Who goes to therapy? Who do psychologists treat & help recover?

Addiction as seen from the viewpoint of a psychologist is an equal-opportunity disorder. Anyone and everyone is vulnerable to developing an addiction. It doesn’t matter about income, gender, upbringing or ethnicity. When we really think about it, the things that make us vulnerable to drug and online addictions (such as porn addiction, gaming addiction or gambling) is universal.

The percentage of doctors, pharmacists, drug addiction professionals, lawyers, athletes, teachers, social workers, unemployed aren’t different from bricklayers, military, police officers, emergency services, hospitality.

Here are some factors of many that affect your risk of addiction.

• Depression

• Anxiety

• Traumatic experiences

• Misuse of prescribed medication

• Family and social relationships

• Nature and means of using the drug or digital media.

Sometimes we think of these as separate and clinically distinct but we forget that the entire range of human range. Most people will experience feeling out of control or know someone that does.

Source: Papaioannou Kostas, Unsplash

The following pseudo-case is a surprisingly common story:

K is a successful solicitor and has an impressive client list. He works hard, long hours and he is well paid for his efforts. He considers himself a strong and mentally tough person. He has studied very hard, competed with the best and made many sacrifices to get to his role. After a hard day at the office, he has a generously poured glass of single malt scotch when he comes home. Things are going fine. Then unfortunately he gets into a fender bender and really tweaked an old surfing injury in his back. His doctor has prescribed on pain meds to help manage his pain. He a little annoyed at being injured because he is already under the pump at work. He prides himself at having a stiff upper lip, and is happy to “grind it out” until things get better.

Normally the pressure at work isn’t a big deal, but his pain is making him more irritable and less composed. He’s feeling the work pressure more, he starts drinking a little more at home to help him relax and he’s asked for an increase his pain medications. Over the last 3 weeks, the pain is making him toss and turn in his sleep, he’s grumpier in the mornings and doesn’t feel fresh. K’s been warned before that some pain medications could affect his quality of sleep. A few weeks pass but the pain isn’t going away.. His physiotherapist is telling him that he’s going to need time off work to heal otherwise K’s going to risk it getting worse, but that’s not really an option given the importance of his projects.

So K takes a few more pain pills before work and starts drinking a little more at night to help get to bed. His pain meds are no longer working quite as well, his doctor suggests that his body is getting used to it and increases his dose. His doctor has also recommended for him to explore other strategies to manage his pain such as meditation and mindfulness. K declines, he feels that what he is currently doing is working for now. He starts drinking a little more, and wakes up a little dusty for work. He’s more irritable and the sleep problem is affecting how he is managing his colleagues.

It’s a familiar story, K isn’t your Hollywood-sold rock-bottom self-destructive “addict”, he’s a high performance individual under ordinary circumstances. For many, addiction creeps up on you because on any given day, K’s decisions are understandable and reasonable for the short term. But from an outsider’s perspective, it is clear he can’t do this all the time without things deteriorating.

For most people with good health, supportive friends and a sense of a meaningful work/life balance, they cut back on their own (or encouraged by loved one) before it becomes a significant problem. Sometimes this moment sounds like

“I overdid it yesterday, better cut back today”
“Hun, I think I’ll to cut back on drinks this month”
“Time to do a dry July! or Sober October!”
“Can’t keep this up, I’ll have to figure something out”

In this way, K starts his own recovery and begins deliberate attempts to reconnect to his meaningful life. He sits and reflects on what a “good 2018 would look like”, “bad 2018 looks like” and a “good next 3 years would look like”. K knows that he still enjoys his work but lately the pain gets in the way. He is thinking that taking more breaks throughout the day and pacing himself might help. He’s also considered delegating more tasks to his team. Perhaps he checks his leave allowance and thinks about taking a small break. He talks to his prescribing doctor about his stress, concerns about medication dependence and wants to try additional strategies. K starts to make active choices towards a life where addiction isn’t a problem and accepts that it might mean more discomfort in the short term.

If K were a surgeon or an architect, would the story change?
Imagine if K was already suffering from depression or anxiety.
Imagine if K repeated the same patterns for years.

Would the choice away from addiction might be harder to make?

When we begin to empathise with our loved ones who struggle with addiction, we have a chance at really understanding their choices. We begin to understand that anyone can make the same choices that lead toward or away from developing a problem.

The take home message: Everyone is vulnerable to addiction.