Is personal experience necessary for addiction treatment?

Do you really think only addicts can treat addicts? Come on...

Posted May 25, 2011

In the "recovery" community, one often hears about how the best person to reach an addict is another addict in recovery. The question is whether personal experience with, and victory over, addiction is necessary for a counselor or therapist to be successful in providing successful addiction treatment?

I'll spoil the surprise by telling you that I personally don't believe such personal experience is necessary, and that is despite my own personal experience with addiction. I also think that spreading the notion that the above is true is counterproductive to addiction treatment as a field and that it creates an atmosphere whereby mental health professional are a little wary of getting involved in treating drug addicts.

Personal experience as a requirement for treatment in general?

Imagine for a second that you had acne and needed to get a treatment for it, would you only seek out dermatologists who have had severe acne as teenagers themselves thinking they will be best able to assist you? What about if you were diagnosed with cancer or diabetes? I'm assuming most of you can see that requiring the ones treating us to have experience with the same issues we're dealing with is a bit silly, at least in the physical health sense. We need clinicians that know what they're doing, can diagnose problems quickly and accurately, and who are familiar with appropriate treatment options and keep up with the latest advancements. They don't need to have personal-experience with the problem.

But what about mental health issues like depression, schizophrenia, or bipolar disorder, would having one of those require a therapist who suffers from the same disorder in order to truly provide tangible results? Should schizophrenics only be treated by schizophrenics? Here again I think that most people can see that experience is not necessary. It might be nice to have a therapist who sympathizes, but really, what we need is knowledge and ability, which often involved empathy, but not necessarily shared experience. 

So what makes addiction so different and special?

There's no doubt that addicts like to think of themselves as special. I would certainly place myself in that group and have personally heard countless addicts who are no longer using exclaim that once addict recover "we are a special and capable bunch." All of this makes sense in the whole "in-group/out-group" mentality that is so familiar to everyone in psychology as an effect generally observable in the population. But my sense is that when it comes to treatment it can be a dangerous premise.

Think about it - There is no question that addicts are far less common than the general non-addicted population. This means that in essence, believing this dogma - that addicts are best treated by other addicts - leaves the field less open to outside influence that are no doubt able generate great insight into the addiction treatment field. We can feel as special as we want, but I hope that no one believes that addicts somehow have a monopoly on knowledge, expertise, ability, and empathy. We don't, and thinking we do is at best narcissistic and at worst ignorant and stupid.

I work with dozens of researchers who have no first-hand knowledge of what smoking crack uncontrollably is like (and probably a handful who do) and I can tell you that each of them has had incredible insight into the problems of addiction. I can also tell you that I've met many addicts in recovery who think they have found the end-all-be-all answer to our collective problems simply because these things have worked for them. Experience as an addict does not equal insight into addiction treatment. Experience in recovery may give some insight, but thinking that it is necessary and sufficient for providing great treatment is... unwise.

I believe that we need to get better at measuring, identifying, and replicating good addiction treatment, not setting up barriers for clinicians interested in treating addicts based on their own personal experience. My guess is that as we do this we'll find that some addicts are great at treating addiction and some are horrible and that the same goes for "normies."

© 2010 Adi Jaffe, All Rights Reserved

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