PART III. Treatment of

Addictions and Addicts

Problems with Traditional Approaches to the Treatment of Addictions

• 1. Physiological chemistry and its unbearable driving sensations arising with overwhelming force before conscious rational beliefs and strategies can be invoked and intervene dictate that the addict will eventually, always, fail to inhibit the addiction behavior.• 2. Inner, unresolved, repressed, past personal conflicts that engender unbearable emotional pain which is exclusively reduced by object of the addiction and is therefore a prime catalyst of the physiological process cited in (1.) will continue its pattern of resurgence and pairing for accelerating, cumulative causative drive toward the addiction behavior. Medication, education, rational strategies and beliefs, and group pressure and/or support will have no effect on this major, perpetual source of addiction behavior.• 3. Idiosyncratic social situations and pressures that are triggers for the inner addiction drives can rarely be excluded from occurrence, even in an institutional environment and will, therefore, always be a potential source to invoke factors (2.) and (1.). Furthermore, the person with these unresolved conflicts is always (unwittingly because they are repressed) searching for these precipitating triggers because they are trying (again unconsciously) to find a scenario in which they are trying to master that type of situation and its accompanying trauma.

THE THREE PRINCIPLE FACTORS PREVENTING SUCCESSFUL TREATMENT OF ADDICTION

Diagram of the Three Factor Theory

1. Physiological

2. Repressed Psychological

3. Social, Triggering Situations

Separately and Together, the Three Factors Result in Blind, Relentless Compulsion to Repeat Addiction Behavior.

These three factors can combine for a cumulative, intensifying effect that blindly and relentlessly impels the addict toward the objects of addiction, regardless of how severe the consequences are in the short or long term.

•Professional Stigmatizing

•‘Recipe” Programs Eliminate Majority Who Do Not Fit

•Identity And Dynamics Of The Addict

•Language Traps

•Ego Strength Development Traps

•Recurring Melodramas

•Advice That Pushes The Addict Into The Abyss

AA And Twelve Step Types Of Approaches

•Three Factors Involved In Prevention And Treatment Of Addiction

•1. Physiological.

•Inform people concerning the entire longitudinal course from seduction, through all physical and psychological experiences, to intransigent addiction.

•Expose and inoculate people against seduction and use enactment of strategies for dealing physical sensation and for extricating oneself at each stage.

•2. Repressed Psychological

•Always encourage openness and accept non judgmentally the surfacing and confession of any troubling repressed psychological difficulties.

•Provide strategies for dealing with horrible emotions and compelling ego states.

•3. Social, Triggering Situations

•Expose and inoculate people against seductive people, their roles, typically sites for seduction.

•Provide training in alternative responses to triggering situations and people and dealing with the consequences of using them.

•Non Traditional Treatment Of Addictions

•Opening people up to possibilities and potential of alternatives to AA and 12 Steps.

Alternatives To AA Types Of Approaches

Treatment of Addictions and Addicts in a Non Traditional Manner

How to Change Structures in Institutions and Programs

To Facilitate Treatment

Dealing with Underlying Processes and Dynamics and Contributing and Perpetuating External Structures

versus Dealing with Symptoms and Providing Ballast's for Ego Weaknesses

UNDERLYING PROCESSES AND DYNAMICS

PERPETUATING EXTERNAL STRUCTURESSYMPTOMS

CURRENT FOCUS

DISTORTED SCHEMATA

DYSFUNCTIONAL SCHEMES

UNDERDEVELOPED, RIGID, INACCURATE MODES OF ASSESSMENT

DISCREPANT REGISTERING OF HEDONIC TONE

AGONIZING, DISRUPTIVE EMOTIONS

MIS-ALIGNED ITEMS IN INCORPORATION STATES

RIGID, SELF DEFEATING, CRITERIA FOR FULFILLMENT AND PROCESSES OF ENVISIONING, UNDERDEVELOPED, INEFFECTIVE ENVISIONING PROCESSES

