Conventional Addiction Treatment Can Increase DependencePosted By William Dubin, Ph.D. on July 5, 2010 at 4:26pm | Excessive Appetites
Conventional treatment for addictive disorders often makes the problem worse. The term “iatrogenic” refers to a pathological condition caused or exacerbated by treatment efforts—that is, outcome would have been better if the treatment had not been administered.
For example, most treatment for problem drinking is based on the 12 Steps of Alcoholics Anonymous, which advocates that alcohol abusers admit powerlessness over their “disease” and comply with a treatment program developed and supervised by an external agent [e.g., treatment provider, support group]. For alcoholics whose cognitive or medical condition allows them no options other than to replace dependence on a substance with dependence on a more benevolent source of control, this is the only viable approach. However some problem drinkers can develop the skills and faculties to act in accord with their interests and principles, even during crises. For those capable of exercising will, promoting the idea that they have a disease over which they are powerless can increase their dependence and expectations of being helpless during a crisis.
The Problem of Immediate Gratification (The PIG)
Addicts are suckers for the promise of an immediate payoff. True to form, most seek immediate gratification of their desire to be free of their problem. Turning responsibility for good outcome over to a powerful external agent generally makes them feel better right away., Indeed, accepting the passive, patient role does promote good short-term outcome as long as the external source of control [treatment provider, support group, rehab program] is salient. The downside of this strategy shows up some time after the program has completed and the change agent is not available to exert its influence. Individuals who are not prepared to cope with crises of stress and temptation are likely to relapse when they encounter high-risk situations on their own.
Over the past 30 years, psychologist William Dubin, Ph.D. has accompanied thousands of individuals through their passage to freedom from dependence. The Path of Greatest Advantage: How to escape addictive traps and act in accord with your interests and principles is the resource kit that has emerged from these collaborations. The ambitious goal of this kit is to enhance the user’s ability to follow his or her path of greatest advantage rather than yield in the direction of least resistance.
“Depending upon an external agent to free you from slavery is part of the slave mentality that maintains the addictive trap. You become free of dependence when you can act in accord with your own interests despite the pull of local stressors and temptations. The capability to exercise your will emerges during a developmental passage that no one can take for you nor spare you,” says Dr. Dubin.
The passage from dependence to personal sovereignty is a difficult one with many traps and pitfalls. Real escape from dependence requires that the individual, rather than an external source of control, be the responsible agent of change. The Path of Greatest Advantage provides methods and tools developed by Dr. Dubin and the thousands of collaborators he has accompanied through their passages to freedom from dependence. Reviewing the text can spare the kit’s the falls and painful lessons of cause-and-effect that these collaborations have identified and resolved. More than passive reading of text is required to develop the skills and faculties to escape an addictive trap. Supplementing the printed manual are audio and multimedia tools including thought experiments, meditation exercises, and hypnotic inductions designed to enhance the user’s cognitive and imaginative faculties.
Good long-term outcome is the byproduct of exercising these faculties during the real-time crises each user is bound to encounter. Each individual is different and each will develop a unique solution to his or her problem. The kit offers several general strategies to approach the problem, along with a wide range of specific tactics to cope with crises.
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Posted by William Dubin, Ph.D.
Bill received his doctoral degree in Psychology from the University of Iowa. He has dedicated his career to the study of mood and addictive disorders and how to escape them.