integrative addiction psychotherapy€¦ · drug use is meaningful people use substances in...
TRANSCRIPT
![Page 1: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/1.jpg)
Toward a Humanistic
Addiction Psychotherapy
Scott Kellogg, PhD
Diana Calvario
![Page 2: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/2.jpg)
Mechanisms of Change
http://farm4.staticflickr.com/3575/3403107361_55a670e132.jpg
Leonardo Da Vinci
![Page 3: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/3.jpg)
Drug Use is Meaningful
![Page 4: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/4.jpg)
Drug Use is Meaningful
People use substances in problematic ways for a
range of reasons
Reasons that need to be respected
In many cases, they will need to be addressed
directly
Sometimes before the person is ready to
decrease or cease their use of substances
(Tatarsky)
![Page 5: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/5.jpg)
Multiplicity of Self
Dancing of the Selves
By Brenda Clews
![Page 6: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/6.jpg)
Id, Ego, and Superego
![Page 7: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/7.jpg)
http://4.bp.blogspot.com/-KvzxuH-qZps/Ui4T5DFX1EI/AAAAAAAAAdg/7jJ-njnJLCM/s1600/37856228.png ; http://i.booksee.org/covers/388000/43547ab8369307f7ae47472def439dd0-d.jpg
![Page 8: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/8.jpg)
Schema Mode Therapy
![Page 9: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/9.jpg)
Multiplicity of Self
The internal world of patients is conceived of as
containing different parts, selves, modes, or
identities –
Many of which may not only play a role in a
patient’s suffering and drug use,
But also in his or her healing and recovery
![Page 10: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/10.jpg)
Gestalt Chairwork
http://www.atpweb.org/grof/slideshow2/image-
pages/pix.asp?cp=148&pp=1
Taken by
Stanislav Grof,
MD, PhD
Frederick “Fritz” Perls, MD Developed
Chairwork into a Psychotherapeutic Art Form
![Page 11: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/11.jpg)
http://ideaswar.com/wp-content/uploads/2012/05/Goals.jpg
![Page 12: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/12.jpg)
Greater Internal Freedom
http://louisparsons.typepad.com/.a/6a01156f2690a2970c0120a590e701970b-800wi
Freedom
By Louis Parsons
![Page 13: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/13.jpg)
Increased Personal Complexity
13
http://www.archiscene.net/wp-content/gallery/archiscene/swiss-clockwork-embassy09.jpg
![Page 14: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/14.jpg)
Gradualism
Crossing
Infinity
Diana
Calvario
![Page 15: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/15.jpg)
Gradualism
Embrace and Work with Complexity
Harm Reduction as a Method
Not a Goal in Itself
Small Steps
![Page 16: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/16.jpg)
Substance Use Goals
![Page 17: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/17.jpg)
Short-Term
Monitoring Use
Harm Reduction
Moderation
Cessation
![Page 18: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/18.jpg)
Long-Term
Abstinence
Moderation
“Non-addictive” Use
![Page 19: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/19.jpg)
Methods of Healing
Wide Rothko (2008) by Joao Vasco Paiva
http://www.siusoon.com/dat/2010/07/31/hong-kong-contemporary-art-biennial-awards-2009/
![Page 20: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/20.jpg)
Therapeutic Relationship
![Page 21: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/21.jpg)
Therapeutic Relationship
Love
Empathic Listening
Authenticity and Optimism
Courage and Determination
![Page 22: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/22.jpg)
Heroic Self
http://www.contentrow.com/wp-content/uploads/2012/07/12_branding_archetypes.jpg
Margaret Mark and Carol Pearson
![Page 23: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/23.jpg)
Heroic
Self/
Healthy
Adult
Difficult
External
Realities
Social
Oppression
No Future
Orientaton
Anxiety and
Internal
Suffering
Physical
Pain
Self-
Soothing
Drug Use
Self-
Stimulation
Drug Use
Inner Critic
Attack
Before Treatment
Trauma and
Loss
![Page 24: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/24.jpg)
Heroic
Self/
Healthy
Adult
Claiming the
Future
Facing
Fear
Confronting
Self-Hatred
Taking
Action
Self-Directed
Choices
Resisting
Pressure
Controlling
Drug Use
Reducing
Harm
During and After Treatment
Self-
Compassion
![Page 25: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/25.jpg)
Existential Language
This is the Language of the Heroic Self
“I want”
“I am deciding to”
“I am choosing to”
“I will”
“I will not”
![Page 26: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/26.jpg)
Horizontal and Vertical
Interventions
http://www.kazuya-akimoto.com/2004revised/2004revised_images/1954_vertical_bars_450.jpg: http://rlv.zcache.com/horizontal_red_abstract_rectangle_art_print_poster-p228408191587260255tdcp_400.jpg
![Page 27: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/27.jpg)
Interventions
Horizontal Interventions
Those focused on controlling and/or
discontinuing drug use
Vertical Interventions
Those that are used to address and treat the
underlying issues and co-occurring
psychopathology
![Page 28: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/28.jpg)
