This is the first of a series of articles on professionals who have developed an addictive relationship with a substance [such as alcohol or drug] or an activity [such as sex/pornography or gambling].
Medical, legal and business professionals engage in demanding, high-stress tasks. The importance of their work and the pressure to perform at a continuously high level makes them particularly vulnerable to addictive traps.
The Problem of Immediate Gratification [the PIG]
A byproduct of the hard work and high standards of performance typical of people who achieve professional status is often an Imbalanced lifestyle [all-work-no-play]. As a rule of thumb, when the hassles and stressors of life and not balanced by its pleasures and comforts, using a substance [alcohol, drug, food] or activity [sex/pornography, gambling] that can deliver immediate gratification can be awfully tempting.
Falling into an addictive trap is easier than you might think. Once you have discovered an incentive that helps you cope with the raw experience of life, escaping its corruptive influence is deceptively difficult. To achieve good outcome you will have to do something powerful enough to change the course of your life.
Most people who have developed an addictive disorders can quit or control their use for a period, but few achieve good long-term outcome. The problem is relapse: Most people who go through conventional treatment relapse within the first year.
Understand this: There is No Single Solution
The disappointing results of outcome research is particularly surprising considering the impressive potency of the behavior change strategies currently available. The key to good outcome is to match the treatment methods to the attributes of the individual receiving the treatment.
Following the decision to change, the most important chore is to match the treatment strategies to the attributes of the person receiving the treatment. The best path to good long-term outcome is likely to be different for a homeless, neurologically impaired, problem drinker than for a successful professional whose problem drinking is worrying his wife, than for a 22 year old coed who just got her second DUI. In practice, they may each be referred to the same Program.
Treatment programs based on the Twelve Steps of Alcoholics Anonymous are, by far, the most commonly used treatment strategy for people with Substance Use and other addictive disorders. This is a powerful path to change, and extremely beneficial for some individuals. However, accepting the premise that you have a disease over which you are powerless and hence must turn over responsibility for change to a higher power does more harm than good for individuals who are capable of performing as they intend, despite the influence of local stressors and temptations. Indeed, for some individuals who have fallen into an addictive trap, programs that promote the belief that they are powerless can be iatrogenic [do more harm than good] and decrease the likelihood of good long-term outcome.
Matching personal attributes with strategy of change
People seeking escape from an addictive trap may differ from each other in many ways, including:
- Religious beliefs
- Intellectual level [i.e., cognitive strengths and impairments]
- Personality variables [e.g. dependent vs. independent]
- Social stability and family relation
- Psychiatric severity,
- Employment,
Many professionals have access to good cognitive skills (including many who have retained their intellectual abilities despite a substance abuse history) that enable them to utilize methods that are not appropriate for addicted individuals with intellectual and psychiatric impairments. Along with financial resources, social and family support, being smart promotes good long-term outcome. This is especially true if they follow a path that promotes independence and problem solving.
Which Path to Change is Best Matched with You?
Some individuals—including many professionals—are gifted with imagination, intellect, and the ability to solve real-world problems, despite their Incentive Use Disorder. The belief that an Incentive Use Disorder is a disease over which one is powerless effects how that person responds to the challenge. Whether that effect is helpful or harmful depends on the attributes of the individual.
When it is time to change the course of your life, it is important to choose a method that is well matched to your personal attributes. , Please click here for a self-test to help you match the strategy to bring about the intended change with your personal attributes. .