Addiction - This Being Human: A New Perspective

By Ronnie Aaronson

This is a compassionate, unique and innovative book about addictive behaviour.

Who is likely to develop an addictive habit? What draws people to use addictive substances? How do addictive substances serve the user? What are the possible conscious and unconscious reasons behind their use? The author, using vignettes and actual case histories, presents a clear, dense and compelling narrative to offer answers to these and many other questions by expanding upon theories taken from different orientations within psychotherapy, including body psychotherapy.

She considers the part that shame and fear can play in addictive behaviour and how it can get acted out in treatment. She identifies building a strong sense of self and the ability to self-soothe as essential for long-term abstinence and presents a clear and convincing case for bodywork and long-term counselling or psychotherapy to be included in treatment so that the recovery process can be completed.

This book is useful for anyone in the helping professions who works with or around individuals who present addictive behaviour. It is essential for counsellors and psychotherapists and a must for anyone working in the drug and/or alcohol field.

• Language: English
• Publisher: AuthorHouse UK
• Release date: Oct 4, 2006
• ISBN: 9781467012393

Ronnie Aaronson

Ronnie Aaronson started her career as a teacher of children with learning difficulties. She studied psychodynamic counselling for her MA at the University of Reading before gaining a diploma in supervision and an integrative psychotherapist training at the Sherwood Psychotherapy Training Institute in Nottingham. She studied body psychotherapy with Jochen Lude, co-founder of the Chiron Institute in London. Ronnie is currently the joint leader for the SWAN Project; an initiative focused upon addiction to alcohol. She is a visiting lecturer at Bristol University. She works as a psychotherapist and supervisor in private practice andruns training courses.

Book preview

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© 2006 Ronnie Aaronson. All rights reserved.

No part of this book may be reproduced, stored in

a retrieval system, or transmitted by any means

without the written permission of the author.

First published by AuthorHouse 10/2/2006

ISBN: 1-4259-6045-6 (sc)

ISBN: 978-1-4670-1239-3 (ebk)

Printed in the United States of America

Bloomington, Indiana

Contents

Acknowledgements

Preface

Introduction

1

2

3

4

5

6

7

8

9

References

This being human is a guest house.

Every morning a new arrival.

A joy, a depression, a meanness,

Some momentary awareness comes

As an unexpected visitor.

Welcome and entertain them all!

Even if they’re a crowd of sorrows,

Who violently sweep your house

Empty of its furniture,

Still,

Treat each guest honourably.

He may be clearing you out for some new delight.

The dark thought, the shame, the malice,

Meet them at the door laughing

And invite them in.

Be grateful for whoever comes,

Because each has been sent

As a guide from beyond.

Rumi

Acknowledgements

I would like to thank Sarah House for working with me to set up the SWAN Project and Alison Scrivens, in particular, for helping us to keep the dream going. Appreciation also, to all my colleagues who added their encouragements especially to Simon Richardson, Morris Kapatula and Alison Scrivens for their valuable comments and to my goddaughter, Hannah Pearce for editing my work. Special thanks for the Bristol Drug and Alcohol Team and to John White, in particular, funding manager for the College House Social Work Team when we set up the project. I would also like to thank Robin Aaronson for his continual support in all aspects of my work and in the writing of this book in particular.

Preface

Whatever you can do,

Or dream you can, begin it.

Boldness has genius,

Power and magic in it.

      Goethe

My bold act was to set up an alcohol-only project with next to no financial backing and little hope of receiving any future funding, in a city I had just moved to where I had few local contacts in the field. My initial interest in individuals who use alcohol to cope with difficult emotions started several years before, when I had the privilege to work with Kevin, who at the time was drinking a bottle of cider a day.

I worked with Kevin for about fifteen months. When we parted he had been sober for about five months and had passed through several shorter periods of sobriety during our time together. I found working with Kevin both rewarding and fascinating, but I came away from the experience feeling that I probably could have helped him to get sober more quickly if I’d known more about the field. To that end I took a placement with an alcohol agency.

Now I have worked in this area for many years and I know that there is no easy, quick solution. There are useful strategies that working in the agency taught me; for example, the use of a drink diary to help clients acknowledge how much they are actually consuming, but the main part of this work is exactly what I had been doing – by instinct - with Kevin: building a sense of self.

What I also learnt from the agency was how group work speeded up the recovery process. Instead of one non-judgemental, empathic person relating to the client, as in one-to-one therapy, there are several. Each member of the group describes incidents and feelings that others can identify with and in this way practicalities are solved and unpleasant and difficult feelings become normalised due to the evidence presented by so many others in a similar situation.

There came a point when in order for it to survive financially, the agency in which I worked had to change its programme to address the needs of those who had been using hard drugs many of whom were on Drug Treatment Testing Orders. As the service adapted itself to comply with the demands of this new client group and those funding the service, those using alcohol to self-soothe did not thrive as they had previously. These events spurred on a colleague and me to set up an alcohol-only project. We knew there would be no funding available but we hoped that we might attract individuals who were drinking at harmful, rather than dangerous levels, who might still be employed and could thus possibly fund themselves. In this way we hoped we might be able to support at least a few non-paying places.

We spent hours working out exactly what we wanted to offer. We based our philosophy, and the practice that was to follow from it, on psychotherapy theory. The universe seemed to smile on our folly and, only three months after we set up, our day programme attracted the attention of our local Drug and Alcohol Team. They started to spot-purchase places for their service-users so we found a means to fund our proposed work.

The conscious impetus for writing this book was to share the theoretical base on which our project was established in the hope it will prompt and enrich the thinking of anyone working in the field of addictions. Even more importantly, I hope this book will prompt discussion around the issues presented here.

