What is Addiction therapy?
Addiction therapy is the collective term for treatment of persons who suffer from substance abuse or behavioral addiction (internet, sex, porn, handheld, etc.).  Definition of substance addiction Following   the   classification   manual   ICD-10,   at   least   three   of   the   criteria   mentioned   below must apply: A    strong    desire    or    sense    of    compulsion    to    take    the    substance    (”Craving”, “psychological addiction”) Difficulties     in     controlling     substance-taking     behaviour     in     terms     of     its     onset, termination, or levels of use A   physiological   withdrawal   state   when   substance   use   has   ceased   or   been   reduced (withdrawal symptoms) Evidence   of   tolerance,   such   that   increased   doses   of   the   psychoactive   substances are required in order to achieve effects originally produced by lower doses Progressive   neglect   of   alternative   pleasures   or   interests   because   of   substance   use, increased   amount   of   time   necessary   to   obtain   the   substance   or   to   recover   from   its effects Persisting     with     substance     use     despite     clear     evidence     of     overtly     harmful consequences   (such   as   harm   to   the   liver,   job   loss,   health   problems,   relationship problems, loss of drivers license, etc.) Ingredients for a successful addiction therapy Self-motivation:   In   order   to   attain   real   and   sustainable   change,self-motivation   is absolutely   essential.   If   the   affected   person   is   coming   to   therapy   to   please   others   or to   make   up   for   something,   the   therapy   might   not   work.   In   my   experience,   no   one starts    an    addiction    therapy    unless    they    experience    some    level    of    suffering    or negative consequence from their addiction. Interest in getting to know yourself better, including the vulnerable aspects Wllingness to self-reflect A good, trusting relationship with the therapist Social support in the environment or a supportive partnership A regular daily routine / work What is the standard procedure in a addiction treatment? It   is   obvious   that   the   treatment   will   not   solely   focus   on   addiction   but   on   the   person   with   all of    its    facets,    traits,    skills    and    experiences.    The    addictive    behaviour    usually    is    just    the symptom   of   an   underlying   issue,   such   as   a   self-esteem   problem   or   a   trauma.   Oftentimes, the   drug   is   used   as   a   strategy   for   dealing   with   stress   and   emotional   issues.    So,   in   therapy,   I am   interested   in   the   entire   person   and   which   function   the   drug   is   playing   in   their   life.   It   is crucial   to   explore   what   a   person   gets   out   of   a   drug   for   themselves,   what   got   somebody started.   If   you   will   just   quit   the   drug   without   understanding   its   function   in   your   life’s equilibrium,   this   will   most   likely   render   you   out   of   balance   and   be   unsustainable.   In   order for   the   change   to   be   stable,   it   is   necessary   to   substitute   the   function   of   the   substance   by finding   a   healthier   way   to   satisfy   this   need.   If   the   drug   is   used,   for   example,   to   be   able   to act   more   assertively   in   social   situations,   then   the   substitution   could   be   to   improve   social skills,   to   build   up   self-acceptance   and   self-confidence.   This   will   help   improve   the   internal balance     and     therefore     render     the     drug     useless.     Usually     these     processes     happen simultaneously,   (a)   reducing   the   consumption   of   the   drug,   and   (b)   practicing   new   skills. Moving   ahead   too   quickly   stopping   the   drug   by   doing   a   quick   detox   -   without   sufficient functional   replacement   –   often   leads   to   a   quick   relapse.   The   affected   person   has   not   really understood    the    deeper    layers    of    their    addiction.    That    is    the    reason,    why    therapeutic support    is    essential    after    detox,    and    why    in-patient    detox    is    usually    followed    by    a ‘Entwöhnungstherapie’. The psychodynamic of addiction People   with   addiction   oftentimes   feel   ashamed   of   their   addictive   behavior.   They   perceive themselves   to   be   inadequate   or   inferior   in   some   way.   These   feelings   are   so   uncomfortable and   agonizing   that   those   affected   try   to   get   rid   of   them   in   various   ways.   