How Understanding the Window of Choice Aids in Recovery

“If you don’t know someone who’s had a problem with addiction, you will.” –Dana Boente

Working in the addictions field is not easy.  It is not predictable either.  Some of the people who start treatment and sound like they are making healthy choices in their lives, end up relapsing, while others who struggle to start suddenly have a turnaround.   Recovery is a journey and every person dealing with addiction and recovery need to forge their own road to determine what works for them.  As I work with clients I discuss their window of choice and help clients to figure out what stretches it.

I define addiction as both a choice and disease.  As I envision it, there is a window of time when a person has a choice, but once it reaches the threshold, it flips into a compulsion.  At that threshold, the disease of addiction takes over and there is no longer a choice in the matter.  During active addiction, the window of choice is minuscule.  There is not much time from when the person feels the urge to the time they start using.  Recovery is about stretching the window of choice.

So, what stretches the window of choice?  Whenever a person does something that brings them peace and joy they stretch the window.  When they feel connected with someone or when they are able to shift their perspective of a situation they gain more power to choose.  Every time a decision to not use is made and honored the window gets bigger.  I encourage my clients to make a list of things they can do to stretch the window of choice.  They may listen to music, take a walk, journal or draw.  It may take a lot of slow work to stretch the window of choice out enough to abstain or the window can seemingly stretch in the moment that the person hits rock bottom and decides that they need to change.

Recovery is about continuing to stretch out the window and adding more time of choice before hitting the threshold.  Stress shrinks the window of choice.  When someone has a setback or faces the pain of confronting the repercussions of addiction it causes the window of choice to get smaller, which leaves them closer to the threshold of relapse.  Understanding this balance is critical.  The window can shrink slowly or it can vanish the instant a certain person, place or thing appears.  The key to recovery is understanding the window of choice and continually monitoring the growth or reduction of the window.  When the window begins shrinking, self-care is critical to stop it.  I encourage the clients to revisit the list they created and encourage them to choose at least one thing to try from their list.  If you or a loved one are struggling with addiction, become curious about the window of choice and have a discussion about how to support its growth.  It could be the key to change!

When Our Parts Don’t Agree

“My goal is to make space for my selfhood. All of it. All of me, not just the parts I like or think that others like but all of it.” –Tracee Ellis Ross

We all have parts to us.  Part of me may want to go out to eat, but another part wants to stay home.  Part of me wants to clean the house on a Saturday morning, but another part wants to sleep in.  It is normal for our parts to be in conflict with each other, but when they don’t agree, how do we decide who wins?  I envision all of us to have many different parts within.  These aspects of our self all have their own personalities.  We all have a lazy part, but when the lazy part constantly wins we begin to define ourselves as lazy.  When the addiction part constantly wins, we define ourselves as an addict.  I envision each part to have a counterpart.  The lazy part is balanced by an energetic part.  The responsible part is balanced by an irresponsible part.  So, what do we do when our parts are in conflict?

I recently had a session with a client who was frustrated with her habit of procrastination.  She discussed how whenever she had a project to do in school, she would wait until the last minute and then rush to complete the assignment, often getting poor grades.  She was aware that other people in her class were working on their projects from the moment they were assigned.  She wanted to know why they could be disciplined, when she couldn’t.  We discussed how she has a disciplined part as well, it is just being overshadowed by the procrastination part.  We talked about the power that the procrastination part had been given over the years and why her procrastination part felt the need to take control whenever she had a project to complete.

The key to controlling our parts is to increase our awareness of the parts.  We are not our parts.  Our awareness is the director of the parts.  It is our authentic self who is actually in control of our parts.  When our director is able to recognize that a part has taken over it can decide if the part’s action is in alignment with who we say we want to be, or not.  It is the director’s job to decide which part wins when our parts don’t agree.  Our authentic self knows what our goals are and what actions we need to take to be true to ourselves.  It can then choose which part will win when the parts don’t agree.  How much control does your director have, or are the parts running amok?

Where is your baseline?

“If you don’t change your beliefs, your life will be like this forever. Is that good news?” –W. Somerset Maugham

We all have our own way of being in this world.  Some people are optimistic and ‘happy go lucky,’ while others are pessimistic and constantly waiting for the next stroke of bad luck to hit.  We all fall somewhere on that continuum and that is our baseline experience of the world.  It is our default internal programming that keeps us stable in life.   When we are on our baseline, life feels ‘normal’ or routine.  When events happen, they sometimes throw us off our baseline.  We can tell when things are off.  We either have a feeling of being down, below our baseline, or things are going well and we are above our baseline.  Resiliency is often discussed as being able to get back to ‘normal,’ or baseline after an event occurs.

