Oddly, it was something a client had never asked me before: "What makes me leave the comfort of my home, forsaking my wife and my kids, to drive an hour to spend three days getting high in a crack house?"

The simplicity of the question, the desperation I heard in his voice, shook my well-practiced counseling equilibrium. Well, I countered, why did he think he did it? He had no good answer. Nor, on the spot, did I. Five years of counseling should have prepared me better for this moment, but as I groped for some wisdom, the only thing that came to mind were clichés: Fish gotta swim, birds gotta fly, alcoholics drink and addicts get high. Or, in five words: what we resist will persist. I wondered if there is an answer as simple as the question. Was the "why" of addiction all that important for this victim of relapse?

Not really. So, in a moment of inspiration, I decided to shift the conversation from remorse to rehearsal for the inevitable next time. We began to focus not so much on the "why" as on "what" - event, feeling or trigger - had started him back down that familiar self-destructive path. Could it be that his ability to cope with life's stressors had been overwhelmed by circumstances and he simply acted on the ever-lurking thought to use a mind-altering substance to change how he felt? More importantly, when he experienced that familiar whatever, "what" could he have done in response to cope and ask for help? Those were the real questions, I realized.

We delved further into the how of his latest demoralizing relapse, which he admitted was a threat to his marriage and livelihood. The relapse had created significant tension and stress in his life, and he even suffered a hematoma in his calf from squatting in the crack house while using. I pointed out that our sources of stress are internal and external.

Common internal stressors include the baggage of our pasts and any trauma we have experienced - impulsive and irrational thinking, which can prompt harmful behaviors, such as promiscuity, gambling, and compulsive spending, to cope with undiagnosed or untreated mental illness; negative self-talk, also known as stinking thinking; and the inability to reason or think a situation through versus responding to a stimuli.

External stressors are perhaps, easier to identify and relate: pressures of the job; raising a family; paying the bills; and not having time to decompress and recover from all the demands of daily life all are external pressures that up the ante of the hand dealt to us by stress. 

From there our discussion segued to the "Big Lies of the Disease of Addiction," and that these are actually untruths we tell ourselves. The top three are: I really wasn't that bad last time. It'll be different this time. And, in a take off on the old Lays potato chip commercial, I can have just one.

I've come to refer to these insidious self deceptions as the "Shuns" that prevent recovery: Minimizashun, Rationalizashun, Justificashun, and Manipulashun. Which alcohol-dependent person hasn't attempted to low-ball the number of highballs he used to drink? Which drug-dependent person hasn't underestimated the bong hits she took, or the lines of cocaine or the bags of dope he consumed? Manipulashun is probably the most insidious of all "Shuns," as many suffering with the disease of addiction learned to manipulate others to get their perceived needs met in a dysfunctional dance of "survival." The net affect is to be "shunned," alright, cut off from ourselves, our loved ones, coworkers and the rest of society. The "Shuns" can serve to push a person deeper into isolating behavior, never seeking the help readily available, and, as my client said, "forsaking my wife and kids."

But that's what addicts do when they don't know what else to do. Consider that many men in our society have difficulty asking for directions when lost while driving their vehicles. Is it logical to think that a man shamed by his disease of addiction would somehow miraculously and instantaneously find the capacity to ask for, and open himself to getting help? Asking for help and expanding the network of persons a client can reach out to in moments of crisis is critical in preventing relapse. But it's a learned behavior - a habit that replaces an earlier and more destructive one. A client in detox once told me that the phone was light as a feather when he called his dealer to deliver drugs, while the receiver was tantamount to a 600-pound gorilla when he needed to reach out to others for help.

To sum things up for this client, I drew the diagram below on a white board. Maybe, I thought, a picture is a simple way to attack a complex disease:  

There are no simple or easy answers to my client's question. Addictions speak to us like drill instructors, and without tools between us and our preconditioned response we jump to obey the old compulsions. But in avoiding relapses, it's not the "why" of it so much. Rather, it's the "how." When we hit that moment of truth, it is the techniques we have instilled in ourselves in how to cope and how to ask for help, that strengthens our recovery - or puts it back on track.

This article is published in Counselor,The Magazine for Addiction Professionals, December 2006, v.7, n.6, pp.46-47.

Comments

Add New Search RSS

Write comment
Name:
Email:	do not notifynotify
Title:
	Please input the anti-spam code that you can read in the image.

Powered by !JoomlaComment 3.26

3.26 Copyright (C) 2008 Compojoom.com / Copyright (C) 2007 Alain Georgette / Copyright (C) 2006 Frantisek Hliva. All rights reserved."

---