As a therapist, I’ve heard this many times. You probably have, too. Maybe you’ve even said it yourself! And sure, you can absolutely choose to believe or not believe in something despite the evidence for or against it! But you’re probably not really saying you don’t believe in it, you’re probably saying:
1. I don't think people can change or I don’t think therapy works (for me).
As people, we are constantly changing whether we realize it or not. Our brain is constantly taking in new information and adapting or solidifying behaviors to accommodate. Yet, we don't know what we don't’ know. A therapist is educated and trained in understanding these processes of the brain and can introduce new ideas, concepts and behaviors that will challenge whatever is been holding you back. People can change. Therapists know this because they get to have an active role in clients make amazing and inspiring transformations in their lives. They are witnesses to human adaptability and change nearly every day.
Now, it’s true that some people start therapy and don’t or won’t change. Some people drop out of therapy when challenged on self-protective thoughts or behaviors. Or they give up when they don’t like the therapist or even feel judged by the therapist. There is a term called attrition which is when someone drops out of treatment before desired results are achieved. There are lots of reasons for early drop-out but let’s save that for another article. The point is, just like a diet not followed, an exercise regimen not implemented, or a budget disregarded, the therapeutic process is going to be more useful if you participate in session, be willing to adapt your behavior and challenge your go-to thinking patterns outside of sessions. It’s. Hard. Work. Yet, change is possible and achievable!
2. I don’t want/like to talk to a stranger about my problems
Fair enough. But consider this: When you talk to a therapist, you are not a stranger, you are a client. The difference? Therapists have taken on an ethical oath to have “unconditional, positive regard” for their clients. Their job is literally to see the best in you, to like you, care for you, and to do all in their power to help and not harm you. They’ve also legally promised to keep almost everything you share confidential (unless your at risk of serious bodily harm). This is not the same relationship you have with a random stranger standing at Walmart. Your therapist cares. Yes, it’s their job, but it’s their job to genuinely care. However, not only does your therapist like you and care about you, they care about you enough tell you when something in your life isn’t serving you well. They have no personal motivation to get you to change your behaviors other than to want you to have success in therapy and in life. They also have the skills and tools to back that up by helping you figure out what things would work better for you in your life. The goal of therapy is to work together to create and implement a plan that will bring you the most peace and fulfillment in your life. Not many strangers do that!
So, believe in therapy or not. Go to therapy or don’t. Make meaningful change in your life or maintain the status quo. We, as therapists, will be there as your guide, coach and cheerleader the moment you are ready to believe in us and make the changes you desire. We know it can work because whether you believe in us or not, we believe in you.
There are many who would say that addiction is not a disease or a mental illness. I would like to draw a parallel between two mental disorders to prove that addiction is a disease. Addiction is very similar to obsessive-compulsive disorder. When we think of OCD we tend to think of someone who is really organized. But that is not an accurate description of OCD. OCD is characterized by an irrational obsession that leads to extremely high levels of anxiety. Once anxiety is present a compulsion is acted upon in an effort to relieve anxiety. While compulsion is being actuated anxiety is lessened, but as soon as the compulsion is stopped the anxiety comes back worse because it is reinforced by the obsession. The obsession is driving the anxiety and the compulsion gives credibility to the obsession thus people who suffer from OCD get stuck in a cycle.
Cycle of OCD
Obsession -> Anxiety -> Compulsion -> Anxiety reinforced by Obsession
Let me illustrate what I just explained. Lets say someone has OCD and their obsession is that they will contract some viral disease that will kill them. Being exposed to any type of germs creates high levels of anxiety. The compulsion to try to lessen the anxiety is to wash their hands. While washing their hands the anxiety melts away because they feel they are clean from the germs. The second they grab a towel to dry their hands their obsessions kicks in and says, “there’s germs on the towel”. So the person will wash their hands again, and again only to have the same outcome. Then they get stuck in a cycle of OCD. And you may see someone who suffers from OCD wash their hands 300 times in a day until their hands are cracked and bleeding. This obviously creates a problem for people and it’s easy to see how OCD is a mental disorder.
How does OCD relate to addiction? Addicts suffer the same cycle as someone with OCD. For drug addicts the obsession is the results of the drug. For example with methamphetamines the obsession is the high, escape, numbing, or all of the above. When a drug addict is without their drug (obsession) they get high levels of anxiety manifested through a craving. These levels of anxiety are comparable to OCD, they are very intense and are intrusive in the lives of the individual. Make no mistake extreme anxiety is truly suffering. The addict’s compulsion is to use the drug. While high the anxiety is relieved, but as soon as the high wears off the anxiety comes right back stronger than before. At this point the addict reverts back to their compulsion reinforced by the obsession. And they get stuck in the same cycle.
Cycle of Addiction with Substance Use
Obsession (Effects of Drug) -> Anxiety (Craving) -> Compulsion (Use Drug) -> Anxiety reinforced by Obsession (Guilt, shame, embarrassment, craving)
The parallels between OCD and Addiction are obvious. I make this observation in an effort to help those who would argue that addiction is simply a choice and not a disease or mental disorder. Addiction to drugs may have been a choice initially but once someone is addicted it has become a disease and a mental disorder.
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