Some musings on behavior....

It’s interesting how rational we can be about some drugs and behaviors, and how irrational about others. When I was a teenager my best friend kept trying to get me to do coke. I always declined, and he was baffled. I had tried nearly everything else! I just said that I was afraid I’d like it too much. I instinctively felt that it was addictive and I was scared of it.

Oddly enough, when I did finally try it a couple of years later I kind of enjoyed it, but not enough to go out and buy more. I could pretty much take it or leave it. Meanwhile, I drank every day...steadily more and more. Nothing in my mind ever said about alcohol, ‘this is addictive and you like it too much’!

My sister, on the other hand, tried coke and it spiralled rapidly into an expensive habit; she got into debt to dealers, and the family had to pay them off and move her across the country and away from all her old contacts. For some people it is very casual, while for others it is very, very habit-forming.

Many people find pot smoking to be a casual, occasional thing; others can’t imagine a day without it (it can certainly become a compulsive behavior like anything else). I think if you asked most people about heroin, they’d say they would never consider using it—too dangerous, too addictive. But cigarettes and alcohol? I knew a girl who told me quitting heroin was nothing compared to quitting smoking. For years I was the only non-smoker in my family, and I can’t even imagine starting. It seems totally irrational to me.

Once you’ve tried a drug the harmful effects that you read about seem somehow unreal. But you know that smoking is bad for you, right? You know that the effects are cumulative. You know that eating junk food every day is bad for you. Dealing with substance abuse and harmful behavior involves dealing with both our rational responses and our emotional responses to the urges.

Remember that the three things that people who achieve sobriety have in common are that:.

·      they make a firm commitment to abstinence;

·      they make lifestyle changes to enhance that commitment;

·      they plan and practice for urges and situations.

 

 

The firm commitment part is....

coming to a belief that the substance or the behavior has no place in your life anymore.

·      No matter how tempted you are;

·      No matter how appealing it may seem;

·      No matter how much some friend encourages you;

·      No matter how much some situation may seem to call for it—as consolation or celebration;

·      No matter how good you think it might make you feel temporarily—

 

You don’t consider actually doing it, any more than a vegetarian considers eating meat.

Sure, you may think about the things you think it will do ‘for’ you. That’s what urges are, and they can be very intense. So it is helpful to have already prepared, in your mind or in writing, the answers to those urges: the things it will do ‘to’ you—the costs of using or compulsively eating or cutting yourself, or whatever the harmful behavior is. That’s why the first thing you usually do in behavioral recovery is to write that list of the costs and benefits. So those costs are detailed, in writing, and in your wallet if necessary.

First and foremost, you have a plan for not engaging in the behavior. A concrete plan, with specific steps to take when confronted with the urges. This is your plan; if you are honest about your behavior, you will know what is likely to work. It’s what you’ll say or do; when you’ll leave a situation and where you’ll go; who you’ll call. It isn’t a sign of weakness to call on someone else for help! First and foremost, you don’t take the drink, or do the drug, or engage in the behavior. And you can repeat that process successfully for weeks and months.

Our more intense urges have to do with a need for immediate gratification or relief, and for our stress about feelings and situations. So we deal with those.

·      You deal with all those beliefs about how it—the drug, the behavior—will make you feel, or how the friend will react, or what you think you’ll be missing.

·      You deal with being upset for considering acting on the urge.

·      You deal with the irritability of not giving in to the urge.

·      You deal with the discomfort of changing deeply engrained patterns of behavior.

 

You deal with those things by planning for them.

So why is it that we willfully use some drugs, and stay away from others? Why do some people cut themselves, or engage in thrill-seeking behaviors, or go through one unhealthy relationship after another? What makes a person use highly toxic household cleaners, but refuse to buy relatively benign pesticides for their garden? Why do we fear things that are very unlikely to occur—such as flying—but engage daily in behavior that has a far greater risk—such as driving on the freeway?

