Drug Rehab Center

Geoff Thompson, MA, CCC

Geoff Thompson, Program Director for the Sunshine Coast Health Centre, discusses how internalizing a label such as depression or bi-polar disorder can negatively affect an individual.

Geoff Thompson, MA, CCC

Geoff Thompson, Program Director for the Sunshine Coast Health Centre, offers a review of the disease vs. anti-disease debate regarding addiction, discussing researchers who do not agree that addiction is a disease.

Geoff Thompson, MA, CCC

Geoff Thompson, Program Director for the Sunshine Coast Health Centre, discusses the ongoing debate on whether or not addiction is a disease. He refers to Dr. Vaillant’s argument that there are beneficial reasons for classifying addiction as a disease.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services for the Sunshine Coast Health Centre, compares physical recovery & sobriety to emotional recovery & sobriety.

By Geoff Thompson
Program Director
Sunshine Coast Health Center

Several of the alumni have been asking recently about the biology of addiction. One asked whether eating sugar was a sign that one was still in addiction (sugar is a mood-altering substance); another fellow asked if it were possible to be born an addict.

These questions are asking if addiction is mainly a biological condition. That is, is addiction mainly a disease or illness? There’s a lot of controversy about whether addiction is a disease or not. And this debate is a good thing, because it means that people are talking openly about what addiction is. There is energy on both sides of the debate, bringing in new life.  

This article will look at this debate. It’s interesting in itself; researchers and clinicians like to argue about these details. But for those in recovery, this is not an academic question, removed from life. The answer that you tell yourself will dictate, in large part, how you live your life in recovery.

Those who believe that addiction is a disease will likely have a different recovery plan than those who do not believe it is a disease.

If you believe addiction is a disease, then you face certain ‘realities’. For example, you have to come to terms with the ‘fact’ that the disease of addiction has no cure. Most people compare it with diabetes; others say it is a “brain disease” like depression. In either case, though, recovery demands daily treatment. This treatment may be through self-help programs such as Alcoholics Anonymous or SMART Recovery. It may be through long-term counseling. Or both.

Those who adhere to the disease model also believe that they will always have a dagger hanging over their heads. They have to learn to accept this situation, because having a slip means there is a real danger of again being overcome by the addiction—it’s the interaction of the drug with the brain that is the addict’s illness.

Those who do not believe addiction is a disease still have to deal with the effects of drugs on their brains. They know they will have to deal with cravings and other neurobiological effects. They know that they will likely have troubles if they are not true to themselves. But they don’t believe that they are only one drink or drug away from being plunged back into active addiction. This is because they do not believe that the substance is the problem; that is, they don’t believe that their brains are hijacked by the drug.

Generally, they believe that they will ‘recover’. Those who believe in the disease model, on the other hand, face the prospect that they will be in recovery for the rest of their lives.

So let’s examine some of the more public examples of the disease debate. As always, if you are in recovery you are the author of your life, so you’ll have to figure this out for yourself.

Part One: Alcoholics Anonymous and Disease

The Big Book of AA states that alcoholism is an “illness.” Of course, it’s a very strange illness, since the Big Book also says that alcoholism is “an illness which only a spiritual experience will conquer.” At one point, the book calls alcoholism a “spiritual disease.”

When we examine the meaning of the words illness and disease in the Big Book, it is obvious that they are not technical terms. Bill W. never took a medical course in his life and certainly knew nothing of Koch’s Postulates (or other illness definitions), which is how diseases have been identified scientifically for more than a century. (You can google Koch’s Postulates if you’re interested.)

So, if the Big Book doesn’t define illness or disease in a technical sense, then why does it use these words? Generally speaking, the Big Book uses the terms as metaphors. The early members of AA wanted to point out a couple of things about alcoholism. First, they knew that alcoholics reacted differently to alcohol than did non-alcoholics. They were also convinced that there must be a biological reason for this, which is why AA looked to Dr. William Silkworth and several other physicians as sources of scientific information.

