Other articles

I do not write on this blog much anymore.  I am writing articles for a local publication and I post them on my website as well.  For further reading around addictions, counselling, and other life issues please see the articles section of my website at: www.jasonmccarty.ca/kelowna-counselling-blog


Freedom and Responsibility (and Addiction)

Freedom and Responsibility (and Addiction)

The experiences of freedom and responsibility are very closely tied to addiction, but are so much more in the forefront of a human being’s struggle that addiction is quite secondary and symptomatic.  It is not the major issue.  Many clients are in addiction because it is the ultimate place to hide from freedom and responsibility.  “That’s crazy,” you say!  Yes and No.  We all do a lot to run from freedom and responsibility.  “No, not me!” As human beings we live within many paradoxes, and one major paradox we deal with on a daily basis is confronting our freedom and responsibility.  We both crave it and run from it.  People will die for it (terrorism, martyrdom, etc.) and die to avoid it (addiction).

I will let someone else explain this better than I and then discuss.  Yang (2009) writes:

According to Fromm, freedom is unavoidably tied to responsibility and destiny. Responsibility is equated with authorship.  Jean-Paul Sartre (1956) wrote that to be responsible is to be “the uncontested author of an event or thing” (p. 633). To be aware of responsibility is to be aware of creating one’s own self, destiny, life predicament, feelings, and, if such be the case, one’s own suffering. Sartre, like Fromm, believes that human beings are doomed to freedom.  Again, a paradox. (p. 184).

How can discussing freedom sound so negative and depressing??!!  No one ever said the existentialists were a bubbly sort and their writings definitely struggle with the sunnier side of life, but they do write about human realities. We are in a paradox.  We do fear our own freedom.  We do fear our own sense of responsibility.  It can feel like walking a plank.  It can make us want to run Home or stay in bed.

Addiction is also a paradox.  It can serve both as a way to avoid, as well as, a way to discover.  It can be a way one’s psyche forces them to take responsibility.  The only way out of addiction is to take responsibility and confront one’s freedom.  I have seen adolescents and people in their twenties arrive in addiction because so much was done for them by parents that they don’t know how to stand on their own two feet.  Addiction is a way to cope with that but it is also a way to change the dynamics in the relationship so drastically that parents can no longer “rescue” their “child” and that child is forced, by their own accord, to grow up, take responsibility, and live life.  This becomes a choice for the person in addiction.  Do they want freedom?  Without choice and responsibility, we have no freedom.

As the quote stated above, the scariest thing about responsibility and freedom is that it is ultimately up to us to create our life, “to be the uncontested author” of our lives.  We create our predicament.  “No, not me, the government screwed me, my parents have wronged me, my boss is unfair, my family won’t talk to me, I have a disability, I’m clinically depressed!!!”  We all have limitations, and some more than others, but the only true way out of them is to realize what responsibility we do have for our feelings, our thoughts, and our lives.  There are also limits to freedom, and accepting and realizing this will help to “experience” freedom within those limits.

But why is it so scary to be the author of our lives?  That’s what we want isn’t it???  Yes and no.  If it is all up to us, then we are very much to blame.  We don’t’ want to hear that.  We don’t want to feel like failures in a world that expects perfection the first time.  We want a place to lay blame if it doesn’t work out.  “I’m not clean because that treatment center sucks!”  “I cheated on my wife because she won’t have sex with me.”  “You made me angry.”  “I can’t go after my dreams because my mother needs me to take care of her.”  Even the things we think are to blame are choices we make.  We already are the author’s of our lives but we can often ignore that.

Accepting responsibility for everything, gives us freedom.  Realizing we make choices everyday, and accept responsibility for those choices, gives us freedom.  Freedom is scary, but once we step into it, it is liberating.  We are all looking for some aspect of liberation, but ultimately we are needing full liberation from ourselves – that part of ourselves that gets in the way of freedom: our fear.

Hoffman, L., Yang, M., Kaklauskas, F., & Chan, A. (2009). Existential Psychology East-West. University of the Rockies Press: Colorado

Tough Love or No?

