Substance abuse therapists advise people who suffer from alcoholism and/or drug addiction problems. They provide treatment and support to help the client recover from addiction or modify problem behaviours.

Overcoming a substance abuse disorder is a major accomplishment. But for most people with a drug addiction, detox is only the beginning of a long-term battle against craving and relapse. Psychotherapy is an essential part of drug abuse treatment for many people. Cognitive behavioural therapy, family counselling, and other therapy approaches can help people recovering from a substance addiction stay clean. Psychotherapy can also treat the other mental health conditions that often contribute to drug abuse.

Why Is Psychotherapy Important in Drug Addiction Treatment?

Substance addiction is more than a physical dependence on drugs. Even after detox, when physical dependence is cured, addicts are at high risk for relapse. Psychological and social factors (triggers) are often powerful stimuli for drug abuse relapse:

  • Stress, especially sudden life stresses.
  • Cues in the environment, like visiting a neighbourhood.
  • Social networks, like spending time with friends who continue to use drugs.

These factors can create ongoing, nearly irresistible urges to use drugs. Drug abuse therapy helps addicts escape cravings and learn to cope with life, without using drugs.

Several counselling therapies are available for the treatment of drug abuse, and no method is known to be the best. Likewise, no one approach is appropriate for everyone with a substance addiction. The right drug abuse treatment plan is tailored to a person's addiction and his or her individual needs.

Individual vs. Group Therapy

While any counselling therapy for drug abuse treatment is better than none, group therapy is generally preferred over individual therapy. In group therapy, a person is more likely to be both challenged and supported by peers who are also going through drug rehab. Twelve-step programs like Narcotics Anonymous are the most well-known group therapy organizations.

Individual therapy can be helpful in the case of a dual diagnosis: coexisting depression, anxiety, bipolar disorder, or another significant mental health condition that requires treatment in its own right, separate from the drug addiction.

Psychotherapy (Group and Individual Formats)

The term "psychotherapy" encompasses a broad spectrum of interventions led by therapists, for the benefit of patients. A partial list of the things that psychotherapy may attempt to accomplish would include but not be limited to:

  • Providing a safe and trustworthy forum in which hurting people can discuss their present-day issues and problems.
  • Providing a safe and trustworthy forum in which hurting people can talk about how they came to be the way they are (exploration of past experience).
  • Promoting the sharing and releasing of shameful and emotionally toxic experiences in a way that promotes personal empowerment and feelings of self-worth and belonging.
  • Teaching specific coping skills for managing specific problems and symptoms.
  • Providing a place where people can make friends and give and get interpersonal support.
  • Providing a parental-style figure who gives authoritative guidance to those people who are in need of external guidance.
  • Providing a model and personal experience of what trust-worthy relationships look like (so that  such relationships can be pursued outside of therapy).

From among this list, at least four specific therapy agendas may be distinguished:

Supportive Psychotherapy aims to offer patients a safe and trustworthy forum in which they may discuss the troubling aspects of their lives. The therapist strives to listen to the patient, who is encouraged to share emotionally. When needed, the therapist may act as a strong guide/authority figure, outlining things that the patient should do and not do. This type of therapy is not exploratory and does not delve into the past histories of patients. It is most helpful for interpersonally and emotionally fragile patients, and/or patients who become disorganized when confronted with stressful situations and memories.

Coping-Focused Psychotherapy aims to teach patients specific and practical ways to cope with specific problems such as Depression, Anxiety, Panic and Substance Abuse relapse prevention. The best and most effective forms of coping-focused psychotherapy are those that are based on scientific research. Most forms of Cognitive-Behavioural Therapy are recommended. Relapse Prevention programs are highly recommended.

Social Skills/Interpersonal/Growth Psychotherapy aims to teach patients to become more emotionally and socially mature in their dealings with others. For a variety of reasons, many addicts tend to have poor interpersonal skills and tend to deal with their emotions in self-destructive ways. Social skills/interpersonal/growth psychotherapy (usually performed in a group therapy context) helps patients to learn about and practice (within the session amongst each other) healthy ways of communicating with others.

