Working through negative cues while in treatment
I’ve been working in substance abuse counseling for the past two years. I never intended to go into substance abuse counseling — I just jumped into an opportunity that came up as I was preparing to leave my time-limited job at the university where I was completing my second master’s degree in Human Development Counseling.
One of the patterns that I’ve picked up in my two years working in the field is that an individual’s story and life experiences will come back to haunt them and will often lead them back to relapse or continued use if not worked through appropriately and in a healthy way. For many, using drugs and alcohol became a way to escape and numb all of the feelings and emotions that they do not want to feel and all of the experiences they’ve had in life that they don’t wish to remember. Individuals who have never been taught how to process these emotions and experiences in healthy ways turn to substances to cope with them instead.
I show a movie to my clients in treatment about every 30–45 days (that’s about the average stay at our treatment facility, so usually by the next time I show the movie, a good portion of the clients are new and have never seen it before), and the movie deals with heavy topics such as self-harm, mental health, sexual assault, and, of course, substance abuse.
I was recently critiqued for showing this movie to the clients by one of the supervisors. She sat me down in her office and asked, “Did you show such and such movie to the clients on Sunday evening?” I replied that I had. She went on to ask me if I realized that three of the clients had been triggered by the self-harm scenes in the movie. I confirmed that I had known about that, because each time I show the movie, I make sure there’s enough time before the group ends to properly process and work through what the clients watched and experienced.
This supervisor went on to tell me that I should take the movie home and never bring it back to show the clients again. “We can’t show the clients movies that are going to trigger them” is what she provided to me for a rationale as to why I could never show this movie again.
Before I left her office, I turned and said to her: “If we spend a client’s entire stay trying to avoid triggering them, we are doing them a disservice. Being triggered in treatment where there are counselors to help them process their negative cues is the best place they could be when those experiences occur. No one in the outside world is going to shield them from the cues that bring up negative feelings and memories for them, and no one in the outside world is going to talk them through it when it happens.”
I haven’t been in the field for very long, but it seems self-explanatory to me that if we want to properly equip our clients to reenter the harsh reality of the real world and not come running back to our doors when it becomes too much for them, we have to be willing to push them — to trigger them — and then teach them how to utilize coping skills to work through their negative cues in a healthy way, so they don’t return to substance use and self-harm to numb out the feelings they don’t want to experience.
I don’t claim to have all of the answers, but I always want to provide the best service to my clients and give them a jump start on facing their inner demons before they leave my care (because let’s face it: 30–45 days isn’t long enough to completely eradicate every single thing in life that may trigger a client), and sometimes that means being ok with purposely providing them with situations in treatment that will trigger them. And when they are triggered, it means sitting down with them and showing them empathy, genuineness, and unconditional positive regard as we work through those triggers together and develop coping skills that will provide them with a solid foundation to start building a successful recovery on.
I don’t want to shield my clients from the negative cues in the world that trigger them. I want to equip them with the right weapons to face those experiences head on and come out on top.
As always, I’d love to hear your thoughts on this piece. Thanks for reading!