ItŐs interesting how rational we can be about some drugs
and behaviors, and how irrational about others. When I was a teenager my best
friend kept trying to get me to do coke. I always declined, and he was baffled.
I had tried nearly everything else! I just said that I was afraid IŐd like it
too much. I instinctively felt that it was addictive and I was scared of it.
Oddly enough, when I did finally try it a couple of years
later I kind of enjoyed it, but not enough to go out and buy more. I could
pretty much take it or leave it. Meanwhile, I drank every day...steadily more
and more. Nothing in my mind ever said about alcohol, Ôthis is addictive and
you like it too muchŐ!
My sister, on the other hand, tried coke and it spiralled
rapidly into an expensive habit; she got into debt to dealers, and the family
had to pay them off and move her across the country and away from all her old
contacts. For some people it is very casual, while for others it is very, very
Many people find pot smoking to be a casual, occasional
thing; others canŐt imagine a day without it (it can certainly become a
compulsive behavior like anything else). I think if you asked most people about
heroin, theyŐd say they would never consider using it—too dangerous, too
addictive. But cigarettes and alcohol? I knew a girl who told me quitting
heroin was nothing compared to quitting smoking. For years I was the only
non-smoker in my family, and I canŐt even imagine starting. It seems totally
irrational to me.
Once youŐve tried a drug the harmful effects that you read
about seem somehow unreal. But you know that smoking is bad for you, right? You
know that the effects are cumulative. You know that eating junk food every day
is bad for you. Dealing with substance abuse and harmful behavior involves
dealing with both our rational responses and our emotional responses to the urges.
Remember that the three things that people who achieve
sobriety have in common are that:.
make a firm commitment to abstinence;
make lifestyle changes to enhance that commitment;
plan and practice for urges and situations.
The firm commitment part is....
coming to a belief that the substance or the behavior has
no place in your life anymore.
matter how tempted you are;
matter how appealing it may seem;
matter how much some friend encourages you;
matter how much some situation may seem to call for it—as consolation or
matter how good you think it might make you feel temporarily—
You donŐt consider actually doing it, any more than a
vegetarian considers eating meat.
Sure, you may think about the things you think it will do ÔforŐ
you. ThatŐs what urges are, and they can be very intense. So it is helpful to
have already prepared, in your mind or in writing, the answers to those urges:
the things it will do ÔtoŐ you—the costs of using or compulsively eating
or cutting yourself, or whatever the harmful behavior is. ThatŐs why the first
thing you usually do in behavioral recovery is to write that list of the costs
and benefits. So those costs are detailed, in writing, and in your wallet if
First and foremost, you have a plan for not engaging in
the behavior. A concrete plan, with specific steps to take when confronted with
the urges. This is your plan; if you are honest about your behavior, you will
know what is likely to work. ItŐs what youŐll say or do; when youŐll leave a
situation and where youŐll go; who youŐll call. It isnŐt a sign of weakness to
call on someone else for help! First and foremost, you donŐt take the drink, or
do the drug, or engage in the behavior. And you can repeat that process
successfully for weeks and months.
Our more intense urges have to do with a need for immediate
gratification or relief, and for our stress about feelings and situations. So
we deal with those.
deal with all those beliefs about how it—the drug, the behavior—will
make you feel, or how the friend will react, or what you think youŐll be
deal with being upset for considering acting on the urge.
deal with the irritability of not giving in to the urge.
deal with the discomfort of changing deeply engrained patterns of behavior.
You deal with those things by planning for them.
So why is it that we willfully use some drugs, and stay
away from others? Why do some people cut themselves, or engage in
thrill-seeking behaviors, or go through one unhealthy relationship after
another? What makes a person use highly toxic household cleaners, but refuse to
buy relatively benign pesticides for their garden? Why do we fear things that
are very unlikely to occur—such as flying—but engage daily in
behavior that has a far greater risk—such as driving on the freeway?
There is a rational and an emotional component to these
decisions (and recognizing that they are decisions can be important!).
