psychology Is Counseling Good for Addiction

When a person asks for help with some issue in his/her life, a safe answer is to suggest counseling. Trouble with your marriage? Get counseling. Kids acting up? Send them for counseling. Have a flight get cancelled? Try some counseling!

There seems to be this assumption that any counseling is good counseling? But why would that be? What if we take the word counseling and change it to a different word with the same meaning; do we still feel the same way? For example, by counseling I think most people mean interacting with another person, and receiving feedback in the form of interpretation, clarification, or advice. How would you feel about the idea that if your kids are acting up, you should send them to a stranger and have the stranger give them advice?

There is no shortage of bad advice out there, so why is there an assumption that advice is OK, as long as someone is calling it counseling? One could say that there is the assumption that a counselor has had training, and therefore the advice will be better than the random advice one typically receives from strangers. But we all know bad doctors, and the standards to become a doctor are incredibly stringent compared to those for counseling!

There is one thing about counseling that does guarantee a certain degree of safety-- any recommendation to undergo counseling is usually ignored! But in all seriousness, the people who are referred for counseling are often vulnerable, and so the issue of whether to blindly send them for advice from strangers does deserve some consideration.

There are, of course, different types of counseling. The counseling done by advanced-degree practitioners, such as psychiatrists and psychologists, is generally referred to as therapy rather than counseling. Therapy can be broken down into different types, and some conditions are more responsive to one type of therapy than another. Therapy is placed along a continuum from supportive therapy on one end to expressive therapy on the other. Supportive therapy would be the appropriate approach for a person undergoing trauma or significant stressors; expressive therapy would be the choice for a person who wants to develop better insight into how his/her mind works.

What is supportive vs. expressive therapy? Supportive therapy is aimed at strengthening the persons defense mechanisms, as those defenses are what keep us sane during times of stress. Expressive therapy, on the other hand, is aimed at questioning assumptions, digging up repressed content, challenging long-held impressions of relationships, etc. If a person is already under a great deal of stress, and then undertakes frequent sessions of expressive therapy, he will often get worse, even to the point of psychosis.

Undergoing therapy during active addiction at first seems to suggest some contradictions. During addiction the addict is very stressed out, so wouldnt that suggest that supportive therapy would be best? Absolutely not-- when treating addiction, I WANT the person to question the assumptions and rationalizations that keep the person using. So does that mean that expressive, psychodynamic psychotherapy would be a good idea? To that I would also say no. The using addict is so full of BS that psychodynamic therapy is generally a waste of time.

There are other problems with therapy during addiction, even in recovery. A psychiatrist may see addiction in a way that runs counter to the view of an addictionologist. Psychiatrists often see addiction as a symptom of something; addictionologists on the other hand see addiction as a primary disorder, that may be the cause of psychiatric symptoms or illness. To one, addiction is a chicken, to the other, an egg!

The addictionologist worries that the addict in therapy will start to find reasons for what he is doing, when the reasons arent the issue; the point is to just stop doing it! I get this image of two extremes among my patients; both have a month of sobriety and it is time to be working full time, and one says OK and starts filling out applications without even thinking about the nature of the job, and the other sits for weeks talking about how it feels to go back to work, wondering why it feels this way, and wondering if he will always feel this way. I like the addictionologist approach in this setting, including the as if approach that I have mentioned before. You dont feel like working? Just act as if you DO feel like working, and get to work. You feel tired? Act as if you dont feel tired. To a tired, nonworking person this sounds harsh; but I am only trying to help.

This gets to the issue of the harm that the wrong therapy or therapist, can do to a patient. If we have a person in treatment who is struggling-- nobody is laughing at the cocky, stupid jokes and he is getting close to that place where he drops the cocky attitude and brings his genuine self to the treatment scene-- If at that point, a sensitive, kind therapist came on the scene and started making little poor baby faces with the person, that could completely destroy the treatment. Addiction treatment is challenging-- it takes a person who can distinguish the real person and the BS person, and use the BS persons own words back on him to try to break though the cocky front. This is the work of a good addiction counselor. There are plenty of counselors who think they are treating addiction by providing education and support, but the great counselors are the ones who are addicts themselves, who hate addiction and who come to work ready to rumble every day. In a way it is like a chess match. Knowing how hard to push, and when to push a bit harder, and then knowing when to shift gears and reel in the newly-opened mind. It is tiring work, and given that we are literally talking about saving lives, the pay is not near good enough.

