Communication is essential to treatment. It’s the lack of honest communication that is frequently one of the biggest stumbling blocks in reaching and maintaining sobriety.
There are several reasons why a person might not communicate effectively. Sadly, one of the most common reasons is a by-product of addiction itself. Let’s examine an addict entering treatment. She’s hit rock bottom and wants to end the cycle of abuse. Her nerves are shot, her ego is fragile and she probably hasn’t had a restful night’s sleep for longer than she can remember. She’s a wreck. Now, she deeply wants to please her family, her therapists, and even her fellow addicts, so much so that she will tell them whatever they want to hear, even if deep down inside her soul is screaming otherwise.
I recently came across a 2017 article in the Atlantic Magazine, “What Your Therapist Doesn’t Know,” written by Tony Rousmaniere, a leading psychotherapist. In the article, the author described a situation with a patient, who was struggling with suicidal thoughts and who, for all intents and purposes, seemed to be improving. However, after reviewing results from a recent survey completed by the patient, a predictive program indicated a near-emergency situation. The therapist was skeptical but decided to more actively engage the patient in the next session.
As the therapist probed, the patient opened up, saying, “I’m sorry, but I think I’m worse. I just don’t want you to think it’s your fault; it’s mine.”
This article reinforced a study from Western Journal of Emergency Medicine I read about in the latest US Surgeon General’s report on addiction. People “were found to be significantly more likely to disclose their substance use at a kiosk compared to a health care professional or other interviewer.” In other words, they are more likely to open up to a nameless, faceless computer than they are to another human being.
Thankfully, in the instance shared in this article, the therapist was openminded enough to delve more deeply. The therapist and his patient began to communicate with one another, and it saved the patient’s life.
This problem was further illuminated in the Atlantic Magazine article. In a typical psychotherapy environment, it’s been proven over time that around 8% of patients will get worse. However, in one study involving 48 therapists with several hundred clients, the therapists predicted that only three of these patients would deteriorate. The study findings revealed that over 7% of the patients (over 40 out of 600) actually experienced a decline. That was considerably more than predicted. Why?
One explanation could be the therapists’ overestimation of their personal abilities. It seems more likely, though, that the greater cause was the patients’ desire to please their caregivers, to the point of fooling them into unrealistic expectations. Once again, this block to open communication prevented them from getting the benefit of treatment.
The essence of the issue is as follows: when are we truly willing to say exactly what’s on our mind? Most of us typically hedge our replies or simply stay silent to avoid uncomfortable subjects and circumstances. Those defense mechanisms are counterproductive in addiction treatment. You can’t merely follow the program by rote and expect an effective long-term impact.
What do you mean? You might wonder. I followed all the rules. I did one-on-one sessions with my therapist, I attended group meetings and even went to AA/NA when I finished treatment. I participated, I did what everyone said. What do you mean I wasn’t communicating?
You need to get involved. Communication requires a connection, taking things to heart, actively embracing ideas and concepts. If you’re not improving, then speak up. If you feel like you want to use, let someone know. That’s what therapists need to know. We’re only human, and through the entire treatment, we are an everchanging work in progress.
Which now brings us to, well, us. Are you or a loved one struggling in recovery? Are you in mid-therapy or just about to start? If so, now is the time to re-examine the treatment process.
Go in willing to expose your soul and your deepest, darkest secrets. It’s a safe environment. You need to actively listen to what everyone else has to say and be brutally honest with yourself and others (without being hurtful, of course). You need to let therapists know exactly how and what you’re feeling despite treatment, including if you are angry, in distress, or at the end of your rope.
Finally, ask questions and admit when you don’t understand. The only stupid question is the one you don’t ask. Therapists aren’t mind readers. They need you fully involved in your own treatment. With the “art of communication” in place, you will be better prepared to succeed in your long-lasting recovery.
Gilbert J. Fiorentino, JD founded TigerDirect, which, with the acquisition of CompUSA and Circuit City, grew to nearly $4 billion in sales worldwide, as part of a NYSE company. He is a philanthropist, former adjunct professor of business law at the University of Miami and has undergone over 600 hours of drug and alcohol addiction treatment in federal prison, where he is serving a sentence for failing to report his full income while CEO of TigerDirect. He has spent the last five years reading, writing and becoming a spokesman in the battle against addiction.
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