The professor described how one of his mentors, a therapist, had a plastic blow-up beer bottle in his office. Inflated, this bottle of brew was about 6 feet tall, and more than a foot across. It took a fair chunk of space in the corner of the therapy office. The therapist would refer to it when he had a couple come for therapy presenting with problematic alcohol use in the relationship.
The reality of addictions is this: Almost always, when someone expresses a concern regarding an addiction, the person who is accused of the problem minimizes and belittles the issue. Often, the person who experiences the most pain of addiction most overtly is not the addict him/herself. Rather, the one who is most vocal about the pain of addiction is the partner/parent/child of the addicted person. The person addicted to a substance or behavior also experiences pain creating the need for the addiction and resulting from the addiction, but one feature of the addiction itself is denying this pain.
My professor described how the therapist worked with this couple—the wife was convinced that her husband’s use of alcohol was devastating in their marriage. The therapist asked her to position the bottle where she best felt it represented its presence in their relationship. The wife leaped up to claim that monstrous bottle and plunked it in the middle of the loveseat between them. She sat back down, squished into the corner of the two-seater couch—because there was now very limited space for her.
The therapist asked if there was anything else to sculpt this scene to further depict the relationships between the couple and the bottle. She again nodded. Without hesitation, she took her husband’s hands and pulled them so that his arms were wrapped around the bottle.
As he embraced the bottle and she perched uncomfortably on the far end of the sofa, she said with pained and weary satisfaction: “Yes, this is what my marriage feels like.”
◆◆◆
Very simply, addiction is when a person:
Finds temporary relief from pain or discomfort or experience pleasure from a substance/process/activity
Experiences cravings for the activity/substance
Subjects themselves to long term negative impact by continuing this behavior
Has an inability or lack of desire to stop despite the negative consequences[11]
Addictions are an attempt to deal with pain by not dealing with the pain. They create a bigger problem even as they are an attempt to solve the pain problem.[12]
The paradox of addiction treatment is this: To deal with the addiction, one has to deal with the very pain that one has been avoiding by having the addiction in the first place. The pain felt overwhelming or there weren’t adequate resources to deal with it prior to the addiction and the addict still does not have the internal resources.
The route out of addiction is to learn to deal with the pain. That is daunting. Exponentially disheartening and discouraging. Additionally, an addiction is hard to stop. The body is used to the substance and needs it. Withdrawal can be agonizing.
Sobriety seems too much. To quit is too hard. Often, previous efforts to stop using the substance or activity has been a miserable failure. It just seems the attempt to stop again is to set oneself up for failure and create yet more pain. Failure hurts. So much of addiction arises out of people despising themselves and being disappointed in themselves. Repeated failure to stop the addiction further feeds into this self-hatred.
Addictions can reach a threshold where it becomes intolerable. The impact on a person’s life is devastating:
Getting fired from employment
The credit cards reach their limit, and the line of credit is maxed out
Losing your license for a serious driving violation
Your spouse leaves you
A medical crisis with a narrow escape from death
Sometimes, people call this hitting bottom—when it seems the only option is to pursue treatment.
Often, though, there isn’t an enormous tragedy that precipitates the crisis. Rather, it’s a slow dawning, or a point where a person just says, “Enough”. It may seem no different from a thousand other moments, but this time, it feels distinctive:
A person is sick and tired of being sick and tired
The weight gain has continued, and you aren’t willing to go up yet another pant size
You have had enough of the four walls of your basement and you desire more out of life than just clicking the buttons on a video game controller
The substances mellow you out and have pulled you out of life in a way that you’re no longer willing to tolerate: no more missed promotions, no further lost opportunities for a relationship with a partner, or no more missing the pursuit of goals that align with your values.
◆◆◆
One hallmark of addiction is that there is negative long-term impact. Your overuse/misuse of a substance, compulsive spending or use of pornography, etc.:
is threatening the end of a relationship
has your children distance themselves
strains your finances
preoccupies you to the extent that you don’t attend to the necessities of life
impacts your health
has you feel worse about yourself (which is numbed for a short while when you engage in the addictive behavior only to reappear with a vengeance after)
Talk to any person who has fought the hard-won battle to reach sobriety and maintain it. They will tell you it was hard but worth it.
◆◆◆
This book generally is about helping the reader make an informed and wise choice regarding therapy with a counselor at a clinic. This chapter on addictions encourages you to choose the appropriate treatment, which may not always be having one counselor with whom to talk. For an addiction, the right level of intervention may be a treatment center, a hospital program, inpatient detox, or a remote residential setting. A counseling session once per week may be woefully inadequate.
