By: Lisa Himelstieb, LCPC - Addictions Therapist Chicago


Substances (i.e. alcohol, marijuana, etc.) and other vices are all around us in our work-related events, holidays, performances/concerts, social interactions, sporting events, music lyrics, TV shows, movies, and advertisement. It is a major part of our social culture and identifying it as a problem or ceasing use can be challenging. Part of the challenge can be comparing one’s use to another...why can Sally drink alcohol in moderation with no issues, but I can’t? 

It is a mix of biological, behavioral, and environmental factors that could increase one’s probability of developing an addiction. This is the disease concept of addiction as it is a chronic and progressive brain disease. If you have a family history of addiction, then probability of passing that along is present similar to other diseases (for example: diabetes, high blood pressure). In addition to the genetic component, growing up and observing and learning from others using unhealthy coping skill (i.e. parent(s), aunts, uncles, or grandparents) or living in a chaotic living environment can also be factors. Combined with feelings or thoughts of anxiety, depression, fears, worries, stress, grief, loss, and trauma, it can lead to the development of addiction. 

What are the symptoms of a Substance Use Disorder per the Diagnostic and Statistical Manual (DSM-5)?

A problematic pattern of use leading to impairments or distress.

a)Often taken in larger amounts or over a longer period than was intended.

b)Persistent desire or unsuccessful efforts to cut down or control use. 

c)Great deal of time is spent in activities necessary to obtain substance, use substance, or recover from substance. 

d)Craving, or a strong desire or urge to use. 

e)Recurrent use resulting in failure to fulfill major role obligations at work, school, or home. 

f)Continued use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance. 

g)Important social, occupational, or recreational activities are given up or reduced because of use. 

h)Recurrent use in situations in which it is physically hazardous. 

i)Use is continued despite knowledge of having persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by use. 


i.Need for markedly increased amounts of substance to achieve intoxication or desired effect. 

ii.Markedly diminished effect with continued use of the same amount of the substance. 



When Is it Time to Get Help with an Addiction?

Similar to other diseases, being able to identify any problematic use or behaviors earlier can make it easier to make positive changes. If we compare one person using substances a few times a week for approximately a year compared to heavy daily use for years, you can imagine which individual would have more difficulties making changes in their daily lives while decreasing use or ceasing use. 


Whether it is one use that caused impairments in your life or years of use, if it is problem it is better to address it. 


The idea of “hitting rock bottom” is not required to get support when struggling with addiction or addictive behavior. 


Will-power can play a huge role in initiating the process of making changes to address addiction, but it should not be relied on for lasting changes. One example of relying on will-power is setting New Years Resolutions. How many times have those been identified, worked towards for a brief period of time, and then....oops. Will-Power can help give us initial motivation to take steps towards our goals, but we want to have other tools and resources to use when will-power is not present. Also, addiction alters the brain’s chemical make-up so when we are trying to make changes, there may be times it could feel like a “tug of war” within ourselves with what the addiction may be telling us versus what we are changing. We want to have an armor to help us confront our addictions. 



If you think your use/behavior has been problematic “here-or-there” or you feel like your use/behavior is uncontrollable, working with an addiction's therapist can be a significant first step. Recovery, especially early recovery, can feel uncomfortable, anxiety-provoking, new, and challenging. But, being able to get through this discomfort can allow you to be able to develop more healthier relationships with yourself, significant other, children, friends, family, coworkers, etc. Recovery includes building trust (with self and others), healthy coping skills, responsibility, accountability, connections, self-identity, and balance. 


Cognitive-Behavioral Therapy (CBT), Motivational Interviewing (MI), Acceptance and Commitment Therapy (ACT), and Dialectical Behavior Therapy (DBT) have all been found to be effective in treating issues with Addiction. Our Cityscape addictions therapists understand the significance of taking this first step of setting up an initial appointment to address these issues. We will work with you in collaboration of developing healthier and more effective coping skills, stress management skills, and work through cravings and urges as they arise. 


Passion, Presence, and Purpose:

Cityscape Counseling’s mission of finding passion, presence, and purpose, can align with what we will work on in recovery. 

  • Finding Passion in our daily lives including cooking, exercising, connecting, etc. can help us find the small and large enjoyments in our lives. 

  • Being Present allows us to not focus on the past or future. One statement from self-help groups for addiction is to “take it one day at a time.” Being present today is the best thing that you can do for yourself and not getting caught up in past thoughts, behaviors, or experiences nor future “what ifs.”

  • Finding Purpose in our lives allows us to work towards having a meaningful and valued life. We feel good about what we are doing and what we are working towards in our lives. 

Including these missions can decrease opportunity for boredom, numbness, and feeling out-of-control and help you work towards what you want.  

In addition to outpatient therapy (1-3 times per week), attending self-help meetings such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Refuge Recovery, Smart Recovery, and many more, can be important in learning how to interact with others and enjoy those interactions while not using substances and forming impactful connections in recovery. 

You are not alone and we would be honored to work with you to make healthier changes for yourself and your life. 

if you're looking for An Addictions Therapist in Chicago, cityscape counseling would love to work with you.

We know that seeking out therapy can be a daunting endeavor so we're dedicated to helping you each step of the way.

© 2020 by Cityscape Counseling Chicago

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