WHY IT’S SO HARD TO QUIT AN ADDICTION, EVEN WHEN YOU REALLY WANT TO

Photo by Ike louie Natividad on Pexels.com

Many clients I see usually come to counselling for addiction when they are concerned enough about their problem to want to do something about it. If you’ve been reading this blog for a while, you’ve probably heard me talk about the “stages of change” model by Prochaska & Di Clemente. If you want to you can familiarise yourself here but for those that hate within article links, here is an ultra-brief rundown. The model shows that people move through stages when they are making a change, and that could be any kind of change, from quitting a substance to embarking on a new career. The changes are pre-contemplation (not thinking about change), contemplation (obviously, some thinking about change), preparation (deciding to do something), action (actively making the change/s) and maintenance (engaging in the new behaviour regularly) and finally, we have lapse/relapse – a return to the pre-change behaviours.

It is important to distinguish at this point between a lapse and a relapse. A lapse is usually considered a one-off detour where one engages in the old behaviour, but it doesn’t continue. A relapse is when you slip back into the old pattern of use that existed prior to the 1st change attempt. According to Prochaska & Di Clemente, lapses and even relapse are part of the journey. On average, it takes a person approximately seven attempts to make real and lasting changes. It is all part of the process, and it’s important to see lapses as opportunities for growth, rather than signs that you are failing or worse, a failure.

Often this information is helpful to clients who present with the best intentions to ‘do something’ about their drinking, drug use, or porn habits but find that their decision to control or reduce their addictive behaviours is often in itself not enough to make it stop. They are often filled with shame, remorse and self-defeat when they come to realise that it is not as easy as just completing a detox or having some ‘strategies’ prepared. Don’t get me wrong, both those things are important and helpful, but what I try to stress to my clients is that they should not underestimate the power of their habit and that they are engaging in a battle with a very worthy opponent. One that has bested many before them and will continue to win many more battles to come. After all, why are there so many treatment centres, services and books written on the topic of substance use and addiction if it was that easy to just ‘stop it’.

I often point my clients to an excellent article which explains the science behind why people develop addictions (in this case to alcohol, but it could translate to almost any addiction) and how the process happens gradually, over time. The point is no-one wakes up one day and decides to have a problem addiction. It is often a process which involves several systems working in concert to create the brain and body of a person with an addiction. It is an incremental and inter-dependent process that involves your brain chemistry, your neurobiology, your physiology, your psychology, and your attachment system all working together. Each playing a specific and important role in making it super difficult to quit that behaviour/substance without real effort.

There is no sugar coating this. Changing a behaviour, any behaviour is not easy. Although the steps are simple, the effort required is significant. You are fighting against an army of adversaries that are all working together to keep the status quo. Your mind will come up with several reasons why you need to keep drinking, why you can’t stop today, why it is not worth the effort, why you cannot cope without it. Your limbic system will rise up with fear, anxiety, and trepidation at the idea of letting go of your addiction. Fear of change, uncertainty of what life will be like if you make this change and fear of having to face any underlying trauma or unpleasant reality that your addiction has helped keep hidden will attempt to sabotage all your good intentions.  You will argue with yourself, your family, your partner, even your therapist as your amygdala fires up with anxiety, even when you know that your substance use has caused you nothing but pain, trouble and drama.

This quote from Eckhart Tolle on addiction summarises it well:

Every addiction arises from an unconscious refusal to face and move through your own pain. Every addiction starts with pain and ends with pain. Whatever the substance you are addicted to –alcohol, food, legal or illegal drugs, or a person — you are using something or somebody to cover up your pain. That is why, after the initial euphoria has passed, there is so much unhappiness, so much pain in intimate relationships. They do not cause pain and unhappiness. The bring out the pain and unhappiness that is already in you. Every addiction does that. Every addiction reaches a point where it does not work for you anymore, and then you feel the pain more intensely than ever.

~Eckhart Tolle (The Power of Now pg152-153)

The difficulty in changing a behaviour is rooted in fear and pain. Fear of the original pain returning, fear of the pain of withdrawal in some cases, and fear of a future where pain must be endured raw, without the perceived buffer of the substance or behaviour.

So what is the answer? I encourage my clients to move through their recovery with a focus on self-compassion. Be kind to yourself and don’t buy into those critical voices that tell you it is hopeless, you are not worth it or that you have somehow failed just because you have not managed this transition perfectly. Change takes commitment, effort and support. But just because you have slipped up, doesn’t mean the game is over. Nothing worth doing has ever been easy. With courage, the support of a counsellor or peer support group and self-compassion you can make the changes your heart truly desires.

What to say to yourself when reality threatens to ruin your day, again!

 

It happens to all of us. One minute we’re humming along, going about our day with our faculties in check and then, wham! Reality slaps us with an unexpected challenge. Maybe it’s an unwanted text, a disappointing email, a parking ticket, an intrusive memory, a flashback, or some other emotional trigger that threatens to capsize our equilibrium. What to do?

ACT (Acceptance & Commitment Therapy) tells us that thoughts are just thoughts. Transitory events that pass through our minds. Thoughts can be positive, negative, or neutral. Neutral and even positive thoughts are often easily forgotten but those negatively, emotionally charged ones, they tend to stick around a lot longer. Depending on the thought, that can be for a few minutes, hours or sometimes days and days. So, what to do?

There are two main ways to shift your mood state caused by negative thoughts. Bottom up or top down. Bottom up are bodily focused strategies to help you shift your mood, these are not what we are talking about today. Today we are talking about top down cognitive strategies to help you swat those unpleasant, unhelpful negative thoughts away before they take hold.

