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 1stchange 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.
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.
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.
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.
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.
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. 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.
So, you have completed detox and you have promised yourself, and others, that you will stay sober.
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.
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.
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…
Can we be addicted to negative emotions? Such as outrage, anxiety, fear, anger, depression, guilt or feeling ‘hard done by’?
We normally associate addictions with more or less positive things. Substances and behaviours that make us feel good or better in some way. Alcohol, helps us to relax, or feel happier or intoxicated. Cannabis can help us to chill, calm down or get lost in the music. Amphetamines can makes us feel confident, energised or ‘on top of the world’. Porn can makes us feel powerful, in control and aroused. All these things can help us to forget or distract us from pain, discomfort or relieve stress in some way. So it would make sense that some of us could get ‘addicted’ (attached to if one goes by the old definition of addiction as I discuss in an earlier post Why is the word addiction so controversial?) to these sorts of things. However, it has recently occurred to me that perhaps we can also become addicted to negativity in some way.
You may balk at the suggestion. Anxiety feels awful. Depression is terrible. Why would anyone want to continue with such negative emotions? I guess one needs to look at the pay off. What does one get by continuing with these emotional states that make us feel bad or worse in some way. Or, another way to look at it is, what do you get out of doing by continuing to feed the negative emotion?
Let’s take anxiety as an example. What does anxiety stop you from doing that you might otherwise do. Drive a car? Get a job? What do you get to do by not doing those things…. well you get to avoid the discomfort, fear and the possibility that you may get hurt in some way. You get to feel safe. You get to avoid uncertainty. And you get to avoid having to change. And, ever notice how the more you give in to your anxiety, and the more you allow depression to weigh on you the bigger and heavier they tend to get? It’s as if you are carrying around a heavy load or burden around with you…
Eckhart Tolle, author of The Power of Now, spiritual teacher and all round amazing human often talks about the concept of the “pain body“. The concept of the pain body is a strange one to get your head around. It is, according to Tolle, made up of all the slights, painful experiences and unfinished business that you carry around with you in your body, unconsciously. Any painful experience or trauma memory that has not been adequately faced or resolved at the time it occurred becomes part of our pain-body. In a healthy person, it may lay dormant most of the time, but some people live entirely through and completely identify with their “pain-body”.
Your pain-body can be awakened or ‘triggered’ by anything – an event, a person, an argument, a situation. Often it is awakened by something that happens to remind us of a past trauma or event. The current painful event awakens the pain-body and in that moment we become the pain-body. That is, we identify with our pain-body 100%. In ACT we call that “fusion“. Fusion is when we are so caught up in our beliefs, thoughts, memories, or pain that we believe those thoughts and are overwhelmed by the emotion generated that we in a sense, stuck to those thoughts, so much so that we become those thoughts.
The pain-body wants to live, according to Tolle, like any other entity, and it feeds on negativity and pain. And, the more we feed it, the more it wants and the stronger it gets. When we are living through pain, or in our pain-body, it can seem as if everything and everyone is against us. We see the world in terms of black or white, us vs them, good and evil. When we are in pain, we often lash out at others, and want others to be in pain too. We want to be right about our pain and therefor unconsciously seek more pain in order to prove ourselves right about how bad everything really is. The more we live through our pain-body the bigger, stronger and more dominant it becomes.
When we identify 100% with our painful thoughts and memories, we can sometimes act in ways that are unhelpful, hurtful to ourselves and others and are generally unpleasant to be around. We can act in ways that take us further and further away from our goals, values and true self. When we act in the service of our pain-body, we may think that we are doing something about our pain, but we often act in ways that bring us more pain. I am reminded of another famous quote by Eckhart Tolle which is,
addiction starts and ends in pain.
We can also become so used to being in our pain-body that we may come to prefer it. We may become more comfortable being angry, depressed or outraged that we no longer remember what it is like to not be those things. In essence, we can become addicted or attached to our pain because for some of us, that is how we identify.
