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Running Head: INTEGRAL RECOVERY GROUP from ADDICTION 1 Running head: INTEGRAL RECOVERY GROUP FROM ADDICTION 1 Integral Recovery Group from Addiction A Research Paper Presented to The Faculty of Adler Graduate School ____________________ In Partial Fulfillment of the Requirements for The Degree of Master of Arts in Adlerian Counseling and Psychotherapy _____________________ By: Daniel Ronken Adler Graduate School 2014 INTEGRAL RECOVERY GROUP FROM ADDICTION 2 Abstract This project proposes to create a integral recovery group from addictions. Since addiction is a multifaceted and complex conundrum, ongoing recovery needs to address multiple levels of functioning. From an Adlerian view, addiction is a neurotic solution to deal with the inherent inferiority feelings of being born into this world as a human being. The framework and roadmap for the group will be focused on five levels of functioning: Physical, Cognitive, Emotional, Ethical, and Spiritual. The current state of addiction and associated literature is reviewed highlighting the strengths and weaknesses of existing models. The proposed group may be offered to people seeking integral recovery from addiction as well as professionals in the helping field looking to work with addiction recovery in a more integrative fashion. INTEGRAL RECOVERY GROUP FROM ADDICTION 3 Integral Recovery Group from Addiction Addiction has a complex etiology requiring complex treatment approaches. Addiction work has come along way, but it’s not perfect. Humans are infinitely complex beings and there are varying degrees of processing stimuli as we relate with and integrate our experiences of the world. Research and programs such as the medical model of addiction and recovery 12 Step Models tend to focus on slices of the whole human. Examining current research to date and existing treatment programs reveals that there are some important gaps in our knowledge base and treatment approaches that need to be considered and integrated into new treatment options. According to Adler’s Individual Psychology (Ansbacher & Ansbacher, 1956), humans are innately whole but arrive into this world with an inherent inferiority feeling. Adler’s Individual Psychology is a subjective psychology, thus proposing that humans create ‘tricks’ to make sense of his or her ultimately fictional reality. Humans experience a shock when confronted with a problem and a certain segment of the population who isolate from others are susceptible to the shock ultimately becoming a type of neurosis. The result is a mistaken belief of worthlessness. There are two ways humans choose to deal with this worthless feeling. First is the healthy approach of recognizing this mistaken belief and taking ownership of it and creating a new fiction. The second way is an unhealthy neurotic solution (trick and fiction) that serves to hide and distract and is accomplished by using various safeguarding strategies like excuses, aggressiveness, and exclusion (Ansbacher & Ansbacher, 1956). This is the plight of those who suffer from addiction. Addicts display many of the above-mentioned safeguarding strategies in their effort to keep the addiction a secret. The antidote to secrecy is to develop a striving toward more healthy behaviors that encourage social interest. INTEGRAL RECOVERY GROUP FROM ADDICTION 4 In light of this framework, this paper will examine biological, psychological, social and spiritual ways of understanding addictive processes and the treatment approaches that have emerged out of these understandings, and will then propose a new group recovery model that builds upon strengths of these programs while attempting to address the existing gaps. Biological Aspects Addiction has a clear biological basis and is influenced by biological factors. Current brain research (Smith, 2012) has discovered that people who suffer from addictions have had their most evolved section of their brain (the neocortex) which is involved in decision-making (technically called Executive Functioning) essentially highjacked by the pleasure and reward (nucleus accumbens) area of their brain. From a biological perspective, Smith (2012), defines addiction as “a primary, chronic disease involving brain reward, motivation, memory and related circuitry.” Furthermore, according to a publication put out by the Harvard Health, “the current theory about addiction, dopamine interacts with another neurotransmitter, glutamate, to take over the brain’s system of reward-related learning. This system has an important role in sustaining life because it links activities needed for human survival (such as eating and sex) with pleasure and reward. The reward circuit in the brain includes areas involved with motivation and memory as well as with pleasure. Addictive substances and behaviors stimulate the same circuit—and then overload it” (helpguide.org, n.d., Learning process, para. 2). Biological factors clearly influence addictive behaviors and the negative consequences associated with them. These biological propositions are helpful for understanding a particular aspect of the addictive process, but limited in the answering to what extent sociological or psychological factors influence the expression of the genes associated with addiction. INTEGRAL RECOVERY GROUP FROM ADDICTION 5 Although we know that certain neurochemicals are involved in the addiction process, we don’t know the extent of what other neurochemicals may potentially be involved in this sinister vicious cycle. Another missing component of the biological view is identifying what makes an individual susceptible to this highjacking while others seem to be able to take it or leave it. For example, some people can abuse substances (even during adolescence while their brain is still developing), and seemingly grow out of it and use chemicals responsibly upon entering adulthood, whereas others do not. The biological perspective doesn’t address this mystery, and thus purely biologically based treatment approaches will be inherently limited in the factors of addiction that they will be able to address or treat. When it comes to recovery, physical exercise positively affects the neurochemicals in brains that have been negatively affected by addiction. However, that’s not the main purpose of exercising in recovery. Matesa (2014) states, “exercising in recovery is not about counter-jacking the reward system. It’s about re-establishing a foundation of fitness that helps us conduct our lives from a position of stability and strength” (p. 37). By moving the physical body, the biochemistry is positively affected as well. People in recovery benefit from gaining a better understanding of their physical selves and how the treatment of it affects their recovery (Brown et al., 2009). Topics such as diet, exercise, movement, body awareness, etc., are to be addressed in an integral treatment group. Psychological Aspects Since we are more than just our brain’s mechanistic electric impulses, addiction also affects our mental experiences of ourselves and how we relate to others in this world. Adler pioneered and advocated for the importance of social and contextual factors being incorporated into mental health in order for a person to be psychologically healthy. Overholser (2010) states, INTEGRAL RECOVERY GROUP FROM ADDICTION 6 “Adler’s theory emphasized the importance of social interest, cooperation, feelings of inferiority, and working for the betterment of society” (p. 348). As we grow and develop, environmental factors such as relationship with others and emotional validation influence how we find our place in the family, community, and society at large. The individual then creates private logic. A subjective ‘positive’ experience for the individual leads to healthy convictions (i.e., I am significant in this world). A subjective ‘negative’ experience for the individual would lead to a neurotic mistaken conviction such as ‘I am unloved.’ (Ansbacher & Ansbacher, 1956). These environmental factors influence personal traits that correlate with addiction. Mate proposes, “Traits that most often underlie the addiction process: poor self-regulation, lack of a healthy sense of self, a sense of deficient emptiness, and impaired impulse control” (Mate, 2008). The great challenge for people susceptible to addiction is for them to learn how to accept all emotions and to not try and manage them via chemical intervention. A good of example of an experience that influences the development of the above mentioned personality traits is the connection we feel early on and the type of attachment with our primary caregivers. Attachment theorist Bowlby (1951) felt that in order for an individual to grow up to be a healthy adult, they need to have experienced a healthy relationship with their primary care giver. He asserts that in order for humans to develop optimally, “the infant and young child should experience a warm, intimate, and continuous relationship with his mother (or permanent mother substitute) in which both find satisfaction and enjoyment” (p. 13). The key word here is ‘both’ (meaning the infant and the primary caregiver). If the primary caregiver is anxious and stressed in life, the infant will occasionally absorb these stressors thus making them part of his or her core personality. Some theorists believe that this attachment process influences future vulnerability to INTEGRAL RECOVERY GROUP FROM ADDICTION 7 addictions (Fletcher, Nutton, & Brend, 2014). For example, an individual who is susceptible to addiction may find the ‘mother’ who was never there for them and thus they become attached to the drug.
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