Not too long ago I had a question about treating addiction from an Uncommon Practitioner on one of our Monthly Q&A sessions.
The question was:
My new client is a successful 50 year old businessman. He drinks alcohol daily and uses cocaine on the weekends. He lost his wife due to drinking and cheating, and he feels alone and fills that empty loneliness hole with alcohol. He is from a divorced family, where his father was also an alcoholic, and my client was brought up by his grandmother. He does not complete my homeworks as he feels unable to write his feelings down, yet he is very much capable of expressing them verbally. Where would you start?
Now this may seem like a strange segue (or lack thereof!), but bear with me! I want to start by sharing an interesting idea I once read about the origin of our concepts of devils and angels.
On the (possible) nature of devils and angels
The idea (and it is just an idea, before I ruffle religious or atheist feathers!) was that devils might represent aspects of the self that seem to try to subvert our good intentions, that whisper in our ear and make us stray from the path of what is truly best for ourselves and others. Angels, on the other hand, might be metaphorical avatars of those parts of the mind and understandings that become awakened through spiritual development.
The angels and devils may be us, or parts of us, and may have become externalized through successive generations of understanding. Perhaps by ascribing different identities to the parts of the self, we help people see them.
I’m not suggesting we start to suggest to impressionable clients they are full of devils or angels! I’m just illustrating the idea of externalization of inner characteristics as a way of helping clients see parts of themselves in new ways.
The currents of reality
Stories, both traditional and those used in therapy, can help us see patterns of reality and psychology both within ourselves and others, and even within life in general. When we can see different characters as representing different parts of ourselves, we can detach from those parts and see ourselves more clearly.
I’m reminded of the writer and psychotherapist Pat Williams‘ experience of telling a story from Homer’s epic Odyssey to a comatose heroin addict. The story goes that our hero, Odysseus, has his sailors’ ears blocked with beeswax and himself tied to the mast so that, no matter how beguiling the song of the evil (but beautiful) sirens might be, they can continue their voyage past the island trap and find freedom.
We could say that the heroin-addicted man was both Odysseus and the crewmen. That the sirens were his inner promptings and outer encouragement from other addicts to continue ‘listening’ to the beguiling call and deadly seductions of the drug.
At any rate, when he finally awoke from the coma the story was all he could recall. He did manage to sail beyond the deadly siren call of the heroin and rebuild his life.
Separating interlopers from real identity
Much as that little devil inside of him may have convinced him otherwise, the young man was not just his urge to use heroin. It was all a beguiling lie.
When we externalize a pattern, whether through story or simply the way we talk to our clients about their problems, we encourage mastery over the problem by separating it from who they essentially are.
- How will you stand up to that anger when it next tries to make you do things you’ll later regret?
- Those cigarettes may try to win you back again, because they’ve bullied you before. But their voices can seem weak and pathetic, even barely audible…
- What does depression try to get you to think?
By externalizing an addictive or problematic inner pattern we are not seeking to let the client ‘off the hook’ by abrogating responsibility, but rather to defamiliarize the pattern so the client can begin to detach from it.
Anyway, I think the main thrust of my reply to the question on that Q&A call has to do with the art of removing the problem from the client’s core identity.
This isn’t all we do with people who are addicted, but it can make a huge difference. In my answer I reframe overcoming addiction as a consequence of becoming more assertive with the imposter of addiction.
You can simply listen to my reply here, or read the transcript below.
Listen to Mark’s answer or read below
Or click here to download the clip to play later (you may need to right-click and select ‘Save As…’)
My new client is a successful 50-year-old businessman. He drinks alcohol daily and uses cocaine on the weekends. He lost his wife due to drinking and cheating, and he feels alone and fills that empty loneliness hole with alcohol. He is from a divorced family, where his father was also an alcoholic, and my client was brought up by his grandmother. He does not complete my homeworks as he feels unable to write his feelings down, yet he is very much capable of expressing them verbally. Where would you start?
Well, I would stop asking him to write his feelings down, as it’s not working or he’s not complying, and you may have already stopped trying that.
It seems that he is trying to meet his needs via the imposters or fraudsters of alcohol and cocaine.
I might, whilst he’s deep in hypnosis, tell him a story of a man who is lost in a strange country. There are many beautiful and amazing places in this country, but the man keeps asking directions from a trickster who continually changes his disguise.
The trickster is charming and convincing, and the man, each time he encounters him, believes he really can help him… but the trickster always leads him to worse places and never to where he really wants and needs to be. What’s more, when the trickster journeys with the man, leading him down all sorts of dead ends and cul de sacs, the fraudster steals from the man, taking his money, his dignity, and making him lonelier than he was before.
Now what are we doing here? We are reframing the alcohol and cocaine abuse as abusers, tricksters, conmen.
Bit by bit, though, our man starts to see through the lies and empty promises of this imposter. He learns to ignore him, to find his own way and not be conned, tricked, lied, or mis-sold to.
We don’t have to spell it out, as we never do with therapeutic metaphor, but the alcohol and cocaine, two disguises of the trickster, have been stealing from your client whilst seeming to promise a cure for loneliness or meaninglessness. The question, then, is how can we help your client stop listening to the lies of the addictive trance state?
One way is to remove the pattern from his core identity. You can begin to refer to ‘it’ (the addiction): ‘How does it cheat you? What lies does it tell you and what makes it good at convincing you where others might be more skeptical of it?
What has it stolen from you? What might it have stolen from you in the future had you carried on listening to it? What will it feel like to begin to stand up to its bullying?
He can express his feelings verbally but he also needs to change his feelings. So reframe the pattern as something outside of him that he can stand up to and see through. Sometimes overcoming an addiction is, in part, about developing more assertiveness toward the addictive tactics and bullying. Standing up to what we might call ‘addictive coercion’ – not just from other people but from oneself.
Along with removing the pattern from his core identity though metaphor and the way you talk with him, you need to look at how he can genuinely and authentically meet his basic human needs.
I recall working with a chronic gambler who had lost, over the years, hundreds of thousands of pounds. Gambling had stolen his wife, too. It had taken a promising career from him because it had convinced him to steal from the company he was working for to give over to the gambling.
I asked him when he had not felt like gambling, and he told me when he was working for a charity as a coach driver on a trip abroad for children with special needs. He was meeting his needs to contribute to a greater pattern of reality than just himself, he was busy and felt appreciated, and so on. When needs are met legitimately, then phony ways of trying to meet needs – like drinking engine oil when thirsty instead of pure water – fall away.
So focus on how you and he can work together to begin to help him meet his needs healthily and sustainably. The pure will drive out the impure. Help him develop a plan for his weekends which is healthier.
We also need to help him stand up, in the moment, to the promptings and manipulations of the addictive trance state. Remind him that the trickster induces amnesia, via the dopamine pathways, for all it steals from him. You can help him access the feelings of being about to fall under the trance of addiction, maybe as the weekend approaches, and then pollute that state, as it were, with a visceral sense of all the things this trickster has stolen from him, and also his father perhaps. In this way we teach clients to remember whenever the dopamine-laced memories of the addictive pull try to induce them down a dead end.
How to Lift Self-Esteem in Your Clients
Low self-esteem manifests as part of many clients’ overall symptom picture, so it’s really useful to know specific and dedicated techniques to address it. As practitioners we know, often from painful experience, that complimenting clients with low self-esteem can be worse than useless, so a more artful approach is usually required. Learn about Mark’s approach to low self-esteem, grounded in what he learned teaching a UK-wide seminar to more than 20,000 health professionals. Read about Mark’s online self-esteem course here.
Read more therapy techniques »