Components of Treatment—Extended Evaluation and Referral

We are a neuropsychoanalytic psychiatric service, so we are organized to understand both the brain changes that have been created by addictive drugs or alcohol, and the underlying issues that contribute to addictive illness. Every patient is screened for depression. Every patient has a careful cognitive examination because drugs and alcohol cause such frightening changes in one's ability to think. One cannot have addiction unless one has a "denial system" that explains to the addicted person just why returning to drug or alcohol use makes sense.

Sometimes addiction treatment involves a long-term commitment to psychotherapy. Sometimes addicted persons are too sick to benefit from a relatively unrestricted program such as ours and they need inpatient rehabilitation or halfway house services. Our goal is to do a short-term treatment that facilitates returning to normal adult development for an addicted person. Ideally, we would stabilize the person enough so that they could simply attend Alcoholics Anonymous or Narcotics Anonymous for the rest of their lives.

There are many ways that the distress of addiction is shared socially. Some members of the family or social group of the addicted patient in our program will have a healthy attitude about loving the person but maintaining good boundaries and limits about addictive behaviors. Other persons who have to deal with an addicted person will have more trouble, and may even do things unconsciously that work against recovery. We will often suggest that the Sober Support Person(s) have an individual meeting with one of our medical professionals. They may then attend a support group for family and friends of addicted persons.