A treatment approach to recovery from addiction
Once an individual expresses a level of intrinsic motivation to change, and has insight and awareness into how the problem is sustaining in their life, they are now in a position to begin learning psychosocial approaches to sustaining recovery over time.
The starting point of this process often looks like provision of education to the individual so they can understand the nature of addiction, and most importantly the role of triggers, cravings, and urges in sustaining their use of the substance. The next step is to collaborate with the person in accurately identifying and understanding triggers - people, places, occasions, situations, events, thoughts, and emotions associated (classically conditioned) over time with their substance use and subsequent alleviating effects.
Once an audit of triggers is done, the process can begin of developing plans to avoid triggers where possible or, if unavoidable, developing alternate means of navigating the trigger(s) when faced with them. Beyond this, treatment begins to focus on equipping the individual with base level coping skills including learning to 'urge surf'.
Urge surfing is an effective but elementary technique useful for the individual in the early stages of recovery. It is a great way to 'get early wins' with addiction and subsequently provide the person with a sense of confidence and efficacy regarding future recovery and work to be done.
Urge surfing works on the premise that urges are time limited - evidence-base shows that the pre-activation of D2 in the limbic region of the brain is temporary, and can subside in a matter of seconds or minutes. With this technique, the person is taught to not resist or deny an urge if they indeed occur, but rather accept it, sit in the discomfort whilst breathing calmly and engaging another part of the brain with sensory input. By flooding the brain with sensory input when an urge is occurring, it engages a part of the brain called the pre-frontal cortex (section of the higher brain) which acts as a distraction and quickly quietens down activation of D2 in the lower brain.
Repeating the urge surfing process over time successfully can in itself move pre-activation of D2 towards extinction over time. In this case, the path towards recovery for the person can become easier, and the focus can move towards addressing psychological dependence and the issues underpinning addiction in the first place.
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