DISTORTIONS OF TIME AND LEVELS OF PERSPECTIVE

INAPPROPRIATE AND INEFFECTIVE BEHAVIOR PATTERNS

DYSFUNCTIONAL PATTERNS OF MONITORING AND MIRRORING

INEFFECTIVE RELATION TO AND USE OF FEELING AND TIMING FEEDBACK SYSTEMS

UNRESOLVED ISSUES

BEHAV IOR

NEEDED REORIENTATION OF FOCUS

•Similarities And Differences Between Substance, Sexual, And Psychological Addictions, Panic, And Compulsions

•Differing Physiological Processes With Different Substances And Non-Substance Addictions

•The Dynamics Of Taking Multiple Substances

•Different Withdrawal Symptoms

•Different Relapse Timing

•Different Internal and External Triggers

Dealing with Physiological Processes Underlying Different Types Of Addiction

Intentional Processes RevisitedSchemata and Schemes

• Revising Intentional Processes in Contexts• Identifying How and Why The Contexts of the External Environment Are Internally

Represented in Memory As Schemata and Beginning to Alter These Representations.• Identifying How Schemata Typically Take the Form of Settings and Their Constraints

on Behavior and Situations That Are Typically Tied to Particular Settings and Recognizing One’s Options to Change One’s Behavior.

• Recognizing How Schemata Are Matched With Behavioral Schemes Suitable to the Setting and Its Constraints and Situations and Recognizing One’s Options to Change.

• Recognizing That These Schemata Include Identities That Have Evolved Conjointly and Have Been Attributed to the Self in Various Settings and Situations and That One Can Shake off Old Identities and Reconstruct Different Ways of Being.

• Recognizing That Identities Have Come to Encompass the Assignment or Assumption of Roles and These Roles Typically Entail Role Specific Behavioral Schemes and That Identities, Roles, and Behavioral Schemes Can All Be Changed.

• Recognizing That Parallel to Identities, the Self Also Adopts Self Concepts That Entail Behavioral Schemes That Are Consistent With or Contrary to the Self Concept and That Both Self Concepts and Their Entails Behavioral Schemes Can Be Changed.

• Recognizing That Situational Identities Can Evoke or Demand Behavioral Schemes That Are Contrary to Those Required by the Self Concept and This Dilemma Invokes a Sense of Loss of Integrity and Guilty or Shame and That by Adopting the Posture of Transparency, Integrity and Authenticity Can Be Regained.

• Recognizing That Since Schemata and Schemes Remain Relatively Constant Over Long Periods of Time and Are Rigidly Defended Against Change, Dedicated Effort Must Be Marshaled and Directed at All of the Intentional Processes and Environmental Structures If Changes Are to Be Successfully and Enduringly Made.

•A Personal History Chronolog

•Use of self reflexivity and journalizing

•Use of retroflexivity and journalizing

•Re-Shaping the Inner Child’s View Of The World

•Identifying One’s Internalized Parents by their Effects and Grasping their effects on one’s personality

•Inferring The Influences Of Implicit (Internalized) Parents From The Addict’s Behavior

•Grasping and beginning to overcome The Tyranny Of Internalized Parents

•Grasping The Origin Of Inauthentic Public Personality

•The Competing Effects Of Implicit Parents And The Inner Child

•Loving, Accepting, And Nurturing The Inner Wounded Child

Revisiting and Focusing on the Role of Family and Childhood Developmental History in Addictions to

Break the Hold of Past Patterns

Your Attitude to Yourself at the Core of Your Being is Determined by the Attitude of Your Implicit Others Toward You and

Is Reflected in Your Reaction to Yourself as a Hypothetical Baby

If this is a baby, and you have just seen the baby, what might your primitive, initial feeling reactions be?

Now let’s try and pretend that you are both a baby and yourself at the a same time and you are now looking at yourself as the baby. NOW, what might YOUR primitive, initial feeling reactions be toward YOURSELF as that baby?

Any BabyAny Baby

Yourself as the Baby you are looking at.

