Cognitive Behavioural Therapy For Dummies
Page 16
Securing Suitable Support
Chapter 21 goes into detail about how to get professional support for your mental and emotional problems. The same rules apply for seeking addiction treatment. Extra points to consider, however, include replacement drugs like methadone for heroin addiction, and other prescription drugs that may reduce cravings for alcohol in the early period of abstinence. You may also want to discuss an in-patient rehabilitation programme with your doctor if you don't feel confident that you can stay clean and sober in your normal environment. Most programmes last a minimum of 28 days and can set your feet firmly on the right path.
If you think your addiction is masking an underlying psychological problem like depression, be sure to talk to your doctor about it. You may benefit from antidepressant medication to help you stop self-medicating with harmful substances. Most medical professionals will be familiar with all sorts of addiction and won't be shocked by whatever you tell them. Be honest and accurate about the extent of your use so that professionals can properly assess your problem.
Support groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are available pretty much everywhere. Many people find them a tremendous help. Even if you don't agree with everything a support group purports, you may still gain something from attending. Try to keep an open mind about recovery from addiction and make use of whatever resources are on offer - the AA, for example, offers a twelve-step recovery programme.
Deciding to Desist
Deciding to give up using alcohol, drugs or a compulsive behaviour is a large and difficult step. After all, your DOC has probably been one of your biggest (if not the biggest) coping strategies for a long time. As with Kelly, Jack and Percy's examples earlier on, you may doubt your ability to cope with stress in your life without a little chemical help. Equally, pornography or gambling may be the only way you know to relax and distract yourself from your daily cares.
You may resolve to cut down on your use before deciding to give up entirely. This approach can work - but may actually be even harder than opting for an initial period of total abstinence. Many people report that ‘stopping after one' is much more difficult than avoiding a substance like alcohol in the first place. The same holds true for gambling and related behaviours. It's hard to stop once you've got started.
Making a decision to stop involves really investigating the costs of your addiction and what you stand to gain by giving up. You need to clearly see that going through the discomfort of withdrawal in order to be addiction free will be worth it. The following sections help you to count the cost your addiction and reap the rewards of recovery.
Addiction is deceptive and powerful. You may find yourself thinking ‘maybe my problem isn't so bad' after a period of abstinence and be tempted to chance your arm at moderate use. Doing so is rarely, very rarely, successful - particularly where drugs and alcohol are concerned. So when your addiction whispers sweet-nothings in your ear and gives you those ‘come hither' eyes - remain strong.
Counting the costs
You may not be wholly aware of the price you're paying to maintain your addiction. The effects of drug and alcohol use can sneak up on you. Wittingly or unwittingly, you may have been denying, ignoring and minimising the negative impact of addiction on your life. Sometimes, not until you sit down and really think about it do you realise the full extent of the damage.
Figures 10-1 and 10-2 show how Jack and Percy worked out the costs of their addictions.
Use the Pricing-up Addiction form in Appendix B to work out the personal costs of your own addiction. List as many addiction costs as you can - however small. The better you understand the negative impact of your addiction on all aspects of your life, the greater your chance of sticking to your goal of giving it up. Review your list regularly to keep your motivation strong.
You can also use the Cost-Benefit Analysis (CBA) form found in Chapter 8 to help you weigh up what you stand to lose and gain from abstinence.
Highlighting health
Long-term health problems often result from excessive alcohol and drug use. Booking yourself in for a complete physical examination (including blood tests for liver function and so on) can be a very good idea in early recovery. As well as an overall check-up, your doctor may also be able to offer you additional support. In addition, a good old health scare can sometimes give you extra motivation to give up your addiction. Many of the health problems associated with excessive alcohol and drug consumption improve exponentially with length of abstinence. Thus regular health checks, as you continue with abstinence, may show positive physical changes and spur you on.
Even if you've been fortunate enough to escape any serious health implications, giving up drugs and alcohol is likely to make you feel much more physically fit and well. Sleep and appetite are likely to regulate and you'll probably feel generally more energetic and alert. You'll also look more healthy and vibrant. Your sex drive may improve too. So remember to keep the physical benefits of abstinence on your list of why gritting your teeth and carrying on is worth it.
Figure 10-1: Jack's Pricing-up Addiction Form.
Figure 10-2: Percy's Pricing-up Addiction Form.
