1. Comprehensive Model of Addiction Richard Matthews

3. Definition of Addiction WHO A Pathological Relationship with any Mood Altering substance or experience. A life damaging relationship Two questions Can you control how much you use once you start using? Can you control the stop and stay stopped?

4. Bio/Psycho/Social/Spiritual Biology = Family History, Genetics Psychological = Childhood Trauma Social = Poverty, Alienation, Despair, & Disparity - PAD Spiritual = Values & Beliefs, a Relationship to something greater than oneself.

5. Biology Twin Studies Family History of Addiction Genetic Predisposition Dopamine D2 receptor site deficiency

6. Psychology Chaotic Childhood Childhood Trauma “Breach of the We” Unity Experience Fritz Kunkel Shame = there is something wrong with me Egocentric i.e. Narcissism

7. Social “Breach of We” = loss of at-one-ment Feelings of Alienation Not Belonging A sense of being other than, othered Further sense of Shame

8. Spiritual Loss of connectedness to the mother Loss of connection to something greater than myself Unconditional Love replaced by conditional Love Separateness No Atonement

9. Padd Poverty Alienation Despair Disparity = More Shame

10. An attachment disorder resulting in an internal breach with the authentic self producing a search for meaning and identity externally from another. This search results in the sufferer becoming dependant upon another for self-worth, meaning and significance A codependent’s dependency needs were unmet in childhood and as a result they become dependant on another person, object or experience. One could say that traditionally women become codependent in their relationships with men while men are codependent on their jobs for feelings of significance, self- worth and security. Codependency Definition

11. Harm Reduction is a Response Harm reduction is a non-anxiety driven strategy with a clearly defined purpose and goal. Harm reduction is an attempt to minimizing the health consequences of the behaviour until the person is in a position where change becomes possible. Harm reduction strategies usually result in decreased isolation and increased exposure to health care professionals thus facilitating change.

12. Enabling Behaviour is a Reaction Any behaviour motivated by fear or anxiety that attempts to protect another from non-life threatening direct consequences of their behaviour. Enabling behaviour is a short- term anxiety driven solution that is non- purposive and has no long-term goals attached to it. Enabling behaviours arise from the enabler’s emotional attachment to the person exhibiting the maladaptive behavior. Enabling behaviour is usually designed to reduce the stress of the enabler.

13. Treatment Substance use must be understood as an essential and integral part of the person. It is not a pathological part that can be treated outside of the whole person and removed. Addiction must be understood as a systemically holistic disease that affects the body, mind, emotions and Soul. If treatment of any aspect of the disease is omitted treatment failure is likely.

14. Precontemplation Has no intention to take action within the next 6 months Contemplation Intends to take action within the next 6 months. Preparation Intends to take action within the next 30 days and has taken some behavioral steps in this direction. Action Has changed overt behavior for less than 6 months Maintenance Has changed overt behavior for more than 6 months. Relapse: Not failure, an opportunity for fine tuning Stages of Change

15. Stages Of Change 2

16. STAGES OF CHANGE AND WHAT CAN BE DONE CLIENT’S STAGE COUNSELLOR’S MOTIVATIONAL TASKS PrecontemplationRaise doubt - increase client’s perception of risks and problems with current behavior. ContemplationTip the balance - evoke reasons to change, risks of not changing; strengthen the client’s self-efficacy for change of current behavior. DeterminationAssist the client to determine the best course of action to take in seeking (Preparation)change. ActionAssist the client to take steps toward change. Are there barriers? MaintenanceAssist the client to identify and use strategies to prevent relapse. RelapseAssist the client to renew the processes of contemplation, determination, and action, without becoming stuck or demoralized because of relapse. STAGES OF CHANGE