Editor
Bonnie Jacobs, PhD, ABPP

The disease of addiction has many components: bio-chemical, emotional, spiritual, family, culture, race, gender, current and historical. In this article I will focus on the emotional and spiritual aspects of the diseases.

The field of addiction treatment has moved from the traditional concept of individual addictions to a more generic understanding that the disease, Addictiveness, manifests itself in many ways in a persons life. Addictiveness is a condition which is marked by obsessive compulsive thought and behavior (which may or may not involve: drug or alcohol abuse, food, shopping, gambling or sex), anxiety, overwhelming low self esteem, fear of intimate relationships, poor intimacy skills, difficulty dealing with painful feelings, fear of being discovered, isolation and resentment. Addictiveness is significantly associated with dependent personality characteristics.

Addictive persons often have issues with spirituality and frequently have deep resentments attached to the concepts of God which were for d upon them during their development. I have found that making peace with some concept of God or a Higher Power is also central to successful recovery. All of these issues are amplified in the GLBT community. GLBT persons often have difficulty with the above issues because of homophobia, both internalized and societal.

Much of recovery consists of self empowerment. Twelve-step philosophy and practice is one of SHARING experience, strength and hope. The traditional hierarchical practice of psychotherapy is often an impediment to self-empowerment. It is very appropriate for the therapist to insist on, but not necessarily require, 12 step involvement; including getting a sponsor (in program) and working the 12 steps of recovery. Addictive persons achieve recovery most effectively in a group setting and context. It is important to remember that therapy is only an adjunct to recovery, NOT a replacement for it.

In my opinion, it is best if therapy focus on helping the person comprehend their belief systems (and their origins) and their emotions, and gain an understanding of the distinction between the two. Simple re-directing (i.e., Is that a belief or a feeling?) is very appropriate until the person has gained self-awareness. Most of the GLBT persons I know in recovery are no longer closeted because they have found it is impossible to remain in that place of fear and stay clean/sober.