There are other dangers to therapy for those in recovery from addictions. All of us in recovery have what I like to think of as the addict inside. The addict is there for one reason-- to get us to use. The addict is crafty, or as they say in AA, cunning, baffling, and powerful. The addict inside has advantages over our sober selves; the addict has access to all of our minds, including our unconscious, where our fears, lusts, prejudices, hatreds, and other powerful forces reside. The addict can use these unconscious feelings to push us to do things that may ultimately destroy us. But our sober selves have our own advantages; we get to control our arms and our legs. Sure, the addict inside can push us up down, left, right, into using once we are in a dirty bar at 3 AM; but our legs can carry our sorry heads to the edge of the bed at 10 PM and then drop us there, so that we cant get near that bar! The problem with therapy is that is does at least two things to strengthen the addict inside. First, the addict LOVES to talk; you start up that therapy, and the addict gets to start up with all the BS, and given free rein the addict will win over logic every time. The second thing is that the addict will use confidence of our sober selves to the addicts advantage, like this: I see it now! I used because I was teased on the playground, and that created this pain in my heart that never went away-- so I needed a pain killer, and I took one, to ease the pain! Sounds pretty logical-- but you have just told the addict in you about a big weakness. The next time you are in a situation that is somehow similar to being teased at the playground, the addict will be ready to tell you about how much you hurt, and about how good it would feel to medicate the pain, and about how much you deserve to be medicated. And even more-- you are now a smart guy! You had that therapy, and so you are probably OK to use just a little bit!

Right.

I am not totally down on therapy for addiction. Just dont kid yourself. One of my favorite lines from the movies is still number one, a couple decades after when the movie came out--Clint Eastwood saying A good man knows his limitations. This is important advice to any addict who would like to stay clean. Know your limitations. Having psychotherapy--even real good psychotherapy that truly adds insight doesnt make you any safer. If anything, it increases the risk that you will talk rings around yourself some day and get into more trouble. Ill close with another wise saying-- nobody is too dumb for recovery, but some unfortunates are too smart for it.

Read More..

psychology Why Do We Publish

A major "character" in Mark Salzmans first autobiography is his father. Sometimes his father paints. But his father hates painting. He likes it when his painting is done. He likes having painted. But the act of painting itself is, in his opinion, a big pain in the backside. 

Nobody reading this approaches writing like that, do they? I know I dont. Of all my experiences as an author, whacking those words down onto the paper is the best of the best. Always has been, always will be. Even though I cut most of them. I like creating. 

Ive quoted Hemingway before. Long periods of thinking, short periods of writing. These days, my thinking takes longer and my periods of writing are getting less frequent, but both still happen, and I still love creating something from nothing. 

If it werent for me, you would never read the words youre reading right now. Nobody else would ever write them. And they contain my thoughts. Through time and space, better than telepathy, you hear what Im saying. 

So, theres one reason to write, isnt it? The biggie, if you ask me. I write what I do because I cant NOT write it. I may be clarifying my thoughts in my own head. But, most certainly, Im just so moved by those thoughts that I must put them on paper. Theyre in me and they have to get out, kinda like those critters in the ALIEN movies. 

Is this the only reason to write? Because I want to zap my thoughts into your heads? I dont know. But let me change the question. Is this a reason to publish? Why not write your books and stick them in a filing cabinet like Sean Connery did in the film FINDING FORRESTER? Write it, express it, file it away. Why publish it? 

(Its okay if you havent seen this obscure little gem. I will explain all.) 

In fact, there are writers who do exactly that. Some fear rejection or criticism. We hear about them whenever we pop into a writing workshop. But I dont think there are very many of them. I have trouble picturing someone who can spend months (years?) doing something as essentially egotistical as writing a novel, but who is fundamentally lacking in any sort of self-confidence. Naw, theyre thinking posterity but lack the stones to admit it. 

At times Ive got an inferiority complex I wouldnt dream of whacking onto your shoulders, but it was absent when I wrote my books. During the act of writing itself, you think, "My words are better than your words." You do. You feel that you must record your thoughts because theyre that much better than most. Thats what writing is. So, I would say that by definition the author isnt ALWAYS plagued by self-doubt. 

In FINDING FORRESTER, the Sean Connery character won the Pulitzer with his first book, saw that every reviewer misunderstood him, and decided they could all get stuffed. This is a movie, a work of fiction, but I understand the attitude. I once wrote a true story, where the main character was Michael LaRocca, only to have a critic slam the main character as "unbelievable." Apparently I dont act like real people. 

I could never shove all my writing in a filing cabinet, unpub- lished, and tell the establishment to get stuffed. But yep, there are stupid people in the world, and some of them review books. 

So, weve identified two groups who wont be seeking publication. Hopelessly insecure and hopelessly arrogant. But, like Aristotle, I prefer moderation. You still may be wondering why I seek publi- cation. So do I. Let my exploration of this question continue. 

Ive hit best-seller status for two different e-publishers with three different books. Minor thrills at the time, but theres no way I could call them enough of a reward for what I put into writing. 

Youre an author. You know what Im talking about. We all but kill ourselves to make our books. And lets be blunt here. Unless youre going to throw Rowling/King/Clancy/Grisham money at me -- and youre NOT -- money isnt sufficient reason to publish. 