One of the hardest things about having a loved one addicted to something is how to draw boundaries.  The traditional method has been something called “tough love” which means you take drastic measure to not support the person in the hopes that they will hit rock bottom and wake up in a ditch wanting to change their life.  Maybe you kick them out of the house, maybe you cut off all communication because your doctor told you to do so – or maybe you cut them off of all money supply.  Because addiction is so complicated and can make us all feel helpless, we can often take too drastic a measure to manage a loved one who is addicted.  Knowledge is not always a helpful thing, but in this case it is, and many people who will tell you what to do don’t really know addiction.  So the best our collective knowledge in the community can muster is “cut them off, kick them out, or stop talking to them.”  This can often make things worse for someone who is addicted and feeling helpless themselves, lost in a fog of self-hate and/or irresponsibility.  When any of us are lost we at least need something to tether to and when we do not have that we can fall deeper into the abyss.

While it is very important to draw boundaries with addicted loved ones, cutting them off from your relationship is not the answer (sometimes it may be).  You do not have to swing the pendulum all the way to the other side to begin managing boundaries better.  We can easily get ourselves caught in enabling behaviors.  It becomes a gradual process intended to help and protect and then we fear if we don’t continue they will end up dead on the street.  This catastrophic fear is not helpful either.  It can keep you stuck in the cycle.  The key is to find boundaries, smaller ones, that communicate the loved one what you will tolerate and what you won’t.   When they use in the house or when they come around high, it makes you or the kids or whoever scared, uncomfortable and angry.  You do not want this happening anymore.  You might stop giving them money, but will feed them.  You may have begun to learn their manipulations and start calling them on that.  Allow yourself to care for yourself just as much as you care for your loved one who is addicted.

People in addiction are still people.  Instead of focusing on them stopping their use, focus on what you don’t like about what they do in the relationship.  Not much of what you will do or say will get them to stop using directly.  But you can draw boundaries that protect yourself emotionally and mentally around their behaviors.  This way, as you speak from your experience in the relationship, they will not feel like you are trying to change them.  They will lose interest in being in relationship with you if they feel like you need them to stop using.  Keep them close to you in relationship so that when there are moments to discuss using and stopping, they will feel open enough to speak with you.

This is love.  Love is not tough.  Further, Love is not meeting all their needs, or doing too much for them because of fear.  I mentioned to a group of moms one time that all their worrying and attempts to control their addicted children were not even doing anything.  It is an illusion that our worries and attempts at control are doing anything.

Lastly, this is not easy!  Living with or being in relationship with someone who is addicted can be maddening, confusing, and downright unfair!  You might not have the energy to help anymore, or their might be other reasons why you need to cut them off from your life.  Physical safety, emotional abuse, and constant boundary crossing on their part need to be addressed appropriately by you.  You must care for yourself and/or your children while the addiction is running rampant.  But doing so in the name of “tough love” is not actually helpful.  If you have the energy and want to help this person, find a balance between enabling and cutting off.  It is all about balance when we decide to do things differently.

Overcoming Addictions: Two Decisions

Overcoming Addictions: Two Decisions

In my work with substance abusers in residential treatment, I’ve noticed that the ability to initiate the recovery process is a two-decision process.  Before I get into that process I want to address a phenomenon that occurs with practitioners working in this field.  We often have clients who seem resistant to treatment or counselling and for the most part this is normal.  Not everyone comes to treatment super motivated, and some come to alleviate pressure from family and friends.  Some clients going through treatment or counselling will not comply with all programming or homework assignments and this is just where they are.  When clients are showing some of this resistance many of us assume they are “not yet ready for treatment,” or they “just aren’t finished using yet.”  For some clients this is true, but this assessment can sometimes be a mistake with others.

The client who actually isn’t ready for treatment did not choose to quit yet.  I even say that statement with caution because we don’t really know this.  People are complicated and our resistances are there to protect us, whether one calls it denial or something else.  Someone may go to treatment and come across a personality type in their counsellor that keeps them from moving forward with being open.  We all then decide that client isn’t ready.  This may or may not be true.  What is going on behind a person’s resistance and defenses is not knowable until it is.  We can make some general assumptions and logical inductions, but we don’t really know what is or isn’t motivating that person.  Let’s say that client did not make the choice to really quit, that his/her parents, spouse, friends, etc, pushed her/him to come to treatment.  That client has not yet made the first decision in the process of recovery.  The first decision is to stop and want a different life.

