Addiction is an area of mental health that for better or for worse has existed in sociocultural dialogues for some time, though the conversation does appear to be taking new shape – what do we need to do differently…or keep the same. Traditional treatments of Addiction involve some form of 12-step program, psychiatric (psychopharmacological) treatment, and ongoing psychological therapy. Current conversations regarding addiction refer to the influence of experiences (such as Trauma) and their impact on Brain Wiring – that deems one person more vulnerable to developing addiction than another. Mirroring this shift in understanding is also the recognition that what we’ve been doing so far socially, culturally, politically has not been effective.
Grant me the serenity to accept the things I cannot change, The courage to change the things I can, And wisdom to know the difference.
- Serenity Prayer, originally popularized by and recited in AA (12-step) programs
One of the cornerstones of recovery involve the 12-step program that formed by Bill Wilson, an Alcoholic in Recovery who formed a series of steps, delivered in a peer-led group format for people needing a way through addiction. Since its conception, 12-step programs have withstood some significant socio-cultural transformations and remain relevant in current treatment programs for addiction. Though current iterations of the 12-steps have broadened to include a variety addictive behaviour – there is something to be said about the important role of community, relationships and connection in sobriety.
“The opposite to addiction isn’t sobriety it’s connection”
- Johann Hari
The healing power of relationships, connection in instilling hope and motivation is not only evident through the ongoing relevance of 12-step programs but also in models of addiction that include the role of trauma. This would reframe addiction to being a way of coping (albeit unhelpful) with experiences that at some point overwhelmed a person’s resources. Protocols that place focus on values and meaning to build motivation for change, have unsurprisingly shown significant efficacy in this domain. Behaviour change that is closely tied to personally meaningful outcomes is evidenced to be more effective i.e. people are more motivated to commit and maintain behaviour change where the outcomes are personally derived (Miller, Rose, 2009). Therapist style has also been indicated an important factor in commitment to treatment i.e. accurate empathic expression, which accounts for up to two thirds of variance in outcomes 12-24 months after treatment (Miller, Rose, 2009). In part, recognising underpinning features of recovery and the success of 12-step programs in prioritising community and connection – the significance of therapist empathy in mitigating outcomes in addiction treatment is clear.
The power of understanding in reframing addiction is not only essential in offering treatments that are effective but also pivotal in shaping a more accurate socio-cultural dialogue regarding addiction – a behavioural excess that originated at some point as a way of coping with the world.
Helpful resources
Turning Point (SBS Short Series)
In the realm of hungry ghosts – Gabor Maté
Lost Connections – Johann Hari
Healing the shame that Binds you – John Bradshaw
Citation
Miller, W. R., & Rose, G. S. (2009). Toward a theory of motivational interviewing. American psychologist, 64(6), 527.