- Do you value and respect yourself and what you’ve accomplished thus far in your life?
- What have you been telling yourself about you?
- Why do you make the choices you do?
- Do you occasionally overdo it when it comes to using substances, gambling or engaging in excessive behaviours?
- Do negative consequences seem to follow every decision you make?
If you have quickly reflected on the questions above and concluded that; “Wow! I’m fabulous! I’m focused on achieving my goals and I maximize my potential with every breath I take. My life has never been better.” you can stop reading now. You have little to learn from the answers I present.
For everyone else, we’ll talk about the questions in a moment. First, though, a word about ‘denial’
Many of you would accept the premise (for other people, never for yourself) that sometimes people are less than honest with themselves and others when the subject of problem behaviours or substance use comes to the fore.
You fib to yourself about the extent and consequences of using substances or engaging excessively in certain behaviours. And then, that little fib grows up and becomes your truth. This is not to say you intentionally lie to yourself. No – you believe the lie wholeheartedly. The lie is what sustains you. And of course, the lie is what makes talking with you about it so mind bending for others.
Denial’s function is to make it possible for us to engage in what at times is shocking behaviour without a true appreciation of the magnitude of it all. The mind is capable of presenting the facts to us in a minimized, seemingly insignificant manner
Once you have developed a powerful relationship with a substance or behaviour and can’t imagine life without it, you can’t seriously challenge the lie or it would threaten your ability to continue the behaviour unchecked. If you allowed yourself to see what others see, your sense of shock, even horror would be so overwhelming, the acting out would have to stop immediately. And of course, at some level, you do see the magnitude but denial helps you dismiss it or blame it on someone else.
The only change you want is for the bad stuff to stop happening. And so the lie grows.
“Well, it’s not as bad as my wife makes it out to be.”
“I’m not in trouble with booze, Roger drinks more than I do; he’s the one with the problem.”
“I know I crashed the car but it wasn’t because of drugs, the other guy cut me off.”
“These shoes fit perfectly. I know I have a few pairs that are similar but these fit much better.”
Honesty, the shear unvarnished truth about yourself and your behaviour is pushed out of the frame. My hope is that you will beard the lion in his den and tackle the questions without any of the usual omissions or embellishments (blaming others, making excuses, ignoring, denying, disputing the facts, etc.) See yourself, honestly, through your own eyes without resorting to the usual rose-coloured glasses.
SO…… Let’s Get to Those Answers and What They Could Mean to Your Life.
1) Do you value and respect yourself and what you’ve accomplished thus far in your life?
This question speaks directly to your feelings about your self-esteem at this moment in time. It also asks you to think about yourself and accomplishments as a journey in progress. Are you happy with the journey so far? Has the path led to a person of value in your estimation?
We have all experienced self-esteem slippage from time to time. It’s usually a nudge to give ourselves a tune-up, or at the very least, review our goals and find out what isn’t working and how we can address the situation.
Let’s take a look at some of the indicators of low-self-esteem. Can you see some of these tendencies in yourself?
- Unsure about yourself – who you really are, what you really believe and what you truly value
- Unable to trust others
- Unable to freely express your opinions, needs and feelings.
- Having problems with interpersonal relationships
- Problems with anger. Too little expressed anger – too much expressed anger
- A powerful need for approval and acceptance
- Never feeling “good enough”
- Easily frustrated and overwhelmed by life’s issues. Always saying “I can’t…”
- Feeling depressed, anxious, inadequate.
- Needing to control – manipulating people
- Rescuing, pleasing, enabling
- Looking good on the outside, dying on the inside
If you recognize some of these indicators as problems in your life, you’re probably wondering how to make improvements in self-esteem.
Changes to boost your self-esteem:
- Change distorted thinking. You ask yourself; “Is what I tell myself factually true or is it exaggerated and catastrophic?” If it is not factually true, list all of the possibilities that could be true in this situation with special emphasis on the positive. You have power over “I never get it right.” I’m so lazy.”
- Accept personal responsibility and stop blaming others for your choices and decisions.
- Identify self-defeating behaviours and begin to change them. Buy one piece of cake and enjoy it. Stop buying the whole cake, eating it and hating yourself as a result.
- Accept your feelings. Feelings are never wrong. Feel your feelings and practice self-control over your reactions. You are in charge of you.
- Work on your communication skills. A book or a course on Assertive Communication would be a real eye-opener for you.
- Work on interpersonal relationships. Stop isolating, get to know a few people, invite someone out for coffee, and spend time with the people you admire, not the losers who help you feel better about yourself because they are in much worse shape.
- Re-connect with your partner and kids. Make time for fun and family activities.
- Don’t forget about words and phrases like – appreciate, thanks, I love you, I’m so sorry, I apologize, that’s my fault, I forgive you. I hope you’ll forgive me.
- Change what you can and accept the rest. Building self-esteem is a process of change and acceptance that continues throughout your life.
