Addiction Counseling


Addiction Counseling

Some key ingredients of successful relationships?

How about trust and compromise, for two

Good counseling of any school (client-centered, Gestalt, Cognitive Behavioral, Freudian, etc.) will marry both, and recognize another.

That third ingredient separates counseling wheat from chafe is an intangible that only a chosen few are able to build in a counseling relationship, regardless of the presenting problem.

In fact, job number one of any addiction counselor worth hiring is to earn the client's trust. To accomplish this, the experienced counselor pivots to the French.

Rapport

Rapport, rapport, rapport.

One will recognize its presence, or lack thereof, within (my best guesstimate) twenty minutes of the first session.

It can also happen instantly.

When it does, we may be reminded of a lovely scene from the movie Casablanca, when Rick Blaine, played by Humphrey Bogart, says to Louis, the gendarme:

"This could be the beginning of a beautiful relationship."

As in Counseling.

Good counseling will induce a reservation on a calendar. Nothing short of an emergency will infiltrate that space. Once a week, with the exception of two weeks minimum per annum that the counselor should take off for his/her own mental health, a client will ideally winnow his shares (what he tells the counselor under the strict confines of confidentiality) from extraneous underlying issues to the incompatible roommates familiar to every substance use disorder person's head:

Their Fantasy of Moderation and their competing Memory of the pain

Inside the framework of those dueling forces, effective addiction counselling will also terminate the client's intrinsic urge, her ace in the hole defense if you will.

That is, to stop telling a secret to keep one.

Once addiction, and not their ploy to distract from it with a made=up secret, is established as their raison d'etre for each session, certain staples of the disease take centre stage:

Anticipatory Anxiety

People-pleasing

Procrastination

Unreasonable resentment

Cross Dependency

Isolation

Unhinged boredom

Trauma

Just to mention a few.

With rapport, empathy, and commitment as foundations, those will be fertile, often interlocking topics to spill and devour on a weekly basis. To the extent they can be identified, accepted as issues, and resolved can signal either appropriate discharge of their ongoing assimilation in further therapy.

Along the journey will be resistance to giving up those defense mechanisms. In fact, rather than viewing the goal of counseling as eliminating that resistance, the qualified counselor understands resistance as the therapy.

Consider an exchange:

Counselor: "How much time have you devoted to people-pleasing historically?"

Client: "Well, I'm just a natural people person. I like making people feel good."

Counselor: "Ok. But do you genuinely fear disappointing any of them, for an y reason.?"

Client: "Well, yeh, definitely."

Rather than affording the client a cheap way out, an escape route from her obvious people-pleasing, the counselor effectively paraphrased and allowed the client to see that toxic substance use disorder staple from a different angle.

Engaging addiction counseling is a bit like finding a good mechanic. You need the mechanic more than he needs you. But there's something in the conversation, the initial air, if you will.

"I don't have a ton of rules," he says in the first meeting. "Except that I don't put up with being late."

You agree to a time and a date and a commitment.

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