November 16th, 2010
In a previous post (see A Million Ways to Treat an Addict) I had mentioned that there are many ways to approach the treatment of addiction to drugs and alcohol. I mentioned methods such as cognitive behavioral therapy (CBT), motivational interviewing (MI), and a growing number of medications (like Vivitrol) and possibly some preventative measures (like an upcoming nicotine vaccine). The reason its important to know about the options for addiction treatment is that even if one treatment doesn’t work, there’s nothing to indicate that another will not and I believe that it’s the duty of those who treat alcohol and drug addiction to be aware, and make use, of multiple therapies to give their clients the best chance at treatment success. However, even within specific categories of treatment methods, like psychoanalysis, there are several schools that approach the individual problem differently.Here I think that an individual therapist’s discretion is the best tool we have in terms of therapy selection, at least for now.
Alfred Adler and addiction
While he was part of the group that started the school of psychoanalysis along with Sigmund Freud, Alfred Adler had his own ideas about psychology. I’ll let you read more about the man and his history on your own time, but I want to point out his emphasis on family structure, dynamic, rank, and power structure as a main source for later psychopathology.
His concept of ‘inferiority complex‘ is one that is especially familiar to addicts. Feeling somehow incompetent, many addicts compensate by attempting to prove their worth at every possible chance. The overcompensation can make them seem cold, competitive, and insensitive. This often alienates them more, straining relationships and making them withdraw further. This is at least one of the reasons for the necessity of ‘drug buddies’ or ‘using friends’ to make up for the loss of many other social relationships.
Adler stressed equality as important for the prevention of pathology. Adlerian therapy establishes equality from the start with a therapist-client relationship that is collaborative rather than one in which the therapist is a teacher or master. Some clients will find this method more suitable, while other will need a more confrontational therapy, which we will address soon.
Overall, Adler’s approach seems very much in line with motivational interviewing methods whereby the therapist and client move together to find appropriate solutions that come from the client’s own resolution of ambiguity and indecision. I personally believe that such non-confrontational methods are important for many clients as they avoid the accusations, finger pointing, and blaming that normally goes along with trying to direct addicts to treatment. Still, there are many options out there, and being aware of what is available allows clients, and their loved ones, find the right treatment and produce much better choices.
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