Blog : recovery

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
What Happens in Rehab and Recovery
Joseph R. Sanok, MA, LLP, LPC, NCC

What Happens in Rehab and Recovery

By: Steve Greenman, MA, LPC, NCC

“You can get the monkey off your back, but the circus never leaves town.” Anne Lamott.

In the modern recovery world “rehab” can mean many things. To treat addictions a person can choose long-term (usually 90 days) and shorter-term (30 days to 2 weeks) in-house programs. Each type of program has its own specific strengths and weaknesses.

Inpatient Rehab

The benefit of an inpatient program is that an individual is isolated away from their substance of choice and is thus given an opportunity to begin to think clearly. Isolation away from behavioral triggers allows them to focus solely on their recovery without distractions from the outside world.

Over time, family members and close friends may be invited to participate in visiting days or family therapy sessions. This helps to build the support system that is so crucial to those in recovery once they leave the rehab facility.

Outpatient Rehab

In outpatient, the individual has freedom of movement and is able to handle day-to-day activities of life outside of a facility. Depending on possible involvement of court system, there could be required drug testing in place.

An outpatient program gives an individual the opportunity to gather facts and converse with fellow members of the group to learn coping skills to avoid the decisions of the past. Outpatient care is best for those with short-lived dependence and is not recommended for those with serious or long-term addictions or those with dual diagnosis conditions.

What Happens in Rehab

Once an individual passes through the initial detox from drugs or alcohol, they will move on to the rehabilitation portion of the recovery process. The rehab portion of recovery is where the patients get to evaluate the underlying reasons behind their addictions, addressing those issues so they can effectively move on with their lives without going back to drugs, alcohol, or other addictive behavior.

In individual behavioral therapy, the patient will identify when they began using the substance and why they started abusing it. The patient will receive strategies on how they can direct their time to focus on getting involved in new hobbies or interests. Time management skills will allow them to better use their time so they have less opportunity to think about relapse.

Patients learn to identify triggers, and how to deal with these triggering situations when they come up. If patients have a plan for various tempting situations, they are more likely to put their plan into action and avoid relapse. This type of cognitive behavioral therapy also addresses thoughts that patients have in relation to substance abuse, or life in general. It helps to reform their thinking patterns and make behavioral changes toward a healthy, sober life.

The addiction rehabilitation process usually includes group therapy. These group sessions allow the recovering addict to interact with others who are in the same situation. It is often helpful for recovering addicts to know that they are not alone in their struggles. Likewise, it can be beneficial for addicts to share their own stories of addiction and recovery, as others find solace in them. This sense of community support is integral to the recovery process.

Most addiction rehabilitation facilities offer family therapy as part of their program. Addiction is far-reaching, affecting many more people than just the individual with the addiction. Family members are often those who are most deeply affected by their loved one’s addiction, and they are an important component of the recovery process for that person.

Initially, patients may be restricted from contacting loved ones, but later in the recovery process, family members are often welcomed to participate in family therapy sessions. During these sessions, family members can discuss pain caused by their loved one’s addiction and their desire to see that person live a healthy life. Family therapy can help to resolve issues so the family can serve as a pillar of support once their loved one leaves the rehabilitation facility.

Choosing a Drug Treatment Program

According to the National Institute on Drug Abuse, there are several things to consider when choosing a drug treatment program. These include:

  • There is no one-size-fits-all solution to treatment.
  • Different treatments work for different people.
  • Patients must commit enough time to treatment in order to effectively overcome their addictions.
  • Everyone should have easy access to treatment when they need it.
  • Addiction affects the way the brain works.
  • Effective treatment should address all areas of the addict’s life, not just the abuse or addiction.
  • Medicinal treatment is often necessary and should be used in conjunction with therapy.
  • Treatment plans should continually be tailored to meet the individual’s needs and circumstances.
  • Mental disorders are often linked to drug addiction and should be addressed in treatment.

A setting that provides recovery in a holistic manner and provides services that treat the underlying reasoning behind the need to escape or numb is critical to helping those we serve to find long-term recovery.

The best services include the following components:

  • Individual and Family Therapy
  • Dependence Education
  • Self-Realization
  • Individual Treatment Plan Creation

The service must be helpful in creating long- and short-term goals in the recovery process:

  • Establishing an individual relapse prevention plan
  • Daily reflections and meditations
  • Learning how to encourage longer-term dependent free living
  • Creation of a spiritual-based premise of a higher power

To meet the goals prescribed above a service covers areas such as:

  • Past and current medical history
  • Employment and educational background
  • Basic needs being met currently
  • Substance abuse history
  • Legal issues (current and past)
  • Family/social genogram of dependent history
  • Psychiatric diagnoses (current and past)
  • Personal insights and supports each client has

What Exactly is “Recovery”?

