Negative self-talk and addiction recovery

January 29th, 2012

Everyone has internal beliefs about what they are, or aren’t, good at. For many these have become an implicit reality – facts about life that are rarely examined and never questioned. The “gravity” of our lives.

When I review these internal beliefs with clients, especially those in early recovery but also others who don’t have trouble with addiction per se, we often find that they are packed full of negative self-beliefs and self-talk. Phrases like “I’m impatient/rude/stupid,” “I’m not good at doing _____,” or “I can’t handle _____” are so commonplace in psychotherapy circles that restructuring them can often become the focus of many sessions. And negative self-beliefs are a huge source of shame, and you know how I feel about that.

Inevitably these negative self-beliefs and the associated shame are often the remnants of past experience, whether personal or “other” inflicted. Poor performance in some childhood activity, ridicule by peers, or harsh words from misguided parents can lead to seemingly permanent imprints on the world-view of the young, and then the older. Ironically, even seemingly self-assured views like “I am in control of my life” can become defeating when they turn into “I am a failure because I can’t handle this on my own.” We get that one a lot in addiction treatment from clients who think that they are weak because they’ve found themselves needing help. Again, this thought pattern leads to shame and often resistance to receiving the necessary addiction help.

As usual, a big part of dealing with these issues, from both a cognitive behavioral therapy (CBT) point of view and a humanistic one, is to examine their sources and test their appropriateness. It’s rare that these statements prove universally true and it’s even more infrequent that they turn out to have no connection to a small set of past hurts that happened long ago. In recovery from addiction, I often have clients look at how many other things in life they’ve needed help with – learning how to read, how to play sports, or how to do well at their job. We’re constantly relying on others for help, but when it comes to our psychological functioning we believe that we should be masters regardless of our level of training – a belief that I see as having no basis. But then again, I am a psychologist…

How to break negative self-talk and self-belief cycles

For readers who want to test their own beliefs and the existence of their own negative self-talks it helps to keep a written journal. Make a list of such negative self-beliefs that you are already aware of and try to be as aware as possible of negative self-talk as it happens over the course of one whole day. Write those down too. Now, using a whole line on a piece of paper (or a spread-sheet if you want to be super organized about this) create little spaces (columns) to write down a single situation in which those thoughts and beliefs come up for you in everyday life. In the nest column put down an objective assessment of what actually happened. In the last column write a short assessment of how close your initial internal dialog was to the “truth.”

Let’s use an example – Imagine getting an upset email from your boss that brings up your good old “I’m never going to succeed” negative self-belief. When you go to your journal and find the line for that specific negative belief you write “got upset email from boss” in column one and “boss was upset that I forgot to send out update email yesterday as expected” in column two. Now examine your current level of functioning at work in light of this specific mistake, past work occurrences, and the very near future.

If you’ve been held back from advancement repeatedly and been scolded, fired, or nearly fired for forgetting these sorts of things in the past, the belief might be a sign that you need to become active about finding ways to improve on this sort of forgetfulness in the future. But if such occurrences are relatively rare and haven’t caused negative consequences at work or other environments, then it sounds like the belief is an exaggeration of a much less frightening reality along the lines of “I don’t always perform perfectly at work.” I don’t know about you, but that sort of internal belief I can live with.

Now go on and do your homework – or are you a slacker?!

Posted in:  Education, For addicts, For others, Tips Tags: addiction, belief, beliefs, negative, negative self, negative self beliefs, negative self talk, self, self beliefs

Addiction recovery help by replacement

December 20th, 2011

contributing author: Katie McGrath

It’s easy to see why some people search for ways to escape their everyday life. Daily obstacles and challenges are common, and sometimes, life can seem like a difficult, if not impossible, test of wills. Addiction recovery help is about finding another option.

People turn to many different coping methods, including addictive behaviors such as drinking alcohol, using drugs, or gambling (1). But many other behaviors that aren’t considered as deviant as those just mentioned can also develop unhealthy patterns, including excessive work, promiscuous or risky sex, and high adrenalin activities like car and motorcycle racing, skydiving, rock climbing, and other forms of “extreme sports.”

In fact, researchers have found that drug users and extreme sports atheletes rationalize their respective involvements in very similar ways (2).

Unfortunately, if the activities are used for escape, people usually find the relief they get to be temporary. When the “high” is finished, they find their problems alive and well as life comes back at them full-force. A temporary distraction, no matter how exciting or effective (like extreme sports, alcohol, or drug use) is just that – temporary.

The idea of “switching addictions” has come up in psychological research in the past (4). The question is: Can addicts substitute their choice addiction for a behavior that is actually beneficial?

Some research suggests that they can.

