When someone is struggling with addiction, one question comes up very often in therapy:
“How could talking help me? My problem isn’t talking—it’s alcohol, cannabis, gambling, food, sex, or screen time.”

This reaction is perfectly understandable. After all, when you’re struggling with an addiction, it’s the behavior that’s most obvious. Naturally, you assume the solution must focus on that behavior.

However, in therapy, another question quickly arises: what if the addiction isn’t the problem, but the response to a problem? Very often, it isn’t the source of the suffering, but a way of coping with it—sometimes the only one available at a given moment.

This is precisely where talking comes into its own.

Talking doesn’t instantly make an addiction disappear, and therapy isn’t a magic solution; some situations also require medical or addiction treatment. However, talking gradually makes something else possible: it creates a space to ask ourselves why this addiction is there, what it relieves, and why it’s so hard to do without it.

In other words, it’s not just about making a symptom disappear, but about understanding what it’s trying to address.

Addiction isn’t just a matter of willpower.

I hear this phrase very often in my practice: “If I really wanted to, I’d quit.”

Behind these words, there’s often a lot of guilt. The idea is that if you can’t do it, it’s because you lack willpower, discipline, or character. Yet if addiction were solely a matter of willpower, it would simply disappear with a decision. However, that’s not what we see in practice.

I see patients who are fully aware that their substance use is harming them. They know the consequences for their health, their relationships, and their work. Despite this, they describe a feeling of losing control, as if something were beyond their grasp. This is precisely what causes so much suffering for many people: knowing that it’s harmful… yet being unable to stop.

Very often, addiction isn’t limited to a behavior. It serves a function. It helps ease internal tension, soothe something unbearable, reduce anxiety, or sometimes simply to “get by.” I like to tell my patients that it’s a crutch—necessary for a time.

In this sense, addiction isn’t just a problem—it’s also, at a certain point, a solution.

That’s what makes therapeutic work unique. In therapy with people struggling with addiction, we don’t just ask someone to stop; we try to understand what makes that behavior so necessary.

Two people may consume exactly the same amount of alcohol. For one, it is an occasional pleasure. For the other, it’s an essential way to alleviate suffering. It is therefore not the substance itself that causes addiction, but the function it serves in the person’s psychological life.

Don’t confuse behavior with function:

When we first start working in an addiction clinic, we may be tempted to focus on the consumption itself.

But very quickly, another question takes center stage: “What purpose does this addiction serve for this patient?”

The object of addiction (alcohol, cannabis, sex, gambling, screens, etc.) is rarely the core of the problem. What matters is the role it plays in the patient’s psychological balance.

This question completely changes the clinical approach.

We don’t just work on eliminating the symptom, but on what would allow the patient to no longer feel such a strong need for it.

Why can talking actually make a difference?

At first glance, it may seem strange that simply talking could have an impact on an addiction. Yet this is often where things start to shift.

In sessions, I very often hear: “I don’t know why I do this.”

Patients are well aware of their behavior in detail—sometimes even very precisely. But they don’t always have insight into what actually triggers the urge to use or act in a certain way.

At the start of therapy, there’s often a sense of uncertainty. Some say they have “nothing to say” or that their story has no connection to their substance use.

Then, little by little, something changes: patterns begin to emerge—using after an argument, a stronger urge during stressful times, a systematic reliance on alcohol or screens when feeling lonely, or a difficulty coping with certain emotions without acting on them.

This process of making connections is fundamental: talking not only allows people to tell their story, but above all, it helps them connect elements that, until then, seemed unrelated. It is often at this point that the behavior ceases to be merely something endured and begins to make sense.

From Acting on Impulses to Thinking Things Through:

For many patients with an addiction, action precedes thought. This means that when an emotion arises, it is immediately vented through behavior.

What is often missing is not just the ability to speak, but the ability to transform what is experienced into something that can be thought through. The therapeutic setting gradually facilitates this transformation. It does not involve interpreting too quickly or assigning meaning prematurely, but rather providing a space where connections can emerge. It is a slow process, but it is often this process that allows the addiction to gradually lose its central role.

Why is it so difficult to talk about one’s addiction?

In my practice, I’ve found that talking about one’s addiction is rarely easy.

There is often shame, guilt, and very often a fear of judgment.

Many patients tell me things like: “I should be able to quit on my own,” “I’ll come across as weak,” or “I don’t want to let my loved ones down.”

These thoughts can significantly delay the moment when a person finally dares to speak up.

Added to this is another issue I often encounter: some people know they’re not doing well, but have trouble pinpointing exactly what they’re feeling. They describe a general sense of unease, tension, being overwhelmed, or a feeling of emptiness, without being able to go any further.

Under these circumstances, talking about the addiction itself can seem almost impossible at first. The therapeutic process then involves creating a space that’s safe enough for words to gradually emerge, without pressure.

Is therapy effective against addiction?

This is a question my patients often ask me, sometimes with high expectations, sometimes with doubt. Therapy does not promise the complete elimination of any desire to use, nor does it guarantee the absence of relapse. However, it can profoundly transform the way a person relates to their addiction.

Over time, I often see patients who better understand their own patterns of behavior, who identify risky situations sooner, and who gradually learn to respond in ways other than acting on their urges.

The goal isn’t to quit, but to stop relying exclusively on the addiction to cope with life’s challenges. This distinction changes everything.

Some people quit abruptly and hold out for a while, but relapse as soon as a difficulty arises. Others move more slowly but build something more stable, because they gradually come to understand what’s at stake for them.

What if relapse were part of the process?

A relapse is often seen as a failure. For my part, I see it more as a moment of insight.

It’s telling us something: a difficult period, overwhelming emotions, a life event, or sometimes simply mental exhaustion.

Rather than viewing it solely as a step backward, it’s often more helpful to approach it as part of the process of understanding that can lead to recovery.

This helps prevent guilt from reinforcing the cycle of addiction.

Finally, I would say that talking isn’t a magic solution. It doesn’t always replace medical care or addiction treatment when that’s necessary.

But when addiction is linked to psychological distress, it can profoundly transform the way a person understands themselves and relates to themselves.

Over the course of the sessions, what was previously merely acted out can gradually be processed through thought. Emotions become more identifiable, the connections between life situations and substance use become apparent, and other ways of coping become possible.

This, in my view, is the essence of therapeutic work.

Recovering from addiction isn’t just about stopping a behavior. It’s about gradually rediscovering the possibility of living differently, without that behavior being the only way to cope.

We don’t change just for the sake of changing. We change when another way of living finally becomes possible.