Exploratory Psychotherapy aims at helping people to uncover the links between past experiences (trauma, violence, abuse, etc.) and present behaviour. Because exploratory forms of psychotherapy often involve recalling painful past events, this sort of therapy can be disorganizing and itself traumatic to fragile recovering persons, and to dually diagnosed patients with psychotic or other severe symptoms, it is not recommended. There is much evidence in fact that healing from many forms of mental illness can proceed just fine without any need to bring up past traumas (the most effective forms of psychotherapy for improving functioning being the coping focused varieties). However, exploratory psychotherapy (and particularly a behavioural form known as exposure therapy) is useful in treating many anxieties and trauma based disorders, and should not be ruled out as an option for recovering persons with stable sobriety under their belts.

Definition of Sex Addiction

Sex addiction can refer to a range of behaviours that are done in excess and significantly impact one’s life in a negative way.

The Diagnostic and Statistical Manual of Mental Disorders-V (DSM-5) does not list sex addiction as a diagnosable condition yet, but research indicates that there is a clear prevalence of adverse sexual behaviour that is similar in development to a “chemical” addiction.

Is Porn Addiction the Same as Sex Addiction?

Porn Addiction and sex addiction are not the same disorder. Addiction to porn is considered to be a type of sex addiction and can manifest itself differently than other types of sex addiction. Like “sex addiction,” “porn addiction” is not an official diagnosis in the DSM-5 yet. However, an addiction to porn can lead to serious distress and consequences in many facets of life.

What Are the Different Types of Sexual Addictions?

There are no distinct categories, but sexual addictions can come in different forms, including addiction to:

  • Pornography
  • Prostitution
  • Masturbation or Fantasy
  • Sadistic or Masochistic Behaviour
  • Exhibition/Voyeurism
  • Other excessive sexual pursuits

What are the Signs, Symptoms, and Effects of a Sexual Addiction?

Several signs can serve to indicate whether someone is addicted to sex. These can be emotional or physical. Furthermore, it’s important to know the debilitating effects of sexual addiction.

Emotional Symptoms of Sex Addiction

If you or someone you love suffers from a sex addiction, you might not have healthy boundaries. If your partner is addicted to porn or sex, you may feel alienated, isolated, depressed, angry or humiliated and need treatment yourself. If you are addicted to sex, you might become easily involved with people sexually or emotionally regardless of how well you know them, according to Sex and Love Addicts Anonymous. Because most sex addicts fear being abandoned, they might stay in relationships that aren’t healthy, or they may jump from relationship to relationship. When alone, they might feel empty or incomplete. They might also sexualize feelings like guilt, loneliness or fear.

Physical Symptoms of Sex Addiction

Although a sex addiction or pornography addiction can create many physical side effects, few physical symptoms of this disorder exist. However, the most common physical sex addict symptoms you might notice from having a sexual addiction is feeling immobilized due to sexual or emotional obsessions.

Effects of Sex Addiction

The effects of a sex addiction can be severe.

  • According to Departmental Management of the USDA, about 38% of men and 45% of women with sex addictions have a venereal disease as a result of their behaviour.
  • Pregnancy is also a common side effect that can occur due to risky behaviour. In one survey, nearly 70% of women with sex addictions reported they had experienced at least one unwanted pregnancy as a result of their addiction.

Additionally, sex addiction likely has a negative impact on several areas of one’s life. It can lead to:

  • A decline in personal relationships, social, and family engagement.
  • Decreased concentration and productivity at work.
  • Physical consequences like sexual dysfunction or sexually transmitted diseases (STDs).

It can have profound psychological effects, like generating feelings of shame, inadequacy, and emotional distress. It can lead to, or stem from, comorbid psychological disorders like:

  • Anxiety
  • Depression
  • Substance Abuse
  • Problems related to impulse control and emotion dysregulation.
  • Obsessive-Compulsive Symptoms

It is important to know that addressing co-occurring problems in one’s life, like depression, social anxiety or social isolation, can make it easier to recover from sexual addiction.

Am I Addicted to Sex?