Isn’t that enough?  Wouldn’t that motivate someone to get clean?  No, not completely.  Someone could decide to stop, go to treatment, but not fully benefit.  They say they want to stop but yet, seem to be standing still.  There is an old adage in the addiction treatment community that if you want to change you have to change everything.  That can be quite scary to most people.

So what does the second decision consist of then?  The second decision is to move forward with doing the work. We talk quite often in the addiction treatment world of “doing the work”, and this really entails the examining, changing, and processing of one’s emotions, thoughts, behaviors, and relationships, to keep it simple. Doing the hard work sometimes is about being vulnerable enough to allow other human beings to help. Doing the hard work sometimes means exploring events of the past that continue to keep one stuck.  Doing the hard work sometimes means deciding who one wants to be.  Doing the hard work sometimes means taking medication.  Doing the hard work sometimes means taking more responsibility for one’s life.  Although I describe this as hard work, it can be, and usually is, very rewarding and transforming.  The pain that most people are in emotionally is about the fear of their pain, not the actual pain.  Facing our own demons and pain is not as painful or scary as the fear about having that pain.

To quit and be successful, these two decisions might need to be revisited or renewed often in early recovery.  It is also important to determine what one needs in order to follow through with both decisions.  Sometimes that is support from others.  Other times it is letting go.  I have watched clients stay “on deck” like a batter on a baseball team and not step up to the plate.  It is like they are in a holding cell.  This assessment is not a negative judgment toward those clients, it’s just where they are.  I wonder, “what does this person need to move into the batter’s box?”  They’ve obviously decided to play this game (i.e. recovery, treatment, counselling) but they sure are having a hard time “getting in there.”  As practitioners it is our job to help them navigate fears and hesitations so they can step in when they are ready.  Once they make that choice, the recovery process becomes a lot more doable.  There is no cure here, or arrival, but the second choice is necessary in the way any of us change something about our lives – we actually have to DO something.

Lastly, I want to say this is my own observation in doing this work for several years.  The change process is quite complicated and this portrayal is only an aspect.  Take it for what it is worth.

Two Decisions:

1.             To Stop

2.             To Do the Work (actually start changing)

Scratching the Itch

Urge-surfing is the process of allowing a craving or an urge to use to be fully felt without doing anything – without distracting yourself, without going and using. If we look at cravings as merely body sensations, the mind can also interpret them as just that. We do not need to make decisions or engage in behaviors just because we feel a certain way or have an urge to move. This is not an easy concept to embrace but it can be revolutionary for some that struggle with substance abuse;  you are no longer fighting with yourself by trying to “get rid of” your craving. Instead you ride it out like a wave and observe that experience like a surfer, until is subsides. This will create new learning for your whole body as well as your brain.

The reason I bring this up is the other day I was holding my son and had a very annoying itch in my ear that I desperately wanted to scratch. I couldn’t scratch it because I was trying to get him to sleep so as you can imagine, the itch became more intense. It made me think of addiction and urge-surfing right in that moment so I tried it. Instead of wanting it to go away or scratching it, I just felt it, observed it, and allowed it to be there with no action. Don’t get me wrong, it was partially driving me crazy and it felt like a bug was tickling my ear, but also just observing this as what it was allowed me to ride it out. I can’t actually recall if it went away totally but it certainly lessened from when it first began to itch.

The experience I had with my itchy ear helped me to better understand the internal process of addiction. I don’t mean to demean or lessen the intensity of addiction by comparing it to my itchy ear (smile) but in many ways it is similar. Ultimately, cravings are an experience in the mind/body. Addiction is also an experience. It’s not a disease in your body that forces you to use like a robot. It is something experiential. Therefore, in many ways, experiential approaches to overcoming cravings and addiction will be quite beneficial to a substance abuser. One may need to have some clean time under their belt to be able to withstand the urge-surfing, but it can eventually be a useful tool.

So is addiction one huge itch? No. Cravings are one big itch and addiction is the constant scratching. Just because any of us feel something compelling doesn’t mean we have to act and often times, if we wait it out, it goes away or subsides to a tolerable level. I would encourage you to start trying urge-surfing with things like an itch in your body, or a desire for a coffee or sweets, or a negative emotion. Instead of “doing something”, just feel it, let it wash over you, and know it’s only a sensation.