Awareness is important here. Noticing your thoughts, the words you are using, the tone, the content of your thoughts is an important first step. Without awareness, we cannot change anything. So, if you are trying to change something, it’s helps to get into the habit of tuning into the radio in your head. Once you catch yourself speaking negatively, identify what it is you are saying. If you can, writing it down can help to articulate and identify the actual words clearly. Then, trying some of the below alternate thoughts below might help to reorient yourself, choose a more helpful way of thinking and get on with your day. Think of it as an experiment. Try it out and see what happens. What have you got to lose except some pretty unhelpful, not very useful and unpleasant thoughts? Old stories we’ve been telling ourselves for as long as we can remember. Long held beliefs and assumptions that are no longer fit for purpose. You can’t always choose what happens to you, but you can choose how you respond.

Often clients ask me what should they say instead? How to counter those emotionally charged thoughts, what should they say to themselves instead? It helps to have a few phrases prepared. Of course, not all of the below phrases will suit every situation, but I find some of them are pretty universally helpful, whatever the situation. Read through the below list, and maybe choose a few that you think might be helpful for you to remember and write those down somewhere easily retrievable. Like, in a journal or in the notes section of your phone. That way, you will have something prepared that you can counter an emotionally charged, negative thought with on hand. Or, you may want to add some of these to your daily affirmations if you find yourself struggling with the same sorts of thoughts often.

 

  • This is just a moment of suffering; this too shall pass.
  • What’s another way of looking at this?
  • Do I have all the facts? Or am I jumping to conclusions?
  • What is a more useful thought here?
  • Just because it feels real, doesn’t mean it is true.
  • Am I catastrophising?
  • I can handle this.
  • How am I breathing?
  • I feel pain, that is true, but what else is here?
  • Is this about what is happening now, or am I reacting to something that reminds me of my past?
  • I am having the thought that…. (Insert unhelpful thought, statement)
  • Thoughts are not facts. Some thoughts may be factual, but they may not be true, helpful or useful to me right now.
  • What’s the bigger picture here?
  • Will this still bother me tomorrow, next week, in a year from now?
  • I’ve got this.
  • Am I assuming the worst possible outcome will be the only outcome?
  • Am I mind reading?
  • Am I mistaking worrying for effective problem solving?
  • What can I control?
  • Is there anything productive I can do about this right now?
  • Will worrying about this solve anything?
  • Things aren’t always how they seem.
  • Don’t assume.
  • Remember, nothing’s perfect/nobody’s perfect.
  • I am not my mistakes.
  • I am good enough.
  • I am loved and supported.
  • Is this a set-back, or a hidden opportunity?
  • I have a choice here.
  • Feelings are not facts.

 

So, I hope you found the above list helpful. You may already have your own. If so, please comment below if you have your favourite negativity busting thought as this list is by no means exhaustive.

What is Post Induction Therapy?

Whilst YouTubing my way during this public holiday Monday I came across this video featuring Pia Mellody on the Meadows Model. I especially like her conceptualization of induction theory. The idea that as children we tend to be ‘inducted’ into our family system and take on certain beliefs, values and or rules as a consequence. This is fine if our families, or caregivers are ‘good enough’ parents, not so much if we grow up with one or more dysfunctional parents, or without adequate guidance.

Pia Mellody is a senior fellow of The Meadows which is an addiction treatment centre based in the United States. The Meadows model sees addiction as a symptom and treats the whole person, rather than the specific substance or behaviour. Other senior fellows of the Meadows include some of the greatest trauma, addiction and mental health experts today such as Patrick Carnes, Bessel Van Der Kolk, Peter Levine, Stephanie Carnes & Richard Schwartz among others. The following video shows Pia outlining the Meadows Model. I’ve summarized the main talking points below if you haven’t got time to watch the whole video (it goes for about 30 minutes) but I recommend you do if you have time.

PostInductionTherapy

Post induction therapy involves, according to Pia, addressing the “crap” that’s been introduced into your psyche during childhood. Usually the result of, shall we say, less than ideal parenting. If your parents were immature, addicted, mentally unwell, absent, abusive and/or relentlessly critical – or in some other way dysfunctional to varying degrees, chances are you’ve been left with a psyche that’s been polluted by a set of imposed toxic beliefs about yourself, other people and the world, which have infiltrated your system in much the same way as dirt added to water becomes mud. This can leave you feeling as if you are mud, rather than clear water with this extra stuff added. Mind you, I don’t think there is anyone on earth that manages to get through their childhood, adolescence, or early adulthood without something crappy added. However, some of us unfortunately have a lot more ‘crap’ to deal with than others, and so the sifting process can take a little longer. This means that recovery, in one sense, is a process of removal, of refinement and of letting go. Letting go of that extra baggage that feels like a part of us, simply because it has been with us for such a long time. Unresolved trauma is a bit like that, it feels like something that is a part of you, but it is not. Not really. Recovery often involves putting down, letting go of those beliefs, habits, behaviours that no longer serve you and of becoming the person you really are. As Louise Hay has said, a healthy, productive life is your birthright.

