Part 2 – A New Perspective on the Treatment Process
~The Quest for Solutions to Addictions is Hindered by Gross Mislabeling of the Problem~
By Jason Wittman, MPS, LAADC, CATC-IV
One of the major reasons why I believe the success rate for rehabilitating people with addictions is nowhere near as high as it could be is due to the inaccurate labeling of addictions, including alcoholism, as diseases. Doing so locks those looking for better solutions into a medical model that focuses on curing the symptoms (choice of addiction) rather than on the underlying cause itself. It also has a big influence on the choice to develop treatments for specific substances rather than focusing on attending to the root causes of all addictions.
I see the root cause of all of the addictions, chemical and nonchemical (i.e. gambling, obsessive eating, etc.) alike, as maladaptive and very poor behavioral choices to cope with internal hurt generated by very low or lack of self-esteem/love. This is the missing ingredient that addicts refer to as “that empty hole inside” when they describe having it filled by their initial use of whatever was their choice of drug or behavior. Creating treatments for specific drugs or alcohol misses that those are just symptoms of low or no self-esteem/love. Focusing on them without also dealing with the underlying self-esteem issue is a fool’s errand. Without building great self-esteem, eventually, they will either go back to their original addiction or switch to another, probably non-chemical one.
Laid on top of this root cause is the very real physical addiction, in the case of alcohol and drugs. On top of that is the very real, well-developed habit of reliance on the addiction of choice to relieve their emotional pain. As with all habits that have been reinforced through lots of repetition over a long period of time they take on a life of their own.
Accepting this new definition of addictions highlights how futile it is to attempt to solve addictions by anything that does not eventually lead to the clients developing a high degree of genuine self-esteem/love. One would think that the medical profession would have by now figured out that introducing suboxone and methadone as a cure for heroin which was supposed to be a cure for morphine addiction after WW I, are nothing more than medically endorsed addictive substitutes.
Unfortunately, labeling addictions as a medical problem put recovery professionals in a frame that thinks of addictions in the same way as thinking about real, medically “incurable” diseases that are controlled and put in remission through drug therapies. Also in that frame, it is acceptable to dismiss clients returning to their addictions as relapses (think “cancer coming out of remission”). It takes the onus off recovery professionals, who can say that it is just part of the recovery process instead of it being an indicator that they didn’t do a complete rehab job to prepare their clients for an addiction-free life.
I have little or no problem with using drugs to assist in detoxing and withdrawal from chemical addictions or to bridge the void of internal emotional support until such support is developed. It has been shown that the success rate in working with meth addicts is greatly improved with the short-term use of antidepressants. The emphasis, here, is on “short-term” use. In this same vein, I would include all of the “evidence-based” techniques and protocols that are focused on alleviating the actual usage but do not directly address the building of self-esteem/love. They are possibly good interim steps but not addressing the root cause.
Where do 12 Step programs and the Steps, themselves, fit into this model? Unfortunately, the 12 Steps do not directly address the building of self-esteem/love. It looks like Bill W. was on the verge of incorporating it in some way when he wrote about “emotional sobriety.” He was on the right track but hadn’t quite made the connection that he was really describing self-esteem/love. The 12 Steps are an essential prerequisite for the development of great self-esteem/love in that they both clean out all the negativity of the past (Steps 4-9) and create a firm foundation on which to build this positive inner life. At the same time, the sponsorship and the fellowship provide universally available support that can reduce the need for the use of short-term bridging drugs. The final Step, though, is the development of a huge sense of self-esteem/love.
©2018, rev. 2019, Jason Wittman, M.P.S., LAADC, CATC-IV
[Permission to reproduce this article is granted as long as this notice and the “About the Author and the copyright information is included.]
*About The Author*
Jason Wittman, MPS, LAADC, CATC-IV (aka Successful People’s Secret Weapon) is the former Executive Director of Los Angeles Youth Supportive Services, Inc. ( http://www.la-youth.org ) and has had a private practice as a Counselor and Coach for over 40 years. His practice, http://Stage2Recovery.com focuses on coaching and advising business and professional clients, who are recovering from alcoholism and addictions, to work and live at their exquisite best. He is an expert on teaching and coaching the “getting-on-living,” self-esteem building and spirituality parts of recovery. He has his master’s degree from Cornell University in counseling-psychology and is certified as a drug & alcohol counselor, a clinical hypnotherapist and a practitioner of Neuro-Linguistic Programming (NLP). He can be contacted at firstname.lastname@example.org or