Identifying and Isolating the Effects of the Negative Implicit Other

Grasping How Perceptions of the World Were Shaped and Seeing

Alternative Ways of Seeing the World

IMPLICIT OTHERS’

ATTITUDE TO SELF

SELF

SELF’S ATTITUDE TO

SELF

WORLD’S ATTITUDE

TOWARD SELF

ATTITUDE TO SELF PROJECTED

ONTO THE WORLD

IMP

LIC

IT O

THE

RS

’ ATT

ITU

DE

TO

SE

LF

PR

OJE

CTE

D O

NTO

TH

E W

OR

LD

Altering the world view

Reconfiguring and practicing new modes of assessing the internal and external worlds

Regaining contact with original, pristine individuation

experiences

Reassigning schemata and schemes to different states of

incorporation

Supplanting the Implicit Others’ Attitude to Self and Generating a New Attitude to Self and the Attitude to Self

That Is Projected Onto Other People

•Intimacy-Ambivalence And Addictions

•Mutual Self Destruction In Love Relationships

•Boundaries, Borders, And Authenticity In Relationships

•Differentiating Between Self And Other

•The Cycle Of Co-Dependency-Depression-Resentment-Rage-And Addictions

•Detecting And Altering Inner, Personal, Criteria For Fulfillment In The Relationship

•Emancipation From Attachment To A Parent Before Forming Adult Love Relationship

•Friends And Social Situations Versus Isolation As Triggers

•Unrelated Situations That Accidentally Become Triggers

•Re-Engineering Situations And Relationships In The Treatment Of Addictions

Dealing with Social and Intimate Relationships and Situations That Act As Triggers

•The Addict’s Inner Pain And Emptiness

•Anxiety And Dealing With Anxiety

•Rage And Dealing With Rage

•Transformations From Anxiety To Fear To Rage

•Dynamic Inter-Changeability Of Rage And Depression

•Traumatic Life Experiences As Perpetual Triggers

•The Addict’s Living Nightmare

•The Function Of The Addiction In The Suppression And Release Of Emotion

•Detecting Cycles In Relationships, Emotions, And Behavior In Addictions

•Learning To Live With Emotions

•The Transformation Of Emotions Into Feelings You Can Live With

Dealing with Trigger Emotions and the Dynamics in the Treatment of Addictions

Emotional independence

Adventuring into the unknown and remaking oneself

Public versus Private Self

e. young, PhD

A GRAPHIC DEPICTION OF

THE DIVID

ED PERSONALITY

InhibitedInner Child

WALL

Situational

Identity

Socializing

Situational Identity

At Work

Private

Person

SO

CIA

LE

NV

IRO

NM

EN

T

Inauthenticity

Situational

Identity At

Home

Authenticity: Requiresexiling Implicit Others,recovering Inner Child,and letting true feelings,

preferences, andcompetencies creativelyassert themselves in the

mature adult.

Repressed

Trauma

Child

Differences between

Private Person and

Public Personas in

various contexts

results fromconstellations of

Implicit Others .

PUBLICPERSONAs

Dealing with Identity, Situational Identities, Self Concept: The Zelig Syndrome

Each situation calls for the self to be different from every other situation. Situations A, B, C, and D call for beliefs and behaviors and identities that are inconsistent with each other. If the people in A are opposed to the beliefs and behaviors in B and find out that Zelig’s identity has changed to fit in with B, they may call Zelig a phony or traitor and pressure or disown him. The same would be true for inconsistencies and contradictions between adopted identities for all situations (A, B, C, D) that are in conflict. Zelig will feel spineless, worthless, hypocritical, fearful of being found out, and feeling as though he has no core, can never be himself, would rather be dead.

Situation A

Situation B

Situation C Situation

D

Zelig’s Identity A Zelig’s identity B Zelig’s identity C Zelig’s identity D

Now he asks? Who am I anyway?

