Harm reduction and psychotherapy

Recently it was brought to my attention that some one struggling with addiction was denied psychotherapy because the therapist did not believe that therapy would be affective while the person was still on drugs. I find this difficult to swallow since most people develop a tolerance and end up only taking drugs to function. Then there is also the double standard that therapy is acceptable if the patient is on anti depressants which can also impede or repress emotion; I regard them as opiates on a receptor level.

This is the kind of outdated thinking that needs to open the doors to harm reduction; anything which minimises risk to the patient.

I also think its counter productive to remove some ones coping mechanism before you have some thing to replace it with.

In a collection of case studies by Andrew Tatarsky "Harm Reduction Psychotherapy" the studies showed that once the patient began psychotherapy and started to work on the issues which lead to or surrounded addiction they were quite willing to change their destructive drug or alcohol usage without coercion.

The point I am getting to is that there is too much emphasis on the drugs instead of the behavior. For instance some one can be drug free but still exhibit the addictive behavior by compulsive shopping; over eating or even using work as a means of escape or to avoid facing the issues that need dealing with. In the end the drugs have little to do with the situation; its all about the behavior; which reminds me of the "dry-drunk" joke: I am still the same ass-hole I just have fewer dents in my car.

In my opinion there is not much point to being drug free unless you are prepared to deal with the issues that brought you to that place. I listen to endless accounts of people who are now drug free but they are not happy in their lives or their work; they have a hard time convincing themselves that everything is better since they are now "on the wagon". To me its about enjoying life without the fear of facing yourself or your baggage.

I would recommend reading anything on harm reduction as an alternative to self help groups that require you to conform to a preset standard which is non-negotiable and turns away people wanting help who do not conform to that standard.