- Become a person you, yourself can trust. Build integrity.
If you’re unhappy with your level of accomplishment, do you consider yourself worthy of success? This can be a key issue for many. You go into an action expecting to fail, and, big surprise, you do. Sometimes you need to reevaluate what success means to you. Are you comparing yourself to someone like Bill Gates and expecting the same results? When you find you’re not quite as ingenious as Bill Gates, do you judge yourself a complete failure?
See yourself as worthy and then do the work! Set reasonable goals along a timeline and celebrate each and every success, even the smallest, along the way.
“How will I feel when I’ve improved my self-esteem?”
- You will like and respect yourself as a person of character and integrity.
- You will know you matter and you will feel ready and capable of success.
- You’ll be much more optimistic.
- You will live as an independent person who enjoys others but does not need someone to save you. You will happily build interdependent (equal) relationships with others.
- You will know when unhealthy relationships must end.
- You’ll handle conflict and solve problems in a much more effective manner. No more overwhelming, crazy-making situations. Problems will be solved with compromise, not just shouted about and endlessly repeated.
- You will know yourself as a good person who cares for others. No more navel-gazing. No longer devoting 100% of your time focused only on yourself. Here’s some really big news – It’s NOT all about you!
- You will accept your accomplishments and look forward to your future goals.
- You’ll have dreams, aspirations, and hopes that you’ll know are within your grasp with time and work.
- You’ll expect and give encouragement.
- You’ll have healthy coping skills and no longer rely on mood-altering substances or other excessive behaviours to numb unpleasant feelings or artificially create good ones.
- Finally, you’ll be able to put problems, concerns, issues and conflicts into perspective without guilt and personal recriminations.
2) What have you been telling yourself about you?
This question goes hand in hand with issues of low self-esteem. Part of the reason you lose your sense of confidence and your self-esteem takes a hit, has to do with what’s going on in your head. Do you recognize your use of the following?
- Constantly criticizing yourself, your worth, your efforts and your accomplishments. Everyone is better than you – smarter, more energetic, better results, a better family and looks better. Let’s face it – everyone is better, period. This constant refrain sets you up to anticipate nothing but negatives in your life.
- Giving up before you’ve really tried. You are always so sure of failure that you feel hopeless, helpless and powerless to do anything about the situation. You let life roll right over you.
- Worrying about the future. “What if-ing” yourself constantly. Imagining the very worst that could happen and then thinking about it as though it were fact. Catastrophic thinking is poison to the soul.
- Thinking that you should be better than you are, more perfect, only serves to focus your attention on your perceived flaws. If the goal is perfection you’ll always lose. Perfection is unattainable.
- Are you constantly draining your reserves of motivation with procrastination? Sometimes procrastination is caused by the mental fatigue generated by imagining how you will complete the task, perfectly. Any degree of motivation is frozen solid in the presence of: “I should…., I could…., my boss expects….., anyone in my position would……, or, I’ll never be as… “
- Give yourself a break. “Just a little bit more than enough is by far, much too much.” was a favourite saying of my husband’s father when he observed others applying the perfectionism law to themselves. Stop being excessive and driving yourself to a goal that doesn’t exist – establish a standard of ‘enough’.
There are many things over which we have no control. Self-talk isn’t one of them.
First you need to catch yourself spewing this contamination into your brain. Immediately counter the thought. Argue with it fiercely and then replace it with a positive affirmation that is reasonable and within the realm of possibility. “I can handle problems as well as anyone.” “I have a job that I’m good at and that fulfils me daily. “ I feel supported by family and friends.” “My business is growing daily”. You literally re-program your brain.
People ask: “What‘s the point of rattling something off in my brain if I don’t believe it?” You may have heard the expression: “Fake it until you make it” This statement is, quite literally, true. Repeating positive statements will, in time, become your truth. It’s as if your brain throws out the old CD and replaces it with a much more positive and up-beat CD. STOP repeating all of those negatives to yourself. Don’t tolerate it, support it, or believe it – and certainly, don’t give it any space at the table.
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3) Why do I make the choices I do?
Is your response, “I don’t know?” Give me a break! I submit you do know but are feeling very ambivalent about making changes of any kind. Saying “I don’t know” lets you off the hook quickly, no harm, no foul and it’s on to the next thing.
When your self-esteem is wounded and you’re awash in negative self-talk, it’s not surprising when asked a sensitive question you shut down with “I don’t know”. This is the easiest of all statements to make when you ‘don’t want to talk about it’. It also serves the purpose of allowing you to stay in denial.
The truth is, you make the choices you do because you feel you are getting benefit from them. They’re working for you! Sometimes the benefit is numbed feelings, an absence of worry, and freedom from conflict, name your poison. All of those fears, all of that pain you would be feeling is completely anesthetized. Substances and excessive behaviours take you out of conscious reality. They reward you with artificial feelings of power, success, attractiveness, control, intimacy and belongingness. They allow you to feel good about yourself, at least for the moment.
