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Posts tagged ‘Addiction and Recovery’

Natural Recovery: Recovery From Addiction Without Treatment

SOURCE:  A. TOM HORVATH, PH.D., ABPP, KAUSHIK MISRA, PH.D., AMY K. EPNER, PH.D., AND GALEN MORGAN COOPER, PH.D.

The most common approach to recovery is natural recovery. Natural recovery is recovery that occurs without treatment or support groups (NIAAA, 2012). When people recognize the cost of their addiction exceeds the benefits, and correct this, they become the “heroes” of addiction recovery. We don’t hear about these folks too often. However, we can learn a great deal from them. Specifically, there four key ingredients in any successful recovery process. These are 1) humility, 2) motivation, 3) sustained effort and 4) the restoration of meaning and purpose. We will discuss each in more detail.

Four key ingredients to recovery from addiction

1. Humility

At the most basic level, recovery is about humility. Some people independently solve their addiction problem (natural recovery). Others ask for help. In both cases, it is a humbling experience to face the reality of addiction. This humility extends to treatment professionals as well. To quote the famous French surgeon, Ambroise Pare (c. 1510-1590), “I bandaged him and God healed him.” Treatment professionals can point the way. However, each person’s recovery is ultimately a personal triumph and victory.

Professional treatment for addiction is really the path of last resort. Think about it for a moment. At its most basic level, treatment involves asking for help. Ordinarily, we don’t ask for help until faced with the realization we need some! An analogy might make this more sensible. Suppose you want to drive your car to an unfamiliar location. Perhaps you never visited this destination before. Do you immediately drive to a gas station and ask for directions? Or, do you first attempt to navigate there on your own?

Until we realize we are lost, we do not consider pulling over and asking for directions. Of course, different people will arrive at this conclusion more quickly than others. Some people are fiercely independent. The notion of asking for help is akin to admitting defeat. Other people are more prone to pull over and ask for directions at the first hint of trouble. The same is true with recovery from addiction. By the time people come in for treatment, they have usually attempted to recover on their own. They’ve reached their own individual tolerance level for “being lost” and decided they could use some “navigational” help.

Treatment is a type of navigational help. Let’s continue with our previous example. When we pull over and ask for directions, we don’t expect someone to jump into our car and drive us to our destination! Sure, we’ve asked for help. Hopefully, we received some helpful directions. Nonetheless, we still have to drive ourselves to the desired location. This is true of addictions recovery. Ultimately, everyone must drive themselves down the road to recovery. Therefore, even with “navigational help,” recovery still involves natural recovery.

But wait, you say. Does natural recovery mean that people addicted to heroin or alcohol stopped on their own? Are there are more of these “natural recovery” folks than people who successfully complete addictions treatment? Yes and Yes. Heroin use is a classic example. Many Vietnam veterans were addicted to heroin when they returned home. Public health officials were quite concerned about this. What would happen to the government’s financial resources if all these heroin-using veterans sought treatment? What if they didn’t seek treatment? Would there be a devastating surge in heroin use? None of these outcomes occurred. Most heroin-using veterans simply quit on their own (Robins, 1973). How did they do it? The short answer is natural recovery. Of course, not all veterans fully recovered. Some developed other addictions when they gave up heroin. Others only partially gave up heroin. However, in general, natural recovery occurred for most.

Smoking is a more familiar example. If you have been around since the 1960s or 1970s, you own experience will confirm the following facts. Tens of millions of Americans have quit smoking. Very few of them sought treatment or attended a support group. How many rehabs are you aware of for quitting smoking? If quitting smoking were easy, these results would not surprise us. Most people recognize that quitting smoking is quite difficult. Yet almost everyone who quits smoking does this without specialized help or treatment. It may take a handful of serious attempts in order to finally succeed.

A similar result has been found for alcohol (NIAAA, 2012). Most individuals who stopped or reduced their alcohol use have done so on their own. Unless you are a student of addictions research, you might not know there are so many of these successful quitters and moderators. Indeed, it would be quite unusual to hear someone say, “I used to have a really bad drinking problem. You might have even called me an alcoholic. But you know, I just cleaned up my act on my own.  Now I don’t think about it much anymore.” It’s quite sensible that someone wouldn’t advertise these facts about themselves. Unfortunately, this silence means most people are unaware of the ways people recover from addiction without help. Researchers became aware of this because of large-scale, federally-funded surveys.

