Do you struggle with addictive tendencies? Do you find yourself only able to complete things when there’s a deadline in place, procrastinate over boring tasks but equally get caught up in things that are enjoyable to you? Almost to the point of obsession! It may be that you are one of the 2 to 4% of adults that have ADHD. 

I have worked in the field of addiction for over 30 years and have been a qualified addiction therapist for 25 of those years. I remember hearing the term ADHD for  the first time almost 30 years ago. It was from a friend who had just been diagnosed with it. To be honest I thought it was a nicer way of calling someone an attention seeker! I was also really worried that it could be used as a way of minimising addiction. Over 30 years later and thankfully I’ve learnt so much more about both addiction and ADHD. It turns out that ADHD has nothing to do with attention seeking and everything to do with struggling to keep your attention focused on things that are either difficult or somewhat boring and challenging to you. 

Have you ever had a school report that said ‘…… does not concentrate’? Disclaimer: ADHD does not mean you didn’t do well in school or can’t become a high achiever. It probably does mean that if you found a subject challenging and that  subject didn’t ‘light you up’ that you would have found it very difficult to focus and concentrate on it. 

Have you ever been called a daydreamer? Daydreaming is a way of dissociating from difficult tasks and is very common with people with ADHD. Neuro typical persons also daydream. They also procrastinate and can become obsessive over enjoyable things. When you add risky, impulsive behaviours such as addiction into the mix you are possibly looking at ADHD. It can be difficult to know what’s what because so many ADHD symptoms are also things that most of the population struggle with from time to time. Having ADHD means you have less dopamine than a Neuro typical person thus are more likely to get your ‘feel goods’ from addictive behaviours such a substance use, gambling or sex addiction. (We could substitute the aforementioned addictions for workaholism, gym addiction, shopping addiction, food addiction, phone addiction etc). All the above hit the pleasure reward spot in the brain – the part of the brain that creates and releases dopamine. If you have less dopamine than what is considered the normal amount it then makes sense that you may keep returning to a behaviour that stimulates those feel good chemicals. In time that behaviour may turn into an addiction. Addiction is when that behaviour no longer feels like a choice. You begin to feel obsessed and compelled to carry out that behaviour. You begin to ‘act out’ in order to feel ok. 

Many of my clients have to make a choice between controlled use of their addiction or abstinence from it. Every client is different and needs a different course of treatment. It is my role to explore with my clients whether they can control their ‘use’ or not. What I have found is that those clients who present with ADHD symptoms do not always fit into the classic mold of the ‘addict’. And by that I mean that they are able to have control of their use at some points rather than the 12 step philosophy that states that more often than not when someone takes that first drink/drug/gamble/bit of sugar etc – it will set off a physical compulsion and a mental obsession to consume/act out more. Those with ADHD may actually have addictive tendencies rather than be struggling with addiction. Therefore if the correct diagnosis and treatment is sought and given they may be able to have control over their use in the future. It is only through a comprehensive assessment – exploring a person’s past experiences that a plan of action can be agreed. Many of my clients have both ADHD and addiction in which case abstinence may well be the only way forward. 

For a full addiction assessment please get in touch via email at Victoriaabadi66@gmail.com

For an ADHD assessment please contact your GP or private specialist ADHD consultant psychiatrist. 

Worried about your drinking during covid 19 lockdown?

I have been in the very fortunate position of being able to continue to work all the way through covid 19 lockdown. I don’t say this to show off or brag but to display how I’ve been on the cutting edge of hearing and seeing people’s responses to it at a first hand therapeutic level. What it has meant is that right from day one I have been able to see and hear what the effect of this global pandemic and subsequent social isolating measures has had on my client group. Not only have I had that first hand experience of seeing it, I’ve also had my phone ringing with new clients looking to get advice and support for their anxiety and often related increase in drinking.

