Philosophy

Much can be done to prevent the strong psychological and physical urge to drink, smoke a cigarette, gamble, or use drugs. Recurrence of addictive habits does not imply failure has occurred. At Eastside Addiction Professionals I believe that it is never too late to help a person recover their life from active addiction.

To diagnose substance abuse there are two sets of criteria that assist is assessing if you are dealing with substance abuse or substance dependence. These criteria for abuse is:

A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
1. recurrent substance use resulting in a failure to fulfill major role obligations at work, school, home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household)
2. recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
3. recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
4. continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)
The symptoms have never met the criteria for Substance Dependence for this class of substances.

The criteria for substance dependence is:

A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
1. tolerance, as defined by either of the following:
• a need for markedly increased amounts of the substance to achieve intoxication or desired effect
• markedly diminished effect with continued use of the same amount of substance
2. withdrawal, as manifested by either of the following:
• the characteristic withdrawal syndrome for the substance
• the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms
3. the substance is often taken in larger amounts or over a longer period than was intended
4. there is a persistent desire or unsuccessful efforts to cut down or control substance use
5. a great deal of time is spent in activities to obtain the substance, use the substance, or recover from its effects
6. important social, occupational or recreational activities are given up or reduced because of substance use
7. the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., continued drinking despite recognition that an ulcer was made worse by alcohol consumption).

In addiction counseling for the family member as well as the addicted person it is helpful to explore ideas of a personal philosophy and sort through beliefs that are distressing, painful and destructive. How you interpret, percieve and make sense of the world around you plays a large roll in explaining the difficulties you are encountering.  By developing an inner life through questioning and contemplating, your unconscious self-defeating thoughts and beliefs emerge.

I invite discussion about these thoughts and beliefs as they surface. As one's self-awareness increases the likelihood increases that the self-defeating beliefs will be purged in favor of vital and positive thoughts and actions. It is essential that people develop a personal philosophy to guide their daily attitudes, thoughts and behaviors. The phenomenon of transformation is possible for everyone.

"Here and there, once in a while, alcoholics have had what are called vital (spiritual)experiences. To me these occurrences are phenomena. They appear to be the nature of huge emotional displacements and rearrangements. Ideas, emotions, and attitudes which were once the guiding forces of the lives of the men (and women) are suddenly cast to one side, and a completely new set of conceptions and motives begin to dominate them." (Big Book of Alcoholics Anonymous pg. 27, fourth edition)

One goal in counseling is to match a person to their stage of readiness for change. Even people who don't want to change have an opportunity to put into motion the process of change by exploring the dilemmas encountered when others have asked them to change.

I will work to help a person tip the balance in favor of change by examining how their addictive behavior is preventing them from achieving a life of purpose and intention.  One approach in counseling comes from the Stages of Change model also known as the Transtheoretical Model. These stages help to define one's readiness to change.

Precontemplation

• At this stage a person is not aware that a problem exists.
• It is not that a person is trying to be obstinate, he or she truly is not aware that there is a problem. This is especially true if there has been someone in the addicted person's life who "rescues" and "cleans up" after the addicted person. If the consequences of a behavior were not self-evident it would be difficult to believe a problem exists.
• Things you may hear from your loved one or found yourself saying in this stage: "I'm not hurting anyone", "they need to get off my back", and "I'll go if you want me to".
• To help someone in this stage avoid the use of the word "you" as in "you should really think about quitting or "you should think about calling someone for help", etc. This only serves to build resistance against changing. Instead try talking in generalities using the term "people" as in "I read here that some people have found going to treatment helps".

Contemplation

• At this stage a person is becoming aware that a problem exists.
• The person is beginning to think about changing the problem and may begin to do such things as calling a treatment center to find out what treatment costs and what kind of participation would be required.
• No commitment has been made to change...yet.
• Things you may hear from your loved one or found yourself saying in this stage: "I think I might be using too much" or "the other day I was really uncomfortable with how much I drank at the party".
• To help someone in this stage provide information you have learned about addiction or treatment in a non-blaming, non-threatening manner that is informative while avoiding building resistance with confrontational language with statements that begin with "you".

• At this stage a person is beginning to accept responsibility for changing.
• The person is intending to take action to change within the next month.
• The person is evaluating the ways to approach change and a plan is being made. Hope, confidence and commitment are building.
• Things you may hear from your loved one or found yourself saying in this stage: "I want to stop so I can be a better parent", "I am ready to quit abusing myself like this", "and I deserve to be happy".
• To help someone in this stage support the strong feelings of hope and desire that are beginning to emerge in your loved one with statements such as "yes, you do deserve to be happy", "getting sober will help you be a better parent".

Action

• At this stage a person is taking the responsibility for change i.e., going to counseling and attending meetings.
• The person is making a conscious choice to adopt new behavior and to learn ways to avoid the old behavior.
• This stage takes about six months before progressing.
• Things you may hear from your loved one or found yourself saying in this stage: "Things are going great, my boss is really happy with me", "I just celebrated three months of sobriety and got a coin at my homegroup" and "I feel great".
• To help someone in this stage provide praise and recognition. Go to Alanon to support your own efforts at recovery.

Maintenance

• At this stage a person is stable in recovery.
• He or she has a plan for dealing with the desire to use and plenty of support to help when times get tough. The person is conscious of high-risk situations.
• In this stage the person has maintained change over six months.
• Things you may hear from your loved one or found yourself saying in this stage: "I have a homegroup I attend every Wednesday so I cannot go to the movies with you." or "No thank you, I think I would rather not go where there is drinking".
• To help someone in this stage continue attending Alanon and focusing on your recovery.

James O. Prochaska, PhD and Carlo DiClemente, PhD developed the Stages of Change model over the course of 25 years of experience providing psychotherapy. The belief that people can and do successfully arrest addictive behavior underlies this theoretical approach that has been empirically researched the world over with excellent results*.

*"Changing for Good"

Prochaska, Norcross, DiClemente