I admit that I am powerless over my client’s substance abuse addiction

with Galit Serebrenick-Hai, MA, MSW, Somatic Experiencing® Practitioner (SEP)

My clients lie. Friends, family, colleagues, strangers, themselves, no one is excluded from their liar’s club, myself included. As the clinical director of an inpatient detox and rehabilitation center (addressing all forms of substance addiction), I was lied to by my clients so often I started to expect it. However, and this is even more important, I did accept it as a symptom of the disease called addiction.

After five years at the center I realized that dishonesty in general and manipulative behaviors in particular, especially when clients were still struggling with active addiction and frequent relapses, were not embedded in their personality or characteristics. Rather, they resulted from past experiences and how the addict viewed his/her problem and its solution. I believe that accepting such a point of view can help therapists improve their ability to handle their countertransference and enable them to remain compassionate even when confronted with their clients’ dishonesty.

Dishonesty and manipulative behaviors take on many forms. Therapists often discover that their clients have never really stopped using drugs/alcohol. If therapy occurs in an agency with mandatory screening for drug/alcohol abuse, addicts find various creative ways to forge the results. For example, some of my clients explained to me that while supposedly seeking help at outpatient clinics they were actually calculating the day and exact point in time that they needed to stop drinking in order to pass those screening tests. Drug addicts introduced me to various ways in which urine screening tests can also be forged.

One may assume that there must be less chance for dishonesty when treatment is held at an inpatient facility, which is initially an alcohol and drug free environment. While this is true to some extent, the magnitude of the false pretense that addicts are willing to live through is surprising. In the detox and rehab facility where I worked clients were only able to leave the facility for the weekend after three months of extensive therapy. Very often, the choices they made during their weekend away (if they ever returned…) were the only indicator of their sincerity during those three months in which they nodded their heads in agreement during group therapy.

Although clients usually managed to refrain from the use of alcohol or drugs, more often than not they still indulged themselves in behaviors such as gambling, partying with friends who used drugs or alcohol, communicating with people with which they had abusive relationships, etc. These kinds of choices clearly indicated they were not taking the information given to them at the rehab seriously. Their chances to “stay clean and sober” in the long run were practically non-existent.

To read the rest of Galit’s article, please CLICK HERE

Galit Serebrenick-Hai, M.A, M.S.W, SEP, is a certified psychodynamic psychotherapist who holds an M.S.W from Haifa University (Israel), and an M.A. in Business and Industry Counseling from Kean University (NJ). Between the years 2012-2017 Galit had served as the clinical director of an inpatient detox and rehabilitation center in Israel.

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