Apart from the doctors’ opinions, they also knew that alcoholics were not particularly comfortable in the world; they had a “dis-ease.” The idea of ‘dis-ease’ provides a much better definition of how the Big Book uses the word.

As an aside, it is one of the more baffling things historically that AA became associated with the disease/illness model of addiction. AA is, after all, a bunch of alcoholics, not medical doctors. Most experts have suggested that the reason why the public links AA with disease was that AA received two major public awards.

The 1951 Lasker Award of the American Public Health Association was awarded to AA. The citation read, in part, “In emphasizing alcoholism as an illness, the social stigma associated with this condition is being blotted out.” The 1983 President’s Service Medal was presented to AA, praising Bill Wilson and Bob Smith for “helping each other to overcome the disease.” So the public latched on to these medical ideas, even though the Big Book clearly considers alcoholism as a “spiritual condition that requires a spiritual solution.”

Part Two: Dr. George Vaillant and Addiction Medicine

Perhaps the most famous addiction medical doctor (a psychiatrist), George Vaillant, says that addiction is a “disease.” Dr. Vaillant is a top-of-the-line researcher at Harvard University Medical School. In fact the medical doctors who specialize in addiction medicine state publicly in their association that addiction is a disease.

It’s interesting that because Dr. Vaillant knows so much, he is very open in saying that there are good reasons for not calling alcoholism a disease!

One of his major points is that medical experts don’t actually agree on what a disease is. They keep changing their minds whether, for example, ‘heart disease’ is a disease or a lifestyle problem. He lists several other objections, but the most important is that alcoholism is a “behavior.” In fact, he says, “alcoholism is often better treated by psychologists skilled in behavior therapy than by physicians with all their medical armamentarium.”

Although Vaillant is quite convinced that alcoholism is a medical issue, he also says “In other words, calling alcoholism a disease, rather than a behavior disorder, is a useful device both to persuade the alcoholic to admit his alcoholism and to provide a ticket for admission into the health care system. I willingly concede, however, that alcohol dependence lies on a continuum and that in scientific terms ‘behavior disorder’ will often be a happier semantic [word] choice than ‘disease’.”

To sum up, if addiction is a disease, it’s an odd one; and, technically, it is probably better to call it a behavior disorder. However, if alcoholics think they have a condition similar to heart disease or diabetes, then they will more likely ask for help. And if the public thinks it is a disease, then it won’t stigmatize addicts and think of them as criminals and irresponsible lay-abouts.

Part Three: Dr. Nora Volkow and Neuroscience

The July 16, 2007, issue of Time magazine said that addiction is a “disease,” because drugs “co-opt” the brain. The March 3, 2008, issue of Newsweek reported that drug use is a “disease,” because drugs “hijack” the brain, leaving the addict powerless.

The journalists who wrote for Time and Newsweek got their information from Nora Volkow and her colleagues. Dr. Volkow is the head of the National Institute of Drug Abuse (NIDA). NIDA is the US national institute of health concerned with ‘drugs’ (the other is the ‘alcohol’ institute of health). These institutions are funded by the federal US government, and are quite public that they consider addiction a disease.

Dr. Volkow’s perspective is a little different than Dr. Vaillant’s. Volkow is more specific, calling it not merely a disease, but a “brain disease.” It’s almost routine that when journalists want information, they ask NIDA, which is why Volkow shows up often on television and in newspapers and magazines.

Basically, she says that addiction is biological, a direct result of the effects of the substance interacting with the brain. The brain progressively deteriorates just as in any disease. From her point of view, because addiction is a disease, it will be ‘cured’. Through some medical procedure to be discovered, she is quite certain that we will eliminate the disease, just as we have essentially eliminated leprosy.

Of course, other brain scientists think Dr. Volkow’s belief in a cure is wishful thinking. One of their major arguments is that the brain is so complex that it will likely not be possible.

Part Four: Addiction as Not a Disease

So now we have shown the theories of two of the finest scientific minds studying addiction: Dr. George Vaillant of Harvard Medical School and Dr. Nora Volkow, who is head of one of the biggest drug research institutes in the world.

