Addiction and Recovery: A Practice Guide for Therapists

Addiction and trauma have been primary aspects of my professional practice for more than 30 years. I've worked with thousands of clients and hundreds of organizations. I provide consulting services for the development of addictions programs, clinical supervision for counsellors, psychotherapists, and front-line staff, and education for the wider community. The complex landscape of recovery is my neighbourhood.

The resources on these pages are drawn from my experience and reflect my interest in the deeply creative aspects of addiction and trauma. Recovery is an odyssey that reaches back as well as forward. It weaves together childhood development, adolescent vulnerability, mental health, and trauma. It's a complex and layered experience that cannot be understood by reducing the process to substance use or behaviour. Addiction is more than that. It's deeper.

Addictions rarely announce themselves as single problems with singular solutions. They arrive as territories—emotional landscapes shaped by what a person has learned about safety, belonging, and survival. This guide maps eight distinct geographies of addiction, each with its own logic, its own pull, its own way of organizing experience around what feels unbearable without it.

The geographic metaphor is deliberate. Addiction isn't just about substances or behaviors; it's about where people go when here feels impossible. Some move toward defiance, others toward stillness. Some seek constant departure, others the disguise of what appears benign. Understanding these patterns means learning to recognize not just what your clients are using, but what they're trying to inhabit—or escape.

Each page addresses a distinct addiction geography while acknowledging overlap and complexity. Recovery isn't about leaving these territories behind so much as learning to navigate them differently, to find what's legitimately needed without requiring the addiction to provide it. The work asks therapists to hold steady in uncertainty, to resist premature fixing, and to recognize that descent often precedes integration.

This isn't a treatment manual. It's a framework for thinking alongside your clients about why their addiction makes sense, what it's trying to solve, and how healing might emerge not from abandoning these landscapes but from learning to move through them with greater awareness and choice.

The Geography of Healing: A Framework for Understanding Addiction

This guide explores addiction through what I call the "geography of healing" — a framework that maps the directional movements addiction takes through our inner landscape. Each direction represents a distinct pathway connecting early developmental disruption, trauma response, mental health adaptation, and addictive pattern. Understanding these geographies helps us recognize not just what substances or behaviors someone uses, but why the system organized itself this way, what it's protecting against, and what healing requires.

The framework integrates Ecological Dynamics theory, trauma theory, and Bodynamic somatic developmental psychology, recognizing that addiction is not a simple cause-and-effect mechanism but a complex adaptive system. Each person's pattern emerges from the intersection of:

• Developmental vulnerabilities from critical windows of early formation
• Trauma responses that organized to protect the developing system
• Mental health adaptations that extended these protective responses across the lifespan
• Addictive patterns that maintain the entire configuration

The following pages explore eight directions, each revealing a different facet of this complex territory:

Elsewhere: The Geography of Escape

Developmental Stage: Existence and Belonging (prenatal-3 months)
Trauma Response: Flight
Mental Health Pattern: Dissociation
Substance/Behavior: Hallucinogens, online worlds, geographic wandering

When the earliest experiences teach that presence invites threat, that belonging is dangerous, the nervous system learns to flee—physically when possible, psychologically when necessary. This page explores addictions organized around departure: how hallucinogens and other escape vehicles facilitate the flight response, how dissociation becomes a habitual refuge from unbearable here-and-now, and what it means to help someone discover that arrival is possible. Like the morning crows flying toward an unseen destination, these patterns involve perpetual movement away from presence toward elsewhere.

Inward: The Geography of Stillness

Developmental Stage: Need Fulfillment (1-18 months)
Trauma Response: Freeze
Mental Health Pattern: Depression
Substance/Behavior: Opioids, benzodiazepines

When an infant's needs go chronically unmet—through parental depression, substance use, absence, or chaos—the developing system cannot flee or fight. It can only freeze: shut down, stop asking, wait passively. This page explores addictions of solace: how opioids and benzodiazepines provide chemical comfort that substitutes for the human warmth never reliably available, how depression extends the freeze response across a lifetime, and why healing requires learning that needs can lead to satisfaction. The bridge with its jumping spot, the cold water below—these images evoke the perpetual proximity to endings that characterizes inward addictions.

Onward: The Geography of Motion

Developmental Stage: Autonomy (8 months-2.5 years)
Trauma Response: Orient (Hypervigilance)
Mental Health Pattern: Anxiety
Substance/Behavior: Stimulants, compulsive activity

When a toddler's world is unpredictable or dangerous during the Autonomy stage—requiring constant scanning for threat, perpetual adjustment to avoid consequences—the nervous system develops chronic hyperorientation. The child never learns that some places are safe enough to explore, some moments safe enough to settle. This page explores addictions of departure: how stimulants match and justify the hyperaroused state, how perpetual motion prevents the settling that might reveal safety, and what it means to support someone in discovering that stillness is survivable. Like Coyote scanning for threat, never resting, these patterns involve restlessness as both protection and prison.

