It’s Okay

It’s okay to disagree. Really, it is. It’s fine. I’ll get you started: Chocolate is the best flavor. If you agree with that, how about this one: baseball is the best sport. Or, punk rock is the best music genre. There you go, three statements and most people will likely disagree with at least one of them. How was it to disagree? It was okay, right? Everything is fine?

So candy, sports and music are different than moral issues, but the disagreement is the same. We don’t have to agree on moral issues. Whatever experience or biology in my life that influences my preference for chocolate, baseball and punk rock differs from your experience and biology that influences your dislike of chocolate, baseball and/or punk rock. Our opinions develop from our experience and biology.

If you remember back to the time before digital photography there was camera film that needed to be developed. I don’t know the chemistry behind that process, all I know is it is a process and took some time to accomplish. Our opinions develop in a similar fashion. Opinions are unique and individual. So why can’t we accept that and feel comfortable disagreeing?

My preference for punk rock doesn’t demean or destroy your preference for country or pop music. Nor does my opinion on moral issues demean or destroy your opinion on moral issues. Right? It’s okay to disagree.

Hitting Rock Bottom

I want to take you on a visualization trip, so sit back and make yourself comfortable, now close your eyes… Just kidding. Keep your eyes open and continue reading, please.

Imagine we are out in a field and there is a deep hole next to us. It’s not a wide hole, but it is deep. As we stand on the edge looking down the shadows are too dark to see the bottom, but we assume there are some nasty jagged rocks down there. Rock bottom.

You might mention to me while we stand above this hole that you’ve noticed something amiss in my life and you are concerned for my welfare. I may reject your observation and thank you for your concern. Perhaps you push it and suggest I seek help to make a change in my life. Maybe I say “you’re not the boss of me” and turn away.

What happens next?

If you follow traditional thought about addiction you might say, “Well, I can’t help you unless you hit rock bottom, so…” and then push me into the hole.

If you have ever used the “rock bottom” approach, it’s okay, you were probably doing the best you could in that moment, only please don’t do it again. Remember imagine moving on? Until a person begins to imagine a new future there likely won’t be much change. I’m suggesting that hitting rock bottom will not bring about that new future vision in any useful way.

I believe the idea of a person needing to hit rock bottom before they can make a change, such as overcome an addiction, is totally bogus and dangerous. Again, if you’ve said it, or done it, no judgment from me. We don’t know what we know until we know it, even then sometimes it takes a while to recognize we know it. We can’t change what has happened in the past, we can only prevent it from happening again in the future.

Back to the visualization. We are standing next to the deep pit and I have turned down your suggestion of help. If you believe I need to hit rock bottom, you will push me towards it, even if unconsciously. By denying me healthy help (which is incredibly difficult to identify and provide, I know! More on this in the future) you are allowing me to drift towards that rocky bottom if not pushing me there directly.

So you say the “rock bottom” part and I turn away and take a step closer to the edge and lose my footing. I catch myself at the mouth of the hole and hang on by my finger tips. I ask you for help now that I see the precarious state I am in and you repeat the refrain, “You need to hit rock bottom before you will make a change.”

You deny helping me when I am a few feet away, when all that is needed is for you to take a knee and reach out a hand. Instead, you watch, or turn your back so you don’t have to see, as I lose my grip and fall into the pit…or you put your foot out and tap my forehead with your toe after saying “You’ll shoot your eye out, ho, ho, ho.”

I fall deeper into the pit, further from your ability to help. As I fall I ponder our relationship while confusion and injury creep over the love and attachment once felt, like a mold. Finally I hit rock bottom, we were right, jagged rocks. I lie in a bloody heap, isolated and abandoned, or at least that’s how it feels. I yell up to you, possibly from a gurney in an emergency department, hopefully not from a pine box. “I hit rock bottom,” I say.

Put that on pause for a second. At the same time I’m experiencing this change to my perception of our relationship, you are doing the same thing. It probably didn’t feel right for you to leave me to hit rock bottom, but that’s what the professionals said, so you let it happen. And now you are experiencing dissonance. The quickest way to resolve the dissonance is to change how you classify me, thereby tearing apart the fragile bond between us. Resume.

Justified in your beliefs, you now say, “Great, grab my hand and let’s get out of here.” We both reach, with all our might, but can’t quite cover the distance.

That’s how I see the whole “rock bottom” thing. I don’t like it and don’t recommend it as an approach to helping someone dealing with addiction. Why punish pain? If feelings of disconnection lead to addiction then how can disconnection help to overcome addiction?

It’s like fighting fire with fire. The phrase suggests that we strike back at an aggressor with whatever method the aggressor has employed. Taken literally it paints a different picture. When was the last time you saw a fire engine pull up and the firefighters strap on flame-throwers and go after the blaze? Never? Fighting fire with fire isn’t practical and would likely make things worse. We use water or other agents to extinguish the consuming flames.