According to Pia Mellody, Post Induction Therapy means addressing the trauma that you encountered in childhood and working towards being comfortable with the idea of intrinsic self-worth. Intrinsic means, already there. You are worthy just as you are, all your faults and fabulousness included. Intrinsic self-worth involves an attitude of “My faults don’t make me any better or worse than you, same with my strengths”. Working on your faults, improving your strengths are part of the work. Getting rid of dysfunctional behaviours and dependencies such as addictions and learning how to be a ‘functional’ adult is also part of it. To do that, we need to be sober and to stop those behaviours which are essentially symptoms of our inner ruptured psyche. Those things you do to self-soothe, to punish yourself and others, to escape the sense of acute loneliness and the relationships we scorch along the way, are not discrete problems but symptoms of the foundational issue, which essentially is a poor foundation. Learning about self-worth, boundaries, respect for self and others and how to generally go about being a functional adult, these are the sorts of things parents or adult caregivers are supposed to be teaching their children. It is not your fault if your parents did not or were not able to do this for whatever reason. Learning to accept that is a big part of the healing process.

BoundariesAreEverything

Pia also talks about the importance of learning about setting healthy boundaries. According to Pia, a healthy boundary is a “cross between a wall and nothing.” A wall is not healthy. It may keep you ‘safe’ but it also keeps you isolated from others and stops you from fully relating, honestly, authentically. A wall keeps you from experiencing joy and happiness, even if keeping away pain and disappointment. Having no boundaries is not good either, of course. It is not safe to fully trust someone without reservation, to fully expect them to be your everything before getting to know them. A healthy boundary also alerts others to what you will and won’t accept from them and allows them to feel safe with you too. Learning how to enact your boundaries involves experiencing the emotion when a boundary has been transgressed, breathing through your emotions, accepting the emotions as being whatever they are, then using your ‘talking boundaries’ to tell the other person how they made you feel. This teaches self-regulation and healthy expression, rather than hiding, using substances, or blaming to avoid the discomfort that a boundary violation often involves. Learning how to enact your boundaries takes practice. Group therapy is great for this, as is working with a therapist one on one.

It is important to remember that healing involves acknowledging the trauma that has informed your current situation, but it doesn’t have to involve reliving that trauma. For some, it can be enough to know that what happened was not their fault and that their future doesn’t have to be the same as their past.

Supporting your immune system the natural way

I know it’s been a while since I posted on here but I just wanted to share this excellent article from “Mind Body Green”. If you don’t already subscribe to their newsletter I recommend you do for updated, regular information on health and wellbeing.

This article lists some super basic things you can do, starting today, to improve and support your immune system. It basically outlines what I constantly say to all my clients, all the time, because it is super important. Take care of your self, that includes your body, your mind and your environment for they are all connected.

Check it out:

How To Support Your Immune System On A Daily Basis, So It’s Ready For Anything,
from Mind Body Green

The prevalence of porn on the internet – and a tribute to the late Gary Wilson

Gary Wilson, co-founder of the website Your Brain on Porn passed away recently. He was a pioneer in the field of porn addiction harms advocacy and was one of the first to sound the alarm on the potential effects and associated harms of internet porn. Gary was an honest, authentic and true champion of truth and science. His website, http://www.yourbrainonporn.com served as both a clearing house for the rapidly growing research and as a source of support for the growing numbers of, mostly but not all, young men struggling with issues which they suspect are related to their use of porn. His legacy will live on and his name will be remembered long after some of his critics’ are forgotten and relegated to the wrong side of history.


How much porn is there on the internet? The answer depends on your source, but It is estimated that between 4 and 37% of all internet traffic is pornography related, depending on where you look.[1] One intriguing source of statistical data relating to pornography is Pornhub’s annual year in review. Porn Hub, while not the site with the most traffic on the net, is the only site that publishes annual “year in review” statistics, which includes the year’s top search terms, site visit stats and most popular categories. In December 2019, Pornhub published its seventh annual year in review statistics for the previous 12 months. It triumphantly boasted of its’ continued growth:

            Pornhub keeps on growing and it doesn’t show signs of letting up. In 2019 there were over 42 Billion visits to Pornhub, which means there was an average of 115 million visits per day. One-Hundred-Fifteen Million – that’s the equivalent of the populations of Canada, Australia, Poland and the Netherlands all visiting in one day![2]

            The equivalent of the populations of Canada, Australia, Poland and the Netherlands. Given the population of the world is currently estimated at 7.5 billion, 42 billion visits for the year of 2019 equals 5.6 visits per person on the planet. Let that sink in for a moment before we move on.

            Other sources relating to the internet, numbers and porn show a variety of, depending on your perspective, disturbing statistics. According to a 2006 study of Google searches[3], “adult” was the biggest search category for mobile device searches, counting for 20% of all searches. Other popular search terms included “sex”, “porn” and “free porn”. A 2014 study estimated that 4% of all websites on the internet are dedicated to porn, which may not seem like a lot, but when one looks at the traffic on Pornhub as a guide to how many visitors porn sites may be serving, the numbers start to add up.

            Here are some more, numbers that is.

Every Second:

  • 28,258 users are watching pornography on the internet.
  • $3,075.64 is being spent on pornography on the internet.
  • 372 people are typing the word “adult” into a search engine.

Every Day:

  • 37 pornographic videos are created in the United States.
  • 2.5 billion emails containing porn are sent or received.
  • 68 million search queries related to pornography- 25% of total searches- are generated. 
  • 116,000 queries related to child pornography [sic] are received.

