April 7, 2019
Addiction. It is all over the news and in the hearts and minds of many. Where did it start? How do we stop it? What causes it? Over the past ten years, I have worked in various settings that have dealt with individuals living with addiction. I started my career as a therapist for the Georgia State Parole Board counseling former inmates who had substance abuse problems. Later, I worked in a Suboxone/Methadone clinic as a therapist. I ran Intensive Outpatient substance abuse programs for community services boards in Georgia, worked as a Partial Hospitalization Program therapist at a psychiatric hospital, developed a substance abuse program for a prison in Georgia and I also served as the CEO of an outpatient program for addiction for a time. I have worked in the Detox, Residential, Partial Hospitalization, Intensive Out Patient, and Outpatient levels of care for various treatment centers.
Through my experience, I have noticed that we are treating the wrong thing. Addiction is such a huge and destructive beast that we often focus too much attention on just stopping a person from using again instead of understanding why a person would use in the first place. As I listen to peoples’ stories, they usually make sense. For most individuals, the act of using drugs, alcohol or any other addictive substance is based on them trying to meet a need. I hear the same story over and over: the individual is using in order to deal with the emotional or physical pain, to numb or to escape from it.
Instead of focusing on the addiction (which I see as a person’s maladaptive attempt to cope with their issues) let’s treat the underlying issues. So many families and individuals need to understand that to treat addiction we must drive deep into their core issues. There must be a willingness for the individual to understand who they are, accept who they are, and change the things that cause them pain and discomfort. This is, by no means, simple work. As I work with people today, I strive to help them push past the surface issues and problems to understand what emotional needs are not being met. I push them to gain insight into their lives, their feelings and their actions, to better understand their needs. For most people with addiction, this will be a life long process. Whenever you think the work is done, there is yet another level to uncover. We must educate individuals about the necessary work it will take to stay clean and live a life of recovery. Though it can be hard and seem impossible at times, we must support them and provide them with the hope they need to push through to the next level.
It is possible to live a life where you are truly happy and not dependent on any substances to be okay. I encourage all of you that may suffer from addiction, or know someone who suffers, to continue the work and not give up. It is worth it. It will pay off. I believe in you.
“I love myself...?”
When working with clients, I usually find that at the root of their problems lies a lack of self-love and self-esteem. I will ask a client whether they love themselves. Most of the time I get the answer, “Of course I do.” I usually follow this question with, “Well, do your actions say the same thing as your words?” I will challenge the client to evaluate their past days, months, or even years to see if their description of how they say they feel about themselves is congruent with their actions.
The path to self-esteem and self-love is arduous. For some people, there is an inner battle to overcome years of negative programming. This negative programming comes in the form of internalized messages from childhood and adolescence. Most self-esteem issues can be traced back to these negative messages. Before we can correct these beliefs, we must become aware of them and the impact they have had on our lives.
That's when the real work starts. We must challenge the validity of these believes. Are the actions or words of our parents, siblings, or friends actually true? Or did we take ownership of those actions and subsequently create a story about who we are and what we are worth? Breaking these beliefs down and challenging their validity can be a length process, depending on how strongly they were ingrained in us. Once these beliefs are seen for what they are, we start the process of replacing them with truths. Our truths about who we are. We must remind ourselves daily, hourly, or even minute-by-minute, of these truths. For many of us, we are going to be stripping ourselves of these beliefs we have identified with for decades.
Daily affirmations are essential for building our new truths. Write sticky notes with your truths. Examples are, “I am worth it,” “I deserve love,” “I am beautiful,” or, “I matter.” Place the sticky notes on your car dashboard, bathroom mirror, and computer. This prompts us to remember the daily work we need to do in order to heal.
Not only must we speak our new truths to ourselves but our actions must match. As I was once told, self-esteem comes from doing esteemable acts. Before I take an action, I ask myself, is this something that would make me proud of myself? Is this action congruent with the person I want to be? Would I do this if someone I cared about was watching me? Through these steps, we can start to create a foundation upon which self-esteem and self-love can blossom.
Daniel Rubin, M.S., LPC, LMHC
During some down time at my office, I decided to pick up my phone and scroll through a few of my social media apps. As I scrolled through my apps, I started to notice an ever increasing trend of people posting selfies of themselves at the gym. Viewing picture after picture, I start to think of how the world not only embraced these “selfies,” but also encouraged the continual importance of the body over the mind. Now, don’t get me wrong, I think a person’s physical health is very important, especially in regards to how it relates to mental health. But these pictures caused me to start to think… why are there no selfies of people at their therapist’s office? Why are we not celebrating the work that is being done on our brains, the thing that controls the body?
The truth is that there is still a huge stigma related to mental health and seeking help. It has improved over the past decade, but there is still a lot of progress to be made. I encourage people to start to change this stigma and the way society views mental health through their actions. We should be as proud of our of ability to take care of our mental health as we are of our six packs.
Therapy is not just for the “sick.” Therapy is a tool that can be used by all people to help improve their mental health, their lives, their relationships, etc. I hope this entry starts a conversation that leads to more acceptance and and understanding. Speak up, spread the word. “I go to therapy!” Let us show our families, our children, our friends and our co-workers that we value our insides as much as our outsides. I truly believe that this work will lead to a happier society that can benefit us all. #mentalhealth is the future.
Daniel Rubin, M.S. LPC, LMHC