Fighting addiction (which may be more accurately labeled a symptom of disconnection) with disconnection is fighting fire with fire. The best you can hope for is that your fire will use up all the fuel and oxygen so the other fire dies. Death is the best outcome from fighting fire with fire.  This doesn’t mean you sell your house to fund someone’s heroin use, but maybe you spot them $20 if you can manage it. Heresy! No, just being human. You see, the thing about addiction is that the drug doesn’t actually matter. It’s not about the drug. The drug does not cause addiction. Substance or behavior is only part of the equation, and it seems to be an interchangeable part, meaning it could be alcohol or crack or pornography. Substance/behavior + past experiences + current situation = addiction.

So I just tore apart the “rock bottom” approach, or at least said I don’t like it, now what? Unfortunately there is no easy answer. Using the fire fighting analogy, water is the usual approach to extinguishing fire, but not always. Instead of letting someone hit rock bottom I’m going to suggest compassion and love, radical acceptance and unconditional forgiveness. Those aren’t tangible behaviors, however, so the specific what’s and how’s are going to vary case by case. As long as the methods follow this approach I have hope it will be successful. Remember, addiction is a symptom of disconnection, or dislocation. Compassion, love, radical acceptance and unconditional forgiveness are the remedies for disconnection and dislocation.

There are so many thoughts here that I want to expand upon, it’s going to take some time. Someday I plan to write a book called We are All Sick Things: a call for radical acceptance and unconditional forgiveness. So expect a post on here by that title sometime soon. In the meantime, please stop pushing people into pits with rocky bottoms. It isn’t good for them or for you. Literally or figuratively.

Imagine Moving On

And while she tries to help them get on with their lives, she knows, better than most of her colleagues, that there isn’t much help she can provide. Until they’re ready. Until they’ve already begun to move on, or at least to imagine moving on. That’s when a little nudge can go a long way. The Biology of Desire, Lewis, 2015, p.69

The she above refers to a woman named Natalie whose story is shared in The Biology of Desire, written by Marc Lewis, wherein it is explained neuro-scientifically why addiction is not a disease and shares the personal accounts of several people who have battled addiction. The book is fundamental.

When I started work in the field of addiction treatment I was brand new to the topic. I’ve seen people addicted to substances and behaviors, I’ve experienced addiction-like behaviors myself, and I’ve studied psychology. General psychology doesn’t cover addiction much, however it did allow me to study the brain and social psychology. When I started planning for a Master’s program I narrowed it down to Industrial/Organizational psych or substance abuse counseling. I went with I/O. I provide this background to make the case for the evolution of theory I have experienced.

My first job in the field was as a clinician at a medication assisted treatment facility for opiate dependence (I’ll use opiate though there is a technical difference between opiate and opioid; I think opiate is more generally recognized). Medication assisted treatment is directed by a doctor who prescribes Methadone or Suboxone (Buprenorphine plus Naloxone) to treat the withdrawal symptoms of the individual who is experience opiate withdrawal. I’ll get into MAT in another post. I have some thoughts on that topic. For now I’ll say that working in that environment I was exposed to the theory that addiction is a disease, and only that theory. I accepted it at first. It made sense.

Until I started thinking about it, and read and watched videos on YouTube from Gabor Maté and Marc Lewis. I changed my mind. I no longer believe addiction is a disease any more than I believe playing guitar is a disease. Imagine Moving On isn’t about defining addiction though, so dust off your flux capacitor because we are headed back to the topic!

I like Back to the Future references, a lot, so you’ll see them often in my writing, and sometimes they are more relevant and obvious than others. Since the topic is future related, I think this one landed.

Imagine Moving On. This phrase popped up a few times in The Biology of Desire and ever since I read it it has been bouncing around my brain. I think it is a very pure and simple statement on how to start overcoming an addiction. If addiction is an unhealthy pattern of behavior, then it stands that imagining a new behavior would be the start to change. Addiction thrives in sameness and routine. I’ve taken to calling it being comfortable in discomfort. That is adapted from someone I read recently, but I don’t recall who so I can’t cite it. Addiction becomes the comfort zone. The bond with the substance or behavior, as unhealthy as they may be, represents safety.

But it isn’t safety and it isn’t comfortable and it isn’t healthy. Spending the day hustling money or drugs in order to obtain the drug of choice only to use, have at most a few hours of supposed comfort, and then repeat the process is counterfeit safety, comfort and health. It becomes familiar, and that’s what gives the sense of safety, comfort and health.

In my experience it seems that this uncomfortable comfort zone is so powerful that it becomes difficult to imagine any possible difference, like really truly believe something different is possible. At least early on, and then over time with maturation and other changes it becomes more possible to see a different future.

