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Addictions Are an Attachment Disorder

When I think of addiction, I think of attachment. When we have no one to reach for, to soothe us, and help us stay grounded and safe and secure, we reach elsewhere. When our childhoods are chaotic sufficiently to create a tear in our ability to bond, we develop an insecure or anxious connection, and when that happens, we have no one to safely reach for. A men’s therapy group can be just the right antidote.

Group Therapy for Attachment Deficits

In the process of healing, group therapy has long been known as an effective modality for working with attachment processes. In fact, in the EFT model, it is within the couple-ship that the work is done. Its within that ‘space between’, that we supply ourselves and our foibles and fragilities that manifest within our relationship yet were most likely there pre-existing our relationship union.

Attachment starts the second we are born, perhaps soon. How we are touched, how we are held and how the environment surrounding our space remains (calm/chaotic; consistent/inconsistent). As does our sexual self-start simultaneously.

Healing attachment trauma requires connection and, as such, a group format for healing addictions is indicated (Philip Flores: Addiction as an Attachment Disorder, Group Psychotherapy with Addicted Populations).

Having trained in group psychotherapy in the mid/late 80’s, Irving Yalom was my mentor, albeit not in person just in his written words. Given that, here is the context in which his teachings apply to group therapy for the sexually aberrant (addicted, out-of-control) population. Aberrant or unhealthy simply relates to those who act out of their relationship agreement and/or engage in behaviors which are destructive for which they cannot control.

And at the outset of embarking on a new venture, a psychodynamic/object relations oriented process group for men with a history of sexual acting out, whether it be via fantasy, actual sex, porn watching, chat room engaging,  etc., I deem this topic appropriate.  A men’s therapy group is in need.

The Therapeutic Factors of Irving Yalom:

  1. Installation of Hope: With the support of others, some at the same place and some further along in their healing, the helplessness and hopelessness reverse and there becomes a space for healing.
  2. Universality: Sharing of oneself and being heard alone can be healing; one learns that regardless of how much alike or different one member is from the next member, he/she is not alone. Unlike the 12-step groups, this group is all about cross-talk. With this, there is real validation and a sense of belonging.
  3. Information Giving: Through the exchange of information and sharing, members learn that their behavior is not unique and understand the nature of addiction and relationship dynamics.
  4. Altruism: As members feel a part of a community, sharing and helping enhances their own self-esteem while helping others.
  5. Corrective recapitulation of the primary family: It is within the group context that earlier relationships are played out. This is the bones of a process group. As such, a corrective experience is encouraged as members work through these transference and counter-transference reactions.
  6. Improved social skills: With addiction and issues of intimacy, social skills after often lacking in one place or another. True intimacy with an authentic connection that occurs in group provides the opportunity for an improvement in social behaviors.
  7. Imitative behavior: Through the observation of member’s communication as well as the often role-playing of the group leader, members have the opportunity of learning new ways of expressing their emotions and their thoughts, requests, needs, etc.
  8. Interpersonal learning: Group provides the emergence of all kinds of relationship dynamics, typically those replicating the early life and the unhealthy repetition of that trauma. By looking at the micro-moments of connection, members have an opportunity to soften that pain and learn new ways of connecting.
  9. Group cohesiveness: As there is often a disconnect with addicts and particularly men, whose social structure is not built on intimacy, members learn authenticity through an alliance established with the other members.
  10. Catharsis: Through the examination of the ‘space between,’ as we do in EFT with couples, members have a space to grieve and release pain from their past and present.

It is essential that not only the group is appropriate for the member, that is, there is a well-qualified and experienced therapist with knowledge of both group work and addictions, process and substance (given the incidence of co-occurring addictions), but that the member is appropriate for the group. This group is not for those engaged in physical violence or where there is a complete lack of regulation of affect.  Nor is it for the sexual offender, (although the overlap of this with some forms of sex-addiction has been in dispute as of late.) This is a high functioning group and having some insight and some ability to connect is often helpful.

It is essential for group members to be engaged in individual therapy, on at least a monthly basis, to provide a space for them to turn to process that which cannot wait a week or they need individual attention to do so.

Dr. Barbara Winter is certified in group psychotherapy and has led process groups on and off for 30 years. Dr. Winter is leading a men’s recovery process group for men who have or are acting out in a sexual manner such they are violating a relationship contract and/or are engaging in troubling and ineffective behaviors that they are unable to stop. You can find information about current group offerings here.

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