It is best to consult with a healthcare professional for proper evaluation of your sex addiction, however, you may also want to look out for the following signs:

  • You feel powerless over how you act sexually.
  • Your sexual choices are making your life unmanageable.
  • You feel shame, embarrassment or even self-loathing over your sexual acts.
  • You promise yourself you’ll change, but fail to keep those promises.
  • You’re so preoccupied with sex it becomes like a ritual to you.

If you’re exhibiting any of these symptoms, it might be time to seek sex addiction treatment. If you also have a co-occurring substance addiction (e.g., alcohol, cocaine), call to learn more about treatment options.

Get Help for Sex Addiction

It is important to understand that although sex and porn addiction are not “formally” diagnosable, these conditions exist and often present with very adverse consequences and high levels of distress, guilt and emotional turmoil. If you can relate to the symptoms mentioned above, or know somebody who meets these criteria, do not hesitate to ask for help. Call to speak to a treatment support specialist who can provide you with more information.

Trauma is a distressing event in which a person feels severely threatened emotionally, psychologically, or physically. Most people will experience a traumatic event at some point in their lives, such as a car accident, abuse or neglect, the sudden death of a loved one, a violent criminal act, exposure to the violence of war or a natural disaster. Many people recover from trauma with time and through the support of family and friends, bouncing back with great resiliency, but for others, the effects of trauma are lasting, causing a person to live with deep emotional pain, fear, confusion or post-traumatic stress far after the event has passed. Often, the support, guidance, and assistance of mental health professionals is fundamental to healing from trauma.

What Is Post-traumatic Stress (PTSD)

Post-traumatic stress is the psychological reaction to a severely stressful and physically threatening event that often results in anxiety, flashbacks, hyper-vigilance, depression, suicidal ideation and other mental health concerns for an extended period of time. People who experience PTSD may continue to feel afraid or anxious even when no danger is present.

PTSD is commonly associated with war veterans, and in fact, it was first classified as a mental health condition as a result of the Vietnam Veterans Working Group who lobbied the American Psychiatric Association to recognize PTSD as an official condition. The condition was finally incorporated into the Diagnostic and Statistical Manual, Third Edition (DSM-III) in 1980, and Veterans Administration Hospitals began offering treatment shortly thereafter. Prior to the 1970s, the phenomenon was casually referred to as “battle fatigue” or “shell shock.”

Studies indicate that 3.5% of the population in America alone will experience PTSD in any given 12-month period, and almost 37% of these cases can be classified as “severe.” Although men are statistically more likely to experience traumatic events than women, women are more than twice as likely to develop PTSD than men, perhaps due to the fact that sexual assault leads to PTSD more frequently than other forms of trauma, and women experience sexual assault at higher rates than men do.

Diagnosis & Symptoms

PTSD can develop from a variety of traumatic incidents, from natural disasters to sexual assault. According to the Diagnostic and Statistical Manual, 5th edition (DSM-5), to be diagnosed with PTSD, a person must have experienced or witnessed a traumatic, physically threatening event or have learned that a traumatic event happened to a close friend or family member, and display specific symptoms for at least one month. Four types of symptoms are listed in the DSM-5:

Avoidance Symptoms:

  • Avoiding specific locations, sights, situations, and sounds that serve as reminders of the event
  • Anxiety, depression, numbness or guilt

Re-experiencing Symptoms:

  • Intrusive thoughts, nightmares or flashbacks

Hyper-arousal Symptoms:

  • Anger, irritability and hyper-vigilance
  • Aggressive, reckless behaviour, including self-harm
  • Sleep disturbances

Negative Mood and Cognition Symptoms:

  • Loss of interest in activities that were once considered enjoyable
  • Difficulty remembering details of the distressing event
  • Change in habits or behaviour since the trauma

Therapy for Trauma and PTSD

Psychotherapy is the most effective form of treatment for healing from the effects of trauma. Therapy or counselling can help people who have experienced trauma and those diagnosed with PTSD make sense of their experiences and feelings, develop plans to stay safe, learn healthy coping skills and connect with other resources and support. A qualified therapist can help people heal from trauma, even long after the traumatic event took place. Unresolved trauma is one of the most common reasons people seek counselling or therapy.

