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Relapse does not mean 'back to square one'

Drugs, alcohol, exercise, sex, pornography, gambling....It seems anything pleasurable can become addictive, but how to draw the line between a harmless hobby and a problem? What elements of treatment are most important in helping tackle addictions?

Immediate gratification vs long term costs

It seems that almost anything pleasurable can become addictive. Whether it be drugs, alcohol, exercise, pornography, sex, gambling or the internet, the type of dependencies capable of being formed are almost as varied as the people who form them. But how are they distinguished from a harmless hobby? How much do you have to engage in a certain activity for it to be deemed problematic?

There are no hard and fast rules here, as they are entirely subject to the particulars of each person’s situation, but a general definition of an addiction can be understood as the continued use of a substance or behaviour despite adverse dependency consequences.

For example, continuing to drink heavily despite being diagnosed with liver problems, finding ways to carry on gambling even after having to file for bankruptcy because of it, or choosing infidelity and encounters with sex workers even though it is destroying your marriage. We’ve all heard stories like these either in our own lives, or those of friends, acquaintances or celebrities – what’s common to them all is prioritising immediate gratification of the addiction over the long term costs.

The mechanisms of addiction are both psychological and physiological. For many, their addiction is all they can think about: even if they are able to maintain many of their usual activities such as employment and relationships, it is always the first thing on their mind when they wake, and the last when they go to sleep, buzzing in the background at all times in between. Also, (particularly for substance-based addictions), physiological effects are common too.

For example an individual may begin by using half a gram of cocaine at a time and feeling that positive high. Over time, however, their body will adapt to this and require increasingly larger amounts to achieve the original effect, until they find themselves with a habit costing them hundreds of pounds a week to maintain. This descent into heavier use can feel hard to escape, especially when frightening psychological and physical withdrawal symptoms are experienced when trying to cut down or completely stop. These can include anxiety, irritability, intense cravings, nausea, hallucinations, headaches, cold sweats and tremors.

Maintaining commitment to long term payoffs

At City Addictions we have extensive experience in helping a diverse range of addicts. We work with our clients to develop an understanding of how their addictions are being maintained, and how to choose responses to their thoughts and feelings that will help them to maintain a commitment to long term pay-offs, rather than the immediate but damaging gratification of their addictions.

Our consultants are also experienced in helping clients deal with the range of emotional issues which are often related to to addiction, such as anxiety, depression or low self-esteem. Sometimes the key to abandoning addictive behaviours is actually to focus on the underlying issues they are an attempt to mask or alleviate.

Just as no two clients are exactly the same, so treatment itself cannot be ‘one size fits all’. Recovery is a deeply personal and unique process, and there is no single ‘right’ way to recover from addiction. Our psychologists have been trained in a number of treatment approaches which they tailor to the needs of the individual.

Treatment for an addiction is not something that can be done ‘to’ you. It is an active, collaborative process and, though the expertise of the consultant is important, the greatest catalyst for change must always be the client themselves. Approaching us for help in the first place is often the hardest and most important step, for it entails two crucial factors in successful recovery – a recognition that your behaviours are problematic, and a willingness to change.

Relapse does not mean ‘back to square one’

Crucial to our approach to addiction treatment is a culture of openness and acceptance. Unlike hardline ‘abstinence-only’ approaches such as the 12 step programme in the USA—where people can be expelled for the slightest mishap—at City Addiction we do not view relapse as a ‘back to square one’ situation for which you should be castigated.

Recovery from addiction is rarely a straightforward, linear process in which you decide to stop and never engage in addictive behaviours again. Indeed, if it was that easy, nobody would need the help of a therapist! Of course, relapses are setbacks, but they don’t have to negate all your prior hard work, or mean that recovery is impossible. Periods of relapse are when the most help and support is needed, not abandonment or shaming. We encourage you to use these frustrating situations for productive ends, as a chance to learn your ‘triggers’ or warning signs for relapse, and how to mitigate them.

In this way, we maintain a non-judgemental position, in which our clients can feel comfortable in being open and honest with us without fear of being looked down on or punished. A positive therapeutic relationship between client and therapist is a critical factor for success — often more critical than the therapeutic approach chosen — and it is one that we recognise must be underpinned by trust.

City Addictions, March 24, 2017

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