But there is another way to be. When we realise that the only power our pain-body, or our trauma history, has over us is the power we give it then that is the first step towards becoming free of our free-loading pain-bodies. Often in therapy, at some point in time clients often say they feel lighter, more at ease, or as if a weight has been lifted from them. Maybe, this is their pain-body dissolving? It is worth a thought.
A positive affirmation to help dismiss or weaken our own body of painful experiences:
The only power the past has over me is the power I allow it to have.
I’ve decided to start offering online counselling sessions for anyone who is interested. Please visit my counselling website: FrancescaPcounselling.com for more information.
Just in time to cash in on today’s social distancing trend I might add… 😦
However, seriously, I work as an addiction counsellor full-time, so I can only offer sessions after hours (AEST) and on weekends. I will be offering video sessions only (I’ve been using google meet but can do zoom, skype or FaceTime etc)
Those who follow this blog may know that my speciality and interest is in addiction, but I am trained as a generalist counsellor so whatever your concern or issue is, please feel free to contact me for a confidential chat and we can go from there.
I have a profile on psychology today which I keep updated regarding my availability so you may want to check that out too.
Exploring the Lived Experience of Problematic Users of Internet Pornography– A Qualitative Study is a research project I conducted as part of the requirements for the Master of Counselling & Psychotherapy course I have recently (finally) completed. This paper was published in the peer reviewed journal Sexual Addiction & Compulsivity, published by Taylor & Francis. In this post I reflect on what it was like to research this topic and I share some of the responses I received which highlight, to me, the seriousness of this emerging problem.
In 2019 I completed the last few subjects of a Master of Counselling & Psychotherapy course I had started in 2016. As a qualified counsellor, working as a clinician in a youth mental health service at the time, I decided to take my time and just work through the units one subject at time. With a couple of semesters off here and there, three years later I was happy to see the end in sight with the last hurdle being the big research project which took up 4 out of the 12 units I needed to pass to complete the course.
I decided to do my research project on sex “addiction”, specifically, problematic use of internet pornography (note, there is no DSM diagnosis of sex addiction, to date, however, the ICD-11 now has a diagnosis of Compulsive Sexual Behaviour (CSB) disorder, which covers problematic sexual behaviours.) Having encountered several young male clients through the youth mental health service I worked at who were experiencing problems with their porn use, as well as previous experience with a partner who disclosed his own struggles with porn use (which I initially discounted as nothing to worry about!) – I thought there was something to this issue which needed to be looked into further. At that time, (2015 ) when I first started to research the literature on problematic internet porn use, I was completely unaware of the extent of the problem. In my informal research, however, I found the website www.yourbrainonporn.com and Gary Wilson’s now infamous TED talk (The Great Porn Experiment) and other TED talks on the subject, which was a wealth of information as well as an eye-opener. In my academic research I found some very interesting papers, including A. Cooper’s prophetic 1998 paper: Sexuality and The Internet: Surfing into the New Millennium which described some of the ways the internet was having an effect on human sexuality. In this paper, which has been well cited, Cooper highlights three factors related to porn on the internet which he predicted, accurately it seems, would transform human sexuality. These were access, affordability and anonymity. Access: most smart phones can access a plethora of porn and sexual partners with the click of a mouse. Affordability: most internet porn is accessible for free or a very low cost. Anonyminity: users can remain anonymousThe results of these three factors has resulted in an explosion of pornography on the internet and to give you just a drop-in-the-ocean statistic, Porn Hub boasted a whopping 42 billion visits in 2019 alone. And that’s just one website. That figure alone is staggering. (In my literature review which forms part of my research report I provide an extensive overview of the literature for and against the conceptualization of problematic porn use as an addiction.)
