Alcohol and Substance Misuse, Abuse or Addiction

Counselling in Perth

Alcohol and substance abuse and addiction is common in many societies, causing problems not only to the person involved, but also to family members and the wider community.

Problems within families with alcohol and/or substance use can lead to other issues such as:

  • domestic violence
  • crime
  • homelessness
  • sleep problems
  • legal issues
  • relationship difficulties
  • social isolation
  • loss of employment
    loss of access to children

Often this is exacerbated by co-occurring mental illnesses such as depression, anxiety or trauma (such as post traumatic stress disorder – PTSD).

Why do people use drugs?

There are many reasons why people choose to use drugs, but the common underlying factor for all drug use is that it is functional – it serves a purpose in some way. It might relieve boredom, it might address curiosity, it might reduce peer pressure, it might make someone less inhibited socially, it might help to escape or avoid uncomfortable thoughts and feelings that seem unbearable.

The cycle of addiction

As mentioned earlier, drug use is functional. There is some sort of an emotional trigger (such as an uncomfortable feeling or an environmental cue) that starts a craving response, which leads to a ritual before the actual substance use. The immediate effect is one of satisfaction, which reinforces future drug use (because it reminds you how good it feels). Following this is a feeling or thought that is uncomfortable or overwhelming or unbearable (such as feeling guilty or a failure, or thoughts such as “you’re useless…pathetic…why cant you stop…”) which is the emotional trigger starting the cycle again.

Breaking the cycle of addiction

Breaking an addictive cycle is not easy but it is definitely possible. Treatments available are varied, but the cycle needs to be broken before the ritual and the substance is used. The aim is to replace the ritual with an alternative healthy behaviour or activity.


In order to work towards breaking this cycle, you need to be a bit of a detective and start to identify your own high-risk situations (triggers and cues) as well as your cravings. An experienced counsellor can help you with this.

Common high risk situations (triggers and cues) for substance use

Interpersonal: going out with friends, meeting new people, prior to sex, following conflict…

Occupational: doing household chores, looking after children, shiftwork (especially at night), working long hours, clubbing/partying, studying, driving…

Physical sensations/states: feeling tired, low in energy, “fat”, craving, agitated…

Emotional: feeling angry, anxious, depressed, sad, bored, resentful, excited, sexually aroused…

Cognitive: thoughts or images of experiencing the feeling of using, thoughts or images of performing or functioning better, persistent reminders of the opportunity to use, racing thoughts, thoughts or images of rituals preceding use…

Times: payday, weekends, number of days since last use, particular times of the day or night…


Everyone is different so it is important for you to start to recognise how your own cravings manifest. When you recognise that you are craving, what else is there? Are there thoughts?…emotions?…physical sensations?…actions/urges/behaviours? Often it is a combination of all or many of these. It is also useful to know that a craving comes and goes. It starts, increases, then decreases all by itself. Once you can recognise that you are craving, and know that it will go all by itself, you are more able to “surf” the craving as well as choosing to do something different – something that is not automatically reaching for the substance to stop the craving.

What’s the difference between a “lapse” and a “relapse”?

A “lapse” is where a person slips up and uses once before realising that this has happened, then getting back on track working towards their abstinence goals. A “relapse” is where a person has slipped up and then continues back into old addictive habits and regular substance use again.


Types of Rehabilitation

Rehabilitation needs to meet your own personal circumstances.

Sober up units: a place where you can go (usually for one night) so that you can sober up before leaving the following morning.

Detox: usually as an in-patient so that you can detox safely under medical supervision.

Residential: there are options for residential rehabilitation – short term and long term, private hospital or privately run rehabilitation centres. There is usually counselling offered as a part of the rehabilitation, as well as opportunities to learn how to readjust back into a non-using environment and social situations. Be aware that there are often long waiting lists for this type of treatment.

Non residential: offer group and/or individual counselling and therapy. This could be accessing services as an out-patient of a private hospital, a privately run rehabilitation, or seeking counselling with a psychologist in private practice.

How can a counsellor help me with my alcohol or drug use or addiction?

I believe that substance use is a learned behaviour which means, that with the right type of support, you can unlearn it. Beating an addiction is not easy, and working with a counsellor will help you to learn new skills and gain more confidence to succeed.

I have worked for many years with clients who have substance addiction problems with many positive results. I understand the cycle of addiction and how hard it is to reduce or abstain completely from use without external support. Relapse rates are high, with some people making many attempts at cutting down or giving up completely before they succeed.

Often, people with addictions have withdrawn from a normal type of life, living a somewhat restrictive existence that revolves around their substance use. Friends and family have been pushed away or left behind, interests and other social activities are almost non-existent. My approach to working with someone with a substance problem is holistic. That is, we will work not only on the substance or addiction, but we will also change your behaviours relating to your diet, exercise, sleep, work, and social relationships. Skills training will include “urge-surfing”, communication, mindfulness, relaxation, self-compassion, acceptance, recognising triggers and high risk situations, and then developing a plan to reach the goals you have set for yourself.

Family members who do not use alcohol or substances can find this behaviour hard to understand and may struggle to find ways to support the person with the problem. There are many services in the community that specifically support family and friends. (see Links to Useful Resources and How to Support Someone). Individual counselling is also available to help them.

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If you are seeking the services of a psychologist or counsellor in Perth, please contact me on 0406 033 644 or