Are you really an addict? The words we use to describe ourselves are crucial to determining the way we feel and define ourselves. Modern science acknowledges the spectrum of severity of substance use disorders and the various effective approaches based on the severity of the problem. Not everyone who has a problem is addicted or has a progressive disease. While the recovery community sees addiction as a disease, our culture, and many addiction counselors still stigmatizes addiction as a moral failing. We must use language that is optimistic and affirming of those that struggle with these issues if we are to provide real support. This conversation is an example of how a compassionate perspective can support a real shift within someone who has had a problem with overusing substances.
~ Len Van Nostrand, M.A., CCP
A Simple Conversation
I recently had a client say to me, after having nagging thoughts about using, “I have this addict inside of me”. She had been told that she had a disease after a brief season of overuse of substances. For over 5 months she had been successful in making good decisions about whether she would return to this destructive behavior. It was clear that there was more going on than a simple craving…
I was immediately reminded of the power of language and the role it plays in empowering or hindering us in moving forward. Is it important to identify ourselves as addicts when this label causes shame or stigma?
I asked “is it true”, that she was an addict? My question confused her because she had been told by well-meaning people that because of her past behavior she had to accept that she was destined to a life of struggle against this thing inside her. She was also encouraged to choose grateful acceptance of this “character flaw” and get into “recovery”.
Unfortunately, the word “recovery’ has been often been coopted by those who define it as complete and total abstinence from all mind-altering substances and behaviors (drugging, smoking, caffeine, drinking, eating…) and engaging in a lifestyle of ongoing processing about your success or failure at this task. The standard is “clean and sober” and there is no middle ground. Is “recovery” an attractive option? This would include complete abstinence from any substance use or behavior that would change the way one feels, ongoing admittance of having an uncontrollable and unmanageable illness and possibly living in fear of a recurrence of harmful using behavior. This definition is at odds with the definition of SAMHSA (Substance Abuse and Mental Health Services Administration) which sees recovery as “a process of change”, without mention of abstinence or any specific path way toward wellness.
I asked her if she would prefer to see her harmful drug use as a bad habit, during a brief season of her life (rather than “I have a disease and am an addict for life”)? Had she moved on? Did she want to define herself by those difficult times? As she considered a new way to look at her substance use she developed a deep sense of empathy for her choices. She was empowered to choose a narrative that made sense to her and allowed her to experience a sense of self-respect.
She became visibly relieved to consider another way to describe her experience. She just hung her head and cried. The year before, her partner had died in a car crash. She was now working at a dead-end job in a new town, few friends and limited support or direction. I suggested that it wasn’t that unusual to want some relief by using, that there was an overwhelming amount of pain and sorrow in her life. Somehow she felt that her desire to use was abnormal. I invited her to do some “urge surfing”, a mindfulness exercise of self-inquiry around the craving. What was the message under the urge to use? Given her story, it seemed like an option for some relief. She came to have some compassion for her vulnerable state and respect for her need to protect herself from so much pain. We explored some of the pros and cons of this choice: short term relief versus long term goals. We also looked at how this urge to use could remind her of her need to grieve and to recommit to loving herself and reclaiming her life. She had come to embrace this feared thing as a messenger of meaning.
As a result, our conversation turned to what she would prefer to see happening in her life. She wanted to explore continuing her education and taking a long hiking trip. As she began to see a small glimpse of a future goal that involved nature and movement and learning and planning for the trip we quickly found local resources to support her intentions. As she shifted her focus from the dark past to an enjoyable and meaningful future there was a marked shift in her posture, her breathing, her face relaxed, she lit up, smiling as she considered the possibilities of creating this event.
As we approached the end of our session, I asked about her craving. She looked at me with surprise. She said It no longer made sense for her to use. It did make sense to look at her craving and her self talk with curiosity and compassion. It made sense to her that the craving had been in fact a doorway to deeper self-knowledge and self-compassion. We agreed she would reaffirm her decision to remain abstinent, which came easily to her. Her attention was already turned to the new plan she had which was completely aligned with her “true” self. She had changed her habit of using by coming to a decision that was in line with self-compassion and her highest values. This is the path that leads beyond recovery, to come to the place of connection to oneself.
Len Van Nostrand, M.A., CCP
Certified Coach Practitioner