The definition of addiction that Dr. Covington has used in her work with women – and that we use in our work with men as well – is “a chronic neglect of self in favor of something or someone else.” The overall model of addiction that we use, also based on Covington's work, is also comprehensive, comprised of seven areas: Physical, Psychological, Emotional, Behavioral, Spiritual, Environmental, and Sociopolitical. We believe all seven areas are necessary and any approach to addiction treatment that leaves any of these out is incomplete.
If any of these areas would be overlooked in traditional treatment it would likely be the last one - the sociopolitical - because it requires us as clinicians as well as our clients to look at political power, the privilege of being a man, and the impact of entitlement. For some those issues are not even on the radar; for others, it is not clear how they could be related to a man’s sobriety. While this area may not be related immediately to a man’s sobriety it will definitely affect his ability to be in healthy and mutual relationships, particularly his relationships with women. At the same time, you have to be very thoughtful about how and when you approach these topics so that men can hear what you are saying and feel supported in taking a look at this part of their lives. One tool that we have used that has worked incredibly well has been what we call an interactive lecture where we outline the topic and ask the men to essentially lecture the facilitator/s. Because the men are not being talked at they are much more comfortable engaging in difficult topics and allowing a surprising amount of depth to the discussion.
It would not be uncommon for the other six areas of our framework – most of which are parts of the traditional paradigm - to be under-examined. For instance, while an exploration of the psychological impact of addiction is inherent in any treatment that does not mean that the psychological impact of being raised as a man in this society or the limitations of the traditional western paradigm (i.e. – individuation of self) are part of that exploration. We have found that to be essential and eye-opening for the men. The experience of addiction treatment and the process of recovery are almost antithetical to how we are raised to be men and that should be addressed with the men right away. In fact, the act of seeking treatment or some other form of professional help is not part of the traditional male role and that should be part of the consideration when interacting with or treating any man at any point along the continuum of services – from intake to discharge.
What we are espousing as a model for addiction is not contrary to the traditional model – it merely builds upon it and includes new areas of focus necessary for the improvement of men’s services.