Applications to Practice

The initiation of a therapeutic relationship between an addiction practitioner and someone in an addictive relationship often provides the first step in the processes of resocialization and reintegration. But in many circumstances introducing a therapeutic relationship—a relationship with high intimacy potential—adds further fragmentation into the addictive social system. Family members who are bewildered and frustrated by their loved one’s deteriorating behavior, and are buoyed up by expectations and hope that these services can fix addictions, are only too willing to hand over their involvement to addiction professionals. The practitioner’s presence and the prospect of quick solutions provide them with some reprieve, and they willingly withdraw to allow the practitioner to exercise his or her knowledge and skills. While family members may have little idea of what is happening during a mysterious sequence of counseling sessions, they are reassured by the prospect of change and their confidence is reinforced when after several sessions the behavior of their loved one seems to improve. However, a little later their confidence is rocked when, following a series of sessions or time in a residential rehabilitation program the therapeutic relationship draws to a close and by implication the responsibility is handed back to the family. Their loved one returns, and acts differently for a while, but in time returns to old routines, which leads on eventually to the addictive relationship reasserting itself. Now, facing a full reversion, the intimates are left wondering whether there is any real prospect for change. What hope is there when not even addiction services with all their wisdom and resources are able to make things different? In their despondency they continue to distance themselves from their loved one, and their fragmented world seems more solid and powerful than ever.