An important aspect of addiction treatment is helping individuals take a clear-eyed view at the damage done by addiction. That often means acknowledging embarrassing past behaviors and understanding the tendencies or personality traits that have contributed to the addiction so that they can avoid making the same mistakes.
But the negative tendencies or traits that contributed to addiction don’t make up the whole person. That same individual may also have many positive attributes – optimism, resilience, wisdom, compassion or spirituality, to name a few.
Helping people struggling with addiction to recognize and cultivate their positive attributes is part of a growing movement in the mental health field known as “positive psychiatry.” Instead of focusing only on what’s gone wrong, positive psychiatry guides patients through a process of self-discovery to identify their positive traits. In doing so, individuals enhance their overall well-being, which can help in maintaining sobriety.
“Traditionally, in medicine, we’re trained to find out what is wrong with someone. Positive psychiatry is figuring out what is right with someone ¬ their strengths, what makes them tick, who they are as an individual and what makes them unique,” explains Dr. Anish John, Associate Medical Director at Positive Sobriety Institute.
Facing Hard Truths in Addiction Treatment
When individuals struggling with addiction enter treatment, many are still in denial about the extent of their disease. Facing the truth, including exploring the behaviors that have harmed themselves and their loved ones, is important in helping people struggling with addiction accept the seriousness of their disease and want to make changes, says Dr. John.
Accepting the disease and admitting to mistakes is also at the core of therapies such as the 12 steps, says Dr. John.
For physicians, there’s no question that figuring out what’s “wrong” – for example, diagnosing co-occurring mental health disorders such as depression, anxiety and bipolar disorder using the DSM (Diagnostic and Statistical Manual of Mental Disorders) – is also essential to developing a plan of treatment.
But research has shown that fixing what’s wrong is only one side of the coin. Positive psychosocial characteristics such as resilience, optimism and social engagement are associated with better health outcomes across populations.
Positive psychiatry recognizes the importance of also assessing those factors or attributes associated with well-being. Through the process of identifying those traits, individuals can start to reframe their personal narrative, and develop the skills that will help them in maintaining sobriety.
“It’s common with people who are struggling with addiction that they have experienced trauma, strife, family or personal setbacks. The narrative for them becomes, ‘Nothing goes right. Everything always goes wrong.’ While acknowledging there have been things that have gone wrong and patterns of behavior that have led this to happen, you also have to highlight their resilience,” Dr. John says.
Dr. Ishani Dalal, Medical Director for the Continuing Care Outpatient Program at Positive Sobriety Institute, also incorporates positive psychiatry into her practice. “So many of these individuals aren’t getting enough of it in their lives. They don’t have that individual who is telling them, ‘This is what makes you a special person in this world,'” Dalal says. “That is something people need to hear. They need someone to believe in them.”
A person who has struggled with relapsing might recognize that they have the perseverance to keep trying to get healthy. Someone who has been through trauma may start to see their strength in surviving adversity and seeking help.
A person who is deeply spiritual or religious might recognize that their belief in a higher power is a quality that they can lean on to resist the temptation to use again, while someone who has high levels of “social engagement,” or close bonds with family or friends, may come to see those relationships as an important source of support and a reason to maintain sobriety.
“In spite of everything they’ve been through, they are still here. They’re a fighter,” Dr. John says. “So let’s identify why certain things keep happening. But let’s also empower them, reminding them that they can take control of their life and make good decisions.”