While getting back to baseline is comfortable, this doesn’t always serve us.  I often use an example of someone who has been living in poverty their whole life and they suddenly win the lottery or inherit a fortune.  Many times, these people spend the money in excess and find themselves right back at their poverty baseline.  It doesn’t have to be that way though.  If they are able to raise their baseline and see themselves as a wealthy individual who respects the money they have, they can budget and invest to remain wealthy.

In order to raise our baseline, we need to see ourselves differently.  This comes from doing the work of self-compassion and forgiveness.  It comes from questioning our beliefs about who we are and what we want in our lives.  Working in the addictions field, I frequently see people who start doing well once they get clean.  For a period of time, things seem to be improving and changing.  Then suddenly something happens which causes them to relapse.  While they tell me that they have bad luck, what I often see is self-sabotaging behaviors.  Their baseline beliefs about who they are have not caught up with the changes that are happening in their lives.  They often feel unworthy of good things happening, or feel that they need to be punished for choices they made.  While intellectually they want the good, their underlying beliefs are stuck on seeing themselves as ‘broken’ or ‘dirty’ because of what they did.  Their baseline beliefs are still low, so their behaviors bring them right back to baseline.

In order to grow, our baseline beliefs about ourselves need to change.  When we go through a difficult period, many people emerge stronger than before.  This is referred to as post-traumatic growth.  The baseline of how they see themselves shifts during the low point and they have more confidence and awareness once they get through.  When we go through joyful times our baseline can raise as well.  Knowing that we are deserving of the good and worthy of the blessings allows our baseline to float up and become our new normal.  The key to growth is recognizing our baseline and questioning the beliefs that hold the baseline down.  What are your baseline beliefs?

Social Support: The antidote for the shame and isolation of addiction

“My best friend is the one who brings out the best in me.” –Henry Ford

There is a big difference between the disease of addiction and other health related diseases.  When someone battling cancer has a relapse they are often surrounded with love and support, but when someone suffering from addiction has a relapse, most people cut them off and avoid them.  The love given to someone dealing with cancer is withheld from some going through addiction.  It is not easy to be around someone struggling with addiction, but does shame and isolation work to get them to stop using?  I was at a conference last week and Brené Brown asked a very powerful question.  “Does shame and isolation make people more or less dangerous?”  Think about the implications of that question.  We have realized for decades that shaming hurts people, yet it is one of the most frequently used techniques to control behavior.  What we all long for is connection.  It is the support piece that is often missing and what we, as humans, crave.

We are wired for connection.  It is part of our genetic makeup.  From the time we are born until the time we die, we look for connection with others to share this experience of life.  Somehow in our society we seem to have adopted a belief that we need to pull ourselves up by our bootstraps and go on alone.  While it is true that we are the only one who can choose our behavior, having someone to talk to and share experiences helps to shift our perspective.  Successful recovery includes forming a positive social support network.  We all need at least one close friend to be open and honest with in our lives. We need that one person we can talk to when we have entered a ‘shame storm.’  It is someone who can help remind us that we can do better next time and help us to see that all is not lost.  Social support is a critical piece of successful recovery and successful living.

If you know someone who is suffering from addiction, take notice if people around them are using shame or isolation to try to change their behavior.  Reach out and provide a connection.  It may save their life.

Why do addicts relapse? The ups and downs of the recovery process

“Life is not linear; you have ups and downs. It’s how you deal with the troughs that defines you.” –Michael Lee-Chin

After years of counseling people in addiction and their families, the question I hear most often from loved ones is ‘why don’t they just stop using?’  Addiction is complex and although it seems like the answer is easy, it is anything but simple for the person dealing with addiction to stop.  While there are no cures for addiction, research has shown that counseling, inpatient treatment and support groups are beneficial for many people.  One of the ways I have found to explain addiction and recovery to my clients and their families is to envision a ‘Chutes and Ladders’ game board.  The work of recovery is like going up the ladder.  Along the way though, there are many opportunities to go right back down the chute of relapse.  In order to keep them moving up the ladder, I discuss the importance of having a vision or goal they are working towards.  Climbing the ladder day after day is hard work.  It would be much easier to take a break or go down the slide, but knowing why they are doing the work of recovery is critical.  One of the things I reinforce to my clients is that they can’t be doing the work of recovery for anyone except themselves.  Many clients tell me that they are getting clean for their children or significant other.  While I agree that their loved ones are important, the more important thing is to recognize that they are doing the work to be the best mother, father or partner they can be.  It really is for them to be the best they can be and give their best to their loved ones.

