IQ Treatment Challenge- Chemically Dependent Patients with Gifted Intelligence
Lewis Hales Considers the Treatment Challenges of Chemically Dependent Patients with Gifted Intelligence
I worked as a counselor specializing in addiction and adult psychiatric disorders at medically based US treatment programs for 25 years and have conducted individual, group and marriage and family therapy with hundreds of chemically dependent patients and their families during my career as both a treatment coordinator and case manager.
Especially in working with alcohol and other drug dependency patients, I observed an ongoing treatment issue, about which I have not been able to find much information or research. It has been my experience that patients who have gifted intelligence combined with an addictive disorder display more difficulty dealing with recovery issues than individuals who do not have exceptionally high IQ ranges.
Addictive personalities, gifted children and adults share similar traits and face comparable challenges such as the tendency to be a perfectionist, isolation, feeling awkward in social interactions, frequently experiencing boredom, having concerns with authority and feeling different than others. Many a gifted individual never has problems with chemical abuse or dependency. However, both personality types seem to bring their own separate, yet remarkably similar, set of problems to the table. When an individual has both, the dual factors appear to potentiate each other, producing a double trouble effect more challenging than if just one factor was present. This would explain the unusual level of intensity and struggles some of my gifted A-D patients have experienced.
Often those with the disease of addiction prefer to be alone and display poor interpersonal and social skills, regardless of whether they are practicing or in recovery; this is an ongoing and permanent tug of war for them. A few years ago, I worked with a counselor who had over 30 years of recovery and still she had to prompt, sometimes force, herself to interact with her support system. Her initial reaction to stressful situations was to try and handle the problem without talking to anyone.
Gifted children or adults also experience comparable issues of social skills and isolation. Freedman and Jensen (1999), in their article, “Joy and Loss: The Emotional Lives of Gifted Children,” cited research conducted by Karen Stone McCown, founder of the Neueva School, with a group of Nobel Prize winners. The authors indicated that, “One finding was that, almost unanimously, they reported that their social-emotional development was shortchanged. They said they were so self-motivated to pursue their intellectual passions that almost nothing would have stopped that work – but missing from their lives were the social skills that would help them interact with and connect to family, friends, and the larger world”.
Intellectual boredom is a particularly intense problem with gifted alcoholics and addicts. I worked with a recovering alcoholic I will call David, who is a brilliant lawyer and owns a prestigious law firm in Georgia. David was identified as gifted in elementary school, and because of his short attention span and tendency to get bored easily, he recalled designing one project after another in order to stimulate his intellect since early childhood. His disease of addiction fed into this tendency, causing a synergistic effect which resulted in becoming an adult intellectual workaholic to such an extent that he almost had a relapse during outpatient treatment because he did not know when to stop working on cases. David’s therapy included a few initial confrontations, limit setting and assignments designed to facilitate developing healthy coping strategies and better interpersonal and social skills as he interacted with other patients, co-workers, clients, his sponsor and other 12 step members. After a year of being in individual therapy with me, David had started making significant progress, although he was one of the most challenging gifted patients of my career.
Perfectionism is a personality characteristic common among addiction patients and gifted individuals. The National Association for Gifted Children website (March 2014) states that, “Approximately 20% of gifted children suffer from perfectionism to the degree it causes problems”. I observed the dysfunctional version of perfectionism with all my gifted patients, which frequently took the form of relentless self-criticism and venting anger on themselves in some way for not meeting their own unrealistic expectations. Overall, it is my observation that gifted-addiction patients are harder on themselves than any other type of patient in recovery with whom I have worked.
Most gifted patients have a long-term tendency to overanalyze problems instead of focusing on recovery solutions. They over-complicate issues and attempt to have long intellectual conversations with their counselors to evaluate every aspect of a particular struggle they are experiencing. If patients are allowed to control their sessions with these unproductive conversations, they will not learn how to deal with the stress of everyday life without using. Perfectionists endeavor to be the perfect friend to new folks they meet or people they have known for a long time, which usually is based in issues of control and manipulation and will eventually sabotage their recovery program. However, over time the gifted patient can learn the bottom line reasons for these behaviors if he or she has a genuine desire to be honest, work the steps, find an insightful sponsor and change their lifestyle. I worked with a 45-year-old patient I will refer to as Lori. She focused on analyzing issues when she felt insecure because doing so created a familiar comfort zone that gave her a sense of relief and control. The overall treatment goals for Lori were to get her to talk about her feelings, find a sponsor and start making healthy lifestyle changes. Lori eventually worked through her analytical smoke screens and she remains sober today.
Recognizing and addressing gifted individuals in recovery is an important subject to include in our disease of addiction concept. Counselors who have worked in the field for any length of time already are aware of these patients, although specific protocols for identifying and treating them have not yet been officially developed. It is important that ongoing research and attention be devoted to this previously unexplored recovery topic to better understand the special issues these patients are facing on a daily basis. This will provide pertinent information for more accurate treatment planning and long-term recovery objectives and results.
I would like to dedicate this submission to the memory of my friend Kelly, who was a brilliant physician and recently passed away after a relapse.
Freedman, J. and Jensen, A. (1999). “Joy and Loss: The Emotional Lives of Gifted Children.” Page 1. Retrieved July 1, 2015, from http://www.kidsource.com/kidsource/content4/joy.loss.eq.gifted.html
Perfectionism. (2014, March 1). Retrieved July 1, 2015, from http://www.nagc.org/resources-publications/resources-parents/social-emotional-issues/perfectionism
About the Author
Lewis Hales is a retired therapist who specialized in chemical dependency and adult psychiatric disorders in Georgia for 25 years.