Reprinted from:

Counselor: The Magazine for Addiction Professionals

Article Intro: The New Psychotherapy: There is a whole new way of practicing psychotherapy on the rise. NAADAC and NIDA award winning researcher Michael Picucci tells us how it is done.

The New

Psychotherapy

"Complete recovery is a 2-stage process-'recovery from' addictions and traumatic histories, and 'recovery of' fulfillment, wisdom, serenity, and emotional, spiritual and sexual wholeness."

As we enter the dawn of a new millennium, traditional psychotherapy-and the therapist's role-appear caught in the sort of crisis described by Denise Breton and Christopher Largent in their book, The Paradigm Conspiracy.¹ The detached, analytical approach often practiced by psychotherapists since the days of Freud no longer makes people well. In fact, this strict therapist-patient/ normal-sick paradigm may actually make them worse, contributing to deeper feelings of alienation and frustration. For our own field of addictions therapy as well as other specialties, it is evident that the time has come for a "paradigm shift" toward a more "soul-sensitive" ² approach to psychotherapy. The need for change was championed in recent statements by Dr. Patrick Carnes at the National Council on Sexual Addiction and Compulsivity conference in St. Louis. Fr. Leo Booth echoed the view that spirituality has become the cornerstone of both our individual and collective healing when he stated that as therapists, "We must open our mind to new ways of seeing our future...and bring to that the energy of creative positivism."³

Authentic Process Therapy (APT) represents such a paradigm shift in psychotherapy -- combining the structure of the healing community found in 12-Step recovery programs with a facilitating therapist, and employing traditional as well as contemporary healing techniques to address the deeper issues that invariably arise in the course of long-term recovery. APT and its core concept of "complete recovery" grew out of my own personal struggle toward wholeness as an AIDS survivor, as a gay man, and as a person in recovery, as well as from my experience with clients from diverse cultural and transpersonal perspectives, and from the maturing recovery movement over the past 20 years. Authentic Process Therapy may offer an important alternative for treating addictions and compulsions. This article provides a summary of APT, its goals, methods, basic philosophy and spirit.

Incorporating Strengths and Acknowledging Limitations of 12-Step Programs

Since 1935, with the founding of Alcoholics Anonymous, tens of thousands of alcohol and drug-addicted men and women have begun the journey to recovery by turning to a compassionate spiritual community embodied in AA and other 12-Step programs. This approach has been unrivaled in its ability to help people stop active addictions. Yet, all too often, the process of recovery is limited in terms of healing the issues that underlie alcoholism, drug dependency or other life-threatening addictions. The realization of one of AA's Promises, "We will know a new freedom and a new happiness...,"⁴ eludes many 12-Steppers who struggle between feelings of gratitude (thankful to have their lives back in control) and feelings of frustration and emptiness that something is still missing.

These secondary issues are profoundly important to complete recovery. Even individuals with years of sobriety can experience problems that threaten their continued recovery -- among them: codependency and other secondary addictions; depression; self-destructive behavior; underachieving; fear of abandonment; lack of sexual fulfillment; and the array of challenges facing those who are also living with HIV and other serious illnesses. I can attest to the fact that issues regarding sexual orientation can be a particular challenge for recovering gays, lesbians and transgender individuals. All of these, and other manifestations of internalized dilemmas, can keep people in recovery from what we want the most: mutual trust, love, and respect.

To overcome these limitations, notable therapists including John Bradshaw and Earnie Larsen ^{5, 6} have suggested an expanded model of recovery that goes beyond coping with primary addictions. Authentic Process Therapy is one such approach. APT recognizes that recovery is a two-stage process. Stage One, the healing from a primary addiction to alcohol, drugs, food, sex, gambling or any other dependency, requires a committed, singular focus for at least 1 to 2 years-and more for many individuals. But overcoming an active addiction is only half the battle.

Whereas Stage 1 is "recovery from" addictions, Stage Two-the direct focus of APT-is "recovery of" fulfillment, wisdom, serenity, and emotional, spiritual and sexual wholeness.

The objectives of Authentic Process Therapy in Stage Two recovery are:

To identify and express complex feelings... A tendency to be overwhelmed by mixed feelings-gratitude and joy for one's freedom from chemical dependency, and sorrow, grief, or even rage at past experiences-typically emerges with time in recovery. APT helps clients develop a vocabulary for talking about these feelings and coping skills to deal with them.

To connect in more meaningful ways with others in a community... APT is based on the healing community model of AA, but encourages those in recovery to create new "facilitated communities" to deal with specific Stage Two issues such as childhood trauma, sexual orientation and how one's healing impacts and is impacted by culture.

To heal the internalized sexual-spiritual split... A major element of APT is devoted to resolving the conflict between sexuality and spirituality, an overwhelming problem for many individuals in recovery.

