TREATING SUBSTANCE-ABUSE PATIENTS WITH HISTORIES OF VIOLENCE: REACTIONS, PERSPECTIVES, AND INTERVENTIONS

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Abstract

One of the more troubling experiences that occurs in the psychotherapy of addicted persons is when they relate stories concerning their involvements with past acts of violence. Whether these events are regretted or not, they often arouse strong feelings in therapists and can present both patients and clinicians with questions about how to proceed. Attribution theory can be a useful tool for understanding the feelings and countertransference that arises, and a combination of insights from the fields of posttraumatic stress disorder (PTSD) treatment and existential therapy, along with a focus on the question of character, are a potential foundation for the development of therapeutic interventions. The relationship between substance abuse and violence, the importance of treatment context, and the interdependence of identity and action are explored here.

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