Many people start the new year with grand expectations for self-improvement. They want to get into better shape physically, stop bad habits, start good habits, etc. The exercise chains love these grandiose expectations. It’s not malicious, they just want to make a living, and this is probably the best time to sign people up for an extended contract with a health club or dieting plan. However, on the flip side of that, what happens when the grand expectations don’t materialize into good habits that stick? A person could get pretty discouraged, and feel like giving up hope. I would like to suggest a different approach to changing behavior, one that might have a better chance of sticking because it doesn’t set you up for huge disappointment.
The 12 step programs don’t say “one day at a time” for nothing. They get what I’m talking about. If you think about giving up a compulsive behavior like abusing drugs or alcohol, or having sex compulsively or overeating, the thought of giving that up forever seems daunting at best and impossible at worst. The healthy impulse to start cutting back might get undermined by the dread of going without these above-listed coping mechanism forever.
Instead of vowing to quit forever, I’d like to suggest promising yourself to start being more conscious about when and how you do your compulsive behavior. What feelings are you having? What’s going on around you? What body sensations are you having? What were you doing just before you had the urge? Some people might go so far as to keep track of it in a journal, which is great but not 100% necessary. As you become more conscious about these patterns, you can start to be on the look out for things that sabotage your goals.
But say you don’t want to get rid of unhealthy habits. Say you want to institute a positive change, like exercise more or eat more healthy food. For this you can also use more self awareness. Become aware of the excuses and reasons you use to avoid acting on your goals, and then scale down the goal. You don’t have to put aside your lack of motivation or lack of time forever or even for the whole year or month. Just for today, you are promising to yourself that you will exercise for a small amount of time, say 20 minutes. You may further say to yourself, “but it’s cold outside!” Great, then exercise inside! But when you say, “I’m going to do this every day for the whole year,” you may notice that you feel some resistance to it, perhaps some rebellion. “I don’t have to!” may be your unconscious response. Being aware of these impulses may help you recognize what is sabotaging your goal, and help you come up with ideas to circumvent them.
I hope that you use the gift of consciousness and of this present moment to help you achieve your new years’ goals. If you need further help please don’t hesitate to call me at 661-233-6771.
People often ask me whether they should stay in relationships with people who are abusing substances. Often after further inquiry I find that both members of the relationships have compulsive behaviors of various sorts that contribute to the pattern that they perpetuate and that gives them trouble. I don’t have a set answer that I give people because each person’s situation is different. There are many factors involved in having relationships with people whose behavior or substance use is problematic or compulsive. I think that when the following factors are present, there is more hope for the relationship working well than if these are not present.
1. Both people are committed to looking at how their behaviors affect themselves and others. They care about the harmful and helpful effects of their behavior on others and choose to courageously admit these challenges to their relationships.
2. Both people are committed to acknowledging the harmful effects they have had on each other. They both take ownership of their behavior and are willing to sit with the feelings they have about how their behavior affects their loved ones.
3. Both people are willing to listen to each other when conflicts or discomfort arise. This means that they don’t shut down, argue, scream at, or deny the other person’s point of view. There are ways to communicate discomfort that are more likely than others to facilitate listening, which can be learned and practiced for enhanced exchanges of information.
4. The person with the addictive behavior (could be one or both partners) is willing to get treatment for his or her problem and to stay in treatment, even when it gets uncomfortable.
5. The person who is not addicted is willing to participate in couples or family work with their beloved substance abuser so that they can examine how their behavior and feelings can be supported and changed. This is crucial because many people think that the substance abuser is the only one with a problem that needs to be addressed. It’s a systemic problem that needs systemic solutions.
6. Both people are tenacious and fiercely committed to creating a life worth living together. It’s a joint effort that requires both people to be actively involved in reviving and remembering what drew you together in the first place.
I believe that these are ingredients in the re-creation of a healthy bond between substance abusers (or people with compulsive behaviors) and their loved ones. If you need help in getting started, please don’t hesitate to call.