The   most   common strategies   include   denial,   numbing   your   emotions   and   your   body   with   drugs,   projection (“Others   have   much   bigger   problems”),   trivializing   (“It's   not   that   bad,   I   can   stop   at   any time”),   etc.   The   person   is   splitting   itself   into   a   “strong   acceptable   part”    and   a   “weak unacceptable   part   ,   which   contains   vulnerable   feelings.   This   weaker   part   is   responsible   for the   addiction   and   therefore   also   called   the   “addictive   part”.   The   fact   that   is   largely   being hidden   and   neglected   by   the   strong   person,   makes   it   “hungry”   and   unsatisfied.   This   is where   the   addictive   behavior   comes   in.   It   beautifuly   solves   the   problems   of   the   strong   and weak   parts,   unfortunately   only   temporarily:   It   numbs   the   bad   feelings,   therefore   calms down   the   weak   part.   Once   the   effects   of   the   drug   fade,   they   give   space   to   feelings   of shame   and   guilt.   These   in   turn   are   so   uncomfortable   that   they   need   to   be   suppressed   and there we have the vicious cycle of addiction  (see graphic below). The    cycle    symbolizes    this    constant    struggle    for    control    between    the    stronger    and    the weaker   part.   The   stronger   part   tries   to   suppress   the   bad   weak   feelings   and   vows   for   more discipline   each   time   (“This   time   it   will   be   different,   I   am   really   determined   now   to   stay sober…”),   while   the   vulnerable   part   fights   back   to   have   their   needs   to   be   satisfied.   Once   a person   starts   acknowledging   the   needs   of   their   weaker   part,   healing   can   start   happening, meaning    the    equilibrium    can    start    being    strengthened.    Most    of    my    former    addiction patients   wanted   to   make   those   negative   emotions   to   disappear   (their   strong   parts   wanted that).   That   is   not   possible.   We   feel   what   we   feel   and   suppressing   it   will   in   a   way   only strengthen   its   influence.   What   will   help   instead   is   to   learn   to   feel   these   emotions   so   you will   not   have   to   be   afraid   of   them   anymore   and   can   start   integration   them   instead   of suppressing   them.   That   might   sound   absurd   at   first,   but   it   makes   perfect   sense   when   you consider   that   hungry   children   scream   more   than   those   who   are   fed.   In   order   to   get   the vulnerable   feelings   under   control,   one   has   to   learn   to   understand   and   satisfy   the   needs behind   them.   This   needs   to   be   practiced,   in   a   safe   environment   and,   if   possible,   with professional   support.   When   the   weak   part   of   a   person   receives   acceptance   and   support   - almost   like   a   child   in   need   -   it   will   calm   down   and   have   less   motivation   for   ‘bad   behavior’ like    drug    abuse.    Addiction    therapy    has    an    enormous    potential    for    the    development    a person. Treating comorbid disorders As   mentioned   above,   addictions   are   usually   just   the   symptoms   of   a   different   underlying issue.   Therefore   it   is   not   surprising   that   most   people   with   addictions   qualify   for   other diagnoses,    so    called    comorbid    disorders.    These    illnesses,    such    as    depression,    anxiety, trauma    or    neglect    should    also    be    treated,    if    needed    with    medication.    The    order    of treatment   depends   on   the   extent   of   the   drug   consumption   and   the   level   of   suffering   from the comorbid illness. Mindfulness Becoming   more   mindful   /   aware   of   your   momentary   state   can   help   stop   the   ‘autopilot’ that   often   underlays   addictive   behavior.   The   goal   is   to   achieve   more   awareness   in   your daily   life   and   learn   how   to   deal   with   unpleasant   emotions   differently   than   to   use   drugs. Meditation   and   mindfuless   exercises   will   help   you   bring   the   focus   of   your   attention   back to   yourself.   This   method   can   help   not   only   with   addiction   but   with   many   other   difficult situations or disorders. Literature recommendations for addiction therapy Treatment Approaches for Drug Addiction Mindfulness-based relapse prevention  Guided mindfulness exercises with Jon Kabat-Zinn
Practice for psychotherapy & counseling Dr. Phil Stöckli, PhD

