My wife and I were discussing the state of affairs in America.  At least as they apply to our teenage daughters and their peers.  In addition, given my line of work, it is hard for us to have any conversation that does not circle back to drug addiction or some other type of sociological dilemma.  My wife ask a very simple, yet thought provoking question:

“Rich, if America is such a wonderful place to live with great opportunities, wealth and material possessions… why are we so addicted….why is everyone addicted to something and why are so many young people obsessed with altering their state of mind?   WHAT’S SO BAD THAT EVERYONE HAS TO ESCAPE?”  Therefore, in this post I set out to explore this issue of addicted America and the potential solutions to this ever expanding problem.

1.) Is America more addicted than the rest of the world? The short answer to this question is “YES-absolutely”.  There is no clear ranking in this area due to no universal agreement on what constitutes addiction.  However, the evidence suggests America is an over-achiever in terms of addiction.   Relative to the remainder of the world all wealthy and developed countries are more addicted than the undeveloped and poor countries of the world.  According to the U.S. News and World Report and the World Health Organization about 200 million people abuse drugs worldwide and use is much higher in richer nations.  America leads the way in certain areas such as illicit prescription drugs use (for example 80% of the worlds opioids are consumed by Americans) and Americans tend to “be more willing to try a wide variety of drugs”.  In terms of alcohol consumption we are “middle of the road” as Russia sets the standard in this area.

One thing is for sure.  The toll drug addiction is taking on America is obvious.  Overdose deaths have exploded.  When you see these statistics it certainly seems that addiction is a more significant issue in America than other parts of the world:

The World Health Organization looks at regions rather than countries.  Relative to other parts of the world North America far outranks other regions in terms of drug deaths:

An organization called World Health Rankings does assess country level data.  They found that in terms of drug deaths per 100,000 the United States is ranked third worldwide behind only Estonia and South Africa.  Therefore, I would answer yes we are living in ADDICTED AMERICA.  If you include “process addictions” such as pornography, gambling, compulsive shopping and internet gaming the issue is even more wide spread.

We live in a country that, on balance, is incredibly wealthy.  We are not torn apart by civil war, we have leisure time, we have access to clean water, food, and we have endless opportunities.  The issue of addiction is impacting all socio-economic classes so you can’t argue that it is poverty that accounts for these problems.  Addiction is just as likely to take out an affluent white suburban child as an inner city child.  Addiction is not relegated to any certain racial group.  It is the one unifying factor across America.  Regardless of race, political affiliation, socio-economic class we all love getting high.  Why are we so pre-occupied with altering our state of mind and changing our mood?

2.) Is America more addicted now than in the past? For centuries the current generation has suspected that the upcoming generation is going to be the downfall of society.  There is a phenomenon called intentional bias where a group can impose their version of reality onto a situation.  In this case, there is a danger that the older generation (I guess I’m part of that generation) would look fondly on the past as a kinder, gentler, more sober period of time.  Let’s take a look at the facts to see how things stand in terms of addiction.

• The war on drugs has been an abject failure: Despite aggressive policies and enforcement actions against every link in the chain of producers, distributors and users, the illicit trade has become more prolific than ever, exacting a painful toll on every area of society it touches. Over $1 trillion has been spent resulting in over 500,000 people in prison for drug offenses and an INCREASE in rates of addiction.  Well done America! (ONDCP, 2014)
• Illicit drug use in the United States has been increasing: In 2013, an estimated 24.6 million Americans aged 12 or older—9.4 percent of the population—had used an illicit drug in the past month. This number is up from 8.3 percent in 2002. The increase mostly reflects a recent rise in use of marijuana, the most commonly used illicit drug (SAMHSA, 2013)
• Marijuana use has increased since 2007.In 2013, there were 19.8 million current users—about 7.5 percent of people aged 12 or older—up from 14.5 million (5.8 percent) in 2007 (SAMHSA, 2013)
• On a positive note alcohol use has gone down. Rates of alcohol dependence/abuse declined from 2002 to 2013.In 2013, 17.3 million Americans (6.6 percent of the population) were dependent on alcohol or had problems related to their alcohol use (abuse). This is a decline from 18.1 million (or 7.7 percent) in 2002. (SAMHSA, 2013)
• However Opioid use has grown steadily year over year 1991 thru 2012:

• Heroin use, dependency and “initiates (newcomers to using heroin) has also grown year over year:

I would argue that the country is becoming more and more “addicted”.  Drugs are breaking through taboos and perceived risk is falling.  Heroin is very revealing in this regard as it is on the verge of becoming a mainstream drug.  The proliferation of prescription drugs and the associated issues makes it all the more challenging.  We are living in the era of ADDICTED AMERICA.