So even though the consequences of your behaviour may be catastrophic, when you remove yourself from reality, all thoughts of more consequences piling up are banished along with the pain from which you’ve been suffering. Ambivalence about removing or modifying the substance or activity in your life or changing it in any significant manner makes sense when observed from this perspective. Staying stuck, takes you off the hook.
A decision to do nothing “until you know more” is just a decision to stay stuck where you are.
All you really want to change is the trail of negativity and pain that follows your behaviour. The real question is how long are you going to absent yourself from facing the consequences and moving forward in your life in a positive and healthy manner.
Perhaps you need help in sorting through the possibilities before any change is undertaken. You really aren’t going to know what your options are until you’ve discussed the realities of your situation with a non-judgmental ally. That requires you take your head out of the sand and fully and honestly face your truth about where you are in your life and where you will be if nothing changes.
We all know, unconsciously or consciously, why we do what we do. If you don’t admire or respect what you do or who you are, work with a therapist who can help you understand that a part of the reason you make these destructive choices is to continue staying numb and avoiding the question.
4) Do I occasionally (or frequently) overdo it when it comes to using substances, gambling or engaging in other excessive behaviours?
If your answer is well – maybe a little, sometimes – then it’s time to decide if something has to change. You must determine the extent to which your use of the substance/behaviour is impacting your life, health, work and relationships.
Not surprisingly, denial is once again rearing its ugly head. Are you telling yourself the truth or are you blaming, minimizing, and rationalizing? After all, no one pours a drink down your throat, drags you to the casino, or flashes the well-used credit card time and again. You do that all by yourself.
Undoubtedly others impact your life but how you respond is entirely your responsibility. You may decide what has to change but never instigate the behaviour of change. It is usually fear, even terror, which impedes any movement toward change. It’s much easier to keep on procrastinating for ‘just one more day.’
Your reasons for a lack of action may be different. Whatever they are, no doubt, they’re excuses by any other name. The best way to get yourself in gear is to visualize what your life could be like with some degree of change. Imagine all of the benefits you can possibly think of.
Change is easy, but requires persistence. Also, mistakes will happen. This idea that someone is a total failure, a complete loser if a slip or fall happens, is fundamentally ludicrous. If you need to make some changes in substance use, gambling, or spending, get some help with the process so you’ve set yourself up for success.
5) Do negative consequences haunt your every move?
If your answer to question (4) involved some degree of over-doing it with substances, gambling or spending, then your answer to question (5) will also involve a mental list of the fallout. How much you “over-do” has a direct bearing on the number and extent of the negative consequences you’ve experienced. Sometimes people imagine that negative consequences mean huge problems like legal charges or convictions, looming bankruptcy or sleeping in the street over a heating vent. And, of course, these are extremely serious negative consequences.
The term negative consequences also pertains to the day to day costs of continuing your problem behaviour, such as unhappy, resentful family members, employer distrust or worse, hours engaging in the behaviour that should be spent on your responsibilities, serious health concerns, financial difficulties, feeling ill and tired day after day, deep feelings of guilt, shame, regret, grief and loss, the list is endless, literally.
This question will, hopefully, get you thinking about the real reasons you’ve experienced so many problems or crises. Frequently people blame their partners, children, employers, bankers, anyone but themselves. As long as I can convince myself that these problems are caused by others or, failing that, the hand of fate, itself, I can justify my behaviour. And so, once again, denial is in play. I must be able to validate my behaviour to myself in order to permit myself to be impervious to the obvious state of affairs that is so evident to everyone else. Negative consequences are the direct result of your involvement with a substance or activity. Undoubtedly, they will continue to haunt your every move until you make some changes.
I hope you have found these 5 questions and their answers helpful to your situation. Sometimes talking them over with an objective third party makes a big difference in how you view your world and life experiences. It is always useful to get someone else’s point of view even if you disagree. A problem shared is a problem reduced by half.
Please remember, I can help you today – not tomorrow or next week – today. Set up your 15 minutes of free consultation time by giving my office a call, Toll Free at (866) 770-1939. I look forward to speaking with you.
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Lynn Gibbs, MD - Pin Oak Clinic
19255 Park Row Dr, Ste 203 & 106, Houston, TX 77084
Imagine you’re taking the bus to work one morning. You just happen to hear the two people behind you talking.
Person A – “Did you hear about Janet? What a nightmare for her family!”
Person B – “I sure did. It’s the talk of the whole office! You know her dad’s an alcoholic, right? So it’s no wonder Janet is too.”
Person A – “Yeah! No wonder. I heard they’re trying to talk her into going away for treatment, you know, rehab. It’s a disease. You’ve got to go to rehab to get the treatment.