Activities like exercise (running, yoga, and such), art (painting, photography), and other hobbies (such as gardening), may provide a source of comfort for drug users looking for a way to “fill in” the void left by drugs and/or alcohol. Each of these activities may provide the repetitive, mindful, pursuit that people who are prone to addiction may seek without many of the harms and dangers.

When I stopped getting high, one of the hardest things was figuring out what to do with my free time that didn’t involve using drugs. It was what I was used to doing when I was happy, sad, or bored. Now, I would be all those things, but the drugs weren’t there. It took me more than a year to get comfortable with movies, the gym, and books as replacements for what I knew how to do best – using drugs.

In future posts, we’ll go over some specific ideas for changing behavior that may be useful for addicts trying to stop. We’ll also suggest specific strategies to keep from developing unhealthy habits even in these new, more constructive habits, while keeping them long-term. Addiction recovery can be tough, but actively replacing activities can help.

Question of the day:
If you’ve quit drugs or other addiction, do you have any suggestions regarding new habits you picked up that helped you in developing a new, healthier life?

Citations:

1. Hart, A. D. When coping becomes addiction.

2. Larkin, M., Griffiths, M. D. (2004). Dangerous sports and recreational drug-use: Rationalizing and contextualizing risk. Journal of Community & Applied Social Psychology, 14, pp. 215-232.

Posted in:  Education, For addicts, Positive addictions, Tips, Treatment Tags: addiction and recovery, addiction recovery, addiction recovery help, addictions recovery, extreme sports, Positive addiction, recovery help, running, sex addiction, sex addiction help, treatment, yoga

Saving lives made easy – Treating opiate overdose with intranasal naloxone

October 24th, 2011

Contributing co-author: Andrew Chen

Imagine that you and your friend have been using heroin (or another opiate). A few hours go by and you notice your friend is progressively becoming more and more unresponsive. You check on him and find that his breathing is shallow, his skin is cold, and his pupils are constricted. You recognize these as signs of opiate overdose and call for help. Now what?

Well… If you had some naloxone around, you might be able to treat the overdose and save your friend’s life before the paramedics even arrive.

Naloxone hydrochloride (naloxone) is the standard treatment for opioid overdose. Naloxone works by blocking opioid receptors, thereby removing opioid agonists, such as heroin or oxycodone, from those same receptors. As a result, the overdose is reversed and death is prevented.

What makes naloxone great is that it has no potential for abuse. In fact, it makes the user feel pretty crappy.

Naloxone is typically delivered through an injection, which makes it pretty much useless in many situations. However, it can also be delivered using an intranasal spray device. This intranasal form of naloxone is getting lots of attention recently because it is relatively easy to administer.

In 2006, The Boston Public Health Commission (BPHC) implemented an overdose prevention program, providing training and intranasal naloxone to 385 individuals deemed likely to witness an overdose. These individuals were often family members of opiate users or drug-using partners.

15 months later, the BPHC conducted a follow-up:

• Contact was made with 278 of the original participants.
• 222 reported witnessing no overdoses during the 15-month span.
• 7 had their naloxone stolen, lost, or confiscated.
• 50 reported witnessing at least one overdose during the 15-month span. Together, these 50 individuals reported a total of 74 successful overdose reversals using intranasal naloxone!

The BPHC program is not the only example of successful use of naloxone in opiate overdose prevention programs. Similar programs have popped up in Chicago, New York, San Francisco, Baltimore, and New Mexico.

Unlike injections, using a nasal spray isn’t rocket science. All of the participants in the BPHC program were trained by non-medical public health workers, which makes the idea relatively cheap. As the data shows, the participants were able to effectively recognize an opiate overdose and administer intranasal naloxone. By targeting at-risk populations and providing proper training, distribution of intranasal naloxone can help in saving lives.

For more information, check out our post Addiction and the brain part IV – Opiates

Citation:

Doe-Simkins, M., Walley, A.Y., Epstein, A., & Moyer, P. (2009) Saved by the nose: Bystander-administered intranasal naloxone hydrochloride for opiod overdose. American Journal of Public Health. 99(5)

Posted in:  Education, For addicts, For others, Opiates, prevention, Tips, Treatment Tags: addiction, addiction help, death, heroin, naloxone, opiate, opiate overdose, opioid, overdose, prevention, substance abuse

Influential factors in college drinking

October 19th, 2011

Co-authored by: Jamie Felzer

What influences college students’ decisions about whether to drink and how much?

• Do friends peer pressure them?
• Do they do it because they are bored?
• Do they drink to relieve depression or anxiety?

Researchers recently tried to answer these questions by surveying college students…

65% of the participants reported having at least one drink in the past three months. It was astonishing that the typical number of drinks in a week was 10.5 and on a weekend was 7.3 average drinks. These numbers included drinkers and nondrinkers and was the average (meaning around half the people had more drinks as those had less). This indicates that college drinking is far more extreme than drinking happening outside of the college setting.