MODES OF BEING, EGO STATES, AND EGO FEELINGS:

THEIR DESCRIPTION AND USE IN PSYCHOTHERAPYEgo state, modes of being, and ego feeling are all related concepts referring to intrapsychic phenomena

that are extremely difficult to discern because awareness is directed primarily toward the extrospective, exterospective, and exteroceptive and secondarily toward the introspective. These ego state concepts require focus on the immediately past introspective, introceptive and interoceptive and their mutually causal relation to the extrospective, exterospective. This ego state concept is related to modes of being in the world. The world is conceptualized in a manner unique to each individual. Regardless of the way others perceive the world, each individual’s conception of the world is imposed on almost every situation and setting. Contrary impressions are simply re-interpreted and rationalized. Since the world has this certain character, the individual accommodates or adapts their feelings, expectations, goals, and behavior to suit the world view. If the world is conceived as dangerous, ruthless, exploitative, and vindictive if crossed, the individual will feel and behave suspiciously and cautiously. The person may move through the world as though moving through enemy territory: wary, vigilant, attempting to anticipate and prepare for all possible negative eventualities. Below are three examples of the relations between one’s World View or Schemata for the World and one’s Mode of Being in the World. Mode of Being in the World is a generalized, more or less permanent state, that specifies and limits the kinds of ego states the person will have. The ego state brings with it an ego feeling. If the ego state is preparation for a fight, then the person may sense the feelings that result from an adrenaline rush. The person may also perceive that others react in an intimidated manner. These two concomitants may be experienced as pleasant, powerful, and exciting. These effects may tend to reinforce the ego state and create a desire for repetition of the experience.

EXAMPLES OF RELATION BETWEEN WORLD VIEW AND MODE OF BEING IN THE WORLD

Mode of

Being

SCHEMATA for the

WORLD

Bleak

Pessimistic

SCHEMATA for the

WORLD

Mode of Being

Indulgent, Kind and Lenient

Pollyanna

Hostile and Exploitative

Belligerentand Defensive

SCHEMATA for the

WORLD

Mode of

Being

•Ego States-Ego Feelings-Modes Of Being- And Their Use In Treating Addicts

•Splitting And Polarizing Self Esteem Into Public Versus Private

•The Curse Of Urgency And ‘Having To’ Feelings

•The Limits Of Will

•What The Addict Does And Does Not Incorporate And Own

•Searching For Causes And Blame In All The Wrong Places

Dealing with Trigger Ego States and the Dynamics and the Treatment of Addictions

•The Pit of Agonizing Emptiness

•Public Vs Private Personality

•Our Grizzly Twin

•Public-Private Split And Regaining Authenticity

•Compelling Role Networks

•Authenticity And Freedom From Addiction

•Breaking Free And Facing The Unknown You

•Emotional Independence

•Serenity and Transcendence

Dealing With Personality Factors and Social Roles and Scenarios Involved in Treatment of Addictions

•The Nature And Value Of Roles

•The Role Of Roles In Relationships

•Roles And Practice

•Roles And Maturity

•Role Specific Behaviors And Incorporation Of Positive Character

•Roles: Channeling Un Socialized Behavior Into Pro Social Behavior

The Use of Alternative Roles and Relationships

in the Treatment of Addictions

Treatment Agents’ Function in Replacing then Exiling Negative Implicit Others

• Identifying Evidence of the Inner Effects of Negative Implicit Others

• Identifying Situations that Evoke the Negative Implicit Other

• Replacing then Assisting in the Exiling of Negative Implicit Others– Treatment Agents and Addict Learning to Identify and Reverse Attribution

Patterns Incorporated from Parents (Implicit Others)

– Identifying Legacy Interaction Patterns, Repetition Scenarios• Need for Approval and Disapproval

• Need to Set Expectations and Disappoint and Frustrate Helpers

• Need for Nurturing and Rejection or Abandonment

• Need for Success and Resentment over Lack of Appreciation

• Need for Persecution and Rescue

• Need to be Exploited and to Exploit

• Need to be Slighted and Passive-Aggressively Seek Revenge

• Need for Melodramatic Martyrdom and Proof of World’s Insensitivity and Injustice

Addressing and Altering the Sustaining Structural Characteristics of the Environment

