Nachas Ruach Treatment Model (NRTM) for treating Internet Addiction within a Marital Context

written by Dr Naftali Fish, licensed Clinical Psychologist and Hypnotherapist

Dr. Fish will be lecturing in the Marriage and Family Counseling course this fall at Yanar!!

In the 1990s, the issue of drug abuse in the religious world was still surprising and shocking. Today, though the problem of substance abuse in the religious world still exists, the issue of Internet addiction has become a growing phenomenon in the world in general and, unfortunately, in the Torah world as well. It should be noted that Internet addiction will be included in the next DSM manual which is scheduled for publication soon.

The emergence of the “Internet era” has had a major impact on the entire spectrum of the frum world, threatening its ability to remain unaffected by the escalating negative trends within the larger culture.

Working with many cases of Internet addiction, I have been able to understand more of the unique psychological dynamics of this new 21st century experience and culture, as well as its implications and dangers for the religious world.

Nachas Ruach Treatment Model (NRTM) for Initial Crisis Intervention with a Married Couple
This new approach involves four stages.

Stage One — Initial Crisis Intervention with the Married Couple
Based on clinical experience, it is quite common that the initial referral for therapy is made by the wife after she has discovered that her husband has been involved in the wrong way with the Internet, usually for some length of time. This discovery usually evokes a strong and powerful emotional reaction that sets off an acute crisis, which often seriously challenges the ongoing viability of the marriage. Working with this issue, the first stage of professional intervention in the Nachas Ruach Treatment Model is to meet with the couple together for the first meeting. The atmosphere at such meetings is always highly emotionally charged.

One of the major treatment goals is to validate the entire spectrum of the wife’s initial “raw reactions,” including shock, anger, sadness, confusion, and a sense of being overwhelmed.

Stage Two — Intensive Individual Therapy with the Husband: Psycho-Social Assessment, Twelve-Step Orientation, and Value Clarification
After the initial couple session, the main focus of therapy for the next stage is primarily working individually and intensively with the husband. The beginning of individual therapy involves doing a thorough psycho-social assessment that includes obtaining a basic picture of the client’s development since childhood.
Looking at the history of the addiction per se, it is necessary to clarify its development over time. How did he try to cope with it when he began to feel that he was losing control?

The therapist takes the position of viewing the issue of Internet “acting out” as being an addiction that will be best understood and treated through the application of the classic Twelve Step program.
In the Nachas Ruach model, the conventional twelve steps will be supplemented by six additional Torah concepts.
Practically, this means that the therapist will stress the clear position of the Twelve Step Movement, that the only real treatment goal is total abstinence, on the basis of staying clean “one day at a time.”  Seemingly paradoxically, it will be conveyed to the client that he isn’t “responsible for his disease,” but he is responsible for his recovery.
The Nachas Ruach approach also actively incorporates aspects of values clarification.
The process of sincere values clarification involves the client in engaging in a conversation with the therapist and with himself in a way that few have been able to do before.

Stage Three — Healing the Inner Wounded Child and the Sources of Addiction via Hypnotherapy
Assessing and accessing the client’s inner wounded child is in most cases an effective way of addressing and healing the underlying unconscious roots of addiction and other issues. Hypnosis is utilized as a means to help the client internalize in a deeper way the “new” adult program that will powerfully influence how he views himself in the world.

The experience of “going into trance” also is utilized to help the client to stay clean “one day at a time,” with God’s help. Clients will receive suggestions how to react when finding themselves in high-risk situations. This includes automatically taking a number of deep breaths, breathing in “Nachas Ruach” and breathing out “kotzer ruach.”

During this stage, the therapist continues to meet with the wife, often in individual sessions. In most cases where the husband “really got it,” my professional experience is that these couples will eventually reorganize their relationship and go forward. It is important to stress to the wife that she must continue to maintain the non-negotiable position that another relapse is not acceptable and will lead to serious negative consequences.

Stage Four — Follow Up

Marital counseling during this stage is often assessed to be necessary and is helpful after the husband has already committed himself to be totally abstinent and has already demonstrated the ability to be clean for at least six months.