Why do individuals with addiction isolate?

There are numerous reasons for why individuals with addiction isolate:

1) They would like to hide their addiction from others. Friends and family do not generally respond well to someone who is engaged in addictive behaviors. Isolation keeps them from getting scolded and being pressured to change the behavior.

2) Individuals with addiction are often shunned by friends and family and tend to be lonely.

3) Low self esteem is often associated with addictions. As a result, it is easier to not put oneself out into public scrutiny where self-esteem issues may be triggered.

4) Additionally, it is not uncommon for loneliness and isolation to precede the addictive behavior and to contribute to the person adopting unhealthy coping behaviors, such as drugs or alcohol.

Humans are social creatures and we crave connection to other humans. This is even more important for someone who is struggling with addictions as they need the extra support and encouragement. Alcoholics Anonymous has become as powerful of a recovery tool as it has partly because it promotes a sense of community and connection. The isolated mind has a tendency to get stuck in patterns of thinking that are unhealthy. For example, when we talk to a friend about something that is upsetting us, it often helps because our friends validate our feelings and help us put things in perspective and move on. The isolated mind has the potential of getting stuck in a negative loop reinforcing the addictive behavior.
Author: Dr. Seda Gragossian

Clinical Director

How to Evaluate an Intensive Outpatient Program for Treating Addiction

IOP is a mainstream treatment option and one that is frequently covered by commercial insurance. There are many facilities offering programs and there is very little regulation about what should and shouldn’t be done within the treatment setting. It is in the best interest of the patient, then, to do the necessary evaluation of programs to identify a suitable service provider.

Evaluating IOP offerings should comprise the following considerations:

  • Therapist experience and specialty. Look for programs that are facilitated by qualified individuals with past experience in the particular area of treatment. Additionally, the IOP program, as a whole, should be supervised by a certified psychologist with PhD or PsyD credentials.
  • Testimonials from past clients. It is important to see client feedback, even if published anonymously.
  • Group meeting attendance levels. While there is no such thing as a perfect attendance number, it is best to find programs that have no more than ten participants in attendance. If the attendance is higher, there is not enough personalized attention and air time for each participant.
  • Availability of free consultation and initial group meeting participation. While most programs will do an initial consultation, some programs may even offer a participant the ability to attend a live group meeting prior to making a long-term commitment.
  • Program tenure per client. Patients get the most out of a program when they participate for the entire prescribed duration. While most programs will not publish drop-out rates, it is perfectly acceptable to ask other participants directly about how long they have been with the program.
  • Client selection. It is a good sign when a center asks pointed questions to assess client fit. This shows that the program administrators care about the impact that a new patient will have on their existing patient base.
  • Focus on treatment. Since there is no standard around what should be covered during IOP sessions, some programs choose to focus on one-directional rhetoric. Other programs take up group time by showing lengthy videos on a regular basis. A well-rounded program will create a collaborative problem solving environment and will incorporate a variety of services and activities.
  • Availability of therapists outside sessions. Some situations call for quick access to a therapist to discuss an urgent matter. It is advisable to look for programs that offer access to after-hours consultation on an as-needed basis.
  • Treatment planning rigor. Program administrators should take the time to create personalized treatment plans for all their participants.
  • Cost considerations. IOP programs are not inexpensive, given the intensity and long-term commitment of the approach. IOP programs will cost less than residential programs, and should be more aligned with corresponding hourly rates offered in individual therapy.
  • Availability of a pre-screened network of external resources. IOP administrators should offer external references to support services and other providers to maximize a patient’s chance of recovery in the long term.
  • Track record of clients showing improvement. Client records are confidential and it is hard to publish information relative to outcomes. However, the direction of the entire health care profession is moving towards outcomes-based care. In the coming years, this is going to become a reality and IOP programs will need to do their part in demonstrative efficacy of care.

Author: Seda Gragossian, PhD
Clinical Director
Talk Therapy Psychology Center
(858) 205-2490


Self-Medicating and Addiction

At times, Talk Therapy invites our friends and colleagues from the community to share their thoughts. Here is an informative personal story from one of our guest writer:

“At one point in the height of my addiction to drugs and alcohol, a good friend of mine offered a simple insight that would forever change my perspective about my struggle. “I think you are self-medicating,” she said, in a concerned, non-judgmental tone. These words instantly melted away years of guilt and shame. I had never looked past all of the negativity associated with my addiction for long enough to see it this way.

Did this more compassionate perspective instantly make my addiction go away? No. But it did shed light into why I constantly felt the need to be inebriated. By using drugs and alcohol I was not looking to “party,” “get high,” or “get trashed.” I was simply looking for relief. Relief from the constant depression. Relief from the crippling anxiety that seemed to dominate every single day. Relief from the nagging physical aches and pains I felt constantly throughout my body.

Now in my mid-30’s I was armed with a brand new perspective on the addiction that had plagued me since my teens. I no longer viewed myself as simply someone who was hellbent on self-destructing and disrespecting all regard for healthy consumption and society’s rules. I no longer viewed myself as the “black sheep” troublemaker who ruined his life with addiction. I now viewed myself as someone who had enough self-compassion for himself to want to find relief from the very real pains of life. I was simply being my own caregiver.

Unfortunately, my medications of choice were not good for my body, my mental state, or my life in general, even though they momentarily took away the pain. But they were convenient and accessible, and in my case, relatively affordable. Over the next several years, I learned all I could about natural medicines, neuropsychology and neurobiology, nutrition, exercise, and anything else that might provide a healthier pain-relieving alternative to the damaging drugs and alcohol.

Although this insight was immediate, real change took time and I had to do a lot of inner work to keep my “self medication” perspective fresh in my mind. Most importantly, it was critical for me to chip away at the guilt and shame I was holding onto that was directly related to years of self-destruction. Guilt and shame are often so interlocked with our addiction that it can take years of inner work to break free from their chains. Guilt and shame can keep us imprisoned by our old, pain relieving ways.

When we do “the work” we begin to peel back the layers of guilt and shame and learn how to be compassionate toward ourselves. Humans respond best to positive reinforcement and encouragement. Self-abasement, negative reinforcement and coercion are not effective strategies for permanently changing our behavior. Self-compassion and non-judgment toward ourselves is critical if we want lasting change.

Are you self-medicating? Are you drinking or using to mask a particular emotional or physical pain in your life? What specific pain are you escaping from? Identify this pain in one word or sentence (I was escaping from my depression and anxiety). Once you identify what specific pain you are escaping from, ask yourself, is it normal for a human being to want relief from pain? Of course it is! The multi-billion dollar pharmaceutical industry is proof that humans have an insatiable desire for relief from pain.

This does not make us bad people. This does not make us flawed or sick. We no longer need to feel guilty or ashamed of desiring to be free of our pain. We are merely humans seeking relief from our very real pain. We may not be the best choice of primary care providers for ourselves at the moment. But by doing the inner work, this too can change.”

About the Author:

Joseph Cervantes is an advocate for the de-stigmatization of addiction in our culture. As a community organizer and journalist in the addiction treatment space he has had the opportunity to work with hundreds of individuals struggling with various addictions and mental health issues. He is also a vocal advocate for the development of new methods and strategies for treating addiction. Having completed several IOP and inpatient programs himself over the past 20 years, he offers a unique perspective into the rehab experience through both a patient and practitioner lens.