choice processes by examining our contribution to our problems, and work toward an examination of our lifestyle and the re-discovery of our long-abandoned internal and external supports.  Steps four and five allow us to examine our problem development as part of a process in connection with others at a particular time and place.  In addition, it stresses that we should examine our coping skills as strengths that help us to survive.

Steps five and six encourage individuals to look at how they keep unfinished business from the past alive and how it interferes with healthy living.  Relationships become particularly important here as sources of information and strength, because most of our unfinished business is lived out in relationships.

Accepting ourselves

In steps seven and eight, we accept our own and others’ inherent strengths and weaknesses and a healthy interdependency results.  The phenomenological world of individuals becomes enlarged with steps nine and ten, as we fully accept our strengths as weaknesses, pains and joys, as part of the human condition.

Source: Helga M. Matzko, MA, CAGS, CCMHC, ACDP, Gestalt Institute, www.gestaltri.com.

The Addiction Letter: A Resource Exchange for Professionals on Preventing and Treating Alcoholism and Drug Abuse

Vol. 9, No. 11

November 1993

ISSN 8756 405X

Is addiction of any kind a disease or does overusing substances, food etc. cause diseases? Is a disease of addiction a mere concept as Jellinek suggested in the Foreword of his book The Disease Concept of Alcoholism(1960) because he was himself reluctant to call this addiction a disease? Or is it a life style issue as some suggest; a character flaw and the result of spiritual depravation? Certainly there are many such views and more in this hotly debated topic.

Having worked, taught, and written about this thing called addiction for 30 years, I have gained a totally different view. And who taught me? None other than every one of my clients. Kierkegaard wrote that “If you label me you negate me” and labeling, my clients taught me, diminishes their being. Consequently, I no longer see addiction as a disease as it is commonly described, but rather a courageous search for meaning and an ultimate quest toward wholeness.

Here are some of my insights I have gained from my clients:

1. The foundation for addictions was laid in early childhood prior to the actual onset of addictive habits, and in the context of the family and social mores. From the beginning the child and care takers co-created behaviors and relationships.

2. Yet, there existed support and use of internal strengths for the child to live long enough to survive and become sober. Strengths in the life of an addict? Absolutely, yes! Consider, surviving a difficult childhood, using one’s own creativity to modulate and survive experiences while simultaneously evolving into full-blown overuse of substances in an effort to assert a self and attempt to make sense out of a senseless life. Then embracing sobriety,  with or without treatment or self-help programs, they still have stamina and drive to want more, fulfill unmet needs,  and design a life to make unrealized dreams become a reality. That demonstrates strengths of perseverance, resilience, creativity, and hope par exemplar.

3. Contributing factors to the onset of addiction:

In addition to the possibility of genetic vulnerability (at this point unproven, however, possible), most people who develop addictive habits come from an environment that disallows for the natural flowering of a child’s developmental potential. Without detailing all possibilities, many children grew up in dysfunctional families and many have experienced to various degrees trauma, familial mental illness i.e. depression, violence, physical – emotional – mental abuse, or poverty. Minimally, the impact of these toxic experiences on the developing child limited their healthy progressive developmental phases. Similarly, at the opposite extreme, are families who overindulge their children without ever-setting limits and teaching age-appropriate responsibility.

Sounds dismal? At first glance, yes, until individual innate human strengths and creativity in action is stressed, surface, and evidenced when making changes.

4. Creative use of options: barrowing from Gestalt Therapy, a creative adjustments is what one does and how one responds to situations and people. It is a creative response, because one chooses from among the possible options available developmentally and in doing so changes the situation in some way and makes it personally manageable. For example, a child may be sensitive and cry easily, rather than being reassured, she is yelled at and told that if ‘you don’t stop immediately, I’ll give you something to cry about’. That little one may hold its breath, not cry, withdraw or start smiling when hurt. Another may be curious, energetic, and enjoy exploring –and – may break a new toy someone just gave him. He is yelled at for being bad and hit, told that he is a terror and hopeless. That little kid may learn to fight back throwing temper tantrums, hit and kick or begin acting and feeling exactly what he internalized and become a loser.

Most of us have memories of some experiences of ‘injustices’ during our childhood. Luckily, human beings from infancy on are wired and capable of experiencing a lot before we actually internalize a distorted self-image. Yet, when these insults are heaped upon the child incessantly, the once adaptive and age-appropriate modulations become automatic and eventually deeply anchored in the child’s reality, behavioral repertoire, and belief system.

When a larger social system like school requires an expanded repertoire of behaving and responding, the children we are describing lack the experience of flexibility and response-ability other youngsters may have or easily learn. Most likely, the school age child will simply intensify what already exists and ironically recreate experiences that are familiar from at home and ironically reinforce what s/he already know and believes about the world and themselves in it.