3) Why is substance misuse exploding in America at the current time? If you agree that addiction has escalated and is reaching epidemic proportions that next most logical question to ask is…why?  I can offer only my humble take on the situation.  So for your consideration I offer the following factors as coming together to form a perfect storm:

A pill for everything: Our current culture promotes a pharmaceutical solution for nearly all human conditions.  We live in a world that sends the message “take a pill for everything”… and then we are surprised when kids or young adults take pills recreationally.  Why wouldn’t they?  Prescription drugs have become a mainstream recreational option for kids who want to “party”.  Taking a pill to improve your quality of life is completely normal and promoted.  This is not to say that medication is unnecessary.  Many people need legitimate support.  However, over-prescribing is without question common practice.

I recently saw an animated commercial that depicts a woman and a giant pill with Opioid written on it.  The pill has arms and legs and can walk around with the woman. The two of them spend the day together at the park, taking art lessons, and going to the pharmacy to pick up their prescription to treat Opioid Bowel Syndrome.  I thought I was living in some alternative universe when I saw this commercial.  I could not believe my eyes.  The not so subtle message is that pills are your friend.  It’s going to be very hard to convince young people otherwise.  This is a completely different cultural norm.  As recently as 15 to 20 years ago prescription drugs were seen as being “hard” drugs.  There was a taboo around the use of prescription drugs.  Well…that ship has sailed.  Prescription pills are mainstream and viewed as safe because they “come from a doctor”.  For example, according to National Institute of Drug Abuse 27% of teens and 16% of parents think using prescription drugs to get high is safer than using “street drugs”.   Game on.

The Age of Anxiety: Anxiety has been present since the beginning of time, however, it is clear that anxiety has become a modern day plague.  There are variety of reasons for this reality.  One major contributing factor is the rise of information and the constant stream of negative outcomes lurking around the corner.  Parents can request tests for birth defects while the child is still in the womb so the worrying and waiting for results can start before birth.  The constant access to news and the sensationalized nature of the news also contributes to the information overload.  If a child is kidnapped it is broadcast over all the cable channels and parents go into lock down mode.  In the past year we were told of imminent doom.  Experts told us that Ebola was going to cause a pandemic, that ISIS was coming for us, that price of oil is too high to sustain the economy.  Now the reports are that prices for oil are too low to sustain economic growth.  Global warming is going to lead to widespread famine and destroy life on earth.  Unseasonable cold temperatures in other parts of the world are cause for a whole other set of concerns.  There was a time when there were only 3 networks and the news was only on at 6 pm.  There was not 24 hours access.  Today you can watch the play by play destruction of the world.  That’s a little anxiety producing.

A second contributor to collective anxiety is over-stimulation.  The constant     connection to technology, entertainment, and organized activities (especially for kids) leads to a packed calendar and endless to do lists.  It is very hard to “calm down” when you are continually engaged and pulled into cyber-world.  Quiet time is very difficult to come by.  In addition, social media is tailor made for superficial image driven virtual interactions that contribute to a continuous feeling of being less than.  People can easily fall into a pattern of thinking that they are not doing as well as their counterparts.  This produces social anxiety and perceived pressure to “do better”.  Add all of this up and it is easy to see that people would be attracted to the numbing effects of psycho-active substances.  Taking the edge off is more attractive than ever.

The Age of Disconnection: In his book, Bowling Alone, sociologist Robert Putnam discusses the deterioration of the American community.  His thesis is that a major demographic shift has occurred over the past 50 years and this has contributed to a major change in outlook and attitude where community is concerned.  Specifically, the “greatest generation” has died off replaced by the baby boomers, the baby busters and now the millennials.  This has contributed to a steady disinterest in the traditional institutions that held people together.  Putnam is not being negative about these generational shifts he is critical of the institutional responses to the generational shift.  There is no problem with a changing attitude, however there is a major problem when society does not adjust along with the changing attitude.  For example, the American political institutions, educational system and healthcare system has remained unchanged despite these major demographic shifts.  The last time a demographic shift of this magnitude occurred was “the Gilded Age” (1870 thru 1900) and the social problems that arose were unprecedented to that point in American history.  Rapid economic growth and industrialization lead to massive immigration and domestic relocation.  Crime, poverty, and blatant inequality carried the day.

