Importance of Confidence-Building Strategies in the Treatment of the Addict: using Expression to Alter Self-Image

This article proposes a new dimension to be added to the repertoire of the Counselor working with persons addicted to chemical substances. The strategy likely would also prove effective in the treatment of those with other forms of addiction, such as gambling, eating, sex, work and pornography. This dimension is to facilitate activities for the person to work on to increase their self-confidence. Closely related to confidence is self-esteem. Often addicts, especially those with a history of relapse, overdose, blackouts, seizures, arrests, incarcerations, and being mandated to a treatment program, suffer from collapsed self-esteem. This is apparent when they speak or write about themselves in a self-deprecating way. Those who are removed from referring directly to themselves may use third-person references as a way of protecting their shattered sense of self. “Self-esteem is your overall sense of your own worth, value, and abilities, influencing how you feel about yourself and your life. High self-esteem involves positive feelings about your qualities, belief in your worthiness, and a general sense of competence and happiness, while low self-esteem involves negative self-perception, self-doubt, and a feeling of inadequacy. It's shaped by your thoughts, experiences, relationships, and beliefs and can be improved over time through self-acceptance, positive self-talk, and focusing on your strengths” [1]. 

Encouragement through exercises involving prompted expression has been found to open new pathways of confidence in the formerly low-esteemed person. In the author’s previous work, prompted writing was shown to be an effective adjunct treatment modality [2]. By giving voice to formerly silenced feelings of despair, the person may experience a rejuvenation of their quest to seek happiness in healthy ways, manage their problems with clarity and rebuild the foundation of confidence. Confidence in one's value as a human being is a vital psychological resource and a highly positive factor in life. Confidence is correlated with achievement, good relationships, and satisfaction. Possessing little self-regard can lead people to become depressed, to fall short of their potential, or to tolerate abusive relationships and situations. 

This process is exploratory, affording an opportunity to uncover hidden strengths to reach bold new decisions. One such decision is to work towards self-improvement, a component of which is confidence

In the author’s experience working with persons recovering from substance use disorder, the introduction on creative writing challenges has led to discernible therapeutic breakthrough, as evidenced anecdotally both in the self-reports of change in personal feelings of confidence and in the notable improvement in affect—now observed to be much more positive. In the approach, persons in the residential rehabilitation program were invited to participate in a group and received a list of past writing prompts along with a newly created prompt. Participants were invited to read anything they prepared prior to the current meeting. Following each person’s share, commentary and reactions were provided by the other participants, as well as from the facilitator. Time was then afforded for a free-write based on the new weekly writing prompt. Given time limits for the meeting, the facilitator controls each meeting and provides an overarching perspective tying in the various sharing of the group participants.

A middle-aged male has been in several treatment programs for misuse of alcohol and other drugs, seeking relief from the destructive aspects of use and a desire for not only sustainable recovery, but to find a new sense of clarity of purpose. Essentially, this person was locked in a deep cavern of despair, borne from traumatic experiences of shock, betrayal, and use of chemical substances to numb the emotional pain. The person is fully sentient but sits in the middle of his emotional tornado swept around by negative thinking. What he conveys is a pattern of self-deprecating thoughts about himself. These thoughts reinforce a negative mindset, blocking any interpersonal growth because of the feeling of helplessness and unworthiness. Nickerson [3] wrote on the work of Martin Seligman: “Learned helplessness is a psychological state in which an individual, after repeated exposure to uncontrollable negative events, believes they are powerless to change their situation, even when opportunities to do so arise” (p. 1) Powerlessness in the addict is often a trigger for relapse. 

The man reported his trauma in various forums, each time blaming himself that he is a “bad person” and underserving of a better life. His bleakness was the factor blocking growth; therefore, the drug and alcohol insult served to mask any effort to manage his feelings. In the most recent meeting, the person was able to write and share about movement in his mindset from the years-long stuck-point to a new place of strength and healing. When the man shared, even the velocity of his voice changed from the previous weak intonation to one of bold and self-assured strength. What was evident was that this man brought himself out of his self-imposed doldrums to reawaken and now, once again, strive for betterment of his life. His newly confident attitude becomes the propellant from which the increase in his satisfaction of life emerges.

A young man communicated his emotional trauma and stated how depressed and guilt-ridden he felt. Working with him through both counseling and encouragement to write based on prompts led to noticeable breakthrough. He was able to let the formerly repressed traumatic memory be there in the mind without repression, but he was able to diminish the feelings of guilt so that he could start to move forward in his life. His writing became fluid and expansive, and his demeanor and voice became much more confident and brighter. This change allows him to progress through his recovery with a positive mindset.

A young woman expressed her past trauma of being brutally assaulted and the damage that caused to her sense of self. Through her brave writing and her acceptance of vulnerability in reading to the writing group, she was able to gain new strength and resolve to see the past incident as something to leave in the past and not allow it to poison her present sense of self or injure her ability to grow in the future. Her story demonstrates that using writing to unlock the potential for past harm to continue to harm, through sharing, new strength is possible and a new beginning for growth.

These cases infuse new feelings and awareness of self-esteem, the importance of being alive and now a new ability to set new goals. From here, the person can begin to live again. The recovering addict can learn to thrive not just survive through revolution of their inner spirit, striving for new self-confidence to drive their lives forward in productive ways. Using this process allows the person to finish the recreation of a new pattern of behavior to end the cycle of use/recovery/relapse. Through a process of expression, the individual can grow dimensionally and then, choose to continue their newfound growth and seek continued optimism. The word “optimism” comes from the Latin word optimum, meaning ‘the best.’ In psychology, optimism or dispositional optimism is a set of beliefs and traits that help individuals reflect on the positive aspects of life rather than the negative ones. It is a personality pattern that displays resilience and personal strength” [4]. 

There is a connection between addiction and esteem. The addict experiences negative feelings of guilt, self-despising, hopelessness. These feelings undermine any effort to recover, bringing the person down and removing any potential for rebounding. Until the inner trauma causing the deflation is adjusted the person will have great difficulty. Expression is a tool, which can open new channels of growth in both the person’s recovery and with respect to the person’s self-confidence. From here, other forms of interpersonal growth are possible. Martin Seligman's theory of optimism, known as learned optimism, posits that optimism is not a fixed trait, but a skill that can be learned and cultivated through specific thinking patterns. It emphasizes how individuals explaining the causes of events, particularly setbacks, influences their emotional and behavioral responses. Becoming optimistic can lead to other important changes in the recovering addict.

1. Psychology Today (2025) Self-esteem. Psychology Today, New York, USA.
2. Kreuter EA (2025) Creative Exploration of the Complexity of the Prelapse Experience in the Addict: Adding Retrospective Insight, Journal of Addiction &Addictive Disorders 12: 206.
3. Nickerson C (2024) Learned helplessness. Simple Psychology, London, UK.
4. Chowdhury MR (2019) 11 Optimism Exercises & Theories (Incl. Learned Optimism). Positive Psychology, Amsterdam, The Netherlands.