Substance Use

An Existential View of Substance Use

From an existential perspective, substance use reflects a person’s lived experience. In this way, it can be seen as a meaningful and often adaptive response to the difficulties we face in our lives.

When we take time to understand the purpose a substance has served, its presence often begins to make sense. For example, it may have helped turn down emotional intensity, calm anxiety, or offer relief from internal pressure or persistent overthinking.

When we step back and look more broadly at the our patterns of use, it often becomes clear that use is less about a specific drug and more about how difficult it has become to remain fully present with one’s own life.

Questions we might start to explore in therapy include:

• What role or roles does substance use play for you?
• What has it helped you get through?
• What might it now be preventing you from experiencing more directly or fully?

Cannabis, Alcohol, and Other Drugs

Below is an overview of the most common substance-related concerns I encounter clinically in Eugene and Springfield, Oregon, particularly cannabis and alcohol.

Cannabis

In Eugene, cannabis use is widespread and culturally normalized. For some, it is an occasional recreational substance. For others, it becomes a way of managing stress, anxiety, sleep, or emotional intensity. In other cases, it is woven deeply into social life and identity.

In addition, because cannabis is legal in Oregon, its impact can be easy to overlook or minimize, and in some people, it does not produce dramatic or immediate consequences. Instead, its effects tend to be cumulative, unfolding gradually over time.

Patterns people often bring into therapy include:

• A daily ritual that feels less intentional and more automatic
• A general sense of emotional flattening or reduced depth
• Less motivation or urgency around long-term goals
• A growing preference for staying home rather than engaging with others
• Disrupted sleep or reduced sleep quality
• Increased difficulty managing anxiety, anger, or emotions

In therapy, cannabis use is explored with care and respect. The question is not Is this bad? but rather:
Is this still serving the life I want to live?

Alcohol

Alcohol is one of the oldest psychoactive substances and remains deeply embedded in social life and culture. Because of this, it can be difficult to clearly identify when alcohol use becomes problematic.

Often, the issue is not only frequency, but the timing and intention behind its use. For example, noticing a pattern of drinking after difficult workdays, during periods of loneliness, or as a way to avoid uncomfortable emotions.

From an existential perspective, the focus is on paying attention to patterns, meanings, and consequences as they unfold over time, and how alcohol may relate to larger patterns within one’s life.

Other Drugs

Above, I have focused on alcohol and cannabis, the substances most commonly discussed in therapy, but they are by no means the only ones people seek support for. For some, substance use involves stimulants or prescription medications. For others, difficulties can arise around psychedelics, or even caffeine.

Regardless of the substance, the core existential questions tend to remain the same:

• What role does this substance play in your life?
• What experience are you seeking through it?
• How does it shape your relationship to yourself and others?
• Who do you want to become moving forward?

Substance Use, Anxiety, and Overthinking

Substance use is frequently intertwined with anxiety and overthinking. One of the primary effects of many psychoactive substances is a calming or slowing of the nervous system.

In the short term, this often brings relief. Over time, however, substances may begin to reinforce the very patterns they initially helped manage. Emotional avoidance, reduced tolerance for discomfort, and increased reliance on external regulation can gradually develop.

Therapy offers a space to explore these patterns and practice alternative ways of relating to anxiety and thought. Over time, the focus shifts toward building internal capacity to remain present with experience as it is, rather than relying primarily on external means of regulation.

Recovery as a Meaning-Centered Process

For those in stable long-term recovery, therapy serves a different but equally important role. Recovery is about rebuilding a life that feels worth staying present for, a process existential thinkers often describe as becoming.

After the acute work of changing a relationship to substances, deeper questions often emerge:

• Who am I without this substance?
• What do I want my life to be organized around now?
• How do I relate to pleasure, rest, creativity, or pain?

Existential-humanistic therapy supports long-term recovery by focusing on identity, values, responsibility, and meaning, with the aim of supporting deep and lasting change.

My Scope of Practice

My work with substance use is intentionally limited in scope. This is not a rejection of the ways any particular person may be suffering, but a recognition that there are limits to the kinds of substance use concerns I can work with effectively as an individual clinician.

This work is well-suited for people who:

• Are experiencing mild to moderate substance use
• Are in early questioning or ambivalence
• Have cannabis-focused concerns
• Use alcohol in ways that are present but not severe
• Are in stable, long-term recovery
• Are seeking reflective, meaning-oriented therapy

This work is not appropriate for:

• Active, severe substance use disorders
• Situations requiring detox or inpatient care
• High-risk use requiring medical stabilization

If you are unsure whether this work is a fit, I encourage you to reach out. I will help you assess your situation and, if needed, support appropriate referrals.

Honesty and the Authentic Encounter

My work as an existential therapist centers on creating an honest and authentic dialogue, a space where we can explore who you are and who you want to become.

This often begins by understanding the emotional and existential role substances have played in your life and identifying patterns of avoidance, disconnection, or difficulty. From there, we may turn toward deeper work with anxiety, grief, depression, or existential concerns.

Over time, many people find that as they come into more authentic contact with themselves, substance use begins to shift naturally. This process is not about forcing change, but allowing it to emerge through understanding, responsibility, and choice.

Presence, Connection, and Meaning

If you are noticing tension around your relationship with cannabis, alcohol, or another substance, or if you are seeking support in long-term recovery, therapy can offer a place to slow down, reconnect with yourself, and clarify the direction you want your life to move toward.

If this resonates, you are welcome to contact me to explore whether working together may be a good fit.