Being honest about the benefits
Nothing's going to knock your negative feelings on the head like your DOC. That baby gives you much desired immediate relief and gratification. Unfortunately, it also gives you lots of longer-term generalised grief, hangovers, comedowns, mood swings, self-denigration, financial concerns and health risks. Lucky you. So yes, the benefits of your DOC are very potent but also very short-lived; the negative side effects of addiction typically hang around much longer. The trouble is that when you're trying to recover from addiction, the short-term benefits of using can seem very attractive and eclipse the negative effects in your mind. Being honest with yourself about the purpose your addictive behaviour serves is crucial; so too is investigating other ways of getting similar benefits without incurring the heavy costs. Over time you can develop a higher tolerance for negative emotions and everyday hassle without needing to turn to your addiction. Figure 10-3 shows how Kelly weighed up the benefits of using codeine and alcohol.
Figure 10-3: Kelly's ‘What does my addiction do for me?' analysis.
Transforming Intention into Action
Intending to give up an addictive behaviour can go on for a very long time. You may find yourself putting it off until conditions are ‘right' or when you feel ‘inspired' to do so. For example, you may think ‘once this work pressure is off I'll give up the cocaine' or ‘when I meet someone and want to start a relationship I'll stop using pornography' or ‘once I win back some money I'll knock gambling on the head'. If you wait for conditions to be perfect before you kick the habit, you may be waiting for a long time. Basically you're just giving yourself excuses to keep using.
If you know you ultimately need and want to give up an addiction, then you have little choice but to get on with it regardless of whatever else may be going on in your life.
Making a date
There's no time like the present. Try setting a firm date to quit. The earlier the better because you'll be less likely to go on a series of ‘final blowouts' that you may well regret. Decide on a date to quit, ideally within the next one to five days, and plan to stick to it. You may even find yourself looking forward to the challenge!
Cruising through cravings
When you first give up any sort of addiction you'll get cravings. Sometimes you may find them annoying but easy to shrug off and other times they may feel like a monster devouring you. To increase your chances of remaining abstinent, you need to plan for and expect very intense cravings. Follow the tips below to help you ride them out:
Know your triggers. Certain advertisements, environments and even people can trigger off your urge to use. Negative feelings and events can also make it hard to resist your DOC. Write down a list of triggers, when you know you're most at risk of relapsing, and plan what to do instead (see the next point).
Get grateful. Since most people engage in addictive behaviour to help forget woes and dissatisfactions, gratitude for what you have got can be a great relapse deterrent. Focus on the positive stuff in your life and think about how you can capitalise on it.
Get out that pen and paper again and make a list of at least 50 things you've got to be grateful for, however small they may be. (Yes, we said 50. You can find them if you look hard enough.) Review this list if and when you find yourself sinking into self-pity and hopelessness.
Gird your loins. Yes, cravings truly do suck. But lots of things in life are painful and you probably cope with many of them every day. Be compassionate with yourself but also firm. You're big enough to take the pain without welching on your commitment to yourself.
The more often you experience cravings and yet resist using, the more your confidence in your ability to stay clean will grow. You can start to pride yourself on having a high threshold for discomfort and give yourself well-deserved credit for your successes.
Cravings are normal! Giving up an addiction without experiencing cravings would be decidedly odd. Accept your cravings and don't mistakenly decide that they mean that you're destined to lose the battle! Cravings are not a sign of weakness; rather, they show that you're struggling forward.
Extending the time between urge and action
An old, overcoming addiction adage says ‘put at least half an hour between yourself and your money'. If your addiction requires cash to be realised, then make it harder for yourself to relapse by keeping yourself in self-imposed penury. If you need to go to the cash point before you can buy drink or drugs, you've got more time to talk yourself out of relapsing. Get rid of your credit cards so you can't gamble online. Treat yourself like a teenager who can't be trusted to spend your cash responsibly. In short, patronise yourself. You won't have to do this forever, but in early recovery making relapse as difficult as possible is sound sense.
Dealing with deprivation
When life deals you a particularly cruel hand and you're struggling with lots of uncomfortable emotions, being deprived of your DOC can seem a very hard loss indeed. You may find yourself hankering for the supposedly ‘good old days' when you could lose yourself in a haze of alcohol, drugs, gambling or whatever. Getting used to dealing soberly and constructively with stress and negative emotions takes time. Be patient with yourself but also firm. If you give into addiction at the first sniff of discomfort, you're unlikely to successfully kick the habit. It would be great if life just cut you some slack and gave you an easy ride during your early recovery; but life doesn't play fair all the time. We use the acronym ‘HARD LOSS' below to highlight some of the more common emotions and conditions that can pose a real challenge to recovery.
H: Hurt. Feelings of hurt often lead to a sense of victimisation and a desire to use. You may also feel a thirst for revenge: ‘I'll relapse and show them just what they've done to me!' The person you're really causing suffering to is yourself. No one likes feeling hurt but remind yourself that you've got personal responsibility for dealing with your feelings constructively.
A: Anger. As with hurt, the desire to reach for the bottle, pills or computer mouse can be extreme when you're in a rage. Remember that your uncomfortable feelings will subside on their own. Instead of picking up your addictive substance, take some vigorous exercise or remove yourself from the situation until you feel calmer. See Chapter 15 for more on managing anger.
