Tag Archives: counselling

Addiction in Relationships, Part II

ratFor some time, the basic narrative in our society around addiction has been clear and simple.  It goes something like this.  Some substances are so dangerous to the human animal that once we start it is very difficult to quit, particularly for those people whose personality may predispose them to addiction. Addiction has been categorized as a disease that we can catch if we fall prey to a “gateway” substance or if, again, we just have some sort of predisposition to the disease.

The emerging science, and some important science that sat largely ignored for decades, is causing us to reboot our thinking around addiction.

Some of the first studies on addiction were very straightforward. Put a rat in a cage with two water bottles, one of which is laced with a narcotic. Which will the rat choose? Consistently, the results were the same. The rat chose the narcotic and kept choosing it until it died.

Pretty simple. It doesn’t seem like you need to be a scientist to interpret those results.

In the late 1970s, a Canadian researcher by the name of Bruce Alexander decided these results were not nearly as simple as they appeared. He asked, what if the problem is not the access to a drug but the fact that the rat is in solitary confinement in a steel cage?

He decided to perform the same experiment, except with a significant change. The rat would not be alone and it would be put in an enclosure with other rats and in an environment that rats would enjoy living in. The result? The rats rarely chose the narcotic-laced water and never died from an overdose. The rats consistently chose the plain water and enjoyed the good life with their fellow rats in what came to be known as “Rat Park“.

You’ve probably never heard of Dr. Alexander. He had trouble getting this ground-breaking research published. When it was published, it was ignored and his funding was eventually pulled. It’s hard to go against conventional wisdom and politics, even when you have science on your side.

For years, we’ve been encouraged to wonder what predisposes an addict to addiction or what bad choices they might have made that got them addicted.

Perhaps instead, we should be asking ourselves what particular sort of steel cage the person who uses has been in that has made drug or alcohol use a preferred alternative.

Does this mean that those who use don’t have to take responsibility for their actions?  Of course not.  My experience is that people want to take responsibility.  It’s simply much easier to do so if someone really works to understand you and your experience.   That can happen more readily if we have a better understanding of the nature of addiction.

Many of the assumptions that have undergirded our understanding of addiction for decades are under intense scrutiny. Some of the brands that have provided addiction support over that same period may need to check some of their fundamental assumptions.

Our ability to be in healthy and sustainable relationships may well be the best tool we have in dealing with the negative effects of addiction and other compulsive behaviours.

Working with Grief and Loss

Consolation by Andy via Flickr
Consolation by Andy via Flickr

We commonly associate grieving with the loss of a loved one.  The death of someone near to us is very clearly a profound loss that needs grieving.  However, we can experience loss in a wide variety of ways, some of them much more subtle.

Nearly any change in our lives involves loss of some kind.  Even a change that you’re happy about can involve some pretty profound loss.  For example, you might be thrilled to receive a long-awaited promotion.  At the same time you are moving on to new challenges, you might also be losing important working relationships and work experiences that have given you a great deal of fulfilment.

Being aware of these more subtle forms of loss can open the door to dealing with feelings and difficulties that otherwise might not make much sense.  Grieving is something that has been widely studied and worked with.  There are concrete ways of making sense of what is happening to you and working through the pain and other experiences that come with loss.

In the late 1960s, a psychiatrist by the name of Elisabeth Kubler-Ross came up with a well-known five-stage model for understanding grief.  She outlined a progressive process where people experience denial, anger, bargaining, depression and acceptance.  This model has been helpful in normalizing people’s experiences and telling them that it is OK to be experiencing the strong emotions they are feeling.  However, sometimes people get confused if they don’t move through these stages in the order in which they are laid out.  The model can also make it seem like grief is something that happens to you as opposed to being something you can influence and work with.

William Worden, a psychologist, developed another more recent model where grief is seen as involving four basic tasks.  The first is to accept the reality of the loss.  It is normal to want to believe that the loss can be avoided, but one has to work towards acceptance.  The second is to allow yourself to experience the pain of grief.  Again, it makes sense to want to avoid this pain but research and experience show that this is something that must be gone through, not around.  The third is to adjust to the new, post-loss environment.  This is a task that can be actively undertaken, once you have accepted the new reality.  The fourth and final task is to withdraw your emotional energy from the person or situation that has been lost and to invest it in new relationships or new situations.

The ease with which these things can be done varies based on the nature of the loss and your own circumstances.  Sometimes just being aware that you’ve experienced a loss can help you to see and experience it for what it is and work with it.

Terry Noble is a therapist in Peterborough, ON.  You can find information about his counselling practice at www.terrynoble.ca.

Why should a therapist be on social media?

 Vasile Cotovanu on Flickr
Photo by Vasile Cotovanu, Flickr

I’ve been thinking about why I have chosen to have a presence on social media through this blog and Twitter.

Steve Ladurantaye of Twitter Canada came here to Peterborough, ON in July to talk to businesses about using Twitter.  Some of his suggestions were clearly great for many businesses, but simply wouldn’t be appropriate for a therapist.  For example, live tweeting what I do (Look at this picture of a couple in marital distress!) and offering discounts by tweet (Come in before 12 p.m. today and mention this tweet for 25% off an hour of counselling!) are examples of things that you’re not going to find me doing on social media.

However, when he mentioned some of the attributes of a good tweet he allowed me to make a connection about why I want to be on social media.  Steve suggested that authenticity on Twitter is vitally important.  The crowd is pretty adept at sniffing out insincerity and misinformation.

I was motivated to have a larger online presence when I asked one client how he found me and he said that he had asked Siri for a counsellor and was given my name.  In that instant, my mind was blown.  Counsellors have traditionally relied heavily on referrals and word-of-mouth marketing.  Clients have come because someone they trust has referred them.  If potential clients are going to trust digital means of referral, I want them to know who they are being referred to.

I’m going to seek through this blog and other forms of social media to let people know who I am as a therapist.  Informed consent is an important principle in my profession.  It basically means that therapists only work with their clients in ways that have been explained to the client and that the client agrees to.

I have come to believe that informed consent has to start with clients having access to authentic online information about who I am as a professional therapist.

Terry Noble is a therapist in Peterborough, ON. You can find information about his counselling practice at www.terrynoble.ca.