To disengage power dynamics... By encouraging clients to examine their own role in power structures of daily life, APT can help to resolve ongoing difficulties with authority figures and intimates, and foster free expression in all relationships.

To achieve a "shame-free" presentation of self... Through APT, recovering individuals no longer feel ashamed or embarrassed by a difficult personal history.

To discover an individual "life purpose"... Clients learn how to contribute more meaningfully to society, to give back to loved ones, and to help establish a better future.

Simply stated, the key to achieving the goals of Authentic Process Therapy is "being real." The desire to be "authentic"-to present true inner feelings rather than a false front-is a minimum requirement for participation. Certain African tribal ceremonies refer to this as "speaking from the pit of the belly."⁷ While it seems easy enough, it means more than merely speaking what is on your mind, because "what is on your mind" usually refers to surface issues that have been filtered through society's value system. Authentic Process Therapy reaches down past the surface into the deep regions of consciousness to summon feelings that have long been suppressed as the ultimate means of achieving an integration of body, mind and spirit that is often unattainable in conventional 12-step settings, traditional psychotherapy or addiction counseling.

In attaining these goals a helpful device is the use of the The Living Map, in which the healing process is envisioned in the shape of a tree. This bird's eye view can make the transition into the healing process less frightening by providing an overview of what to expect, and when things get tough, we can return to the bird's eye view to reassess our position. Most importantly, clients' trust of their intuition grows during Stage Two recovery, and that it can be increasingly relied on as a compass to guide the individual to wherever he or she needs to be on the tree, and to the people, communities and processes that are necessary for complete recovery.

APT utilizes "Four Powers" that dissolve barriers to complete recovery:

1. The Power of Community-based Healing
2. The Power of Shared Intentionality
3. The Power of Shared Belief
4. The Power of Authentic Process

We use the Four Powers to move through various stations of experience toward fulfilling the constellation of shared desires that are inherent in the human condition. Along the way the Tree of Awareness blossoms, producing wonderful and sometimes totally unexpected fruit.

The Role of the Therapist in Authentic Process

APT is a psycho spiritual approach, meaning that it integrates varied addiction psychology and psychotherapeutic principles merged with modern day and indigenous applications of spiritual wisdom. In spirit, the role of the therapist in APT is much like a shaman. He or she must act as a facilitator, guide, role model and force for healing in both individual and group settings. As such, the therapist is not a removed, clinical authority figure but a special member of the type of therapeutic community defined by M. Scott Peck in his book, A Different Drum as:

"...a group of individuals who have learned how to communicate honestly with each other, whose relationships go deeper than their masks of composure, and who have developed some significant commitment to rejoice together, mourn together, and to delight in each other, make others' conditions our own."⁸

Authentic Process Therapy has its roots in the power of the healing community described by Peck, embodied in the 12-Step model and further developed in the concept of "wisdom circles" proposed by Charles Garfield, Cindy Spring, and Sedona Cahil.⁹ In APT, the therapist's province is defined in large part by the group. A 1993 survey of 130 Stage 2 clients and workshop participants found that the most prominent needs and expectations that recovering people have of their therapists were as follows ¹⁰:

• To encourage the client to take healthy risks
• To give feedback, without which therapy would be frustrating
• To provide a role model of what a fuller recovery might look and feel like
• To be interactive and help illuminate dynamics that are debilitating
• To compassionately include and have understanding of the "shadow self"
• To understand that therapy is ineffective if a client is suffering an active substance addiction
• To recognize that a new approach/ strategy is required if the process becomes stagnant
• To be confrontational in a respectful manner and in the spirit of illumination

In contrast to traditional psychoanalysis, the community dynamic requires that the client view the practitioner as an advanced traveler or someone who is specially educated in this adventure of life -- never as someone who is "normal" while the client is "sick." For recovering people, a clinical setting eliminates the spiritual nurturing that leads to healing. Furthermore, the therapist's removal of the "self," as practiced in traditional psychotherapy can create a painful re-enactment of dysfunctional childhood deprivation. While this might be a treatment goal in psychoanalysis, it can be counterproductive for people in addictions recovery. Instead, in Authentic Process Therapy, therapists and clients work together without hierarchy towards mutual authenticity and community. Everything is discussed, nothing is hidden. APT is not esoteric in nature and is not elitist. People are simply encouraged to speak from the heart.

The Authentic Process approach also eschews transference, the substitution of the therapist for the object of repressed emotions and impulses, such as a parent or authority figure from childhood. This type of relationship makes recovering people feel manipulated, often clouding their continued growth with confusing power dynamics. In APT, therapists are also participants who are encouraged to share their own experiences and life challenges, when appropriate, in order to promote their clients' progress, either by creating a natural and real relationship, reducing shame, or creating a larger framework in which to process feelings and ideas.