Both of these scientists tell us that addiction is, essentially, a disease. But other, equally competent researchers say it is not a disease. These anti-disease experts argue that although there may be a physical basis in the brain for drug use, this does not mean addiction is a disease, and many say it is not even an illness.

They provide lots of evidence for not considering addiction as a disease. William Miller, one of the gurus in the field, says that addiction is a matter of motivation. Bruce Alexander says that drug use is a response to not having a deep sense of belonging (remember Rat Park). Stanton Peele says that drug use is essentially a combination of lack of direction in life and an unhealthy environment. In fact, Stanton Peele wrote a book complaining about the medical professionals who were attempting to convince us that we’re all diseased. 

Conclusion

Thinking of addiction as a disease poses some problems. First, it eliminates sex, gambling, and other behaviors as addictions, because there is no substance to “hijack” the brain. They also point out that there are documented cases of alcoholics becoming social drinkers, something which seems impossible if addiction is a physical illness. And they point out that Dr. Lee Robins would not have found that most Vietnam Vets gave up the heroin on their own after they returned to the US if heroin had “hijacked” the soldiers’ brains.

And almost all psychology textbooks used in university show research that contradicts the idea that addiction is a physical illness.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services for the Sunshine Coast Health Centre, discusses the different bio-psycho-social elements that may contribute to addiction.

By Daniel Jordan
General Manager
Sunshine Coast Health Center

In one of my web surfing sessions I happened to come across a YouTube video showing an interview with Carl Gustav Jung, the famous Swiss psychiatrist. Not only is this a rare glimpse into the world of a master therapist it is, to me, an account of the ‘inner void’ that seems to lie at the core of addiction. 

For those that prefer not to watch the entire video, the key section of the video (2:22 – 7:54) has been transcribed as follows:

Background

Jung: A case where there was an intelligent, young woman, she was a student of philosophy, very good mind; where one would expect easily that she would see that I am not the parental authority but she was utterly unable to get out of this delusion. And, in such a case, one always has recourse to dreams: it was just as if one would ask the unconscious “now what do you say to such a condition?” You see, she says in her conscious “of course I know you are not my father but I just feel like that; it is like that: I depend on you …”

The Therapy Session

Jung: Now let’s see what the unconscious says. Now the unconscious produced dreams in which I really assume the very curious role … she was the little infant, she was sitting on my knees; I held her in my arms. I was really tender father to the little girl. And, more and more, the dreams became empathic in that respect; namely that I was a sort of giant; and she a very little, very human, thing you know like a little girl in the hands of an enormous being; and the last dream of that series was … I cannot tell you all the dreams; was I was out in nature, I stood in a field of wheat that was ripe for harvest and I was a giant and I held her in my arms like a baby and the wind was blowing that field of wheat. Now you know when the wind is blowing over a wheat field there is waves; and with these waves I swayed as if putting her to sleep and she felt as if being in the arms of a god; of the godhead.

“Now the harvest is ripe, and I must tell her. And I told her, “what you want and what you project into me – because you are not conscious of it – that is, you have the idea of a deity you don’t possess. Therefore you see it in me. That clicked.”

“She suddenly became aware of an entirely heathenish image that comes fresh from the archetype. She had no idea of a Christian God or an Old Testament Yahweh. It was a heathenish God, a God of nature, of vegetation, he was the wheat himself, the spirit of the wind; and was in the arms of that numen.” *

(*) Numen – a god or spirit believed to inhabit a place or being.

Jung’s Interpretation

Jung: That is the living experience of an archetype. That made a tremendous impression upon that girl and instantly clicked. She saw what she really was missing; that missing value, which was in the form of a projection in myself and made myself indispensible to her. She saw he’s [Jung] not indispensible; because it as the dream says, it is in the arms of that archetype … idea. That is a numinous experience. And that is the thing people are looking for: an archetypal experience, that gives them an incorruptible value. They depend upon other conditions, they depend upon their desires; their ambitions; they depend upon other people because they have no value in themselves. They have nothing in themselves. They are only rational, they are not in possession of a treasure that would make them independent.

