I guess there are only so many different ways to look at the addiction epidemic. Reminder—88,000 year die as the direct result of alcohol. 65,000 die from overdose. Over 150,000 dead. The worst public health crisis in American history and it’s been going on for decades.
WHICH ONE ARE YOU?
1) SHEEPLE: You don’t even notice it. American Idol is on.
2) SELF-RIGHTEOUS: You notice it but due to your own skeletons in the closet you project disdain onto those with substance use disorder (probably because you have your own unresolved porn addiction or food addiction or your mom/dad had substance use disorder etc…).
You say “they did it to themselves I don’t care what happens to these people”. Your suggested solution to this issue is to build more jails. OR start executing drug dealers and probably sprinkle a few drug users in there for good measure.
Note: these 2 groups are unreachable. Their opinion is not important but we must note they exist.
3) COMPASSIONATE BUT MISINFORMED: You notice the problem. You are not completely sure what to make of it. You may or may not be directly touched by it. Regardless, you have great compassion toward people dealing with this issue. You are seeking info and want to help. (Perhaps some of our policy makers fall into this category).
But you are probably getting much of your info from the wrong people. The system insiders who are gonna play out the same old narrative. OR The academic who wants to talk all research. OR The “governors commission on opioids”. etc….
YOU NEED TO LISTEN TO SOME ALTERNATIVE VOICES AND ASK YOURSELF: DO WE NEED MORE OF THE SOLUTION THAT HAS RESULTED IN 150,000 DEAD YEAR OVER YEAR. OR SHOULD WE TRY SOMETHING NEW.
4) STATUS QUO: You acknowledge the epidemic. You see it for what it is. You have genuine concern.
Perhaps this has been your life’s work. But you view the problem as a) under utilization of an otherwise relatively adequate and “functional system”.
In other words it’s not a system or provider problem it’s an “non compliant patient problem”. OR b) lack of access to an otherwise wonderful and working system. OR c) your business model is working quite well thank you. Rinse and repeat is good.
Your suggested solution probably involves more money for more of the same services. AND PERHAPS SOME TWEEKS TO THE EXISTING STRUCTURE. But fundamentally you think everything is okay on the “solution end” if people would just “do what they are told”.
NOTE: I don’t know what to say to you. 150,000 dead a year seems to be evidence of a MAJOR FUNDAMENTAL problem.
5) RADICAL CHANGE AND NEW SOLUTIONS: You are deeply troubled by the issue and it’s clear to you that the ship is sinking. You know something is fundamentally wrong and the solution involves something brand new.
You have no beef with old school approach, in theory, but you notice it doesn’t work for the overwhelming majority of those in need. You love the people working in the system but you hate the system itself.
You watch with tears in your eyes as addicted people and their families are exploited to pass legislation that props up existing practices. And you watch with growing anger as the CDC reports another increase in the death rate. You don’t want the existing system to go away altogether but you aren’t naive.
You know incremental additions or changes will make ZERO difference.
IF YOU FALL INTO THIS CATEGORY WE SUGGEST YOU CHECK OUT AUTONOMOUS INDEPENDENT RECOVERY SUPPORT SERVICES. THE MISSING PUZZLE PIECE.
WE NEED THE PEOPLE IN CATEGORY 3 TO MOVE TO CATEGORY 5.
✌✌✌CATEGORY 4 WILL BE A TOUGH SELL.
What other categories exist? What category are you in?
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 5th 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:
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:
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.
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.
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.
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.
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.