Avoiding counter transferrence

[TerpGal02, ASN]

I just started a new job in a community hospital psych/detox unit. I have almost 3 years in psych caring for all ages and love it. The addictions part not as much. We have had addicts and drug seekers but never straight detox. We do straight detox for EtOH. We will detox opiates but they have to be on the floor for a co occurring psych problem. Sometimes I have a really hard time having empathy for the alcoholics. I give them good care but some of them trigger me a lot. My father is an alcoholic and my husband is a recovering alcholic (and still in early recovery). So having lived with all the chaos and he'll that is being close to addiction sometimes I feel for their families more than them. Anyone else in a similar situation? How do you avoid being triggered? I went to Al Anon for a while but found the 12 step model does not work for me so well.

[Gooselady, BSN, RN]

It may not sound like 'very much', but having a husband newly in recovery and being a child of an alcoholic, it's no wonder you are 'triggered' so to speak. You go to work, and deal with addicts. You go home, and there's an addict there, too.

It's actually a good question for someone with your experiences.

When I did chemical dependency for four plus years, I went from not being particularly 'fond' of addicts, more like I was familiar with them from regular psych, and my own father was a raging drunk with Axis 2 galore. Over the four years I too had to work on 'counter transference' or whatever. I didn't go into the job with a sense of unresolved issues and didn't get triggered like you describe. This job may just be too much for you and where you are in your life, and that would be SO understandable! Getting 'triggered' is not something you can help.

I guess it's an opportunity for YOU to examine your underlying attitudes and assumptions, and then 'reality check' them with the people you work with. Be extremely open minded. Addicts are suffering people. At the bottom of each and every addict's M.O. is the relief of suffering. Who can't relate to doing stuff to make yourself feel better -- or in the case of addicts, just feel NORMAL or neutral instead of awful? The scary things they do to get their drug is in exact proportion to the suffering, including criminal activities.

Some addicts are also a bit on the sociopathic side, or are a bit narcissistic . . . and this is who they are drunk, stoned or cold sober. Many axis 2 people have comorbidities such as drug dependence, but addicts in general are not axis 2.

Anyway, I was able to develop a lot more compassion for addicts thanks to that job. Ironically, that job made me able to understand axis 2 a lot more than previously. For me the axis 2 is what 'triggered' me, the manipulation, charm, lies, oh the lies.

I get the impression many, including nurses, see addiction as a 'choice' addicts have made in sound mind and that justifies their disgust. I think that is a cop out, albeit common. It's a good way to shut the door on trying to understand what drives the addict, that's for sure. The alcoholic in detox is NOT choosing his vital sign instability or his seizures, hello. And whether or not they 'chose' to relapse and drink again . . .well, it's pretty arrogant for the rest of us to assume we know the real score.

Don't forget this is a very tough population for ANYONE to work with. Don't waste valuable years of your life doing what just doesn't feel right :)