Addictions therapy - Dr. Tal center
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Addictions – diagnosis and treatment

We use the expression "I'm addicted" almost automatically to describe our fixed habits such as our inability to start the morning without coffee, to finish a meal without something sweet, or even our need to check our emails every several hours.

Indeed, in some cases these actions are more expressive of emotional difficulty than a fixed habit, but usually do not meet the criteria of the definition of addiction.

What is the definition of addiction?

Two major characteristics are at the core of the definition of addiction:
 

  1. Developing tolerance and the existence of a progressive and continued process – this refers to the user's adjustment to the addictive substance and to the addict's growing need to increase usage or increase the amount of the substance.

    This characteristic is expressed in unsuccessful attempts to stop usage, increasing the amount because the amount that the addict has become used to is no longer effective (from one glass to two glasses, from a glass of wine to a glass of vodka), repeated use although the user knows that he is causing himself damage, a feeling that the urge to use is uncontrollable, and so on.
     
  2. Usage because of the difficulty involved in withdrawal – an emotional difficulty or a mental void occupies a major place in the addict's life.

    Anxiety, depression, the consequences of a post-traumatic event from the past (mostly sexual assault), are major reasons for the development of addiction.

    The feelings of relaxation and mental calmness are all that those who suffer from anxiety or depression want, and therefore the temptation to use is huge.

    For example, a person who suffers from anxiety will start using marijuana to alleviate his anxiety, to relax, and to function successfully.

    The first times using the substance will indeed lead to the desired outcome and will perhaps even increase his ability in those situations in which his anxiety has inhibited him.

    However, he will soon enough find that the anxiety that had disappeared is returning, and with a higher level of intensity. The person continues to use the drug because the pain of withdrawal is unbearable, and thus finds himself having no control over his addiction.

There are two major categories of addiction:
 

  • Addiction to chemicals, such as cigarettes, drugs, alcohol, and so on.
     
  • Addictive behaviors such as addiction to computer games, addiction to shopping, addition to sex, addiction to the internet, addiction to gambling, addiction to food, and addiction to work.
     

Actually, there is no difference between the two types, and the cycle of progressiveness and tolerance development are similar.

In both there is the same restlessness that characterizes the addict and the same inability to become involved in anything that is not the addiction itself.

The only difference is the different catharsis, which is different with each addiction.

Any addiction affects the brain's functioning (in the frontal area of the brain), and mainly the judgment system of the brain and its ability to distinguish between good and bad.

Soon, a vicious circle is formed, oscillating between the inability to resist the urge and the decrease in the brain functioning that is responsible for the required control.

This cycle increases the urge and the person's submission to it with time, and at the same time reduces the brain's ability to stop this urge.

Treatment of addictions

Addiction treatment is always a holistic-inclusive treatment that does not focus only on weaning from the addiction.

To understand the reason for this requirement, we have to familiarize ourselves with the Iceberg Model that describes the phenomenon of addiction.

An iceberg is a unique natural phenomenon in which only the tip of the iceberg is visible at sea level, and most beneath of the iceberg is unseen.

Addiction can be similarly described: the visible level, the tip of the iceberg, is the external expression of the addiction: the use of grass, the compulsive shopping, etc.

The level below the surface expresses the emotional difficulty or the trauma which caused the addiction to begin with, which is discerned each time at another tip of the iceberg. This is the part that has to be treated.

Hence, treatment has to include the iceberg as a whole, the tip and the depth, the signs of addiction and the reasons for addiction.

Addiction is a whole way of life and therefore proper treatment has to deal with a comprehensive change of life style.

Such a change requires total changes in nutrition, in physical activity, social life and all together the altitude toward life.

Often, psychiatric intervention is needed as well, mainly when the source of addiction is depression, anxiety or any other significant emotional difficulties.

The addict was used to cope with these feelings by using drugs or by his compulsive behavior.

Weaning requires complete cessation of these behaviors and that re-exposes the reality of one state of mind and emotional pain.

Until the individual rebuilds his life and finds his inner strength and resources again, Often times the client has to get help in coping with their emotional difficulties, through psychiatric drugs, only for the time being.

Family therapy is necessary in any addiction treatment. In any attempt to help the addict, the family's actions usually worsen the situation, not deliberately, but because the family does not possess the right tools to help him.

Therefore, professional guidance is necessary for the family as well, so that they will be able to support the therapeutic process of the addicted member.

The treatment of addiction includes participation in group therapy that is based on the 12 steps method.

By belonging to a group, getting to know others who are in the same situation and those who have succeeded in kicking the habit, the support and the feeling that someone does really understand, make these groups most effective in weaning from addiction.

Psychological treatment is a combination of cognitive and deep emotional work.

Cognitive work focuses on coping with the obsessive thoughts and on the understanding that these thoughts will not change soon, and therefore it is necessary to change the way of life in practice.

This change helps improve the low self-esteem of the addicts, who feel that they are weak and unable to beat their addiction.

The emotional work concerns the sources of addiction and coping with the consequences of the addiction on the patient's life and on the difficulties involved in coping with the great change that is required now.

Although holistic treatment is necessary, this does not mean that it has to be done all at once. Actually, the first process in good treatment is diagnosis.

Diagnosis refers not only to the type of addiction but also to the individual's inner strengths and resources.

Then, a therapy program is planned, suitable to his situation, circumstances, ability, character, and wishes.


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