According to the National Coalition for the Protection of Children & Families, (2010) 47% of families in the United States reported that pornography is a problem in their home, pornography increases the rate of marital infidelity by more than 300%, and 56% of divorce cases involve one party having an “obsessive interest” in pornography.[4]

Another way of estimating porn’s prevalence and rising popularity is to take a look at the global ranking of websites with the most traffic. Every year, Similar Web ranks the worlds’ 300 most popular websites. In 2016, it ranked both mobile and desktop data statistics together for the first time and noted a rise in the popularity of ‘adult’ sites. In 2016, the world’s most popular website was Facebook however for the first time, adult websites featured heavily in the top ranked websites, including 11 porn sites in the top 300 most popular sites globally for that year. Pornhub, attracting 1.1 billion visits a month in 2016 globally, saw 54% of its visits from mobile phones, with an average user session lasting about 8 ½ minutes. It rose from 38th place to 23rd, a higher position than online stalwarts such as eBay, MSN and Netflix.[5] However, then as now, Pornhub was not the worlds’ biggest porn site, Xvideos was. It ranked number 18 in 2016 with 1.5 billion monthly visitors.

The popularity of adult content website traffic has risen steadily since. In July 2020 the most recent rankings show adult websites now account for 4 out of the top 20 websites visited, with 3 of those being in the top 10. Xvideos.com is still the world’s biggest adult website coming in at number 7 in Similar Web’s list of the world’s most visited websites. Not far behind is Pornhub at number 9 and xnxx.com at number 10. To give you an appreciation of context, Xvideos’ popularity in 2020 is usurped only by Google, Facebook, YouTube, Twitter, Instagram and Baidu.com – China’s version of Google. Or, in other words, Xvideos is more popular than Amazon, Netflix, Reddit, Ebay and Microsoft.

Given the prevalence of pornographic content on the net, is it any wonder that more and more users would find themselves becoming “addicted” to “fapping” (internet slang meaning to masturbate to online porn). Or that more and more of these users would find each other on internet forums and chat rooms where the problems related to too much of a good thing first started to appear.

In Gary Wilson’s famous TED Talk, “The Great Porn Experiment” from May 2012, which now has over 14 million views, he mentioned that researchers were struggling to find a ‘control group’ with which to conduct comparison studies, simply because they could not find enough non porn viewing male participants, with which to conduct their studies. This and the numbers mentioned above should indicate that whatever one thinks of internet pornography itself, its impact on a generation of young men cannot be underestimated. I recently re-visited his Ted Talk on the topic and was absolutely appalled by the “Note from TED under the talk stating, “This talk contains several assertions that are not supported by academically respected studies in medicine and psychology. While some viewers might find advice provided in this talk to be helpful, please do not look to this talk for medical advice.” This is absolutely not accurate. There were, at the time of this talk, and certainly since, a multitude of studies on the effects of internet porn and its associated harms. For TED to place such a statement under this talk is a form of disinformation and does not reflect what the actual research shows. But more on this later….


[1] Web Porn: Just How Much is There? https://www.bbc.com/news/technology-23030090

[2] Porn Hub, 2019 The Year in Review. https://www.pornhub.com/insights/2019-year-in-review

[3] A Large Scale Study of Internet Web Search, 2006. https://www.researchgate.net/publication/221514705_A_large_scale_study_of_wireless_search_behavior_Google_mobile_search

[4] Internet Pornography by the Numbers. https://www.webroot.com/au/en/resources/tips-articles/internet-pornography-by-the-numbers

[5] Top 300 Biggest Websites. https://www.similarweb.com/corp/blog/new-website-ranking/

Accepting your power

Did you know you have the power to change your future? Your history may have a bearing on your present but it does not have to determine your future. Think of a line, or a road. At one end is the beginning and at some point the road, and the journey will come to an end. One end of this hyperthetical road represents your birth and the other is death, the end of the road. We are all, whether we like to think about it or not, at some point along our own private journey. Behind us we can see the way we came, how we came to be where we are and the people who helped us get here, for better or worse. But what about the way ahead, we can see a little up the road but at a certain point our sight fails us. This point blank reality is a truth that we cannot really ignore, although, many of us spend quite a lot of energy trying to. Yalom wrote extensively on what he called common existential dilemmas, which I have written about previously, here.

None of us are immune to the existential dilemmas that affect as all. Some things we cannot control, our birthdate, who our parents are, when and where we were born, our race, our height, body shape and genetic make up for example. These are all things that were essentially determined not by us. And I get it, some of the particulars of our non determined factors can be unfair, some of us can be born to privilege while some are born into the worst of situations. Poverty, trauma, abuse, neglect, war and enviro-social factors impact us all to some degree and it is understandable to be angry about some of it, a lot of it and for some of us, most of it. But while anger is an understandable response to adversity, it is not always the most useful.

Your present determines your future. Remember ‘the point of power is always in the present moment’. For it is in the present that we can choose. We can choose to look back in anger and despair or we can choose to look back with forgiveness and acceptance. We can choose to look forward in anxiety or hopelessness or take action to determine, as best we can, a future of our own designing. You need only to accept your power, for it to start working for you.

Accepting your power simply means accepting responsibility for your actions, your words, your deeds and your beliefs, from this point onwards. We have the power within us to change how we think, what we do, how we respond to life’s challenges and what we do with our time and energy.


We can choose to love and to be loved, or we can choose let fear take away our natural state, which is love.  Here is an affirmation/poem that can help. 

I am love. 


I attract love, I radiate love, I attract and radiate love.

The more love I give, the more I receive because I am love.

Only love is real, so there is nothing to fear.

Fear is something I create, but only love is real.

Fear is only a figment of my imagination.

So, therefor, there is nothing to fear because only love is real. 

Today I choose love because, I am love. I attract love and I radiate love.

Stress Management 101

Next in my series of ‘how to’ topics is how to manage stress more effectively. Previous posts include Relapse Prevention Essentials and Learning How to Manage Unpleasant Emotions.