R: Reward. ‘I've been good all week and I deserve a reward'. Don't mis-label a relapse as a ‘reward' drink or hit. Find other ways to treat yourself after a hard week at work or for completing a job. Plan ahead. Make yourself a nice meal or go out to the cinema.
D: Depression. People often want to drink or use drugs to escape the pain of depression and perhaps to temporarily relieve sleep problems associated with depression. If you think that you're depressed look at the strategies we outline in chapter 10 and seek professional help.
L: Loneliness. Feeling lonely can be a relapse risk. Especially during the early stages of recovery, scheduling in social activities and renewing friendships is important. Keep yourself in regular contact with friends and get out of the house at least a few evenings per week. Remind yourself that feeling lonely is uncomfortable and unpleasant but it won't kill you. So, you don't need to resort to your addiction as a means of escape.
O: Overwhelmed. When you're trying to give up an addiction you need to be realistic and careful about how much stress you can manage. You'll increase your ability to cope with stress without risk of relapse with practice. In the initial stages of recovery, however, trying to reduce your everyday stresses is prudent. Again, forward planning can really help with keeping life demands under some degree of control.
S: Stagnant. Oh, the curse of boredom. Letting yourself stagnate and get well and truly bored is a serious risk to your newfound sobriety. Keep your schedule varied and interesting to reduce your risk of turning to your addiction for entertainment.
S: Self-pity. ‘Poor little me; how I suffer!' Get a grip. We all suffer, struggle and feel the pain of this mortal coil. Ain't nothing special about you, sunshine. Don't allow your addictive urges to convince you that you need to use because you're so specially challenged in life. You're not. Recognise your personal difficulties and accept your problematic circumstances, both past and present. But saddle up and get back on the horse. Take courage and rise to meet your own personal challenges.
You can make recovery less onerous by reducing your propensity to experience unhealthy negative emotions in the first place. See Chapter 6 for information on helpful attitudes that promote healthy negative emotions and behaviours in response to bad events.
Putting positive obstacles in place
In early recovery you may need to avoid any opportunity or temptation to relapse like mice avoid cats - as if your life depended on it. Try to strike a balance between holding an ‘I can do this' attitude and going out of your way to eliminate potential relapse triggers. Giving up an addiction is hard enough when conditions are wholly favourable let alone when someone's metaphorically cracking open a bottle of whisky in your face. Be realistic. Give yourself the best chance of success by putting obstacles in the path of relapse. Here's how Jack, Kelly and Percy put positive obstacles in place.
Jack decided to tell his colleagues that he was giving up cocaine so they'd tackle him if he gave in and used. He also stopped carrying any money with him beyond enough to buy a sandwich at lunch. Jack also stopped going out after work with his drug buddies and instead made a series of after-work commitments to his family and clean friends. He deleted his drug contacts from his phone and computer.
Kelly got rid of her corkscrew and wine glasses so that she'd be inconvenienced if she found herself wanting to drink wine in the evening. She also told her colleagues and boss that she had an allergy to codeine-based painkillers to make it virtually impossible for her to buy drugs from work. Kelly also made some promises to her kids to go bike riding on specific weekdays knowing that she'd be very unlikely to give in to drinking and let them down.
Percy cut up his credit cards and moved his computer into the living room of the shared house. He also put parental blocks on the Internet so that, even if he found himself alone in the house, he'd have to go through a series of settings to access pornography. Percy also made plans to cook for his housemates twice a week to take his mind off porn use and re-engage socially.
Get a pen and paper and write down all the possible positive obstacles that you can put between yourself and your addiction.
Leaving nothing to chance
Fingers crossed, God willing, touch wood, if the fates allow it . . . Overcoming an addiction isn't a matter of luck. You may find yourself thinking, ‘Hopefull
y I won't feel like drinking when I go to that party tomorrow.' Fat chance. Either don't go to the party and do something else that you enjoy instead, or drive to it so that you can't drink. With addiction, forewarned is forearmed. Don't make the mistake of clutching a rabbit's foot or counting magpies. Take responsibility for your addictive behaviour and make the necessary arrangements to avoid caving in to temptation.
Creating constructive conditions for continued recovery
Overcoming addiction in a meaningful way (one that's going to last) involves lifestyle changes. Reinvesting in previously enjoyed activities and addressing neglected chores are part of overhauling your lifestyle to avoid relapse. You may also benefit from expanding your interests and increasing your involvement with groups and causes that have nothing to do with your old DOC. Keeping busy (but not overloading yourself) can really help close the gaps that your addiction previously filled. Consider pursuing some of the activities below: