In the last several years it has become more and more clear in the media as well as within the mental health profession that addiction has become an out-of-control epidemic, especially addictions to meth, opioids, and heroin.
I supervise post-grad interns who work with this population (addicts of all substances), many of whom are homeless and/or ex-incarcerated. Most of these clients have years, if not decades, of addictive patterns of behavior well established, such as lying, cheating, and portraying some level of aggression or passive-aggressive behavior. Many are dually diagnosed with other mental illnesses and have suffered various traumas during the course of their lives.
These entrenched behaviors often become like masks or shields for the people living inside of them, seemingly impenetrable to those working with them. So many layers of harm from others, self harm, and harm done to others are woven into the horrific disease of addiction, that it seems extremely difficult to unravel and find the human being strangling inside.
Exploring beneath this quagmire of addiction requires the willingness to suspend judgment and presumptions about the limitations of hope placed on or by this person. Societal norms and personal records of misconduct have put boxes of low expectations on addicts. To find the real people hiding in these boxes is the primary challenge of therapy, as I see it. As we go about the careful process of doing so, we need to help that person exposed learn to not be afraid of who he or she really is, but to have the courage to heal and embrace the broken goodness within.
Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.