Time passes; you get older and become an adult. You have gone to college or not, you have a job, you make money, perhaps you are very successful, you get married and have children. You still have parents. They are, if this is the case, the toxic parents you grew up with. They have changed little if at all as you grew from childhood to adulthood. You have a life of your own as an adult, but your parents are still part of your life, still in your life. Read more
Articles by David H Jacobs Ph.D
Based on persistent distress and so on, people ask about themselves or others ‘What’s the matter?’
Over the past 31 years (that is, since the 1980 publication of the American Psychiatric Association’s third edition of its Diagnostic and Statistical Manual, the DSM for short), American psychiatry has trained not only the mental health industry but also the public at large to think and speak in the language of DSM disorder categories. Read more
The title refers to a perennial disagreement among people who treat addictions of all sorts, namely whether to think of addiction (to alcohol or sex or anything else) as the problem (disease, disorder’) itself, or whether to think of addiction as one sign (and not the only one) of a problem that actually generates the addiction (as well as other signs, if one looks carefully).
First the usual caveat about ‘addiction’: It does not lend itself to precise definition. It is really is a term indicating use (substance or activity) on the part of someone that has come to stand out to others or the user him/herself as damaging well-being and which resists efforts to eliminate or modulate. It is consequential for treatment if the person using does not really (as opposed to lip service) see his/her use as ‘over the line’ in terms of self-harm.
Perhaps therapists see a biased sample. Perhaps there are people who recognize a need to change something important about the way they live and execute change in a timely manner. But I must admit that what stands out to me as a therapist as well as through informal (non-therapy) relationships is how hard most people find it to change any well-entrenched aspect of how they face the world or live in the world day to day, regardless of how desirable it might seem to let us say ‘upgrade’ how they go about living life. Read more
The issue of how therapy can help a person move away from excessive, self-harming use of a substance or activity cannot be discussed meaningfully without attention to the actual intention of the person entering therapy. To use learning a foreign language as an adult as a useful analogy, if the person being instructed does not actually want to learn the language and does not make a real effort to pay attention, concentrate, study, practice, etc., he/she is unlikely to benefit much from instruction. The degree to which the person genuinely opens to the subject matter and the instruction cannot realistically be overlooked (I draw upon my own foreign language instruction experience in high school and college, in which I engaged minimally, resentfully, and inattentively, with predictable results).