Once I started writing, it was as if streams of thought held and felt in my body joined to form a river with such power that I could not ignore them until the words were out. At this point I realised that unconsciously these outpourings were an attempt to share my own journey and reflect upon how I discovered my own self-compassion, inspired by understanding these concepts. I hope in doing this I might inspire others to do the same.

My experience has been enriched by contact with others, many of whom have sought me out because their lives have become unmanageable due to excessive alcohol use. These words are dedicated to each one. This small volume is my attempt to normalise and humanise addictive behaviour. Too many individuals who come for help relate events where they have not been treated with respect because of their addiction, even if they were trying to control, or reduce, their alcohol intake at the time, or were on a reducing methadone script.

Although much of my experience has been working with those who are having problems of varying severity with alcohol, I hope that the theories illuminated in this volume will be useful for thinking about addictions in general.

I would like readers to hold in mind that the theories presented are only that. They are not proven hypothesis or fact. If they resonate with your body or your experience, you will be more likely to identify with them and hold them as truth. What is true, though, is that we are all unique individuals who share our human being-ness. Likewise, our experience, though different from each other, will sit somewhere on the continuums - of pain/pleasure, not-good-enough-mothering/too-good-mothering, excessively shamed/not shamed, excessive use of mood-altering substances/little use of mood-altering substances and self-harm/self-care. I am aware that I have had to generalise as I have only been able to portray particular slices of these continuums.

I have made several conscious decisions about how I present these words, keeping in mind how I would like them to be received. I have chosen to keep the word ‘client’ to a minimum as some professionals working in the field work with ‘service users’ or ‘patients’ and it is easy to disengage from the written word if the terminology jarrs with a reader’s routine language. I have tried deliberately to use phrases which are less dispassionate than ‘client’ and ‘service user’ in order to help the reader to think of this client group as individuals, all with their unique stories and difficulties. To the same end, I have also chosen to include some vignettes, with the permission of each person, so as to include more personal stories and bring the narrative alive.

I have kept to a few themes, rather than included all psychotherapy theory that could be useful when working with addiction, so as not to dilute the impact and confuse anyone for whom these ideas are new or less familiar. By using as little jargon as possible and keeping the language plain, I sought to make these ideas accessible to as large an audience as possible. Jargon and clinical terms can also keep us in our heads, dissociating us from our feelings so, since I am writing about people who use substances to distance themselves from their emotions and physical sensations, I did not want this book to parallel that process.

This short volume is offered as a taste of a delicious meal that is on offer, so at the end of each chapter I have suggested further reading for those who might wish to delve deeper. With the exception of Melanie Klein’s book, I have chosen those that are more readable. However, I have included her book because, if you can make sense of it, it is extremely rich. A full bibliography is also provided at the back of the book.

I hope you enjoy the taste of the words and sentiments offered here, even if you do not go on to eat the whole meal.

Introduction

As we listen, try to understand and think theoretically about another person’s inner world, so our way of being with them is subtly changed, maybe in the way we hold our body, our facial expression, or the tone of our voice. Whatever it is, the person picks it up on an unconscious level. They can detect that something has shifted in our thinking about them. They seem to instinctively know that now is the time to make a disclosure that they had previously been hanging on to, for example. The ever-changing way in which we think about a particular person, as our work progresses, has a substantial impact on the relationship.

Professionals who work with individuals showing addictive behaviour will have a particularly wide variety of ways of being with their clients because there are so many conflicting physiological, behavioural and psychological theories about the roots of addiction which will affect the way in which we perceive these people.

Historically, treatment for the majority of clients who misuse chemical substances has been split off from psychotherapy, for two main reasons. First, psychoanalytic psychotherapy was not found helpful with this client group, even if the individual seeking help was dry or clean. Secondly, a process called the Twelve Steps devised by the founders of Alcoholics Anonymous, in keeping with their own experience of recovery, did help large numbers of people to become and stay abstinent. This success story together with its offshoots like Narcotics Anonymous and the failure of psychoanalytic psychotherapy at least partially explain why treatment for substance abuse has developed mainly outside the arena of psychotherapy. Since AA is a self-help group, personal experience of an addiction has been seen as a prerequisite for professionals working in the addictions field and, until recently, counselling and psychotherapy training was a qualification rarely considered particularly relevant.

Psychoanalytic psychotherapy proved unproductive with this client group for several reasons. Following Freud’s pioneering work early analysts believed that their patient’s difficulties were mainly to do with internal conflicts between unconscious wishes and fears. Freud recommended that the analyst should not allow his own personality to intrude in the treatment. Part of the analyst’s task, as he saw it, was to be as unobtrusive as possible. He suggested that if analysts provided a blank screen, the patients would respond to the analyst from their unconscious wishes and fears. These could then be explored and would thus become less potent until at some point behaviour could change.

This blank screen technique encourages the transference relationship to emerge, where we try to make sense of the unknown aspects of the analyst. The transference relationship can be seen as the process by which we transfer our experience of past relationships, our emotions, our thoughts and our expectations, on to our present relationships. For example, if John has experienced abandonment in his first relationship, he will enter other relationships with the fear, at some level, of being abandoned. He will unconsciously notice and interpret actions and comments made by Jill in the light of this fear. As evidence gathers that John is about to be abandoned he might act in a way which leads him either to abandon Jill before she abandons him, or push her into leaving him. In this way the expectation is confirmed. Of course, thoughts about leaving the relationship may not have been initially real for Jill, but she might become confused, or start to have thoughts about leaving the relationship as she picks up these abandonment feelings from John. This transfer of our experience from the past to the present is the body-mind’s attempt to keep us safe. For example, if we have a bad