People in relationships with substance abusers often wonder if they can “cure” their loved one’s addiction with their love. It’s a very romantic idea but it places the loved ones on a slippery slope. By believing that one can “cure” someone else’s compulsive behavior, it takes appropriate responsibility away from the substance abuser and places it with the loved one. For instance, if I think that I can make Bob stop smoking marijuana by acting a certain way toward him, how am I going to feel when he still continues to smoke when I’m trying to be “perfect” or “nice” enough? This means that Bob no longer has to look at his own behavior as a source of difficulty because I elect to take it on for him. In a way it’s very disrespectful of Bob because it assumes that he is incapable of introspection or change. He may not be ready to face his issues or feel inclined toward change at this moment, but if I say that his use is due to the way I treat him, or act around him, I am not giving him a chance to do either of those things.
Both the substance abuser and the loved one will probably start to blame each other when things are not working well in the relationship. The substance abuser may say “I wouldn’t use if you didn’t do X” and the loved one might return fire by blaming his or her stress and anger on the substance abuser. It’s a trap that many couples fall into and usually creates so many bad feelings, that the defensive walls are very hard to overcome. After a while both members of the couple may start to wonder what made them fall in love with each other. All they see is the negative aspect of the person. Alternatively, the loved one may be hanging on to the image of how s/he wants the substance abuser to be, or how the substance abuser was before s/he started abusing drugs. The romance can fizzle out of the relationship and this can make it hard to have faith that it can be restored.
If you see yourself headed in this direction, you need to get some help in setting better boundaries for your behavior and your loved one. You are only in charge of your own behavior, just as everyone else is only in charge of his/her own behavior. The fallacies of control that plague the substance abuser can also confound loved ones. There are helpful books such as Melody Beattie’s Codependent No More, and you might find it helpful to go to meetings for loved ones of substance abusers such as Nar-Anon and CoDA. Addressing the underlying issues that keep you in a relationship with someone who does not change his/her behavior should also be addressed. I hope you develop a romance of a different kind, one with yourself that allows you to treat yourself with the kindness and love that you have been reserving for others.
Maybe you or someone you love is not ready yet to completely stop using drugs or alcohol, but they are concerned about their drinking and possibly willing to take action about it. I help people like this as well as people who are ready to stop using altogether. The type of therapy/treatment philosophy that strives to meet people where they are and find ways to reduce the amount of damage that harmful habits have on them is called “harm reduction.” It’s not that new a concept but people in the US are starting to catch onto it.
The traditional approach to substance abuse (especially chemical dependency) is to insist upon complete abstinence from the drug of choice. This is important when the person’s negative consequences are severe enough that to continue would definitely lead to death or serious illness. However, some people are not quite that severe in their level of substance abuse, and they may not necessarily need to stop altogether. Harm reduction psychotherapy can help people determine what damage they are doing to the different areas of their lives, and how we can reduce that damage.
Here’s an example. Jim (fictional person) Gunn is a 45 yr old man who binge drinks about three times a month on the weekends or his days off. His partner and children are not happy with how he acts when he’s drunk and he sometimes does cocaine when he’s out partying with his buddies too. The cocaine causes nose bleeds and both substances are starting to have a bad effect on his blood pressure. He sees his drug and alcohol use as a problem but can’t imagine giving them up completely, as they are ways to “blow off steam.”
Harm reduction might have him be the designated driver for the group every third time and possibly rotate that task among the other people in the group of friends. Other things he could do include spending more time around non-using friends, or friends who party more moderately and don’t encourage him to get as wasted. He could also have a certain time that a cab picks him up from wherever he’s going so that he doesn’t spend as much time with the other people using and drinking. Finallly, he could also alternate “partying” with other non-using activities that also “blow off steam” but don’t involve using substances. Maybe he can participate in a sport, go running, or some other hobby.
Abstinence can always be a goal of harm reduction, but it doesn’t need to be the only option in some cases. As you see, thinking creatively about how to reduce the damage substances are having on your life can still be fun but less harmful to your life. We all have to start somewhere in our quests for a better life, and harm reduction respects people’s limits and willingness to start the process. If you’re looking for someone who has experience in working with substance abusers, please call me at 661-233-6771 or visit my webpage at www.lisaslarsen.com.
I have run into a lot of people with chemical dependency issues who are deeply ashamed of their more vulnerable, needy selves. They, like most of the people in our culture, aspire to be independent, efficient, good workers, and rich and successful. Note that in that description there is not much room for being fun or fun-loving, nurturing to themselves and others, or human.
