I wrote this relapse prevention manual a while back based on the training I received from several companies. I read recently that the self-medication hypothesis is not supported by concrete evidence. Supposedly, dysphoria (feeling bad), has been shown to fit into the self-medication hypothesis. This is congruent with my work with clients struggling with addiction. Often times feeling overwhelmed, depressed or anxious is a trigger for using substances. An underlying mental illness does not have to be present for self-medication to occur. Substances in this way are used to regulate mood. Finding healthier ways to cope with dysphoria can be beneficial to preventing a relapse.
Relapse Prevention
June 28th, 2009Secondary gain
June 28th, 2009Have you ever tried to change a habit and it just doesn’t change? Freud’s secondary gain concept might be at work. Secondary gain is possibly a big blocker in the treatment of anxiety disorders. Take for example a person who feels anxious going outside their house. The person might wish to change their discomfort but they find it difficult to get outside. With social anxiety staying inside can be rewarding since anxiety decreases in the absence of other people. By staying inside the person receives the secondary gain of feeling more relaxed. This problem becomes a chicken and egg situation where the person wants to stay outside more but doing so creates discomfort. In order to stay outside more the person would have to acquire stress and coping strategies and accept a certain level of discomfort to change their reclusive behavior.
Secondary gain can also be a blocker in preventing new relationships from forming. Dating new people can be anxiety provoking. A person might desire to meet a new boyfriend/girlfriend but they find that they just never get around to it. Secondary gain could be at work here. The person receives a benefit from avoiding new relationships since it keeps expected anxiety at a low level. A person in this situation could benefit from cognitive therapy. A person that feels a high level of anxiety in new relationships might have over-exaggerated beliefs of being judged or criticized. Learning how to change these beliefs into more neutral thoughts could allow the person to break through secondary gain and achieve the relationships they desire.