Stress. It’s a word that gets used often in today’s busy-ness obsessed world, but do we really know what we are talking about when we say we are “stressed”. What is stress, really? Stress is anything which causes a person to feel unable to cope or pressured beyond what is comfortable, from feeling the urgency of a looming deadline to the blind panic one might feel whilst running from a dangerous predator. Both these examples place the person under stress to a degree.

Types of stress: internal and external

The term ‘stress’ is used in both physics and psychology. Both mean similar things, something is causing the system (you) to move beyond a state of equilibrium. When applied to humans, stress can be anything that causes feelings of pressure, tension or discomfort. There are generally two types of stress that humans experience: Internal stress and External Stressors.

Internal stress is stress arising from thoughts, emotions, bodily sensations (feeling hungry, tired, sick) and as a result of trauma. All these things increase tension which we experience as “stress”.

External stressors can come in the form of time constraints, deadlines, traffic, obligations, appointments, demands from others and financial burdens. These are all forms of external stress.

They both play off each other, in that external stressors cause internal stress, and internal stress can make it more difficult to adapt to external stressors.

Dealing with internal stress

Managing internal stress can be tricky. Much of it happens below the level of consciousness and it can seem like our thoughts, reactions and emotions are automatic or just ‘how we are’. This is not the case. Internal stress can be managed by increasing awareness of the content of our thoughts; paying close attention to the words we are saying to ourselves in private, tuning in to our emotional responses; asking questions of oneself such as, what sensations are present when I think these thoughts and generally listening to our body. Sometimes we are just tired, hungry, angry or thirsty. Sometimes, managing stress can be as simple as tending to our physical needs as they arise. For example, you might be tempted to work through lunch because you feel stressed about the volume of work you have to get through. However, working on an empty stomach makes it difficult to focus and you end up making a mistake. This ends up increasing your feelings of stress and overwhelm. If you had stopped when you were hungry and had something to eat, you would have saved yourself hassle later on.

Given that internal stress affects our thoughts, how we feel, and our actions, it is important to have tools on hand to manage all three types of internal stress. CBT (Cognitive Behavioural Therapy) strategies and Mindfulness based behavioural therapies (such as DBT, Dialectical Behavioural Therapy and Mindfulness Based Stress Reduction are all good therapies for understanding how our thoughts, emotions and actions affect each other, and how getting a handle on how these three things can impact our ability to manage stress.

Managing stressful thoughts

Often the way we think about a situation causes us to feel differently. For example, if we think of things in a negative way then we are likely to feel upset and that may cause us to act irrationally or impulsively. And, usually when we act from a stressful place, we usually end up doing things that ultimately make our situation worse, and that of course, leads to more stress. For example, you get invited to dinner with a group of people you don’t really know all that well. This is a situation in which a lot of people may experience some nervousness or anxiety about anyway. However, if your mind starts coming up with thoughts such as “I’m hopeless in these situations, I never know what to say, What if nobody wants to talk to me, Why am I so ridiculous… You get the idea, it’s easy to see how one negative thought leads to another, and another, and how pretty soon the idea of cancelling altogether seems like a good idea. However, if you had stopped yourself at any point from thinking these thoughts and consciously made a decision to think different thoughts, more positive or even neutral thoughts, the negative thought train may not have had a chance to build momentum. Learning how to tune into your thoughts and deciding whether or not these thoughts are helpful, useful or accurate takes time and patience, but it is a skill well worth practicing. At first, you may find that you have already allowed your thoughts to get the better of you and have already acted on those thoughts and are feeling regretful before you remember that you are supposed to be practicing this new skill. Don’t let that worry you. At least you picked up, albeit after that fact, that you could have chosen to think differently. Keep at it, eventually you will catch yourself mid-negative thought and actively change how you think about a situation and then choosing more positive thoughts, change how your feel and act. It takes courage, patience and practice but it gets easier the more you try.

Handling stressful emotions

Focusing on your thoughts, thinking patterns, unhelpful beliefs about yourself is a great start. However, sometimes, stress seems to hit us out of the blue. Like an emotional storm that feels uncontrollable and all consuming. It all happens so fast that before we know it, we have said something, done something or taken something we regret. When this happens, our ability to think, act rationally or even speak can be affected. The opposite can also be true. Emotional stress can build up gradually, or we may experience a series of emotionally stressful events. Sometimes, our tendency is to ignore these feelings, to push them down, or to sometimes drink or use substances as a way of ‘self-medicating’ or coping. This can sometimes go on for some time and become a way of being and merely existing, but it is not really thriving or sustainable.

The best way to handle emotional storms or feelings is to stop. That is, stop whatever it is you are doing, pay attention to the feeling or the emotions as they are happening. If you are in the middle of an emotional storm, you often act out that emotion in ways that you usually regret. The best thing you can do if you find yourself in an overwhelming emotional storm is to hold on and wait for it to pass, and it will. Ground yourself in the present moment, (breath, feel something, look at something in the room) and count to 10, breathing in and out slowly as you do. Sometimes, going for a quick walk or a run can do wonders to settle an emotional storm. And yes, it’s o.k. to cry if you want to.

Learning to experience, process and attend to your feelings as they happen is also a skill that may take some practice. Sometimes, we have old ideas about feelings that may hold us back from experiencing certain emotions. Old “programming” from childhood that may tell us that this emotion Is bad, or not acceptable. What is important to know is that all emotions are healthy, and are neither right nor wrong, they just are. They are our truth in the moment. Emotions don’t harm us it is what we do to avoid feeling those emotions or when we allow our emotions to get the better of us that causes the most damage.

