Text Box: Addictions Text Box: My work with addictions has arisen from a view that people suffering with addictive behavior are not in any fundamental way different from people who develop other, often less visible difficulties as a consequence of emotional distress. Experiences of inner helplessness are a driving force behind addictive acts. Another way of saying this, is that addictions represent an attempt to regain lost control. The addictive process—substance use, gambling, compulsive shopping—is often a substitute for mastery over problems that seem unsolvable. The problem might be rooted in the present—perhaps in an unhappy marriage or career—but most often has its roots in an unresolved childhood conflict. It is important and useful to explore factors that lead a person to want to drink, use a drug, or gamble. Many treatment programs for addiction focus on a person’s powerless over addiction, however, addictions are actually an attempt to have some feeling of empowerment over an intolerable feeling state. One indication that feelings of helplessness are central in addiction, is that the key moment in addiction always occurs prior to the addictive act - taking a drink, going to a casino, going to score a drug, going shopping etc. For instance, an alcoholic may be experiencing a very difficult, very frustrating event. Although she had been maintaining sobriety for some time, what she is experiencing in the moment may be so intolerable that she ends up saying “oh to hell with it” and turns to go to a bar. It is actually at the moment she makes the decision to go to the bar, that she feels better, long before there is any alcohol in her system. My approach to addictions involves exploring conflicted areas in the patient's life, to find the source of the sense of helplessness that the addictive process solves for the moment, and to help the person move on.