For many people – those working in the addiction field, or those experiencing an addict in their lives – it can feel frustrating that the addict keeps using.  We might feel they are being selfish, lazy, and irresponsible. We ask ourselves, “who would put up with not showering, living on the streets, stealing, selling themselves for sex, injecting their heroin with dirty puddle water, and on and on?”  “Those people are disgusting!”  “I can’t stand addicts!”  “I hate working with addicts, they’re always trying to get something from me!”  These are just some of the lines running through our heads at times.  The last thought is “why don’t they stop?”  The million dollar question.  Some answer through a biological explanation, others an adaptive explanation, others a spiritual explanation, and some a social learning explanation.  It is all of these.  But for this essay I want to focus on a more adaptive explanation and one that is more concerned with an ongoing internal process in the here and now, one that concerns itself with the meeting of human needs.

It’s obviously hard to have compassion for those abusing substances.  But, really, that is the easy reaction to have.  Staying there only keeps one in the dark about the addict and about themselves.  Dr. Wayland Myers, PhD, has written a document about “Defining a Nonviolent Communication Approach (NVC) to Addictive Behaviors.” In this he explains how Marshall Rosenberg, the founder of NVC, tries to approach the addict by using empathy and trying to understand what needs are being met by using.  He does not try and get addicts to stop using.  Substance abusers are usually quite perplexed by his approach because they are used to everyone trying to get them to stop.  His focus is on needs so that he can proceed in helping that person meet those needs in ways that are “more effective and less costly.”  This is not easy for many people in our society as we want to FIX people.  It is tough to give up coercive measures, confrontational approaches, and parental directives.  As helpers or loved ones we can often feel helpless, out of control, and frustrated within the paradigm of judgment and control because it becomes a negative feedback loop. Pushing our goals onto someone else may work in the short term, but usually, though, backfires, and can often perpetuate disconnection, a need all humans value.

So why do we continue to stay in this place where we NEED substance abusers to stop? Why do we work so hard FOR SOMEONE ELSE?  Why do we feel so out of control? Why do we get frustrated, angry and hurt by their use?  It is usually more to do with our own needs not being met.  As helpers, we must connect with our own needs in order to connect with another’s.  It is also a paradigm that we are in that using is wrong and we must “intervene”, we must “challenge” them, we must, we must, we must.  “They don’t know how to live life”, “they are irresponsible”, “they have mental health issues”, “they have a brain injury”, “they are still a child”, “they experienced trauma” – ultimately we are invading their sense of humanity, their internal world, their “creative adjustment” as described in Gestalt psychology. Using, for many, has been a very creative way to cope, adjust, and stay alive.  It has become an organismic adaptation to life experiences. Why do we want to pull this carpet out from under them so quickly and harshly??

Instead of making all these assumptions and judgments, we need to “connect” with addicts as in NVC, or make “contact” as in Gestalt psychology. Take away the stories, take away the judgments, and learn what is there.  What need is being met by all this using.  Can we help this person make contact with their own internal world so that they can at least value their own world?  Shame is the result of continuously denying one’s own experience.  We can blast away shame by listening, connecting, and helping those who use to become more in tune with their needs and their internal worlds.  We must remove our judgments and need for control so that we can offer humanity to someone.

From an existential point of view, it is that person’s responsibility to take control of their life how they see fit.  From a person-centered and gestalt psychology point of view, all human beings are moving toward growth in some way.  We can either help them get there taking which ever roads fit best for them, or we can weigh them down on the road of addiction. The more we focus on getting them to stop the addiction, the longer they only focus there and stay on that path.  The quicker we begin walking with them on that path instead of hurrying them off, the quicker they will want to explore other options.  Once someone feels truly supported and understood they will feel the energy to take on new experiences.

So, what are their needs? How can you help them connect to their needs?  If you are addicted, how are you not connecting to your self?

Lastly, I want to make a quick point here about boundaries.  Nowhere in this approach or understanding does it say let substance abusers or anyone for that matter treat you however they feel like it.  You do not have to just sit there and accept all behavior toward you to be compassionate.  It is important for all humans to connect to their own needs and express these honestly.  So if you are feeling manipulated, hurt, taken advantage of, etc, then calmly express this to the person so they understand.  We must meet our needs as helpers as well and do not need to allow dysfunctional ways of relating to hurt us for the sake of “compassion.”  This is not how it works.  The compassion and connecting are to the person and the unmet needs, not to allowing yourself to be treated in ways you don’t want.

Post written by: Jason McCarty, Outpatient Therapist