UNDERSTANDING ADDICTION

One of the first and most valuable things a client can do is learn about addiction. Many people are often stigmatized and told that they are “weak” or “lazy” when they talk about their substance abuse with friends, family, or others in the community. Learning about the biological and psychological aspects of addiction help clients learn that there is a whole other system at play. We all know that humans have a biological need for things like sleep and food, well, once you start using to a certain degree, your body now classifies drugs and alcohol as a “NEED” and your brain acts in the same manner as it does to tell you to eat or sleep. Psycho-education and learning about addiction can help a client learn to be empathetic with themself and help motivate them to change knowing they can.

UNDERSTANDING THE ROOT OF YOUR ADDICTION

Clients often do a series of assessments and are asked about their life history and to provide their “story”. By providing their story they are able to discuss their life and any incidents that have taken place that has caused any real or perceived trauma. Sometimes, trauma and very heavy stressful incidents are overlooked and it isn’t until sitting with a counsellor that clients identify that their use began after or in relation to a traumatic incident, or their environment changed and became more stressful, or their ability to cope started to degrade. Living under stress or feeling isolated and overwhelmed can often lead us to want to self-medicate and “escape”. Reflecting on when you use, and for what purpose can create a starting point on where you need to put the most focus when learning new coping skills to deal with stress and overwhelming feelings. Not everyone will pinpoint the activating event that leads them to start using, but by becoming more familiar with the thoughts and emotions that compel you to use, you can start dealing with those situations in a new manner and replace your use with new, healthy coping mechanisms.

IDENTIFYING CO-OCCURING MENTAL AND PHYSICAL HEALTH ISSUES

Sometimes our use isn’t caused by events in our life or external issues, but instead by internal conflicts and physical or psychological illness that we aren’t aware of, or are being under or not treated for. Clients with anxiety often express that they tried alcohol as a teenager and learned their anxiety lessened when they drank and they learned to drink alcohol to calm their nervous system. As time went by, they had to use more and more frequently and are no longer able to function without alcohol. Maybe a client had surgery and was given an opioid to help relieve their pain and when their doctor stopped their prescription they had to look elsewhere for drugs to deal with the pain and have now become physiologically addicted to drugs they are buying on the street. By screening clients and assessing them for underlying issues we can help identify if there are co-occurring issues that can be addressed by other professionals that once dealt with, can help make the client’s recovery easier.

IMPROVE YOUR MOTIVATION TO CHANGE

By working with a counsellor, clients can discuss where they are at and get a better understanding of the Stages of Change and why and how this may be time for them to stop using. By using motivational interviewing and other counselling methods, counsellors help clients see things that they may be denying and minimizing, and better understand things by having discussions that are collaborative and not authorative. By asking open-ended questions, the counsellor helps clients explore their life and use, and what it looks like. Sometimes this gives the client an eye-opening to the life they are living. Other questions explore what it looks like if they change, and then if they don’t. Self reflection and exploration allow clients to look within themself and identify their need to change and motivate them to take a positive approach to change and see it as a new beginning. When seeing change and quitting drugs and alcohol as a positive vs a negative, a client becomes more motivated to put in the work and attempt to make gains.

BUILDING A THERAPEUTIC RELATIONSHIP WITH YOUR COUNSELLOR

Working with a good counsellor means you will have an ally as well as a professional helper. Good counsellors provide a sense of empathy and acceptance when working with their clients. They provide active or “reflective” listening and allow the client to feel heard and understood. Feeling safe with a counsellor allows a client to open up and share their life and struggles without fear of reprisal or judgement. By clients being “safe” and sharing openly, it allows the counsellor to provide more effective tools for the client to utilize in their recovery and help them develop a healthier way of living and coping with issues they face. By learning to trust someone, the client also develops a better sense of self and respect for themself when they feel they are not being shamed for the things that have lead them to seek help.