“But when that girl can hold that experience then she doesn’t depend any more; she cannot depend any more; because that value is in herself, and that is a sort of liberation.”

“And that, of course, makes her complete. Inasmuch she can realize such a luminous experience, she is able to continue her path, her way, her individuation.”

WHY THE FASCINATION WITH THIS VIDEO

Despite it’s title, neither transference * nor archetypes is central to my interest in this video. Furthermore, dream analysis is typically not a technique we utilize at Sunshine Coast Health Center. ** So why, you may ask, the fascination with this video? For me, it’s the “numinous experience” described by Dr. Jung as the moment when his client, the philosophy student, was able to free herself from her unhealthy fixation on Dr. Jung.

Obviously, Dr. Jung is not some sort of drug but, according to Dr. Jung himself, his client was “dependent” on him as a father figure. From my personal experience with our chemically dependent clients, there seems to be an inner void (clients often call it their ‘donut hole’) that finds them grasping for anything external: drugs, alcohol, cigarettes, sex, gambling, anarchy, etc. Those clients that complete addiction treatment and go on to live happy lives seem to discover an inner “treasure” that, as Dr. Jung points out, makes them independent, complete, liberated.

(*) Transference: the emotional bond that develops on the client towards his analyst/therapist.

(**) Note: Sunshine Coast Health Center does, however, use depth psychology, which is related to archetypal psychology in that they both employ the model of the unconscious mind as the source of healing and development in the individual.

BILL WILSON’S ‘WHITE LIGHT EXPERIENCE’

For Bill Wilson, a similar moment of transformation was the beginning of long-term recovery for the famous founder of Alcoholics Anonymous. During Wilson’s fourth admittance to Towns Hospital in 1934, Bill Wilson recalls his ‘white light’ experience: “Suddenly the room lit up with a great white light. I was caught up into an ecstasy which there are no words to describe. It seemed to me, in the mind’s eye, that I was on a mountain and that a wind not of air but of spirit was blowing. And then it burst upon me that I was a free man.” *

Source: Kurtz, Ernest (1979) Not-God: A History of Alcoholics Anonymous, pgs. 19-20.

CONCLUSION

I will be the first to admit that these peak experiences are rare and that holds true for the clients at our alcohol and drug rehab program. For them, addiction recovery is more gradual, with repeated advances and retreats. Regardless of how long it takes, however, the objective of personal transformation remains valid.

Oftentimes, it’s a difference in language. For example, what Dr. Jung calls a “luminous” or “archetypal” experience, we at Sunshine Coast Health Center call “personal transformation.” The end result of such an experience, what Dr. Jung calls “incorruptible value,” we call “meaning and purpose.” However, this video, if anything, further reinforces my sense that our current approach to treatment is heading in the right direction.

By Daniel Jordan
General Manager
Sunshine Coast Health Center

One of the benefits of residential treatment is the many opportunities that clinical staff have to get acquainted with clients. Having a laugh over lunch, chatting during breaks, and working through issues in structured group and individual therapy allows our clinical staff to learn a lot about the clients they serve. Getting to know our clients so intimately also affords a greater appreciation of the complexities and challenges inherent in addiction and it’s treatment.

A few months back, the clinical team at Sunshine Coast Health Center took an informal poll and found that approximately 3 out of 5 clients were, prior to treatment, acting out sexually. Interestingly, clients rarely, if ever, made any mention of sex addiction on their admission form. Instead, clients come forward after concluding during treatment that their acting out sexually seemed to have a lot in common with their addiction to substances. While we know that individuals with one addiction often have multiple, or concurrent, addictions we underestimated it’s prevalence. As a result, steps were taken to enhance the skills of the clinical staff to treat sex addiction, culminating in a 2-day on-site workshop September 17 & 18,  2009. * Hosted by sex addiction expert Robert Weiss, this event marks an important first step in expanding our program to include process addictions such as gambling, sex, eating disorders, and online gaming.