After a patient has completed a rehabilitation program, they are not finished with recovery. In fact, recovery is a process that an addict must work at for the rest of their life.

Sometimes, the path to lifelong recovery will be easy. Other times, it will be difficult for individuals to withstand the temptation to relapse. Like anything in life, it’s a journey that may feature varying terrain, so constant support is essential.

Prior to leaving an addiction treatment program, a patient will meet with counselors to discuss a plan for aftercare. Many addiction rehab facilities offer follow-up programs to assist the patient as they return to normal life.

These may include weekend stays back at the rehab center when the individual feels a touch-up stay is needed. Or a patient may live in a sober living facility for a while with other recovering addicts before returning home. This offers a supportive transitional time for recovering addicts before being thrown back into “normal” life.

Many patients maintain regular therapy sessions post-rehab, and some submit to scheduled drug testing as a way to keep them accountable to their sobriety. Group therapy is a method for building a support system in your local area. Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are well-known 12-step groups that many recovering addicts attend on a very regular basis. Both AA and NA have meetings all across the country at easily accessible times.

There are various offsprings of the AA model for a wide range of other addictions, such as Overeaters Anonymous (OA), Emotions Anonymous (EA), Gamblers Anonymous (GA) and Sex Addicts Anonymous (SAA). There are also subsets of NA for specific drugs, like Cocaine Anonymous (CA) and Crystal Meth Anonymous (CMA). Some addicts find the type of support they can get in very specific 12-step groups is more beneficial, whereas other addicts gain the help they need from more general groups.

In the end the most important aspect of any rehab and recovery is that it is not just the mind thinking about recovery but also the heart. One must be willing to sacrifice immediate gratification with at times a long arduous plan that leads to fulfillment in never-ending recovery process.

 

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

 

Dependency: Are We Enabling?
Joseph R. Sanok, MA, LLP, LPC, NCC

Dependency: Are We Enabling?

By Steve Greenman, MA, LPC, NCC

“At the bottom of every person’s dependency, there is always pain, discovering the pain and healing it is an essential step in ending dependency.”  Chris Prentiss, The Alcoholism and Addiction Cure

Do you have a love one struggling with emotional/physical pain using an unhealthy dependency (alcohol, pornography, gambling, drugs legal or illegal) to cope, escape or numb?

How helpless do you feel?

During my stay as a clinical therapist at a 28 day substance treatment center I had more than one client suggest the drugs/alcohol filled a void which nothing in the past ever had. One client shared to me his use of Heroin was best described as: “A hug from God”.

How do you combat a hug from God?

One has to remember you cannot save a person using a dependency, change can only come from the person themselves willing to make the effort.  We can very easily if  we are not careful become a part of the problem rather than the solution. It may be how we act out (anger, frustration, helplessness) which creates more division in the family than the person actually involved in the numbing/avoidance behavior.

Sherry Collier from her website – “Creative Path to Growth” in an article entitled   “Compassion versus Co-dependency: Caring without Enabling”  lists questions to ask yourself to determine if one is acting out of compassion or in a place of co-dependency:

  • Ask yourself what is your motive?  Am I trying to rescue someone else?
  • Are we able to walk along side someone or do we need to have to fix the problem?
  • Am I trying to “fix” someone else so as to not look at my own issues?
  • Am I exhausted – physically and emotionally drained?  Do I feel taken advantage of?
  • Are you creating safe solid boundaries for yourself and the rest of the family?

This can be very difficult questions to ask when were dealing with a loved one but the soul inside the one combating dependency is not only struggling with the outside world but also within side of themselves. We need to be able to understand the best way of supporting our loved one. There comes a time when we may need to reach out to others such as professional counselors, close friends who may have been in your shoes before for not just for our loved one but for ourselves as well.

AUTOBIOGRAPHY IN FIVE SHORT CHAPTERS

by Portia Nelson

I

I walk down the street.
There is a deep hole in the sidewalk
I fall in.
I am lost … I am helpless.
It isn’t my fault.
It takes me forever to find a way out.

II

I walk down the same street.
There is a deep hole in the sidewalk.
I pretend I don’t see it.
I fall in again.
I can’t believe I am in the same place
but, it isn’t my fault.
It still takes a long time to get out.

III

I walk down the same street.
There is a deep hole in the sidewalk.
I see it is there.
I still fall in … it’s a habit.
my eyes are open
I know where I am.
It is my fault.
I get out immediately.

IV

I walk down the same street.
There is a deep hole in the sidewalk.
I walk around it.

V

I walk down another street.

It may be time for not only our loved one but ourselves to find our way back home.

And so it goes

HEAD SHOT WITH DESCRIPTION GREENMANSteve 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.