Waging war on worry
To wage war on your excessive worry, resist the temptation to try to solve every problem in advance of it happening. Try to live with doubt and realise that the most important thing is not what you specifically worry about but how you manage your worrying thoughts. Overcoming worry is the art of allowing thoughts to enter your mind without trying to ‘sort them out' or push them away.
Pounding on panic
Panic attacks are intense bursts of anxiety in the absence of real danger, and can often seem to come out of the blue. Panic attacks often have very strong physical sensations such as nausea, heart palpitations, a feeling of shortness of breath, choking, dizziness and hot sweats. Panic sets in when people mistake these physical sensations as dangerous and get into a vicious cycle because these misinterpretations lead to more anxiety, leading to more physical sensations.
Put panic out of your life by deliberately triggering off panic sensations. Enter situations you've been avoiding and resist using safety behaviours. Realise, for example, that feeling dizzy doesn't cause you to collapse, so you don't need to sit down, and that other uncomfortable sensations of anxiety will pass without harming you. Carry out a behavioural experiment (see Chapter 4) to specifically test out whether your own feared catastrophes come true as a consequence of a panic attack.
Assaulting agoraphobia
Georgina was afraid to travel far from her home or from familiar places she felt safe in, which are common characteristics of agoraphobia. She feared losing control of her bowels and soiling herself. She had become virtually housebound and relied heavily on her husband to drive her around. She learned about the nature of anxiety and developed the theory that, although she may feel like she is going to soil herself, her sensations are due largely to anxiety and she will be able to ‘hold on'.
To gain confidence and overcome agoraphobia, develop a hierarchy of your avoided situations and begin to face them, and stay in them until your anxiety reduces. This may include driving progressively longer distances alone, using public transport and walking around in unfamiliar places. At the same time, work hard to drop your safety behaviours so you can discover that nothing terrible happens if you do become anxious or panicky, and ride it out.
Dealing with post-traumatic stress disorder
Post-traumatic stress disorder (PTSD) can develop after being involved in (or witnessing) an accident, assault or other extremely threatening or distressing event. The symptoms of PTSD include being easily startled, feeling irritable and anxious, memories of the event intruding into your waking day, nightmares about the event or feeling emotionally numb. If you have PTSD you may be sustaining your distress by misunderstanding your normal feelings of distress in response to the event, trying to avoid triggers that activate memories of the event or trying too hard to keep yourself safe.
Fascinating phobias
One of the interesting things about anxiety problems is the wide variety of things that human beings fear. In our practice, we still encounter people with fears we've never heard of before. Crucially, what matters is not what you're afraid of but how negatively your fear is affecting your life.
Sometimes people are embarrassed by their phobias because they think others may find them silly or trivial. But extreme fear is never trivial - terror and fear can be very disabling, even if your fear is of something as simple as buttons. We suggest you seek out health professionals who take you seriously so you can get help for your phobia.
Common phobias include:
Acrophobia: fear of heights or high levels
Agoraphobia: fear of open spaces, crowded public places or being away from a place of safety
Aichmophobia: fear of pins, needles and pointed objects
Arachnophobia: fear of spiders
Claustrophobia: fear of confined or small spaces
Emetophobia: fear of vomiting
Haemophobia: fear of blood and blood injury
Lockiophobia: fear of childbirth
Noctiphobia: fear of the night and the dark
Trypanophobia: fear of injections
Less common phobias include:
Arachibutyrophobia: fear of peanut butter sticking to the roof of one's mouth
Automatonophobia: fear of ventriloquists' dummies, dolls, animatronic creatures or wax statues
Barophobia: fear of gravity
Bibliophobia: fear of books (if you've got this one, stick with us - you're doing well!)
Blennophobia: fear of slime
Lutraphobia: fear of otters
Lyssophobia: fear of going insane
Necrophobia: fear of death or dead things
Ombrophobia: fear of rain or being rained on
Soceraphobia: fear of parents-in-law
To combat PTSD, remind yourself that memories of a traumatic event intruding into your mind, and feelings of distress are normal reactions to trauma. Allowing memories to enter your mind and spending time thinking about them is part of processing traumatic events, and a crucial part of recovery. Many people find that deliberately confronting triggers or writing out a detailed first-person account can be helpful. At the same time it's important to reduce any excessive safety precautions you may have begun to take.
Hitting back at fear of heights
Begin to attack a fear of heights by carrying out a survey among your friends about the kind of feelings that they have when standing at the edge of a cliff or at the top of a tall building (see Chapter 4 for more on conducting surveys). You'll probably discover that your sensation of being unwillingly drawn over the edge is very common. Most people, however, just interpret this feeling as a normal reaction.
