Keep your head up – no shame in addiction

A client come in today for an addiction treatment evaluation. She had so much shame about her drug use that even the relative who brought her in didn’t know what drug she’d been using every day for the last year or so. I told her the same thing I tell all those who ask me for help – it is absolutely up to you to figure out who you feel comfortable telling about your alcohol, drug, gambling, or sex addiction problems. Just keep in mind that being shameful and secretive about your problems can cause addicts in recovery to be secretive when they experience cravings, triggers, and thoughts about using or acting out.

As hard as it is, disclosing these issues can provide an amazing amount of support while also allowing those close to you to be a real part of your recovery. Importantly, you don’t have to disclose to your significant other, your daughter, or your aunt. You can find an outside support system, either through peer-support groups like the 12-steps or SMART recovery or another group where you feel truly comfortable sharing. Shame will keep you isolated, sharing will help set you free.

Honesty, trust, and humility, along with the ability to admit that you are not necessarily managing recovery perfectly can actually be seen as strengths, not weaknesses. Try it out.

Shame on me – Stigma and addiction in treatment

I keep hearing that back in the old days of addiction treatment, shame was the main motivating factor used by rehab counselors. Everyone admits that it proved to be a horrible motivator. It simply didn’t work! With all the advances in research into addiction, that must have changed, right?

I don’t think so. I see shame and stigma every time I hear an addict talk about their drug use. The shame is there in their eyes as they tell the stories of their trouble and the struggles of their recovery. Given the low rates of success in addiction treatment, the shame rests firmly in the inability to quit as well. A relapse is often seen as the ultimately shameful experience for an addict. The stigma of addicts as hopeless is rampant.

Still, we have evidence of genetic predisposition to drug abuse and addiction, we know of environmental factors that make it more likely that people will get hooked. The effect of many drugs on the brain make unsuspecting lab animals as likely to become addicted as any one of us and I’m pretty sure that shame doesn’t play a role in their process.

With all this evidence, why is the stigma of drug addicts still around? Why are they the only ones being blamed for their condition?

The evidence I cited isn’t that different from that known for cancer, yet we scarcely blame cancer patients for their disease. Even in the case of smokers who become ill, their is still sympathy for their suffering. So why are addicts different?

There are good addiction treatment options out there, as long as we don’t give up on the person and simply view their addiction as evidence of their weak character. Given the changes that long term drug use produces in the brain, it’s a miracle anyone recovers at all. We should be grateful for that.

The music must change! Obsesssion, compulsion, shame an guilt in addiction

Guest co-author: Jeff Brandler from Changeispossible.org

The nature of addiction is one of obsession and compulsion. Regardless of the substance, behavior, or process, the addicted person will continue to obsess (countless and endless thoughts) and have compulsions (repetitive actions). They will repeat this obsession-compulsion ritual over and over.

music-sheetImagine a radio station that plays the same song over and over. Imagine that song being a steady diet of thoughts, and feelings of guilt, shame, remorse and self-loathing (GSRSL). Imagine an endless supply of obsessive thinking and compulsive replays of the thing(s) that the addict did to start the song playing.

People get involved in all kinds of self-defeating/self destructive behaviors. There are numerous reasons for this. The top ones that I see are: addictive disorders, mood disorders, self-sabotaging behavioral and personality traits. The GSRSL is a constant loop. It never stops. The problem with it never stopping is that it creates more GSRSL. The more GSRSL, the greater the need for the behavior. The more behavior that happens, the more GSRSL that you need and so on and so on. Does your head feel like it wants to explode?

Obsession and Compulsion – An example

Let’s say I had a fight with my spouse. I decide to smoke a joint in order to relax, escape, or unwind. Afterwards, I feel a lot of GSRSL. I have guilty thoughts, feel embarrassed and shameful. I have remorse for what I did, and beat myself up unmercifully. So what do I do in order to stop this behavior? You got it, smoke another joint, or maybe have a drink, only to feel more GSRSL. In doing so I then have the trifecta GSRSL of before, during and after-The music must definitely change!!!!

