Magazine article Addiction Professional

The Client Drives the Exploration of Dreams

Magazine article Addiction Professional

The Client Drives the Exploration of Dreams

Article excerpt

In my work now, I have several clients who appear to be very interested in getting well. Now "getting well" is open to interpretation, I realize. To most, it means stopping the substance use/abuse. Then they think they are done. We know that is when the real work starts.


So, if I am working with someone who has gotten to that point of sustained remission, how would you introduce your dream work in counseling? Would I begin by having them log their dreams into a journal and discussing that when we meet? And I wonder if I am qualified to assist them in understanding what their dreams mean in their waking world.

Hope you don't mind my picking your brain!


Donna, from Maine


Thanks for taking the time with your thoughtful questions. I am glad you are considering letting your clients let you help them with their dreams. It is truly amazing how many of our clients think they "are done" with their work after they have reached some days of sobriety.

Working in a medical clinic, I have seen more of the medical side of this recently. The patient will start feeling better, and then stop taking medications. Having worked in inpatient settings, I have seen this phenomenon on an almost rampant level. The client recognizes several days of sobriety, has picked up a tool or two toward recovery and then leaves against medical advice (AMA). More often than not, in my experience, this patient either will end up in treatment again--if fortunate--or will end up in jail or worse.

"Getting well" is not as black and white as it sometimes may seem. Like any other disease, addiction involves a process of healing. It is not "either/or," that is, from sick to full health with no process.

Part of the work of the addiction professional is to teach the client healthy language. That is, language that can be helpful in a client's recovery. In this situation, the language that can effect the healthy change would be to encourage getting well as a process rather than a week's worth of "stopped drinking." As for counselor "change talk," changing our thinking from, "We know that is when the real work starts," we need to let the client take responsibility for getting well. We need to change what we think and recognize that the change starts when the client has refused the first drink, avoided the first cantina or just begun to recognize the need for the changes with which they soon enough will begin to ask our help.

As far as introducing dream work into our counseling or therapy, it is an individual decision. There are clients with whom I would never bring up the use of dream work. I am one to trust that the client will invite the work when ready. When a client shares the first dream with me, I trust he/she is ready. Then I invite the client to take the dream further. If the client backs up, I back up. If the client is ready, he/she will pursue it further and I will look at the level of work the client may be seeking. This in large part is based on the clinical judgment of the addiction professional.

There is no magic time for introducing dream work. It can be introduced whether or not the client has been able to maintain abstinence for any length of time, or it can be introduced at any point that the client mentions a dream, probably a nightmare. There is no hard-and-fast rule, except that it is usually brought on by the client. …

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