Opinion by EHN Guest Writer
Paul Dilworth is a Toronto-based social worker with a private practice focusing on addiction. He has been in recovery for 26 years.
If most therapists were asked, they would probably say that one third of their clients struggle with substance abuse or their client’s partner has a substance use disorder. Some clients are openly talking about their substance use while others may start talking about it in the future. We are just waiting for another crisis to finally drive reality through the denial wall.
The holidays are usually a fertile time to provoke these crises. Too much stress, the proximity of partying, or visits with some relatives we dislike pushes many people with addiction into more substance use to try to cope with it all. This time of year may cause a partner or friend to realize that “something has to be done because we cannot live this way anymore.”
Honouring Each Client’s Unique Pace
My clients are always at different stages in their recovery. Some have not yet discovered that substance use is a big factor in their unhappiness while others are very aware and just waiting for that final internal push to put the brakes on and keep them applied. We all possess our individual agendas. Everyone has their own timeline.
My January conversations with clients take different forms. Someone might say, “I think I might have a problem with alcohol” or a partner might say for the very first time “Joe overdoes the alcohol at times and I worry about the impact on the kids.” They continue to describe the scenario that made the light bulb go on. Then, there are other people with whom alcohol or drug use has been a significant part of our conversations. With them, we are waiting for the internal push! This push can never be rushed and has to come from within the client as one only acts when one sees the reality of addiction for themselves.
Emotions Drive the Realization That Something Must Change
That reality has to be based upon some uncensored memories of the effects of drug or alcohol use, worries about the future, and the accompanying emotions one can no longer deny, project, or rationalize away. Emotions are a good thing! Thoughts are like a movie without the soundtrack; when you add emotion, you see and experience your whole painful addiction in undiluted Technicolor and you cannot exit to get popcorn or go to the bathroom.
For my clients who are having their first realization, we talk about how they are feeling and what they think of abstinence going forward. If they accept the idea of abstinence, or getting treatment, we can move forward. If the client resists, we still have more waiting to do. At least they have given me permission to make their substance use a regular topic in our sessions. Talking is the only way to bring our fiercely-kept secrets into the light of day, and that is when the romance with our substance begins to end.
Supporting Partners of People With Substance Use Disorders
If my client is the partner of someone with an addiction, they have given themselves permission to start talking to their partner. My task is to support them and get them past their fear of their loved one’s defensiveness upon bringing up the subject of dependency. The treatment goal in both situations is to regularly talk about the problem so that everyone can appreciate its magnitude and understand a solution is required.
Formal Residential Addiction Treatment is Necessary
Those who have experienced the final internal push need help with solving the problem of where they wish to get treatment. Overcoming addiction just by seeing a therapist once a week is very difficult. People often need an experience where they are immersed in the recovery community and culture. To achieve anything you must live it 24/7, eat, breathe, and sleep it with your eye always on the prize. The rest of my work involves helping clients overcome their reservations about joining a program and helping them begin to mourn the ending of a long bitter sweet affair with drugs or alcohol. It truly can be a breakup process.
So January ends with two groups of clients pursuing two different stages of recovery. The first group is on the way towards fully admitting to themselves and their families they have a drug or alcohol use disorder that must stop. The second group are entering the active rehabilitation stage by calling a facility for an assessment. In all, our conversations have created a very productive month!
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