Stress inducing habits

Sometimes, stress can encourage us to take short-cuts in an attempt to manage day to day or because we fear dealing with the underlying cause of our stress. Sometimes this fear is valid. We may have responsibilities, debts to pay, or children to look after and taking time out to manage our stress properly can sometimes seem like too much of a big issue to tackle, or it can slip way down on the ‘priorities’ list of school runs, work meetings, deadlines and bills etc. However, often the short-cuts we take to manage our stress in the sort term unfortunately tend to be not so good for us in the medium to long term. Alcohol, just for example, can lead to serious health problems, relationship issues, loss of time and even premature death in some cases (car accidents, mishaps, violence). In-fact, addictions in general are linked quite strongly with childhood trauma and PTSD (Post Traumatic Stress Disorder). Trauma reactions generally increase stress in the body and an affected person may be more likely to turn to addictive behaviours or substances as a way of coping with the ‘unspeakable’. However, it is important to know that addictions don’t really solve a problem, they just delay the inevitable. Other stress inducing habits include poor time-management, staying up late (when you know you have to get up early the following day), eating junk or takeaway food in the name of ‘convenience’, leaving things to the last minute rather than attending to them as they arise,

External Stress: Prevention is better than cure

External stress as stated above involves stress that is external to you. First thing I recommend is doing what I call a ‘stress audit’. That involves simply writing down a list of all those things that cause you stress and working out what items you can do something about and those you can’t. For a very simple example, driving to work often causes a lot of stress because the traffic is out of control and getting worse. Consider taking public transport or leaving 15 minutes earlier. Or if your work is flexible, arrange for a later start time to avoid the peak hour crush. That is a very simple example and granted, there are some stressful situations which are out of your control. For those situations, practice letting go of struggling with unhelpful thoughts related to a situation you cannot control and try to focus your attention on those things that you can do something about. However, for those things that are in your control, small changes can add up to huge benefits when you put your mind to useful thinking and problem solving.

Making concrete lifestyle changes can be challenging, especially when coupled with having to give up an addiction or habit which previously seemed like your only way of managing or coping. It is well worth the effort however when you find out how to properly deal with stress in ways that truly benefit you and those around you.

Complex trauma and stress management

O.k. time for a disclaimer. The above advice is general in nature and you should consider your individual circumstances before following my or any advice you read on the internet for that matter!

However, I do want to acknowledge for some people who have experienced significant and extended trauma or who suffer with the effects of Complex-PTSD the above information may seem contrite or over-simplistic for your situation. I get it, however, trauma is not what happened to us but how our body responds to what has happened. This response creates added intensity to our experiences of and dampens our ability to handle every-day stress. The above techniques and ideas may not be and is not intended to be an overarching solution to complex stress, but the basic ideas are sound and can help with some of the effects of complex trauma such as anxiety, addiction, depression and avoidance.

If you are experiencing the above symptoms, seek out help. Your GP is often the first port of call however, it is easier than ever to find a therapist online or try out some of these online based courses for managing stress and anxiety. Most of them are free too which is not a bad thing.

https://mindspot.org.au/

https://moodgym.com.au/

Relapse Prevention Essentials

So, you have completed detox and you have promised yourself, and others, that you will stay sober.

Now what?

Recovery is about more than just quitting a particular substance, like alcohol or drugs, or stopping an unwanted behaviour, such as gambling or masturbating to porn. (If it were that easy, there would be no reason for me to be writing this guide!) Recovery is a personal journey, and it is different for everybody. For many, it is essentially a journey into unknown territory, so it is essential to have a plan, or at least a compass to make sure you don’t get lost or keep going around in circles, like the diagram above which shows the stages of change conceptualised by psychologists Prochaska and Di Clemente. The more times you cycle through the different stages, the easier it gets apparently, there-for creating more of an upward spiral, rather than a repetitive cycle.

But how can you turn your cycle of change into an upward spiral instead of a merry-go-round that never ends? Rehabilitation services are lengthy for a reason. It takes time to undo months, or sometimes years of dependency and habitual use of alcohol, drugs or unhealthy behaviours that have developed over time. But, not everyone can take the time to attend an inpatient service, or have obligations to family, pets or work commitments. If you fit into this category, and you have just completed a detox of some sort, then the below are essential for improving your chances of success this time around.

The Change Spiral according to Prochaska & Di Clemente

Recovery Essentials:

1. Get the basics right. Focus on sleeping, diet, exercise, taking prescribed medication as directed, water, nutrition. Getting as good a night’s sleep as possible is the single most beneficial thing you can do to improve your physical, mental and emotional health. Look up sleep hygiene for some tips on getting a good night’s sleep. Watch what you eat, move away from fast or pre-packaged food and try to fit in some home cooking. Look up recipes on YouTube or ask a friend to help if you can. Drink plenty of water. Take any medication as prescribed. Exercise daily. Give your body the love and care it deserves, even if you don’t feel like doing so at times.

2. Connect. Find a peer support group. AA and other 12 step groups or SMART recovery are both free support groups for anyone reaching out for help. The benefits of finding and connecting with a group to support you have been well documented.  Informal friends, online supports and communities are also available nowadays thanks to the internet. Recovery can feel like a lonely place. It helps to know you are not alone.

3. Counselling. See a counsellor or psychologist regularly. Counselling in conjunction with peer support can help you to explore, reflect on and focus on your recovery goals with a supportive, compassionate other. Understanding what led to your addiction can help provide insight, motivation and direction when needed. Simply having someone to talk to, honestly, about your journey can be invaluable.

4. Utilize day programs. Free day programs are available, use them if you are not working or studying full time. Look up out-patient rehabilitation services in your area. Most day programs run 3 times a week, some are daily for 6 -12 weeks on average. Day programs are helpful when you have commitments to children or pets as you get to go home each day.