Know Your Shadow

When people go to treatment or engage in some sort of addictions counselling, they sometimes feel a pressure to not have any urges to use.  Some people actually don’t have urges once they seek help but most do.  The ability to discuss this has not always been open.  I’ve watched many clients behave in ways and say certain things that show they are still ambivalent and think about either using or the culture of using.  But they don’t express what they are truly feeling because they want to be socially accepted; or they want to deny to even themselves that these feelings creep around underneath the surface.  There becomes a stigma in treatment that one should not have feelings or thoughts about using because why on earth would they be in treatment if they wanted to use.  This is all unsaid and gets reinforced even by practitioners that subconsciously feel like failures if their clients still want to use.  Much of this is due to a long time of poor knowledge of addiction, as well as, extreme judgment of addiction.

It needs to be more accepted that changing takes time.  Most people have either thoughts or dreams of using soon after they stop or enter treatment.  There is nothing “wrong” with this.  It might be disconcerting to those who just want it all to go away but it is also very normal.  Intense desires such as those that fuel the process of addiction are not shed overnight.   The other drawback to this unsaid phenomenon is that substance abusers trying to quit start to feel like failures when they have cravings and urges!  How debilitating!  You are not failing or bad at recovery if you have urges to use, even intense thoughts.  You are also not failing recovery if you lapse or relapse.  What? How so?  You do not have to go back to ground zero if you relapse.  You just need to turn around and observe what you just tripped on then keep on going.  Brush yourself off.  You do not have to delve deeper into a full-blown relapse or beat yourself up.  Natural feelings of guilt will arise as your behavior is going against your values of wanting to quit, but it does not have to carry deeper into shame.  Shame is feeling bad about yourself while guilt is feeling bad about your behavior.  Therefore, just having dreams, thoughts, and cravings to use does not mean you are doing recovery wrong.  It means you are a normal person trying to quit something that has had strong chemical and psychological holds on your whole person.  It also means it has been the number one way to cope and deal with everyday life and until your newly acquired skills are fully developed, you will sometimes want to resort back to what feels best.  But remember, just because you WANT to resort back and want to use, does not mean you HAVE TO use.

This idea or line of thinking that I am describing goes for so much more than just addiction.  In our society, we hold addiction to an unintelligently different standard of expectations for change.  Most people take a while to change behaviors/states such as anger, upset, smoking, eating, exercise, depression, anxiety, workaholism, sex, etc.  These same people relapse MANY TIMES!!  But for some reason people with substance abuse problems should get over them more quickly than everyone else who has unwanted, unhealthy behavior.  Interesting, huh?

I encourage clients to discuss both sides of their ambivalence: the side that wants to quit and the side that isn’t quite on board yet, or sometimes the side that really enjoys using and doesn’t want to stop.  Carl Jung (famous Depth psychologist) talks about a concept called Shadow which holds aspects of ourselves we suppress away that we don’t want to see or express.  Eventually, our shadow finds ways to be seen.  It is easier to reflect on the unwanted parts of us and get to know them.  Sometimes they will teach us things that no other part of ourselves could teach.  It is like the saying, “better the devil you know than the devil you don’t,” which illustrates the idea that you can do something about your shadow side of cravings and urges if you know them and explore them.  If you hide them and push them away they will find weird ways out that do not reach your conscious mind.  Basically you won’t know what you are up against.

My thoughts are you might as well talk about what you feel/experience because you are already feeling/experiencing it. Don’t be afraid to explore all parts of you because they all lead to healing.  Just because we have thoughts that scare us doesn’t mean those thoughts are who we are.  Those of you early in recovery or even long time in recovery, allow those thoughts to come to the surface and find a safe person to share them with.  Find a way to give them voice so that voice becomes less powerful. Do not feel like a failure, or that you won’t succeed in treatment or recovery because you have urges, thoughts, feelings, even yearnings about your using life.  You are always up against the choice of how you want to live your life and the more choices you make in one direction the more ingrained that way of life becomes.  It can always be changed.  So let yourself be open to the exploration process of all parts of you and there will be less shame.  Put it all on the table so you know what you are working with and you’ll be further along than if you didn’t.

