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Overcoming Ambivalence: The Benefits of Therapy for Alcohol and Substance Use

Writer's picture: Michael PezzulloMichael Pezzullo

Updated: Dec 30, 2024


Overcoming Ambivalence: The Benefits of Therapy for Alcohol and Substance Use


Cultivate Non-Judgment

During therapy for either alcohol or substance use, encountering shame is almost inevitable. Our culture has traditionally been very harsh on people struggling with addiction and alcoholism. For decades, substance use was viewed as a moral failing rather than a disease or a compulsive behavior. Thankfully, public understanding of addiction has improved dramatically over the years, but the stigma still exists. As you begin your own recovery journey, approach yourself with curiosity and compassion. Your goal is to understand the problem, not to shame yourself for having it. Most importantly, remember that shame doesn’t help. Being hard on yourself will actually hinder, not accelerate, your recovery.


Embrace Resistance

Change is incredibly hard. We often cling to what’s familiar. The devil you know is better than the devil you don’t. You will likely encounter this inner conflict during your recovery. There will be part of you that wants to stop drinking or using, and part of you that doesn’t. Expect this resistance, and when it arises, try not to get frustrated with yourself. Instead, practice patience and understand that resistance—and sometimes feeling stuck—is simply part of the process.


Do It for Yourself

No one wants to be lectured into recovery, and the truth is, it just doesn’t work. Recovery only works when you have "skin in the game"—even if it’s just a small part of you. To begin, identify your personal motivation for seeking sobriety, not anyone else’s. Ask yourself: What are your goals? What are you planning for the future? Whatever your hopes and dreams may be, substance use will only stand in the way of them. Reflect on the discrepancies between your actions (substance use) and your true goals.


Remember: It’s a Symptom

Substance use is just a symptom—it’s not the root problem. We self-medicate because of deeper emotional distress. Don’t miss the forest for the trees. When you seek treatment for substance use, you’ll likely spend little time discussing drugs or alcohol directly. Instead, the focus will be on uncovering the underlying causes—what drives you to self-medicate in the first place.


Therapy for Alcohol and Substance Use

So, how does the process begin? It starts with a clinical evaluation, which is crucial. This assessment will help determine what type of treatment is best suited for you. There are many options available, including psychotherapy, psychiatry, intensive outpatient programs, 12-step recovery, and more. The good news is that there is no shortage of treatment options, so you can find one that works for you.


You can learn more about my psychotherapy practice for alcohol use here and substance use disorders here.

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