5. Talk – to your friends, family and community. Addiction is often clouded in shame. Because of this, many people find it difficult to talk about their struggles. Shame thrives on silence. I’m not saying, shout it from the rooftops, however, those closest to you care about you and are in most cases willing to help. Of course, it is important to be discerning when it comes to who is worth sharing with but don’t think you are in this alone. Connection is the opposite of addiction. This is another reason why formal support groups such as AA or SMART Recovery are so valuable.

6.  Read, listen, watch. There is a lot of ‘quit lit’ out there, starting with the big book of AA (worth a read). If reading is not your thing, check out podcasts, apps and watch YouTube videos about recovery. Learn from others and educate yourself on addiction, brain science and the latest interventions. You will feel less alone and it will help you to stay motivated to continue with your sobriety.

7. Cleanse. Cleanse your device, your social media feed and your life of all potential triggers or people that remind you of your addiction, as much as possible. It is important that you prioritise your recovery especially in the early days/months. Detox is not just for your body. In many instances, detoxification is a process of systematically removing those things, people, places and habits from your life that no longer serve you. You may have to delete several numbers from your phone. At the very least, delete and block your dealer’s number!

8. Get creative or busy. Write, draw, paint, sculpt, tinker, redecorate, fix, repair, renovate, plant something, play something, collect something. Use that brain and fire up those neurons in a way that stimulates novel thinking. Creative pursuits and hobbies can also help with stress reduction.

9. Learn something. If you are not working full-time, recovery is a great opportunity to re-train or up-skill. If there is something you’ve always wanted to learn to do, now is the time to do it. Learn a new language. Learn how to play an instrument. Take a short course or go back to school/uni. Use that newly created space which you created in a positive way. Make a decision to only add things to your life that are joyful, positive or beneficial to you in some way, which brings me to my last point…

10. Cultivate a mindfulness practice. Whether in the form of a formal meditation practice, or simply moments of ‘dropping in’ to the present moment throughout the day. Learning how to pay attention to the present, mindfully, non-judgementally and on purpose is the essence of mindfulness and will help you immensely with your newfound sobriety. In a sense, mindfulness is also the opposite of addiction in that it is the opposite of what happens when we are intoxicated, drunk or high or in some other way ‘out of our minds’. Learning how to tend to ourselves in the present, to sit with and accept all our thoughts, emotions and sensations without trying to change or avoid them takes practice but is worth the effort. In essence you are learning how to be yourself, to be with your self and to accept yourself as you are, compassionately and non-judgementally. There are many resources, including apps, websites and books on Mindfulness available now, a simple internet search will provide you with a tonne of information.

So that’s it. My top 10 essentials for a successful recovery and relapse prevention plan. Of course, this list is not exhaustive but if you think I have left anything out that should be there please feel free to comment below.

Hope lost and found

Photo by Pixabay on Pexels.com

It is Sunday afternoon, December 20th. As I write this, I am sitting in the back yard (if you can call it that) of a little townhouse in Melbourne where I live with my husband, dog and cat. The sun is out. The cat is sitting in her favourite wicker chair and the dog is probably on his favourite spot on the lounge. My husband is having an afternoon nap. For those things, I am truly grateful. However. This morning, I was still hopeful that I would be heading off tomorrow to see my friends and family in Sydney for Christmas. That hopeful state has since been withdrawn as the Victorian premier has announced that he will be closing the borders as of midnight tonight, due to a recent outbreak of the dreaded Covid-19 virus in Sydney. After months of lockdown, and numerous other cancelled trips, I had been looking forward to ending the year on a bright note. Alas it was not to be. However, given that it is still 2020, I shouldn’t have been surprised.

I now find it ironic that my mother-in-law had asked me to prepare and read out a small prayer on the topic of hope for the Sunday service that morning (my husband’s parents are both ministers). I admit, I had not given myself much time to prepare it as I had spent the last two days busily running about buying Christmas presents, and generally preparing for the expected week away. On Saturday, the premier had announced a “traffic light” permit system for returning travellers from NSW. On Saturday, I still held hope as were not going to be travelling anywhere near the “red zone”. By the time the service ended at 11:15 on Sunday December 21st, that hope was gone.

So I found myself sitting through and participating in a service all about ‘hope’ without really giving it much thought I admit. It was not until after the service, when I arrived home (to a message from a friend on Facebook asking me if I had seen the news) that I really understood what hope was and was not. It was not until then, when my hopes were finally and utterly redacted, that I realised what hope truly was. Hope is the absence of hopelessness. Or in other words, the presence of a potential future that contains a desired outcome. Without that future, hope vanishes.

Hope as the antithesis of depression.

Counsellors and psychologists often use the K10 as a measure of psychological distress. The K10 is a short 10 question survey which asks clients a series of questions about their mental health state. Question four on the K10 asks about ‘hopelessness’. Its placement on this widely used measure of anxiety and depression is a testament to the importance of hope as a measure of wellbeing. The lack of hope signifies something is missing, something important and necessary for good mental health. A state of hopelessness certainly makes it very difficult to get out of bed in the morning. A sense that nothing good will happen, that your efforts are useless or that nothing holds any meaning, are among some of the hallmarks, and clinical symptoms, of depression. If hopelessness is a symptom of depression then hope, its opposite, is a sign of a healthy individual. But what is hope, really?

Defining hope.

