Is there a role for counselling in the treatment of addiction? – Part 3

In this, the final installment looking at “Is there a role for counselling in the treatment of addiction?” by Mick Devine Clinical Director Tabor Group he concludes: To address the matter takes skill. Supportive, challenging interventions delivered with care and empathy can play a significant role.

The Role of Counselling in my experience in the field has led me to believe that it is very difficult to separate the impact caused by the addiction from that caused by the contribution of the person themselves; it is as if there is no difference between the two. The person is an addicted person. I mentioned in my previous post Is there a role for counselling in the treatment of addition part 1 and 2 how the person’s reward center is affected by substance use, the person’s motivation and incentive system is affected by the substance use, as is their executive functioning.

It is my opinion that these functions of our brain are instinctive and unconscious; they are part and parcel of who we take ourselves to be. Hence our identity is intricately wrapped around these brain functions. Therefore, to reflect on the thinking, feeling, attitudes, beliefs, perceptual apparatus, judgement and choices that have all become affected by substance abuse is very challenging as it is almost impossible for the person to separate all that out from who they are in the first place.

The education is difficult for the person because the syllabus is themselves and what their life and the lives of their loved ones has become as a result of not addressing their addiction. Additionally, the insight is illusive because the instrument of obtaining insight is the most affected. It’s like the eye seeing itself. I would argue therefore that counselling is crucial to the person in order to succeed in managing the condition. It is within a trusting therapeutic relationship that the person can undertake the necessary reflection so they can see the reality of their situation as opposed to the distorted perspective noted.

Counselling is needed because it is uncommon for the person to be capable of such insight without assistance. The person must firmly but gently confront him/herself about situations that are beyond their ability to see for themselves. Hence, the counsellor is particularly well positioned to assist the person with this task and to provide the necessary emotional support for such confrontations. My experience has highlighted how the honesty required to allow the full picture to emerge is often not easy to come by yet the detached but trusted counsellor can provide the ‘holding’ to allow this to happen.

I have witnessed how the greater the accuracy in developing an awareness of the extent of the impact of addiction, the more motivated the person becomes to manage the condition successfully. The counsellor skilled in the art of listening and empathic response, who has understanding of the defense mechanisms of a person feeling trapped and overwhelmed, and who has the ability to maintain the person in positive regard is crucial to the success of this enterprise. (Mate, 2012)

The insight needed for the management of a chronic condition can be gradual. The contribution of the counsellor can be an indispensable part of the treatment process. Through the expertise in the caring support of an interpersonal relationship the addicted person can achieve enough distance from the catastrophe to see it clearly and to see that that is not all there is to them. The counsellor models in their interactions that there is no stigma, no judgement, no loss of essential value and goodness. The addicted person can begin to believe that recovery is possible.


In this article I have tried to for counselling in the treatment of addiction. I have used the short and long version of the definition of addiction of the American Society of Addiction Medicine. In my experience, concealed within this medical definition of addiction is the securing of the place for counselling in the management of this chronic health condition. I have demonstrated that if we don’t see the chronicity of the disease we overlook the role of the addicted person in the management of the condition.

The organ chiefly affected is the brain. Our brain is the organ where our drives, attitudes and beliefs are seated as well as our executive capacities such as thinking, motivations, deferring immediate gratification and decision making. As such its functioning is central to our identity. I hope it is now clear that, in my experience, the addicted person is challenged with an intractable dilemma. Those seeking to successfully manage the condition need help. For the addicted person to succeed they need to get some distance from this identity to see its operations. When they can do so insight and objectivity are possible. Counselling is central to the addicted person achieving this distance. This is a delicate matter particularly when there is so much shame attached to being addicted and there is so much societal stigma surrounding it. That the person can address painful issues associated with being addicted is central to good quality outcomes.

To address the matter takes skill. Supportive, challenging interventions delivered with care and empathy can play a significant role. From this support the addicted person sees the disease in action and the part they play in its dynamics. They can also see their part in neutralizing these dynamics so as to achieve full rehabilitation (TZU, 2014; Dupuy, 2013).

Tabor Group

Tabor Group is a leading provider of residential addiction treatment services in Ireland. We provide support and care to hundreds of clients each year suffering from addictions to alcohol, substances, gambling and food. Tabor Group offers hope, healing and recovery to addicted people and their families through integrated and caring services. For more information on Tabor Group’s services Click Here

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If you or a loved one are suffering from an addiction to Alcohol, Drugs, Gambling or Food get help today. We can help you recover in a healthy, friendly environment and beat your addiction. Don’t hesitate to contact one of our counsellors today at +353 (21) 488 7110 or Email Us and we can help you

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