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3 Reasons Therapy Can Fail With Addiction

Addiction programs have a higher success rate than traditional psychotherapy.

Key points

  • Most addiction counselors are addicts in recovery who intimately know the language and behavior of addiction.
  • Addicts are skilled manipulators, unresponsive to psychodynamic insights because their thinking is impaired.
  • Studies show that addiction programs, such as 12-step groups, have a higher success rate than traditional psychotherapy.
 Altin Ferreira/Unsplash
Source: Altin Ferreira/Unsplash

If you’ve ever loved someone struggling with addiction, you know that there are few sufferings as agonizing. Addiction is a rollercoaster ride of impassioned highs and lows. It has the power to devastate relationships, rip apart families apart, and even end lives.

What makes addiction so challenging? No matter how many times the addict emerges clean and sober, a dark cloud remains on the horizon: the knowledge that at any moment, a relapse will plunge the person and those who love them into hopelessness.

Missteps on the path to addiction treatment

Families spend much time and money seeking the best therapies for loved ones struggling with addiction. Frequently, they make the mistake of hiring a psychotherapist with little or no training in addiction.

This is problematic because it can be difficult to spot addiction. When confronted, addicts are skilled at concealing their use of substances and claiming to be substance-free. Without a drug test, it’s nearly impossible to tell if they're lying or not.

Even worse, they will complain of unbearable levels of anxiety or depression. And no one wants to see someone they love suffering. Sadly, families tend to believe the relapsed addict despite their erratic behavior. Love often blinds us to painful realities.

Meet Sara

A young woman named Sara joined one of my weekly therapy groups. She was charismatic and popular immediately, yet I had a sinking feeling that something was wrong. Six months later, Sara remained a mystery to me. She wasn't making progress. She missed sessions regularly. She was late in paying her therapy bills. Yet, when I interviewed her for the group, Sara denied abusing drugs or alcohol. “I’m smarter than that,” she told me confidently.

A few weeks ago, she came to the group looking pale and haggard. When Stephen, a group member in recovery, asked, “How was your weekend?” Without thinking, she responded, “I can’t remember.” Quickly she tried to disclaim her statement—but it was too late.

Stephen gently confronted her, and Sara confessed to mixing drugs and alcohol for years. Sara admitted proudly that she was able to fool her psychiatrist, who continued to prescribe her medications for anxiety—which she abused.

At the next group, I told Sara she had to enroll in a substance abuse program or leave the group. After much tumult, she agreed. She said she was relieved; she had grown tired of lying and wanted to be clean.

I wish I could write that Sara’s story had a happy ending—it doesn’t. After a few weeks, Sara dropped out of the group, the addiction program—and disappeared. She hasn’t been seen or heard from since.

Sara’s story isn’t unusual. According to the National Institute on Drug Abuse, 40 to 60 percent of addicts relapse after treatment. It frequently takes many relapses before stable recovery is achieved.

Why addiction counselors are more effective

Most addiction counselors are addicts in recovery. They intimately know the language and behavior of addiction and draw from their own experience. This gives addiction counselors a powerful advantage over psychotherapists. They have an intuitive sense that most psychotherapists lack. For example, in Sara’s case, the addict in recovery picked up on her drug use—not me or the other group members.

Why psychotherapy often fails with addiction

Unfortunately, there can be many reasons why it is less effective.

1. Addicts are skilled liars.

Addicts are master manipulators and instinctively know how to get what they want. They distort and mislead with ease and leverage love by making friends or family feel guilty or ashamed for not believing them.

2. Addiction impairs thinking.

Forget logic and reasoning—the addict isn’t able to sustain that level of introspection. As dependency on drugs groups, so does impulsiveness, destructiveness, and the urge to keep using substances. Their ability to reason is damaged.

3. Programs are more successful with addiction.

Addiction programs utilize a team approach that is no match for a single psychotherapist. What’s more, addiction programs, such as 12-step programs, are proven to be more effective in treating addiction.