An Alternative Approach

An Alternative Approach

DON’T PANIC he says, in large friendly letters

In a minute I’m going to use a word that will almost certainly bring all sorts of images to mind. Pictures of earnest, angst-ridden European arty types wearing black roll neck sweaters and discussing Life, Death, The Universe and Everything in dingy Parisian cafés against a backdrop of Gauloises smoke, absinth – and possibly even apricot cocktails (a favourite, apparently).

Whilst existentialism may have picked up quite a few stereotypes along the way, this branch of philosophy can help us find clarity and solutions, especially at a time when over half of the UK population identifies as ‘none’ regarding faith. Rather than offering the comfort and certainty of religion with answers which cannot be questioned, existentialism is concerned with addressing questions regarding what it is to be human, especially regarding our freedom.

Whilst these questions may never be answered, the search is itself a journey of development that can lead us down fresh paths rather than fixed tracks laid down by others, we can embrace our autonomy, rather than abdicating from it.

Existential psychotherapy has been described (Deurzen and Kenward, 2005) as having the aim to ‘clarify, reflect upon and understand life as each person in practice experiences it in order to overcome particular problems or resolve dilemmas’. In other words, rather than an ethereal search for deep overall meaning, or an academical joust between different hypothetical perspectives, existential therapy is concerned with how we cope with the underlying truths of our lives.

There are therapies which start with the early years and attachment, particularly maternal (‘if it’s not one thing, it’s the mother…’) and which assume that our life script is fixed in our early years – that by about six years old we have decided subconsciously who we are and how our lives will play out. Such approaches can point to the effect of both nature and nurture, apples not falling far from the tree and all that.

It makes sense to assume that a wall will follow the contours of the foundations as it rises. To follow the building metaphor, if a crack appears then it is probably wishful thinking to just paper over it and assumes ‘job done’. Better to trace it back down and find the cause – a failed lintel, or something wrong with the foundations? My experience so far suggests that substance use is often best regarded as a symptom rather than a cause, and that progress will come from working on the cause rather than a focus on controlling the effect – but that this may not require psychological archaeology.

As with a general Humanist approach, existentialism accepts that we are able to make changes in our lives, that we can seek to discover our true goals in life and move purposefully towards them. In contrast to some of the overly enthusiastic perspectives which seem more in tune with self-help seminars, an existentialist view accepts that our lives will have limits, boundaries and restrictions beyond which we cannot go. Attempt to run through a minefield with little more than a positive, ‘can do’ attitude, and we’ll certainly go up in the world but perhaps not in the way we want. As someone who was very nearly thrown out of a seminar for saying that I wanted to be ‘President of the U.S.A by Friday’ in response to a claim by the speaker that we could be anyone we wanted to be, this more pragmatic acceptance of the realities of life greatly appeals.

This acceptance also extends to a realisation that life – for most of anyway – bears little relationship to the works of Disney or Mills & Boone. Nietzsche propose that we should learn to love our fate (‘amor fati’), finding joy in this acceptance of the inevitable. It is certainly possible to create an alternative reality around ourselves, to construct a web of delusions, discounts and denials and don a pair of industrial strength rose-tinted goggles, and this will indeed make the intolerable tolerable – in the same that emotionally shutting down, or addictions do. All these approaches, however, keep us stuck where we really don’t want to be. If the airline takes us to Alaska by mistake, instead of the anticipated sun-drenched beach, do we say ‘mustn’t grumble’ and make the best of it, or do we kick up merry hell and get to where we want to be?

Socrates believed that a reflected life was not worth living, by looking deeply into ourselves, challenging our perceptions and discovering who we really are and who we wish to become it becomes possible to achieve an enlightenment and then liberation. Kierkegaard thought that we should tackle the difficult issues in life by not avoiding anxiety and despair but instead acknowledging and accepting them – looking them fully in the face and deciding to live life fully and honestly. Take the vinegar out of a sweet and sour sauce and it becomes sickly sweet, life needs both Ying and Yang.

Where anxiety can be seen as an illness – something to be avoided, measured and treated (the Diagnostic and Statistical Manual of Mental Disorders has 46 pages covering over 20 types), existential therapy looks not at the normal meaning of worry, but rather the feeling of angst that comes from this head-on recognition, the dizziness that comes not only from an awareness of our own mortality but also the recognition of the freedoms we still have to make decisions. Rather than either a medical or psychological approach, existential therapy draws on philosophy with the aim to ‘clarify, reflect upon and understand life…to gain mastery over the art of living, so that life’s challenges can be welcomed and enjoyed instead of feared and avoided’ (Deurzen 2012). Existential therapists do not offer set ways of living life, a hope that a positive attitude will conquer all or a warm cocoon of escape from reality. The work is instead a focus on the reality of clients’ lives, an awareness of their limitations as well as a discovery of their strengths and desired destination. The aim is to achieve authentic living, defined by Jaspers as ‘becoming oneself whilst suffering defeat.’

