There are many ways that people will medicate underlying psychiatric symptoms by using drugs or alcohol. Alcohol is the most common way for individuals to self medicate only because it is the most available. People may use alcohol to temporarily relieve symptoms of depression or anxiety. Crack cocaine eliminates audio hallucinations for schizophrenics. Drugs and alcohol work very different on every person. While one person may be able to use marijuana to alleviate anxiety, it may cause the next person to have increased anxiety when using. This is where the term drug of choice comes in to play. When someone is experiencing underlying psychiatric symptoms, they may choose to self medicate with alcohol or drugs. If they do, they will likely find their drug that works for them. Once they find it they will likely continue to use it until they become dependent. If someone is experiencing underlying psychiatric symptoms their perception is that their continued use will alleviate the pain or discomfort that they are experiencing in everyday life which is likely better than a life sober. For them.
In the past, people who had psychological disorders were often untreatable. Some were subjected to drastic measures such as brain surgery to remove part of the brain that was thought to have caused the problem or even harsh spiritual encounters such as an exorcist. Others were thrown into an asylum or institution with awful living conditions. Always though, since the beginning of time, there has been a stigma attached to people with psychological disorders.
Overtime, with the benefit of research, technology, and even psychotropic medications, the treatments have gradually become more humane and people who work in the mental health field are trained to have more empathy, compassion, and dedication to understanding the patient’s point of view. Still, there are too many people who are left untreated due to lack of resources or ability to pay. Also, it is more common today than ever before, for people who have a psychological disorder to be handed a pill instead of being able to obtain proper treatment.
The biggest factor in regards to harsh treatment today is still the stigma that is attached to anyone who cannot perform to societal norms. These people appear to the outside world as abnormal and the terms crazy, psycho, lunatic, etc. are still used far too often. There are many organizations such as NAMI www.nami.org whose mission is to fight stigma. Technology has also increased awareness and continues to do so which, in my opinion, is a huge help for those who battle psychological disorders.
Addictive behaviors worsen overtime for many different reasons. Some people experience co-occurring disorders in which treating the addiction is not treating the root cause. Addiction changes the structure of the brain overtime so in many cases it only gets worse. Another reason that addictive behaviors worsen overtime is because of tolerance and the lifestyle that is involved such as stealing and lying.
Addiction in general is extremely difficult to treat and many people are resistant to treatment. My first example was about people who experience other mental health disorders at the same time as their addiction therefore, these individuals may be okay with treatment as a short term option but long term, if the other disorders are not treated then their addiction will likely return. Next, addiction, especially drug addiction, changes the structure of the brain so oftentimes; people will not be able to cognitively make good decisions especially in regards to treatment which may cause resistance. Lastly, people who develop a high tolerance will likely get mingled into the lifestyle that accompanies addiction. This is likely to involve legal situation. Many people who suffer from addiction are forced to get treatment to avoid jail time. These individuals may still be in denial and will resist treatment.
The relationship between you and your addiction counselor will be very unique. Your relationship is based on trust and respect and differs greatly from other relationships that both you and your counselor engage in. If you are suffering from addiction you may likely be cautious, especially in your relationship with your counselor. The counselor is typically trained on how to gain your trust and how to be of comfort to you and your needs. Therefore, you are likely to talk to your counselor about things that you would never talk to anyone else about. This builds a connection that is very different from other relationships.
Since you rely heavily on your counselor to listen, your counselor must be in a personal place to be able to be portrayed in a way that helps you. For example, it would hypocritical and not professional for your counselor to attend a session with you if they are hung over. Other things to consider would be your counselor’s physical appearance including the way that they dress and mental stability. You probably do not want to hear about your counselor’s cheating husband.
It is also very important for your counselor to recognize when there may be periods of time that they should seek personal counseling for themselves. For example, if your counselor is having a hard time with their own child who may be abusing drugs then they should maybe talk to someone else about it instead of keeping it in or even worse, talking about it to you.
The most important thing for your counselor to be aware of is the boundaries that they establish. You may have a very different view of the relationship between you and your counselor. For example, please understand that your counselor should not attend self help meetings with you such as AA. Your counselor should help you understand completely how they view your relationship. If you have any questions or concerns regarding the relationship between you and counselor you can always ask them. If you still feel uncomfortable then switching counselors or asking for a second opinion would be an option too.
Sometimes it can be difficult to determine whether the information that is being read is following an evidence-based practice. It is important to find out though as information about recovery-oriented addiction treatment that is not evidence-based practiced can be ineffective if used or interpreted in any situation.
Evidence-based practice is a practice that will utilize research and studies to support an outcome. When reading about recovery-oriented addiction treatment, it is important to look for research points and real life effective situations that have occurred. There is a great website called http://www.nrepp.samhsa.gov/Index.aspx that will list many evidence based interventions that have been reviewed by their staff. Because the Substance Abuse and Mental Health Services Administration is part of the United States Health and Human Services, the above website would be very reliable. For example, while I was browsing all of the interventions, I came across “Alcohol: True Stories hosted by Matt Damon.” This is basically a set of motivational videos and trainings geared for those in treatment programs. All of the information has been supported by SAMHSA which include the quality of research, outcomes, targets, and costs. It also lists strengths, weaknesses, and provides a plethora of research information like how it was conducted and so forth.
The best way to determine whether the information that I am reading about recovery-oriented addiction treatment supports it as an evidence based practice is to thoroughly research either through the SAMHSA website, or other means, to be sure that the research is thorough and reputable. Googling and reading the first answer that comes up in the search is not a good way to research information about recovery-oriented addiction treatment. There is much more that goes in to quality information and unfortunately, with the way the web is designed it takes understanding and critical thinking to sort through the un-reputable information that is out there today.