So why do some clients seem to climb the ladder relatively quickly and easily, while others struggle and fall down the chutes of relapse time and time again?  One of the things I discuss with my clients is how there are sticking points along the way.  Many clients seem to do well for a time and then begin to backslide or self-sabotage.   I believe that these sticking points are places where limiting beliefs reside.  Many clients begin doing well and then the voice of doubt or fear arises.  The voice reminds them that they don’t deserve to be happy because of all the pain they caused or because of what they did to their child or any other variation of doubt and fear.  The louder this voice becomes, the closer to the downward slide they get.  When the voice is all they hear, it only takes a little push to go right down.  Challenging the voice of doubt and fear, forgiving themselves and learning to love themselves despite the past, dissolves the sticking points and allows the client to continue the climb of recovery.   Helping a loved one in recovery is never easy.  Reminding the person that they are worthy and deserving of love is one of the best ways to help them move through the sticking points and continue the lifelong journey of recovery.

If you love someone suffering from addiction, here are five things you need to know

“People who have never had an addiction don’t understand how hard it can be.” –Payne Stewart

Working in a methadone clinic over the past several years has given me a unique perspective on addiction.  I have been privileged to hear heartbreaking stories of addiction and witnessed firsthand the devastating effects it has on the entire family.  Loving someone struggling with addiction is perhaps one of the hardest things there is to do.  The person that you once loved seems to be replaced by a foreign entity.  It is hard to know who you are talking to.  The addiction masquerades as the loved one and it is unbearable to discover that the person you once knew is unreachable.  So, what do you do if you love someone who is suffering from addiction?

First, know that the person in addiction is not the person you love.  I always think of us as having different parts that take over in different situations.  There are loving and gentle parts, as well as angry and demanding parts.  There is a different part of me in control when I’m at work then when I’m at home with my children.  When someone is struggling with addiction, it is the addict part that has taken control and seals off the other parts.  Sometimes we can get glimpses of the real person, but during active addiction it is difficult to know if you are talking to the addict part or breaking through to your loved one.  Be cautious and discerning when talking to your loved one.  Remember that the lies and manipulative behaviors are the addict part which has taken control and are not behaviors the person you love would do.

Second, know that the person you love did not intend to become addicted.  There is not a single client that I have worked with that told me they wanted to become addicted to heroin.  Of course, they made an initial choice to try it, but once the addiction took hold, they lost all power to choose.  This is why addiction is considered a disease.  The urge and compulsion to use is so strong that the choice to stop is blocked.  Know that if addiction were just a matter of willpower, there would be far fewer people suffering.  It takes support and understanding to break through addiction.  It is complex and there are no easy answers or solutions.

Third, understand that the person in addiction is suffering, too.  Addiction creates a downward spiral.  There is usually a point when the person in addiction decides that they want to stop.  They tell themselves that they are going to stop, but the compulsion becomes so strong that they can’t control it.  After they use they feel guilty about it and the pain becomes stronger.  The stronger the pain, the stronger the compulsion to use.  The spiral continues until they hit the preverbal ‘rock bottom’ and seek help or treatment of some kind.

Fourth, don’t give up.  Loving someone struggling with addiction is painful.  There is no denying that, but when the person hits their ‘rock bottom’ they need love and support in order to heal.  Set extremely firm boundaries.  Enabling and making excuses for the person in addiction does not help them.  They need to experience the consequences of their behavior choices.  This is extremely difficult to accept because death is a very real possible consequence.  Setting boundaries does not mean withholding love and support from them.  Trust has to be earned back.  It is a slow process, but don’t give up on them!  Get family counseling to help the entire family heal and open the lines of communication back up.

Finally, take care of yourself.  Loving someone with an addiction is consuming and feels helpless.  You cannot stop or control a loved one’s addiction.  The person in addiction is the only one who has that power.  The more worn down you become, the less helpful it is for everyone.  Find your own hobbies, attend Al-Anon meetings, spend time in nature or laugh with friends.  It is not selfish to take care of your own needs.  By practicing your own self-care, you are able to help the family heal and move through the recovery process.  Your family deserves the best you can give, which only comes when you take care of yourself.

The journey of addiction is never easy.  It is a dark chapter for many families, but it doesn’t have to be the whole book.  You, as a family, get to write the rest of the story.  It can have a happy ending.

Is Addiction a Choice, a Disease or Something Bigger?