If you would like to read more, may I suggest ‘Existential Counselling & Psychotherapy in Practice’ by Emmy van Deurzen, 2012


Paul Hurst

Nicholas Conn / 2nd April 2018/ Posted in: Latest News

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    Detoxification (detox) is the medical intervention required for someone who is physically dependent to drugs or alcohol. If required, medical detoxification would be the first step taken in residential rehab. Detox is used to prevent uncomfortable and dangerous (even fatal) withdrawals symptoms resulting in suddenly becoming abstinent from alcohol/certain drugs.

    The goal of a medical detox is to aid in the physical healing required following long term addiction and rid the body of all together of substance whilst providing a cushion for unpleasant symptoms of withdrawals. Detox is not considered the whole treatment for drug/alcohol addiction and it is always recommended that a comprehensive rehabilitation program is used along side to help maintain long term abstinence.

    Medication is often required for alcohol detox. If you are dependent on alcohol and experiencing withdrawal symptoms it is vitally important to seek medical advice prior to stopping. There is a long list of medications used when treating alcohol addiction and the exact medication given to an individual will depend on their needs/medical history. Some of these include;

    • Chlordiazepoxide (Librium)
    • Lorazepam (Ativan)
    • Diazapam (vailium)

    Librium and Valium are the most commonly used detox medication in the UK. All medication used to help with alcohol detox have been proven to help reduce the effects of withdrawal symptoms.

    There are also a number of drugs recombined by the NHS to help treat alcohol misuse. Some of these include:

    • Naltrexone
    • Disulfiram (Antabuse)
    • Nalmefene
    • Acamprosate (campral)

    Medication is always required for heroin detox. For someone suffering from heroin addiction, the thought of detoxification (detox) can be exceptionally daunting. Withdrawal symptoms from opiates, such as heroin, can be severe and include pain, vomiting, nausea and shaking.

    There are different ways that heroin detox can be carried out, most usually either ‘maintenance therapy’ or ‘full medical detox’.

    Attempting to switch from heroin to a heroin substitute, usually on a controlled prescription, is known as Maintenance therapy. Subsites used are most often methadone or buprenorphine.

    A full medical detox from heroin will always be carried out in a residential rehab setting and will allow the individual to switch form heroin to a substitute and slowly withdraw completing treatment free of all substances. Someone using a heroin substitute can choose to have a full medical detox at any time, however detoxing substances such a methadone can often add to the length of detox required. Drugs most commonly used to fully detox from heroin are, Subutex, Suboxone and Methadone. Much like alcohol, the exact drugs used will be dependent on the individuals needs/medical history.

    Once detoxed from heroin the risk of overdose is much higher following relapse due to tolerance following withdrawal.

    The length of treatment in a residential rehab depends on a number of elements. Some substances require longer periods of detox than others.

    Private paying patients will also often choose a length of stay that suites their therapeutic and financial needs. As a rule, a full treatment program in a rehab is considered to be 28 days (often referred to as a month), however, treatment is offered in several different ways and lengths starting at 7 days.

    Treating alcohol addiction will always require a minimum of 7-10 days, this would be considered the detoxification (detox) faze. The length required for treating drug addiction can vary drastically depending on the substance being used. Detox for Heroin addiction is generally around 14 days minimum, with more time required if substances such a methadone are being used. Treating prescription drug addiction can often take the longest. The time required for treating gambling addiction, eating disorders and sex addiction will be based on the individuals needs.

    Rehab programs can be as long as an individual requires but primary treatment is normally caped at 12 weeks, with the offering for further secondary and tertiary treatment thereafter.

    *based on average rehab stays, everyone will vary dependant on needs and medical requirement/history.

    There is no need for your employer to know that you are seeking help for trauma and addiction unless you choose to involve them with the process. All employers should have a policy that explains what you do if you cannot come to work due to illness – illness to include treating alcohol addiction/treating drug addiction.

    If your work absence extends over 7 days your employer is likely to require an official statement of fitness to work which would be obtained from your GP. This would need to supply evidence of your illness as well as any adjustments required for returning to work, fazed return or reduced hours, but does not need to specify in detail the reason why you have been absent.

    If you are absent from work for 7 days of less, for example entering rehab for a detoxification (detox) on a Saturday for 7-10 days taking a full week away from work, you can self-certify your illness by letting your employer work you will not be attending work for that period of time. Exactly how an individual would do this would be dependent on a specific companies’ policies on taking sick leave.