This impact around these demographic shifts is made more significant by technology.  The way people “connect” has fundamentally changed.  Our younger generations do not know what it is like to have to find a “land line” to make a call.  They have grown up with the internet being a given, even a necessity.  Communication via text and the utilization of social media is second nature.  In addition, it is possible to be in a room with several other people and to not be there at all:

All of these factors contribute to a fractured, disconnected society.   The founding father of the functionalist perspective in sociology, Emile Durkheim, coined the term anomie to describe social disconnection.  It has been a generally accepted principle that when people feel disconnected within society problems are sure to follow. It is easy to see how a disconnected society is fertile ground for the spread of drug addiction.  Getting high is one way to cope with the void that comes along with lack of community.

The Gilded Age did not end until society developed different institutions in response to these demographic shifts.  This was the beginning of a new political structure and the age of the progressive era was ushered in.  This was also the period of time where labor unions came on the scene and community agencies such as the YMCA were established.  These were intentional efforts to change the “way things were done” to fit the reality of fundamentally different culture.  Unfortunately society has been unwilling to make a shift in response to our current dilemma.  If you drill down into drug and alcohol services you find the same fundamental organizational structures that have existed for 50 years.  There are very few innovative and culturally relevant options.

The Legalization of Marijuana: Regardless of your opinion on marijuana it is clear to see that the legalization of marijuana has created conditions ripe for the expansion of drug use overall.  Stating the obvious: legalized marijuana means more people will use the drug and, ostensibly, some of these people will develop dependency.  More people using marijuana means more people with problems related to marijuana.  I don’t know how anyone can argue that logic.  The secondary issue is that legalization of marijuana contributes to a permissive attitude toward other drugs.  For example, among young people there seems to be a steady decline in the number of drugs that are “off limits”.  I understand this is a “slippery slope” argument and I am not typically a big fan of the slippery slope argument.  However, in this case I believe we are on a slippery slope.  Perceived risk regarding marijuana is relatively non-existent among teenagers.  Everyone, (even if they don’t use marijuana) seems to think marijuana is harmless.  Why would this perception stop at marijuana?  Prescription drugs are already on the way to being considered non-threatening.  Cocaine and heroin are sure to follow.  All of this contributes to a very lax and cavalier attitude surrounding drug and alcohol use.

4)  What do we do about the addiction crisis?  The short answer is “something different”.   Let’s follow the lead of our predecessors that brought us out of the dark times of the Gilded Age and create new institutions and structures to address the addiction issue.  We need to come up with a culturally relevant response to our changing societal conditions.

We must embrace the reality of multiple pathways to recovery: According to the Partnership for Drug Free America there are around 25 million people living in recovery in America.  According to the Alcoholics Anonymous world service website there are around 2 million members WORLDWIDE.  Narcotics Anonymous doesn’t have a membership total.  NA does, however, report on total number of meetings worldwide.  If you factor in average meeting attendance you can approximate total membership.  If you are generous in terms of that average attendance you could ballpark another 1.5 million Narcotics Anonymous members.  Let’s say that these numbers are understated and for sake of argument you push the total 12-step membership to 5 million WORLDWIDE.  That means that are at least 20 million people living in recovery in America that are maintaining that recovery through some means other than 12-step meetings.  However, 95% of our rehabs are based on the 12-steps.  We need to promote and nurture alternative pathways.

We must move away from a segregated and antiquated addiction treatment system toward integration with healthcare in general: We should treat addiction like any other chronic disease.  There is no state department of diabetes.  There is no state department of heart health.  Why do addicts and alcoholics require their own separate state department?   I believe that full integration into a holistic health system is the ultimate answer in this fight against addiction.  If we make the care of substance use disorders a routine part of healthcare you will see the stigma fall and the numbers seeking recovery rise.  By the way I would make the same argument regarding mental health. I believe that mental health is closer to this being a reality than substance use disorder treatment.  Mental health services are already integrated into the larger healthcare systems in many organizations.

We must change the primary service delivery location from office based to community based: This is the most obvious adjustment.  We know that 90% of people in need of services do not access services due to denial of the problem.  We have traditionally sat back and waited for these people to show up at our clinics.  Well that is just straight silly.  The 90% non-compliance rate has not changed for 40 plus years of being studied.  It’s not going to happen.  The 90% are not coming to us…let’s go to them.  More on this in later posts.

I realize that there are people who will read these recommendations and write it off as impossible and inappropriate.  I hope that is the case because we know that when the traditional institutions push back on ideas the ideas are truly innovative.  Maybe these ideas are not the solution.  But there is one thing for sure: the current modus operandi is not the solution.  I welcome criticism and alternative ideas.  But please make sure they are NEW ideas.

The post ADDICTED AMERICA: 4 Points to Ponder Copy appeared first on The Recovery Cartel.

