Therapists Overview

WHAT DOES ADDICTION MEAN TO ME?

GOALS OF THE EXERCISE

1. Establish and maintain total abstinence while increasing knowledge of the disease of addiction, how abuse/addiction has affected the clients life, and the process of recovery. Increase awareness of addictive patterns of thought and behavior. Increase client ownership of issues by creating a personal definition of the problem of substance abuse or addiction.

2. 3.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL

Gambling Opioid Dependence Sexual Promiscuity Substance-Induced Disorders Treatment Resistance

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH CLIENT

The What Does Addiction Mean to Me? activity is for the client who is resistant to accepting a diagnosis of substance dependence or abuse due to mistaken ideas about what the terms mean. It explains the DSM-IV-TR criteria (in terms with which the client is familiar) and analyzes how they fit the clients life situation, including any nondrug-using addictive behavior. Follow-up can include bibliotherapy on alcoholism and addiction; keeping a journal about the clients thoughts and feelings about the lessons learned, conclusions, and plans made; and discussion with the therapist and treatment group of all of the above.

EXERCISE XXXVIII.E

WHAT DOES ADDICTION MEAN TO ME?

You may be doubtful about whether you are an alcoholic or addict, no matter what anyone else says. To answer this question for yourself, you need to be able to identify patterns of addictive or abusive use of alcohol, other drugs, or compulsive behavior, and to see whether your life fits these patterns. 1. For each of the following patterns, please write about whether this has happened in your life, and if it has, please think of at least one example. a. Tolerance. This is needing to use more of a chemical or do more of a behavior (or doing it to a greater extreme) to get the same effect, or feeling less effect if you use or do the same amount.

b. Withdrawal. This means either feeling ill or uncomfortable after stopping use of the chemical or the behavior, or using the chemical or practicing the behavior to relieve or avoid feeling ill or uncomfortable.

c. Loss of control. This means you use, drink, or practice an addictive behavior for longer or in greater quantity than you intended.

d. Attempts to control. This fits if you have had a persistent desire to cut down or stop, or have made efforts to control or cut down your using/drinking/addictive actions, including making rules or bargains with yourself to limit it.

e. Time spent. This refers to spending a significant amount of time thinking about using, drinking, or practicing the addictive behavior; planning or preparing for it; using/drinking/practicing; and dealing with the consequences (such as being hung over or coming down, or being broke until payday).

EXERCISE XXXVIII.E

f.

Sacrifices made. This is talking about giving up or reducing social, work, family, or recreational activities that were important to you because they conflicted with your addictive behaviorsfor example, drifting away from friendships with people who wont drink or use with you.

g. Continued use despite known suffering. This means continuing to use, drink, or practice another addiction in spite of knowing that you have had major physical, psychological, legal, financial, or relationship problems that were caused or made worse by that behavior.

2. Looking back over these symptoms, what do they tell you about your use of substances or other addictive behaviors?

3. For each of the following stages of addiction, please note whether you have experienced this, and if you have, please think of an example of how your life fits the description. a. First stage. The first experiencewhen you begin using a chemical or engaging in a behavior and discover that you like the way it makes you feel.

b. Second stage. Tolerance and withdrawal appear, and you find that you can use the chemical or behavior to cope with situations or feelings that are difficult or uncomfortable.

c. Third stage. You begin deliberately and routinely using the chemical or behavior to cope with stress or other problems. You may feel uneasy about it, and may try to cut down or control use; your normal life is disrupted and others may start thinking that you have a problem.

EXERCISE XXXVIII.E

d. Fourth stage. You come to feel that you cant cope with your lifes stresses without the chemical or behavior. You feel that you must pay whatever price comes with continued use; you feel trapped; your life seems to be falling apart; and/or relationships with others are compromised.

4. Looking over these four phases in the development of an addiction, what have you learned about your own pattern of use?

Be sure to bring this handout back to your next therapy session, and be prepared to talk about your thoughts and feelings about the exercise.