Addiction therapy is not primarily about stopping. Most people with a serious addiction have stopped many times. The question is not how to stop — it is how to build a life in which the addiction is no longer necessary.
What therapy addresses
Effective addiction treatment works at several levels simultaneously. The immediate compulsion. The psychological function the addiction has been serving. The patterns of thinking and relating that sustain it. The damage it has caused — to relationships, to self-esteem, to physical health. And the question of what recovery actually looks like for this particular person.
Alexithymia — from the Greek for “without words for feelings” — is the difficulty identifying what one is feeling, distinguishing between emotions and bodily sensations, and putting emotional experience into words. It is not the absence of feeling. It is the absence of access to feeling.
Anger is one of the most misunderstood emotions in clinical work — and in ordinary life. It is routinely treated as the problem when it is almost always a signal. The question is not how to eliminate anger but what it is pointing at.
A safe space in therapy is a specific clinical concept — not a synonym for comfort, and not the absence of difficulty. It is a reliable container: a relationship and a setting in which difficult, frightening, or painful material can be examined without the person being overwhelmed by it.
Trauma is not the event. It is what happens inside a person when an experience exceeds what the nervous system can process at the time. The memory does not file itself away. It stays active — raw, unintegrated, continuing to behave as though the danger is still present.
It is one of the most common things Philippe Jacquet hears in the consulting room. A patient describes their situation — what happened, what was done to them, what they did not receive, what they lost — and arrives at the same conclusion: it’s not fair.
Philippe Jacquet has worked with men with eating disorders across private practice, hospital settings, and residential rehabilitation. One observation comes back, again and again, with a consistency that makes it impossible to ignore.
A man returns from a period in treatment. He describes the group sessions — the conversations about feelings, the invitations to share. He says: they kept asking me how I felt. And I didn’t know what to say.
Insight — the moment of understanding why something is the way it is — is valuable but insufficient on its own. For change to occur, insight must be translated into action. And action, over time, builds capacities that were never there to begin with.
The wounds formed in childhood do not disappear in therapy. They are roots — foundational to the structure of a person. What changes is the relationship to those roots: the adult self learns to accompany, reassure, and care for the younger self in ways the original environment could not.
A symptom — whether an eating disorder, an addiction, or a compulsive behaviour — often functions as an anaesthetic: it reduces the felt discomfort of an underlying situation to a level that makes it liveable. Therapy, by removing the anaesthetic, temporarily increases the pain. This is not a failure of the therapy. It is how change becomes possible.
Psychotherapy is a collaborative, relational process in which two people work together over time to understand the patterns, feelings, and experiences that shape how the person lives. The relationship itself is the primary medium through which change becomes possible.
Not the medical model
Many people arrive expecting something close to a medical consultation: present the symptoms, receive the diagnosis, follow the treatment, achieve the cure. This is not how psychotherapy works.
Shame is the painful belief that the self — not just an action, but the whole person — is fundamentally defective, unworthy, or unlovable. Unlike guilt, which responds to behaviour, shame responds to existence.
Guilt versus shame
Guilt says: I did something wrong. It points at a specific action and motivates repair.
Shame says: I am something wrong. It points at the self. Because the self cannot be corrected in the same way an action can, shame tends to persist beneath the surface of everything.
“You will suffer better” is the most honest summary of what depth psychotherapy offers. Not the elimination of suffering — that is not achievable. What changes is the quality of the suffering: the meaning found within it, the capacity to bear it without being destroyed, and the ability to feel pain clearly rather than escaping it at cost.