Adolescence, while difficult for most teenagers regardless of mental health, paradoxically holds the potential for bringing some relief to the troubled kids because they find a cohort of similar kids – lost, distraught, violent, and depressed. Together, they introduce each other to alcohol and substances, form a tight group or gang where they are accepted, experience a sense of belonging, and identity. The shy, quiet child may find alcohol and realize she is funny and desirable and has a ball. The wild kid may become a powerful gang leader, use uppers and or smoke pot to calm down and feel one with the universe. Still others began addictive habits to numb their bodies, or to eliminate boredom, anger, depression. When this population reaches twenty-something, many will become troubled by addictive habits, wind up in AA or other self-help or treatment groups, either self-referred or court-mandated.

Final Thoughts: This all sounds simple, very pat and unrealistic when it definitely is not. A book could not do the topic justice. I intended briefly to demonstrate the complexity and co-created inevitability, almost natural evolution of a path to use and abuse addictive behaviors within the context of family/environment. Throughout this process I wanted to stress the presence of many, albeit unaware strengths of creativity, perseverance, courage, determination and awesome resilience that will assist the client to discover a clean and good life fulfilling his wants and dreams.

Let’s go: A life of freedom from compulsion is ready and waiting to be realized!

When I suggest to addiction trained and mental health professionals that there may be more for a sober client to attain in life than sobriety through the successful completion of the 12-step program in AA, I receive various responses:

1. Looks of incomprehension;
2. Questioning of my expertise and credentials in the addiction field;
3. “You are full of it”;
4. Tell us, please, we are tired of the same old; we have been sober for years and are still compelled to attend AA because we fear relapse if we don’t.

These responses are completely understandable. Personally, since 1981, I have worked long hours in the field of addictions. I developed addiction treatment programs, taught in many countries, and published. I cried with my clients, celebrated their hard-won successes, understood the obvious reasons for having developed addictive life styles, empathized, failed and learned continuously (still am), treated trauma with EMDR and struggled with health insurances. Yes, I know about the addiction field, the patients, and treatment approaches.

Please, hear me: The reality is that AA 12-step programs, other self-help groups, and/or religious affiliations have helped and saved many individuals from death; one cannot argue with these statistics. Others gain periodic sobriety and become caught up in relapse cycles; more are white-knuckling sobriety even while attempting to work the rigorous AA 12-step program but stay stuck; still others are developing cross addictions or, just never stop using. A patient once told me that he is addicted to AA. Addictions are considered an illness and treated as such by therapists, medications etc. The addict is the patient seeking HELP, professionals have the knowledge to help and if the client follows recommendations, he will recover. This is as it should be when treating an illness. However, even when recovery is successful, the client is admonished that “once an addict, always an addict”.

So what have I learned from my clients and what do I mean when I assert that the recovering person can attain a fuller life with life coaching than in recovery alone? That is a fair question and I am eager to share the good news.

What is Life Coaching for the Addiction-recovered Client?

Briefly, what I have learned over many years and other Life Coaches may assume that the sober client has gained a measure of personal and social stability; he is creative, resourceful, and competent. The life coach’s mission is to assist the client toward a satisfying, fuller life, forward moving toward authentic joy and happiness as defined by the client. They have proven that the “whole is greater than the sum of its parts”, meaning, they no longer must be labeled by their bad habits from the past. Recovery Coaches will recognize that the recovered client may still have lingering shadows from the past AND are aware that he has enormous strengths to put these shadows in a healthy perspective with determination, perseverance, courage, and hope. Without these attributes, they could not be where they are today. So where to go next to become more of what one already is?

Life Coaching may be the ideal “next step”. Each individual holds more potential, has more desires, and acknowledged (or not) wants, and needs, if given the opportunity to voice them to someone who truly hears without judgment, foregone conclusions, and the intention to “fix” it. Recovery Coaches are completely client oriented, and assist creating goals that have sound intentions and purpose for the life the client designs. The client will become gradually aware of differences as he lives the coaching process from the “inside out”. Minimally, the client will learn life skills so that he can make more choice-full and rewarding decisions in the future and reducing the engrained fear of relapse. Premier researcher and expert George E. Vaillant (1983), echoes Jellinek’s (1960) that addiction is still not understood and that the magic ingredient to keep the recovering individual in recovery has not yet been identified. Recovery Coaching may just provide that magic.

In summary, clients who have opted for life coaching are ultimately best qualified to comment on the good life they have created beyond sobriety and how pursuing and making meaningful choices have resulted in living a life of their dreams that is real, meaningful, and authentic.

____________________

[1]Vaillant, George E (1995) The Natural History of Alcoholism Revisited.[1] In this text, Dr. Vaillant offers various views on the perplexities of addiction, relapse, prevention, and treatment, given credence to both sides of the argument. Jellinek, E. M. (1960) The Disease concept of Alcoholism. In this books Foreword, Dr. Jellinek voiced discomfort with the concept of Alcoholism as a Disease and considers it a concept just as disease is a concept. He uses the word ‘disease’ reluctantly and under pressure of the Publisher.