Many of these new enquiries are telling me that they are really worried about their increase in drinking. My first question to them is ‘do you know why you are drinking more?’ A few have replied because of boredom and the sun has been shining. I am less worried about these clients and I will talk about why that is in the next paragraph. It is those enquiries that answer the ‘do you know why question’ with the following responses that I’m more concerned about. These responses are ‘my anxiety is through the roof’, ‘ I can’t seem to cope without it’, ‘everyday I tell myself today I will have a day off but then it gets to the afternoon and I think god no I can’t handle this without a drink’, ‘everyone else is managing this better than me’, ‘I feel like a failure’, ‘I’m having lots of disturbing memories’. We are going through a collective trauma, that is bringing up profound grief, loss, panic over livelihoods, panic over loss of lives of loved ones. People’s nervous systems are barely coping with the sense of threat and vigilance for safety, or alternating with feeling numb and frozen and shutting down in response to it all. People are trying to survive poverty, fear, retriggering of trauma, retriggering of other mental health difficulties. When a prospective client calls me and starts to talk about how the covid 19 has started to trigger old negative thoughts, feelings and responses I realise there may well be a need for therapy.

I am often asked if I am fearful that there will be a massive spike in problematic drinking once lock down is lifted. My experience and relevant research shows that the majority of people will return to normal patterns of drinking once they return to their usual routine. Many of these people are drinking because of lack of routine, they may be bored, they may well be aware it doesn’t matter too much if they feel a bit rough the next day and of course the sun has been shining. And what do many people do when the sun shines – drink more. These guys are not drinking because they feel they can’t cope without it. If they were to choose not to drink it wouldn’t be that big a deal. Then there is the cohort of people who are using drink as a crutch as a coping mechanism to get through the day/evening. This group may need some extra support in a therapeutic setting to look at developing new coping skills that will help them in feeling more resilient. This group will likely split in to two groups. Those that will not go on to have a problem with drinking but could struggle with anxiety and or other mental health related problems and those that will continue to use alcohol at a more dependent level once the covid 19 crisis passes. Both these groups would benefit from some psychological input.

Working with old emotional wounds and trauma is my field of experience. This pandemic is a trauma for many just on its own. Add past traumatic life experiences into the mix and we start to see people using faulty coping strategies to survive. I work with trauma in various ways. Using talk therapy to express how the individual feels about their experiences and by using mindfulness approaches such as meditation and mindful enquires to see how the body has processed the hurt and/or trauma. When we work at both these levels we can begin to heal both the mind and the body.

if you are worried about your drinking or any other addictive behaviour please don’t hesitate to contact me on 07983726647 or at victoriaabadi66@gmail.com. I’m here to listen.

Have you ever heard that expression ‘if there was a room full of men or women you can bet your bottom dollar I’d be attracted to the most unavailable one in the room.’ Could this even possibly be true? Well actually yes it could. Within 5 minutes of meeting a person they will remind us of our relationships with a primary caregiver. If you have suffered either physical or emotional abandonment as a child there will be people whom we meet that we immediately feel attracted to. There will be something about them that reminds us of a feeling we had as a child. This feeling may not even be wholly conscious. Usually this will be an uncomfortable feeling but we probably will not recognise it as this. We are more likely to recognise it as a feeling of wanting to get closer to this person. The mind is incredibly complex in the way it processes information. Across the room it may look like to an observer that you are just having a friendly chat with someone you have just met. In fact your mind is quietly thinking I recognise this person, I know this feeling, I want to get closer to this person as there is something about this feeling that has not been resolved from my past. This attraction you are feeling is in fact the minds way of trying to solve what was a traumatic event to you in childhood. It will be trying to get you to form a relationship with this person who reminds you of that primary caregiver who either physically or emotionally abandoned you. The reason for this is that the mind thinks if it gets you close to this person then perhaps you can rewrite history by making this new person stay in relationship with you. The problem is that the whole reason you have been attracted to this person in the first place is because they are unable to be emotionally available. So history repeats itself. You try to get close to this person but due to their own issues they
will ultimately abandon you just as that primary caregiver did.

Have you ever experienced the above. Do you find yourself attracted to the same type of person over and over again to find that the result is always the same. Pain and abandonment. It can be extremely helpful to understand your patterns in order to change them. Once we become aware of why we are attracted to certain individuals we can start working on ways to change that.

Please contact me on 07983726647 or at victoriaabadi66@gmail.com if you would like to start changing self defeating patterns of behaviour.