    Any time longer than 7 days it is likely an employer will require a note from the individuals GP certifying their sickness and a fit note on return. Most companies have a clearly outlined policy on sickness and receiving sick pay so the exact requirement can vary. A rehab will always be willing to advise on time off work.

    How much does rehab cost is a very frequently asked question. The cost of treatment can range from £1,000 per week upwards depending on the place, with luxury rehab being the most expensive.

    There are free options available on the NHS but the waitlist of those looking for free treatment is longer than that for privately paying patients. Some private health insurance policies will cover treatment in some rehabs around the country.

    Choosing the right rehab centre will often be based on priced but it is important to follow guidance on the most suitable treatment centre for an individual’s needs which our expert team of advisers are on hand to offer.

    There are certainly pro’s for both treatment near by and traveling for treatment with one of the most asked question being should I get rehab near me? There are rehabs all over the UK and around the world that all offer expert programs, let’s look at how to choose a rehab.

    Local treatment

    Being close to home gives certainly has benefits. Visitors are normally permitted in rehab following the first 7 days stay, therefore if an individual is in treatment for a length of time longer than that being local will make it easier for loved ones to visit.

    Most rehab centres will also provide a full aftercare plan for someone following treatment, this will include ongoing aftercare in the specific treatment centre. Living close by can make it easy to take full advantage of ongoing aftercare. There can also often be the option for ongoing care with an individual therapist, again being close by will allow that treatment to be carried out face to face.

    Some individuals wish to be local but are willing to look broader, for instance the greater city of residence (London, Manchester, Liverpool, etc)

    Treatment Away

    Getting treatment away from home can be very appealing to some. Being out of the local area makes it a lot harder to just walk out of treatment as resources locally are unknown. Some also take comfort in knowing that they are not near home and focus more on treatment.

    As the price for treatment can vary so much from one residential treatment centre to another, private paying patients often would rather travel to keep the cost down. Those using private health insurance may also have to travel to find a treatment centre covered in their policy.

    When opting for treatment away from home this can be anywhere in the UK and also abroad. Aftercare can still be carried out and very successful using tools such as The Online Rehab.

    There is no right or wrong when choosing where to go to residential rehab, but our expert advisors are always on hand to help provide information on all possible options.

    Whilst millions of people in the UK have taken recreational drugs (amphetamine, cannabis, cocaine, crack, crystal meth, GHB, heron, ketamine, methadone, and prescription drugs) and drank alcohol not all become ‘addicted’. Most recent reports show that 279,793 individuals were in contact with drug and alcohol misuse services in the last year with over half of that being from opiate addiction and a quarter for alcohol.

    There are several risk factors invoiced in addiction and those using drugs and alcohol socially, simply take the risk. These risks are as follows;

    Tolerance – basically, if a substance is used repeatedly an individual’s tolerance to it will build. This will result in more of the same substance being required to get the same effect. In the long run this can easily lead to addiction and physical dependencies.

    Environmental risks – these can include influences such a peer pressure and stress as well as physical or mental abuse of an individual (particularly as a child). Overall, those who live with frequent pressures and stress are more likely to reach for a substance to cope and are therefore at higher risk of becoming addicted.

    Drug type – it is very well known that certain drugs are simply more addictive than others. Using substances such as heroin increases the risk of becoming addicted for need to ‘chase’ a high as well as physical dependency.

    Drug administration – how a drug is administered can affect its addictive qualities. A drug injected rather than smoked or snorted will release a quicker and more intense high thus making it psychologically (and in many cases physically) more addictive.

    Biological factors – it is now widely reported that being an addict is not only psychological but also biological. This includes your genetic makeup, mental health, sex and age. It is also reported to be 8 times more likely for the child of an addict to become an addict themselves.

    Its believed that addiction is approximately half genetics and therefore some are 50% more likely to become addicted than others.

    How do you help a loved one trapped in addiction?

    The first step is to help and encourage the individual to become willing to accept help. They do not need to be shouting this off the rooftops, but they do need to be willing to go into treatment. There are ways to help someone become willing to get treatment for alcohol or treatment for drugs.

    Set boundaries – set boundaries and stick to them. Once you have laid them out follow through with whatever consequences you have set however hard it is.

    Stop finances – if you are financially supporting someone stopping these finances can be the quickest way for the addict needing to ask for help. With no money to acquire a substance an addict’s options become very limited.

    Intervention – getting together with other family members/friends/colleagues and staging an intervention is often very successful in the fist stage of acceptance and gaining an admission to residential rehab.

    You can’t make them quit, this can lead to dangerous withdrawal. Boundaries are very important in helping someone become willing to get help. Unfortunately you cannot do someone’s recovery for them and without self-motivation it is very hard to make it work.

    The next step is to call our highly trained advisers 0203 955 7700.

    There is a huge range of rehab options available and where to start can be completely over whelming so let us help.