Ambivalence in addicted and alcoholic patients

Addicted and alcoholic patients usually enter treatment with varying degrees of ambivalence about their dedication to treatment and long term recovery. It’s important that motivation and ambivalence be explored early in the rehab process.

Ambivalence is a conflicting craving to do, and not to do the very same thing. I had a patient some years ago use the most fantastic imagery when describing the conflicted emotions around ambivalence towards addiction and recovery. He said it was like ‘having a huge magnet inside, being attracted and repelled at the same time’.

For addicts and alcoholics to have such strong feelings at the same time about wanting to stop and wanting to keep on drinking and/or using drugs can be very confusing. This ambivalence is even more difficult for addicted and alcoholic people to work through due to the stigma surrounding addiction and the myths that abound about its effective addiction treatment.

Moving towards a point of acceptance where the alcoholic is acutely aware of their illness and accepts the changes they need to make to enter stable recovery, can be a difficult journey. It’s a transition best achieved with professional addictions counselling.

People become addicted to drugs and alcohol for varying reasons, although all would associate a positive emotional change being one of the initial benefits of substance abuse and reason as to why they continued. Of course, this positive emotional change is greatly reduced the more tolerance to the drug or alcohol is increased. This increased tolerance to drugs & alcohol is a natural progression towards becoming addicted. Fear of losing this positive emotional change, regardless of how small it may have become, is another reason some patients may feel ambivalent about giving up their drinking or drug use.

Other reasons addicted and alcoholic people may feel conflicted around recovery is that the chemical use is used as a coping strategy for dealing with life’s problems, and whilst it comes with a heavy price tag, until a better set of coping skills can be given to the addicted person they will resist attempts to get sober and in recovery from addiction.

A great book was written by a guy called William White, it’s called ‘Pathways – From the Culture of Addiction to the Culture of Recovery’ and it describes the various roles that people play in active addiction and what the benefit is for them in playing that role. You see, in alcohol rehabs and addiction treatment centres, until we can assist addicted and alcoholic patients to find meaning and purpose in recovery and a beneficial role that suits them, how could they consider giving up all that they know and are terrified of leaving. Despite the harm it does them and their loved ones. It’s may seem an irrational fear, but emotions don’t have to make sense, they just are.

Being addicted is also an immensely powerful way of making a person feel too weak and helpless to change, this further increases ambivalence about whether the alcoholic / drug addict has what it takes to get well and stay well.

A quality addiction treatment centre will be staffed with professional addictions counsellors who will be sure to explore the patient’s motivation early on in the treatment process. The pre-admission crisis that may have brought about this entry to rehab is key because whilst a car crash, threat of divorce or job loss can motivate a patient to seek help to make the required changes, this motivation will not last and superb addictions counsellors know how to maintain the crisis to keep the patient on the recovery path. Understanding patients underlying reasons will also help to explore potential routes out of the active addiction and into a culture of sustainable recovery.

We provide advice on selecting a suitable addiction treatment centre for those seeking help in moving out of their active addiction.

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