Recently I helped a woman get into a drug and alcohol abuse facility for detoxification and treatment who said that she hated the part of her that needed care. I thought how sad that was. It seems to not just be her, but many people these days. They just want to be the American ideal and not take time out to treat themselves decently. Many people are happy to be helpful and useful to others (especially family, lovers and friends) but when it comes to them, they deny themselves that same consideration and care. How can we stop this?
Recovery from any mental or physical condition requires good self care, which is hard to reconcile with this American ideal we have of independence, not needing or asking anything of anyone, and stoicism. There are things that happen without and outside of us that truly hurt. They cause pain and when we deny this pain, we repress it and it makes its way out into the light of day through treacherous and troublesome ways. For example, many compulsive behaviors, including drug and alcohol abuse, are influenced by unmet needs surfacing to our awareness and our trying to escape the pain involved in that awareness.
We need as a culture to start nurturing ourselves and others, and giving ourselves permission to feel, take our time, and heal. It’s not overnight for any condition, especially for substance abuse or codependency.
If you need help learning how to do these important tasks, please call me at 661-233-6771, or go to my website at http://www.lisaslaren.com. I hope you start treating yourself well today.
Many schools of drug and alcohol treatment insist that the person seeking help identify as an addict or alcoholic, and there is often considerable struggle and resistance to this idea at first. In fact, it seems like many people would be willing to do what it takes to get sober if they didn’t have to identify with a much-maligned, stigmatized and embarrassing label like “addict.” What goes through your mind when you hear that word? What association do you have with the word “alcoholic?” Is the image someone in an alley urinating on themselves or slurring their speech and staggering around? Certainly there are people out there who wind up in those situations due to their substance abuse, but this is where some people’s minds go and when they cannot identify with that severe a problem, they reject the label of alcoholic or addict. I can’t say I blame them.
Addiction is a biopsychosocial and spiritual disease and owes much of the denial that people experience to shame. If you are already ashamed of the things you have done while under the influence of your drug of choice, why should I insist that you experience even more shame? Does that even make sense? Some folks need to realize that they cannot use or drink anymore, without experiencing life-damaging consequences. But is that served when I force someone to identify as an addict? This is not to say that there is no utility for some in identifying that way, much in the same way that a diabetic person recognizes that they have a chornic condition that needs to be managed and cared for in a particular way. Once you have a way to classify what’s wrong, you can benefit from medical and scientific knowledege about it. So for some, knowing they have an addiction means that they need to go to meetings, avoid people who use or drink, find new ways to cope with their feelings, and stop using their substance of choice.
However, I don’t find it useful to force someone who does not find that helpful, to identify that way. I think it makes more sense to help them find their own reasons that their drug of choice is no longer working for them, and find reasons to stop and adopt a healthier lifestyle. So if you are worried about being labeled or having to adopt a label that hurts your self esteem, I am a good choice of therapist. This doesn’t mean that I will collude with denial and say it’s ok to use or drink when it hurts your life, but I have no investment in your adopting that label. If you would like help with your substance use, please call me at 661-233-6771.
Substance abuse recovery can be tricky because other people might sense that there is something amiss with you long before you can admit it to yourself. There might be a prolonged period in which you deny the severity of the problem, and thus it can get worse without your acknowledging it or taking action to stop it. This can be partly due to the nature of the drug you’re taking, in that it numbs you and keeps you out of contact with reality. You may be existing in what seems like others a parallel universe where everything is OK and the only problems that exist are with the people around you. “If only they would understand me better, or get off my back, then we’d get along and everything would be great!” You might say to yourself.
There is also a certain amount of shame that people might feel about being a substance abuser. We are a very work-driven, productivity-oriented society where rest and relaxation, and any kind of sickness that takes us away from working, is frowned upon. There are still many people who believe that substance abuse and chemical dependency are due to moral failure, rather than a disease. I subscribe to the disease model, but I do believe people can choose to stop using if it’s creating problems. Nonetheless, we all pick up on messages and stigmatization of substance abuse and mental illness. This can make us ashamed of admitting that we are out of control and keep us using drugs or alcohol long after much damage has been done to our lives, our psychological well being, and our physical health.
You might want to ask yourself a few questions about your use of drugs and/or alcohol to see if things are starting to become unmanageable:
Do you use drugs or alcohol to cope with unwanted feeling states (like sadness, anger, frustration, anxiety, or fear)? What coping strategy have you used lately that doesn’t involve chemical assistance?
