I have been doing interventions for about 10 years. I have done many. I have always been successful in bringing the message to the still suffering alcohol or addict and his family. The loved one usually goes to treatment. I thought I was good at what I did until the term “addiction interaction disorder” began to crop up in my daily life. The term originally was coined by Patrick Carnes, the great sex addiction guru. It has been further refined by Rob Weiss in all of the groundbreaking work that he has been doing around sex addiction. Now when approaching an intervention I ask many more questions because there are always many layers to addiction and there is always more fused into the process or hidden under the surface. If we are going to do the best job possible we really have to do better discovery which means asking the family system to share where the skeletons are buried.
In my interventions what I have consciously done is achieve a better understanding of addiction interaction, which again puts me in a better position to serve the needs of my clients. This leads to better episodes of treatment for these clients and much better outcomes for clients and their families. I now see what clinicians have long noted, which is that sex addiction has been woven into an intricate web of addictions, compulsions and avoidance strategies. If we consider this going into treatment, then the treatment experience is enhanced as we are treating the whole person and all of the nuances of their personal addiction.
We know that multiple addictions combine to overwhelm a person by their complexity and power. The phenomenon is so strong that no specific focus is strong enough to escape from it. So what happens is that if the addict has pulled the interaction card, they switch from one problematic substance or behavior to another. If they can’t use one substance or activity to escape and dissociate from life, they’ll use another.
Examples abound: Perhaps the sex-addict who buys his cocaine from his prostitutes in a ritualized, predictable pattern is one example; or the alcoholic who has a gambling addiction but to carry it out the person needs to get drunk first; or the cocaine addict who views Internet pornography while high but reports that neither activity works very well on its own.
Each addiction or compulsion has unique qualities but also remarkably similar characteristics. These characteristics, such as a loss of control, consequences for behavior and difficulties stopping the behavior, are often driven by the same list of internal dynamics, including shame, escapism, trauma and stress. Clinicians need to explore issues such as whether the addictions have a common origin, if they are manifestations of core dynamics and if they are interactive in fundamental ways.
With co-occurring addiction, addicts utilize multiple addictions simultaneously. The mono-drug user and addict is a vanishing species in American culture. The reality for our patients is that they have made a number of “bargains with chaos.” If each addiction brings unmanageability to the patient’s life, it would be clinically negligent to think that the resulting chaos from each does not compound the problems of the others. The whole may in fact be more than the sum of its parts. In my own journey I used to attend a meeting in Chicago where a happy and sober friend would announce at the beginning of the meeting that he was addicted to anything he did twice. He would say this in jest! I get it, I understand.