Why We Practice Mindfulness in Groups

Human being are essentially social beings that in most cases need interaction with other human beings in order to be able to function optimally. Originally we lived in large tribal groups where all our social interactions were met within the tribal community. As time passed and humans began to settle more in one place we saw villages and towns spring up. It was the norm to have all of your extended family around you and again for the human need for social connection to be met within these types of community. With the advent of motorised transport people became much more free to be able to live in different areas from their family and often their friends. This could then mean that they had less access to support and community. Add to this the advent of social media and what we are seeing is even more of a break down of social communities. Human beings are becoming more isolated as these types of communities are becoming less common. And as a result of this we have begun to see a huge increase in mental health conditions such as depression, anxiety and addictive processes. Connecting with other human beings helps us feel ‘part of’ the human race and can significantly help with a wide variety of mental health conditions. I include substance misuse as a mental health condition as we now know that the neural pathways of the brain are altered when we continue to use a substance that triggers the excessive release of dopamine. One of the main characteristics of chronic, prolonged substance misuse is that the user begins to become more and more isolated. I work primarily with people who have problems with substance misuse or other behavioural addictions. Encouraging this cohort of people to work within groups can be a vital part of their recovery as very often it is their first step towards feeling part of the human race again. Gabor Mate, one of the leading lights in addiction research states that in its simplest form that ‘the antidote to addiction is connection’. Gabor Mate – In the Realm of the Hungry Ghost – 2009. Mindfulness practiced in a group can help an awareness grow that ‘we are in this together’ thus motivating individuals to keep on practicing as they feel they are not alone, that they are more connected and thus less isolated. When mindful inquiry is practiced in groups it can again allow the individual to feel less alone and more connected when they are able to hear and identify with others experiences and feelings. Hearing other people express their feelings and experiences can also allow other perspectives to enter into the consciousness thus challenging negative beliefs that the individual is in some way less than everyone else. Another of the characteristics of addiction is that many who suffer with the condition also suffer with deep rooted shame, often believing that they are inherently flawed. Mindful inquiry within the group can often help them to challenge this belief by hearing others share their own feelings and judgement of these feelings. When we connect on this deep level – hearing another human being judge themselves so harshly we are often able to have compassion for that person. If we are able through the meditative practice to be able to direct this same compassion towards ourselves we can start to break down the shame cycle. Donald McCown, co-author of Teaching Mindfulness: A Practical Guide for Clinicians and Educators has made the point that participants of mindfulness groups see it as a group activity and that’s one reason they want to come back. He states that
‘They have a group to bring back their experiences to, which takes them out of the echo chamber of their own minds. A mind which is often clouded with self doubt and recriminations’. One of the main benefits of group meditation is hearing other people’s struggles with their practice. Hearing another person share that they feel like they are rubbish at it too can again alleviate that feeling of shame and allow the individual to recognise they are not the only ones who are not perfect. McCown also states that facilitators need to be able to facilitate discussion and discovery not simply serve as the person who has all the answers. Group participants discovering their own answers is often much more beneficial. It is also of great importance to be able to sit with not knowing all the answers – being able to sit with discomfort and understanding ‘it’s ok to not be ok’ is a whole lot easier when you know through the group experience that you are not on your own with feeling this. Addiction is, in most situations, about an individual not being able to sit with discomfort. The substance or behaviour is very often their solution to their problem of being able to sit with difficult feelings and emotions. Ultimately the substance/behaviour becomes a bigger problem in its own right thus leaving the person with two problems – the substance/behaviour and their inability to self soothe. They have to learn to sit with uncomfortableness without ‘numbing’. Mindfulness enables them to begin to learn how to be more present in the moment without preference. Being a member of a group where other people also struggle with being able to sit with discomfort again makes the participant feel less alone, less anxious and less weird thus providing an environment where change can begin to occur.
Often mindful groups take place in neutral surroundings away from the distractions of the individual’s home setting thus allowing the mind to be able to settle more readily. Also if you struggle with feeling distracted it can be very beneficial to practice in a group where you can pick up on the energy frequencies within the group. Calm energy from others may allow the individual to feel more centred. There have been many studies done on the benefits of meditation in communities with the findings often coming back that the ripple effect of the calming properties of group mindfulness can effect whole communities reducing violence and aggression. The group can collectively unify to have a common goal – even if it’s just to be more relaxed.

