My preferred way of working with addiction is working from the self-medication hypothesis.

The self-medicating hypothesis provides a humanistic psychological understanding for addictive behaviour, one which sees people with addictions as a fundamentally vulnerable population. It is an understanding which counters the horrific judgements and stigmas addicts place upon themselves, to say nothing of similar or harsher judgements others place on them. Furthermore, addictions evoke alternating reactions of concern and intolerance in family and friends who witness the problem.

Therapeutic work takes a lot of courage; for clients to come forward and take the risk of finding out about themselves and trusting another with their experience and wounding. I endeavour to honour that and treat all my clients with the humility and respect that they deserve.

One view of addiction is that it is an Attachment Disorder. Establishing and maintaining meaningful relationships is an essential aspect of life which provides a sense of comfort, safety and security. As with so many personality components, the capacity to connect to others reflects back to inborn temperament and early parental relationships.

Starting with the earlier phase of development, a lifelong challenge for human beings is to work out relationships in a satisfactory way. Psychodynamic psychiatrists draw upon the work of Donald Winnicott, who refers to “good enough mothering”. This is a basis of developing a comfortable and secure sense of oneself. When this is absent, the individual is left feeling chronically discomforted later in adult life, and subsequently and not surprisingly they often resort to substance misuse.

The 12 Steps have been going for decades and have supported millions of people in their sobriety, as has the use of CBT. However, just relying on the 12 Steps or CBT can leave some clients feeling that one size must fit all and if it does not work for them then they are often left feeling like a failure. This is not the case; if you were to go to the doctor with an ailment, you can guarantee that there would be alternative treatment options that they might offer, and subsequently you might have to explore alternatives before finding what works for you. The same is true of psychotherapy approaches.