The Heart of Addiction:
An Emerging Paradigm for Understanding Addiction
Presented by Jack Perkins
December 16, 2020 | 1:00pm - 4:15pm CST
Learning Level: Intermediate | 3 Clinical CE Hours
Target Audience: Counselors, Social Workers, Clinical Psychologists, Addictions Treatment Professionals
CE Details
This program has been approved by the Louisiana State Board of Social Work Examiners for 3 Clinical continuing education credit hour for social workers through Tulane School of Social Work.
This program has been approved for 3.0 continuing education clock hours by the Louisiana Counseling Association as authorized by the Louisiana Professional Counselor Licensing Board of Examiners.
About the Workshop
In the past, clinicians who worked with clients with substance abuse issues focused primarily on cognitive and behavioral issues related to “addictive patterns of thinking”, recovery skills, relapse planning, and the twelve steps. Based upon my studies and experience, I have come to believe we must address the underlying issues of addiction, often attachment disorders.
The work of Louis Cozolino, Philip Flores, Larry Crabb and many others stress the importance of healthy relationships as a significant key to a meaningful life. The moralistic model regarding addiction asks, “What is wrong with you?” A better question, one that will help us understand the heart of addiction is, “What happened to you?” This question invariably is answered by talking about deep wounds caused by unhealthy relationships.
Vincent Felitti attributes adverse childhood experiences that have resulted in poor attachments and poor emotion regulation as a high-risk factor for addiction. Kathy Brous says, “alcoholics in particular may be born with a sense of separation (perhaps borne out of genetic impairment) which results in neurotransmitter deficits.” In a paper, "Amygdala Volume and Social Network Size in Humans," the authors report that amygdala volume correlates with reported social network size and complexity. (Bickart, et al., 2010) When considering what has been learned about the brain and “what works,” a new way of looking at addiction and recovery is needed.
The foundation for this presentation has grown out of personal experience. Since 2007 I have worked in residential facilities for those struggling with co-occurring issues, mostly with women. Invariably, at least 95% of those served present with abandonment issues, family systems void of emotional bonding, trauma that has destroyed trust, major losses, and a host of other issues that often result in self-medication.
While serving as the Admissions Director at Rose Rock Recovery Center (Vinita, OK, USA), a trauma focused residential facility for women, I developed a loss and relationship group to address underlying issues to addiction and mental health issues. Each time there was a schedule change staff and clients insisted we keep the Loss and Relationship group.
Co-joined to findings from my field experience, was a growing desire to seek supportive evidence. Philip Flores has worked extensively with this model. He references his clinical experience and research demonstrates the efficacy of attachment theory’s role in maximizing the potential for treatment for substance abuse disorders. (2006)
When reviewing books and research articles related to the correlation between attachment disorders and substance abuse disorders, it becomes clear that this warrants special attention by treatment providers. A research project by Yasmin Borhani (2013) found that participants who exhibited high levels of insecure attachment in their romantic relationships have a higher tendency to abuse substances.
Schindler and Bröning used medical and psychological databases and identified 10 adolescent and 13 adult studies regarding substance use disorders (SUD). They demonstrated empirical evidence strongly supporting the correlation between patterns of attachment and SUD. As anticipated, more studies are needed utilizing SUD assessments that measure attachment disorder.
Until we have treatment that understands the role attachment disorders have on substance misuse disorders, we will continue to have people enter treatment because of poor attachment models. I like to use the analogy of a medical doctor continually prescribing antibiotics but failing to identify the source of the infection. Healing and prevention depend upon helping clients deal with their losses, hurts, and poor relationship building skills.
Attendees will learn how to:
- Learn how to orient clients to the use of contingency management in psychotherapy
- Be able to demonstrate use of effective contingency strategies
- Conduct basic behavioral analysis to reinforce new effective behaviors
- Understand the role of validation and soothing in extinction procedures
The presenter has disclosed the following potential conflicts of interest or involvement in commercial interests: None
About the Speaker
Jack is the founder of Psuche Education, Counseling & Coaching Services. He has 16 years in the field of substance disorders and mental health, primarily with the Oklahoma Department of Mental Health and Substance Abuse, where he served as the Admissions Director at Rose Rock Recovery Center, a female residential facility for women with co-occurring issues, utilizing the Sanctuary Model. He served as the Executive Director at Clay Crossing, a faith-based co-occurring residential facility for men. In addition, he has done contract work and served as a consultant for MONARCH, a residential facility for women. In his doctoral dissertation/project he integrated spirituality, human development theories and psychotherapy. He is currently compiling a book about his philosophy of counseling, including types of groups and presentations he utilizes in a residential setting for those struggling with co-occurring issues. He developed the Together We Thrive, a K-12 program designed to identify at risk children and develop initiatives to assist them. He has 30 plus years of professional experience from a broad range of experiences (i.e., workshop presenter, adjunct teaching, substance disorders and trauma specific counseling and training, administration, research, program development, institutional assessment and development, community service, leadership development, reentry/criminal justice, chaplaincy, etc.).
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