• Identifying Characteristics of Treatment Environments That Are Inconsistent With and Undermining of Treatment Objectives

• Identifying Structural Elements in the Treatment Environment That Facilitate Ego Growth and Replacement of Negative Implicit Others and Negative Interaction Scenarios

• Facilitating Re Education Emotional Expression in Public Situations– Learning to Differentiate Emotions and Feelings– Learning to Identify Pseudo Incorporated Positive and Negative Feelings– Learning to Identify Pseudo Dis Incorporated Positive and Negative Feelings– Learning When to and When Not to Trust Perceptions, Feelings, and Intuitions

• Facilitating Learning to Differentiate Between Imposed Criteria for Fulfillment Versus Personal Criteria for Fulfillment

• Facilitating Learning When to Accommodate and When to Resist Demands and Requests of Authorities, Peers, and Romantic Partners

• Facilitating Learning Balance in Dealing With Boundaries, Borders, Limits, and Territories

• Facilitating Learning Balance in Dealing With Openness, Transparency, and Authenticity Versus Rudeness and Lack of Diplomacy

• Facilitating Learning Balance in Dealing With Empathy, Understanding, Non Judgmental Acceptance Versus Co-dependency, Sympathy, and Gullibility

•A Model Of Addiction: Unresolved Conflicts And Intentional Processes

•A Model Of Inner Processes•Addressing The Brain, Intentional Processes, And Addictions•Use Of Intentionality Model In Psychotherapy•Definition Of Specific Intentional Processes

•Use Of The Intentionality Model In The Treatment Of Addictions

•How to Distinguish Intentional Processes•How to Converge On Maladapted Intentional Processes•How to Open the Way for Self Reflection and Correction of Each Intentional Intentional Process

Addressing and Altering Inner Processes In The Treatment Of Addictions

THERAPY ADDRESSING BRAIN COUNTERPARTS OF INTENTIONAL PROCESSES: RIGHT HEMISPHERE FOCUS

.Therapy Addressing Brain Counterparts left Hemisphere Focus

THERAPY ADDRESSING BRAIN COUNTERPARTS OF INTENTIONAL

PROCESSES:

Life Goal Analysis, Deciding and Goal Setting

Planning, Taking Perspectives on Time, the World, and Strategies

Foreshadowing

The New Treatment Model Emphasizing Transformation of Intentional Processes and Personal Criteria For Fulfillment

– A Model for the Envisioning Process• Themes Of Incompleteness And Dream Interpretation In Psychotherapy

• Revising Self Estimation and Accepting Self Preferences and Values

• Revising World View

• Revising Temporal Perspectives

• Revising Unconscious Envisioning and Foreshadowing Patterns

• Revising Self Monitoring and Maladaptive Engagement versus Disengagement and Replacing with Appropriate Mirroring and Self Correction

• Accepting Aloneness, Feeling Belonging and Connected To Universality

• Learning Authenticity and Being True to Oneself

• Accepting Reality as Your Best Friend

• Venturing into the Uncertain World of Independence

• Serenity and Coping, Regardless of Outcomes and Life Conditions

– A Model for Emotional Independence and Mastery– A Model For Self Transcendence

New Steps to Recovery Using the Natural Systems Concepts of Structure and Intentionality:

Exposure, Replacement, Relocation, Practice,Mastery, and Transcendence

• Repetitions of the same process and event under conditions of mastery eventually leads to transcendence and invention of a novel understanding of the process and event and strategy and possibly integration with related or serendipitous schemata to form a more encompassing and creative vision and strategy, which in turn is stored in world schemata and effects changes in memory retrieval and modes of assessment Transcendence may even restructure states of incorporation. This whole revision process is also called accommodation.

Dynamic Mutual Influences Between Newly Chosen or RestructuredExternal Structures and More Realistic and Accurate Schemata and Schemes

• Schema of the World Derived From One’s Own Personal Judgment Now More Accurately Influences Perception.