2. Motivation

A second crucial ingredient is motivation. During interviews with naturally recovering people, a common theme was found. The need to change finally became important enough. In other words, the benefits of change outweighed the costs of remaining addicted. This realization provided sufficient motivation to make needed changes. People who succeeded in natural recovery were able to accurately evaluate the costs and benefits of their addiction. Not all individuals appear to be able to do so. This is where treatment can be very helpful. Treatment can help people take an honest, hard look at their situation. This helps them to evaluate the costs and benefits more accurately. This will then provide the motivation to make needed changes. Motivation is so important that we’ve devoted an entire section to discuss it.

3. Sustained effort

The third key ingredient to successful recovery is sustained effort. Whether you recover on your own or with treatment, recovery requires a sustained effort. Sustained effort is needed to persevere through the initial periods of discomfort. This lesson is clear from smokers who quit. People who successfully quit smoking spend a substantial amount of time preparing to change. They experience varying degrees of discomfort getting through the transitional period from smoker to smoke-free. Many people who do not succeed in their first recovery effort under-estimated how much effort it would involve.

4. Restore meaning and purpose to life

Finally, it is necessary to restore meaning and purpose to your life. At some point, it will become evident that your world revolved around your addiction. To succeed in recovery, something else must fill that void. At the onset, build your recovery around things that give your life meaning and purpose. This might mean spending more time with your kids. It might mean enjoying the benefits of healthy recreation such as hiking or going to the gym. Perhaps you’d like to revive your social life. Maybe you would enjoy some meaningful volunteer work. You might like becoming more active in your church or to work for political cause. Maybe it just means feeling more rested and refreshed by getting to bed earlier every night. Whatever it is, begin to recognize and enjoy the benefits of your freedom from addiction.

We know these four ingredients are common ingredients of successful recovery. However, we also know there is no single, correct path to recovery. Expect to find your own road to recovery. Seek information and input. Then consider carefully what makes the most sense for you. Go ahead, try it. If it doesn’t work, try something different. A common expression is very fitting. “If at first you don’t succeed, try and try again.” Realize that very few people are successful with just one attempt. Assume that there are many different roads to recovery just as there are many different people.

Motivation For Change: The Stages Of Change Model

SOURCE:  Taken from an article by A. TOM HORVATH, PH.D., ABPP, KAUSHIK MISRA, PH.D., AMY K. EPNER, PH.D., AND GALEN MORGAN COOPER, PH.D.

Let’s face it. Recovery from addiction is not an easy task. In fact, change of any sort is usually somewhat stressful and uncomfortable. Whether or not someone attempts natural recovery or gets help, “something” must change. In other words, “something” must cause them to move away from addiction and toward recovery. That “something” is the motivation to change.

Throughout this topic on addiction, we have stressed that recovery is fundamentally about the motivation to change. At some point in every addicted person’s life, there comes a moment when they realize they need to change. The difference between those who successfully make the needed changes, and those who do not, comes down to motivation. Since motivation is so critical to recovery, it is important for therapists and therapy participants alike to understand the motivation for change. This includes understanding the degree of motivation; the type of motivation; as well as understanding various ways to increase motivation. Once sufficiently motivated, people can and do change.

Most of us recognize that change is not an event that suddenly occurs. Rather, it is a process that gradually unfolds over time. As this process begins to unfold, a person’s motivation changes. The most popular framework for discussing motivation to change is the Stages of Change Model developed by James Prochaska, Ph.D. and Carlo DiClimente, Ph.D. Their work began during the late 1970s when they became interested in the way people change. They developed, tested, and refined the Stages of Change Model. This model is one of the most widely used and accepted models within the field of addiction treatment.

In Changing for Good (1994), Prochaska and DiClemente describe the six stages of change:

Stage #1: Pre-Contemplation

People at this stage may be aware of the costs of their addiction. However, they do not see them as significant as compared to the benefits. Of course, others may view this situation differently. Characteristics of this stage are a lack of interest in change, and having no plan or intention to change. We might describe this person as unaware.