However, while training staff on process addictions is a step in the right direction, we know that implementation is another matter entirely. Therefore, as a program more accustomed to treating drug addiction and alcoholism, Sunshine Coast Health Center is proceeding with caution,  carefully weighing the costs, benefits, and challenges of treating process addictions. An important first step is, I believe, looking at how we, as a treatment center, define addiction.

(*) Note: for more information on the 2-day sex addiction workshop see our promotional flyer.

DEFINING ADDICTION

Addiction is a complex condition that can be defined by it’s etiology, by it’s symptoms, and by its scope.

Defining Addiction by Etiology

In my last article, We Were Powerless Over Our Addiction: Why Step One is So Controversial, I alluded to competing theories on the causes of addiction. Often times, people will define addiction by its etiology, for example, “addiction is a brain disease” or “addiction is a psychological maladjustment or negative coping skill”, etc. However, as important as the origins of addiction may be, this blog article is not about etiology.

Defining Addiction by Symptom Severity

Addiction can also be understood by the severity of its associated symptoms. For example, previous blog articles have introduced the 3 Cs: a self-test that people can use to help figure out whether or not someone has crossed the blurry line between misuse and addiction. To review, we distinguish addiction from a bad habit based on the 3 Cs. This simple test can be applied to any substance or activity:

C#1 – Compulsion – obsessive thinking about, and planning around, a substance or activity so that an individual has regular, convenient access. Compulsion is what happens during the abstinence stage of the cycle.

C#2 – Control – an inability to control the amount of time engaged in an unhealthy activity, or the amount consumed of a harmful substance, once initiated. Control is what happens during the active stage of the cycle.

C#3 – Consequences – repeated engagement in an unhealthy activity or harmful substance despite negative consequences. Often times the Consequences stage is motivation enough to return back to the abstinence, or compulsion, stage.

If a person is observed exhibiting behaviour described in C#1 and C#2 but not C#3, chances are then they are probably still just at the abuse stage. Most abusers will stop or cut back once they experience one or two negative consequences such as a DUI charge, failing grades, or problems at home. Therefore, C#3, consequences, is what distinguishes addiction. Another way of explaining consequences is that addiction is, by it’s very nature, a state of chronic relapse.

However, while it’s important to distinguish addiction from abuse, this blog article is really about how we define the scope of addiction, or the different types of substances and activities normally associated with addiction.

(*) Note: For more information see The 3 Cs of Addiction Test: Are You Addicted?

Defining Addiction by Scope

It was not that long ago that the term “alcoholism” was the predominant term used in addiction treatment circles. According to Hazelden Foundation, one of the first residential treatment programs in North America, it wasn’t until 1958 that their clinical staff recommended using a new term, “chemical dependency,” to replace ”alcoholism” to better reflect the growing trend of marijuana, cocaine, and heroin misuse in the United States. *

Fifty years later, it’s not just illicit drugs but prescription drugs and it’s not just substances but activities, or “processes” such as gambling, sex, online gaming, and eating disorders. However, while the term “addiction” is now in common use (more so than “chemical dependency”), the vast majority of residential addiction treatment centers in North America still focus almost exclusively on drugs and alcohol. Admittedly, our own website and printed literature reflects that we, too, are first and foremost a chemical dependency treatment program. Why, then, has the addiction treatment industry been reluctant to include process addictions?

(*) Source: Hazelden History

THE CHALLENGE OF TREATING PROCESS ADDICTIONS

As mentioned earlier, Sunshine Coast Health Center is in the initial stages of reorganizing our treatment program to include process addictions. During this transition, however, we recognize the challenges involved.

Challenge #1: Lack of Evidence-Based Treatment for Certain Process Addictions

Until recently, the vast majority of addiction research and program development has focused on chemical dependency. In his landmark book first published in 1983, Out of the Shadows: Understanding Sexual Addiction, author Patrick Carnes became one of the first to link unhealthy sexual behaviour to addiction. Twenty-five years later, pornography, particularly online porn, has become a multi-billion dollar industry.