There is a rational and an emotional component to these decisions (and recognizing that they are decisions can be important!).

The rational part:

We may just be uninformed, or have chosen not to believe or listen to facts. So now that you’re contemplating abstinence (else why would you be here?), earn all you can about substance abuse. The facts can help affirm your decision for change. We may perceive the risk out of proportion to its reality. In the case of substance abuse, we may fail to recognize the reality.

The behavior has become so familiar that it no longer seems risky, or the risk may be cumulative, not immediate. That makes it harder to recognize. But is there a person alive today who doesn’t know that smoking is harmful? That our diet affects our longevity and the risk of disease? Just having the knowledge doesn’t prevent the behavior, of course. But repetition does work—just look at the advertising industry. So repeating to yourself the risks of drinking, drugging, and unhealthy behavior is helpful, even when it seems banal and obvious.

We are more fearful of things over which we have less control. Hence our fear of flying instead of driving.

There are two basic approaches to this issue. One is to accept that you have no control over the behavior, and seek an external source of change (a higher power—I will never learn how to fly a plane; someone else is in control of the plane, and I put my trust in that pilot). The other is to recognize that you have gradually relinquished control over your behavior, and to seek to strengthen your internal source of change (self-management—I will learn how to fly the plane).

As with most dichotomies, this one is a little false—these approaches can be blended. Some people describe coming to an understanding that their present course is not working, seek an external source of change, and use that to find the power from within for change. Learning enough about how airplanes work that you feel comfortable putting your safety in the hands of experts. If I stretch this metaphor much more, it’s gonna break....

The emotional part:

The fundamental principle of behavioral therapy is that our emotions and behavior result from our beliefs, and that we can change our beliefs.

Some of it is rational persuasion: recognizing the reality, facing the consequences of our behavior and acting accordingly.

But some of it is recognizing how debilitating our emotions have become. It isn’t surprising that people who abuse substances or adopt unhealthy behavior often have depression, anxiety, phobias, panic attacks…. When we postpone dealing with emotional upsets they get worse. When we take away the substance or behavior that was blocking the emotions, they may take us by surprise. Even if we quit drinking or drugging, the distress can manifest itself in other behaviors.

 

While peer support (such as we get from meetings, forums) may help it isn’t likely to alleviate severe emotional distress. I’ve had long conversations with a person who has successfully quit drinking by going to AA meetings. But she cuts herself, and in my untrained opinion that behavior is related to her previous drinking behavior (duh!). Dealing with the underlying causes is likely to require a trained professional.

In my opinion, the belief that substance abuse results from character defects may be misplaced or even counterproductive. There is an element of self-blame involved when we judge our character and find it wanting. It can lead to secondary upsets: being upset about the urges. Substance abuse is unhealthy behavior, not a moral failing.

Unhealthy behavior is a series of choices, some of which may seem as though they are out of our control. But when you take control of each of the small choices, one by one, day by day, week by week, then you get to a place where using drugs or engaging in the unhealthy behavior doesn’t even seem like an option to you anymore. Those choices include who we spend time with, where we spend time, what we do in our idle hours, and what we say when drugs are put in front of us.

Eventually it doesn’t matter anymore whether others consider it a reasonable or fun thing to do. Eventually it’s just something you used to do. It doesn’t define who you are. This can be hard to imagine at first, but urges diminish over time in frequency and intensity—when you quit the behavior. And as the primacy of the urges and the physical discomfort passes, you can deal with the underlying beliefs that caused you to engage in that behavior in the first place.

 

·      First and foremost, don’t do the behavior.

·      Make the commitment, make the lifestyle changes, plan for the situations.

·      Deal with the urges.

·      Deal with the underlying beliefs and emotions.

·      Learn from lapses.

·      Don’t be afraid to ask for help.

·      Be patient with yourself, and be persistent.

 

 

And to repeat the premise of this entire thread: longterm sobriety has huge benefits that are worth the effort.

Whether you trust the pilot … or learn to fly the plane!