Horizontal Interventions
![Page 29: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/29.jpg)
http://www.examiner.com/images/blog/EXID28785/images/Orla__iStock_000011252279XSmall(1).jpg
Decisional Balance
![Page 30: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/30.jpg)
Positives of Drug Use
Immediate physical pleasure
(10)
Escape/Feeling more “there”
(10)
Feels more emotion (10)
Reduces social anxiety (6)
Shuts out critic (7)
People will know “real” self (7)
Positives of Change
Feel a greater sense self
discipline (9)
Would be more productive (10)
Help him be more comfortable
with self (8)
Greater confidence (6)
Negatives of Drug Use
Feels guilty (7)
Others are concerned (6)
Not as productive (10)
Feels like it a crutch (10)
Feels bad (7)
Health Problems (7)
Negatives of Change
Would not enjoy life as much (9)
Would be ignoring a part of
himself (10)
Breaking up with something he
loves – a hard breakup (9)
Decisional Balance
![Page 31: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/31.jpg)
Motivational Forces
Self- Stimulation:
Using To Feel Alive,
Powerful, Good,
and Joyful
Self Medication:
Using To Reduce Pain
and Suffering;
Using To Feel
More Comfortable
Existential Issues:
Desire For a Better Future
Fear: Health and
Life Concerns
![Page 32: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/32.jpg)
Relapse Prevention
http://www.religion.utoronto.ca/Assets/Religion/assets/marlatt.jpg
![Page 33: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/33.jpg)
33
Relapse Prevention
Involves working with patients to:
Understand triggers and cues
Identify high-risk situations
Develop such coping skills as:
Cognitive Restructuring,
Assertiveness – Drink and Drug Refusal
Urge Surfing
![Page 34: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/34.jpg)
Substance-Use Management
34
http://www.drcnet.org/links/
![Page 35: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/35.jpg)
35
Substance Use Management
Helping people use drugs in ways that are safer
Including
Reducing the amount consumed
Changing methods of use
Reducing the time of involvement
Changing the context of use
Drug substitution (Dan Bigg, 2008)
Overdose Prevention/Naloxone
![Page 36: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/36.jpg)
Ideal Use Plan
“If you were to use drugs or alcohol in such a
way as to maximize the pleasure and benefit you
gain from them while minimizing the pain and
danger involved, what would that look like?”
Can they implement this?
What interferes or stops this from happening? (Tatarsky & Kellogg, 2010)
![Page 37: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/37.jpg)
Contingency Management
![Page 38: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/38.jpg)
Contingency Management
Uses positive reinforcement principles to:
Improve retention
Decrease substance use
Encourage harm-reducing and recovery-
related behaviors
![Page 39: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/39.jpg)
Contingency Management
Harm Reduction, Moderation or Abstinence
Patient Choice
Set Weekly Goal
Decrease the Fee if They Achieve Goal
Increase the Fee if They Do Not Achieve the
Goal
Profoundly Empowering
Increasing Control – Small Steps
![Page 40: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/40.jpg)
Vertical Interventions
![Page 41: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/41.jpg)
41http://feralhouse.com/press/15tolife/press/socialist_worker_1203.html
Anthony Papa
“The Heart of Addictive Disorders is Suffering”
– Edward J. Khantzian, MD
![Page 42: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/42.jpg)
Healing the Past
![Page 43: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/43.jpg)
Grief and Loss
43http://www.southbaytreatment.com/wp-content/uploads/2011/03/grief-pic-1.jpg
![Page 44: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/44.jpg)
Interpersonal Trauma
44
http://assets.families.com/Encyclopedias/iemf_01_img0037.jpg
![Page 45: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/45.jpg)
Claiming the Present
![Page 46: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/46.jpg)
Inner Critic
Your Harsh Inner
Critic…
Methanie Dempsay Binder
![Page 47: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/47.jpg)
https://m1.behance.net/rendition/modules/44312077/disp/1f1d26dcdd170d4b0131d990f7d700f9.png ; http://img.timeinc.net/time/magazine/archive/covers/2002/1101020610_400.jpg
![Page 48: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/48.jpg)
Creating the Future
![Page 49: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/49.jpg)
Voice Work/Assertiveness
49http://buildyourbridges.com/wp-content/uploads/2013/08/AssertiveVennDiagram-300x197.jpg
Helping Patients Develop and Strengthen their
Voice of Respectful Desire
![Page 50: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/50.jpg)
Heroic Existentialism
http://upload.wikimedia.org/wikipedia/commons /thumb/9/9c/William_James _b1842c.jpg/22 0px-Wi lliam_J ames_b1842c.jpg ; http://cp91279.biography.com/Theodore- Roosev elt_The-Talented-Mr-Roosevel t_HD_768x43 2-16x9.j pg ; http://ippnweupdate.files.wordpress.com/2013/07/albert-schweitzer.jpg
Dr. William James President Theodore Roosevelt Dr. Albert Schweitzer
“We like to be reminded that our central calling,
our main task on this planet, is the heroic.”