Or, imagine an alcoholic who receive a 3rd DWI citation after finally getting his license back following a 2 year suspension for his previous offenses. That’s some serious GSRSL. I have the most recent driving incident plus the 2 years where I lost my license swirling around my head like a blender. Talk about a bad song!!!! Please change the music!!!!

How does a person change this music?

It’s easy to change a radio station, but something that is so ingrained, so obsessive & compulsive is going to be much harder to change. Part of stopping this music is recognizing: 1) this is going to be hard to do 2) that I have been doing this for a while, and 3) it’s going to take some time to stop it. The key word that describes this is permission – I have to give myself permission to take the time that it’s going to take to make this major change. I’m also going to need to use a variety of approaches to change these thoughts and feelings (i.e. thought stopping, disputing irrational beliefs, identifying affirmations, (and using them regularly), and finding gratitude despite the pain).

Using this total package will be a first step towards change. It begins a long process of turning down the GSRSL music . I may need to also speak to a therapist to examine why I do these behaviors and what they are “wired” to. If in fact there is something biologically based, there may be a need for medication to “tune” these thoughts/feelings into healthier ones. Yes the music can change– It can go from “Comfortably Numb” to “Peaceful Easy Feeling”. The process of change is possible, but it’s going to take time and hard work.

Internet Porn Addiction – Why is free porn so irresistible and what can love addicts do?

online-porn101In a recent post on Internet addiction, we briefly mentioned addictions to internet pornography. There’s no doubt that the easy access, and anonymity, of online access to any and every sexual whim conceivable is at the heart of online porn’s draw. Here we will take a more in-depth look at how Internet porn addiction develops.

The internet porn addiction connection

Excessive use of online porn can be thought of as a manifestation of both Internet addiction and sex addiction. In fact, porn addiction is one of the most commonly reported sex addiction problems, especially among younger individuals and among what Dr. Carnes calls “Phase 1” sex addicts, or the lighter version of sex addiction that doesn’t involve others.

Porn addiction develops much like a drug addiction. After an initially rewarding experience with pornography (a common experience given the cycles of sex we’d mentioned in an earlier post), individuals may experience uncontrollable urges to obtain sexual satisfaction through that form of entertainment (1). The connection between internet porn and sexual gratification is positively reinforced, and the urges become more frequent and more powerful. These connections can become so strong that simply sitting down at a computer elicits a sexual response.

Like in drug addiction the problems arise when urges to view porn conflict with an individual’s daily responsibilities. Instead of leaving for work on time, the addict may decide to stay at home and watch porn – Some porn addicts report staying at home for porn sessions that can last as long as 8-10 hours. The shame and guilt that often accompany these compulsive sexual experiences are also thought to greatly affect the experience of sex addicts and to reinforce the positive experience they receive from their shameful act. Many porn addicts report that they end up in a distressing situation where their shameful sexual release is the only positive experience they get to have.

It should be noted that the majority of people who use online pornography do so recreationally, with little ill effect (2). As is the case with drug addiction, it is only a sub-group of people that become “addicted” and suffer serious consequences from their porn addiction (e.g. lost jobs, disturbed marriages).

Whether we are talking about pornography, gambling or shopping, our golden rule for diagnosing behavioral addictions has been: no impairment, no addiction.

The toll of porn addiction and the refuge of he internet

Internet Porn Addiction can also bring about a different psychological toll than the shame we discussed earlier. As tolerance develops, individuals with porn addiction may also begin to need more deviant material to achieve the same high. This is again similar to the increased quantity and variety need experienced by many drug users and it’s where rape fantasies, fetishes, and child pornography often come into play. Exposure to such material can grossly distort beliefs about human sexuality and ruin interpersonal relationships. Patients that progress in this fashion often report feeling unsatisfied with their sexual experiences and unsatisfied with their partners (2).