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https://addictioncounsellingwilmslow.co.uk/424-2/

It is such a paradox to call comfort eating comfort eating. We understand that addiction is always about feeling uncomfortable and reaching towards something to take the discomfort away. Whether that be the minor discomfort of boredom or the extreme discomfort of grief. Either way a much more accurate term would be ‘numbing eating’. Initially reaching for your ‘food of choice’ may feel comforting but when you reach for that same substance time and time again, day in day out it becomes increasingly more painful. Eventually the pain of the addictive behaviour outweighs any pleasure or comfort you may have originally felt and you end up with two problems. The initial discomfort you were trying to avoid and the pain of repeating a self defeating behaviour.

It is imperative when working with any form of addiction that the sufferer learns to sit with discomfort. Conversely the more you are able to sit with discomfort the quicker the discomfort passes. I am a qualified mindfulness teacher and an integrative cbt practitioner. I combine mindfulness/ ACT with cbt techniques in order to address the addiction from a two pronged approach. I use mindfulness and Acceptance Commitment Therapy in order to be able to sit with uncomfortableness and be able to accept the present moment just as it is without needing to reach to something to change your reality. The cbt approach enables you to challenge negative core beliefs about yourself, which in turn affects how we feel which has a knock on effect of changing the way you behave.

If you would like to address an addiction of any kind please feeel free to contact me at victoriaabadi66@gmail.com or call me on 07983726647.

Human being are essentially social beings that in most cases need interaction with other human beings in order to be able to function optimally. Originally we lived in large tribal groups where all our social interactions were met within the tribal community. As time passed and humans began to settle more in one place we saw villages and towns spring up. It was the norm to have all of your extended family around you and again for the human need for social connection to be met within these types of community. With the advent of motorised transport people became much more free to be able to live in different areas from their family and often their friends. This could then mean that they had less access to support and community. Add to this the advent of social media and what we are seeing is even more of a break down of social communities. Human beings are becoming more isolated as these types of communities are becoming less common. And as a result of this we have begun to see a huge increase in mental health conditions such as depression, anxiety and addictive processes. Connecting with other human beings helps us feel ‘part of’ the human race and can significantly help with a wide variety of mental health conditions. I include substance misuse as a mental health condition as we now know that the neural pathways of the brain are altered when we continue to use a substance that triggers the excessive release of dopamine. One of the main characteristics of chronic, prolonged substance misuse is that the user begins to become more and more isolated. I work primarily with people who have problems with substance misuse or other behavioural addictions. Encouraging this cohort of people to work within groups can be a vital part of their recovery as very often it is their first step towards feeling part of the human race again. Gabor Mate, one of the leading lights in addiction research states that in its simplest form that ‘the antidote to addiction is connection’. Gabor Mate – In the Realm of the Hungry Ghost – 2009. Mindfulness practiced in a group can help an awareness grow that ‘we are in this together’ thus motivating individuals to keep on practicing as they feel they are not alone, that they are more connected and thus less isolated. When mindful inquiry is practiced in groups it can again allow the individual to feel less alone and more connected when they are able to hear and identify with others experiences and feelings. Hearing other people express their feelings and experiences can also allow other perspectives to enter into the consciousness thus challenging negative beliefs that the individual is in some way less than everyone else. Another of the characteristics of addiction is that many who suffer with the condition also suffer with deep rooted shame, often believing that they are inherently flawed. Mindful inquiry within the group can often help them to challenge this belief by hearing others share their own feelings and judgement of these feelings. When we connect on this deep level – hearing another human being judge themselves so harshly we are often able to have compassion for that person. If we are able through the meditative practice to be able to direct this same compassion towards ourselves we can start to break down the shame cycle. Donald McCown, co-author of Teaching Mindfulness: A Practical Guide for Clinicians and Educators has made the point that participants of mindfulness groups see it as a group activity and that’s one reason they want to come back. He states that
‘They have a group to bring back their experiences to, which takes them out of the echo chamber of their own minds. A mind which is often clouded with self doubt and recriminations’. One of the main benefits of group meditation is hearing other people’s struggles with their practice. Hearing another person share that they feel like they are rubbish at it too can again alleviate that feeling of shame and allow the individual to recognise they are not the only ones who are not perfect. McCown also states that facilitators need to be able to facilitate discussion and discovery not simply serve as the person who has all the answers. Group participants discovering their own answers is often much more beneficial. It is also of great importance to be able to sit with not knowing all the answers – being able to sit with discomfort and understanding ‘it’s ok to not be ok’ is a whole lot easier when you know through the group experience that you are not on your own with feeling this. Addiction is, in most situations, about an individual not being able to sit with discomfort. The substance or behaviour is very often their solution to their problem of being able to sit with difficult feelings and emotions. Ultimately the substance/behaviour becomes a bigger problem in its own right thus leaving the person with two problems – the substance/behaviour and their inability to self soothe. They have to learn to sit with uncomfortableness without ‘numbing’. Mindfulness enables them to begin to learn how to be more present in the moment without preference. Being a member of a group where other people also struggle with being able to sit with discomfort again makes the participant feel less alone, less anxious and less weird thus providing an environment where change can begin to occur.
Often mindful groups take place in neutral surroundings away from the distractions of the individual’s home setting thus allowing the mind to be able to settle more readily. Also if you struggle with feeling distracted it can be very beneficial to practice in a group where you can pick up on the energy frequencies within the group. Calm energy from others may allow the individual to feel more centred. There have been many studies done on the benefits of meditation in communities with the findings often coming back that the ripple effect of the calming properties of group mindfulness can effect whole communities reducing violence and aggression. The group can collectively unify to have a common goal – even if it’s just to be more relaxed.