A Combined Approach

The combined approach offered by Authentic Process Therapy has proven particularly effective in enhancing recovery in three major areas:

Overcoming secondary addictions... In APT we recognize that addictions and compulsions are basically coping mechanisms, self-medications to help deal with and further suppress the deeply repressed effects of early and contemporary traumatic stresses, deprivations and cultural prejudices. Until the underlying chaos is released and cleared up, old addictions will invariably be updated with other primary or secondary addictions, in an effort to maintain a feeling of equilibrium and safety when faced with chaotic, traumatic conflicts beneath the conscious surface. With education and "inner statesmanship," these underlying conflicts can present themselves for healing. As we are able to make it "okay" for them to come out of hiding, addictions fall away with each exposure.

Addressing Shame... Shame is the nemesis that plagues recovering people in their crusade toward wholeness. To understand the impact of shame-based behavior and ideation on daily life, APT utilizes John Bradshaw's "Externalization Process" technique ¹¹ to consciously make contact with one's younger self, and with the shame that impedes its further integration. APT is a highly effective way of releasing toxic shame by exploring unconscious material and making it conscious within the safety of a healing community milieu. Carl Jung called this phenomenon "transcendent function," explaining that when unconscious content becomes conscious we experience a sense of clarity, a fuller understanding of ourselves, an experience that goes beyond ordinary, everyday consciousness. ¹²

Expressing joy... The ultimate goal of complete recovery is the transpersonal breakthrough into what I call "holism." Holism as defined in Authentic Process Therapy encompasses not only the feeling of being whole and complete in oneself, but also of being integrated into the cosmos, one with nature, and connected with all humanity. This holistic experience is accompanied by feelings of great joy, empowerment, creativity and love, from which we can meet future challenges with grace and wisdom. Yet, recovering people are often embarrassed and reluctant to share blissful feelings because they are afraid they will be misunderstood, or that the feelings will not last. Safe friends, communities, or professionals with whom to share these feelings are essential.

Open to All

The freedom to experiment with joy is a giant step beyond traditional definitions of recovery, as well as an issue with which many "normal" people have difficulty. Thus, it is increasingly being recognized that the same techniques which empower former addicts toward states of wholeness and happiness can likewise work wonders for those outside of the recovery community who feel empty and unfulfilled. Authentic Process Therapy shares this view and welcomes all comers who recognize the potential for greater authenticity of expression and interaction in their lives. At the same time, APT, with its emphasis on community, continues to offer an important centering point for individuals in recovery. And, because much of the healing and education can take place in groups, workshops or facilitated wisdom circles, the overall cost is less than that of individual care alone.

In helping to fully respect and appreciate one's own complex nature, Authentic Process Therapy offers clients the opportunity to embark on a most exciting and meaningful inner journey -- a path to wholeness, in which recovering individuals not only learn to chart a more effective course through their inner wilderness but to fully appreciate the unsought gift M. Scott Peck calls "being touched by grace." ¹³

References:

1. Breton, Denise and Largent, Christopher. The Paradigm Conspiracy. Garden City, MN: Hazelden, 1996.
2. Journal of Noetic Science
3. Fr. Leo Booth, Keynote Address, 1999 New York Federation of Addictions Counselors Conference, Albany NY
4. Alcoholics Anonymous. New York: AA World Services, 1955.
5. Bradshaw, John. Healing The Shame That Binds You. Florida: Health Communications, Inc. 1988
6. Larsen, Earnie. Stage II Recovery: Life Beyond Addiction. New York: Harper & Row, 1985.
7. African ceremonies
8. Peck, M. Scott. A Different Drum [tbd]
9. Garfield, Charles, Spring, Cindy, and Cahill, Sedona. Wisdom Circles. New York: Hyperion, 1998.
10. Picucci, Michael. The Journey Toward Complete Recovery: Reclaiming Your Emotional, Spiritual & Sexual Wholeness. New York: North Atlantic Books, 1998.
11. Bradshaw, John. Healing the Shame That Binds You. Florida: Health Communications Inc., 1988.
12. Jung, CG. Psychology and Religion. CT: Yale University, 1938.
13. Peck, M Scott. The Road Less Traveled. New York: Touchstone, 1978.

Michael Picucci, author of "The Journey Toward Complete Recovery: Reclaiming Your Emotional, Spiritual & Sexual Wholeness," is co-founder of The Institute for Staged Recovery and The Institute for Authentic Process Healing. He has a private practice in New York City and serves on National Association of Alcoholism and Drug Abuse Counselors (NAADAC) Clinical Issues Committee. He was the recipient on the NIDA/NAADAC Year 2000 "Outstanding Leadership in Research" award.

 

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