LEARNING SELF AWARENESS

As a counsellor, one of the things I like to teach my clients is how to be SELF-AWARE. By being self-aware, clients can better identify and understand their emotions, behaviours and traits. When we aren’t self aware, we often gravitate to unhealthy coping mechanisms because we don’t identify and understand the emotions we are having. We know they are uncomfortable and not easy to deal with, but not what to do with them. By being more self aware, it becomes easier to have self control. When you can identify the emotions and thoughts you are having, you can examine them and challenge them and control the outcome. When we let our emotions and thoughts get the best of us without examination, it can lead to risky behaviours and dangerous outcomes. This can be seen as someone who may have lost their job and becomes filled with anger and sadness. While these emotions are warranted, by not fully exploring them and finding a healthy way to deal with them, we can let them rule us, and we may be compelled to drink or use to suppress them and try and make them go away. By having awareness, you increase your ability to change your behaviours and the outcomes they bring. When we act out during negative emotions we can hurt ourselves and others, and this can lead to shame and guilt which creates a whole other level of problems and inner conflict which drives our use. By stopping a behaviour before it happens, it removes the potential for consequences and problems in our life and relationship. This then makes us feel better about ourselves and like we are in control of ourself and environment more. Once you are more aware and in control, your self esteem increases and you can identify your strengths and weaknesses and learn to build where you can and minimize conflicts and triggers that compel you to use.

LEARNING THE SKILLS TO STOP ALCOHOL AND DRUG USE AND AVOID RELAPSE

One of the most important aspects of addiction counselling is learning to stop your use. After identifying triggers and things that “drive” you to use, you can learn new ways to deal with them. By learning and using healthier coping mechanisms when faced with triggers, you can begin implementing them and decrease your use. There are a variety of things that you will learn, and you and your counsellor will work together to fit them into your life. Mindfulness, distress tolerance, emotional regulation, boundaries and examining your interpersonal relationships are just some of the things that you will likely work on and set goals towards. By documenting and working on plans and goals to deal with cravings and triggers, you will better understand them and be able to identify them and try new ways to deal with them. People, places, and things aren’t just gameshow topics. These are often the heading our triggers go under, and you and your counsellor will explore these and come up with ways to divert using and stay in recovery with as little potential to relapse as possible.

RELAPSE PREVENTION

You and your counsellor will do work together to build a plan to prevent you from having a relapse. Implementing educational work as well as coming up with plans to prevent relapse will help clients better understand what leads to relapse and ways to avoid it. One of the triggers of relapse is PAWS. Post-Acute Withdrawal Syndrome. PAWS often consists of symptoms such as Depression, Anxiety, Cravings and urges to use to suppress physical and psychological distress, sleeping too much or too little, Stress, Mood swings, and Difficulties with Memory and Thinking. These happen as the body learns to live without drugs and alcohol and the biological chemicals begin to restore to normal levels. New treatments including the use of MAT (medication-assisted treatment) offer clients prescription medications that stop the urge to use by helping with the withdrawl symptoms and the craving to use. Euphoric Recall is when clients begin to romanticize their prior use. Life may not seem “as fun” and problems may seem to drag on now that alcohol and drugs aren’t being used to suppress thoughts and feelings. Clients will start to remember their use in a positive light and identify people, places, and things with their use and be compelled to use and gravitate to those dangerous triggers because they forget or block out the negative consequence their use caused them. The other “ ations” that cause relapse are minimization, justification, and rationalization. Minimizing the problems drugs and alcohol caused, justifying why we can and should use, and rationalizing the use can all cause a person to relapse -FAST. EMOTIONAL RELAPSE SIGNS need to be identified as emotional relapse is a large indication a person is going to begin using again. By learning to identify emotions, thoughts, and behaviours, and having a plan to deal with them if they occur, clients can stop a potential relapse before it happens. Utilizing the tools you’ve got to help get you through an episode that could lead to use again is the best thing to help you in your recovery.

ONGOING COUNSELLING AND CHECK-INS

Some clients like to continue their counselling beyond the point of sobriety. Keeping in contact with a counsellor or moving on to a recovery coach helps them stay honest with themself and ensure they are using their new coping mechanisms and tools to stay clean and sober and avoid relapse. Regular or irregular check-ins or ongoing support help clients manage living a new healthy lifestyle, ensure they are recognizing and managing their triggers, and keep up with their recovery plan. Also identifying the healthy supports in their life and any new or ongoing problems that they feel may lead them to relapse.

HOW MANY SESSIONS AND HOW OFTEN

This is the magic question, isn’t it? When will I be better, and how often should I come are questions only you can answer. The length of treatment depends on a client’s needs and how fast they are able to develop new skills and implement them into their life safely. Someone may come into treatment and feel like it isn’t helping and out of no where start seeing changes, or vice versa. You may have an idea of where your problem areas are and as counselling progresses, you may start seeing things you didn’t know existed that are causing issues in your life and contributing to your use. Your engagement and dedication in and out of counselling will help speed up the process, but it is recommended the only questions be what are the signs you know your life is improving, what does that look like, and when do you think you can safely exit regular counselling?