With Frances
I find addiction and substance misuse counselling fascinating. A substance that affects one person one way can affect someone else differently, dependent on their genetics and family history, personality traits, or their lived traumas. While one person might use a drug as a crutch for a period of their life and then no longer feel the need for it, another person may get deeply entrenched in a very physiological, very hard-to-break addiction to the same substance.
As a therapist, my job is to help my clients dig deeper, beyond the band-aid or temporary relief the substance provides, to find what’s under it. A wise therapist colleague once told me that when working in addictions, it’s not about the drug use itself, it’s about what someone might be running from or running towards. Are they seeking something or avoiding something? After over a decade of working as a clinical counsellor in a hospital with addiction clients of all walks of life, I’ve learned that addiction counselling IS mental health counselling; there is rarely problematic substance use without an underlying connection to mental wellness. Similarly, excessive substance use will start to have effects on one’s body and mental health over time; the two are intertwined.
I’ve learned that someone’s drug of choice can be valuable insight into someone’s inner experience, and if we can move past the shame of using, we can learn a lot about ourselves and why we’re self-medicating in certain ways. I can’t count how many times I saw undiagnosed ADHD show up as people who smoked way too many cigarettes, drank coffee all day without any buzz effect, or maybe struggled to regulate cocaine use. I saw many first responders come in for therapy in their 40s and 50s because they used alcohol to help them sleep at night, as alcohol stopped the nightmares. They hadn’t thought to come in for therapy for PTSD, but when the drinking became problematic, they ended up in my office.
Once we’ve figured out the purpose drugs or alcohol serve in a person’s life, we can try to get those needs met in healthier ways. Simply taking away a crutch without anything else to lean on is putting someone at risk of relapse. I work with my clients to establish if they are working towards abstinence or harm reduction (cutting down, reducing the harms and risks the substance is causing), and we work collaboratively through therapy, practical skills, and non-judgmental accountability to get there. Slips along the way are normal, and aren’t a relapse if you get back on track with your goal and keep working towards it. Moments when clients might lapse into a previous habit reveal areas we need to bolster more support or do more internal work. It’s all a process, and I would be honoured to help guide you through it to a healthier relationship with substances.