Put this new understanding into action to gain more confidence about being in high places. Work through a hierarchy of entering increasingly tall buildings, looking over bridges and climbing to the top of high cliffs.
Chapter 10: Abolishing Addictions
In This Chapter
Recognising addiction
Choosing to change
Overcoming urges and cravings
Making lifestyle changes to prevent relapse
Nowadays, the term ‘addiction' can be somewhat confusing. The word is bandied about to describe an unhealthy relationship with food, love, nicotine, adrenaline, pornography, gambling, and even relatively innocuous things like online gaming or pick'n'mix. For the sake of clarity, this chapter focuses mainly on dependency upon substances that aren't necessary, in any quantity, for survival - such as alcohol and illicit drugs. We also include gambling and pornography since these seem to be a growing problem with the advent of online gambling and pornographic websites. Even if your problem isn't with drugs, sex or poker, you'll still find information in this chapter that can help you to face up to and overcome any unhealthy compulsive behaviours you may have.
Putting a Name to Your Problem
Perhaps you're aware that your use of certain substances is causing problems in your everyday life and negatively impacting on your relationships. However, like many people, you may wish to deny the gravity of the problem.
Many people balk at the term ‘addiction'. Unfortunately, there's no denying that stigma is attached to addiction of any kind. You may think that you're weak, morally decrepit or just plain bad for struggling with a dependency. However, although some people may judge you harshly for your problem, bear in mind that you don't have to accept their judgement wholly or without scepticism. As we discuss in Chapter 14, you can acknowledge your addiction and choose to accept yourself as a fundamentally worthwhile person with a specific problem. Shame about addiction frequently prevents people from accepting that they've got a problem in the first place and thus stops them from seeking appropriate help. Don't fall into this trap. Hold your head up and look your addiction squarely in the face. You really need to acknowledge your problem before you can move toward meaningful recovery.
Having more than one substance or behaviour that causes problems isn't unusual. For example, you might have an addi
ction to alcohol and also smoke marijuana occasionally. Frequently, dropping use of one substance leads to increased use of another. Be aware of substituting your primary addiction or ‘drug of choice' for another one as you begin your journey to recovery. To truly overcome addiction you need to substitute your alcohol, drug or gambling use for harmless, healthy activities.
If you think you might have an addiction problem but aren't entirely sure, try answering the questions below. This short checklist can be used for both substance addiction and compulsive behaviours like gambling and pornography use. We use the term ‘drug of choice' (or ‘DOC' for short) in this checklist so that the questions make sense whatever your problem. Try to answer each question honestly; you don't need to share the information with anyone else at this point.
Over the past week, have you lost time at work because of DOC use?
Is your work performance suffering due to comedown, hangovers, lack of sleep or preoccupation with your DOC?
Over the past week, have you used your DOC even though you may have promised yourself to resist?
Are your finances suffering because of money spent on your DOC?
Over the past week, have you used your DOC at times of day when others may consider it socially inappropriate or unacceptable?
Do you find it very difficult to go for even one day (or a few days) without using your DOC?
Do you get irritable and/or feel low when deprived of your DOC for any reason?
Have activities that you once enjoyed been neglected in recent weeks due to DOC use?
Have you had any accidents or injuries in recent weeks due to DOC use?
Are your friends and/or family commenting about your DOC use or noticing changes in your behaviour?
Do you make efforts to hide or minimise your DOC use in front of friends and family?
Do you feel distinctly uncomfortable answering the questions in this checklist?
If you've answered ‘yes' to even just one of these questions, chances are you have a dependency that may well develop into a full-blown addiction. Answering ‘yes' to three or more items indicates that you do have an addiction. But don't despair! Recognising that you have the problem is an essential part of the ultimate solution.
To help you really acknowledge and accept that you have a problem, try writing it down. A single sentence is fine, such as ‘I, Marcus, have a gambling addiction'. Seeing the truth in black and white can often help you resolve denial and shame.
Addiction is really not that different to mental health or physical problems. You're certainly not alone. The world's full of people dealing with addictions. Many recover, and so can you if you're willing to put in the blood, sweat and tears required to do so.
Familiarising Yourself with the Many Faces of Addiction
Anyone can develop an addiction whatever his current circumstances or background. Certain factors stemming from childhood, such as having alcoholic parents or experiencing social deprivation, may increase the chances of developing an addiction but this outcome is by no means inevitable. Many people with solid careers and families also fall prey to addiction; they're not exclusive to those living in more chaotic environmental situations.