Furthermore, although gambling addiction has been recognized for a long time, very little research has surfaced for the treatment of gambling addiction. This is somewhat puzzling considering the growing dependence of provincial governments on gambling revenues.

Challenge #2: Lack of Consensus on Whether Certain Processes Are Addictions

Another consideration for addiction treatment providers is the lack of consensus about whether anything that is vital to the survival of the human race, such as sex and food, could be considered addiction. For example, sexology proponents argue that much of what is considered sexual addiction is normal sexual behaviour, essential for healthy sexual development and the survival of our species. Other experts believe that sexual addiction is actually a mental illness commonly referred to as obsessive compulsive disorder and refer to it, not as an addiction, but as sexual compulsivity.

Challenge #3: Lack of Medical Care to Treat Eating Disorders

While individuals struggling with eating disorders have had access to specialized treatment, these programs are scarce and are typically government outpatient programs or private residential programs in the US. A reason for the paucity of programs is the long-term medical intensity required to treat moderate to severe eating disorders, particularly anorexia and bulimia nervosa. Eating disorders can be life threatening and require medical monitoring and procedures not typically offered in residential alcohol and drug rehabilitation programs.

Challenge #4: Impact on the Peer Group

Another concern of programs that specialize in chemical dependency treatment is the impact that individuals with other addictions will have on the peer group. While it is quite common for individuals with drug or alcohol addiction to have concurrent gambling, sex addiction, or, to a lesser extent, eating disorders, there is a prevailing notion that people who are exclusively processed-addicted may not be compatible with the dominant, chemically-dependent peer group.

Some treatment centers address this concern by creating separate tracks for process addictions. In other words, someone with a sex addiction will be placed in a group separate from those with chemical dependency and will have their own group therapist. However, the problem then becomes costs associated with extra staff, creating a sense of separation in the peer group, and adverse group dynamics associated with insufficient group size.

Then there is the challenge to the peer group of having an individual whose sexual behaviour crosses over into sexual offending such as pedophilia, compulsive masturbation, incest, and rape. Incidentally, sexual offenders will be a major topic in our September workshop.

Challenge #5: Lack of Clearly Negative Consequences for Some Process Addictions

Unlike chemical dependency, gambling, or eating disorders, individuals with sex addiction or online gaming addiction show symptoms that may seem less harmful. Therefore, the perceived need for treatment may not be as obvious. * 

(*) Note: For addition information on the negative consequences of online gaming see Ambivalence is Fertile Ground for the Growing Popularity of Online Gaming.

Challenge #6: Apparent Lack of Demand

For all of the publicity that certain process addictions have been getting recently, most residential treatment centers do not receive a lot of calls for gambling, sex addiction, or online gaming. This apparent lack of demand may be attributable to the more benign effects of certain process addictions (see Challenge #5 above), the lack of available funding for individuals with gambling addiction, the lack of perceived similarity between process addictions and chemical dependency, or the greater stigma attached to sex addiction.

Challenge #7: Training Clinical Staff

Addiction, particularly process addiction, is rarely taught in graduate or medical school. Professional development workshops rarely offer courses in process addictions. Training, therefore often requires that staff travel to the United States or that a presenter be brought up for training on site. Sunshine Coast Health Center chose the latter because all of our clinical staff needs training, not just one or two counsellors. Any way you slice it, it’s expensive and is tricky to schedule in a 24/7 residential program like ours.

Sunshine Coast Health Center is also interested in training the staff of gambling addiction, however, we have been unable to find an expert in this field. WIth regard to eating disorders, management is unsure if the  demand for men’s eating disorder treatment is sufficient to justify the costs associated with specialized staff training (not to mention the possibility that additional medical staffing or equipment may be required).

Challenge #8: Establishing Clear Admission Criteria

Before we begin to admit clients who have a process addiction without concurrent chemical dependency, clear admission criteria must be established. For example, where do we draw the line on the severity of a process addiction? The challenge of sex addiction that has crossed over into sexual offending is a good example. Fortunately, this aspect of sex addiction and its treatment will be addressed in the upcoming Robert Weiss workshop.