Backward: The Geography of Defiance

Developmental Stage: Will and Power (2-4 years)
Trauma Response: Fight
Mental Health Pattern: Anger
Substance/Behavior: Alcohol, defiant behaviors

When power is systematically stolen during the Will and Power stage—through crushing control, harsh punishment, or cultural oppression—the developing system organizes around fighting back. Defiance becomes survival. This page explores addictions of anger: how alcohol unleashes rage that feels righteous and powerful, how entire communities respond to collective powerlessness through patterns of defiant substance use, and how healing requires acknowledging legitimate anger without demanding submission. The wrecked boat on the shore—battered but still present, refusing to disappear—embodies this fierce persistence of will that both imprisons and sustains.

Sideways: The Geography of Disguise

Developmental Stage: Multiple (variable)
Trauma Response: Variable
Mental Health Pattern: Complex
Substance/Behavior: Cannabis

Unlike other substances with clear directional pulls, cannabis moves laterally—softening edges, blurring boundaries, making everything slightly sideways. This page explores the unique complexity of cannabis addiction: how its chemical sophistication allows it to serve as a universal adapter, managing whatever underlying pattern exists without announcing itself dramatically. Cannabis users may carry vulnerabilities from multiple developmental stages, employ multiple trauma responses, and present with complex clinical pictures. The buried person, soil pressing down, unable to breathe—this image captures how cannabis allows functioning while deferring everything that needs to be faced.

Downward: Into the Dark

Core Principle: Descent as necessity
Method: Narrative, somatic, witnessing
Goal: Completing unfinished stories

Every pathway—whether elsewhere, inward, onward, backward, or sideways—requires descent into the underground chambers where original wounding occurred. This page is not about a specific substance but about the universal necessity of going down into what we've sealed away. Like the tunnels beneath the city, like the lost library of Ivan the Terrible, the underground contains both wounds and treasures. Healing requires descending into these sealed chambers, witnessing what's been hidden, completing unfinished stories, and discovering that the darkness contains not only trauma but also resilience, wisdom, and the resources that were preserved when nothing else survived.

Forward: The Moving Line

Core Principle: Purposeful engagement
Focus: Meaning, connection, integration
Scale: Individual to community

What moves the inner line—that boundary between what has been and what might become? This page explores how recovery requires not just stopping substance use but building a life worth living. It examines developmental freeze and delayed adolescence, the question of success and how we measure it, and what it means to work with authenticity and tenderness in a field awash with new models claiming revolutionary transformation. The page investigates multiple scales: from individual nervous system reorganization to community displacement and systemic injustice, acknowledging that healing happens within contexts we can partially influence but never fully control.

Homecoming: The Geography of Return

Core Principle: Integration and mystery
Focus: The unique path home
Understanding: Complexity resists reduction

The final page returns to where we began: the acknowledgment that we cannot crack open the secrets of addiction, that no equation solves it, that recovery remains fundamentally mysterious. It integrates the previous seven directions into a coherent ecological framework while honoring that each person's geography of return is unique. Like stones on a beach shaped by invisible forces, people in recovery are influenced by countless factors beyond our control or complete understanding. This page explores what it means to work with humility, to measure success differently, to create conditions for transformation while trusting the system's own reorganization. It asks: Is one success enough? And answers: Yes. And then you show up again tomorrow.

How to Use This Guide

This guide is designed for counsellors, social workers, healthcare professionals, and anyone supporting people through addiction and recovery. Each page can be read independently (and, consequently, some concepts are repeated across pages, for those not reading in order). Together, they create an integrated understanding of addiction's complexity.

For assessment: The directional framework helps identify which developmental vulnerabilities and trauma responses may be organizing the addictive pattern. Understanding the geography helps you ask better questions and see patterns you might otherwise miss.

For intervention: Each page includes specific considerations for working with that particular pattern—how to create safety, what to avoid, what the healing path might require. The framework guides you toward approaches that honor the adaptive function of addiction while creating conditions for reorganization.

For self-reflection: Working with addiction requires doing your own inner work. Each page includes reflection questions to help you explore your own relationship to these territories, recognize your edges and limits, and understand how your nervous system responds to activated clients.

For staying grounded: In a field where new models constantly promise breakthrough solutions, this guide returns repeatedly to fundamentals: human connection, tender witnessing, respect for complexity, humility about what we can control, and trust in the mysterious process of healing.

The path of healing is to clear the ground. May this guide support you in that essential work—for yourself, for those you serve, and for the communities we're all learning to inhabit with greater consciousness and care.

The journey begins and ends with homecoming: to ourselves, to each other, to the imperatives of our growth and healing.

Sources and Further Reading

Understanding addiction requires drawing from neuroscience, psychology, sociology, public health, lived experience, and cultural analysis. This curated collection of sources reflects that complexity, bringing together research studies, theoretical frameworks, clinical insights, and interdisciplinary perspectives that inform evidence-based practice.