My work with addiction has two primary features: helping clients build new alternative resources through body-based psychotherapy and developing concrete behavioral strategies to maintain abstinence or sobriety.
I see the addictive process as primarily an affect regulation strategy—a best attempt to manage intense and chronic painful feeling states. In other words, addiction manages our autonomic nervous system when its inherent self-regulatory capacities are injured or undeveloped. At the onset of the addictive process, substance use induces regulation, a process commonly termed “self-medication.” And in the beginning, it works! Initially, the addictive process helps to regulate our internal state, numbing pain and replacing it with often intensely pleasurable experiences.
For example, chronically hyper-aroused persons who are vulnerable to chronic anxiety and agitation may enjoy states of relaxation, ease and internal “quiet” via addictive behaviors; consistently hypo-aroused persons vulnerable to feeling lonely, numb or depressed, often use substances to feel more alive, energetic and capable. This initial success is short-lived. Over time, substance use becomes less successful at inducing regulation. Moreover, use transitions to abuse and then to addiction as the user finds it increasingly difficult to experience pleasure and safety outside the addictive process.
In working with addiction, I will often initially employ resource building techniques to help clients recover their body’s capacity to experience safety and pleasure by means of grounding, centering, visualization, and supportive touch. The ongoing development of internal resources help balance activation levels that most addictions try to manage. We can then proceed to use somatic experiencing to ease and heal the chronic patterns of pain, often rooted in developmental trauma, which fueled the addiction’s development.
Persons battling addiction usually need concrete, behavioral practices that provide an ongoing support structure to counterbalance the addiction’s powerful force of habit. For many people early in recovery, these practices include building a sober social support network, developing a spiritual practice/community, optimizing physical health through nutrition and exercise, developing healthy and consistent sleep habits, and engagement in activities that provide the experience of meaning and connectedness. My work with addiction often includes an individualized behavior plan aimed at supporting the development of these domains within clients’ lives. I also work deeply with members of many 12-step communities.