Seeing a therapist weekly to get a handle on late night shopping that has gotten out of hand may work. Talking to a counselor about how much fast food you’ve taken to eating may be the right venue. If the addiction’s hold is not longstanding and the person is able to recognize the hold of the behaviors early, less intensive intervention may be sufficient. Booking sessions with a therapist at a clinic may address those behaviors and the underlying pain that those behaviors intend to relieve.
However, there are other situations, when you are struggling with addictions where counseling will only throw a bucket of water at a raging fire.
While not useless, counseling may be inadequate to treat a long-standing entrenched addiction. Much more intensive treatment may be required.
Yes, this means that more friends and family will be aware of your situation. To attend a treatment program of some sort:
means a heavy financial investment, perhaps a leave of absence from your job, or losing your job altogether
implies it will become more public that you have an addiction
will also make more public that you have the courage and desire to do what it takes to get the help you require.
Reaching out for help is admirable. It invites support. It is an indication of character strength.
If upending your life gets you on the road to getting your life back, isn’t that worth it?
◆◆◆
Some forms of addictions:
have danger during the withdrawal period
are tenacious in their grip
have been in place for so long it requires that significant support during withdrawal and early recovery
require radical withdrawal from the community and the supply of the substance
necessitate a significant amount of support that a counseling office is not in a position to provide
◆◆◆
If someone gave you this book because they recognize that addictions come between you, pay attention. If they say your use breaks their heart or makes their life miserable, listen up. Their experience isn’t right or wrong: it’s true for them. Their experience
of how you related to a drug, alcohol, work, shopping, video games, pornography, food, sex, or _______ is valid for them. By dismissing their experience of your addiction, you dismiss them.
Relationships cannot survive dismissals indefinitely.
As you care about the one who loves you, allow their perspective to impact you. Trust that the very circumstances of addiction mean that it can be difficult for you to identify how you and the people that surround you are impacted.
Nobody approaches a person to accuse them of addiction without serious misgivings. The brave and loving person who approached you did so because they care enough to risk a hostile reaction, to meet your resistance. They expected it was likely that you would ridicule or shame them.
The person giving you this book with lines highlighted in this chapter didn’t expect the reaction would go well and they did it anyway.
Because they care about you.
Can you let that land on your soul?
◆◆◆
Johann Hari, a journalist, has spoken with many of the top addiction experts in the world. He has given a TED talk and written about addictions. I think his most quoted line is this:
“The opposite of addiction isn’t sobriety. The opposite of addiction is connection.”[13]
Sobriety is important, to be sure. But it is not possible to underestimate the significance of connection. We all need:
a place where to belong
a space where we can make known some of the ugliest parts of ourselves and rather than receive judgement, feel a response of compassion
someone with whom we can bounce ideas—where the spinning thoughts have a place to unwind
a safe place to share pain, to learn how to hold our own pain, to have someone to trust with hearing the pain.
A therapist, either in a treatment center, detox center, or clinic can be the entry point to finding that journey toward meaningful connection. When you are meaningfully connected, you will find ways of holding your pain as the compassionate presence that occurs in connection allows you to learn.
Expect that the therapist will encourage you to broaden the circle of connection—a single therapist is not sufficient to support a person on the path out of serious addiction. Besides writing in a journal or reading or other solitary activities, therapists are likely to encourage group therapy, Alcoholics Anonymous or other support groups, a treatment center, and/or family therapy. It’s important to bring others into your healing journey. You will feel uncomfortable, you will resist it, but connecting with family, friends and others who struggle is essential.
Treatment won’t be easy, but you will get your life back.
26
Counseling with Couples: If you aren’t both happy, it isn’t a happy relationship
Couple/family therapy is a unique conundrum because it involves more than one person in the client unit. Both have to agree to create the consensus for couple therapy to begin.
This is the problem: The very reason for therapy is that the two of you have some trouble understanding and collaborating with each other.
The two of you are having trouble understanding each other and working together—and now have to get on the same page to go see a therapist together.
◆◆◆
It often strikes me we live in a culture that believes in prevention. We:
get oil changes for our cars
go to the doctor and dentist for checkups to address problems in our bodies and teeth
get insurance in case our house burns down
set timers on our phones so as not to forget things
have an alarm on our smoke alarm to warn us when the battery needs replacing.