I am talking to myself right now, as much as anyone else out there. I’m most critical of myself. I have made some mistakes:

The over-reliance on the “recovery group” and “recovery program” is highly problematic.

Professionals, and people in recovery, have to be careful. There is a tendency to automatically recommend attendance at “recovery meetings” or enrollment in group therapy for people who have misused substances.

However, these groups are not designed for people with mild or moderate substance use disorders. It’s a mismatch.

These kids (many times they are younger) DO NOT NEED groups in order to recover. It’s a fact.

Harvard University Recovery Research Institute studied recovery pathways.

There are some key takeaways (in terms of group attendance/”program involvement”).
NOTE: They studied people who needed help to recover (assisted pathway = 54%) versus people who figured it out on their own (46%).

Factors that were related to an “Assisted Pathway” were broadly INDICATIVE OF A MORE SEVERE PROFILE.

MORE SEVERE PROFILE INDICATORS

These included:

• Having used 2 or 3+ substances vs. 1 ;
• Opioid as one’s primary substance compared to alcohol (and alcohol more likely than cannabis) ;
• First use of any substance younger than age 15 ;
• Receipt of a mental health or substance use diagnosis by a medical professional (which, by definition, meant that the person had discussed their substance use and/or mental health with a medical professional).
• Been arrested and, especially, having been referred to drug court.

Dangerous & Inappropriate

If is very possible that when we send someone with less severe SUD to recovery group it’s an inappropriate referral.

The more I learn, the clearer this is.

It’s dangerous to automatically send people to groups.

It is not good to over-prescribe these groups (regardless of the type of group). It’s dangerous.

There are problems and we can make it worse by sending people who don’t really need that level of intensity.

I have learned this the hard way. I will never forgive myself for some of the referrals I have made to meetings/groups.

More will be revealed.

The post SEVERE PROFILE MISMATCH appeared first on The Recovery Cartel.

Hard Working & Solid

There are many good people working hard to provide solid mental health and substance use therapy and coaching.

There are tried and true therapeutic interventions.

The “self-care” list is pretty consistent, containing the standard stress management tips and mental health hygiene recommendations.

For example, this is list on the CDC website:

Ways to cope with stress:

• Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
• Take care of your body. Take deep breaths, stretch, or meditate
• Try to eat healthy, well-balanced meals.
• Exercise regularly, get plenty of sleep.
• Avoid alcohol and drugs.
• Make time to unwind. Try to do some other activities you enjoy.
• Connect with others. Talk with people you trust about your concerns and how you are feeling”.

You can check it out yourself, but every list is basically some form of that CDC list.

Check out Psychology Today. Virtually identical.

No one can argue with those recommendations. However, I vow to work hard to discuss things that are different than that basic list.

I will not say the same thing that all the other providers/experts say.

I will add something different. Or at least I will try to add something different.

Tonight’s Recommendation:

1. Create a Firewall

Create a firewall between work and “home time”. Today I spent 13 hours with zoom meetings packed one after the other, conference calls, FaceTime news interview.

With only small slivers of time in between the calls/zoom meetings.

And then all the sudden BOOM !

The day is over. And I’m home.

2. Ritual & Routine

I recommend you create some type of ritual and routine that marks the end of work and the beginning of home time.

Analogous to someone coming home from manual labor.

Your hands are dirty, your clothes are dirty. You wash your hands, you change your clothes for obvious reasons.

However, this also serves as a transition from work to home.

3. Consistently

Figure out some type of routine that fits your individual circumstances.

Change clothes. Take some time alone. Communicate the plan to your family.

Maybe you go for a run.

Maybe you sit down and journal.

The important thing is to follow this routine consistently.

Otherwise, it won’t be a routine.

The post Rich Jones Recommendations appeared first on The Recovery Cartel.

I read a very insightful article in NEW YORK TIMES Sunday on families living with a person in active addiction.

The article essentially chronicled the exhausting and never-ending journey of dealing with the issue of addiction. The violence, the conflict, in and out of treatment, in and out of jail, the constant worry, the financial implications and the list goes on and on.

The story highlights one case where the addicted individual has 4 overdoses in 6 hours.

We know the tragedy of losing a loved one to overdose. Unfortunately, we hear about this quite often. More often the person stays alive and that is good news. However, these families are faced with an entirely different level of chronic stress and ongoing torment. These families are being torn apart.

This is why we need to turn our full attention to helping the family. The way things are set up now the family is an after-thought. In some rare cases there are family programs while the “addicted person” is in treatment. Sometimes there is ongoing follow up. The best-case scenario being a year of after-care support; which is more often focused on the addicted individual not the family.

