Helping the Addict to Fail: Psychotherapy Before Hitting Bottom | Dr. Thomas Mallouk | MC4 W10b

Thomas Mallouk, Ph.D. A practicing psychologist since 1976

This workshop will show that there's a great deal that can be done to help the actively using addict shorten the duration of the active phase and also minimize the damage done during this phase. This presentation hinges on the idea that the addict needs to “hit bottom.”

“Hitting bottom” is conceptualized in this workshop as failing in one's own eyes. Most of the workshop will be spent articulating an understanding of addiction from three perspectives: intrapersonal, interpersonal, and pharmacological. These perspectives are interlocking and form the circular nature of addictive processes. These perspectives also will become a guide in developing an understanding of what is possible to do and say that will not inadvertently collude with the addict. If you love somebody, in the world of addiction doing whatever comes naturally is often the wrong thing to do.

The final part of the theoretical presentation describes an alternative therapeutic position based on this understanding of addiction. I have developed the concepts of therapeutic doubt and immunity from disappointment as the hallmarks of the therapeutic posture that will increase the likelihood of helping an addict to fail. Therapeutic doubt refers to the belief in the possibility of control that is part of the denial system of the actively using addict. Immunity from disappointment is designed to insulate the actively using addict from the relational consequences of disappointing someone. Addicts are often so acutely distressed by letting another person down that the only way to get comfort, however temporarily, is through their addiction.

Participants in this workshop will come away feeling empowered to engage with actively using addicts and their families in psychotherapeutic conversations which help the addict to fail so that they can begin the process of recovery.

Education objectives:
1. To understand “hitting bottom” as an epiphany that one has failed in some profound way
2. To discover the connection between “hitting bottom” and the beginning of recovery
3. To appreciate the concepts of therapeutic doubt and immunity from disappointment

To appreciate addiction from intrapersonal, interpersonal and pharmacological perspectives

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