In my 50-year-old client, we’ll call him Matthew, addiction had taken two forms: crystal meth addiction and sex and love addiction. It wasn’t until his late thirties that he first encountered the unholy combination of sex and drugs. He was caught up in internet sex, meeting men online and then hooking up with them. The sex almost always involved some kind of drugs. His long experience with alcohol and marijuana gave him false confidence, as he said he could take them or leave them. He felt no compulsion to drink or smoke, so in that respect he was not addicted to those substances. When crystal meth entered the mix, however, his addictive personality took over.

Matthew recounts that he first encountered crystal meth at a party, and he enjoyed the high it gave him. It was highly energizing and, for him, highly sexual. The mix of crystal meth and sex quickly became a potent force in his life, as he was running away from feelings of loneliness and disconnectedness from himself and from others. By now, he was engaging in drug use and having sex every weekend. To this day he doesn’t know how he managed to hold down a job while doing this.

Eventually, however, he was fired from his job, leaving him with spare time at his fingertips–which turned him then to daily use. In addition to the increase in using, and instead of smoking or snorting the crystal meth, Matthew began injecting it intravenously. As his life spiraled out of control, he met someone (another IV user) whom he thought could be his boyfriend. Little did he realize that the whole relationship was fueled by drug use. Eventually, the boyfriend tired of him and wanted to break up. This was heartbreaking to Matthew, and he nearly went mad with grief. Meth can easily lead to overblown feelings, and he realized that he had become addicted to the boyfriend, too, for sex and love.

The withdrawal from the boyfriend was even harder than the withdrawal from using crystal meth. Initial withdrawal from the drug involved a week or two of depression and nonstop sleeping. The withdrawal from the boyfriend, however, lasted months and took a toll on his heart. Someone finally pointed out to him the abusive nature of that relationship, and slowly he started to see in real terms his own part in this sex-and-drug-fueled “relationship.”

Matthew and I worked psychodynamically to reveal the roots of his desire to escape, and he entered a behavioral-modification drug workshop to learn the tools of sobriety. After that, he attended Twelve Step meetings and came to understand the spiritual basis for recovery. For three years, we worked on not only the drug addiction but also the sex and love addiction. It was a happy day when I told him that he was basically ready to handle life on his own, without my help.

Because I have been around many addicts in my practice, I have friends and clients who are still struggling with addiction and often relapse. Sometimes I think that it is much harder to kick an addiction when one is young than when one is older. There is something about the years adding up that forces us to take stock of our lives and makes us willing to give up bad behaviors, especially when faced with a future that finally looks very finite in years.

Ultimately, the decision to enter recovery has to come from the individual. I have thus seen the limits of my ability to help someone stop, but that doesn’t stop me from trying. I use Matthew’s story as an example for these people, how he ran away from himself through drugs and sex, and how, through the help of therapy, he found his true self again. “When I was on meth, I became a person who wasn’t me,” he said later. “Now, I am happy to be me again, facing life square on, without any escapes.” Matthew now attends occasional Twelve-Step meetings as a refresher for everything he has learned. The last I heard, he was renewing friendships, focusing on his career, and avoiding needy and neurotic relationships.

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In the midst of a relapse, it can be hard to live a “normal” life, let alone come to therapy or go to meetings. Finding our way back to therapists, sponsors, higher powers, and the concern of friends and family, however, will help us find our way back to quitting again. Calling a halt to the relapse and returning to a sober way of life demands not only action but also understanding. It is as if the relapse is not over until we have discovered its prompt and its sought-after reward. What was it that called us back to using that substance again after years of doing without?

To look beneath the behavior of drinking or using, we need to understand its intention and desired reward. What was it about that experience that we wanted to relive or those feelings we wanted to feel again? Typical responses to these questions include: to escape reality, to feel a rush, to really relax, to bond with friends and lovers, to lose inhibitions, to feel sexy, to deaden painful or uncomfortable feelings, to turn off the thinking head for a while, to alleviate boredom, to enhance pleasure, and so on. There are a million more.
As we explore the motives for falling back into an old behavior that we thought we had conquered, nuanced patterns can now emerge that were not so apparent at an earlier stage of our struggle to quit. This is the time to revisit our old answers and update them. Are there new feelings and situations that trigger a desire to escape? a need for a boost? etc. Where did we learn that by ingesting a substance—be it food, drink, smoke, or chemical—we could fix a situation and make ourselves feel better?

In the midst of a relapse, asking these questions opens the door for ending the relapse. In fact, the answers to these questions are not even necessary in order to crack the spell of the relapse. (The answers would be nice, mind you, and certainly will be helpful in the future.) Just asking these questions can force another level of thinking, and possibly guilt, but enough upset to call an end to the relapse. Upset can be a good thing. Ending relapse means the choice for a return to self-control. And self-control leads down the path to self-discipline.
To many people, self-discipline is negative compound word, its two halves seemingly warring with each other. To them, self-discipline implies pain, boredom, and stricture. Self-discipline, however, is only the practice of consistency, with the understanding that making yourself stick to your word to yourself is of immense value in itself. Self-discipline allows you to get the job done. Self-discipline may even include an incentive/disincentive system to keep things functioning. The acceptance of the need to control ourselves at times, to say “no” to ourselves at times and be consistent about it, is one of our earliest childhood teachings.

Self-control is usually taught to children in the context of getting along with others. Some of us, however, misread the lesson and conclude that when we are alone, self-control can be jettisoned. And, of course, the relapse itself proved just the opposite. With the help of others and some self-control, we can rejoin the living and benefit from the practice of a much feared but highly productive behavior, self-discipline

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Biochemical Addiction

Clients first deal with the biochemical addiction. When you’ve trained your brain to expect gargantuan doses of dopamine, you can be damn sure it’s going to be calling out to be fed when it feels hungry. Welcome to withdrawal! For those who have linked up crystal meth—a strong stimulant—with sexual release, the expectations of an orgiastic, sexual feast of a lifestyle have become normalized, and clients fear that life without crystal meth will be incredibly dull. Welcome to retraining the mind back to normal, human levels of excitement and sexual activity, including even (o horror!) periods of no sex!

Behavioral Addiction

Later, clients deal with their behavioral addiction. How to deal with life? Feel bad? Get high. Feel lonely? Get high. Feel horny? Get high. Crystal meth becomes the coping method of choice when dealing with life’s little (or big) unpleasantnesses. Unfortunately, while they were out there partying, the problems that were causing those nasty feelings were only getting worse and worse, and my clients’ avoidance of them, together with their muddled thinking when they did look at them, made them all the worse still. Do my clients have the emotional strength to deal with their issues without this avoidance mechanism? Not without a great deal of help from friends, family, therapists, sponsors, mentors, and entire communities. Addiction to crystal meth is an isolating process in the end, and many addicts have been so far removed from “normal society” that they have given up any hope of ever reentering it.

Belonging to Community

For many of us, “normal society” was never that much of a draw to begin with. For boys and men who have been traumatized or who feel “othered,” drugs provided a welcome relief to the painful and rejecting world. All this is well-trodden ground in the gay recovery community. So how do we provide hope? In therapy we try to help addicts change their perspective, stand back and look at life from a meta point of view, and examine their choices in terms of lifestyle and sense of purpose and belonging. Therapy alone isn’t a cure for addiction, but it helps clients see where the light might be, way down there at the end of the tunnel. And having sight of that is one more tool in fighting the good fight.

David Bowman LMFT is a licensed psychotherapist based in Los Angeles, California.

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