Practice for Psychotherapy & Counseling

Dr. Phil Stöckli, ph.D.

Gemeindestrasse 26 | 8032 Zürich

Tel. 076 282 8885

Learn more about my specializations: Gestalt therapy Trauma therapy Asperger’s syndrome Addiction therapy Expat issues High sensitivity (HSP) EMDR NARM

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Cupidatat voluptate Ut adipisicing, in cillum cupidatat voluptate esse $0.00   

Practice for Psychotherapy & Counseling

Dr. Phil Stöckli , ph.D.

Gemeindestr. 26 | 8032 Zürich

Tel. 076 282 8885

Practice for Psychotherapy Dr. Phil Stöckli, PhD
What is Addiction therapy?
Addiction therapy is the collective term for treatment of persons who suffer from substance abuse or behavioral addiction (internet, sex, porn, handheld, etc.).  Definition of substance addiction Following    the    classification    manual    ICD-10,    at least   three   of   the   criteria   mentioned   below   must apply: A   strong   desire   or   sense   of   compulsion   to take   the   substance   (”Craving”,   “psychological addiction”) Difficulties     in     controlling     substance-taking behaviour   in   terms   of   its   onset,   termination, or levels of use A      physiological      withdrawal      state      when substance   use   has   ceased   or   been   reduced (withdrawal symptoms) Evidence    of    tolerance,    such    that    increased doses    of    the    psychoactive    substances    are required   in   order   to   achieve   effects   originally produced by lower doses Progressive   neglect   of   alternative   pleasures or     interests     because     of     substance     use, increased     amount     of     time     necessary     to obtain   the   substance   or   to   recover   from   its effects Persisting   with   substance   use   despite   clear evidence    of    overtly    harmful    consequences (such   as   harm   to   the   liver,   job   loss,   health problems,     relationship     problems,     loss     of drivers license, etc.) Ingredients for a successful addiction therapy Self-motivation:    In    order    to    attain    real    and sustainable          change,self-motivation          is absolutely   essential.   If   the   affected   person   is coming    to    therapy    to    please    others    or    to make   up   for   something,   the   therapy   might not   work.   In   my   experience,   no   one   starts   an addiction    therapy    unless    they    experience some      level      of      suffering      or      negative consequence from their addiction. Interest    in    getting    to    know    yourself    better, including the vulnerable aspects Wllingness to self-reflect A      good,      trusting      relationship      with      the therapist Social     support     in     the     environment     or     a supportive partnership A regular daily routine / work What is the standard procedure in a addiction treatment? It    is    obvious    that    the    treatment    will    not    solely focus   on   addiction   but   on   the   person   with   all   of its     facets,     traits,     skills     and     experiences.     The addictive   behaviour   usually   is   just   the   symptom of    an    underlying    issue,    such    as    a    self-esteem problem    or    a    trauma.    Oftentimes,    the    drug    is used    as    a    strategy    for    dealing    with    stress    and emotional   issues.    So,   in   therapy,   I   am   interested in   the   entire   person   and   which   function   the   drug is   playing   in   their   life.   It   is   crucial   to   explore   what a   person   gets   out   of   a   drug   for   themselves,   what got    somebody    started.    If    you    will    just    quit    the drug   without   understanding   its   function   in   your life’s   equilibrium,   this   will   most   likely   render   you out   of   balance   and   be   unsustainable.   In   order   for the     change     to     be     stable,     it     is     necessary     to substitute     the     function     of     the     substance     by finding   a   healthier   way   to   satisfy   this   need.   If   the drug   is   used,   for   example,   to   be   able   to   act   more assertively      in      social      situations,      then      the substitution   could   be   to   improve   social   skills,   to build   up   self-acceptance   and   self-confidence.   This will     help     improve     the     internal     balance     and therefore   render   the   drug   useless.   Usually   these processes    happen    simultaneously,    (a)    reducing the   consumption   of   the   drug,   and   (b)   practicing new   skills.   Moving   ahead   too   quickly   stopping   the drug   by   doing   a   quick   detox   -   without   sufficient functional   replacement   –   often   leads   to   a   quick relapse.     The     affected     person     has     not     really understood   the   deeper   layers   of   their   addiction. That    is    the    reason,    why    therapeutic    support    is essential   after   detox,   and   why   in-patient   detox   is usually followed by a ‘Entwöhnungstherapie’. The psychodynamic of addiction People   with   addiction   oftentimes   feel   ashamed   of their        addictive        behavior.        