Stage#2: Contemplation

People in the contemplation stage have become aware of problems associated with their behavior. However, they are ambivalent about whether or not it is worthwhile to change. Characteristics of this stage are: exploring the potential to change; desiring change but lacking the confidence and commitment to change behavior; and having the intention to change at some unspecified time in the future. We might describe this person as aware and open to change.

Between stage 2 and 3: A decision is made. People conclude that the negatives of their behavior outweigh the positives. They choose to change their behavior. They make a commitment to change. This decision represents an event, not a process.

Stage #3: Preparation

At this stage people accept responsibility to change their behavior. They evaluate and select techniques for behavioral change. Characteristics of this stage include: developing a plan to make the needed changes; building confidence and commitment to change; and having the intention to change within one month. We might describe this person as willing to change and anticipating of the benefits of change.

Stage #4: Action

At this stage people engage in self-directed behavioral change efforts while gaining new insights and developing new skills. Although these change efforts are self-directed, outside help may be sought. This might include rehab or therapy. Characteristics of this stage include: consciously choosing new behavior; learning to overcome the tendencies toward unwanted behavior; and engaging in change actions for less than six months. We might describe this person as enthusiastically embracing change and gaining momentum.

Stage #5: Maintenance

People in the maintenance stage have mastered the ability to sustain new behavior with minimal effort. They have established new behavioral patterns and self-control. Characteristics of this stage include: remaining alert to high-risk situations; maintaining a focus on relapse prevention; and behavioral change that has been sustained six months. We might describe this person as persevering and consolidating their change efforts. They are integrating change into the way they live their life.

Stage #6: Termination

At the termination stage people have adopted a new self-image consistent with desired behavior and lifestyle. They do not react to temptation in any situation. Characteristics of this stage include: confidence; enjoying self-control; and appreciation of a healthier and happier life. The relapse prevention plan has evolved into the pursuit of a meaningful and healthy lifestyle. As such, relapse into the former way of life becomes almost unthinkable.

Female Sex Addict: Not an Oxymoron

SOURCE:  Katelyn Beaty/Christianity Today

Biblical scholars have yet to determine if the woman caught in adultery (John 8:1-11) was a sex addict. But Nashville-based clinical therapist Marnie Ferree says the woman’s shame and social status make her an apt archetype for women struggling with sex addiction. For one, women sex addicts often face a double dose of shame because they believe they as women aren’t supposed to have sexual sin. And because the number of female addicts is relatively small (expert Patrick Carnes estimates 3 percent of the U.S. population, with male addicts composing 8 percent), few books and recovery groups are available. “I tell some of my colleagues, such as Mark Laaser, ‘you wrote a great book, but the pronouns are wrong,’ ” says Ferree.

Thankfully, the story of the adulterous woman in John’s gospel reminds sex addicts that not even their deepest secret is outside Christ’s healing touch. Ferree knows this from personal experience, because she is a recovering sex addict—something she hid for 20 years until an HPV diagnosis in 1990 brought it to light and kick-started her recovery. Today, alongside her husband of 29 years, Ferree runs Bethesda Workshops, which aims to provide “Christian treatment for sex addiction recovery.” Their dramatic story appears in No Stones: Women Redeemed from Sexual Addiction, Ferree’s immensely practical, deeply biblical book for female sex addicts, out this month from InterVarsity Press. Ferree spoke recently with Her.meneutics editor Katelyn Beaty.

What is sex addiction? How is it different from, say, porn addiction?

There’s no difference between porn addiction and sex addiction. Sex addiction is an umbrella term; the particular form of acting out, whether it’s pornography, affairs, sex chat rooms, prostitutes, picking up people in bars, is immaterial. These are all just one manifestation.

The main characteristics of sex addiction (and any addiction, for that matter) are

Obsession: the behavior becomes the organizing principle of life. The addict is obsessed with acting out, trying to hide the acting out, and figuring out when she can act out again.

Compulsion: continuing behavior in spite of your best efforts to stop. You keep doing what you don’t want to do.

Continuing despite adverse consequences: you continue behavior that clearly isn’t in your best interest. You pay a price for your behavior (in terms of relationships, jobs, shame) and yet you keep doing it.

Several times you describe female sex addiction as an intimacy disorder: the search for “love, touch, affirmation, affection, and approval.” Is male sex addiction also at root an intimacy disorder?