Jellinek, E. M. (1960) The Disease concept of Alcoholism. In this books Foreword, Dr. Jellinek voiced discomfort with the concept of Alcoholism as a Disease and considers it a concept just as disease is a concept. He uses the word ‘disease’ reluctantly and under pressure of the Publisher.

Ever since the profession of coaching has entered the arena of mental health services, the topic regarding which profession is better suited to assist which individuals – coaching or therapy continues. Each branch provides evidence in support for their efficacy and pros and cons have become a much debated topic among the various healthcare professionals. The following paragraphs offer a brief expose’ of salient points for each.

The Coaching profession is the new kid on the block. While coaching as such has been around for awhile in the area of sports and performance, offering coaching to the public as a possibility to improve life is a relatively recent development. Coaches consider it essential that the potential client to fulfill the prerequisite that he is creative, competent, resourceful, and whole.  The purpose of coaching is to assist the individual in evaluating and creating a life he really wants according to personal values and potential, and aspirations. The coach-client relationship is one of equality and the client is believed to know best what needs to change and how. A coach assists and supports the client on this path by reflecting, offering feedback, asking questions, is sometimes challenging, and with permission offers possibilities. Homework assignments are also part of this process. The coaching profession encourages its professionals to develop specialization in various areas to better serve a broader range of services. While professional certification for coaches is encouraged, i.e. ICF, it is not required nor is in-depth knowledge of human development. Anyone hang out a shingle claiming to be a coach.

Unlike coaching, therapy has been around for a very long time. Ever since Papa Freud introduced the possibility that emotional suffering can be explored and alleviated with the “talking cure”, the focus was and remained on exploring “what is wrong”. Over time, new developmental theories flourished, as did research (assumptions) and methods to best effect “healing” human suffering. While the roots of psycho-therapy lay in the 18^th century, the focus and practice in the 21^st century is considered to have grown up, so to speak; it  is today hardly recognizable for what it once was. In Freud’s original writings, he considered suffering a matter of the soul, and termed mental illness Seelenkrankheit (soul sickness). Today, however, findings in neurosciences have contributed largely to the change of therapeutic focus and practice. Current therapies generally reflect the values of society that the mind – thinking over doing – being – matters. While there is certainly validity in this research and practice, the humanistic practice of earlier years i.e. Rogers etc. has fallen by the wayside.  Moving away from integration and Holism to fragmenting the whole person into constituent parts and treating separately i.e. body, mind, spirit, behavior, other etc. hoping to effect the whole, has been considered by many to have taken the “soul” out of therapy. The therapist has become the expert and the client is assumed to follow the expert’s advice.

Therapists are State licensed and supported by health insurances that restrict therapeutic application based on the provider’s diagnosis. One can safely claim that today the insurance companies know best, not the therapist or client.

To summarize, coaching works in the here and now toward the future, therapy concentrates on healing or lessening the pain of past or present ills.

Yet, as clear as the above sounds, the determination which service to choose requires careful consideration and frank client/professional consideration to find the best approach to accommodate the client’s needs and wants. Here is an example:

Tom approached me for therapy hoping I could put an end to his misery. He was a soft-spoken, deeply troubled single man, in his late thirties who was sober continuously for eight years after sixteen-years of cocaine/crack and ‘you name it’ addiction. He worked AA’s rigorous 12- step program, very quickly became labeled a ‘Saint’, a role model, and was in great demand as sponsor. He simultaneously spent ‘years’ in therapy to resolve extreme abuse issues from various family members. Once in the process of gaining sobriety, he began and graduated college, interned at a large international firm and within a short time became a top-level executive. “None” was his description of strengths. “If I had any, I would not be an addict.” Yet he remained extremely depressed; still he wanted to figure out what he was really all about and what was missing because he thought that he already had everything – sobriety, money, and was still unhappy.  In addition, he wanted to stop feeling responsible for living the lives of others.  He couldn’t imagine how his life would be different if he would wake up one day and have the life he wanted because he lived one day at a time and hated it.  He hoped that things would change before he relapsed into self-destructive behavior once more (Tom had stopped attending AA several years ago).

As a Gestalt therapist and Gestalt Coach who has worked for many years with the addicted/recovered population, I was struck by his defeated attitude and posture without any awareness of his strengths demonstrating resilience, creativity, and perseverance. After exploring both therapy and coaching as a possibility to proceed, he enthusiastically (good sign) chose coaching because he was tired of “the same old, same old, been there, done that”. He agreed to see a therapist in case coaching would be insufficient.

Gestalt Theory and methodology differ greatly from the above coaching and therapy descriptions. Gestalt Therapy is a model for health. Erving Polster, the Premier Gestaltist of our times, has insisted for years that Gestalt is too good to be used only for the sick. Extremely, abbreviated, emphasis is on the Here and Now, with a holistic focus on the individual in the context of the environment creatively and interdependently cocreating experience each moment of life. Questions are posed in terms of What and How of experience and awareness of self/other is facilitated by the prudent use of experiments in the context of the paradoxical Gestalt theory of Change.

If interested, you may find more information by clicking on the links above.