The disease model of addiction says that substance use is a brain disease and that people who use substances addictively are powerless over their actions. However, not everyone believes that characterization of addiction. Treatment centers that reject the disease model take a unique approach to treating substance abuse.
At Sunshine Coast Health Centre, in British Columbia, the treatment program is based on the idea that addiction is a response to a life without personal meaning, says Geoff Thompson, PhD., program director at Sunshine Coast. That idea has a long history; it was first voiced by Viktor Frankl in Man’s Search for Meaning, published in 1946.
“Frankl said that if we really want to understand addiction, we have to recognize that it is far more than merely the drugs’ effects on the brain,” Thompson said. “Addiction operates at the level of a fundamental motivation to make sense of ourselves and pursue a meaningful life.”
Accepting that premise changes the way that Sunshine Coast Health Centre delivers care.
At the forefront, building a life
In 12-step addiction treatment, clients are encouraged to focus on abstinence. Then, after they’ve achieved sobriety, they explore creating a meaningful life. At Sunshine Coast, that model is turned around.
“If addiction is a problem of meaning, then the goal of treatment is to help clients begin the process of living a personally meaningful life,” Thompson said.
A meaningful life has three components, Thompson said: self-awareness, positive relationships, and intrinsic motivations. When a client comes to Sunshine Coast, they begin therapy to help them create these components.
“We designed a program to help clients develop an accurate understanding of who they are, develop authentic relationships, and pursue goals based on what is truly important to them,” Thompson said. “The focus is always on helping them get a life.”
Principles of addiction therapy
At Sunshine Coast Health Centre, therapy follows specific principles to help build a meaningful life. Here’s how Thompson describes the principles:
- We don’t treat an addict or an addiction. We treat a complicated, unique human being, who suffers from addiction.
- Each client is the author of his or her life, regardless of biological or environmental limitations. We don’t tell clients what to do, think, feel, or say; that’s the client’s responsibility.
- Each client is a whole human being. People don’t stop being human simply because they’ve succumbed to a drug.
- Meaning is not the absence of suffering. In fact, research indicates that questions of meaning arise precisely because of suffering. Frankl said that the key to a meaningful life wasn’t to eliminate suffering, but to rise above it by pursuing goals that helped others, Thompson said.
- Meaning is not the same as happiness. Research indicates that happiness has more to do with feeling comfortable and getting desires met. Meaning is more other-centered and associated with attaching one’s life to something greater than the self.
These principles extend to the way that the staff at Sunshine Coast treats clients.
“Because we treat all clients as human beings (not as addicts), everyone who works at SCHC follows the three basic principles of therapy: empathy, unconditional positive regard, and genuineness,” Thompson said. “This creates an environment where clients can feel free to be themselves, a requirement for good therapy.”
Expecting the treatment to work
Too often, when treatment for addiction doesn’t work, people blame the client. At Sunshine Coast, that is different.
“Rather than blaming clients, we examine the therapy itself. What were we doing that we could not get through to this client?” Thompson said. “We are constantly refining the program, based on the latest research and feedback from clients and families. Ultimately, we use meaning therapy as a way to improve success rates in treatment, which are currently less than inspiring.”
The focus of that therapy is clear throughout treatment.
“Our goal is not to help clients stay away from drugs, it’s to help clients ‘get a life,’” Thompson said. “If addiction is a response to a life that lacks personal meaning, however, then we need to front-load getting a life. Clients need a reason to do all this work, which is why mainstream treatments do not have inspiring outcome studies.”