Publishing isnt just a case of sending it to a publisher, signing a contract, and being done. 

Next up is editing, which is a blast. Not at the time, perhaps. Any editor worth a damn will beat you over the head with every bad word choice you ever made. And you made hundreds! But at the end of that gauntlet, you know you are da bomb. 

Seeing my cover art is almost always awesome. Yes, I did say "almost." One bad experience among eight. It happens. But if youve worked with a publisher, you know what I mean. You log onto the Internet one morning, not fully conscious, amazed that you poured that first cup of coffee without burning off your naughty bits. You pop open an email and see cover art that almost makes your head explode. You get this big rush, thinking, "Someone understands my writing!" What you dont realize, naive little author, is that some artists dont even read the books they do the art for. But still. The art rocks your world. Feel that. I always enjoy clicking those email attachments and seeing MY book covers. 

Then comes marketing. Biggest pain in the... Well, lets just say it makes me want to not publish sometimes. So why publish? 

Ive entered the EPPIES three times, and been a finalist three times. The second time one of my books was an EPPIE finalist, I made some wisecrack in an authors egroup about how "finalist" is a synonym for "loser" and was raked over the coals. 

Oops! 

(Maybe I annoyed entrants who werent finalists. Id always wondered if they existed...) 

So lets say Im not publishing for money or awards. They sing a siren song to new authors which this jaded old bastard quithearing long ago. I got all that out of my system in the previous millenium. So why do I still publish? What are my rewards? Let me mention a few. 

A psychologist turned English teacher formed a womens reading group at the university where we once worked together in China. Her concept was women readers, women writers. But the first book the group ever discussed was my very own RISING FROM THE ASHES, which is about Mom. My only foray into "womens literature." I couldnt attend the reading group, since Im a guy, but my wife was there. What I learned about my book is priceless, as is knowing what those young students discussed because of my writing. Issues of such depth that Id be proud to inspire any student, in any country, in any language, to tackle them. 

I used to work on North Carolina hog farms. I enjoyed the company of some damn fine people at every one of them. Hog farming is hard work. This isnt the backyard family farm, folks, this is 13 people with 98 boars, 3500 sows, and all the babies they can make. One of my toughest coworkers was a lesbian who could break Xena in half, and my one foray into writing horror gave her nightmares. 

I dont consider myself a poet, and I believe most of the reading world agrees with me. But I have published 6 poems. There is one that a hog farm coworker insists will be read at his funeral. Dont ask me why he was planning his funeral during our lunch break because I have no idea. But, well, I guess Im invited, in a manner of speaking. 

Master Pizza, 30th Street, Tampa, Florida. A bunch of drunken Italian relatives reading one of my less-than-serious poems ALOUD between pitchers of beer. It was like a Joe Dolce moment. 

I was working as a security guard in a particularly unpleasant place. This was 20 years ago, I think. A fellow guard read one of my short stories. It is, by far, the most allegorical thing Ive ever written. I cant tell you how many times Ive thought about throwing it out. But then, I remember Bobs words. "This is me. This is my life." Me too, old pal, and I dont care if you and I are the only two readers to have any idea what Im talking about. {Scapegoat Bob!} 

Ive written some pretty heady volumes, but Ive also written quite a few short works. Ive heard from numerous students here in China that, "This is the first book in English Ive ever finished reading." When I write, I certainly never set out to help anyone learn English. (Some of my editors may claim I never learned the language.) And, students will LIE to teachers. But Ive decided that at least one was telling the truth. 

When I left the US, I embarked on several journeys. Learning to live in China. Learning to love again. Taking another shot at the writer dream. And, eventually, teaching. After all that, I tried my hand at writing humor for the first time. Every time I hear my wife laugh at something Ive written, I file it away as a reason to keep writing. 

Ive written one play in my life. I was young, and quite hooked on the album (pre-CD days) JESUS CHRIST SUPERSTAR. So, you guessed it, I tackled JC. I wrote something that nobody can read without having a powerful reaction. Readers love it or they hate it. Im proud of that. And hey, its only one act long. I have a short attention span. 

I loaned Clint "Two Dawgs" Hill my very first book. My cousin. He took it to Durham (North Carolina) and loaned it to a bunch of hippie buddies. He asked for another, because the first one fell apart from overuse. Thats why we publish. People all but fighting for the chance to read my words. And heck, the book wasnt even good yet. Its 20 years older now. 

I mention all this for the jaded old bastards who have a few novels and bit of minor success under their belts. Nobody else is reading this anymore, are they? 

So, maybe this is why we dont just stop when the book is written, stick it in a drawer, and uncork the champagne. Although I do hope you uncorked the champagne. This planet contains far too many people who "want to be authors" but who havent written a book. Never have, never will. Meanwhile, you and I are sitting here knowing we had no choice. We had to write. 

Read More..