Often people start ‘self-medicating' an underlying mental health problem, such as anxiety or depression, with alcohol or drugs, or through behaviours like gambling. Substance use and engaging in compulsive behaviours (shopping, gambling, using pornography, sex, and so on) can take the edge off emotional pain in the immediate and short term. However, in the long term these strategies typically cause many more problems than they solve.
Consider the examples below illustrating three people with different addictions. These are merely snapshots; countless more types of people and possible scenarios exist, so don't worry if your situation doesn't fit neatly with any of them. Instead, focus on whatever does resonate with your particular experience.
Jack is 33 years old and works as a trader in the City. He enjoys his job but it can involve long hours and be very stressful. Though currently single, Jack hopes to settle down and start a family soon. Jack drank a lot and started experimenting with drugs while at university. At the time everyone seemed to be doing the same, so he didn't see his behaviour as a problem. Two years ago Jack started using cocaine at the weekends with his colleagues. Over the past year he's started using cocaine during the week and sometimes during his working day. Jack worries that, without cocaine, he'll have difficulty meeting the demanding pace of his job. Jack's last girlfriend ended the relationship because she disagreed with his drug use and grew tired of his mood swings. Jack is increasingly aware of his drug problem and the negative effects it has on his ability to form a relationship. However, he rationalises his addiction by telling himself that many of his colleagues use as much cocaine as he does, so it can't be that big a deal.
Kelly is a 45-year-old divorced mother of two, who works part time in a pharmacy. Kelly's ex-husband is often unemployed and is somewhat unreliable regarding childcare and maintenance payments. Kelly gets tired and overwhelmed looking after her two small children as well as trying to make ends meet. A few months ago she started taking strong codeine-based painkillers to ease migraine. She finds it easy to get the pills at work. Kelly now takes painkillers every day - whether she has a headache or not - because she finds that they calm her nerves. In the evening, she also often drinks a bottle of wine after putting the children to bed. Kelly worries that she's too dependent on codeine and alcohol but doesn't think she can cope without them.
Percy is a 28-year-old postgraduate student. He spends a lot of time in front of his computer and, when he needs a break from studying, he often surfs porn sites. Over the past few months Percy's porn use has increased and he finds it difficult to stop once he's started. Often he's up until the early hours of the morning with nothing to show for it in terms of academic work. His grades are suffering; he ends up sleeping late, misses lectures and sees less of his friends. Percy is deeply ashamed of his porn use and daren't talk about it with anyone. Some of his friends joke about porn surfing but Percy thinks that they'd consider him a ‘pervert' if they knew about his problem.
Jack is in denial about the severity of his cocaine problem. Kelly knows she has a problem with alcohol and codeine but she underestimates her ability to cope without them. Percy is riddled with shame about his pornography addiction and can't imagine sharing it with anyone. Denial frequently prevents you from facing up to your problem and making the decision to quit. Chances are that if you spend time every day trying to convince yourself that you're in control of your substance use - you aren't.
Believing that you won't be able to cope with life stresses and problems without your addiction to rely on also prevents you from seeking help to quit. Most of life's problems are actually much easier to find solutions for when you're clean and sober. You probably will go through a rough time when you first give up, it's true, but with time and effort you'll rediscover healthy coping strategies and adopt some new ones.
Shame prevents you from admitting your problem fully to yourself and stops you from seeking much needed support. Remember that all humans are flawed in one way or another. The person most affected by your addiction is almost certainly you. Hard though it may be, take appropriate steps to get help (more on seeking professional support in the next section). Your addiction is a problem, a big one, but it isn't the sum total of who you are.
Accepting Yourself and Your Addiction
Addiction carries a massive stigma. Rather than making rash global and punitory conclusions about your fundamental character on the basis of your addiction, however, try a little compassion instead. We're not suggesting that you let yourself completely off the hook for whatever you may do to maintain your problem or for the effects it may have on those around you. But taking personal responsibility for your addictive behaviour while still maintaining your sense of basic self-worth is possible - though it may well require persistent effort.
No matter how extreme
and all-consuming your particular problem may be, there's more to you than your addiction (see Chapter 14 for more on accepting yourself). Because moderate to severe addictions tend to affect all areas of your life, it can be easy to forget all that you were before your addiction took hold. You'll probably be pleasantly surprised by what you rediscover about your interests, values and personality once you kick the habit (see Chapter 18 on adhering to your values).
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