The type of therapy that is most commonly used and recognized for its effectiveness in trauma treatment is Cognitive Behavioural Therapy, the goal of which is to heal through addressing the existential questions that arise in the aftermath of trauma and in doing so, discover meaning in life. In some cases, medications, such as anti-depressants, anti-anxiety medications, and mood stabilizers, are employed to help manage the more challenging symptoms of post-traumatic stress.

According to trauma therapist Susanne Dillmann, "We may avoid situations or people that remind us of the trauma. We may be emotionally numb, depressed, or anxious. Sometimes, people turn to drugs to numb feelings of terror that last for weeks, months and in some cases, years after a trauma. If you experience such feelings, thoughts, or behaviours after a trauma, know that such experiences are very human and nothing to be ashamed of.

Through the assistance of a trained professional, one can heal from the consequences of a trauma.”

Most of us feel sad, lonely or depressed at times. It is a normal reaction to loss, life's struggles or injured self-esteem. But when these feelings become overwhelming, cause physical symptoms and last for long periods of time, they can keep you from leading a normal, active life. That is when it's time to seek medical help.

Your family doctor is a good place to start. They can test you for depression and help manage your symptoms. If your depression goes untreated, it may get worse and last for months, even years. It can cause pain and possibly lead to suicide, as it does for about 1 of every 10 people with depression. Recognizing the symptoms is key. Unfortunately, about half the people who have depression never get it diagnosed or treated.

Symptoms can include:

  • Trouble concentrating, remembering details and making decisions
  • Fatigue
  • Feelings of guilt, worthlessness and helplessness
  • Pessimism and hopelessness
  • Insomnia, early-morning wakefulness or sleeping too much
  • Irritability
  • Restlessness
  • Loss of interest in things once pleasurable, including sex
  • Overeating or appetite loss
  • Aches, pains, headaches, or cramps that won't go away
  • igestive problems that don't get better, even with treatment
  • Persistent sad, anxious, or "empty" feelings
  • Suicidal thoughts or attempts

Diagnosis

There isn't a "depression test" a doctor can use to see if you have it, so figuring that out often starts with a thorough history and physical exam.

Your doctor will want to know:

  • When your symptoms started
  • How long they have lasted
  • How severe they are
  • If depression or other mental illnesses run in your family
  • If you have a history of drug or alcohol abuse

You will also be asked if you have had similar symptoms of depression before, and if so, how it was treated.

Treatment

If your doctor rules out a physical cause for your symptoms, they may start you on a treatment or refer you to a mental health professional. This specialist will figure out the best course of treatment. That may include medicines (such as antidepressants), a type of therapy called psychotherapy, or both.

Are There Warning Signs of Suicide With Depression?

Depression carries a high risk of suicide. Suicidal thoughts or intentions are serious. Warning signs include:

  • A sudden switch from sadness to extreme calmness, or appearing to be happy
  • Always talking or thinking about death
  • Clinical depression (deep sadness, loss of interest, trouble sleeping and eating) that gets worse
  • Taking risks that could lead to death, such as driving through red lights
  • Making comments about being hopeless, helpless, or worthless
  • Putting affairs in order, like tying up loose ends or changing a will
  • Saying things like "It would be better if I weren't here" or "I want out”
  • Talking about suicide
  • Visiting or calling close friends and loved ones

If you or someone you know shows any of the above warning signs, call your local suicide hotline, contact a mental health professional right away, or go to the emergency room.

Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).

These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment.

Whatever form of anxiety you have, treatment can help!

Symptoms

Common anxiety signs and symptoms include:

  • Feeling nervous, restless or tense
  • Having a sense of impending danger, panic or doom
  • Having an increased heart rate
  • Breathing rapidly (hyperventilation)
  • Sweating
  • Trembling
  • Feeling weak or tired
  • Trouble concentrating or thinking about anything other than the present worry
  • Having trouble sleeping
  • Experiencing gastrointestinal (GI) problems
  • Having difficulty controlling worry
  • Having the urge to avoid things that trigger anxiety

Anxiety Disorders

Several types of anxiety disorders exist:

