Addiction & Co-occurring Disorders
Every action we take is helping us to meet a need— even when the behavior is harmful. Addiction and substance abuse are behaviors often rooted in an effort to regulate ourselves in some way, whether it be physically, emotionally, even spiritually. When we first come into contact with our drug of choice, it can feel like a miracle; “I have finally found what I need to function”, but slowly and surely, addiction begins to impact our finances, careers, relationships, and health. What started as a panacea to our problems transforms into a leech, draining the energy from the parts of your life that matter most. Coming to terms with your addiction is never easy, but it is worth it, and you don’t have to do it alone. When treating addiction, I like to approach how addiction has shown up in your life chronologically, from your first exposure, your own engagement in addiction, and how you see addiction showing up in your future. Without judgement, we will explore your personal journey with addiction, where you are, and where you want to be.
Similar to Substance Use Disorders, behavioral addictions are an attempt at balancing an imbalance somewhere in our lives, whether emotional, social, chemical, et cetera. Someone struggling with depression, anxiety, grief, or trauma might feel short term relief after the dopamine release of buying something new, winning a bet, having a sexual encounter, or the validation and engagement that comes from social media. These addictive behaviors are meeting a need in some way, and my approach is heavily based in exploration and alleviation. I like to work from a hard reduction lens when safe to do so, where we work on reducing the substance use or addictive behavior over time, while integrating new coping skills.
Trauma & Complex Trauma
The word “trauma” encompasses a wide range of experiences. There is physical trauma, which can include injuries from accidents or the lasting impacts of health treatments such as chemotherapy or radiation, and there is psychological trauma, which can come from abuse, neglect, accidents, or being a witness to any of these. Trauma fundamentally changes how we perceive the safety of our world, and these lasting effects can make impacts in our personal and professional lives. Below I have outlined just a few of the diagnoses that are often trauma involved, and how we might address each.
PTSD— or Post Traumatic Stress Disorder, is a trauma disorder associated with flashbacks, nightmares, and avoidance of situations similar to the traumatic event. PTSD is often linked to a singular event, such as an assault, a natural disaster, combat exposure, or a severe accident. Individuals struggling with PTSD will often isolate in order to avoid potentiality of another traumatic event, which can lead to worsening mental health due to lack of support. Treatment for PTSD varies depending on the symptoms being addressed, but common treatments include Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), among others. I am currently being registered to train in EMDR and will be offering this service in the coming year.
CPTSD— or Complex Post Traumatic Stress Disorder is caused by repeated traumatic experiences over a prolonged period of time, oftentimes abuse in childhood where there is little to no control over the environments or situations in which the child is raised. This diagnosis is not present in the latest DSM or ICD, but is likely to be in coming editions. CPTSD is often mistaken for BPD due to some overlapping symptoms, namely emotional dysregulation, self perception and interpersonal issues, but distinction lies in how these symptoms present.
BPD— or Borderline Personality Disorder is a diagnosis which carries with it a heavy stigma rooted in lack of understanding and invalidation which is thought to cause the disorder in the first place. As stated above, BPD often impacts several vital areas of functioning, including emotional dysregulation, self perception and interpersonal issues, and has an increased risk for suicidality due to the pain that accompanies these symptoms. Dialectical Behavior Therapy, along with a Person Centered approach, is how I approach alleviating BPD symptoms.
NPD— or Narcissistic Personality Disorder is a hot topic recently, paralleling BPD in its stigma and reputation. And like BPD, NPD is commonly a response to trauma, invalidation, neglect, bullying, or a combination of these factors. Individuals with NPD are not automatically abusers, and deserve opportunity to heal from their maladaptive coping strategies and defense mechanisms.
PMDD— Premenstrual Dysphoric Disorder, a mood disorder that causes significant distress in the Luteal phase of menstruation, has been heavily linked to trauma and benefits from therapy, medication management, and cycle tracking.
Grief & Loss
Although loss is a universal experience, every loss is a completely unique, and deserves unique processing and intervention. Whether the loss of a person, a pet, a job, a marriage, or an opportunity— grief shows up in our lives more often than we might notice. What often comes to mind when we think of grief are the Kubler Ross stages of grief; Denial, Anger, Bargaining, Depression and Acceptance. While these stages give us some insight into what we might experience in our grief, they also oversimplify a very complex process, which is not predictable or linear. Grief tends to ebb and flow between the stages, sometimes slowly and sometimes rapidly. One day, you could feel like you are beginning to accept and integrate your loss, and then the next day find yourself falling apart.
Much like trauma, grief can exacerbate existing wounds or addictions. When grief feels unbearable, it is natural to attempt to distract ourselves or alleviate our pain. But when this comes in the form of excessive spending or substance use, our grief is prolonged and buried and might be creating more pain in our lives unknowingly.
There is no correct way to grieve, but if it feels as if you are stuck or in such despair that you are losing your ability to function, you deserve help through peaks and valleys that are to be expected. I am trained in Grief Counseling and have also attended an Adlerian specific Grief Counseling conference. I would love to help you move through this difficult time. I will walk alongside you, helping you to process your pain, honor what has been lost, and start building the bright future you deserve.