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January 2010


By Alan Solomon, Ph.D.


As challenging as treatment for an addiction can be, it is often only part of the picture, unfortunately. Frequently, once sobriety or abstinence is established with some certainty (perhaps three to six months, minimum), additional issues become apparent. Significant anxiety, depression, learning disabilities, attention deficit disorder, unresolved grief due to previous losses, a mood disorder (such as bipolar disorder), or previously unacknowledged trauma may become prominent.

In the story of Beautiful Boy, issues of a marital divorce and the complications of the visitation schedule with its unavoidable losses, as well as one parent’s own history of drug use are apparent. In the case of my client’s child, there was an unknown incidence of trauma for his daughter earlier in her life that only came to light a few years after therapy had begun. This was a secret the daughter had been keeping for several years. There was also a false accusation of child abuse within the family made and then disproved when the child was very young.

Professionals describe this as a “dual diagnosis”. In addition to the addictive issues, there is another diagnosis, one that often predates the addiction. This pre-existing condition is perhaps the original source of pain that the child is trying to relieve with self-medicating behaviors. Only with more ongoing support and therapy, beyond establishing abstinence, and the involvement of family members, can these issues be identified, and cared for, so that the risk of relapse and ongoing difficulties can be reduced.

Not to minimize the absolute importance of dealing with an addiction, some professionals add that “deeper work” begins once abstinence is established. This work supports longer lasting health and benefits, so that a client and family can resume their journey along a path of continued development.




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