“Man never made any material as resilient as the human spirit.” – Bernard Williams

As I sit with my clients week after week I hear how frustrated they are with their inability to change.  They often say they want to stop using and when they are thinking rationally they tell themselves that they are never going to use again, but then the compulsion takes over and they lose the choice, only to find themselves using again.  It is frustrating and disappointing each time they use and the hope that they had of stopping gets harder to find.  I have often pondered whether the addiction they describe so clearly is a disease or if it truly is a choice.  There is a big debate in the field and there are strong proponents on each side who argue their case.

For a long time addiction was touted as a moral issue.  People suffering from addiction were judged as not being strong enough to simply say ‘no’ and thus were treated poorly.  More recently though, addiction has become definedheart-665091_640 through the medical disease model.  The American Society of Addiction Medicine has defined addiction as “a primary, chronic disease of brain reward, motivation, memory and related circuitry.”  (http://www.asam.org/quality-practice/definition-of-addiction)  They clearly discuss the physical changes in the body that occur throughout the progression of addiction and discuss the way the brain’s circuitry and neurochemistry are physically changed.  There are debates going on throughout the addiction field as to whether addiction is a choice or a disease.  What I have come to believe is that it is not either/or, but instead both/and.  Addiction is complex and to simply say it is a choice denies the fact that there are physical changes within the body which limit the person’s ability to access the rational part of the brain where choices are made.  At the same time to say it is purely a disease denies the fact that people can and do stop using by choice.

So, how can these two sides find some agreement?  I believe it starts by looking at addiction through the mind, body AND spirit.  In the mind we have the choice, in the body we have the physical disease, but the third aspect, the spiritual aspect is not usually addressed.  To me, the spiritual is the authentic and genuine aspect of each of us that is under the ego.  It is who we truly are.  It is the spark of life itself that is breathing us and beating our heart.   When we are able to help clients tap into the authentic part that is their true self, they are able to access both the power to choose and the power to heal a disease.   Ultimately, whether it is a disease or a choice truly doesn’t matter.  What does matter is helping people overcome their addiction.  Helping each person reconnect with who they truly are is what I believe to be the first step towards recovery.  It is helping them to see that under the addiction they are whole and well.  Despite what they may or may not have done, they can begin to love themselves and the power of developing the spirit, the authentic part of them, is where true healing begins and addiction ends.

Opening the cage to experience our higher power

“Honestly, I’m not a big person in terms of religion, but I really believe in nature. I feel like anytime you see anything beautiful in nature that’s the closest I’m ever going to get to God or a sense of a higher power.” -Sara Rue

Working in the addictions field leads to many discussions about spirituality with my clients.  The Twelve Step model is based on opening up to a higher power and while there are some clients that this resonates well with, others struggle to understand what a higher power means to them.  They often note that even though a broad definition of higher power is encouraged and that definition can include anything outside of themselves, they struggle to see how something like a tree or someone they admire or even the group itself can be a higher power for them.  To understand this is to go back to the cage exaharmony-1229886_1280mple I discussed last week.  We have an authentic self that sometimes gets locked in a cage by our ego.  When the cage door is open and the authentic self is able to connect, that to me is spirituality.  Moments of deep connection, whether it be in nature, when looking into a baby’s eyes, during quiet meditation or a moment of deep intimacy with another person are among the most spiritual experiences we can have.  We can interact with nature or a baby, but if the cage door is closed we lose our ability to truly connect.  This is a significant point.  When I come home from a busy day at work and my son is talking to me there are times when I hear the words he is saying and I respond, yet my mind is still busy thinking about the comment a co-worker made or something that happened.  Although we are talking and communicating, there is minimal connection.  When I become fully present and listen openly to what he is sharing there is a significant difference in the interaction.  There is a deepening in the moment and the connection can be felt.  This is a spiritual moment.  Sometimes we aren’t able to recognize that our cage is shut, we think it is open, but yet become frustrated, feeling isolated and misunderstood.  That is a good indication that we are in the cage of the ego.  Opening the door of connection between our authentic self and anything else is a spiritual experience.  We can feel the difference in the quality of the connection when we touch in to the authentic level.  This is sometimes defined as a spark or a deep knowing or even a sense of peace and calm.  Although it is hard to describe in words, it is a connection that is felt and sensed.  Due to prior experiences, the ego may not open the cage door very wide or even to other people, so for some people developing a sense of connection with nature or pets can feel safer.  When someone finds that they can be calm and peaceful when sitting in nature, that becomes their higher power.  They have found a place where they are able to connect with their authentic self.  The more we are able to experience deep connection and go into the authentic self, the more we are able to expand that connection to include other places, people and the world around us.  As our connection with our higher power opens the door to our authentic self, we become healthier.  We all have a higher power, so take some time to connect with yours today!