But despite these numbers and the overwhelming amount of academic research I found, including this 2019 review which did a pretty good job of summarizing the research and some of the controversy surrounding the, still ongoing, debate on sex and pornography, there are some who insist on downplaying the issue. Despite the inclusion of CSB disorder in the World Health Organization’s ICD-11, I found articles which went so far as to say Sex Addiction and Porn Addiction “do not exist”, or were not “real” or a “myth” and that believing you are addicted to porn is the cause of your symptoms, not the result of engaging with porn itself. I noticed pretty quickly that these authors tend to selectively quote studies which support their position, whilst stating that there is no “scientific evidence” to support the notion of sex or porn addiction (I found plenty). These types of articles all seem to share common themes; that religious beliefs or morality play a big part in why people struggle with porn use, and that those who voice any opposition or concern about the effects of excessive porn use are “anti-sex” moral crusaders, puritans or religious prudes. Granted there is the understandable concern that the term “sex addiction” is problematic in that it could potentially pathologize activity that is just a normal variant of a natural human behaviour, but their contention that porn addiction does not “exist” is “harmless” or is beneficial to society is itself problematic. Granted, there is evidence that moral conflict about pornography plays a part in users’ distress, (how could it not) however, it is a factor only, there are others. Rarely do they mention the potential effects of exposure to extreme pornography on children, the extreme and highly concerning content available to anyone, the links between internet pornography and sex-trafficking and rarely do they take into account the ocean of anecdotal evidence from users themselves. If anything, pro-porn advocates actively dismiss the growing tide of anecdotal evidence to be found online.
So, what’s the real story here? Are users getting addicted to internet pornography use, or not? Or are we too hung up on semantics? Does it really matter whether we label something an addiction or not anyway? In the end I suspect not, however, to blanket deny that there is an issue is the height of irresponsibility, somewhat delusional and invalidating in the extreme for those who self-identify as problematic users of internet pornography, or “porn addicts” – for want of a shorter term. Perhaps the issue is the word “addiction” and what can and can’t be called an addiction, medically speaking. Well, that is a topic for a whole other post, but if we can get over the linguistics for a moment, surely, what really matters here is that people, men mostly and their families, are suffering. Why, in this age of #metoo am I so interested in men’s suffering? Because, as a society, we cannot afford to ignore men and their suffering because men who suffer often effect others around them negatively too. Children, partners, other men and society in general. We all have a stake in this issue. That is why, for my research I wanted to find out why there are more and more people turning up on internet forums and sub-reddits, such as nofap and reboot nation to name two of the most popular ones, complaining of their struggle to give up porn and related problems, which they attribute to their ongoing and excessive use of internet pornography and masturbation.
Qualitative research is used in the social sciences to describe something in detail and more depth. It mainly uses words rather than statistics and is not meant to be generalized, but rather a deep dive into a particular topic. It is specific and often descriptive. My study took the form of an online anonymous survey of 20 open ended questions which asked participants who self-identified as problem users of internet porn, to write about their experiences. The questions asked were general and required participants to write out answers in their own words. There was no word limit, so I got a broad selection of answers, some short and to the point and some lengthy and detailed.
The survey was live for around 6 weeks and altogether 53 participants took the time to answer all 20 questions and submit their responses. I remember reading the first few survey responses as they came in, and immediately started highlighting and taking notes of what I was finding. I was firstly surprised at the level of apparent openness and honesty of some of the answers. It soon became apparent to me that these participants, (99% men), had clearly struggled with an issue that was bigger and more formidable then they had first thought. Concerningly, many reported first accessing online pornography as children, and the youngest said he was 6-years-old the first time he viewed internet pornography:
I must’ve been aged 6, I was laying in bed—alone—flicking through channels, & from nowhere came, well, porn. I can distinctly remember being: traumatised, intrigued, disgusted & aroused. My innocent infantile mind couldn’t process it.
At the other end of the scale, one man reported first finding online pornography at age 40. As you can see, quite an age range. Yet, the average age of first-time-viewers of porn on the internet turned out to be 14.89 years. I put together some super-simple stats that came out of the study below.
36% (19) respondents mentioned erectile dysfunction (ED) or weak/flaccid erections or inability to maintain an erection during actual sex.
70% (32) respondents report engaging with online porn instead of doing other important tasks, such as going to school, university or work
88% (46) reported their porn tastes changing or escalating to more extreme porn over time.
Only 9 mentioned seeking professional help for this issue.
