I do some work at a rehab and halfway house with people who are called addicts, and it strikes me that addictions are a particular class of problem distinct from other types of problem.
The way I work (which is not a common way of working) is to identify and heal the sources of a problem. Most specific problems have a fairly limited number of sources in the person's past, and sometimes there's just a single source. Whether a problem relates to fear, guilt, anxiety or stress, once the sources of the problem are healed, the problem is resolved.
Addictions are different from the average problem. An addict takes to alcohol, narcotics, food, co-dependency (or whatever the addiction is) in a whole range of circumstances. Why do they do this? Because, in the perception of the addict, the object of their addiction actually provides a solution to their problems. It's a one-stop solution: various problems; one solution. Even if the addiction looks like a nightmare from the outside, it provides a solution which, at least in some respect, the addicted person likes and probably (if they admit it) enjoys.
Any problem the addicted person faces leads directly to the addiction, since the addictive object is the perceived solution. Problems with relationships, problems at work, problems with confidence and expression, anxiety about money or career, guilt, anger, fear - all of these find their 'solution' in the object of the addiction. Just as all roads lead to Rome, all problems lead to the addiction. Addicts (until they begin recovery) don't know any other convincing place to go with their problems.
To onlookers it seems as though the addiction is the problem. In fact, the addiction is really the symptom.Whatever problem the addict is experiencing, the addiction provides the solution. Whenever the addict feels bad, he or she engages in the addictive behaviour and for a short time ceases to feel bad. Of course it's not a solution at all, but the source of other problems - other problems for which there is only one perceived solution...
Addiction is a much greater challenge to treat than most issues because (1) for the addict the object of addiction provides an apparent solution; and (2) overcoming addiction requires not the resolution of one problem but, usually, very many.
Consequently, the addiction is unlikely to be overcome until (1) all the individual's major problems have been resolved; and (2) the addictive object is no longer seen as the solution.
Success is unlikely to be achieved by trying to take away the addict's solution without also resolving the addict's significant problems.
Typically, addicts are treated with traditional psychotherapy. Psychotherapy doesn't have the best tools to help people identify the past sources of issues and achieve full resolution.
Most rehab centres work only with traditional psychotherapy, and their aim is more modest than complete resolution of the addiction. Although they achieve success in many cases, the addict's problems, better understood and managed through treatment, often remain unresolved, and so the threat of relapsing always remains. This is why twelve-step programmes always regard 'addicts' as being 'in recovery' - however long it is since they last practised their addiction.
If addicts are also given treatment which identifies and resolves the sources of their problems, the addiction itself is absolutely resolvable. This can take time when there are many problems to resolve. Each problem that is resolved is another real step towards resolution of the addiction. But at any time, until all the major problems have been resolved and the addictive object no longer appears to be the solution, the addictive behaviour can manifest again. When a person relapses, it can seem that the treatment has failed, when in fact it is just unfinished.
A good rehab offers a safe structure for the addict to learn to live a purposeful life; to explore ways of relating honestly with themselves and with others; to find helpful solutions to everyday difficulties; to improve self-esteem; and to learn about who they really are. Such a structure provides the ideal context for helping the addict to resolve their problems at their sources and successfully resolve the addiction.
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