Person B – “I heard Janet’s still in denial and everyone at home is fit -to -be -tied about what to do. I saw “Intervention” last night. That’s what she needs. Just get in the limo and go. I bet she won’t go.”
Person A – “I’m glad no one in my family has ‘it’. Jeez, the genes you’re born with sure can wreck your life.”
Aren’t you glad your office is just ahead?
As a culture, the above dialogue is still pretty much what we hear, believe to be true and perpetuate. In other words, addiction is a ‘disease’ and as such requires a medical intervention – ‘treatment’ at a medical ‘rehabilitation’ centre. I hope to broaden your knowledge base considerably so the next time you hear a conversation like the one above, you will be able to intervene with some sorely needed facts about the causes of addiction.
What Causes Addiction?
Addiction results from a complex interaction of physical, emotional, social, and environmental influences. The combination of factors is different for everyone. It’s important to stress that addiction is never the result of a single factor, say, biology, alone. As the factors at play in an individual’s life vary, so does the level of risk. In other words, the conditions which combined in one person’s life and later resulted in addictive acting out are, undoubtedly, different from the factors that will put someone else at risk.
What Are These Individual Factors that Interact?
- Genetic vulnerability plays a small role. Biology can never, by itself, explain addiction. It’s worth repeating, addiction is complex and multifaceted. If addiction was present in the family of origin, do the siblings begin drinking because of their genes or because they were raised in a hard-drinking household and simply believed their lifestyle reflected normal family life? If one child in this family remained abstinent for life, to what do we attribute this? It becomes the “nature versus nurture” debate, or, if you like, the “Which came first the chicken or the egg?” debate.
- One’s emotional well-being, social factors, and past learning experiences all play a significant role. Social learning is considered a very important factor in addiction. It includes patterns of use in the family of origin, peer pressure in adolescence and advertising or media influences. Think about emotional well-being for a moment. Doesn’t it make sense that the more mature, resilient, socially connected and capable you are, the less vulnerable to addictive acting out you will be.
- Personal characteristics: The qualities that make you the person you are – interact with the people, events and day to day stresses of your life. Perhaps at one time having a drink, gambling or shopping made you feel more positive, less anxious and fearful, more in control. If having that drink also contributed to increased feelings of confidence, attractiveness, assertiveness and vitality, it’s entirely possible that enjoying the experience predisposed you to repeating it at the next opportunity. We can all relate to the idea of repeating what we have previously enjoyed or found to be positive in our lives.
- Increasing involvement, (More using it/doing it). Perhaps you began to experience a need to stay involved with the substance or activity for longer periods of time. Perhaps you found yourself reaching out for your substance or activity in a greater number of stressful or social situations. Before long you arrived at a feeling of not being able to tear yourself away regardless of your responsibilities. You began looking forward to it and searching for more opportunities when you could justify it.
- Addiction occurs: The substance or activity becomes your habitual response in almost every situation. Negative consequences begin to accumulate in your life.
The behaviour that once seemed to support you through many of life’s experiences begins to turn against you. Without it, you experience craving. Unpleasant consequences begin in accumulate in your life.
What Are the Distinguishing Features of Addiction?
People frequently argue about who is addicted and who might just have a problem. How can you tell for sure?
Quick Answer: You can’t. This is one of the consequences of the disease or medical model. If you have a problem, you don’t have “it”- the disease. It has become a black/white, you’ve got it or you don’t issue. If you have “it” then treatment at rehab and lifelong abstinence is your only option. You will have “it” for the rest of your life. Problems, as we understand the common usage of the word, can be solved. This is one of the reasons people so fear the label of being “addicted.”
Just before we go over the distinguishing features of addiction, I feel it’s important to note that the greatest amount of damage to life, limb, productivity and personal contentment in our society is caused by those who “just have a problem”. Sometimes we get so caught up in absolutes, in black/white issues, we don’t see the forest for the trees. It’s not the label, it’s the behaviour and the negatives adding up in someone’s life that we need to pay attention to.
Several of these features will be present with addiction. Remember, we are individuals. People have different features of the disorder.
The urge, the craving, the overwhelming need, to engage in the behaviour whether it be using alcohol, drugs, gambling or any other excessive behaviour.
Preoccupation, Obsession or Fixation:
The individual can’t stop thinking about the behaviour. It battles with thoughts that reflect his or her better intentions, but eventually the urge to engage in the behaviour rules the day.
Despite every intention to stop or cut down, the behaviour happens over and over again.
The individual has experienced many negative consequences when engaging in the behaviour. Employer threats, family quarrels or breakdown, legal and financial hardships, tremendously embarrassing or endangering situations to self and others, all fail to bring about lasting change.
The “This time will be different” refrain leads the individual into yet another repetition of the same old pattern.
“Just one or at the most two” is heard over and over again. An individual may be able to control the behaviour in certain high demand situations like having dinner with the employer, but he or she can’t guarantee it 100% of the time. Usually it’s a no-win situation.
