Substance misuse

Helping clients with addiction or compulsive behaviour

Why do humans consume substances or engage in activities compulsively? There are many competing theories about this, but in schema therapy we are more interested in the function of the behaviour than the particular substance or activity our clients are compulsively pursuing. In my opinion, drinking a bottle of wine every night, spending three hours on Facebook or snorting lines of cocaine are all symptoms of deeper problems – they are ways to numb painful feelings or distract ourselves from them.

My thinking on this subject has been significantly enriched recently by coming across Dr Gabor Maté, a doctor working with drug addicts in Vancouver. His harrowing but brilliant book, In the Realm of Hungry Ghosts, backs up the idea that drug addiction is always linked to trauma – it’s a way to escape unbearable or overwhelming thoughts, memories and emotions linked to a painful past. I see this again and again with my clients and I’m sure you do, too.

In schema therapy, we conceptualise the part of our clients that seeks numbness or distraction as the Detached Self-Soother mode. This ‘mode’ (a part of the personality, that has a distinct character and function for the client) helps them detach from uncomfortable feelings; this detaching is usually a conscious choice – ‘God I need a whisky after that day!’ – and the self that is soothed (or more accurately suppressed or numbed) we formulate as the Vulnerable Child mode.

This is the part of our clients (and us) that closely maps on to the inner child from other modalities. It is a young, vulnerable, emotional part that carries all of the wounding and unmet needs from childhood. The work of schema therapy – or any other approach – is to contact, care for and heal this part of our clients. When we do so, deep healing can take place – even with the most complex or seemingly impossible-to-help people and presentations.

If you would like to learn more about working with modes like the Detached Self-Soother and Vulnerable Child, come along to my workshop on 21st June 2019, Working with Modes: Embracing Complexity and Achieving Integration. I hope to see you there!

And if you would like to know more about any of my Schema Therapy Skills workshops, call me on 07766 704210, email or use the contact form to get in touch.

Warm wishes,