• Structure of External World No Longer Holds Absolute Sway Over One’s Perceptions and the Person Sculpts Assessments and Interpretations, Chooses What Structures to Be In, and Even in Some Cases Alters the Structures Themselves.

• New Perceptions and New World Schemata Influence Memory Retrieval of Revised Schemata and Schemes.

• Memory Retrieval Influences Levels of Assessment With Greatly Expanded Flexibility and Options for Direction of Level of Focus and Content of Assessment.

• New Experiences Were Almost Always Assimilated Into Prior Schemata and Schemes. Now New Experiences That Even Slightly Depart From Prior Schemata and Schemes Result in Accommodation Rather Than Assimilation and Are Eager to Confront and Include Contrasting Information and Form New Sets of Schemata and Schemes. Now Even When These New Schemata and Schemes Are Incorporated, They Do Not Become Rigid and Intransigent As Before.

New Processes Influencing Envisioning• Level of Assessment Focuses Either on the Internal World As Sensations, Feelings,

Introspective Conceptions or on the External World As Stimulus, Immediate Setting, or Distal Future-past.

• Individuation of Immediate Physical and Cognitive Pleasure-pain Sensations and Feeling Accompanying Assessment Now Influences More Appropriate, Realistic Incorporation Processes and States Which Subsequently Influences a More Realistic Sequence of Perception-Retrieval of More Accurate Schemata of the World the now Replace, through Accommodation the Old Processes and Results of Assessment and Individuation.

• Envisioning Now Draws on the Revised, More Hospitable Schemata of the World Content for

– A] What Is Going to Happen, – B] What One Is Going to Do, and Lastly, – C] How One Is Going to Do It, or Strategy.

• 1. Envisioning Invokes Criteria for Fulfillment and Cycles Through Envisioning A] and B] and Arrives at Foreshadowing and Deciding and Readiness to Act Which Formerly Took Place Under the Ubiquitous Shadow of the Implicit Others and Now Takes Place Solely With a Sense of Being True to Oneself.

• 2. Cycle of Envisioning Now Recurring Without Being Under the Shadow of Implicit Others Is Modified by Self Selected Changes of Criteria of Fulfillment and Deciding and Foreshadowing and Envisioning Goal. The Vision Is Now Clear and Clearly Present in an Un Compromised Manner.

New Criteria for Fulfillment and Mobilizing and Guiding Action

• New Authentic Criteria for Fulfillment Guide in Selection of and Relation to Goals and Selection of Strategies and Behavioral Schemes for Goal Attainment. They Come From Within the Person and Are Aligned With All Other Intentional Processes or Are Imposed and Are Tacked on As Foreign and Disjointed. The Nature of Criteria for Fulfillment Affect the Experience of Time and Feelings.

– Liberation and Peace Result From Selecting Personal, Owned Criteria for Fulfillment

• New Processes of Setting and Orienting to Goals Leads to Whole Hearted Adventuring.

– Selecting Owned Personally Designed Goals Results in Exhilarated, Enthusiastic Pursuit and Adventuring

• New Processes of Adventuring Is Guided by Genuine Inner and Outer Experiences (With Assessments) and Results in Punctuated Disengagement Only to Mirror Progress, Assess and Evaluate Progress, Revise Direction and Strategy to Align With One’s Own True, Personal Criteria for Fulfillment, and Enthusiastic Re-engaging in Adventuring.

– Single Minded, Focused Adventuring Toward Goals Becomes Unfettered, Un Self Conscious, Undistracted and Disengagement Results Only When There Is a Need for Self Correction.

Repetition, Mastery, and Transcendence

• Completion results in mirroring whole completed process, revising and storing in world schemata.

• Subsequent attempts repeat the process until the challenge is mastered.• Repetitions of the same process and event under conditions of mastery

eventually leads to transcendence and invention of a novel understanding of the process and event and strategy and possibly integration with related or serendipitous schemata to form a more encompassing and creative vision and strategy, which in turn is stored in world schemata and effects changes in memory retrieval and modes of assessment.

• Transcendence may even restructure states of incorporation. • This whole revision process is also called accommodation.