If you’re measuring your own behaviour by the above list of telling behaviours, make sure you’re being scrupulously honest with yourself. This is the time to stop rationalizing, minimizing and denying your behaviour. What others are telling you is true.
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Lynn Gibbs, MD - Pin Oak Clinic
19255 Park Row Dr, Ste 203 & 106, Houston, TX 77084
If you’re reading this article I can almost guarantee that you’re not terribly interested in any discussion that features research findings on brain imaging or reward pathways. My guess is you’re seeking an explanation of the WHAT, WHY and HOW of addiction that makes sense to you. You’re hoping for one of those epiphany moments when the fog lifts and all is revealed.
The question being asked is
“Addiction: What is it? Why me? Why can’t I just stop? How come it showed up in my life and not in the life of my neighbour or my sister?”
I hope my words will enlighten you. Having had a relentless longing to understand these questions as they related to me personally fuelled my interest and years of study deepened my understanding. But definitions do not necessarily square with insight. I hope my attempt to put clothes on the definition will further your understanding of what is meant when we use the word ‘addiction’.
The Burning Question: What is Addiction?
The World Health Organization defines addiction as:
“a persistent, compulsive dependence on a behaviour or substance. Addiction has been extended to include mood-altering behaviours or activities…”
As you can see from the above definition, today it’s more helpful to take a broader view in order to more fully understand exactly what we mean when we speak of addiction. Think of addiction as a process of increasing desire that expresses itself in different ways through many different objects – alcohol and other drugs, gambling and spending, excessive exercising, shopping, working, gaming – even eating, as so many of us already know.
Increasing desire means that a relationship is developing between you and your substance or behaviour. It’s an intensely powerful relationship without which you cannot imagine living your life. The power of this relationship is so strong that it drives all else from your mind’s eye. You crave it relentlessly, persistently and without relief until you succumb to its demands. You repeat this pattern over and over again regardless of the wreckage it creates in your life and the lives of others.
Addiction describes an out of control relationship with an object of desire. The individual feels an overwhelming urge to engage in using the substance or doing the activity and therefore it continues over time in a repetitive pattern despite the negative consequences to self and/or others. Preoccupation, craving and negative consequences are hallmarks of the disorder.
And here’s the kicker. It’s not the substance or activity that causes addiction although it can unquestionably be said that certain substances lend themselves very easily to addiction, it’s the RELATIONSHIP, the level of desire that creates the situation of craving, compulsion and negative consequences.. If you want it desperately enough in your life, it is, for you, addicting.
Addiction, as a behaviour can be quantified. Think of it as a condition which resides somewhere on a scale from 1 to 10. At the 1 level, the involvement with the substance or activity is low. At the 10 end, the individual is in serious trouble and the effects of the behaviour being acted out are transforming his or her life. An individual can find his or her niche anywhere along the scale. Indeed, much of the debate within families can be tied to where on the scale individuals are placed by themselves and others. Rarely, is there agreement. There is no set point on the scale at which we can say the person has crossed the line into addiction territory. That point is different for everyone. Addiction is no longer thought of as a single, static disease entity – once you’ve got it, you’ve got it for life. You can move up or down the continuum. More addicted, if you will, at one point in time until you take some action to change your placement on the scale.
One can be more severely addicted than someone else, in other words, at or close to 10 on our scale. With work and a desire to change, however, this individual might well move from, say, an 8 to a 3 at which point addictive acting out is no longer an issue.
Before you roll your eyes and click another link on your computer let me say emphatically that all of this discussion about scales and placement matters not one whit. All you really need to know in order to understand if you have a problem is to ask yourself if you crave your substance or activity obsessively and once you succumb; you’re transported to a different place and time. After the event, there are the negative consequences to cope with that cost you and loved ones dearly. The costs in fact are grave – lost family, job, money, self-respect and on and on it goes. Despite your very best intentions, the cycle begins all over again and plays out each time in a very predictable fashion. Craving, loss of control, persistence and compulsion and ongoing negative consequences becomes the pattern of your life.
Ask the question “Why not me?” Everyone, and I mean everyone, can be vulnerable to addiction at some point in time. The more coping skills and supports in your life, the less likely vulnerability will have you reaching out for the same favoured substance or activity time and time again. You will be utilizing more effective methods to solve your problems and you will not be battling it out alone.
Again, I repeat: Everyone is vulnerable to addiction at some point in their life. When you’re battling stress and that feeling of desperation wells up in your gut, your level of vulnerability is escalating. The more adept you are at handling stress and the more resources and supports you can call on to help you, the lower your risk of spiraling into addictive behaviour. Remember, addiction is all about an intensely private and personal relationship. It’s just the two of you, together again. When you’re feeling stressed you seek comfort in what you know from experience works. If you reach for the same pacifier each time, the attachment grows. Soon it will be the craving that signals reaching out for the trusted friend. Before you know it, that friend is your greatest enemy.
