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Can therapy on its own deal with addiction?

I sometimes work with clients who have addictions, such as alcohol or pornography. A question I’ve had to ask myself is whether one-to-one therapy alone is sufficient in dealing with addiction.

While I think psychotherapy is extremely useful in helping clients learn about the underlying causes of their addiction, I believe that usually the individual needs extra help in coping with the day-to-day challenges of addiction.

An obvious source of such support is a 12-step group such as Alcoholics Anonymous, Narcotics Anonymous or Sex Addicts Anonymous. These are called 12-step groups because their model has 12 steps that that individual is encouraged to complete as part of the recovery process.

I know that some therapists discourage their clients from 12-step groups, perhaps because they disapprove of the spiritual aspect or see it as a ‘one size fits all’ approach.

The advantage of these groups is that there are many of them dotted around the country, especially AA, and they are free or only ask for a small financial contribution.

Of course, not everyone takes to the 12-step model and some people struggle with the spiritual aspect. There are other support groups for addiction that do not adopt the 12-step approach, but these may sometimes be harder to access.

Either way, the advantage of being in a group is that the individual learns that they are not alone, that others are facing the same challenges. The individual can also find inspiration from hearing others’ stories and experiences. 

Social circle

One of the main challenges in many addictions is the addict’s social circle – he or she often finds themselves socialising with others who have the same addiction. A benefit of a 12-step group is that it offers a new community of like-minded people and therefore reduces loneliness and isolation, which in itself can be a trigger for addiction.

I don’t see any competition between individual therapy and 12-step groups –  I think they can complement each other. The aims are the same – to help the client stop a damaging addiction. 

I like the emphasis in 12-step groups on taking responsibility for one’s actions and accepting that one is powerless in the face of the addiction. Accepting the power of the addiction over one’s life is a key part of making positive changes.

Where I think therapy can help in particular is the individual relationoship the client makes with the therapist and the changes that can emerge over time through that relationship. Meeting with the therapist every week can help the client, in particlar, work through some of the early childhood experiences that may have contributed to the addiction.

One of the things some people struggle with in 12-step groups is reference to a higher power. I understand that for some this is difficult but I think it can be understood not in a conventional religious way but rather as a recognition that there is a greater meaning to our lives, one that is beyond our ego.

Another teaching of 12-step groups, that one is powerless in the face of the addiction, represents the paradox that in addmitting this powerlessness a person can actually be taking an essential, first step towards freeing oneself.

Overall, therefore, I believe that 12-step groups offer a lot for people with addiction and that their model can complement individual counselling or psychotherapy.

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More information at http://www.patrickmccurrycounselling.co.uk