Interviewed by Trish Cleary, MS, LCPC-MFT-ADC, CGP, FAGPA
Dr. Jeffrey D. Roth is an addictions psychiatrist and group psychotherapist. He graduated from Yale University Medical School and did his residency in psychiatry at the University of Chicago. Dr. Roth is the past-president of the Chicago Center for the Study of Groups and Organizations. He is board certified in addictions medicine and a Fellow of the American Society of Addictions Medicine. He is also a Fellow of the American Group Psychotherapy Association. Dr. Roth is the author of the book Group Psychotherapy and Recovery from Addiction: Carrying the Message. He is also the editor of the Journal of Groups in Addiction and Recovery.
Dr. Roth’s perspective on addiction as a disease of isolation focuses on the paralyzing impact of shame in compulsive disorders. His unique skill in facilitating cyber-relationships has resulted in cutting edge applications for treatment and supervision via the Internet and Skype. Visit his interactive website workingsobriety.com to explore this powerful educational resource and to discover more about his web-based Recovery Assistance Program that provides online support for those seeking support and recovery from the impact of addiction.
Years ago, I participated in one of Dr. Roth’s online groups via AGPA. It was a remarkable experience that allowed me to discover the power of interactive group connection while alone in my office. In this time-limited co-facilitated group composed of individuals from all over the country, we worked together round-the-clock and across time-zones. We witnessed each other’s thoughts and feelings in and out of sequence as they streamed onto our computer screens. In this cyber-format that went beyond the sequential interactions of an in-person group circle, predictable group processes of projection, transference, counter-transference, and projective identification reactions played out. Without overt and covert stimuli and the distractions of sight, scent, and sound, opportunities for self-awareness were plentiful and personally revealing.
My experience with Dr. Roth’s skill in establishing a high level of emotional intimacy in a cyber-group format suggests how powerfully engaging he will be as our guest presenter for the MAGPS 2013 Spring Conference, “Group Psychotherapy and Recovery from Addiction.
Trish: As mental health providers, regardless of our particular client population and treatment approach, addiction issues emerge regularly in our work. From an assessment perspective, please identify some of the personal and social characteristics that can help us detect unstated addiction issues.
Jeffrey: Any of the difficulties that bring someone to treatment may be related to unstated addiction issues, either in the person coming for treatment or in a family member. When we consider that addiction is a family disease, we may be hard pressed to find someone who does not have unstated addiction issues.
Trish: In your writing you draw parallels between 12-step recovery principles and psychodynamic group psychotherapy. When and how did your thinking about these parallels evolve into a focus for your career?
Jeffrey: I served as the medical officer on an inpatient drug and alcohol rehabilitation unit shortly after graduating from my psychiatric residency. I was also becoming more involved in group relations conference work and I attended my first nine-day residential conference. Between seeing certain aspects of my own dysfunction emerge in that conference, and realizing that my personal analysis had barely touched those difficulties, I began several decades of integrating 12-step recovery and psychodynamic group psychotherapy.
Trish: In your book Group Psychotherapy and Recovery from Addiction: Carrying the Message, you state that “Addiction is a disease of isolation” regardless of the addictive substance or behavior. How did you identify isolation as a common theme in addiction?
Jeffrey: The primary affect that paralyzes the practicing addict is shame, and shame is the affect that leads us to hide. When we hide progressively larger parts of ourselves from others, we lose the capacity for intimacy and become increasingly isolated.
Trish: How does your therapeutic model integrate 12-step group recovery principles and group-as-a-whole processes to support recovery from addiction?
Jeffrey: An integrated model benefits from the understanding of addiction as a family disease. The use of group-as-a-whole creates an intentional family where the dynamics of addiction and recovery may be systematically investigated for the benefit of members and therapists.
Trish: How do you define and think about boundaries from a group-as-a-whole perspective for your group clients who might also be involved together in the larger 12-step recovery community?
Jeffrey: The boundaries of the group-as-a-whole are consistent with an open systems model of group and organizational functioning. The group ideally is not sequestered from the environment. The important boundaries to attend to are those that relate to the authority differential between therapist and group members. Therefore, members ideally bring any outside contact with other members into the group sessions. The therapist in this model has no anonymity; if group members attend a 12-step meeting where the therapist is present, any information received by the member is speakable in the group.
Trish: What new perspective(s) about addiction treatment do you hope the MAGPS Spring Conference participants will take away from their training experience with you?
Jeffrey: Participants may experience the work in the demo groups as “magical,” which is a common response to the degree of aliveness that is possible in working in the here-and-now. Considering the option of letting go of the illusion of control and embracing what occurs in each moment of the group would be ideal gifts for participants to take away from their training experience.