by Thaddeus Camlin, Psy.D.
This week we look at how to be unpopular in the addiction treatment industry – a topic we at Practical Recovery are certainly experts in!
1. Treat Addiction in Stages, Not Steps
To be unpopular in the addiction treatment industry, the first step is to treat addiction in stages, not steps. Framing addiction within the stages of change (precontemplation, contemplation, preparation, action, maintenance) helps treatment providers match interventions to each individual’s level of motivation. With the stages of change as a framework for treatment a higher power, character defects, and spiritual maladies are optional and not emphasized. While emphasizing self-guided recovery through fluid, often non-linear stages of change creates individualized and flexible treatment approaches, it also makes one a target for practitioners of the usual.
2. Accept Progress as Success
After a treatment provider has started down the path of exile by framing treatment with stages of change rather than steps, the next move to further isolate oneself is to accept progress as success. Unlike every other diagnosable condition, perfection is the goal for addiction. Complete, immediate, and everlasting abstinence is the standard of success. If you want to be unpopular in the addiction treatment industry then an excellent maneuver is to promote the idea that symptom reduction equates to progress. Nevermind logic, sayonara reason, there is no place for such silliness in addiction treatment. Popular opinion, collective wisdom, and the industry’s ‘best thinking’ somehow got us to the point where a 99% reduction in symptoms is considered failure. To suggest otherwise, or that moderation is a viable outcome, is to consign oneself to the ostracized cavities of the addiction treatment realm.
3. Question if Addiction is a Disease
After you’ve framed treatment in the stages of change and suggested that progress rather than perfection is success, the last and ultimate move to dismiss oneself into the lonely abyss of the addiction treatment industry is to question whether addiction is a disease. Despite the Surgeon General saying that only the most rare and severe cases of substance use qualify as a disease (see page 6 of the intro), the mainstream addiction industry maintains its disease tunnel vision with voracious vigor (see NIDA). If you want your privileges revoked from the old boys’ club of addiction there is no surer way than to wonder aloud about the veracity of the idea that addiction is a disease. Nevermind that no definitive, conclusive evidence exists for or against the disease model, questioning the party line is not allowed in the addiction tribe.
There are certainly other ways to find yourself rejected and lonely in the world of addiction treatment (e.g. suggest substitution as a useful tool). However, you can guarantee that fellow professionals in the addiction treatment industry will omit you from the invite list time and again if your treatment is based on stages of change rather than a step ladder to God, if you accept progress rather than perfection, and if you point out that the notion of addiction as a disease is far from settled. For those who revel in being the underdog, follow these guidelines and you are sure to find yourself as the odd person out with nothing but research and common sense to comfort you faster than you can say “denial.”
At Practical Recovery, we’re okay with being unpopular amongst providers of traditional addiction treatment. After years of going against the grain, we’ve found our evidence-based, compassionate and humanistic approach to be quite popular and effective for those who matter most… the clients.
