Addictions and their treatment
Addictions have roots in trauma and a lack of healthy and supportive social connections. As you may have heard, Johann Hari said in his famous TedTalk that addiction is the opposite of connection. Therefore, the treatment needs to include both of these areas. To strengthen social relationships, one should look at their communication with family and friends and their well-being in school/workplace. Ultimately a structure in life and engagement in leisure activities, such as programs and groups, are crucial to recovery.
The addiction tree model
In my practice, I often share the addiction tree as a way of understanding one's addiction and treatment. The Addiction Tree illustrates the complexity of addictions. By pointing out that the addiction is not the main issue; instead, the roots and soil that make the tree grow are what need to be addressed within the treatment in order to stop the addiction. This pattern is often demonstrated when a person successfully stops using one substance (e.g. alcohol) and soon starts engaging, obsessively, in something more culturally acceptable (e.g. workaholism or excessive exercise). This explains the nature of addictions, a behaviour that relieves pain and allows one to escape what is intolerable (shame, secrets and overall pain). As you may know, this is just short-term relief, and when the pain returns, it is much stronger. The tree has three main parts that I will briefly describe now.
Let's start with the branches; these are different forms of addiction, such as the substances (e.g. food, caffeine, nicotine, drugs), activities (e.g. work, exercise, crime, gambling), thoughts (e.g. obsessional thinking, perfectionism, worrying, fantasy), feelings (e.g. anger, hate, jealousy, fear) and people (e.g. co-dependency, sex, violence, groups). Addiction is seen as compulsive behaviour that one is engaging in, regardless of the long-term consequences (e.g. loss of job, imprisonment, health issues).
The tree's roots vary for each person and can include loneliness, fear, grief, genetics and/or guilt. The most prominent root that would be consistent for everyone with addiction would be shame. Even though shame is a natural emotion that we all have, shame is often very hidden and suppressed, making it one of the hardest to acknowledge and subsequently address. Part of what makes shame such a powerful emotion is that it stops us from reaching out to seek support and ultimately confront this feeling. An easy way to check what our shame may be, is to ask ourselves, "What is something that I don't want anyone to know about me (ever)?". Shame is characterised as a feeling of inadequacy, self-loathing or inferiority. It also includes unconscious beliefs, such as 'I'm unlovable, 'I'm defective', 'I'm a bad person, 'I'm not important, etc. As we often suppress shame, it can fuel other behaviour such as anger, envy, being judgmental of others or talking down to others.
The part that makes the addiction tree grow is the soil that feeds the roots and keeps the tree alive. It consists of childhood trauma and different types of neglect and/or abuse (physical, sexual, emotional, and spiritual). Therefore, unless the relevant trauma/neglect is addressed and worked through, the tree will be nourished and continue to grow. Speaking about these topics is very difficult for most people, as they try to suppress their memories and emotions. When addressing these topics, it is essential to work from a trauma-informed practice, creating safety and allowing each person to take their own time and allowing them to share as much or as little as they feel comfortable with at any given point (as there is a high risk of re-traumatisation). A trauma-informed treatment does not revisit the past traumas per se but looks at the current day-to-day symptoms one is experiencing.
https://www.slideshare.net/mulimartin/addiction-is-like-a-tree-46680693