Staff from rehab and/or staff from the local outpatient clinic are not engaged with the process long term.

Even if a person was somehow in a program for a year it is still just a fraction of the lifelong recovery process. In most cases, long after treatment has been “completed”, and the family/client are a distant memory, the struggle continues.

The facts are: most people bounce from rehab to rehab. It’s not unusual to hear about $100,000 or more being spent. Despite the money the struggle persists. Those of us who “get recovery” are blessed beyond belief. We are miracles.

But our personal good fortune doesn’t erase the reality of this CHRONIC, relapsing disease.

THIS IS WHY WE TURN OUR FULL ATTENTION TO THE FAMILY.

The family is going to bear the full burden of this disease. Detachment was created for wives of alcoholic middle-aged men. Not parents of heroin users. Families are going to need to become mini experts and accomplished system navigators.

Our family Recovery coaching is a family to family model. An assertive and aggressive model where you learn to trust your own judgement and follow your plan rather than “calling the 1-800-GET-HELP” number pushed by the some in the treatment industry.

If you are a family in need we recommend you take the following actions immediately:

1).  Read, get educated, learn what addiction is:

Learn what Recovery options are. You can access the recovery cartel site for basic information. Attending support groups can help. Reading can help. Be careful where you get your information. There are many self-proclaimed experts out there.

2). Become an expert on what your insurance will cover.

Get ready to appeal denials. Understanding your insurance benefits is a very difficult process.

You will need to be very aggressive and persistent with the admission teams and with the insurance company. The insurance company’s strategy is to wear you down. The denials are usually not appealed and the insurance industry fully understands that reality. They are banking on you letting it go.

The stigma and embarrassment around this issue will keep you from asking questions.

3). Start to develop your “team”:

Are we all on the same page and what are our options? Do you believe that your loved one is dealing with addiction? What about others in the family? In general, the more people involved the better. However, you need to make sure everyone is on the same page. Mixed messages are not good.

4).  Support groups.

Whatever is available in your area. Try different types. Al-Anon, Naranon, if you are fortunate enough to be in the Upstate of South Carolina check-out FAVOR family recovery groups.

5). Develop “crisis” plan:

What are you going to do if the person is violent? If their use escalates and their life is in danger? Research the commitment process in your area. Understand the law as it relates to “kicking a person out” of your home. Call 911 when in doubt. Sometimes legal charges are a blessing in disguise.

6). Develop “save my loved one” plan:

This involves finding rehab and/or recovery programs. It often involves an intervention. It involves setting up new boundaries.

Again, the importance of having everyone on the same page can not be over-emphasized enough. Sometimes you can start with a family meeting rather than an intervention. The power of the family can be very profound. You need to prep for the meeting and have the details worked out regarding program placement ahead of time.

Also, compromise is sometimes necessary. Depending on the circumstances, it is sometimes appropriate to settle on a less than ideal resolution. For example, you wanted your loved one in rehab but he has agreed to intensive outpatient. Maybe you take that deal.

7) Develop your own “family recovery plan”:

This can be hard for many family members to understand. Your own family recovery plan involves you focusing on yourself. You need to find a way to have a good day independent of the status of your loved one. You need help and support in managing your emotions and your stress. Support groups can help with this process. Therapist, coaches, sponsors as well.

8) surround yourself with positive supports to help you stay on plan(s):

You don’t have time or energy to deal with negative and toxic people. Your stress level is high enough. All those self-righteous people who want to pass judgment on the situation. Eliminate them from your personal universe.
None of this is easy.

Family members have to view this as a long-term process rather than a single event. There will be ongoing need to course correct. There will be ups and downs. The key is to not get too high or too low.

Please leave your email and sign up for ongoing news from the recovery cartel.

We are here for you and we know the journey will continue!

The post FAMILIES LIVING WITH ACTIVE ADDICTION appeared first on The Recovery Cartel.

Many times, I write a blog post to “scratch my own itch”; meaning I need to solve a problem or address a personal issue with which I am struggling.  As I work this issue out for my own benefit, I share it with you.  The hope is you will also gain from this process.

What’s bothering me?