If you are reading this and think mindfulness in either a group or 1 to 1 setting can help you with your addiction (whether that be to a substance, a behaviour (sex, gambling, overeating, restrictive eating etc) or to a person (codependency) please call me on 07983726647 or email me at victoriaabadi66@gmail.com to arrange an initial appointment.

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Is someone really an addict if they have been prescribed medication for pain and can no longer function without the medication? This is a question I am often asked. They are certainly dependent on the painkiller but they are not necessarily an ‘addict’. They may well need clinical help coming off the substance due to the physical withdrawals they may experience. If they have maintained using the painkiller as prescribed and have not varied from the prescribed regime I would suggest they are not an addict in the sense of addiction being a disease. The addiction as a ‘disease’ model states that an addict will have lost the ability to control the use of the substance: that once they take the first one they will be physically compelled to consume more alongside being mentally obsessed to use more. Many people go into hospital and have to be treated with opiated painkiller. These patients as a rule do not go on and become ‘addicts’. They stop taking the pain killers, feel a little under the weather for a few days and then get up and carry on with their lives. It is those that cannot stop using once they have been given pain killers despite experiencing negative consequences that are ‘addicts’. Doctors are prescribing more and more opiated pain killers than ever before. Those that go on to become addicted to these opiated drugs end up facing many of the same problems as any other ‘addict’. They are not special and different and in some way ‘better than other addicts’ as is often the thought processes of people with addictions to OTC (over the counter) or prescription drugs. This thought process ties into their denial of the problem. Denial is one of the main characteristics of all ‘addicts’. They have moved into what is called non-medical use of OTC drugs and/or prescription drugs. The nonmedical use of a prescription or over-the-counter (OTC) medication implies that the user is using it for reasons other than those indicated in the prescribing literature or on the box label. The abuse of these medications is a national issue. Prescription medications are those pharmaceuticals dispensed by a pharmacist on the presentation of a prescription written by a physician, dentist, or other health care provider who is legally authorized to write prescriptions. OTC medications are pharmaceuticals that do not require a prescription and are sold on the shelves of markets, stores, and pharmacies.

Addiction to OTC medication and prescription medication needs to be treated in exactly the same way as any other addiction. For help with prescription painkillers please contact Victoria Abadi Therapies on 07983726647 or victoriaabadi66@gmail.com

 

 

Is someone really an addict if they have been prescribed medication for pain and can no longer function without the substance? They are certainly dependent on the painkiller but they are not necessarily an ‘addict’. They may well need clinical help coming off the substance due to the physical withdrawals they may experience. If they have maintained using the painkiller as prescribed and have not varied from the prescribed regime I would suggest they are not an addict in the sense of addiction diagnosed as a disease. The addiction as a disease model states that an addict will have lost the ability to control the use of the substance. That once they take the first one they will be compelled to consume more alongside being obsessed to use more. They will continue to use the drug despite negative consequences.