3 main influential factors for someone’s decisions in college drinking and to what extent:

• If their close friends were drinking,
  
• How drunk they thought they were, and
  
• Their drinking intentions.

Interestingly enough, the more students thought others on their campus approved of drinking, the less they tended to drink. We recently reported similar misconceptions about students, their peers and marijuana use. Typically, if people intend to get drunk they use less protective factors (see here for a previous post about these) such as pacing or eating or keeping track of what they were drinking. Friends’ drinking was the best predictor of drinking habits in all cases.

You can tell a lot about a person by watching their friends, so watch who you surround yourself with. Those who think favorably of drinking tend to think they can drink more before reaching intoxication and also tend to hang out with others who do the same. However, these people are the ones that need the most intervention yet are the most difficult to change.

Those who socialize with a wide variety of people typically are lighter drinkers and tend to respond better to treatment immediately as well as have fewer problems further down the line. The heavier drinkers benefit more from motivational interventions focusing on their attitudes toward drinking.

Regardless of stereotypes, ethnicity, weight and gender did have an effect on any of these findings. It was peoples’ closest friends that were the most significant factor in influencing all aspects of college drinking.

Citation:
Examining the Unique Influence of Interpersonal and Intrapersonal Drinking Perceptions on Alcohol Consumption among College Students. Journal of Studies on Alcohol and Drugs. Volume 70, 2, March 2009

Posted in:  Alcohol, Education, For addicts, For others Tags: anxiety, binge, college, college drinking, depression, drinking, friend, peer, peer pressure, protective factors, social, treatment

More money more problems? Rich teens and drugs

September 7th, 2011

Teens raised in affluent homes display the highest rates of depression, anxiety, and drug abuse according to a recent article in Monitor on Psychology, the APA‘s monthly magazine.

One of our recent posts dealt with some of the issues unique to teens and drugs. In addition to the issues we’d already mentioned, the article named a number of reasons for the high prevalence of mental-health issues among affluent teens. Among them were an increasingly narcissistic society, overbearing parents, and an common attitude of perfectionism.

Each of these reasons are likely contributors to the prevalence of mental health and drug abuse issues among upper-middle-class (and above) teens. Still, as far as I’m concerned, the main take home message of the article is this:

Money truly doesn’t buy happiness – Rich teens and drug use.

While drug abuse research often focuses on the lower socioeconomic strata these recent findings indicate that being financially stable offers little in the way of protection from some of the most common psychological difficulties.

Thankfully, the researchers cited in the article gave some simple advice to parents:

• Give children clear responsibilities to help around the house.
• Take part in community service (to unite the family and reduce narcissism).
• Reduce TV watching (especially of reality TV shows that glorify celebrity and excess).
• Monitor internet use.
• Stop obsessing about perfect grades and focus instead on the joy of learning for its own sake.

I couldn’t agree more with these recommendations. Having taught a number of classes myself, I have witnessed the ridiculous inflation in students’ expectations of top grades. I think it’s time we turned attention back to the family and reintroduce some of the basic skills that many addicts find themselves learning much too late… Often in recovery.

Posted in:  Alcohol, Cocaine, Drugs, Education, For others, Marijuana, Meth, Opiates, Opinions, Prescription, Tips Tags: abuse, affluent, anxiety, celebrity, challenge, class, depression, grades, internet, middle, money, monitor, narcissis, perfectionism, responsibilities, rich, skill, substance, teens and drugs, television, tv, upper

Higher drug abuse among gay youth likely tied to rejection

July 17th, 2011

For a lesbian, gay, or bisexual youth, “coming out” is an extremely stressful, though important event that can result in improved self-esteem, social-support, and psychological adjustment.

However, a recent study found that the reactions to such a disclosure have a lot to do with the risk of those youths abusing alcohol and drugs.

Social rejection and drug abuse among gay youth

The results revealed that the more rejecting reactions a youth receives, the more likely they are to engage in drug abuse including alcohol, cigarette, and marijuana use. This was true even after researchers controlled for a number of other important variables like emotional distress and demographics (race, ethnicity, education, socioeconomic status, etc.).

This makes a lot of sense. After finally deciding to go through with such a monumental disclosure, harsh rejections likely cause some serious damage to a youth’s self-esteem, making escape by drugs an attractive option. Although coming out can eventually lead to increased self-esteem even for this youth, the road there is not an easy one.

The good news was that accepting reactions seemed to protect youths from the harmful effects of being rejected – Social support helps!

The researchers suggested that drug abuse prevention attempts with LGBT youths address the impact of rejecting reactions to sexual-orientation disclosure directly in order to hopefully reduce their negative impact.