Addiction, Needs, & Compassion

For many people – those working in the addiction field, or those experiencing an addict in their lives – it can feel frustrating that the addict keeps using.  We might feel they are being selfish, lazy, and irresponsible. We ask ourselves, “who would put up with not showering, living on the streets, stealing, selling themselves for sex, injecting their heroin with dirty puddle water, and on and on?”  “Those people are disgusting!”  “I can’t stand addicts!”  “I hate working with addicts, they’re always trying to get something from me!”  These are just some of the lines running through our heads at times.  The last thought is “why don’t they stop?”  The million dollar question.  Some answer through a biological explanation, others an adaptive explanation, others a spiritual explanation, and some a social learning explanation.  It is all of these.  But for this essay I want to focus on a more adaptive explanation and one that is more concerned with an ongoing internal process in the here and now, one that concerns itself with the meeting of human needs.

It’s obviously hard to have compassion for those abusing substances.  But, really, that is the easy reaction to have.  Staying there only keeps one in the dark about the addict and about themselves.  Dr. Wayland Myers, PhD, has written a document about “Defining a Nonviolent Communication Approach (NVC) to Addictive Behaviors.” In this he explains how Marshall Rosenberg, the founder of NVC, tries to approach the addict by using empathy and trying to understand what needs are being met by using.  He does not try and get addicts to stop using.  Substance abusers are usually quite perplexed by his approach because they are used to everyone trying to get them to stop.  His focus is on needs so that he can proceed in helping that person meet those needs in ways that are “more effective and less costly.”  This is not easy for many people in our society as we want to FIX people.  It is tough to give up coercive measures, confrontational approaches, and parental directives.  As helpers or loved ones we can often feel helpless, out of control, and frustrated within the paradigm of judgment and control because it becomes a negative feedback loop. Pushing our goals onto someone else may work in the short term, but usually, though, backfires, and can often perpetuate disconnection, a need all humans value.

 So why do we continue to stay in this place where we NEED substance abusers to stop? Why do we work so hard FOR SOMEONE ELSE?  Why do we feel so out of control? Why do we get frustrated, angry and hurt by their use?  It is usually more to do with our own needs not being met.  As helpers, we must connect with our own needs in order to connect with another’s.  It is also a paradigm that we are in that using is wrong and we must “intervene”, we must “challenge” them, we must, we must, we must.  “They don’t know how to live life”, “they are irresponsible”, “they have mental health issues”, “they have a brain injury”, “they are still a child”, “they experienced trauma” – ultimately we are invading their sense of humanity, their internal world, their “creative adjustment” as described in Gestalt psychology. Using, for many, has been a very creative way to cope, adjust, and stay alive.  It has become an organismic adaptation to life experiences. Why do we want to pull this carpet out from under them so quickly and harshly??

 Instead of making all these assumptions and judgments, we need to “connect” with addicts as in NVC, or make “contact” as in Gestalt psychology. Take away the stories, take away the judgments, and learn what is there.  What need is being met by all this using.  Can we help this person make contact with their own internal world so that they can at least value their own world?  Shame is the result of continuously denying one’s own experience.  We can blast away shame by listening, connecting, and helping those who use to become more in tune with their needs and their internal worlds.  We must remove our judgments and need for control so that we can offer humanity to someone.

 From an existential point of view, it is that person’s responsibility to take control of their life how they see fit.  From a person-centered and gestalt psychology point of view, all human beings are moving toward growth in some way.  We can either help them get there taking which ever roads fit best for them, or we can weigh them down on the road of addiction. The more we focus on getting them to stop the addiction, the longer they only focus there and stay on that path.  The quicker we begin walking with them on that path instead of hurrying them off, the quicker they will want to explore other options.  Once someone feels truly supported and understood they will feel the energy to take on new experiences.

 So, what are their needs? How can you help them connect to their needs?  If you are addicted, how are you not connecting to your self?

 Lastly, I want to make a quick point here about boundaries.  Nowhere in this approach or understanding does it say let substance abusers or anyone for that matter treat you however they feel like it.  You do not have to just sit there and accept all behavior toward you to be compassionate.  It is important for all humans to connect to their own needs and express these honestly.  So if you are feeling manipulated, hurt, taken advantage of, etc, then calmly express this to the person so they understand.  We must meet our needs as helpers as well and do not need to allow dysfunctional ways of relating to hurt us for the sake of “compassion.”  This is not how it works.  The compassion and connecting are to the person and the unmet needs, not to allowing yourself to be treated in ways you don’t want.