They        perceive themselves   to   be   inadequate   or   inferior   in   some way.    These    feelings    are    so    uncomfortable    and agonizing    that    those    affected    try    to    get    rid    of them     in     various     ways.     The     most     common strategies   include   denial,   numbing   your   emotions and    your    body    with    drugs,    projection    (“Others have   much   bigger   problems”),   trivializing   (“It's   not that   bad,   I   can   stop   at   any   time”),   etc.   The   person is   splitting   itself   into   a   “strong   acceptable   part”   and     a     “weak     unacceptable     part     ,     which contains   vulnerable   feelings.   This   weaker   part   is responsible   for   the   addiction   and   therefore   also called   the   “addictive   part”.   The   fact   that   is   largely being   hidden   and   neglected   by   the   strong   person, makes   it   “hungry”   and   unsatisfied.   This   is   where the    addictive    behavior    comes    in.    It    beautifuly solves   the   problems   of   the   strong   and   weak   parts, unfortunately   only   temporarily:   It   numbs   the   bad feelings,    therefore    calms    down    the    weak    part. Once   the   effects   of   the   drug   fade,   they   give   space to   feelings   of   shame   and   guilt.   These   in   turn   are so      uncomfortable      that      they      need      to      be suppressed   and   there   we   have   the   vicious   cycle of addiction  (see graphic below). The    cycle    symbolizes    this    constant    struggle    for control    between    the    stronger    and    the    weaker part.   The   stronger   part   tries   to   suppress   the   bad weak   feelings   and   vows   for   more   discipline   each time   (“This   time   it   will   be   different,   I   am   really determined    now    to    stay    sober…”),    while    the vulnerable   part   fights   back   to   have   their   needs   to be   satisfied.   Once   a   person   starts   acknowledging the   needs   of   their   weaker   part,   healing   can   start happening,    meaning    the    equilibrium    can    start being   strengthened.   Most   of   my   former   addiction patients      wanted      to      make      those      negative emotions   to   disappear   (their   strong   parts   wanted that).   That   is   not   possible.   We   feel   what   we   feel and   suppressing   it   will   in   a   way   only   strengthen its   influence.   What   will   help   instead   is   to   learn   to feel   these   emotions   so   you   will   not   have   to   be afraid   of   them   anymore   and   can   start   integration them    instead    of    suppressing    them.    That    might sound   absurd   at   first,   but   it   makes   perfect   sense when   you   consider   that   hungry   children   scream more   than   those   who   are   fed.   In   order   to   get   the vulnerable    feelings    under    control,    one    has    to learn   to   understand   and   satisfy   the   needs   behind them.    This    needs    to    be    practiced,    in    a    safe environment    and,    if    possible,    with    professional support.   When   the   weak   part   of   a   person   receives acceptance   and   support   -   almost   like   a   child   in need   -   it   will   calm   down   and   have   less   motivation for    ‘bad    behavior’    like    drug    abuse.    Addiction therapy     has     an     enormous     potential     for     the development a person. Treating comorbid disorders As   mentioned   above,   addictions   are   usually   just the    symptoms    of    a    different    underlying    issue. Therefore    it    is    not    surprising    that    most    people with    addictions    qualify    for    other    diagnoses,    so called   comorbid   disorders.   These   illnesses,   such as   depression,   anxiety,   trauma   or   neglect   should also   be   treated,   if   needed   with   medication.   The order   of   treatment   depends   on   the   extent   of   the drug   consumption   and   the   level   of   suffering   from the comorbid illness. Mindfulness Becoming     more     mindful     /     aware     of     your momentary   state   can   help   stop   the   ‘autopilot’   that often   underlays   addictive   behavior.   The   goal   is   to achieve    more    awareness    in    your    daily    life    and learn    how    to    deal    with    unpleasant    emotions differently    than    to    use    drugs.    Meditation    and mindfuless   exercises   will   help   you   bring   the   focus of   your   attention   back   to   yourself.   This   method can   help   not   only   with   addiction   but   with   many other difficult situations or disorders. Links & literature for addiction therapy Treatment Approaches for Drug Addiction Mindfulness-based relapse prevention  Guided mindfulness exercises with Jon Kabat-Zinn
Learn more about my specializations: Gestalt therapy Trauma therapy Asperger’s syndrome Addiction therapy Expat issues High sensitivity (HSP) EMDR NARM