Here’s a video about the difficulties of coming out in high-school:

Reference:

Rosario, Schrimshaw, & Hunter (2009). Disclosure of sexual orientation and subsequent substance use and abuse among lesbian, gay, and bisexual youths: Critical role of disclosure reactions. Psychology of Addictive Behaviors, 23, 175-184.

Posted in:  Alcohol, Education, For others, Marijuana, Tips Tags: abuse, accepting, Alcohol, bisexual, coming, drug abuse, Drugs, gay, lesbian, marijuana, out, pot, rejection, self-esteem, smoking, support, transexual, weed

Parenting advice – What’s important when it comes to teens, alcohol, and drugs

July 8th, 2011

Parents often ask us what they can do to prevent their children or teens from becoming alcoholics, drug addicts, criminals, and the likes. I’ve been all of these and more, and so I’d like to share my insight with you now that I’ve made it over to the other side:

You can’t prevent anything – but you can educate, inform, prepare, and support.

My family breaths success; it also breeds its. My father was a star athlete who turned into a star doctor and a star family man. He also never drank alcohol and couldn’t care less about drugs. My mother was a beauty queen who always helped me get the best grades in school, even if it meant that she ended up doing my art projects for me and keeping me up all night so I’d finish my work. I’m not sure if it was my perception or my parents’ actual wish, but I always felt like unless I saved the world, I would end up a nobody. Drinking enough alcohol to black-out and consuming every drug on earth was never supposed to be on my menu.

A recent article I read in a monthly psychology magazine (see my post on it here) talked about this sense of perfectionism in our culture and its effect on teen depression, anxiety, and alcohol and drug abuse. Did you know that these are highest among more affluent teens?

Advice #1 – Shooting for good performance is important, but focusing on it as a sole measure of success can lead to trouble.

I got gifts for grades, and the best gifts came only with the best grades. Anything short of perfect was pretty much frowned upon and considered “less than my best.” It became impossible for me to actually enjoy anything but the school subjects I excelled in (math, physics, chemistry). It wasn’t until I graduated from college and did some of my own exploration that I learned to appreciate art, English, and history as worthwhile pursuits. It’s a well-know fact in developmental psychology that you don’t reward behaviors that are supposed to be appreciated in their own right. If you do reward them do so with small gifts, nothing large. Big gifts take away the perception that the activity itself brought about enjoyment.

Advice #2 – Parenting requires consistency and openness, but leave the preaching for church.

This constant need for perfectionism also lead to the repression of many issues in my family.

My parents fought often when I was a kid, screaming loud enough for me to take my sister away often and go play. We never talked about the fights so I never managed to learn about conflict, relationships, or resolution. We never talked about my stealing either, whether I was stealing from my family (mainly my father’s porn) or from the neighborhood toy store. The one time I got caught, my father sternly told me to return my new toy and to never be caught stealing again. I began stealing away from my neighborhood; it would be years before he’d hear about me stealing again. It probably would have been better to sit down and talk about what just happened.

Later on, when my mother would find my weed in my room, she would hide it so that my dad won’t find it because he would get mad. We call that enabling. When I was caught stealing at my work, my father didn’t want to tell my mom, so as not to upset her, so he never brought it up again. We call that denial. Neither of these work since they don’t teach a child anything except how to hide things properly and that even responsible adults lie.

But research shows us that preaching is not a good parenting technique so stay open and talk about struggles without being hypocritical and trying to teach lessons that are obviously forced. Kids and teens pick up on that very quickly but they’re ready to learn from their parents.

Advice #3 – Don’t let your sense of pride, or your ego, prevent you from dealing with real issues with your children. Parenting requires you to be the adult in the relationship with your children even when things don’t go your way.

By the time my parents were forced to confront reality, things in my life had spiraled way out of control. They received a call from my LA lawyer telling them that their son had been arrested for some pretty serious drug dealing. My bail was set at $750,000 and I was facing 18 years in prison. That’s pretty difficult to ignore.

Ironically, my arrest, court case, and the year I spent in jail brought my family closer together than we had even been during my teen years or my later drug addiction phase. Having to actually confront many of our issues allowed us to bring some actual intimacy into the family I had run away from so many years before. The important thing was that my parents didn’t pull out the “we told you so” card but rather helped me confront my demons and treat them. It was the best parenting I’d received in my life and it worked.

My parents did the best they could. I know that. Still, I can’t help to wonder if worrying a little less about how things “should be” and a bit more about the reality of parenting their deviant son may have prevented the latter part of this story. Then again, there’s no guarantee of that either. That’s the most important parenting advice I can give when it comes to teens and drugs…

Posted in:  Education, For others, Tips Tags: addiction, addiction help, Alcohol, best, best grades, caught stealing, drug abuse, Drugs, family, help, important, parenting, parenting advice, stealing, teen addiction, teen drug use, teens and drugs