How do you feel when you don’t use the drug of choice?
Do you use more of the drug/alcohol than you intended to?
Do you have times that you can’t remember what you did, but other people could tell you what you did? How often does this occur?
Do you use the substance in the morning? How often do you use it, and how much?
These are just some of the questions that are important to take a look at. If you’re looking at this blog perhaps there’s a part of you that thinks that your relationship to drugs and alcohol might be in trouble. If that is the case then please give me a call and we can discuss it: 661-233-6771 (if you’re in the Antelope Valley area). I answer the phone between 8 AM and 10 PM PST. You can also visit my website at http://www.lisaslarsen.com/aredrugsaproblem.html.
It takes courage to consider change, and by taking the first step you can make strides in improving your life.
When I work with substance abusers’ loved ones, they often express frustration with the addicted person. It is frustrating for both parties because they don’t understand each others’ needs.
The substance abuser may be acutely and painfully ashamed of what s/he did while under the influence. Hearing about it repeatedly just drives that shame deeper into them like a knife in the back. Nonetheless, their partner/child/friend/family member/coworker has a right to his/her feelings and to express those feelings honestly and openly to the substance abuser.
It can be hard for the loved one to deal with the denial or oversensitivity of the substance abuser when they talk about the wounds left over from the substance abuser’s actions. Betrayal, grief, sadness, anger, and confusion are all things that they might experience. Such is the nature of the disease of addiction; it thrives in secret until it cannot hide anymore and when it becomes apparent to everyone, there is often so much wreckage that it’s hard to get back to a normal level of functioning in the relationship. It can be helpful for both the substance abuser and the loved one to have somewhere to vent about their frustrations besides with each other. Use the support in the community like 12 step groups, your spirtual community, friends, family, and professional help.
If you are the wronged party, try to make sure that when you express your hurt you are not being insulting or demeaning to the substance abuser. That can shut the person down with shame. Nonetheless, if you are hurt you have a right to say so, from your own experience. Rather than saying “you are this or that”, try to own your feelings, such as “I was really hurt by that and I’m having a hard time trusting you now.” Insulting and name calling just make the other person even less willing to hear your hurt, and creates further distance between you.
If you arethe substance abuser and have hurt someone you loved, realize that the damage you did might take a while to heal. Try to have patience with the other person. No, you don’t have to take verbal or physical abuse but you do need to realize that just because you’re trying hard in recovery now, does not mean that people HAVE to forgive you right away. It took you a while to get to where you are now; similarly, it will take a while for the other person to let go of the hurt.
If you need help dealing with these issues please feel free to call me at 661-233-6771.
One of the issues I help people grapple with is living life in the present. More than you may realize, many people have been treated pretty roughly by their families, their school or work peers, their communities, or this culture. This can create wounds that make us hyper-alert to situations that remind us of those hurts from the past. When we are reminded of the old wounds, it can make us react by getting really upset and sometimes by shutting down (e.g., becoming numb, isolating, and/or going somewhere else in your mind, or dissociating, which can be mild or severe). Some people reach for alcohol or drugs, some people have sex indiscriminately, some work or eat too much, and so on. This is sometimes called acting out. The point is, wounds from the past can make it hard to live life in “real time” as I call it.
I have found that helping people get grounded in the present reality and check out their assumptions about the present situation can be helpful. For instance, in relationships if something a friend or lover says reminds you of a critical or abusive parent, you may react as though that parent were here and threatening your physical or psychological space. If you can learn to recognize that you’re time traveling back to that ugly time period, you can make more realistic choices. You might say, “What you said to me sounds really harsh. It feels like you’re attacking my self esteem. What are you trying to say?” Then the person 1) knows what’s going on and 2) can change the way they’re talking or correct your assumption. They might say, “Gosh, I didn’t realize I was sounding like that. What I’m trying to say is….” You might try this next time you’re in a heated argument with someone, so that you don’t fight, freeze or flee (which is what humans are programmed to do in threatening situations).
I am a licensed psychologist in private practice who just moved from the SF Bay Area to Lancaster, CA. So far it’s been very interesting and I’ve enjoyed the clean, dry air, the friendly people, and the small-town feel of Lancaster. I welcome comments and feedback from people interested in knowing and healing themselves, people in recovery from substance abuse and dysfunctional relationships, or trauma, and other psychotherapists. Thank you for coming!
