Avoidance, in the realm of psychology, is typically characterized as an individual’s intentional evasion of certain situations, environments, or interactions to prevent anticipated negative outcomes or uncomfortable feelings associated with them. While avoidance can sometimes offer individuals a sense of control over their environment or their internal emotional state (Hofmann, S. G., & Hay, A. C., 2018), when it morphs into a maladaptive coping mechanism, it can give rise to severe issues such as alcohol addiction. In such cases, individuals frequently consume alcohol to escape or avoid negative affective states (Sheynin et al. 2019).
Alcohol addiction epitomizes avoidance behaviour on a large scale and presents a significant contemporary challenge (Längle, 2019). Individuals grappling with this addiction often act against their own interests, thereby becoming their own adversaries. As they progressively lean on alcohol, they increasingly evade the real causes of their anxiety, consequently losing responsibility for reality and eventually themselves (Horney, 2013).
In the tapestry of our lives, we thread the strands of our physical, social, psychological, and spiritual existence, as articulated by Van Deurzen (2010). A harmonious interweaving of these dimensions shapes a balanced life. However, when one dimension ensnares the others, it disrupts the intricate balance, leading to a discord in our lived experience. Equally important, we are persistently shadowed by existential anxieties – a haunting quartet of death, freedom, existential isolation, and the daunting void of meaninglessness, as demystified by Yalom (1980). Caught in this existential quandary, individuals often seek solace in avoidance behaviours, a precarious refuge that can culminate in alcohol addiction.
This essay will delve into the principles and techniques of Compassion-Focused Therapy (CFT)—an approach that marries cognitive-behavioural techniques with mind-training practices steeped in ancient wisdom—and the Existential-Phenomenological approach. The objective is to elucidate their respective takes on alcohol addiction as a manifestation of avoidance behaviour. The theoretical discussions will be enriched by a critical analysis of a pertinent case study, culminating in a robust discourse on the potential integration of CFT principles within existential therapeutic practice.
Compassion-Focused Therapy and Alcohol Addiction
Compassion-Focused Therapy (CFT), a brainchild of Paul Gilbert, emerged in the 1980s as a multifaceted approach to cognitive-behavioural therapies (CBT). CFT’s focus is on the emotional resonance individuals create when striving for self-support. This therapy blends cognitive-behavioural strategies, evolutionary psychology, neuroscience, and mindfulness practices with ancient compassion methods (Gilbert, 2009a).
Unlike traditional CBT, which often emphasises cognitive and behavioural aspects sometimes at the expense of emotional or bodily experiences (Beck et al., 1979), CFT proposes a broader therapeutic model. It fuses cognitive-behavioural techniques with mindfulness and compassion practices, integrating thoughts, emotions, behaviours, and physical sensations. CFT’s unique focus on self-compassion, emotional resilience, and compassion itself promotes non-avoidant confrontation with painful experiences. This approach provides an innovative way to treat addiction, contrasting CBT’s tendency to inadvertently foster avoidant coping behaviours, such as procrastination and thrill-seeking (Burns et al., 2001).
It can be seen that individuals dependent on alcohol often employ behavioural strategies to evade negative affective states. CFT with its emphasis on compassion, provides a means to engage with these distressing experiences in a non-avoidant manner. It perceives maladaptation as an unintended consequence of compensatory and defensive behaviours, not specific to death but also the outcome of thoughts related to uncertainty, social exclusion or uncontrollability (Sullivan et al., 2012). It involves being kind and understanding towards oneself, recognising that pain and failures are shared human experiences, and maintaining a balanced awareness of one’s emotions (Neff et al., 2007).
Moreover, Gilbert (2010) suggested that a self-compassionate mindset serves as a shield against emotional distress, promoting overall well-being and health. The correlation between increased self-compassion and decreased stress, anxiety, depression, and alcohol consumption further support this perspective (Rendon, 2007).
It is apparent that CFT, with its roots in evolutionary theory, neuroscience of affect regulation, and the qualities of social relationships, offers a comprehensive approach to dealing with alcohol addiction as a mode of avoidance behaviour, accentuating the importance of cultivating self-compassion. In a manner that transcends the traditional confines of cognitive and behavioural aspects of addiction, this approach places a significant emphasis on emotional and somatic experiences. This integrated methodology offers a holistic perspective on addiction treatment, thereby providing a comprehensive therapeutic model that encapsulates the multifaceted nature of addiction.
