A letter from: Robert L. Johnson, MC, MCAP, CST, LPC - National Clinical Director - Hope Street Treatment

A letter from: Robert L. Johnson, MC, MCAP, CST, LPC – National Clinical Director

Firstly, I’ll like to express my gratitude and appreciation for the wonderful opportunity to work with an extraordinary organization such as Hope Street and its sister facilities. I am also most humble; this particular characteristic is one, in my opinion, clinicians must have in order to “create a safe, healing therapeutic relationship with their clients” as quoted by my esteem colleague Faith Niece.

Over the years, I have developed a complementary array of related clinical skills and provided services to recognize the need to treat multiple addictions, mental health issues, and sexual concerns, often simultaneously. I’ve studied and been trained in many therapeutic modalities and often, employ an eclectic approach based on the client and their need with unconditional positive regard and healthy boundaries. I’m also a firm believer of Attachment Disorder theory and the very strategic coordination of client, family, relationship, academic, and vocational services.

Addiction can be viewed as an attachment disorder as stated by Dr. Philip Flores in his book of the same name. Because clients have difficulty maintaining emotional closeness or intimacy with others, they’re more likely to substitute a vast array of obsessive-compulsive behaviors such as sex, food, gambling, shopping, nicotine, video gaming, and of course, drugs and alcohol. He refers to this in his book as “cross addiction.” Dr. Patrick Carnes has coined the term “Addiction Interaction Disorder” referring to the concept when one obsessive-compulsive type of behavior is given up, another is likely to be substituted unless the emptiness and internal discomfort in a client’s self-structure is addressed and corrected. Therefore, if a client has more than one addiction or mental health issue when entering treatment, it will not be addressed separately, which is the practice at most treatment facilities.
Here at Hope Street or any of our sister facilities, we’ll view it as a package deal, assessing appropriately, and will approach it as a whole, simultaneously and concurrently.

A client doesn’t have to have a chemical (ingestion) addiction, i.e. alcohol, drugs, nicotine, for admittance into treatment. A client can have a process addiction occurring, i.e. sex, food, gambling, hoarding, video gaming, etc. that is impacting their mental health, their relationship with others, and causing significant consequences in major life areas. Again, I must refer back to the research done by Dr. Flores and Dr. Carnes, and with some modesty, by myself due to the years of working with this population. There is a high correlation between sexual compulsivity and cocaine use; sexual compulsivity in the gay community and crystal meth use; nicotine dependence and rage; nicotine dependence and alcohol dependence; compulsive spending and compulsive gambling; eating disorders and self-injury; sexual trauma and eating disorders and sexual compulsivity (acting in or acting out). Video gaming continues to be on the rise with much concern there is more evidence of it being an emotional and mental disorder that is compulsive in nature.

All of this lead back to my clinical approach to treatment. As I take a psychodynamic approach, armed with the attachment theory and, have in my arsenal, the addiction interaction disorder theory, I help the client recognize the importance of early childhood experiences on adult and/or young adult psychopathology as I clinically address the relationship between addiction, attachment, and fear of intimacy. Recently, I was reading an article on human connectedness and the importance of “closeness” (intimacy) is needed for long term recovery. I agree with Dr. Flores when he states intimate long-lasting relationships are an integral part of human nature and the inability to establish long lasting relationships is directly related to the quality of early attachment experiences.
Subsequently, many of Hope Street and its sister facilities’ success, speak to the clinical belief in long term treatment, and exceptional IOP and OP programs, which help structure long term recovery. Therefore, the luxury of addressing the whole person, or as I stated earlier, the whole package, is what the exemplary clinicians and I at Hope Street and its sister facilities are prepared to do.

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