  • Agoraphobia is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
  • Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.
  • Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.
  • Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred.
  • Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.
  • Separation anxiety disorder is a childhood disorder characterized by anxiety that's excessive for the child's developmental level and related to separation from parents or others who have parental roles.
  • Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
  • Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
  • Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.
  • Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

When to Visit Your Doctor

Please seek the help of a medical professional if:

  • You feel like you're worrying too much and it's interfering with your work, relationships or other parts of your life.
  • Your fear, worry or anxiety is upsetting to you and difficult to control.
  • You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety.
  • You think your anxiety could be linked to a physical health problem.
  • You have suicidal thoughts or behaviours — if this is the case, seek emergency treatment immediately.

Your worries may not go away on their own, and they may get worse over time if you don't seek help. See your doctor or a mental health provider before your anxiety gets worse. It is easier to treat if you get help early.

Causes

The causes of anxiety disorders are not fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor.

Medical Causes

For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem.

Examples of medical problems that can be linked to anxiety include:

  • Heart disease
  • iabetes
  • Thyroid problems, such as hyperthyroidism
  • Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
  • Drug misuse or withdrawal
  • Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications
  • Chronic pain or irritable bowel syndrome
  • Rare tumours that produce certain fight-or-flight hormones

Sometimes anxiety can be a side effect of certain medications. It's possible that your anxiety may be due to an underlying medical condition if:

  • You do not have any blood relatives (such as a parent or sibling) with an anxiety disorder
  • You didn't have an anxiety disorder as a child
  • You don't avoid certain things or situations because of anxiety
  • You have a sudden occurrence of anxiety that seems unrelated to life events and you didn't have a previous history of anxiety

Risk Factors

These factors may increase your risk of developing an anxiety disorder:

  • Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders.
  • Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future.
  • Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety — for example, a death in the family, work stress or ongoing worry about finances.
  • Personality. People with certain personality types are more prone to anxiety disorders than others are.
  • Other mental health disorders. People with other mental health disorders, such as depression, often also have an anxiety disorder.
  • Having blood relatives with an anxiety disorder. Anxiety disorders can run in families.
  • Drugs or alcohol. Drug or alcohol use or misuse or withdrawal can cause or worsen anxiety.

Complications

Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as:

  • Depression (which often occurs with an anxiety disorder) or other mental health disorders
  • Substance misuse
  • Trouble sleeping (insomnia)
  • Digestive or bowel problems
  • Headaches and chronic pain
  • Social isolation
  • Problems functioning at school or work
  • Poor quality of life
  • Suicide

Prevention

There's no way to predict for certain what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you're anxious:

  • Start Early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
  • Stay active. Participate in activities that you enjoy and that make you feel good about yourself. Enjoy social interaction and caring relationships, which can lessen your worries.
  • Avoid alcohol or drug use. Alcohol and drug use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your doctor or find a support group to help you.

Marriage rates supposedly are on the decline and statistics indicate that 50 percent of first marriages end in divorce. That number has remained unchanged for the past 30 years. Divorce rates also vary with the partners’ level of education, religious beliefs and many other factors.

But when divorce does happen, it results in difficulties for adults as well as children. For adults, divorce can be one of life’s most stressful life events. The decision to divorce often is met with ambivalence and uncertainty about the future. If children are involved, they may experience negative effects such as denial, feelings of abandonment, anger, blame, guilt, preoccupation with reconciliation and acting out.

While divorce may be necessary and the healthiest choice for some, others may wish to try to salvage whatever is left of the union. When couples encounter problems or issues, they may wonder when it is appropriate to seek marriage counselling.

Here are seven good reasons:

1. Communication has become negative. Once communication has deteriorated, often it is hard to get it going back in the right direction. Negative communication can include anything that leaves one partner feeling depressed, insecure, disregarded, or wanting to withdraw from the conversation. This can also include the tone of the conversation. It is important to remember that it’s not always what you say, but how you say it.

Negative communication can also include any communication that not only leads to hurt feelings, but emotional or physical abuse, as well as nonverbal communication.