We noted that in addiction, shame is a major component of the addiction cycle. This is especially true for sexual addiction. Social norms tell the sex-addict that there is shame in buying an adult magazine (like playboy or hustler) and that there is shame in soliciting a prostitute. Internet porn substantially reduces the risk of getting caught, and therefore of being shamed. Many individuals who experience porn addiction are able to hide their activity from their partners and remain completely anonymous on the web. Online porn is easily accessible, it’s available all the time, and getting free porn is easy. When you add complete anonymity into the mix, you get a recipe for a potentially serious addiction (2).

Porn addiction help – Some Advice

Relapse is common during recovery as patients often experience withdrawal symptoms when their normal consumption of pornography is reduced. In this case, like in many others, relapse is to be thought of as a misstep, and not a failure. See our post on treatments for sexual addiction to see how porn addiction is usually dealt with. In addition to these standard methods, patients can often benefit from the use of Internet filters and “accountability” software that sends a report of their online activity to a partner or therapist. Again, it’s important to recognize that although porn addiction is serious, there are solutions out there and sex addiction help resources in general are growing with the recent jump in awareness brought about by high profile cases like that of Tiger Woods.

Citations:

1. Griffiths, M. (2001) Sex on the internet: Observations and implications for internet sex addiction, The Journal of Sex Research, 38(4)

2. Cline, V.B. (2002) Pornography’s Effects on Adults and Children

Is anonymity the final shame frontier in addiction?

I’m a drug addict and a sex addict, and as far as I’m concerned, staying anonymous let’s me remain buried in shame, and a double life, that keeps me always one step ahead of those close to me. Did I say too much? Did I give away my secrets? None of those  questions matter when everyone knows everything there is to know about you. For a disease couched in anxiety, obsessions, and compulsive behavior, there’s very little that can be more triggering.

The difficulty of confessing addiction

Obviously I’m not naive to the consequences of confessing to others, and I’ve had a few very uncomfortable conversations that ended in people losing my number or superiors telling me they didn’t need to know. When it comes to the former, it’s their choice, and it might be a wise one, but having those who stay close to me know my truths keeps me safe by making me accountable and protects others from being hurt. And I can hurt with the best of them. Maybe that’s why when it comes to physician treated addicted physicians, there are no secrets, no anonymity, the family and employers are made part of the process. Some notable addiction providers (like Journey Healing Centers and others) have programs that explicitly involve the family in the treatment process as well. Getting the secrets out works to break away from the shame.

We’re only as sick as our secrets, even together

On an organizational level, I understand the need for anonymity to avoid having any specific member represent the group. But that logic only holds when everyone is told to remain anonymous. Otherwise, the entire group represents itself, which is, if nothing else, truthful. If one person slips, relapses, or goes into a homicidal rampage, it only makes the rest of us look bad if no one knows that millions others are “the rest of us.”

Over and over I hear people talk about the secret of their addiction and the lies they have to tell to cover up their shameful acts. Unfortunately, that only contributes to the stigma of addicts and makes it all the more difficult  to get some perspective on the actual problem: We do things we don’t want to over and over regardless of how much they hurt us or those around us

If you’ve read anything on this site, you know that I believe in many factors that contribute to addiction, including biology, environment, experience, and their interactions. Still, when it comes down to it, the misunderstanding of addiction is often our number one problem. And anonymity does nothing to reduce that misunderstanding.

How we can make a difference

Media portrayals only exacerbate the problem as they show us stories of addicted celebrities who are struggling but then leave the story behind before any recovery occurs. That way we only get to see the carnage but have to look pretty hard to see anything more.

But we can change all this with a small, courageous, action. We can let those around us know that we’re addicts, that we’re doing our best to stop our compulsive behavior and that we want them to hold us accountable. If we slip, we can get back up because we don’t compound the shame of a relapse with lies we tell, and those around us know that even a relapse can be overcome because they’ve seen those examples over and over in all the other “confessed” addicts around.

It’s time to leave the addiction “closet” and start living. We may not be able to change who we are easily, but we can change the way we go about living and make it easier on ourselves and on others. By breaking our anonymity, we can help assuage our own shame and let everyone know that addiction is everywhere and that it can be successfully overcome.

Just a thought…