Having established the role of CFT in addressing alcohol addiction, it is pertinent to juxtapose this with the Existential-Phenomenological approach, which provides its unique contribution and allows us to gain a more comprehensive understanding of the topic.
Existential-Phenomenological View on Addiction
Rooted in the profound tradition of existential philosophy, the existential-phenomenological approach to psychotherapy is an illuminating compass to navigate life’s complex labyrinth, going far beyond mere surface-level personality analysis. It invites individuals to delve deeply into the profound inquiries of existence, unravelling the multifaceted layers of self and existence. By accepting the contributions of natural science but transcending its bounds, existentialism provides a holistic account of the human condition, confronting fundamental concerns such as freedom, responsibility, isolation, death, and meaning (Yalom, 1980).
The existential-phenomenological perspective on alcohol addiction rejects rigid labels and definitions, espousing a nuanced interpretation of human experience. Addiction is seen not as an inflexible entity nestled within an individual but as a multifaceted existential project shaped by physical, social, psychological, and spiritual dimensions (Adams, 2013). Addiction emerges as a flawed coping mechanism, an illusory sanctuary from a world perceived as harsh and meaningless.
Existential therapy, in this context, acts as a reflective mirror for those battling addiction, helping them uncover the meaning and purpose veiled behind addictive behaviours that are often attributed to disease or compulsion (Wurm, 2003). The process enables individuals to grasp their autonomy and explore alternative choices in their journey through addiction’s tempestuous seas (Du Plock, Fisher, J. (2005)).
Equally important, Existential therapy leverages phenomenology, a philosophical method to explore human experiences, challenging rigid self-concepts (Heidegger, 1927/1962; Merleau-Ponty, 1962). It’s a way of engaging with phenomena, suspending judgments and verifying observations, focusing on how things appear rather than what they may truly be.
Existential-phenomenological therapists partner with clients to explore their existence, without coercion or reward. By inviting the client to unravel the meanings and purposes underlying their addictive behaviours, existential therapy facilitates the recognition of individual freedom and the capacity to discover alternative life meanings. This approach encourages curiosity and care, allowing a re-evaluation of one’s relationship with addiction.
By building a therapy space of mutual trust and respect, this approach facilitates open examination and articulation of personal values and perspectives (Van Deurzen, & Arnold-Baker, 2018). It assists clients in recognising their power to shape their values and worldview, allowing them to align it with their unique experiences.
Furthermore, existential approach probes the depths of human tensions, desires, and fears and their intricate influence on life. It acknowledges the existential void, the lack of meaning that might breed frustration or despair (Yalom, 1980). Addictive behaviours like excessive drinking are viewed as attempts to fill this ‘existential vacuum’ (Frankl, 1972), emphasising the essentiality of uncovering underlying causes and highlighting the power of choice.
To sum up, the existential-phenomenological approach to alcohol addiction offers a humanistic, dynamic alternative to standard definitions. It accentuates a personal, idiographic viewpoint, spotlighting the roles of individual choice and accountability in combating addiction. By redefining addiction as a potential avoiding strategy and illuminating the symbolic reflection of existential struggles, this perspective offers a sophisticated, nuanced understanding of addiction that resonates with the core of the human experience.
The interplay of CFT and Existential Approach
It is apparent that the link between both Compassion-Focused Therapy (CFT) and the existential-phenomenological approach can be seen through the prism of alleviating existential anxiety in individuals struggling with alcohol addiction. Existential therapists approach clients with a compassionate humility born from the shared experience of human struggle (Iacovou & Weixel-Dixon, 2015). This shared struggle often manifests as existential anxiety, a reality that individuals sometimes circumvent through alcohol use. The existential approach is less about treating symptoms and more about understanding the client’s being-in-the-world, a therapeutic orientation echoed in CFT’s emphasis on the client’s cognitive-emotional experience. Notably, existentialism and CFT converge on the perspective of accepting the unchangeable aspects of life and addressing them in a different manner (Gilbert, 2010).
Recent research shows an increasing focus on existential issues in empirical clinical psychology (Iverach et al., 2014). These existential concerns also weave into cognitive behavioural therapy (CBT) discussions. The legacy of Albert Ellis and Aaron T. Beck’s work demonstrates that cognitive behavioural approaches have elements compatible with existential issues. Moss (1992) notably argued that Beck and other cognitive therapists have effectively incorporated central insights from existential phenomenology into academic discourse.
