In a rush to relieve the suffering addict from the painful grasp of addiction we counselors too often breeze by the very factors which are crucial to embracing and maintaining sobriety. More and more we are finding out that it is the very factors which we have been skipping over that create, maintain and secure the recovery in the first place.

One of the first and primary blocks to active recovery is overcoming low self-esteem barriers. People seeking addiction treatment do so because "they have hit bottom." Normally, we think of this "bottom" as a long series of consequences which, when they become too painful and obvious to ignore, begins to break down the denial of the addiction and leads the individual to treatment seeking relief.

Unfortunately, hand-in-hand with the break down of denial, comes the break down of the person's self-esteem. The typical individual who enters treatment for chemical dependency is awash with regrets, failures, shame, painful memories, remorse and guilt. Looking back over their using career of several years they see nothing but failures, let-downs and pain. The client or patient will often waste the majority of his or her treatment trapped in the shame of the past rather than focusing on the solutions of the future. This low self-esteem is invariably a mild, or not so mild, form of depression. Struggling in early recovery, they have few real (or at least recent) references for success, and so they consciously or unconsciously conclude they are unlikely to succeed or are unable to do so. It is easy to see why the depression rates among addicts is double that of the general population.

For true recovery to begin, a clear break must be made with the past. The addict must not average in the failures of the past against the successes of early sobriety. The individual must come to understand that the past does not equal the future and by using different approaches, attitudes, and strategies we get different results. Clearly, greater progress seems to occur in those who judge their ability to succeed on how they have performed since abstinence accompanied by a willingness to look forward.

Along with increasing self-esteem this process also produces a surge in motivation because "success breeds success" (Dr. David Schwarz). This focus on success rather than failure makes it far easier for the recovering person to see themselves as effective individuals who are not powerless to effect change in their lives. In treatment we often talk about "motivational momentum." Actions cannot be separated from benefits, so the more positive actions you take the more positive benefits you receive. As you begin to see more benefits coming back to you, you are motivated to take more and more action, thus gaining momentum. Another positive gain is that this positive momentum and action typically spreads to multiple areas of the patient's life.

Henry Ford once said, "If you think you can, or think you can't, you're right!" If you think you cannot do something (based on poor self-image) you are right, because you literally shut down the part of your brain that needs to be activated in order to successfully accomplish the task. The thought that you cannot do something literally becomes a self-fulfilling prophecy because your mind cannot both decide that you cannot do something and that you can do something. The mind resolves the conflict by having you fail, thus "proving" you "right."

Motivation and self-esteem are so closely linked that they cannot be separated and their power to effect change in the individual's life cannot be underestimated. The quote, "you never rise higher than your image of yourself" speaks directly to the link between self-esteem and motivation. For the addicted person to make a change in their life they need to clearly see the benefit of the change, and see themselves as capable of making the desired change. If their self-image shows them that they are not capable of change, then change will never come until this negative self-image changes.

Motivation works like a muscle, and due to long periods of drug use, these motivational muscles have atrophied over time. I often use a "stretching analogy with patients in setting goals, they should first be simple and easily attainable. As confidence increases, the individual should "stretch" themselves to make more challenging changes which require more effort but can be done successfully with perseverance. As the person progressively does more and more, what they once though was impossible has now been "stretched" into the possible. The recovering person must continuously be "stretching" the range of what they think is possible for them to achieve As what they see as their range of what is possible for them to accomplish grows, so does their self-esteem, motivation and achievements.

A capable clinician must have full working understanding of self esteem and motivational processes Otherwise he/she will have man "treatment failures," (despite all their fine skills) and may often feel that it is the client's fault, or that they are "treatment resistant," when the simple fact is that they don't like themselves very much and need us to show them how to do that again.

Advanced Counseling Services in Keene, NH. (603) 357-1708

Email: Therapist2@netzero.net