2. When one or both partners consider having an affair, or one partner has had an affair. Recovering from an affair is not impossible, but it takes a lot of work. It takes commitment and a willingness to forgive and move forward. There is no magic formula for recovering from an affair. But if both individuals are committed to the therapy process and are being honest, the marriage may be salvaged. At the very least, it may be determined that it is healthier for both individuals to move on.

3. When the couple seems to be “just occupying the same space.” When couples become more like roommates than a married couple, this may indicate a need for counselling. This does not mean if the couple isn’t doing everything together they are in trouble. If there is a lack of communication, conversation and intimacy or any other elements the couple feels are important and they feel they just “co-exist,” this may be an indication that a skilled clinician can help sort out what is missing and how to get it back.

4. When the partners do not know how to resolve their differences. When a couple begins to experience discord and they are aware of the discord, knowing is only half the battle. “We know what’s wrong, but we just don’t know how to fix it.” This is a perfect time to get a third party involved. If a couple is stuck, a skilled clinician may be able to get them moving in the right direction.

5. When one partner begins to act out on negative feelings. We believe what people feel on the inside shows on the outside. Even if we are able to mask these feelings for a while, they are bound to surface. Negative feelings such as resentment or disappointment can turn into hurtful, sometimes harmful behaviours. In the words of another therapist, "I can recall a couple where the wife was very hurt by her husband’s indiscretions. Although she agreed to stay in the relationship and work things out, she became very spiteful. The wife would purposefully do things to make her husband think she was being unfaithful even though she wasn’t." She wanted her husband to feel the same pain she felt, which was counterproductive. A skilled clinician can help the couple sort out negative feelings and find better ways to express them.

6. When the only resolution appears to be separation. When a couple disagrees or argues, a break often is very helpful. However, when a timeout turns into an overnight stay away from home or eventually leads to a temporary separation, this may indicate a need for counselling. Spending time away from home does not usually resolve the situation. Instead, it reinforces the thought that time away is helpful, often leading to more absences. When the absent partner returns, the problem is still there, but often avoided because time has passed.

7. When a couple is staying together for the sake of the children. If a couple feels it is wise to stay together for the sake of the children, it may help to involve an objective third party. Often couples believe that they are doing the right thing when staying together actually is detrimental to the children. On the contrary, if the couple is able to resolve issue and move toward a positive, healthy relationship, this may be the best decision for all involved.

In my opinion, children should never be the deciding factor when couples are determining whether to stay together. Children are generally very intuitive and intelligent. No matter how couples may think they are able to fake their happiness, most children are able to tell.

Not all marriages are salvageable. In the process of marriage counselling, some couples may discover it is healthier for them to be apart. However, for those relationships that can be salvaged, and for those couples willing to commit to the process, marriage counselling may be able to remind them why they fell in love and keep them that way.

Spiritual psychotherapy is a type of counselling that focuses on a person's spiritual side. There are a several reasons why a person may consider spiritual counselling. However, I have found that most people seek out spiritual counselling in order to explore or solidify their own personal spiritual beliefs and to experience inner peace.

Spirituality is usually the search for the meaning of one’s existence or the belief in some sort of greater existence outside of humankind, and it can be linked to religion, but the practice of spirituality is generally considered to go beyond religion.

Both the therapist and client seeking treatment may hesitate to include spirituality or religion in the practice of therapy, due to the potential of differing beliefs and the possible controversy of the topic. But research suggests a therapist's inclusion of an individual's spiritual beliefs may assist in therapy and in the process of healing.

Understanding Spirituality

Spirituality is generally considered to be broader than any religion one might practice, as it takes into account cognitive and philosophical areas of thought as well as aspects of emotions and behaviour. Some might describe spirituality as the attempt to understand one's nature or the meaning of one's existence, but spirituality is also linked to one's path to internal awareness and happiness. Many cultures and belief systems hold that one's spirit is the essence of one's existence, and thus, spirituality may also describe for some people their connection to each other and to themselves.

Though some may describe themselves as spiritual without adhering to the principles of any religion or even having any religious thought, for others, religion is the manifestation of their spirituality. This manifestation may involve the performance of rituals—in one tradition or in some combination of traditions—with varying degrees of commitment and involvement in that faith. Spirituality may also describe the attention people pay to their own well-being and that of others. For many, the practice of dance, yoga, meditation, or volunteer work, among others, are outlets in which to express spirituality.

