Love and Addiction Counseling (Bill White and Jason Schwartz)
Addiction counseling has become an increasingly professional and pristine affair, and service relationships reflect a more detached process than in years gone by. And yet one worries about the loss of something precious in our current fixation on the technical mastery of evidence-based counseling practices. We would suggest that this endangered precious quality is captured in a word rarely if ever written in the professional counseling journals or spoken in addiction counselor training programs. The word is LOVE.
Today, love in the context of addiction counseling is more likely to be thought of in terms of ethical violations than a quality of the most effective addiction counselors. But having trained and supervised addiction counselors for decades, we contend that the most effective of such counselors bring a deep, non-possessive love of those they serve. The importance of love as a foundation of addiction counseling is understandable only when one considers the historical disrespect, contempt, and even hatred those with the most severe, complex, and prolonged addictions have so often experienced in their encounters with helping professionals.
Few health conditions are so deforming of character that one’s humanity gets lost in what is sometimes a most unlovable veneer. No one can be expected to love traits so endemic to addiction. What distinguishes the best addiction counselors and recovery coaches is their recognition of such traits as an expression of the disorder and not the essence of the person. The guiding mantra of the best counselors is a very simple one: hate the disease, love the person. In our preoccupations with the technologies of effective addiction counseling, we must not lose a much more foundational requirement: the ability to not just accept and respect those with whom we work, but to love the person beneath this unlovable veneer.
Below are a few quotable observations that set the value of such love in perspective.
What is this attitude that I call the key to successful [alcoholism] treatment? First, it is accepting of the other person just as he is, for exactly what he is. Second, it accords him the dignity of his humanity quite apart from his illness which may have buried that humanity deep out of sight. He is regarded as a person, in great trouble to be sure, but not a non-person for all that. Third, it offers him understanding and, as a result of that, compassion, or as many recovered alcoholics flatly put it, love. Finally, and perhaps most important of all, it exhibits faith, a belief that he too, this alcoholic whoever he may be, can and will recover.….[Too many professionals are] condemning, and therefore often hostile. They are quick to blame the alcoholic for his condition and to see the horrors of the condition as the man. They unwittingly treat him as less than human because he is not as they are. They are contemptuous of his weakness, his failure to stand up to life. They are sometimes punitive, believing that what he really needs is to be taught a lesson. They do not understand him and so they do not really like him. And he knows it….The first requirement for successful counseling of the alcoholic is the correct attitude….If you don’t have this, then it doesn’t matter how many techniques you use, they aren’t going to work. –Marty Mann, 1973, Attitude: Key to successful treatment. In: Staub, G. and Kent, L., Eds. The Para-Professional in the Treatment of Alcoholism. Springfield: Illinois: Charles C. Thomas Publisher
I can remember in my own time some of the early NAAC and NAADAC awards going to people who were obviously not educated. You could tell from their choice of language when they stepped forward to receive the awards. But what they had was so much more important than that. They had love. They had a passion for helping within them that was so powerful that they were selected by their peers—many of whom had all kinds of degrees—to receive outstanding awards. They represented the soul of alcoholism counseling as it originally existed. They had the power to help somebody understand that he or she is a loveable human being and a child of God. This is a quality that is hard to transmit in a classroom. –Mel Schulstad, 2011 interview
What the addiction counselor knows that other service professionals do not is the very soul of the addicted—their terrifying fear of insanity, the shame of their wretchedness, their guilt over drug-induced sins of omission and commission, their desperate struggle to sustain their personhood, their need to avoid the psychological and social taint of addiction, and their hypervigilant search for the slightest trace of condescension, contempt or hostility in the posture, eyes or voice of the professed helper.—William White, The Essence of Addiction Counseling, 2004
Four things have allowed addiction treatment practitioners to shun the cultural contempt with which the addicted have long been held: 1) personal experiences of recovery and/or relationships with people in sustained recovery, 2) addiction-specific professional education, 3) the capacity to enter into relationships with people with severe AOD problems from a position of moral equality and emotional authenticity (willingness to experience a “kinship of common suffering” regardless of recovery status), and 4) clinical supervision by those possessing specialized knowledge about addiction, treatment, and the recovery process. We must make sure that these qualities and conditions are not lost in the rush to integrate addiction treatment and other service systems. –William White, 2003, A History of Contempt
So let’s review. The experience of addicted people with professional helpers is often characterized by:
* condemnation and hostility,
* blame for their condition and circumstances,
* conflating the illness and the person,
* objectifying the person due to their illness;
* contempt for the person’s perceived “weakness” and failure at life, and
* a desire to punish and “teach a lesson.”
In short, traditional professionals don’t understand this person masked by addiction, they don’t like this person, and he/she knows it.
But such attitudes are not restricted to allied professions. They can be found within the addictions treatment and recovery support fields among those filling diverse roles–regardless of their personal recovery status. All of us are imperfect human beings. All of us have had thoughts and feelings within the helping process that we are not proud of. Encountering such thoughts and feelings is not a matter of if, it’s a matter of when. The key is to quickly notice when these attitudes creep in during periods of increased vulnerability or when we encounter a particular client or type of client that elicits such sentiments. And most importantly, it’s a matter of what we choose to do about it. Such experiences are ideally gut-check times and a call for supervisory guidance. It is in this process of self-inventory and professional guidance that we can rise above our own defensive reactions and authentically connect with and care for those we are pledged to serve.
The open wounds of the men and women seeking sanctuary within addiction treatment and recovery support settings offer the potential for life-transforming encounters. What the wounded need in such moments are not just our technologies, but our humanity–not just counseling technique, but the kind of empathy and compassion that transcend the roles of the helper and the helped. We call that love.