So it appears there are two issues running side by side here. Those that are using prescribed painkillers addictively and those that are using painkillers as prescribed but are struggling to stop because of the withdrawal process. In both instances the need for psychological input will probably be needed. Opiated pain killers affect dopamine levels. Dopamine is the chemical that gets released in our brain when we perform high reward activities like eating, having sex and listening to music.
When you take an opiated pain killer such as codeine the chemicals travel through the bloodstream all the way to your brain where they link up and attach themselves to specialised proteins known as mu opioid receptors. Once this chemical connection occurs, it sends a signal to the ventral tegmental area in the midbrain, which is involved in cognition, motivation and most importantly reward, and from there, the brain dumps a neurotransmitter, dopamine, into the nucleus accumbens. In short this biochemical process, and in particular the release of dopamine creates a feeling of pleasure, even euphoria. This feeling is so pleasurable that it is not unusual for those who are suffering with a pain condition to want to experience this feeling again and again. When it becomes time to reduce and stop the use of opiated painkillers the brain struggles to produce dopamine thus creating low mood, depression, anxiety and insomnia.

If opiates are used for longer than 2-4 weeks, then a lack in natural “feel good” brain chemicals known as neurotransmitters occurs.

Your brain has four primary neurotransmitters and each plays a critical and different role in your health and how you feel.
The four primary neurotransmitters are dopamine, serotonin, GABA, acetylcholine.

So what do they do for you?

• Serotonin regulates sleep and appetite.
• Dopamine is the feel good chemical, plays an important role in mood, energy, attitude, motivation.
• GABA acts as your calming neurotransmitter, helping you relax.
• Acetylcholine for processing information and memory.
• Endorphins are feel good chemicals our bodies release under extreme pain. They are considered the bodies own opiates.
When heroin and other opioid prescription pain relievers are abused for longer than a couple weeks, your brain slowly stops producing these critical neurotransmitters.
When your neurotransmitters are low or imbalanced, like they are almost always after addiction, you will likely feel flat, lifeless, depressed, nervous, anxious, stressed and unable to enjoy the things that use to bring you pleasure and joy in life.

This is the point where seeking help from a counsellor may be important. It can feel like these feelings are never going to pass. Seeing a therapist can help you to develop tools to deal with these post acute withdrawal symptoms in order to reduce the risk of relapse.

If you are struggling with coming off opiated medication and want help from a specialist addiction therapist please call Victoria Abadi Therapies on 07983726647 or email vivtoriaabadi66@gmail.com

Face to face sessions can be arranged in the Hale and Wilmslow area. Alternatively Skype sessions can be offered to those living in areas outside of Cheshire and Manchester.

