Analytic Therapy for Addictions

In this blog I want to briefly explore the analytic approach to addictions.  Freud stated that his aim in Psychoanalysis was to help the patient transform ‘hysterical misery into common unhappiness’. In Buddhism, a central concept is that of Dukkha, commonly translated as ‘suffering’, ‘unhappiness’, ‘pain’, or ‘stress‘. It refers to the fundamental painfulness of mundane life.

Henry David Thoreau (1854) declared that most men lead a life of quiet desperation.

As depressing as these concepts seem, the intention is actually to relieve suffering, that it is the excess of suffering that we visit upon ourselves by an excess of demand, the demand to be excessively happy, to criticize and shame ourselves for not being ‘good enough’, the sadistic internal voices that berate us for the shortcomings of what is often an unachievable internal ideal that creates an unbearable pressure.

Modern life is designed to sell us things. One the most successful early pioneers of advertising, Edward Bernays was a nephew of Freuds and advertising has very successfully realized that we are driven to buys things that we imagine will make us feel better about ourselves, that within the object brought is an identity of ourselves as, better, more desirable, happier etc, in short to offer us promises of less painful or even pain free lives.

Zizek notes that the unconscious ideology of today is the demand to ‘enjoy’.

In terms of addictions, especially the addictions, now facilitated by the internet, and even more so by the internet in the pocket, the phone; gambling, pornography and shopping, these promises are ever ready. Its is also worth noting that addictions can be hidden in seemingly healthy pursuits; healthy eating, work, exercising, that can also be used as an avoidance of emotional pain through compulsive stimulation.

There are broadly speaking two approaches to therapy and to treating addictions and their underlying causes, the conscious strategies and good advice model and the more exploratory underlying approaches. Both have their place and it may be necessary to utilize both to really address issues.

The first model; involves CBT and specialist structured interventions; – managing access to the source of addictions, keeping diaries, replacing destructive habits with healthier ones and these will be more advice led. Sometimes it may necessary to utilize these approaches to try and get something under control. However, what these models may not do is to really dig down and get underneath the causes of the problems. The addictions are often the symptoms of underlying traumas and difficulties, sometimes these are not conscious and this is where the analytic or exploratory approach focuses its beam. The problem with not doing this, is that in true wac-a-mole style, the underlying causes tend to resurface and one addiction will merely be replaced with another.

Lance Dodes (2019) an analyst specializing in addictions highlights three pertinent areas of exploration:-

1. Feelings of helplessness or powerlessness, produced by specific situations whose meanings interact with prior traumas. In this situation the additive act or even just the decision to undertake an addictive act can help the person regain a sense of control. The exploration of the issues leading to these feelings can unpick the unconscious feelings leading to the urges and ‘allow anticipation of future addictive urges, with the possibility of mastering the behaviour.’
2. These feelings of powerlessness are often related to past traumas and difficult experiences often in relation to the clients attachment history, which has led to internal feelings of powerlessness and corresponding feelings of rage against these feelings.
3. These feelings are displaced into addictions, through therapy these feelings that were once felt to be overwhelming and unbearable can over time and within a strong therapeutic relationship begin to be able to be felt to be understood and able to be experienced, often through the experience of the therapist being able to face and contain the feelings with and alongside the sufferer.

Paul Salvage is Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

Further reading by Paul Salvage –

Loss

Post Natal Depression in Mothers & Fathers

The Therapeutic Relationship and the Unconscious