Why Can’t I Just Stop?
Think about this for a moment. If every substance or activity were inherently addictive, then WE WOULD ALL be spinning out of control with something. This does not happen. Believe it or not, there are people who occasionally use heroin or cocaine and do not become dependent on it. Certainly no one would suggest you try such a thing, but it’s none the less, quite true. The heroin or cocaine addict, on the other hand, has a much different relationship with the substance than the occasional user. Life depends on it, not just to escape withdrawal, but to escape a life without the relationship.Addiction is not about the substance or activity at all. Addiction is the active back and forth engagement (relationship) you have with YOUR substance or YOUR activity. You are not passive in this relationship. It’s not that the ‘something’ has you in its grip. You have each other in a grip. And when that ‘something’ is not there, you crave and obsess about it until the situation is remedied. First cigarette, first sip, first bite of double -fudge cake. All of your earthly cares vanish in that moment. In what seems but a moment, you are swiftly returned to reality and facing, with horror, the calamitous results. Choruses of never again are heard. Promises are made again. Then the craving dragon breathes fire on you and once again you say: “This time will be different. I’ll control it this time. I’ll just have one or two.”
Here we go again. And the results:
- The father who leaves his kid sleeping in the car while he gambles his paycheck away.
- The obese teenager who’s feeling sick with shame and the discomfort of her physical body, who will have to face the hideous remarks of her peers at school.
- The grandmother who drinks herself into oblivion while the two year old rifles through cleaning liquids under the sink.
We shudder in disgust. This is what addiction is. This powerful relationship that’s really impossible to adequately describe has the power to destroy lives and relationships like nothing else. And so when someone says, “just stop”, I hope you now have some idea of why that seems so impossible to someone who’s addicted.
I should also note that the three examples I’ve given above are people who have been addicted for some time. They are at the extreme end of the scale. If our scale measures behaviour from, say, 1 to 10, they would be close to the 10 end.
The more extreme your behaviour and the more negative consequences that are piling up around you, the more addicted you are. And yes, it’s possible to be mildly addicted. Let’s use our gambler again. Let’s say that it is only recently that his family has noticed he’s away from home more than usual. Sometimes, the older kids have to baby sit when he doesn’t come home early. His wife has noticed that a bill wasn’t paid on time and makes a mental note to inquire about it. Compared to the behaviour of our gambler above, the second example shows that consequences have begun – hours away from home, a slight shortage of money, not available to be with the little ones when mom is at work and the teenagers are playing hockey, but the relationship the gambler has with his activity is not nearly as all-powerful as gambler number 1. The downward spiral has begun. It will be up to the gambler himself how far into addictive living he goes.
What is Addiction?
I’ve used up a lot of your time and my energy to explain that… “Addiction is an out of control behaviour with a substance or activity. Craving drives the behaviour and it results in increasing negative consequences. The pattern is repeated persistently over time.”
I hope this article has increased your understanding of this highly complex and multifaceted problem.
Business Results 1 - 5 of 1
Lynn Gibbs, MD - Pin Oak Clinic
19255 Park Row Dr, Ste 203 & 106, Houston, TX 77084
Have you ever wondered why you keep drinking, gambling or engaging in compulsive behaviour when you know it’s causing calamitous difficulties in your life and in the lives of those around you? Have you wondered if you have a bad habit or even – hold your breath – an addiction?
I’m going to speculate that your answer is…“Yes, I’ve wondered countless times and I still haven’t figured it out.”
Let’s consider a question or two to help you make sense of the senseless.
What happens when you first think about your substance or behaviour?
When the notion of using a substance or engaging in a certain behaviour first occurs to you, do you feel a pull toward the idea that is very pleasurable? Do you suddenly feel energized? As your anticipation grows stronger, do unpleasant feelings like anger, boredom, fear or loneliness begin to fade away?
If you answered “yes” to this question, you have your first clue as to why you keep repeating problematic behaviours despite getting into trouble with yourself and others, time and time again and why it’s a good idea to begin to consider how habits differ from addiction.
Habits don’t generate feelings of need – no anticipatory energy, no urge to jump right in. A habit is a routine action of any kind that you repeat on a fairly regular basis. The costs and benefits are about equal. Habits can be good or bad.
Addiction, on the other hand, is a relentless urge. You crave it even though experience has proven time and again that partaking of the experience is equivalent to lighting the fuse of a bomb. The resulting explosion of negative consequences will cause suffering to yourself and others. The costs are much greater than the benefits. An addiction feels wonderful in the moment but the rest of the experience is downhill. There are very few “good” addictions.
When does a habit turn into an addiction?
Behaviour can be quantified. It’s a matter of degree – one drink or ten, one bout of reckless spending or many. What is the extent of the behaviour?
We can measure the degree of the behaviour on a continuum or scale.
It might look something like this.