Spirituality in Therapy

People often turn to religion to seek help and counsel for many of the concerns that lead a person to seek therapy, and a person who is spiritual or religious may utilize both fields in the pursuit of healing or well-being. Therapy, a model of treatment for mind and body, is considered to be a more scientific or medical approach. Spirituality, which encompasses the spirit and other immeasurable aspects, is generally believed to have little place in the field of psychoanalysis, and with the exception of pastoral or religious counselling, therapy does not often include discussion of religion or spirituality, although a therapist may inquire about the beliefs of a person in therapy and encourage that individual to connect with others in the religious or spiritual community.

An ethical therapist will not attempt to push personal beliefs on a person in therapy or otherwise attempt to change that individual's spiritual or religious beliefs. However, if it becomes apparent in therapy that a person's beliefs are causing unnecessary distress or if the person expresses difficulty reconciling contradictions between personal values or goals and the constraints of spiritual or religious belief, the therapist may draw the individual's attention to this area. In this case, the therapist may put forth the effort to assist the individual in the process of clarifying what is essential for that individual to achieve optimal well-being.

When a person obtains benefit from spiritual practices, a therapist can also assist in the process of more deeply understanding the person's spiritual self. This does not involve any particular teaching on the part of the therapist, but rather, encouragement to inquire into the individual's nature, conscious mind, unconscious mind, surroundings, and so on. A person's choices and the motivation for and consequences of those choices might also be discussed, and a therapist may ask people in therapy who have expressed religious or spiritual beliefs how those beliefs impact choices they have made and what they believe a higher power might want from them.

However, discussion of religion and spirituality in therapy, even to this extent, is still controversial, and many people believe the inclusion of religiously guided treatments may bring about more harm than good. Some research indicates discussions of spirituality and religion in therapy may be challenging for individuals coping with certain issues. However, because spiritual distress may manifest with both mental and physical symptoms, a therapist who addresses these topics may be able to provide greater healing and support. 

Spirituality as a Coping Mechanism

For many, spiritual beliefs play a significant role in the ability to cope with adverse events in life. Spiritual practices may offer social and emotional support, help people find meaning and purpose in life, provide comfort in times of grief, and provide ethical and moral guidelines that many choose to live their lives by. Individuals who gain strength from their spiritual faith may find it difficult to achieve progress and healing in therapy when unable to address and incorporate all dimensions of who they are.

Prayer, religious meditation, or some other aspect of spiritual connection may form part of an individual's self-care routine, as might church or volunteer work in the community. Some individuals or families may be deeply committed to their faith and base much of their lives around spirituality or religion. When a person who is religious or spiritual seeks treatment, sensitivity on the part of a therapist may be beneficial to treatment because it may lead to a broader evaluation of the person seeking treatment and allow the therapist to explore a wider variety of treatment solutions. Therapists who are aware of therapeutic strategies based in spirituality, such as spiritual journaling or forgiveness protocols, may also be able to provide people in therapy with resources on these topics, whether or not they are able to address them personally.

Many 12-step programs base their principles on belief and trust in a higher power, though this power may not be named specifically. One recent study found the spiritual beliefs of people in therapy impacted their levels of worry, stress, and tolerance of uncertainty. Those participants who trusted in a higher power were found to be more trusting and to have lower levels of worry, stress, and intolerance. Other studies have determined spiritual therapy may be helpful for those experiencing substance abuse.

Spiritual Therapy

Spiritual therapy is a form of counselling that attempts to treat a person's soul as well as mind and body by accessing individual belief systems and using that faith in a higher power to explore areas of conflict in life. People who believe in a guiding higher power may find spiritual therapy helps them achieve a deeper connection with this power. Through spiritual therapy, a person who is experiencing depression may find a moral conflict is present in some area of life. Anxiety may result when a person is unconsciously engaging in acts of self-sabotage. Spiritual therapy is only one method of uncovering and addressing areas of conflict and possible mental health concerns that may arise in life, but some people may find it to be a beneficial model.

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