Yes, absolutely.

Doesn’t that challenge some assumptions about male sex addicts, that what they seek is the physical sexual release?

To be clear, there’s no doubt that [the desire for physical sex] is a powerful force, and some women really just like sex. And some men really just like sex. And it’s still bigger than that. That’s where the Christian framework differs from our clinical colleagues and the professional associations that deal with this issue, because for a Christian, genital-based sex is not enough. Even if it’s just with your husband, God longs for us to have so much more than genital-based sex. That one-flesh union is spiritual and emotional and [about] companionship and fun and recreation, and God longs for us to have so much more than orgasms. So even someone who has a higher sex drive than others—and there is some validity to that concept, they are wired differently—but still on a continuum, it’s a pretty narrow one. It’s not nearly that wide of a continuum.

At many points in No Stones, the language of addiction reminded me of alcoholism. How does sex addiction compare with other addictions?

Many addictionists consider sex addiction, along with food addiction, a core addiction. They are core because they are central to who we are and to survival. Obviously you can never drink alcohol or smoke a cigarette, and you’ll be fine. But you do have to eat, and we’re made as sexual beings—that doesn’t mean we have to have sex, but sexuality is part of who we are and our automatic nervous system response. That makes recovery from either one of those significantly harder. A sex addict is, neurochemically speaking, constantly carrying within her own body her drug.

Is sex addiction best understood as sin or as a neurological disease?

The answer is yes. Unquestionably this is sinful behavior. There’s no getting around that or trying to make excuses. And it does follow a disease model in terms of having predictable neurochemistry involved, predictable withdrawal involved, and being progressive without intervention.

In terms of the mental illness category, sex addiction is what’s known as an attachment disorder. Attachment describes a person’s experience with early caregivers and how well the child “attaches” to her parents. When parents aren’t attuned to the child’s needs, when they fail to make eye contact with her, when they don’t touch her affectionately, when they don’t respond to her verbal cues—the child doesn’t bond adequately with her parents. She doesn’t develop the sense that the world is a safe place and others will be there for her and take care of her needs. These early experiences (especially those before age 5) imprint the child emotionally and even neurochemically. Sex addiction is rooted in attachment failures, which is why it’s often described as an intimacy disorder. A woman doesn’t learn from her parents about healthy intimacy, and she tries to fill that in unhealthy ways.

How would you advise a single Christian sex addict to proceed in recovery?

Bless her heart. It is hard. I think obviously to proceed in integrity and holiness, I think to really focus on her healthy relationships, and they can be of opposite gender, but to be certain about what’s driving them and what the foundation is. And I think to embrace her sexuality, and by that I mean to be very aware of and in touch with her feminine side, whether that’s her appearance or her creative side or her athletic side. To really be a whole person and not just focus on “Well I’ve gotta find a man.”

What do sex addicts need most from the people who love them?

They need loved ones to educate themselves about sex addiction, especially about women. They need to understand the extraordinary challenge that the female sex addict is facing. Second, female sex addicts need their loved ones to be working on themselves. My husband would say that he enabled me for years by his passivity. I’m still totally responsible for what I did, but it sure would have helped had he been healthy enough to put his foot down and say, “I am not going to live with a wife who is unfaithful to me.” That’s what I mean by doing their own work: setting healthy boundaries, learning themselves how to address their own attachments and the impact they have had in their own life.

A Female Perspective: What I Wish I’d Known Before Watching Porn

SOURCE:  Lauren Dubinsky/Huffington Post

Pornography is a charged subject, and it’s a word that rarely crosses the lips of most women. Yes, there are now breeds of the modern woman who watch, talk and joke about it regularly, but most of us still stay farther away from speaking the word than we actually stay away from it.

Over the last couple of years, men have begun to enter the discussion, but women have remained primarily silent. For most of us, it’s still the men’s world, but statistics show that, at least in Australia, more than one-third of pornography viewers are women. Just last week, I received an email from a girl who leads a small women’s group; they’d just discovered that every single one of them were watching porn.

When I was in high school, pornography was on the long list of “bad things” that I didn’t know much about — and unfortunately also on the list of things I had participated in. Nevermind why I was watching it, the how is the same for nearly all of us: We stumbled upon it because of someone else. And none of us knew what to expect, or how to handle it.