Over the years I have devised a three tiered way of working with clients. Think of an iceberg divided into 3 parts. The top part of the iceberg is the bit that clients usually present in therapy with. They come to me stating that they are obsessively and compulsively using a substance or addictive behaviour, such as gambling or watching pornography. If they are using a substance such as alcohol or cocaine daily then the first thing we need to work on is stopping that behaviour so that they can become psychologically available for counselling. At this point the work that I may be doing with the client may look and feel more like advice and guidance rather than therapy. This is the bit that is visible. We will look at what support the client can access, what are the barriers to them accessing that support. Helping the client understand that life has to be better clean and sober than it is using or drinking. This looks and feels different to every individual but in my experience has to be about connection to their life and others in some meaningful form or other. It may be a connection to other recovering people, a connection with a hobby such as yoga, running or painting. Again this is more effective in making the client have a sense of wellbeing if they are connected to others practicing/participating in the same thing. I remember one of my clients describing to me the importance of having found her tribe. She had tried the 12 step model of attending mutual aid meetings but had not felt comfortable with this. She went on to use therapy weekly combined with yoga for the next 12 months. Within her yoga practice she met a lot of other likeminded people. She felt connected. She had found a place where she felt she belonged. Addiction more often than not takes a person to a place of isolation. I now understand isolation to be something born from a sense of shame and self-loathing. It doesn’t start out that way. It starts out as using substances on your own primarily so as to not be seen to using too much, not having to explain yourself, an underlying sense that the way your using is not quite right, maybe a sense of paranoia if other people are around, it may even be you just don’t want to have to share your stash. Whatever the reasons may start out as somewhere along the line something changes. That desire to be alone turns into a need to be alone. Facing other people becomes too difficult whether it be due to shame, embarrassment, social anxiety, depression, paranoia, psychosis and the result is the same – addicts spend more and more time alone due to need not want.
Once the client has connected to their lives in some meaningful way the addiction tends to decrease. The next layer of the iceberg is the bit that is just under the water. This is the way the client thinks and feels. It may be that they are reluctantly making connections in their life by attending AA/NA meetings or joining other types of groups as discussed above. At this point my work focuses on why they are thinking in the way that they are and have been doing. It is really important here to remember that addiction is an illness of the mind, a distortion of thinking, hence the reason why it is treated in psychiatric hospitals. Clients are not making life style choices to go and throw away all the good stuff in their lives. They are dealing with thought patterns that are distorting the truth. The number one thought offender that this client group present with is ‘This time it will be different/better! Second offending thought is ‘just this one, I will stop/give up tomorrow’. Often clients presenting at this stage are suffering with a mind that feels like it is on overdrive. It is often described as ‘the washing machine mind’ This is the point where the client is starting to face the reality of the damage they have caused to themselves and everyone around them. They are also projecting into the future worrying about how they are going to move forward and recover what often they have lost – relationships, jobs, driving licence, self respect. For the addict at this stage these relentless thoughts can drive them crazy and the one way they know to shut their mind up is to use their substance of choice. hence this is the point in therapy where we start to look at what tools they can develop to stop their mind racing other than returning to their drug of choice and to the addictive cycle. I use such techniques as mindfulness .https://neuroscienceofmindfulness.com/sympathetic-and-parasympathetic-nervous-system/ This helps the client to begin to focus on the present moment using breathing and relaxation techniques. This starts to bring the body from the sympathetic nervous system (fight or flight) to the parasympathetic nervous system (rest and digest). This helps reduce cortisol; levels thus reducing stress which in turn helps the mind to slow down and become more present. At this point the brain is laying down new neural linguistic pathways that are helping the client to move away from the reward system of the addiction neural pathway to the reward system of using breathing to help feel calm. mindfulness on its own in my experience is not sufficient at this point to slow the mind down. There needs to be a way for the client to challenge some of these negative thought processes. At this point I will use CBT techniques to help the client search out what thoughts they are having that drive them to behave in negative ways. Often these thoughts are below the level of consciousness so it is my job as the therapist to help the client raise these thoughts into their conscious mind so that they can challenge them. Typical examples of negative thought drivers are ‘you’re not smart enough to do that’, ‘you’re lazy’, ‘you’re selfish’. These thoughts often have been fed to the client during early childhood and have become the clients own negative critical parent voice. I will help the client challenge those thoughts by asking if they are behaving in a selfish way today are they being lazy today are you smart enough to do that today. Often the client can find evidence to suggest that because they have stopped using that they are not any of those things in the present moment. Sometimes we will find evidence to suggest that they still are behaving in those ways and that becomes another focus for therapy and helps them change their behaviour.
Once the mind starts to slow down and the client feels like they are less traumatised we can start to look at the final layer of the pyramid. This is the bit that is often deep under the water. This is the part where we explore what has been the initial underlying cause for the client to start using in the first place. It is important to state that this is not always a linear way of working. Sometimes the underlying reason for using is so prevalent that it comes out within the first couple of sessions. I will never close a client down but sometimes it is more useful for them to park it whilst we address the active addiction with a very clear understanding that we will go back to the initial trauma and it is given the important space it deserves. We have to explore that initial discomfort otherwise it will reoccur and the client is then in great danger of relapse. Sometimes it can take a while for the client to stop blaming themselves and saying they only used because they were ‘hedonistic’ or ‘they just liked to party’. Therapy is never about blaming somebody else and always about understanding why things happen and exploring the clients response and coping mechanisms to those events. My experience has shown that there is nearly always some form of trauma underlying addiction. Remember trauma is subjective. What is traumatic to me may not be traumatic to you and vice versa. Once that trauma is identified we can work together to heal that pain by bringing it out into the open. Shining a light on it and helping the client understand that their reaction to the events have not been about them being bad people, morally corrupt people but hurt people who have found faulty coping mechanisms for dealing with that pain. It is often useful to involve the family at this point if they are available and open to being supportive. It is important for them to develop compassion for ‘their addict’ without blaming themselves for their loved ones addiction. Often the family members themselves may need therapy at this time to come to terms with their experience of loving an addict.
Here at Victoria Abadi Therapies we understand that the process of recovery can take time. We are currently working from premises in Hale, Altrincham and Wilmslow to provide the above services.