Existential phenomenology and CFT, despite being framed as opposites (Ottens and Hanna, 1998), have core principles that interrelate and resonate with each other. For instance, both approaches take an active stance in constructing meaning, are oriented toward the relational context, and concern themselves with actualizing potentiality and experiential components (Fabry et al., 2007).
In critically evaluating CFT, a “third wave” cognitive-behavioural approach, it becomes evident that its practices, such as mindfulness, can enrich existential-phenomenological work. The focus of CFT on compassion, acceptance, and being present in the ‘here and now’ mirrors existential phenomenology’s emphasis on immediate lived experience.
The application of mindfulness, a cornerstone practice in CFT, can be effectively utilized in the existential therapeutic setting to bring clients into the immediacy of their lived experience. This technique can also provide an effective counterbalance to the avoidance behaviours often associated with addiction, enabling clients to confront existential realities they have been evading.
Hence, while CFT and existential approaches may appear as opposite ends of the psychotherapeutic spectrum, the incorporation of mindfulness and the alignment of their core values demonstrate how they can inform and enrich each other, particularly when dealing with clients struggling with addiction. This integration could mark a new pathway for therapy, emphasizing both cognitive-behavioural and existential-phenomenological aspects, to tackle the complex challenges of addiction.
Case study
Alex, a 40-year-old stock trader and father of two, came forward with concerns about his chronic weekend binge drinking. On paper, Alex’s life seemed enviable— a lucrative profession and a family. Yet beneath this façade, he maintained an isolated existence, marked by an aversion to social contact. His personal history, marked by his parents’ divorce at 16 and a mother with alcohol addiction, had left deep imprints on his psyche.
Emotionally, Alex grappled with pervasive feelings of apathy, often harshly criticizing himself. He eagerly awaited his Friday night sojourns into alcohol, a desperate attempt to numb intense anxiety and a gnawing sense of emptiness. Within our therapeutic sessions, Compassion-Focused Therapy (CFT) emerged as an integral tool. The focus wasn’t on chastising Alex’s addictive behaviours. Instead, it was about understanding the genesis of his feelings and the reasons behind his actions. The therapy underscored the idea that his emotions and reactions weren’t his fault. Through CFT techniques, a concerted effort was made to align Alex’s cognitive perceptions with his genuine emotions, aiming to mitigate the weight of shame he carried.
This compassion-centric groundwork set the stage for the introduction of the existential-phenomenological approach. Within this perspective, we delved deep into Alex’s existential concerns—his relationships, his perceptions of the world, and his underlying anxieties rooted in a sense of meaninglessness. In one telling session, Alex voiced his angst, admitting, ‘It’s so silly, but I can’t stop drinking. It feels automatic.’ His words echoed the existential themes of freedom and the quest for meaning, forming a core component of our therapeutic explorations.
The synergy between CFT’s mindfulness techniques and the depth of existential-phenomenological probing allowed us to anchor Alex in the present, enabling him to face his realities without seeking solace in alcohol. This approach mapped out Alex’s intricate emotional terrain, discerning the complex interplay of his past, the challenges he faced, and the coping mechanisms that, albeit unintentionally, exacerbated his distress. Our objective transitioned from mere avoidance to fostering genuine understanding, self-acceptance, and employing therapeutic tools to identify and address core fears. This amalgamation of therapeutic modalities offered a journey towards self-discovery, tackling not just the superficial layers of Alex’s addiction but the profound existential dilemmas fuelling it.
In essence, the therapy evolved as a confluence of compassion, mindfulness, and existential exploration. It offered Alex alternative avenues to rediscover meaning, forge connections, and lead a more authentic life. It wasn’t just about identifying pain sources but navigating a route towards genuine change and self-acceptance.
Conclusion
To wrap up the discussion, despite the unique theoretical roots of Compassion-Focused Therapy (CFT) and Existential Phenomenological Practice (EPP), they both harbour significant potential for cross-pollination. Cognitive behavioural therapies, traditionally, have not been seen as the natural bedfellow for addressing existential concerns of clients. However, the progressive development of CFT offers an interesting diversion from the norm, embodying elements reflective of the philosophical underpinnings of existential therapy. This confluence of perspectives underpins the relevance of integrating CFT’s compassion and mindfulness-oriented methods with the rich existential exploration fostered by EPP, thereby enriching our therapeutic approach in managing psychological distress. To truly appreciate the potential of this integrated approach, further investigation and empirical research are required, broadening the horizons of therapeutic intervention possibilities.
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