Quitting #4: The Therapeutic Power of Relationships

Treatment for any chronic disease, whether diabetes or substance use disorders, is more likely to be successful if more than just biological factors are considered. This week I will address the social/interpersonal “track” of nicotine use disorders.

One relevant social issue relates to the motivation of smokers to quit. Smoking has now become so stigmatized that one of the reasons that many people seek treatment at Triple Track is embarrassment and even shame about their cigarette use being known by other people, especially their young children. My patients describe to me the elaborate lengths to which they go, often with remarkable success, to keep their smoking hidden from others.

Our treatment program is designed to therapeutically leverage this social factor by making group therapy a cornerstone. Most of our patients, no matter how much they want to quit, have difficulty believing that this will be possible to accomplish. Much more impactful than any reassurance that I can provide is for them to hear directly from another group member who recently had those same doubts and has now successfully transitioned to a nicotine-free state.

Patients become important resources for one another in other ways. Many of them redirect the ingenuity that they had used to maintain their use to design creative ways to support quitting. One patient, for example, designed a plastic straw, with a circumference and length that filled the empty place between her fingers where her cigarette had rested for so many years. Adding cotton to the end of the straw allowed her to experience the familiar draw of a cigarette while filling her lungs with fresh air instead of smoke, as well as satisfying her “oral fixation.” This allowed a separation of her behavioral dependence on the act of smoking from her physiological dependence on nicotine, which was addressed with medication, in a way that made the quitting process more manageable. In group sessions, she would describe this to other patients, who would adopt and personalize it in ways that were beneficial to themselves.

Volunteer mutual support groups, such as Twelve Step Fellowships, have been a mainstay of recovery for other substance use disorders since the establishment of Alcoholics Anonymous in 1935. In conjunction with – or even in lieu of – professional treatment, these organizations have demonstrated the therapeutic power of interpersonal relationships and social structures. At Triple Track, we encourage our patients to explore Nicotine Anonymous, which was established in 1982 by members of Alcoholics Anonymous. Although much smaller than other 12-Step programs and operating primarily online, “NicA” provides important social support for people with nicotine use disorders, especially for the “staying quit” phase of recovery.

If you have concerns about the group aspect of our program, we would be glad to discuss this with you if you contact us by clicking here.