Challenge #9: Tailoring the Program to Address the Unique Aspects of Other Addictions

Part of treating other addictions is to first differentiate their unique aspects then to integrate new treatment techniques or knowledge into a program that embraces these differences but includes the effective components of previous modalities.

Fortunately, for Sunshine Coast Health Center, our smaller size and favourable counsellor-to-client ratio allow us to provide a higher degree of individualized treatment than what’s possible in larger facilities.

WHY SUNSHINE COAST HEALTH CENTER REMAINS COMMITTED TO TREATING PROCESS ADDICTIONS

With all of the challenges present in integrating other addictions into chemical dependency treatment, one could be excused for maintaining the status quo. However, Sunshine Coast Health Center is committed to expanding our treatment of addiction to include process addictions. If one considers the needs of the addicted client, there are a number of good reasons for making the change.

Reason #1: Risk of Drug or Alcohol Relapse

Clients who abstain from drugs or alcohol but continue to participate in process addictions run the risk of eventually relapsing back to their drug of choice.

Reason #2: Living Out of Integrity

Clients who abstain from their drug of choice may be considered by some programs to be a treatment success. However, at Sunshine Coast, abstinence is only part of what is considered true recovery. The clinical program at Sunshine Coast emphasizes personal integrity, being true to one’s sense of self. Shifting to another addiction precludes developing inner strength and authentic connectedness to others, particularly family.

As Geoff Thompson, Sunshine Coast Program Director, often tells clients, “it’s not in the bottle.” Including individuals with process addictions in the peer group will help chemically depend clients understand that, even in the absence of drugs or alcohol, individuals can still have addictions. Process-addicted clients, therefore, are living proof that drugs and alcohol do not have some sort of magical, addictive property.

Reason #3: Reducing Client Shame Associated with Their Addiction

By identifying with individuals that have different addictions but find themselves in similar circumstances, clients may come to see that addiction manifests itself in many ways in our society.

A few months back a therapist explained her philosophy of addiction. To summarize her approach, she explained that “all human beings are in recovery from something.” Our talk has stuck with me because I see how all human beings have moments of insanity as defined by Albert Einstein: doing the same thing over and over again and expecting different results.

As Christina Grof writes in her book, The Thirst for Wholeness, “By recognizing that as human beings, we share the common dilemma of attachment, but to different degrees, we open the way for understanding and compassion toward ourselves and others. We can even discover a sense of relief and liberation as we recognize the reality of our mutual dilemma.” The AA spiritual principle of surrender is closely linked to addiction and attachment. Just as recovery from addiction is made easier by surrender, so freedom from attachments also requires surrender.

CONCLUSION

As mentioned in this article, Sunshine Coast is hosting a 2-day workshop hosted by sex addiction expert, Robert Weiss of the Sexual Recovery Institute based in Los Angeles. Out of this training, we hope to make some important distinctions between sex addiction and chemical dependency, as well as the difference between a sex addict and a sexual offender. It promises to be an engaging two days.

As part of our new program at Sunshine Coast Health Center, the idea that addiction is strictly a substance-related phenomenon is coming under scrutiny. Clients with multiple addictions require treatment that recognizes the complexity of their predicament. However, just as mental health issues can complicate treatment, treating multiple addictions at the same time is the best approach to take, despite the additional challenges to staff and program. For the time being, clinical staff believes that treating both chemical dependency and process addictions with clear, thoughtful admission criteria, will mean better treatment and, thus, better outcomes for the clients we serve.

Yesterday, Oprah Winfrey dedicated a segment on her TV show to severely obese children. A 14-year-old girl interviewed in the middle of a food binge confessed that “once she starts she cannot stop.” She went on to say that when she starts to feel down about herself, she eats. I know more than a few kids that find the same sort of relief through online gaming. Hopefully, other private and government addiction programs will also consider expanding their notion of addiction to include process addictions. Now, more than ever, it’s clear that addiction is more than just a ‘skid-row’ phenomenon.