My Approach to Problematic Substance Use and Behaviours

My approach to problematic substance use and behaviours starts with understanding the root cause and the role that the substance use or problematic behaviour has for you. I can work with you from either an abstinence or harm reduction model. I will focus on working with you to understand their relationship to the substance or behaviour. Additionally, I will help you add skills and strategies to increase your ability to cope and heal the trauma behind the problematic substance use or behaviours. As we go through the process of changing your behaviour patterns, we will work on building a path towards a better future for you.

What Problematic Patterns I Work With

I work with substance use patterns and problematic behaviours that may or may not reach the level of a diagnosis. More specifically, I work with problematic substance use and most problematic behaviours such as gambling problems, excessive internet/social media use, shopping addictions, impulsive spending, food and exercise addictions, and video game addictions. I do not work with sex and porn addictions.

I realize that you may have significant trauma which causes issues with restricting use when you first start therapy, so I have the expectation that when you attend our sessions that you will be sober enough to do the work. You do not have to be completely sober. I will also work with you after you have completed detox as well. It is about what works best for you.

Trauma-Focused and Root Cause

Focus on the Root Cause

I will focus on helping you with the pain behind the addiction. Usually, there is pain behind the addiction and the behaviour or drug use is used to cope with the pain or other symptoms the sufferer wants to get rid of or replace something that is missing. This can come from chronic pain, trauma, or other causes.

It is through understanding what the purpose of the substance use or behaviour is for you that we can work on things that will fill the need or heal the wound. Sometimes you may have a lack of awareness of these purposes until we bring attention to them. Through exploration of the emotions, urges, and thoughts you have prior to engaging in substance use or problematic behaviour, we can understand what is behind it better. Once the root cause(s) are dealt with it usually becomes easier to release the hold that the substance use or problematic behaviour has on you.


Trauma is common among people with addiction. Additionally, trauma can lead to addictions when you don’t have the skills and resources to cope with the traumatic triggers. Substances often provide relief that other techniques do not. Unfortunately, they also come with negative consequences that can negatively impact many aspects of your life.

Trauma-Addiction Cycle

Often what happens with people with trauma symptoms who try to overcome their addictions without addressing their trauma is that they end up relapsing when the trauma symptoms increase due to lack of management.

They start with good intentions getting off the substance or breaking away from the problematic behaviour. However, as time goes on the trauma symptoms increase until they reach a breaking point. When they reach that breaking point, they end up using the substance or engaging in the problem behaviour to deal with the trauma symptoms and they feel shame that they weren’t able to break their habit. They end up using the substance for a time until they try to break free of the behaviour again, but the same thing happens because the trauma symptoms are too big of an obstacle to overcome.

The way to break this cycle is to get treatment for the trauma and gain skills so that the obstacle to overcome is not as large.

Often through the healing of trauma you will find that you are better able to reduce your reliance on the  substances and behaviours. As the trauma symptoms reduce you are better able to ride the waves of the urges to break the pattern of substance use or problematic behaviour.

Influences on the Brain

The problematic substance use and behavioural patterns are embedded in neural networks in the brain. Your brain is used to going down the same path, so it is harder to get your brain to choose a different path. This is also why people who are trying to quit their substance use end up using after a stressful event.

When someone has an addiction, the brain starts to associate specific sensations or feelings with the urge to use a substance. When that association is broken it becomes easier to avoid the substance or the behaviour.

We will work together to change those patterns so that you are less likely to repeat those patterns. There are psychological techniques that can help to rewrite the neural networks to reduce the associated habits and meanings.

These substances and behaviours can hijack the dopamine response system. Dopamine is the neurotransmitter that is responsible for the feeling of pleasure and is part of the reward system in the brain. With problematic substance use and behaviour patterns, a person may start to only feel pleasure with certain drugs or behaviours and not feel pleasure with other substances and activities. We can work together to prepare you for the experience of being without a sense of pleasure for a period of time while your brain readjusts to being without those substances and behaviours that trigger pleasure and help you start to discover new ways to feel pleasure that are more beneficial and have fewer consequences.

Managing Life and Preventing Relapse from Problematic Substance Use and Behaviours

Understanding the Impact on Your Life and How It’s Working for You

We will work around understanding the role that addiction has in your life and how you use it. Most of the substance use and behaviours that end up in addictions are because the substance or behaviour is providing some benefit for you, even though you may not be conscious of the reason. Unfortunately, substance use and behaviours also have negative consequences. These negative consequences can have really damaging effects on your life, relationships, and quality of life.

Learning Skills to Deal with Cravings and Triggers

There are skills that you can use to deal with cravings and triggers, so you are better able to ride those experiences. We will work with skills and strategies that come from Dialectical Behaviour Therapy (DBT), Cognitive Behaviour Therapy (CBT), mindfulness, somatic theories, and EMDR to help you deal with your cravings and triggers.

Planning for Urges

We will create plans for when you experience urges, so you are able to ride the urge and come out of it without bad consequences. These plans will focus on your preferences, values and what is important to you. We will also consider when those urges often happen so we can lessen the chance of it happening in the first place.

Problematic Substance Use and Behaviours

Photo by Dan Meyers on Unsplash

Building a New Life After Problematic Substance Use and Behaviour

Building a Plan for What You Want from Your Life

We will focus on what is important to you and respect what you value. We will build a plan based on your values, interests, and goals for your life. This can involve repairing family relationships, reconciling with friends lost due to the addiction, pursuing a career, returning to school, or something else. This can also involve exploring what you want from your life.

Learning Skills to Enhance Different Aspects of Your Life

Based on what you want from your life we will work on skills that will help you get the most out of your life. We can work together to bring you from a life of pain to a life of purpose. We will work together to enhance your skills so that you are more effective with different aspects of your life.


I want to work with you on where you are in your journey with your problematic substance use or behaviour pattern. I want to work in a way that will work for you to help you overcome your struggles and start to build a better life.

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Published by Leona Westra

A Registered Clinical Counsellor (RCC) based in Surrey, BC with specialized training in Chronic Pain, Trauma, Nervous System Dysregulation, and Grief.

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