Whilst my study was very small, only 53 complete responses, the answers were far richer and more detailed than I had even hoped for. It was overwhelming to be honest. After painstakingly coding and collating the codes into themes, I slowly built up a picture of what it means to live with a pornography consumption and masturbation problem. And while I ended up with three main themes, the one overarching feeling I personally got after reading through answers could be summed up in one word: Loneliness.
Loneliness, disconnection, isolation, feeling cut-off from other people and society, an overwhelming inability to engage with other human beings, and ultimately the Self, in a positive, meaningful, joyful or authentic way. The spectre of porn addiction appears to cast a long, diffuse and murky shadow on its followers, and it looks to be one that many users struggle to get themselves free of. Comorbidity is a factor (as it is in substance addiction) however, that does not discount the specific issues reported that seem to be directly related to these users’ excessive porn use.
But enough from me, the whole point of my study was to essentially let the data speak for itself. I will certainly post a link to my study when it gets published, but in the meantime, in order to do justice to the participants who took time out of their day to share their experiences, I thought I would post a “sampler” if you will of some of the particularly poignant responses I received, of which there were many. Too many to post here.
“After 16 years old, after my tastes escalated, I was very sad (nearly depressed). I had low self confidence, ashamed of myself and some social anxiety. I had no concentration also, porn may be related. I had no love or desire to search someone other than to have sex or for the social benefit of it (bragging to friends). So I had no relationships during highschool, I think porn impacted it deeply. In the beginning of college, I was alone in my appartment so I could watch when I wanted. Then I developed a very strong social anxiety, I was very stressed. I was very depressed as well, it occurs a lot when I drank alcohol. I still had friends but no love relationships. No erection without porn. Less ambition. I was more introverted and not very open to people.”
“I have never been in a serious relationship. My sex life is non-existent and I have an unhealthy sexual ideal. I have noticed mental, emotional and physical symptoms similar to the high and crash from drugs/alcohol. During the time in adolescence that I should have been learning and building social skills and healthy connections, I isolated and defaulted to porn and video games as well. Instead of pursuing real sexual relations and healthy friendships with women, porn has served an easier, quicker solution.”
“Guilt. The sense that I continue to let myself down, and let others down. The fact that it has any kind of hold over me is disconcerting. Then there is the sheer amount of time I have spent viewing internet porn rather than doing something constructive.”
“I’m lonely and depressed. I’m scared of trying to connect with women and commit to stopping because I’m ashamed of being inexperienced.”
“I’m not doing well in life, i barely have sex i love fapping ive become an under achiever and have achieved nothing worthwhile i entertain too much i dont sow but wish to reap a huge crop.”
“For a very long time I have been dealing with depression, anxiety, loneliness and isolation and it’s difficult to determine what is the relationship of my porn use to these problems. On the one hand, porn has brought me relief and even a better mood in many difficult moments. On the other hand, porn might have influenced my view of women in a negative way.”
“It took away my ability to process the world with any emotion. My porn use put me into a state of emotional and social withdrawal in almost every aspect of my life, and because of that, I suffered significantly socially, romantically and academically. I lost many years of my development because I could not feel any pleasure and I could not make sense of the world – my mind was in a state of constant turmoil.”
“I never had a partner because porn kept me from even looking for one. I was scared to interact with someone in general but then also having to slowly bond with them and constantly working on maintaining a relationship seemed like too much of a struggle and not worth pursuing. Porn was a way easier “fix” for my loneliness.”
“I don’t really have relationships. That’s why I view internet porn. But a couple of times I’ve come out of short-term relationships and felt a sense of relief that came from knowing I was free to go back to internet porn, and I know that that can’t be a good thing.”
The above are direct quotes from the survey responses I received as such they have not been edited. As I said, these are just some of the answers received to my survey. I just want to take the opportunity to say a big thank you to all the participants who took time to complete the survey. I was humbled by their honesty, vulnerability and willingness to participate. I wish anyone struggling with this issue healing, connection and encouragement to seek help and support. Some resources are listed below. I am currently taking on a limited number of private clients (via Zoom only) for individual therapy. My counselling website is www.francescapcounselling.com