BEFORE YOU YELL AT ME FOR INSENSITIVITY: I HAVE GREAT RESPECT FOR THE LEGITIMATE DIAGNOSIS AND TREATMENT OF MENTAL HEALTH ISSUES. I AM NOT MINIMIZING ANYONE’S EXPERIENCE IN COPING WITH MENTAL HEALTH. I AM MERELY POINTING OUT THE OVERWHELMING PROCESS OF “UNDERSTANDING” WHAT AILS US…

Identifying what is bothering me is easier said than done.  I decided to google it and begin some research. I typed in my symptoms (restlessness, distractibility, low grade worry, dysphoric mood, a bit of anhedonia, pre-occupation with work, difficulty making career decisions)

The diagnostic and statistical manual 5^th edition (DSM-V) has nearly 300 different disorders in it. So far, if I base it strictly on the criteria in this book, I may have the following disorders:

• Attention Deficit Hyperactivity Disorder (ADHD) Combined Presentation
• Caffeine Intoxication
• Caffeine Induced Anxiety Disorder
• Generalized Anxiety Disorder
• Adjustment Disorder with Anxiety
• Adjustment Disorder with mixed disturbance of emotions and conduct
• Unspecified Anxiety Disorder
• Unspecified Trauma and stressor-related disorder

Or if I want to stay away from a medical diagnosis perhaps I am suffering from:

• Mid-life crisis (what the hell?)
• Entrepreneurial depression and mood swings!
• An existential crisis!
• A theological crisis!
• According to the Big Book it’s a spiritual malady. Irritable, restless and discontent!
• According to others in recovery it’s a lack of self-acceptance.
• Or maybe I have not worked the steps?
• Or maybe I have not worked on core issues?
• According to time management gurus I have too many open loops and uncategorized projects.

Or maybe I a human being…being human.

This is my dilemma, I’m human

I do not have a diagnosis or a “condition”.  I have not missed the boat on some type of spiritual conversion. There is no magic answer to be found in any time management system and I don’t need any medication. My condition is serious enough to be a nuisance but not serious enough to warrant drastic measures.  I have diagnosed myself and the condition I am suffering from is:

HUMAN BEING DISORDER – NOT OTHERWISE SPECIFIED

That being said, I definitely need to make some changes. The symptoms I listed above are real. I can be overwhelmed with life from time to time. I don’t want to just survive. I want to THRIVE. Therefore, I need to choose how to attack these issues.  For me it comes down to 4 essential factors:

1. What’s happening to me physically? Am I eating right, am I getting sleep? Am I exercising and if so am I pushing myself beyond my comfort zone?  Am I sick or suffering from another allergy attack?  It is impossible for me to separate the way I feel physically from my mental state.
2. What happening in my “circumstances”? The serenity prayer nails it with the line “the courage to change the things I can”.  If am living with a situation that is unacceptable and IT CAN BE CHANGED, I have an obligation to change it.  And, as the serenity prayer states, if it can’t be changed I must accept it.  This simple prayer is a mantra for many in the world.  However, I would argue few take these wise words to heart.
3. What’s happening to my mindset? Am I in a growth mindset?  What new things am I learning? I cannot stand still. Just like physical well-being I need to push myself beyond my comfort zone intellectually and mentally.  I need to find new things, start new projects and fully embrace the mission.  With a why I can do anything.  Without a purpose, I will stumble through life.
4. What’s happening with my thinking? I need to stay mindful of my past and how it influences my core issues. I need to be willing to acknowledge the traumas of my past, identify the schema associated with these experiences and explore ways to work through these issues in the present.

These are areas within my control and they influence the other important areas of life. Relationships, work and finances are all positively impacted when I’m on my game in these 4 categories. Conversely, when I struggle in these areas my relationships and my work and all areas of my life suffer.

THE BIG FOUR

1) Physically

I have not been doing well in this area lately.  I have 4 businesses that I currently work in. I work about 70 hours a week.  I also have 4 children 10 and under at home. It can be very easy for me to get run down if I don’t take care of myself. This category is frequently related to eliminating bad stuff (cigarettes for example) and adding good (exercise). For me it’s about behavior change on the elimination side.  I am doing relatively well with exercise and better with sleep. I can’t control my ever-present allergy issues unless I move to Arizona. I need to manage this on an ongoing basis. But there is at least one major problem in relation to physical issues:

It all starts with sugar.  Sugar is addictive. This is a known fact. 

At FAVOR Greenville, we have a serious sugar problem.  Candy everywhere, donuts everywhere.  Sugary snacks that are yet to be identified. I have not imposed my will on the masses at FAVOR by banning candy and donuts. It’s an interesting phenomenon. I can abstain during the morning and into the early afternoon. However, around 3 pm it’s all over. I give in.

Here is my plan:

More important than anything, I need to assess where I am in the stages of change? Am I sure I want to make this change?

Do the benefits of giving up sugar (healthy etc…) outweigh the payoff (it tastes really good; I get a sugar buzz). I cannot take motivation for granted.