There are so many checks and balances to help us stay on top of things to ensure our safety. We believe in problem prevention. We address issues when they are small so as not to allow them to get away on us and create much greater quandaries down the road. So why do so many couples allow their relationship to deteriorate for years without tending to it? We consider an intimate partner relationship to be the most important relationship in a person’s life. Why does anyone let it fall apart under their noses? Why does anyone push away the wounding and let it fall apart behind their backs?
◆◆◆
We also recognize the need for experts:
I go to a:
Hairstylist to cut my hair
Mechanic to fix my car
Lawyer to draw up a will
Real estate agent to sell my house
Doctor to tell me what the pain means and what the recommended treatment is
Teacher to instruct my children on trigonometry and calculus
Why wouldn’t I also go to a relationship expert to help me when my relationship is showing signs of deterioration?
◆◆◆
My husband, Jim and I, made an agreement with each other when we got married: If either of us says we need to go see a marriage therapist, the other one is obliged to cooperate with the process. No exceptions.
Frankly, it is more likely that Jim will pull the trigger on seeing a therapist.
Here’s the deal: I work with words and conversations and relationship dynamics for a living. I know my way around a marital conflict like nobody’s business. It’s my job. We have discussed the possibility that without my realizing it, I could talk him out of his feelings. Or I might work my way out of a situation in a manner that slights him and do it without either of us even noticing it. This disadvantage he has because I am a therapist means that our relationship could become unfair for him and I might not even be aware. He might not even understand what is happening. He’d just know that it wasn’t good. For that to happen falls outside of my values. I don’t want to hurt him deliberately or inadvertently. Intentional and unintentional pain hurts the same.
I want Jim to love our relationship. I hope that if I am doing something destructive without being aware of it, that he will call me on it, on his own, or with the help of a therapist. So, when I heard friends had this understanding, I thought it would be great for us to adopt it, too.
If either of us feels:
in over our head,
repeatedly that we aren’t heard,
something critical in our relationship is missing and our efforts to figure it out are unsuccessful,
something isn’t working and nothing is working to get it working again,
then we will go to a therapist together.
Even if we:
don’t want to go
are embarrassed
think it’s silly
We will go to couple therapy, regardless of our discomfort or distaste, because we have decided in advance our relationship will be more important than our desire not to go to a therapist.
It will be difficult for me to go see a therapist in our city. I know a lot of the more experienced ones personally and so to identify a suitable counselor for us will be a challenge. Our agreement makes sure that I won’t use this challenge as an empty excuse not to go to counseling should he feel it would be valuable.
◆◆◆
Going to a couples therapist is often something one partner doesn’t want to do. However, the request from the partner doesn’t arise in a vacuum. The request signals a distance that exists that can’t be overcome, or that a rupture has occurred that hasn’t been repaired.
Saying no therapy isn’t just saying, “Don’t make an appointment.” When a partner disregards the request for therapy, the implication, however unintended is this: “My discomfort/dislike for therapy is more important than your concern or hurt regarding our relationship.”
That is a painful message to receive.
It’s a dangerous message to send.
It’s a catastrophic way to live.
Therapy is uncomfortable. We are getting to the end of a book whose content explores why this discomfort is worthwhile. Most don’t anticipate a therapy appointment like an evening out or a special date. When you reject this uncomfortable act of therapy, the i
mplicit message is that you don’t value the relationship more than you dread the discomfort.
◆◆◆
A therapy session with me has unfavorably been compared to a root canal. People mention this to me with a chuckle, but they aren’t joking, really.
I had a root canal once. It was most unpleasant. Several needles in my mouth with freezing, digging around in my gums in ways that were uncomfortable and felt unnatural. I hated the sound of that drill in my mouth—second only to the feeling of the vibration of said drill throughout my skull.
Yet, as much as I didn’t like that root canal, I was grateful once it finished. The pain that had me awake at midnight, rocking in my bed in agony, disappeared. I could eat and sleep normally again.
The root canal wasn’t comfortable, but it was effective in solving an important problem. It allowed me to actually live my life again.
If I need another root canal, I won’t be happy. But I will readily go.
And if your partner asks you for couple therapy, can you say, “Yes” in the same spirit as I said, “Yes” to a root canal?
It might surprise you that counseling likely won’t be about blaming you, or scolding. If you don’t like the way therapy unfolds, you need to let your therapist know. Collaboration between the three of you will be key to couple therapy success. You will shape the therapy sessions along with your spouse.
Hell No to Hmmm, Maybe Page 19