Blog : addiction

Why Do People Become Addicted?
Joseph R. Sanok, MA, LLP, LPC, NCC

Why Do People Become Addicted?

By: Steve Greenman, MA, LPC, NCC

 

“Every habit he’s ever had is still there in his body, lying dormant like flowers in the desert. Given the right conditions, all his old addictions would burst into full and luxuriant bloom.” Margaret Atwood

When discussing an addiction or dependency, most standard beliefs center around the continued repeatability of use of a substance and/or behavior, in which the user loses site of the ramifications of his/her actions. The user can become so attached to substances or an action (pornography, gambling) that the instant gratification of the moment far overrides the consequences.

It is like having a little voice on your shoulder telling you everything will be fine–go ahead–just one more. Someone who is fighting an addiction or dependency is fighting both urges from the outside world and a battle with voices inside of themselves.

Negative Reinforcement: I am Worthless Because You Say I Am

Many of my clients have suggested their addictive behaviors began with the need to escape or numb from the world around them. They understood the consequences of their addictive behaviors, but the pain—through either anxiety or depression—was so intense they could not seek any other alternative.

To someone overwhelmed in the moment, long-term recovery seems as difficult and tedious as climbing a mountain. On the other hand, their addictive behaviors can be instantly satisfying.

All of the judgment and opinions from friends and loved ones in fact become reinforcement to continue. To a certain extent, it is socially acceptable to use alcohol, gamble, or shop when emotionally stressed, as long as you don’t cross certain social norms. When a user does violate those norms, the reaction of others reinforces the feelings of weakness, worthlessness, and being out of control. So, he thinks, I might as well keep using.

As Robin Williams once stated in Weapons of Self-Destruction: “As an alcoholic, you will violate your standards quicker than you can lower them.”

When talking about any kind of addiction, it is important to recognize that its cause is not simply a search for pleasure, and that addiction has nothing to do with one’s morality or strength of character. Experts debate whether addiction is a “disease” or a true mental illness, whether drug dependence and addiction mean the same thing, and many other aspects of addiction.

Pleasure Principle: This is Your Brain on Drugs

The brain registers all pleasures in the same way, whether they originate with a psychoactive drug, a monetary reward, a sexual encounter, or a satisfying meal. In the brain, pleasure has a distinct signature: the release of the neurotransmitter dopamine in the nucleus accumbens, a cluster of nerve cells lying underneath the cerebral cortex. Dopamine release in the nucleus accumbens is so consistently tied with pleasure that neuroscientists refer to the region as the brain’s pleasure center.

All drugs of abuse, from nicotine to heroin, cause a particularly powerful surge of dopamine in the nucleus accumbens. The likelihood that the use of a drug or participation in a rewarding activity will lead to addiction is directly linked to the speed with which it promotes dopamine release, the intensity of that release, and the reliability of that release.

Even taking the same drug through different methods of administration can influence how likely it is to lead to addiction. Smoking a drug or injecting it intravenously, as opposed to swallowing it as a pill, for example, generally produces a faster, stronger dopamine signal and is more likely to lead to drug misuse.

Is it a wonder that a depressed individual would seek out this pleasure—any form of relief from the darkness that surrounds their soul?

Diagnostic Criteria for Addiction

Based on the criteria by the American Psychiatric Association (DSM-IV) and World Health Organization (ICD-10) an addiction must meet at least three of the following criteria:

  • Do you use more alcohol or drugs over time?
  • Have you experienced physical or emotional withdrawal when you have stopped using?Have you experienced anxiety, irritability, shakes, sweats, nausea, or vomiting? Emotional withdrawal is just as significant as physical withdrawal.
  • Limited control. Do you sometimes drink or use drugs more than you would like? Do you sometimes drink to get drunk? Does one drink lead to more drinks sometimes? Do you ever regret how much you used the day before?
  • Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?
  • Neglected or postponed activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?
  • Significant time or energy spent. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spent a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?
  • Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?

Many people with addiction issues who I have spoken to shared how they had a high tolerance, and could drink more than peers when in their early stages of drinking. At the time, one who could chug the beer and down the shots and still be able to stand was regarded in high esteem. Many clients have told me, though, as life went on, having a high tolerance for booze became a curse as it became a thirst that could not be quenched.

Relapse and Recovery

Symptoms of addiction include tolerance (development of resistance to the effects of alcohol or other drugs over time) and withdrawal, a painful or unpleasant physical response when the substance is withheld.

Many people who are addicted deny it. They often emphasize that they enjoy drinking or taking other drugs.

People recovering from addiction can experience a lack of control and return to their substance use at some point in their recovery process. This faltering, common among people with most chronic disorders, is called relapse. To ordinary people, relapse is one of the most perplexing aspects of addiction. Millions of Americans who want to stop using addictive substances suffer tremendously, and relapses can be quite discouraging.

To appreciate the grips of addiction, imagine a person that “wants to stop doing something and they cannot, despite catastrophic consequences,” says Dr. Nora Volkow, director of the National Institute on Drug Abuse. “We’re not speaking of little consequences. These are catastrophic. And yet they cannot control their behavior.”

Many in the addiction recovery field suggest that it takes more than just “not using” to fully recover. Recovery needs to come from the heart and the way one perceives him- or herself.

The following are important points your clients in recovery should know:

  • Check into your values; what’s important to you. What are the things that mean more to you than remaining addicted.
  • Develop and practice the skills you need to manage your life without relying on your addiction
  • Learn how to control addictive urges through mind management techniques
  • Find and appreciate the rewards that come from a “sober” (non-addicted) lifestyle
  • Build and appreciate personal relationships and turn to positive communities for support and companionship
  • Find your purpose and plan a future that leads to accomplishing your life goals
  • Mature into a new, non-addicted you — a person who simply and naturally rejects addiction in all forms

“I am spinning the silk threads of my story, weaving the fabric of my world…I spun out of control. Eating was hard. Breathing was hard. Living was hardest. I wanted to swallow the bitter seeds of forgetfulness…Somehow, I dragged myself out of the dark and asked for help. I spin and weave and knit my words and visions until a life starts to take shape. There is no magic cure, no making it all go away forever. There are only small steps upward; an easier day, an unexpected laugh, a mirror that doesn’t matter anymore. I am thawing.” Laurie Halse Anderson, Wintergirls 

 

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701

Steve Greenman Traverse City Counselor
Steve Greenman, MA, LPC, NCC | Thoughtful Experience
Coping with–and Reducing Stress, Anxiety and Worry
Joseph R. Sanok, MA, LLP, LPC, NCC

Coping with–and Reducing Stress, Anxiety and Worry

By: Steve Greenman, MA, LPC, NCC

More often than not, when clients enter my office that are struggling with anxiety, they have immediate need for relief and long term plans to gain coping strategies.

Numerous life situations have, in many cases, added up and created the environment for potential relapse back into old patterns for the use of substances and other addictive behaviors to numb and avoid.

At times, it is too easy to fall back into short term behaviors that work in short run but can lead into long term disasters.

When I was working in an inpatient recovery house, the difference between the safe environment of the house versus the outside world was enormous.

Clients would be afraid to walk outside the walls of the house for fear that the worries, stressors and fears would be waiting for them the moment they stepped outside.

They did not want to relapse, but the pull at times of the outside world was too much and a safety plan versus the immediate gratification of the old addiction was too much to handle. Anxiety and worry sit in and take over their lives once again.

“It was one of those days when I was thinking too much, too fast. Only it was more like the thoughts had a mind of their own and going all by themselves at a hundred miles a second, and I was just sitting back, feeling the growing paranoia inside of me.”
Sasha Mizaree

Coping Mechanisms Short-Term

When an individual begins to feel the anxiety of stressful situations, there are ways of temporarily relieving the physical reactions–Band-Aids if you will:

  • Deep breathing – take three deep, full, conscious breaths whenever you need to.
  • Breaks – a quick nap, snack, reading, walk or drive; a bath/shower/sauna; an exercise break (yoga/stretching); movie/DVD/TV; connect with a friend (email/call/text).
  • Healthy Venting – no obsessing, righteous justification or a pity-party!
  • Visualizations – e.g. visualize a peaceful scene (combine this with deep breathing).
  • Gratefulness – recite to yourself a few things you are grateful for despite what might be lacking in your life at this time.
  • Get honest – be honest – with yourself first and foremost. Admitting a difficult truth should bring immediate relief (especially if you’ve been avoiding/resisting it).
  • Separate what you can change from what you can’t – (and focus on the former, not the latter!)
  • “Keep your eye on the prize” – pick your battles (wisely)…pace yourself.

Reducing Stress – Prevention

 The following items take longer to learn, but are fruitful to create longer-term programs combating stressful, worry filled situations. It is best to understand ways of preventing the feeling of anxiety to formulate in   the first place:
  • Make a list of the “warning” signs – of your stress before it gets out of hand.
  • Prepare for a particularly stressful situation – ahead of time if possible.
  • Take responsibility -”own up to” your own limitations, unhealthy biases.
  • Treat: substance abuse (including caffeine), poor eating/sleeping habits, thyroid
  • Expand your roles – i.e. don’t get stuck in one role e.g. achiever/perfectionist/caretaker/rescuer/, comedian, rebel, wallflower; controller.
  • Learn to set boundaries – learn to say “no;” learn to be assertive
  • Resolve old issues – (old baggage) i.e. resentments, trust issues; intimacy issues; chronic low self-esteem; fears of abandonment; strong inner critic.
  • Learn to recognize your limits
  • Learn to live your own life; let others live their own lives
  •  Learn to risk saying what it is you want/need from life – others and yourself (keep it “reasonable”, focus on 60% on your needs and 40% of your wants.
  •  Consistently “let go” of things you cannot control.
  • Don’t get stuck in either/or thinking – for example – not either I do a good job or forget it…either you’re for me or against me but I both do my best and it’s not perfection…you are both supportive of me (in certain areas) and critical of me (in other areas).
  • Challenge unreasonable expectations – desires, demands, standards, etc.
  • Challenge limiting beliefs – challenge dysfunctional loyalties
  • Clarify your goals – one-year plan, three-year plan,five-year plan; take “baby steps”
  • Learn meditation/mindfulness practices
  • Learn good time management skills and good financial management skills.

Conclusions

The more in tune with ourselves, the better off we are to combat the fears and anxieties of life that can, if allowed, paralyze the soul or worse yet, involve ourselves in unhealthy ways of coping (substance abuse etc.)

We so many times in life take for granted how we feel rather than taking the time to examine the underlining causes of our feelings.

Many who I have worked with in substance abuse recovery struggle with the easier coping mechanisms such as submitting to a relapse rather than the daunting task of struggling with what they suggest are demons within their soul.

Anxiety, worry and stress can be regarded as the norm rather than something to be met head on and over the course of time, to understand and mediate to manageable levels.

“I keep the telephone of my mind open to peace, harmony, health, love and abundance. Then, whenever doubt, anxiety or fear try to call me, they keep getting a busy signal — and soon they’ll forget my number.”
Edith Armstrong

 

Steve Greenman Traverse City Counselor
Steve Greenman, MA, LPC, NCC | Thoughtful Experience

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701

 

Conquering Codependency
Joseph R. Sanok, MA, LLP, LPC, NCC

Conquering Codependency

By: Steve Greenman, MA, LPC, NCC

I remember the ice hitting the glass.

After working all day and sitting down in the living room, I would hear the noise of the ice from ice maker entering the glass. The hair on the back of my neck stood straight up. My mind raced to what may or may not happen. Would I have to cancel the evening plans? How were the boys? I wonder if anyone noticed we have been missing at meetings? When was the last time my then-wife did not get into an argument, prompting the boys to ask if everything was all right?

I had known for some time that I needed help dealing with my wife’s drinking. I had been trying to control it and always labeled it under the heading “what was best for the kids.” What I was forgetting in all this was the toll the drinking was having on me personally. I was depressed, feeling alone, and just plain tired of it all.

Life changed dramatically when my wife took a second-shift job. Night brought a quietness and peace I had not felt for some time. I had previously tried to control the use of alcohol by screaming, pleading and trying to ignore the triggers. None of it worked. Once my wife went to evening shift, the drinking took place in the early morning hours, when the rest of us were sleeping. I realized the difference was not allowing the drinking to dominate my waking hours. I needed to take this one step further. After many years of threatening, I finally attended an Al-anon meeting.

Powerless against it

Strength, not weakness. Allowing the controlling aspect of alcohol to dissipate was beginning to slowly enter my mind as I listened at my first Al-anon meeting. Powerless? You mean I did not have the duty to control, enable and cover up any more? I did not have to carry the burden of the disease? I could think about myself?

I could begin to see what alcohol was doing to me. I was dealing with the same urges as the drinker, but didn’t have the release of alcohol to numb my pain. I was in many ways the dry drunk in the family. My reaction to the situation was affecting my 8- and 14-year-old sons more than the actual drinking. I thought I was protecting my boys, but actually I was adding fuel to the fire by creating the environment to drink.

Those at the meeting shared their stories of their first time in attendance. They spoke of being scared; of being too good for this silly program; and that they were not the one with the problem. Each person expressed that control was not an option. The act of controlling was destroying more than the drinking. I was not leading a healthy lifestyle. For once it was all right to think about myself and review my own feelings.

Codependent Relationship

In a codependent relationship, feelings are often painful. You may have cut off the following feelings:

  • Anger. Are you having one crisis after another? Do you feel you’re doing all the work in the relationship? Are you angry you’re covering up for your partner?
  • Isolation. Do you stay home because you’re not sure whom you can trust? Do you feel you have to hide your feelings because things will never change?
  • Guilt. Do you feel no matter how hard you try it’s never good enough? Do you think that if you were a better partner things would be better?
  • Fear. Do you fear confronting your partner because they may abandon you? Do you fear physical or sexual abuse? Do you fear the loss of your home and security?
  • Embarrassment. Do you avoid bringing people into your home because your partner’s drinking is unpredictable? Do you avoid social gatherings where drinking may occur?
  • Despair. Do you feel helpless and trapped at times? Do you feel it will never change so why bother to confront? Do you spend most of your energy worrying about his or her drinking?

The more that was shared, the more it felt I was beginning to break up that wall in my heart. It was all right to take care of myself; it was all right to focus on me for a change.

How to take care of yourself

It is natural to want to protect the people you care about. But in a codependent relationship, how do you begin to take care of yourself?

  • Recognize you have a problem.
  • Start to focus on your needs.
  • Begin to educate yourself on codependency.
  • Start setting limits.
  • Start trusting and get supports.
  • Understand recovery and the process for everyone.

I felt a bit lighter when I left the meeting. I had shared my thoughts with others and I was able to speak freely about control. I was beginning to make a crack in the wall. I was actually telling someone else that we had a pink elephant in the room that in itself was a huge step forward. I was beginning to understand to cover up pain and shame in the family dysfunction. I needed to learn to respond to an outer reality instead of my own inner reality.

Steve Greenman Traverse City Counselor

Steve Greenman, MA, LPC, NCC is a counselor at Mental Wellness Counseling in Traverse City, MI. He specializes in helping families dealing with complex family situations, addictions, and transitions. Steve is also helping clients through the Intensive Recover Program, which helps with recovery treatment, alcohol treatment, and other addictions treatment. Contact Steve at 231-714-0282 Ext. 701