Maybe I should write this down.  There are normal and predictable stages that people go through when it comes to making a change.

Announce my intention to change to people who are important to me. Publicly proclaiming my plans increases likelihood of follow through. I just announced my plans!!!

Bring more healthy food to eat during the day. This capitalizes on the principle of replacement behavior. (I will need to beg my wife to help me with this.)

Which brings me to an important point. Having someone in your corner to support you through these changes is very important.

Move the freaking candy bowl off the front desk. Clearly environmental triggers are the easiest to control. Putting a barrier between you and the behavior you are trying to eliminate increases the likelihood of success.

Beware of the Abstinence Violation Effect (AVE). The AVE is the very natural human tendency to throw the towel in when we make a mistake. When we try and make a change and “fail” we tend to give up.

Develop the mental awareness and toughness to simply refocus and re-engage in the change process.Track my behavior. There is universal agreement. When you track something you improve by virtue of the tracking.

I will use a program on my iPad to chart my behavior daily. Including food.

How are you doing with your physical well-being? What is the issue you need to address? Is it a matter of eliminating a bad habit or adding a good habit, or both.

Once you identify the change then get together an action plan.

These principles are universal.

2) Circumstances

Believe it or not the discipline of positive psychology has identified a happiness formula.

Our circumstances clearly influence or happiness.  However, at a surprisingly low level of influence. At 10%, our circumstances are not going to make or break our subjective well-being.

I have much to be grateful for and, truth be told, I have already made significant changes to my circumstances. This was mostly related to work and career and involved a great deal of risk.

In order to identify additional changes, I need to spend some time in silence and actively reflect on my situation. I cannot expect to come to some understanding without meditating and reflecting on what needs to change. For me, simply saying the serenity prayer will have little impact.  Therefore, my action plan will include the following:

Journaling for 7 consecutive days on the following subjects:

• Work/Business: I have MANY opportunities and that is great. However, I need to get clear and make some difficult decisions. I also need to be honest about what holds me back on these decisions. In my case it is the difficult/uncomfortable conversations that are sure to follow some of these decisions.
• Family: Directly related to business; I need to clarify work/life balance and make changes or come to some level of acceptance. I need to focus on the long view and compartmentalize better. I need to maximize time off and think in terms of decades rather than day to day or week to week.
• Financial: How much money do I want to make? Write it down and don’t be vague about it. Our relationship with money can be strange. Especially in the “nonprofit” human services field. We seem to believe we must be martyrs. Visualize what you want. Visualize your ideal life.

Work on acceptance:

Acceptance is a very unusual concept. Similar to forgiveness or “letting go and letting God”.  How does one “accept”.  I believe it is an active process of repetitively identifying “lack of acceptance” and redirecting thinking. It also involves setting an intention and focusing on one area at a time.

For example, if I need to accept my relationship with my parents I must set that intention every morning and then actively redirect that thinking through the course of the day. Remember our thoughts are mostly automatic and we will need to bring effort in order to reprogram our thinking:

Do you have any circumstances in your life that need to be reevaluated?  You need to be honest with yourself and take some time to examine your life.  Maybe it’s a relationship or perhaps a work situation.  Living mindful and intentionally requires time and effort. However, it is well worth it. Then challenge yourself to have the courage to change the circumstances that need changed. Have the difficult conversations and take the necessary risk to live your life. Not someone else’s life. 

NOTE: Many of us deal with very serious issues related to addiction. Either our own recovery or the recovery and struggles of a loved one. Some may have even lost someone to this deadly disease. Recognizing your circumstances and exploring ways to improve the situation and/or cope with the outcome is essential to your well-being.  Of course, there are very specific ways to get support surrounding addiction. Not the least of which is staying tuned to the cartel.

3) Carol Dweck

Her book – Mindset: The New Psychology of Success

How we can learn to fulfill our potential”,  has brought the term “mindset” into the mainstream.

I am certainly a proponent of the growth over fixed mindset, however, my thoughts on mindset include some additional principles.  For me Dweck’s growth mindset is absolutely essential to my well-being.

Dweck’s thesis, in VERY brief summary form, is that people develop a growth mindset (“I can learn and grow and become more”) or a fixed mindset (“I am born a certain way and that is all I can expect from life”).

I know this is a fact and I know that our educational system is set up to differentiate “smart kids” from “average” or “below average” kids and most of us spend our lives living up to, or down to, these expectations.

We must throw off these expectations and not live our life according to this limiting dogma. We must realize that the world was created by people no smarter than we are, they just did not buy into the conventional wisdom of the day.

