Psychoanalysis at Work with Addictions
In BGSP’s new Addictions Counseling programs, faculty member Eugene Goldwater, M.D. and alumna Sherry Ceridan, Psya.D. teach counselors to go above and beyond traditional help with addictions.
Dr. Eugene Goldwater, Program Director for BGSP’s new Addictions Counseling programs, first began counseling people with addictions during the Vietnam War, when he was drafted to a military base in Arizona during his psychiatric residency. There, he worked with veterans who returned from Vietnam with heroin addiction or suffered from alcoholism. Since he was new to the field, he says, the existing staff gave him a crash course in addictions counseling. His contribution at the time was to ask good questions, and to listen.
After two years in the army, he says, he was “suddenly the expert” in addictions back in his psychiatric residency program. He introduced people to AA, lectured on addictions, and landed his first job directing an inpatient substance abuse rehab program at a state hospital. At that time, he had begun his psychoanalytic training at the Center for Modern Psychoanalytic Studies in New York. Using his analytic skills, he says, he “astonished” his staff by being able to explain concepts by referring to the group process going on in the staff meeting. Likewise, he says, he was unusual among the directors because, as he comments, “I was willing to listen to patients, and staff.” Rather than taking an authoritarian approach and focusing solely on medications, he also focused on understanding the underlying reasons for patient and staff behaviors.
Dr. Sherry Ceridan, Assistant Director for BGSP’s programs in Addictions Counseling, concurs on how important this understanding is. As a graduate of BGSP’s Doctor of Psychoanalysis program, she comments that her training helps her to be “much better equipped to work with addicts from the very first clinical encounter.” In order to help people with addictions give up their destructive behavior, she adds, you “need to learn about the person’s resistance” to relinquishing that important defense. Twelve step programs and other clinical approaches to working with addictions are very helpful to people and allow them “to live in the world,” she adds, “but it’s not always enough.” An analytic perspective allows them to broaden their own sense of what they do in their lives and why, to make better choices.
Dr. Goldwater adds that a modern psychoanalytic approach in particular allows the clinician “to accept people where they are and use that as a starting point,” rather than starting with what others want them to be. He adds, “We’re not attempting to change people without understanding them first.”
At the same time, Drs. Goldwater and Ceridan have a deep appreciation for all the different approaches currently in use in addictions counseling. The Alcoholics Anonymous model, Dr. Goldwater reports, is now only one of many treatment models, including the harm reduction model, the use of medications, the use of spirituality and religion, and motivational interviewing. He is struck by how similar motivational interviewing (a newer technique) is to modern psychoanalysis (which he learned many years ago). In both cases, he notes, “you are accepting both sides of the ambivalence. This is brand new to most people – accepting people and working with their resistance.” This allows the clinician to “try to fit the approach to the person rather than fit the person to the approach.”
Dr. Ceridan agrees, and adds that psychoanalysts may need to work differently with people with addictions than they usually do with other populations. Unlike other patients, with whom she might use more silence, with her patients with addictions, she says, she is “more active. They often need more contact, more feedback, and to know there is another presence in the room with them.”
Dr. Goldwater sums it up by commenting, “Psychoanalytic understanding doesn’t mean we rule out any mainstream methods – rather, that we hope that psychoanalysis will add to the efficacy of those approaches.”
Drs. Goldwater and Ceridan are leading BGSP’s programs in Addictions Counseling, which are available either as a specialization within the M.A. program in Mental Health Counseling or as a freestanding Certificate in Addictions Counseling. The programs are approved by the Massachusetts Department of Public Health Bureau of Substance Abuse Services as Approved Addiction Education Programs, meaning they serve as the first step in obtaining the Massachusetts License in Alcohol and Drug Counseling.
The Addictions Counseling programs combine knowledge and skills related to addictions with a deeper understanding of healthy development, co-occurring disorders, and counseling techniques. Unlike other programs, the curriculum provides an exceptional level of individual and group supervision on working with addictions. BGSP offers training in addictions counseling, both through an addictions specialization in the M.A. program in Mental Health Counseling, and through a Certificate in Addictions Counseling.
Eugene Goldwater, M.D., began working with addictions in 1971 and spent 17 years either directing inpatient substance abuse programs or working in community mental health centers providing psychiatry, psychotherapy, and supervision. He has also been a psychoanalyst in private practice for many years. He serves as Program Director for BGSP’s programs in Addictions Counseling.
Sherry Ceridan, Psya.D., has been working in substance abuse since 1998 in a variety of inpatient and outpatient settings. Most recently, she directed a public methadone clinic and was Director of Behavioral Health Services (including both mental health and substance abuse) for a Boston clinic. She also has a private practice with an emphasis on dually diagnosed patients. She serves as Assistant Director for BGSP’s programs in Addictions Counseling.