The rational part:
We may just be uninformed, or have chosen not to believe
or listen to facts. So now that youŐre contemplating abstinence (else why would
you be here?), earn all you can about substance abuse. The facts can help
affirm your decision for change. We may perceive the risk out of proportion to
its reality. In the case of substance abuse, we may fail to recognize the
The behavior has become so familiar that it no longer
seems risky, or the risk may be cumulative, not immediate. That makes it harder
to recognize. But is there a person alive today who doesnŐt know that smoking
is harmful? That our diet affects our longevity and the risk of disease? Just
having the knowledge doesnŐt prevent the behavior, of course. But repetition
does work—just look at the advertising industry. So repeating to yourself
the risks of drinking, drugging, and unhealthy behavior is helpful, even when
it seems banal and obvious.
We are more fearful of things over which we have less
control. Hence our fear of flying instead of driving.
There are two basic approaches to this issue. One is to
accept that you have no control over the behavior, and seek an external source
of change (a higher power—I will never learn how to fly a plane; someone
else is in control of the plane, and I put my trust in that pilot). The other
is to recognize that you have gradually relinquished control over your
behavior, and to seek to strengthen your internal source of change
(self-management—I will learn how to fly the plane).
As with most dichotomies, this one is a little false—these
approaches can be blended. Some people describe coming to an understanding that
their present course is not working, seek an external source of change, and use
that to find the power from within for change. Learning enough about how
airplanes work that you feel comfortable putting your safety in the hands of
experts. If I stretch this metaphor much more, itŐs gonna break....
The emotional part:
The fundamental principle of behavioral therapy is that
our emotions and behavior result from our beliefs, and that we can change our
Some of it is rational persuasion: recognizing the
reality, facing the consequences of our behavior and acting accordingly.
But some of it is recognizing how debilitating our
emotions have become. It isnŐt surprising that people who abuse substances or
adopt unhealthy behavior often have depression, anxiety, phobias, panic attacks‰Ű¦.
When we postpone dealing with emotional upsets they get worse. When we take
away the substance or behavior that was blocking the emotions, they may take us
by surprise. Even if we quit drinking or drugging, the distress can manifest
itself in other behaviors.
While peer support (such as we get from meetings, forums)
may help it isnŐt likely to alleviate severe emotional distress. IŐve had long
conversations with a person who has successfully quit drinking by going to AA
meetings. But she cuts herself, and in my untrained opinion that behavior is
related to her previous drinking behavior (duh!). Dealing with the underlying
causes is likely to require a trained professional.
In my opinion, the belief that substance abuse results
from character defects may be misplaced or even counterproductive. There is an
element of self-blame involved when we judge our character and find it wanting.
It can lead to secondary upsets: being upset about the urges. Substance abuse
is unhealthy behavior, not a moral failing.
Unhealthy behavior is a series of choices, some of which
may seem as though they are out of our control. But when you take control of
each of the small choices, one by one, day by day, week by week, then you get
to a place where using drugs or engaging in the unhealthy behavior doesnŐt even
seem like an option to you anymore. Those choices include who we spend time
with, where we spend time, what we do in our idle hours, and what we say when
drugs are put in front of us.
Eventually it doesnŐt matter anymore whether others
consider it a reasonable or fun thing to do. Eventually itŐs just something you
used to do. It doesnŐt define who you are. This can be hard to imagine at
first, but urges diminish over time in frequency and intensity—when you
quit the behavior. And as the primacy of the urges and the physical discomfort
passes, you can deal with the underlying beliefs that caused you to engage in
that behavior in the first place.
and foremost, donŐt do the behavior.
the commitment, make the lifestyle changes, plan for the situations.
with the urges.
with the underlying beliefs and emotions.
be afraid to ask for help.
patient with yourself, and be persistent.
And to repeat the premise of this entire thread: longterm
sobriety has huge benefits that are worth the effort.
Whether you trust the pilot É or learn to fly the plane!