Now let’s imagine at the 1 end, not much is happening and as we move along the path to the 10 end, the behaviour we are measuring is getting bigger, stronger or more intense.
Let’s measure the behaviour of, say, drinking.
One drink is very different than ten. Gaining one pound is less significant than gaining ten or twenty pounds. Let’s look at it the other way around. Traveling down the scale from having five drinks in an evening to one or two represents a big change in drinking behaviour. Traveling down the scale from being ten pounds overweight to only one pound is a change any dieter would celebrate.
Continuums flow back and forth. You can travel up the continuum from 1 to 10 or down the continuum from 10 to 1. And, of course, you can use any set of numbers you like.
How you feel about the behaviour is incredibly significant in terms of future decisions you might make. If you really like the behaviour or feel you need it, chances are good that you’ll travel up the line – from one drink to, perhaps, four or five.
If the behaviour is so-so or ho-hum, chances are good that you’ll travel down the continuum. Instead of washing the dishes three or four times every day in order to keep your kitchen neat, you might decide that once would be sufficient.
The benefits, real or imagined, are important in your decision-making process.
What is the strength of your desire or need to engage in the behaviour? How desperately do you want to do it?
Is it a take it or leave it relationship or do you feel a compelling need to engage in the behaviour? Is it an “I must have it” – “I must do it” relationship that is growing stronger, more powerful every second as you consider it?
At the lower end of the continuum, the behaviour (using or doing) is occasional and probably, appropriate. There is no intense relationship developing – no feeling of needing – that keeps growing stronger? This is the territory of habit.
At the mid to upper end of the scale, extreme desire and an intensely powerful pull has developed between you and your behaviour. Wanting or craving it keeps driving you to continue despite any negative consequences that might occur. It feels as if you’re out of control, as if you’re powerless over your own choices and decisions. And of course, dear reader, you are not out of control. It just feels that way. Endlessly giving in to the temptation could be a set up for addiction.
- A habit is a routine pattern of behaviour that doesn’t generate a feeling of need or craving.
- An addiction is a behaviour (using or doing) that is relentlessly persistent. Craving is intense and you begin to justify the benefits and deny the costs. Negative consequences damage your life, health and relationships.
Habits reside at the lower end of the continuum. Habits do not generate a life or death need to continue or escalate the behaviour – no overwhelming desire.
Addictions, on the other hand, cannot exist without craving, that feeling of overwhelming need. These behaviours exist at the mid to upper end of the scale and wreak havoc in your life.
It’s really important to note there is no magic spot on the scale that shrieks “addiction”. The point of no return does not exist. Your own actions and the resulting consequences, positive and negative, provide all the information you need as to the state of your relationship with a substance or behaviour.
We are all creatures of habit: brushing teeth, getting exercise, going to work, being on time, etc. Forming habits is a normal and necessary behaviour of humans. Routine habits add structure and shape to your life. They reflect your pattern of day-to-day living. You don’t feel an overwhelming desire to engage in these daily habits, you perform them as a matter of routine from which you derive some measure of benefit, if not distinct pleasure. Habits don’t exact extreme costs. You might not like a habit very much but you feel it’s a worthwhile or necessary routine and you’re willing to continue – preparing your tax return, for example. Your relationship – the intensity of your desire is low.
Let’s consider one or two examples.
Keeping your body strong and healthy through good nutrition and exercise is an excellent habit. The benefits are many, the costs very few. Some days it’s tough getting started on your program but you feel good about yourself when you’ve finished. There’s no reluctance to stop. There’s no craving to begin again. A normal habit.
Feeling compelled to work out at the gym five times a day because you feel a kick of pleasure and positive expectations as soon as you think about the gym is not a normal habit. As soon as craving comes into the mix along with negative consequences, addiction is present. You feel an overwhelming compulsion to go to the gym well beyond doing so for health or fitness. An extremely strong relationship between you and the activity has developed. I know of one individual who had to make nine trips to the gym daily. Despite the fact that he had virtually no time for anyone or anything else, he still insisted that without this pattern of attendance his health would suffer. Just imagine what other areas of his life were suffering because of his extreme need to go to the gym the prescribed number of times.Purchasing needed items for the home and family is a normal, day to day behaviour, a necessary habit.
If your home is in mortgage default and you’re facing bankruptcy because of your needless spending behaviour but you keep on doing it anyway because you feel driven to escape negative feelings regardless of the costs to you and your family, we can say quite certainly that this behaviour has gone well beyond habit. The shopper is driven and gets a kick – a high- from acting on the preoccupation of shopping. Craving the activity is present. Negative consequences have almost taken over this individual’s life.
Remember, the power of the relationship and the necessary step of giving in to it is what drives the behaviour despite any negative consequences that may follow. The behaviour feels like it’s controlling you, not the other way around.
The Continuum is not static. There is movement up or down, as has been said.
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Let’s consider another few questions.
