To understand and address complexity in dual diagnosis treatment, it is useful to think about “The Four Dimensions:” biological, psychological, interpersonal and spiritual. The more severe the impairment, the greater the damage to the four dimensions. Jeff Jay and Jerry Boriskin, Ph.D. are the authors of At Wit’s End, the ground breaking book on co-occurring disorders published by Hazelden. Here is an excerpt:
Top Down, Bottom Up
Utilizing all four dimensions adheres to the simple principle of “top down” and “bottom up” mentioned in chapter 3. We now know that higher-order interventions –cognitive and spiritual– have a powerful effect on the brain and body. Similarly, there is very strong evidence that bottom-up factors –diet, exercise, and medicine– affect thinking, decision making, and behavior. Addressing all four factors means you are addressing co-occurring issues from both directions: top down and bottom up.
–At Wit’s End, by Jeff Jay and Jerry Boriskin, Ph.D.
For best results, the core issues must addressed simultaneously in an appropriate treatment setting. Medical detox and psychiatric stabilization pave the way for meaningful treatment that goes below the surface. After primary treatment, an extended care facility may be recommended. This extends the treatment process and provides a structured environment for continued progress. We strongly encourage mentoring and monitoring in these cases, as well.
Working with dual diagnosis can be challenging. We will be happy to discuss your situation with you and to guide you in choosing a treatment center.