The key to open the cage of isolation

“Loneliness is proof that your innate search for connection is intact.” -Martha Beck

Last week’s post was about the self-inflicted cage of isolation that people sometimes find themselves in.  This is the isolation that is felt because although they may be physically surrounded by people, they do not feel emotionally connected to them.  What is blocking the emotional connection and how do people develop the courage to open the door to their cage and reconnect with life?  I believe we need to explore the role of the ego.  I envision us as people as having two distinct aspects. We have our authentic self and we have the ego.  The authentic self is the aspect of us that is genuine and true.  Religions call it our soul.  When we are acting from our authentic self we feel key-106885_640good about the decisions we make and our actions are in alignment with our core values and beliefs.   When we are in our ego we are usually justifying, defending and protecting ourselves from embarrassment or harm of any kind.  The ego is fear based thoughts, the authentic self is love based.  I envision it as two separate layers with the ego on the outer layer, just like a cage, and the authentic self on the inner.  To get beyond the ego layer, the cage door must open which allows us to reach into our authentic self.  True connection can only happen at the authentic level.  When we interact with someone who is in ego state with their cage door shut, they come across as phony.  They are either saying ‘look how great I am’ or the flip side of the ego, ‘look how terrible I am.’  They either boast about what they do, or they are the victim of everything that happens to them. It is difficult to connect with someone who is in an ego state and unfortunately for the person stuck in ego state, they have lost connection with their own authentic self which makes it difficult for them to connect with others.  It is almost as if the door to their cage is shut and they have forgotten that they have the key to open it up.  When we get stuck in ego, the voice of doubt broadcasts so loud that it drowns out the voice of our authentic self.  The ego has no awareness of the authentic self, so once we are completely in the ego state it is like we forgot that we can choose to open the door to connect authentically.  It takes a lot of courage for the ego to open that cage door when it is screaming for you to keep it locked tight, but once we open it up it gives us the freedom to authentically connect once again.   So, the secret to getting out of the self-inflicted cage of isolation?  Recognizing that we are in the cage in the first place and remembering that we can choose to open it up the moment we are ready to truly connect.

Why do so many people feel so alone?

“It is strange to be known so universally and yet to be so lonely.” -Albert Einstein

In all counseling theories there is discussion of the importance of connection and healthy relationships with other people.  Attachment theory focuses deeply on the innate need humans have for connection and how not having a safe attachment figure leads to various difficulties and even mental illnesses.  One of the things that I hear over and over again from many of my clients is how alone and isolated they feel.  In this world of billions of people how is it that so many people feel so alone?  In his book and Ted Talk, Johann Hari discusses how he believes that a lack of connection is a root cause of addiction.  He uses as evidence the famous Rat Park study.  In the early research of addiction they put a rat in a cage and amazing-736881_1280presented two bottles of water, one laced with heroin or cocaine and the other one plain.  In those experiments all of the rats kept going back to the drug water and eventually overdosed and died.  Then an experimenter in the late 1970’s thought about the fact that rats are social creatures and he wanted to see what happens when rats are placed in a social environment.  They called it Rat Park and provided a large cage filled with about 20 rats.  They had all kinds of things for the rats to play with and explore.  When the rats of Rat Park were presented with the same two bottles of water none of them overdosed, none of them died.  When I share this study with my clients many of them discuss how they always felt like the ‘black sheep’ of the family or they talk about how they never felt like they truly fit in or belonged with their family or friends.  Through their addiction they hurt others, which then lead to even more isolation and stigma.  In effect, they describe what living in the cage of isolation feels like.  What is going on that so many people, not just people dealing with drug addiction, feel alone even when they are surrounded by people that care about them?  I believe that it comes down to how we see ourselves and what we say about ourselves when we look in the mirror.  I had one client say to me that he felt that he should have a warning label when he is around others because he believed that if others got too close to him, he would eventually hurt them in some way.  For him, he felt it was better to stay isolated then to hurt others, but what he didn’t see was how his choice to stay isolated was also hurting those who cared about him.  While we all have an internal critic, for some that voice is so loud and so persistent it is becomes hard for them to believe that they are worthy of love and connection.  It is the fear that others will see their unworthiness that creates a separation which cuts them off from connection.  That internal programing of self-doubt, insecurity and fear is like a self-inflicted cage.  So how do we develop the courage to step out of the cage and into life?  I’ll talk more about that next week.