Never stop learning and growing.  For me this means I need to read more books this year than I did last year (at least 23).  I am behind pace at only 8 to this point but I intend to have a good second half of the year.

I must also continuously challenge myself professionally.

I will never again be part of the machine in the addiction treatment industry. It is my intention to disrupt the industry.  It is my intention to remake the delivery of addiction recovery services from top to bottom.

I cannot live in a static, fixed mindset.  What worked for my personal development in early recovery will not carry the day now.  I would rather burnout than fade away.

• Beyond growth versus fixed mindset: I need to go beyond growth versus fixed mindset. I must develop a mindset of mission and disciplined effort. If I work for the weekend or work for vacation I will not make it. If I think I’m going to cruise when I get home from work I will not make it. I must maintain the mindset that the merit is in the struggle. The journey is the reward not the destination. In order to do this I must get a better morning routine and set my intention for the day. I also must redirect my thinking when I drift into a victim mentality.
• Three good things: A conscious effort at maintaining an attitude of gratitude can go a long way. Some people keep a gratitude list. For some gratitude comes very naturally. I am going to continue the practice of 3 good things. Each night, sometimes via posting on Facebook, I will write down 3 specific good things that happened during the day. This practice will condition my mind to pick up on the good rather than notice only the bad.
• Peak performance: Similar to Dweck’s growth mindset, Anders Ericsson’s book, Peak, explores the limits of human performance. Through deliberate practice it is possible to become a true expert in a chosen area. I intend to apply deliberate practice to the art of staff development. People are the most important asset in my line of work and I intend to become the best in the world at supervising and developing a recovery workforce. This will help keep me in a growth mindset.

Mindset is essential to your growth and sense of purpose.  What are your plans surrounding mindset? Maybe it’s as simple as reading Dweck or Ericsson. Or maybe you want to set specific goals around professional or personal development.

4) Core beliefs, past issues and present thinking.

Thoughts lead to feelings lead to actions lead to thoughts etc… Cognitive behavioral therapy. Rational emotive behavioral therapy. SMART recovery. Even the 12-step programs all rely on identifying thinking and challenging irrational thoughts. “Play the tape the whole way through” for example is all about challenging the euphoric recall and getting a realistic view on what it would be like to use again after some time in recovery.

I would like to go a little deeper than surface thoughts, however, and explore core beliefs and how our past influences our present.

As a certified EMDR trauma therapist I learned about “stuck” experiences and how unprocessed trauma can influence our behaviors. This was one of the most powerful experiences I have ever had. I had always heard this was the case, however, experiencing it first-hand changed my outlook.

Our past experiences contribute to core beliefs. For example: “I’m not worthy” or “I must be perfect”. This leads to us being hypersensitive to modern day experiences and “data” that supports this core belief.

For example, let’s say my core belief is “I am not smart enough” due to invalidating and emotionally abusive parenting I experienced. Maybe as an adult I go back to school and get a grade lower than desired.

This “failure” in school will fit nicely into my core belief. Conversely, when I do something well (pass a test for example) the data will not fit into my core belief.

It’s going to take substantial effort and time to pave new pathways and reprogram this core belief.

I have worked hard on identifying my core belief (“I’m not worthy”) that arose via growing up with an alcoholic father who could be violent. Now I need to work just as hard at identifying when I’m feeding into the core belief or discounting the positive data.

In the same vein, I am going to work on identifying the most common thinking errors that plague me day to day and track my responses to these errors.

The list below is a universal list that all human being cite as being present from time to time.

If I can establish a pattern for these thinking errors then I can self-correct. In time, due to neuro-plasticity my brain can rewire and I can respond differently to provocative situations.

What is the core belief that holds you back? 

What are the most common thinking errors with which you struggle? 

Awareness is the first step.

Obviously there is much more to life than these four areas. Spirituality, for example, is a big part of life and can go far in soothing the soul. However, I will leave those discussions for another time.

If you are progressing as you wish, if you are doing well then don’t bother with these suggestions. If it is not broke don’t fix it.

However, if you are looking for some new ideas then experiment with some of the things discussed in this post. Do a research project on yourself; n=1.  See what works for you and what does not work for you.

More important than anything. Do not let life happen to you. Take as much from life as you can. You only live once. Many people don’t want us to thrive. They want us to assume our designated place in the machine. When you thrive and chase your dreams it makes them uncomfortable.

Do not give in…. you are powerful beyond measure!

Stay human…we love humans…

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Wanted to reblog this idea. Find a good cornerman or cornerwoman…cornerperson to support you through tough times…

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