- Which direction, up or down on the continuum do you think would be more difficult to achieve? Why?
- Where would you place the addiction point on the continuum? Why?
- What is the agent that propels someone up or down the continuum?
Let’s see how you did:
- Down is the more difficult direction. Remember, it’s about the strength of the relationship. You have an intense relationship with the behaviour. The craving urges are so strong that you continue to engage in the behaviour despite mounting negative consequences. Working on your own to change your behaviour might result in damaging your level of confidence if you keep going back to the behaviour time and time again. I often hear people say; “It’s no use, I’ve tried to quit a thousand times.” There are evidenced-based techniques that have proven very effective in instituting and maintaining behaviour change effectively and quickly.
- There is no discernible point on the continuum at which we can say you have crossed over a line into addiction. Neither can we say definitively that you have crossed the line out of addiction territory unless your behaviour has moderated to an appropriate level and you’re able to maintain it, with or without some level of difficulty. You are an individual. You are not stamped out as an identical widget to all the other widgets. After getting some help, an individual brought his level of engagement down from a 9 to a 2. This represents a very successful change in the problem behaviour for this individual. Whether he or she stays in the moderate range remains to be seen. There are no guarantees that the behaviour won’t escalate again. Most people feel better about their chances of maintaining their positive changes if they follow a few strategies that guide them safely along.
- The agent that propels change in an upward direction is positive expectations and need. You feel you need the drink, gambling or shopping behaviour and you expect it to be a positive experience. Conditions such as stress, conflict, isolation, boredom and many other emotions can cause habits to escalate. We all seek some expression of comfort when we are hurting; a drink, a quick trip to the mall, another piece of cake or an online game of poker seems, in that moment, an innocent diversion. But a habit can become an addiction if it is used excessively and persistently to cope with situations or intense emotions. You seek comfort in what you know. But if what you know is also causing harm, it is time to learn a more effective and healthy coping strategy.
Small changes in your placement on the continuum are happening all the time in your life. You only notice it, (or others notice it for you) when the behaviour in question is escalating due to cravings. Negative consequences begin taking a toll. When this happens, craving is driving the bus. Or perhaps what’s noticed is a lessening of the behaviour. Negative consequences are no longer an issue and cravings have become much less intense. In this case, you’re driving the bus and it feels really great.
The agent propelling you down the continuum is once again need – a very different need than above. You recognize you’re in very serious trouble and understand even bigger, more costly consequences will result if change, however reluctantly begun, is not accomplished. The need for change in a downward direction calls for persistence, a high degree of motivation, a belief that it is possible, compassionate support and a therapist to help you acquire the skills and strategies to expedite the process in a timely fashion.
The behaviour loses its power as you move down the continuum to a moderate level. The relationship is no longer extreme. It has lost much of its intensity.
Our Key Point:
It’s the relationship you have with your behaviour of choice that determines its frequency, quantity and duration. How powerful is the desire for you to have it or do it?
But, and it’s a big but: You are not powerless.
Always remember, if you don’t give in, the cravings and urges will lessen over time.
If you do succumb to the desire, the next time craving rolls into your awareness, it will be bigger, stronger and more difficult to resist.
Take it or leave it experience – no craving, no escalating negative consequences — no problem. This is a habit, good or bad, but not an addiction.
Must do it/must have it relationship – severe craving, many negative consequences — big problem. You are engaging with your behaviour of choice at the upper end of the continuum and you are flirting with addiction.
Bottom line:” If I must have this experience regardless of the negative consequences, at any price to myself or others, because of the craving, I must say addiction is a strong possibility”
Do you remember the question that was asked at the beginning of this article?
“Why do I keep drinking, gambling or engaging in other compulsive behaviours the way I do even when I know that it’s causing calamitous difficulties in my life and the lives of my family members?”
Our Answer :
“You behave the way you do because craving is driving the bus. Even though you feel desperate and guilty about the behaviour, you feel compelled to engage in it. You give in. As a result, craving builds and the negative consequences continue.”
By using a continuum, a simple up and down scale, I hope you can see that habits and addictions begin life as a single entity – a habit. But the rate of the behaviour can move along the continuum in either direction, quickly or at a snail’s pace.
Addiction is no longer thought of as a static entity – once you’ve got it, you keep it for life, as was once believed Habits and addictions are subject to change just like everything else in this wild world of ours. Just because habits and addictions CAN change, doesn’t mean they WILL change. Habits can stay habits for life with little change. And as sad as it is to think about, some people might choose to do nothing about their problem behaviour and remain addicted.
Perhaps you’re already pondering an obvious question, namely:
Why Aren’t Negative Consequences Enough to Instigate Change? How Bad Does it Have to be Before I Kick My Butt into Gear?
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Lynn Gibbs, MD - Pin Oak Clinic
19255 Park Row Dr, Ste 203 & 106, Houston, TX 77084