– Dr. Ernest Becker
![Page 51: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/51.jpg)
Heroic Existentialism
An Injustice to be Remedied and Corrected
A Suffering to be Healed and Relieved
Something of Beauty to be Protected and
Preserved
Someone or Something that is Loved to be
Nurtured and Developed
![Page 52: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/52.jpg)
Identity Theory
http://rickrick1946.photos.military.com/photos/119709615_abiNx-S.jpg; http://farm1.static.flickr.com/45/131631198_5a0c3f43b4.jpg?v=0; http://ursispaltenstein.ch/blog/images/uploads_img/lois_siegel_fiddle_page_1.jpg; http://web.centre.edu/smart/images/supplementary/alcoholism.gif;
http://onderdiemaanensterre.files.wordpress.com/2009/03/vintage_romantic_couple_stock5_by_l.jpg
![Page 53: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/53.jpg)
The Case of N
http://info.sdiworld.org/gallery/8/motherandchi ld.jpg
"Agape" by Jane Korinshttp://3.bp.blogspot.com/_IB98SVrY53 k/Sc6hLLJWQ7I/AAAAAAAAEKs/g IChiF1 Kt1s/s4 00/176 090~A -Drug- Addict-I njecting -Hersel f-Early- 20th-Century-P osters.j pg
![Page 54: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/54.jpg)
Identity and Recovery
The core idea:
Drug use will decrease and eventually cease or moderate as:
Nondrug-using identities become more central, reinforcing, and important to individuals
And as they compete with and replace the Drug-Using Identity
(Anderson, 1998; Biernacki, 1986; Granfield & Cloud, 1996; Kellogg, 1993)
![Page 55: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/55.jpg)
Identities are a Way for the
Heroic Self to Create a New
Future
![Page 56: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/56.jpg)
The War on Drugs interferes with Identity Creation;
Therefore the War on Drugs interferes with
Healing and Recovery
![Page 57: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/57.jpg)
Jane Uitti – Two Chairs
(www.janeuitti.com)
Dialogues and Encounters
![Page 58: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/58.jpg)
Positives of Drug Use
Immediate physical pleasure
(10)
Escape/Feeling more “there”
(10)
Feels more emotion (10)
Reduces social anxiety (6)
Shuts out critic (7)
People will know “real” self (7)
Positives of Change
Feel a greater sense self
discipline (9)
Would be more productive (10)
Help him be more comfortable
with self (8)
Greater confidence (6)
Negatives of Drug Use
Feels guilty (7)
Others are concerned (6)
Not as productive (10)
Feels like it a crutch (10)
Feels bad (7)
Health Problems (7)
Negatives of Change
Would not enjoy life as much (9)
Would be ignoring a part of
himself (10)
Breaking up with something he
loves – a hard breakup (9)
Decisional Balance
![Page 59: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/59.jpg)
Basic Motivational Dialogue
Desire to
Stop, Reduce, Or
Change The Pattern
Desire to
Continue Using
Substances
![Page 60: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/60.jpg)
Strategic Guidelines
http://revolutionarydesire.files.wordpress.com/2010/01/11.jpg?w=223&h=300
![Page 61: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/61.jpg)
Strategic Guidelines
“Superego-Based Change says: “I should…”;
however,
“Ego-Based” Change says: “I want…”
Patients heal and recover by:
Strengthening the part that wants to change
Not by persuading the part that wants to use
to desire recovery
Desire Engages with Desire
![Page 62: Integrative Addiction Psychotherapy€¦ · Drug Use is Meaningful People use substances in problematic ways for a range of reasons Reasons that need to be respected In many cases,](https://reader035.vdocuments.us/reader035/viewer/2022071212/6023fecd3597c748e23693d4/html5/thumbnails/62.jpg)
Diana Calvario