Here’s another quote from a book, a different book than the last:

The addict dreads and abhors the present moment; she bends feverishly only toward the next time, the moment when her brain, infused with her drug of choice, will briefly experience itself as liberated from the burden of the past and the fear of the future – the two elements that make the present intolerable. In the Realm of Hungry Ghosts, Maté, 2008, p. 272

“The burden of the past and the fear of the future” are what make imagining moving on a difficult and necessary part of overcoming addiction. I haven’t taken good notes on all the books I’ve read in the last year, so again I don’t know where this idea comes from, but I think it is Lewis’ …Desire. The perception of time changes with the neurological changes in the brain which result from addiction. With this perception of time change the past becomes a giant monster chained to the individual while the future appears as a tiny pinhole of light on the horizon ahead. Maybe it was Maté, not Lewis, that I draw that from, because it fits so well with the “burden of the past” and “fear of the future” phrase. Whatever it is, that’s the situation. A large monster following closely, chained to you, while you make your way to some barely seen unknown future.

The first step to change is to identify what needs to change. That’s easy to understand. We often hear how a person in addition can’t be helped until they decide they need help, etc. Um, duh? That’s what imagining moving on is all about. You think ‘I need to change this’ and then you start to imagine what that change will look like. Maybe you want to learn an instrument so you picture yourself sitting behind a drum kit banging out a rhythmic beat. You likely imagine the drum sticks, the color of the drums, the pulse of a beat and the hours of practice it will take to get there. You create a narrative vision in your mind of how you will get from point A to point B. And then you go to work.

Imagine Moving On is understanding the problem, making a plan, and going to work. It is acknowledging your discomfort in your current comfort zone and then deciding you want something different. This is the first step. It starts with imagining. If you can’t imagine moving on, find someone to talk to and ask them to help you. Seriously, find someone you trust, or hope to learn to trust, and ask them to help you imagine moving on. Their vision will be presented through their perception, but it may be enough to get you started.

This concept is generally known as visualization and in some circles as the law of attraction. There are many different methods for putting it into practice, each person needs to find the way they feel most comfortable with, which may take time and effort. I recommend starting simply with closing your eyes and creating a mental image of you after whatever change it is you want to make. Then work out from there the changes in your daily activities and relationships. If it helps, write it down in narrative, as though you are telling the story of someone else, when really you are telling a possible future for yourself.

Addiction is a pattern of behavior. Patterns can be tough to break, but they can break. It is important to remember that addictions don’t form over night, and often they persist for many years, even decades, so they don’t often go away quickly. Sometimes they do, every situation is different. It took years of practice to become “good” at addiction, so it’s going to take some

Start Simply

Or rather, simply start.

I have been planning and drafting and re-planning and changing my mind for months now regarding how I want to share my thoughts and information I feel is important to share. I wanted to do a podcast for a long time, then it was a YouTube channel, and then I settled on a blog, something I have experience with. Once that decision was made I still struggled to get started. I’ve had this domain registered for several weeks now. The ideas are there, but not the follow through. So I decided to start simply.

Or rather, simply start.

That’s about as artistic as I plan to get in my writing here, and even that’s just for fun. If you haven’t read my about section, I’ll recap here: I am a licensed alcohol and drug counselor with a Master of Science degree in Psychology. I have been in this profession since July 2014. The purpose of this blog is to share my approach to counseling and to do one of those things, I forget the word for it, where you can go to one location and get all the best information. They do it with news sites all the time. There’s a fancy word for it. I’ll remember it in a few hours in the middle of a session and become distracted. I’ll apologize now to the individual who will see my eyes light up and then seem to disconnect from the conversation.

I love to read books and watch interviews and TED Talks and documentaries about psychology and addiction. Some of these sources of information have shifted some paradigms in my life and I want to help get the word out on those theories and ideas. I also know there are a lot of questions people are uncomfortable asking, or don’t know who to ask, so I want to try to answer those as best I can from the experiences I have. I don’t know everything, or much of anything relative to others, but it’s possible that I know more than the average person, or even you, regarding some of these topics. I separated you from the average person because you are above average, not below. Well, most of you.

There’s a lot of taking things too serious in the world, so I want this to be a lighter approach to a very heavy subject. I believe that can be done respectfully, and I’m going to give it a shot.

The plan is to write something at least once per week. As I mentioned earlier, I have done blogging before and in that tried to maintain posting schedules and have conformity and tried to like the idea of SEO writing, but none of that is me, so I’m giving that up. I’ll try to spell things correctly (by which I mean accept the spell-check suggestions) and use proper grammar, unless it’s funnier not to.

Finally, simply start. If I wait until I get some cool graphics for the page, or the perfectly written article I’ll never start. So it’s time to just do it. Like any behavior change you want to see, there may never be a perfect time to start it, though we often fool ourselves into thinking, “I’ll turn off the Xbox and go to bed at a good time when school starts back up,” or “January 1st I am back to the gym every day.” The best time to initiate change is when the motivation strikes you. If it’s three weeks before school starts and you think you could benefit from a more disciplined bedtime, simply start. If it’s December 14th and you think you need to begin exercising again, simply start, and start simply.

So when you register a web domain and want to begin a blog, simply start, and start simply.

[The next post I’m working on is going to explain why this is called Imagine Moving On. So if you are curious, stay tuned. -PAB]