We often use the word hope in everyday language without giving much thought to its deeper meaning. How often have you heard yourself say, “I hope I get through these next set of traffic lights” or “I hope my boss doesn’t notice that I’m running five minutes late.” Hope is so much a part of our everyday language and expression that its true meaning and importance are often overlooked. So, for a basic definition I turned to Webster’s dictionary online. Hope is defined firstly as an intransitive verb, meaning “to cherish a desire with anticipation or to want something to happen or be true”. That, I would say is how most of us use hope in everyday language, as in the examples I give above. However, the transitive definition hints at a deeper, more nuanced meaning, “to desire with expectation of obtainment or fulfillment” and “to expect with confidence”. Webster’s also links the definition of hope to the word “trust”. Hope, it seems, is something more than a simple desire or wish as it is sometimes defined. Hope is a desired outcome expected to come about.

Hope, a vital ingredient

In psychotherapy research there is a concept called the “common factors approach”. This came about when a bunch of researchers[1] got together and did a lot of reading of many studies of different types of therapy models, compared apples to oranges so to speak, to see which therapy style was the most effective. They ultimately found that there was little difference between therapy styles. All were more or less equally effective in helping clients to change in the ways they wanted to. This has come to be known as the ‘dodo effect’. The idea borrowed from Alice in Wonderland when the dodo bird declared, “All have won, and all shall get prizes!” The next logical question that these researchers asked was, well if the type of therapy isn’t what matters, then what is it? What is it about therapy that clients find actually helpful?

It was from this research that the idea of the common factors approach emerged. That is, there are factors similar to all types of therapy models that form the key ingredients of change in therapy. You see, psychology has always had a bit of an inferiority complex, it has always wanted to be seen as a ‘real science’ (ignoring that people are not as easy to study as other mammals or nature in general). In order to be accepted as ‘scientific’, psychology has tried to measure the effectiveness of specific, (usually manualised) psychological approaches on certain populations, comparing this approach with that approach, and generally attempting to treat people as laboratory specimens and mental health issues as biological diseases. These approaches are similar to those used in medicine and clinical trial research which prioritizes random controlled trials and generalizable statistics. What these researchers discovered was that the answers to what works in therapy are not that ‘clinical’ it seems, but more human and relational in general. The four common factors were identified as

  • Extra-therapeutic factors (things external to the therapy sessions such as getting a new job, relationships etc.)
  • The strength of the therapeutic relationship
  • Theoretical knowledge
  • Hope and expectancy

As you can see, hope forms a vital ingredient in the value of counselling and without it, therapy usually stalls. Quoting psychotherapist Jerome Frank in his article, Hope – the neglected common factor, Denis O’Hara echoes the importance of instilling hope in counselling as he notices, “Hopelessness can retard recovery or even hasten death, while mobilisation of hope plays an important part in many forms of healing.”

So there you have it. Hope gives us energy, motivation and direction. Without it, we flounder, flop and fail to thrive. The year 2020 has been a terrible year for humanity and we have all suffered to a degree due to a variety of factors, the covid-19 pandemic being just one of them. Though I started writing this post 10 days ago it is now the eve of 2021. If ever there was a need for hope, now is that time. Not just the simple hope that we throw about mindlessly, but the hope that is bound in faith, trust and gratitude – the kind of hope that I imagine Christmas was meant to be about.

So here is my little prayer for hope that I shared that day. It is my sincere ‘hope’ you find it comforting in some way.


A prayer of hope

Lord,

Help us to live in hope, rather than in fear.

And help us to understand that hope equals faith when it is linked with love

Teach us to live with hope in our hearts, so that we can fill our days with quiet assurance, instead of anxiety.

Please shine a light where there is darkness.

And let truth, love, joy and peace reign instead of hate, lies, fear and grief.

Right now, the world needs hope more than ever!

For hope is the spark that sets good things in motion,

So hope turns to gratitude, and gratitude to peace.

We trust that your light will show us the way and to help us

To live in hope, love and fearlessness.


[1] Duncan, B. L., Miller, S. D., & Hubble, M. L. (1999). The heart & soul of change : what works in therapy / [edited by] Mark A. Hubble, Barry L. Duncan, and Scott D. Miller. Washington, DC: American Psychological Association.

Mindfulness at the coffeeshop

I wrote this piece a few years ago when I first started practicing mindfulness.

The other morning I was on the way to a training class for
my upcoming clinical placement. I stopped into this newish
coffee shop that had just opened around the corner. A typical
hipster joint so I wasn’t expecting too much in the way of
friendly service. However I was still rather shocked when
the young and expressionless barista abruptly raised her hand at me,
in a kind of ‘talk to the hand’ gesture, as I was giving my
order. Apparently, I had spoken out of turn. (According to
some new world social order in which barista’s held the
highest authority and us mere customers were supposed
to wait until spoken to before opening our mouths.)
It took me a second to register what had just happened. My
internal dialogue went something like this, “Did she just
raise her hand at me, essentially treating me like a child?
Did I just see that?” My first instinct was to say something
in order to voice my sense of righteous indignation, but
instead, I stopped. And asked myself the question, “What is
really going on for me here, right now?” And, I observed that
my heart rate was going a little faster, and I could feel
my cheeks get a little hotter. In other words, I was pissed
off. In that one simple gesture, she had made me feel like
I was about 3 feet tall.
So I let it go. Somehow, simply acknowledging my anger and
just sitting with it for a few seconds, it had lost its
sting. And then I thought, is this what they call being
mindful. Is this mindfulness in action? Well, if it is I guess it
works. I had been attempting to learn meditation over
the last few weeks and up until that moment, I had thought
it wasn’t having any effect at all, but maybe it was…