Taboo or Not Taboo: Discussing Substance Use in Therapy from the Perspective of a Denver Trauma Therapist
By Jordan Kurtz, MA, LPCC, Denver Trauma therapist
In a previous blog, I advocated for holding more space in therapy to talk about sex. This blog roughly follows suit in its advocacy for discussing substance use in counseling to a greater extent. Stigma is so closely related to substance use that many feel shame, trepidation, or at the least- uncertainty- even broaching the topic of substances in therapy.
At CZ Therapy Group, we believe one of the primary forces of healing is undoing aloneness, and that does not come with any caveats.
Below I explore more in depth why discussing use with your therapist may be of benefit to you, no matter what role substances play in your life, and how our team of Denver Trauma Therapists approach this work.
What do you mean by “substances”?
Broadly, substances encompass anything that, when used/ingested, alters your state of being, consciousness, and emotional/cognitive processes. This includes, but is not limited to, alcohol, medical or recreational use of marijuana, psilocybin (mushrooms), ayahuasca, mescaline/peyote, stimulants (i.e. cocaine, amphetamines) and depressants (i.e. benzodiazepines, opiates).
The substance I use is illegal. Does confidentiality cover substance use? Clarity from a Denver Trauma Therapist.
Therapists are not considered mandatory reporters for substance use or misuse. The only exceptions to this are if you disclose:
you are providing substances of any kind to a minor
using substances in front of minors
involving minors in the sale of substances
you intend to use a substance as a means to intentionally end your life
We Believe That Denver Trauma Therapy and Harm Reduction Go Hand in Hand
Substances are often used, or misused, as a way to cope and protect ourselves from feeling the painful impacts of trauma on a daily basis. As such, our Denver therapists at CZTG believe that substance use should be lumped into the ‘protective strategy’ box just like any other adaptive way you have learned to deal with trauma (ie intellectualizing, isolating, perfectionism, etc).
All of this is to say that we do not view substance use or misuse as inherently bad, shameful, or needing to be stopped cold turkey. Instead, our trauma therapists take a harm reduction approach to any substance use that is brought to light during the trauma therapy process. We know how important it is to get curious about your use of substances, their impact on you - both positive and negative - and ultimately support you in creating a relationship with substances that feels uniquely aligned and beneficial for you, your life, and your relationships.
Benefits of Your Therapist Knowing About Your Substance Use- even if it is not the focus for counseling in Denver
Helps discern the presenting problem and streamlines treatment goals
While diagnosing is something that only happens within specific parameters at CTZG, holistic understanding of sources of disconnect, pain and aloneness as well as resilience are essential for all clients. Sharing about the role of substances in your life helps your therapist track areas of concern and unwanted triggers and behaviors with you, or provides insight about how substances can supplement other coping skills.
Alleviates guilt, doubt and shame
While support can often be found within friends, family and societal circles, sometimes these advocates can be the very ones who stigmatize substance use behaviors- whether concern is warranted or not. Regardless of whether you use substances recreationally or recognize concerns with your use, your therapist can undo shame and aloneness surrounding your use alongside you.
Fosters awareness of our templates for inspiration, social norms, stress reduction, and avenues for insight
When we notice a need to unwind or pursue motivation, how frequently do we assess the adaptiveness or origin of these inklings? Collaborating with your therapist about how substances destress or inspire us- and if any other important figures in our lives model this – brings deliberate insight to our actions and catalyzes discussion about how these choices are serving us.
Offers opportunities to collaborate care with other providers
While CTZG therapists are very attuned to our client’s bodies, we are not medical experts about the impact of substances on bodily function. Cluing your therapist in to somatic problems or benefits that are the result of use (i.e. microdosing) allows your therapist to track with your medical providers (with your consent) the mind-body impacts of substances that you experience.
Facilitates different varieties of somatic awareness
Many of us carry purposefully or unconsciously repressed painful experiences that substances have the power to numb, exacerbate, or clarify. Bodily responses, others involved, strong emotions, or time limitations can prevent us from reflecting intentionally on the relationship between our use and emotional experiences. Exploring this connection with your therapist may illuminate the function of use and foster discussion about how use facilitates or inhibits your healing.
External Resources for Substance Use Support in Denver
*About CZTG specializations: CTZG clinicians offer somatic-based and attachment-informed therapy for trauma and relationships. While substance use often intersects with our trauma or is a direct coping mechanism in response to it, CTZG clinicians do not specialize in working with severe substance misuse or withdrawal symptoms.
If you are in need of more intensive substance use support, please see the resources listed below for more tailored care.
Harm Reduction Action Center - supports for safer substance use
Wellness Winnie - mobile harm reduction efforts in Denver
Mountain Treatment - substance use groups
Red Rock Recovery Center - inpatient treatment, detox support, MAT
Denver Health Addiction Services - medical support
About the Writer - Denver Trauma Therapist
Jordan Kurtz (she/her) is a trauma and relationship therapist at CZTG who focuses on therapy for grief, trauma, adolescence, and couples. Jordan is authentic, warm, and affirming of her clients’ identities and experiences.
If you’d like to connect with Jordan to learn more about what it would be like to work together, feel free to reach out for a free consultation.