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Comprehensive Model of Addiction

Comprehensive Model of Addiction. Richard Matthews. Definition of Addiction. WHO A Pathological Relationship with any Mood Altering substance or experience. A life damaging relationship Two questions Can you control how much you use once you start using?

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Comprehensive Model of Addiction

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  1. Comprehensive Model of Addiction Richard Matthews

  2. Definition of Addiction • WHO • A Pathological Relationship with any Mood Altering substance or experience. • A life damaging relationship • Two questions • Can you control how much you use once you start using? • Can you control the stop and stay stopped?

  3. Bio/Psycho/Social/Spiritual • Biology = Family History, Genetics • Psychological = Childhood Trauma • Social = Poverty, Alienation, Despair, & Disparity - PAD • Spiritual = Values & Beliefs, a Relationship to something greater than oneself.

  4. Biology • Twin Studies • Family History of Addiction • Genetic Predisposition • Dopamine D2 receptor site deficiency

  5. Psychology • Chaotic Childhood • Childhood Trauma • “Breach of the We” Unity Experience • Fritz Kunkel • Shame = there is something wrong with me • Egocentric i.e. Narcissism

  6. Social • “Breach of We” = loss of at-one-ment • Feelings of Alienation • Not Belonging • A sense of being other than, othered • Further sense of Shame

  7. Spiritual • Loss of connectedness to the mother • Loss of connection to something greater than myself • Unconditional Love replaced by conditional Love • Separateness • No Atonement

  8. Padd • Poverty • Alienation • Despair • Disparity • = More Shame

  9. Codependency Definition An attachment disorder resulting in an internal breach with the authentic self producing a search for meaning and identity externally from another. This search results in the sufferer becoming dependant upon another for self-worth, meaning and significance A codependent’s dependency needs were unmet in childhood and as a result they become dependant on another person, object or experience. One could say that traditionally women become codependent in their relationships with men while men are codependent on their jobs for feelings of significance, self-worth and security.

  10. Harm Reduction is a Response Harm reduction is a non-anxiety driven strategy with a clearly defined purpose and goal. Harm reduction is an attempt to minimizing the health consequences of the behaviour until the person is in a position where change becomes possible. Harm reduction strategies usually result in decreased isolation and increased exposure to health care professionals thus facilitating change.

  11. Enabling Behaviour is a Reaction • Any behaviour motivated by fear or anxiety that attempts to protect another from non-life threatening direct consequences of their behaviour. Enabling behaviour is a short-term anxiety driven solution that is non-purposive and has no long-term goals attached to it. Enabling behaviours arise from the enabler’s emotional attachment to the person exhibiting the maladaptive behavior. Enabling behaviour is usually designed to reduce the stress of the enabler.

  12. Treatment • Substance use must be understood as an essential and integral part of the person. It is not a pathological part that can be treated outside of the whole person and removed. Addiction must be understood as a systemically holistic disease that affects the body, mind, emotions and Soul. If treatment of any aspect of the disease is omitted treatment failure is likely.

  13. Stages of Change Precontemplation Has no intention to take action within the next 6 months Contemplation Intends to take action within the next 6 months. Preparation Intends to take action within the next 30 days and has taken some behavioral steps in this direction. Action Has changed overt behavior for less than 6 months Maintenance Has changed overt behavior for more than 6 months. Relapse: Not failure, an opportunity for fine tuning

  14. Stages Of Change 2

  15. STAGES OF CHANGE STAGES OF CHANGE AND WHAT CAN BE DONE CLIENT’S STAGE COUNSELLOR’S MOTIVATIONAL TASKS Precontemplation Raise doubt - increase client’s perception of risks and problems with current behavior. Contemplation Tip the balance - evoke reasons to change, risks of not changing; strengthen the client’s self-efficacy for change of current behavior. Determination Assist the client to determine the best course of action to take in seeking (Preparation) change. Action Assist the client to take steps toward change. Are there barriers? Maintenance Assist the client to identify and use strategies to prevent relapse. Relapse Assist the client to renew the processes of contemplation, determination, and action, without becoming stuck or demoralized because of relapse.

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