Part 1. Instinct or Paranoia?

A question I’m often asked in my line of work is what is an ‘adult child of an alcoholic?’ The term became more widely used when American psychologist and researcher Janet G Woititz wrote a book in 1983 about growing up in a family where one or both parents are addicted to alcohol. In its very simplest terms the child of an alcoholic grows up to become an adult child of an alcoholic. In her book she recognised that these adults tend to have a set of similar characteristics and a similar way of behaving and responding to situations.

One of the primary characteristic of these adult children is being hyper sensitive to atmospheres. When you grow up with an alcoholic you grow up with unpredictability. It is in your best interest as a child to be able to gauge what mood the alcoholic parent is in and thus adapt to the behaviour that will bring the least amount of criticism your way. That criticism might manifest itself verbally by the parent or it could be acted out physically with some form of physical violence being meted out. Whichever way that unpredictability gets acted out that child learns how best to adapt to survive and brings the skill or curse of being hyper aware of moods and atmospheres into their adult life. If I had a pound for every time I heard an ACOA (adult child of an alcoholic) say ‘I can’t trust whether it’s my gut instinct or paranoia that’s telling me to react in a certain way’ I’d be a rich woman. What they actually mean by this is:- that they have learnt to assess a situation they walk into immediately through the atmosphere and mood in the room. They are often correct in their judgement but because trust is in short supply in addicted families it’s hard for them to figure out if it’s a true assessment of the situation or whether their lack of trust is making them feel paranoid and therefore scewing their judgement of the situation. So here’s an example….an ACOA walks into a room full of her friends. She trusts most of them implicitly but one of her friends has always reminded her of her alcoholic mother. The reason for this is that if she doesn’t behave in a way which her friend approves of she withdraws her affection. She is unpredictable like her mother. The young woman senses some kind of vibe in the room. She thinks the one friend she doesn’t entirely trust has been saying unkind things about her. She thinks this because she has walked in the room and scanned it for mood and atmospheres the minute she walked in, just like she did every time she walked into a room with her mother in it when she was a child. When she was a child if her mother was drunk there was a good chance she would be verbally attacked and criticised. So she has learnt to do this in all situations in order to protect herself. This was a skill she needed as a child. As an adult that skill can cause her to pick up on things that aren’t always happening. So she walks into the room with her friends and immediately feels on red alert, on the defensive. She asks herself is this a dangerous situation or is she being overly cautious to the point of paranoia. She doesn’t know. She can not fully trust her gut instinct because of past experiences. She feels confused and different. A feeling she has often felt. Feeling different is another characteristic that most ACOA’s experience.
So how does she learn to trust her judgement? She needs to understand that what she is feeling is normal due to the experience she has had as a child. She needs to learn how to communicate effectively with the people close to her so that she can truly figure out who she can and can not trust. She will also be enormously helped by going through counselling in order to heal from the trauma of growing up in an alcoholic household. She may well also benefit from attending a 12 step program called Adult Children of Alcoholics. This is a fellowship of men and women who have survived growing up in an addicted family and come together to support themselves through experience strength and hope.

If you have grown up in a family where one or both of your parents had a problem with alcohol or other substances then you may want to seek help with a counsellor who specialises in addiction and its associated traumas. Victoria Abadi therapies is a busy counselling service which specialises in addiction. We are based in Hale, Wilmslow and Northenden. To contact us please email victoriaabadi66@gmail.com or call 07983726647