Later in life, I caught myself remembering how I used to watch it for a few minutes here or there, and wondered strictly out of boredom if it would fill the big, empty space of loneliness in my late nights. There were no parents around to hide from anymore, and no one checking my Internet history. Pornography was easy, and I never exactly knew why it was bad, particularly since I wasn’t actually having sex. To me, it was just something dirty that you probably shouldn’t have anything to do with. But “probably shouldn’t” never stands up against loneliness and boredom.

I am not one with an addictive personality. Meaning, I binge and then drop things quickly. I knew this about myself, and so I used this as an excuse for watching pornography. (I also used it as an excuse for getting wasted at other times in my life, but that’s besides the point.) I’d watch porn every night for a couple weeks, then not at all for a few weeks. Always off and on. Clearly I wasn’t addicted. Just like I smoked and never became addicted to nicotine and drank, but never became an alcoholic. I was just watching it, and could stop anytime I wanted. No damage done, because I was still in control.

Right?

Not really.

Nicotine still seared my lungs, and alcohol still did some decent damage to my liver and personal life. Just because we aren’t addicted doesn’t mean it does no harm. Even while I wasn’t “addicted” to watching pornography, I always wanted more. It existed as a guaranteed time-filler and pleasure-bringer, and when you get an hour to yourself, that’s an easy default. An easy default activity that establishes a heavy precedence in what you do with your next bad night.

I wish that 10 years ago someone had educated me on pornography. What it is, what it does and what it reaches in and destroys in the hearts, minds and bodies of men and women.

I wish that someone would have told me that researchers have suggested it sabotages your sex life.

I wish someone would have explained how dopamine, the chemical that is released every time you experience pleasure, drives you to return to what provided that feeling before.

I wish someone would have told me that the kind of pornography you’re most turned on by is usually linked to a corresponding hurtful event in your life, further injuring your brokenness.

I wish someone would have told me pornography would normalize things I wasn’t emotionally or physically ready to handle in my relationships with men, making me feel like I had no options or control over my sex life, filling me with much regret and physical pain.

I wish someone would have told me I would begin to objectify men, build up images in my mind and think of sex day in and day out, to the point where I couldn’t remain focused on anything else.

I wish someone would have told me it would make me feel less valuable to men and bring up insecurities for years in the bedroom.

I wish someone would have pointed out pornography can establish your sexuality completely apart from real-life relationships, causing huge problems in your intimacy with real significant others.

I wish someone would have explained what “sexual anorexia” was and that countless young men are unable to get erections because they’ve been watching porn since they were around 14 years old.

I wish someone would have told all the men I’ve dated that the porn they are watching is keeping them from being turned on by me, ultimately destroying our relationship.

I wish someone would have told me that the dopamine and oxytocin being released from my watching certain types of pornography would cause me to question my sexual orientation, which in turn cost me relationships with friends.

I wish someone would have told me it would subtly create a “victim” mentality in my mind, causing me to be even more sensitive than I already was to catcalls, whistles, and even sincere compliments.

I wish someone had talked about how women watch it too, so I wouldn’t have had to spend years living under the shame that comes with being “the only one” and thinking there was something wrong with me.

My “I wish” list is nowhere near complete, either. In the end, I simply wish someone would have told me why it was so harmful, instead of simply putting it on a list of things we don’t talk about. We all know our rights and wrongs, but seldom do we know what makes them so. Had I known how much it would have harmed me, I would have left it alone.

If you’re a woman who has watched pornography, or is watching pornography, studies are now showing that we make up more than one-third of pornography viewers. It’s no longer a taboo topic, and I would personally like to give you permission to speak openly about it. I guarantee you that you have friends who watch it, and are desperate to talk. Even in your church. Especially in your church.

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Lauren Dubinsky

Lauren is a 50/50 left-brained/right-brained extroverted introvert, and is an awkward clash between a Southern Belle and a West Coast mover and shaker. She’s a tech and arts girl, adores photography, and is slowly learning that she lives to love and loves to write. She writes & blogs on living life well, sex & relationships, dealing with pain, becoming a good woman, and being the kind of Christian that people don’t hate. She also runs GoodWomenProject.com.

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