“I’m struggling with…addiction.”

Addiction can be an intimidating topic for anyone seeking mental health support. It can be scary to talk about, and hard to describe to another person, especially if you are worried about being judged and shamed.

I take a harm reduction approach to addiction, which means I am always mindful that:

• Addiction is possible with virtually any substance or activity–even things that seem like they would be good for you

• Our society arbitrarily judges some addictions as normal and harmless, while stigmatizing and pathologizing others. Societal judgment often has little to do with the actual impact of the addiction on the person.

• Whatever the addictive substance or behavior is, abstinence may not be a realistic goal. It is better to focus on the person’s relationship with the addiction, rather than the substance or behavior itself.

Therapy that is founded in harm reduction is not about eliminating or abstaining from anything. Instead, we focus on the following strategies to target addiction at the root:

Get support.

If you are struggling to change your relationship to a substance or behavior, you need support. This can be from a therapist, a support group, trusted friends or family. Turn to people you feel safe to talk to and supported by, and keep them in the loop on how you are doing. Dealing with addiction is very hard work, and you should not try to go it alone.

Acknowledge shame and set it aside.

Considering the way our society handles issues around addiction, it is natural to feel shame about your own relationship to an addictive substance or behavior. However, the feeling of shame is not going to be helpful in making a positive change in your life. You might find, in fact, that shame contributes to addictive or otherwise self-destructive behavior. Now is the time to acknowledge that you feel shame, and then try to set it aside. Shame will try to get in your way as you are attempting to make positive changes in your life, and it needs to be put in its place.

Explore your relationship to the substance, and what needs it serves.

All addictive relationships have a psychological or emotional component. No matter what type of addiction you are struggling with, it likely has a powerful impact on your mood, emotions, or behaviors. The addiction has been reinforced by some positive feeling that you have come to associate with it. Take your time and consult with a trusted supporter as you explore how this substance or behavior has begun to look like the best way to serve an unmet need in your life.

Explore alternative strategies for serving those needs.

With that insight, now look into alternative ways of meeting that unmet need. Consult loved ones and professionals and create a menu of strategies that serve this purpose. Perhaps you are in need of social or communication skills to enhance your relationships. Perhaps you would benefit from coping skills that help you manage emotional distress. Maybe there are medical interventions that could address physical or emotional pain.

Explore your relationship to the addiction and what it helps you avoid.

While the addictive substance or behavior likely induces some positive emotion that reinforces use, it may also be helping you to avoid problems that feel unsolvable. These problems may reside in relationships, your state of mind, or even your way of living. Take time and get help in looking for avoidance at the root of your substance use.

Explore strategies for confronting what you’ve been avoiding.

With a skilled and trained therapist, get yourself ready to confront what you have been avoiding. Even unsolvable problems can be mitigated and managed with the proper support and boundaries in place. Once you are facing these problems head on, you may feel less of a pull toward addictive behaviors that have helped you to escape and avoid. 

Consider starting from a place of adding variety to your life, rather than restricting behaviors.

The core problem with addictions is that they limit your freedom. When living with addiction, your schedule is not your own, and everything comes second to the addictive behavior. Recovering and healing from addiction is about regaining freedom–to do what you truly want to according to your own agenda, values, and priorities. When thinking about managing addiction, remind yourself that this process is about expanding your life, not about punishing or restricting yourself.

If you are struggling with an addiction of any kind, consider how a harm reduction approach can help you to improve your life.