".....And Yet?"

Thank you for wanting to read this short essay about using simple questions in psychotherapy to elicit useful possible conversations.  It has been moved one quick click away to my primary website which I hope you will enjoy for the information you find there.
-Bill

.....And Then What?

Every addict thinks about relapse. That's an inevitable part of the recovery process. When I counsel people who have addictive disorders, I recommend they keep a three-word question handy whenever they ponder the possibility of relapsing. The question is: ".....And then what?"

Here's an example:

An alcoholic thinks about having just one beer but then asks himself ".....And then what?". (It will taste great.) ".....And then what?" (I'll probably have another.) ".....And then what?" (I'll start thinking I can drink normally.) ".....And then what?" (I'll do OK for a few weeks.) "And then what?" (I'll start drinking every day again.) ".....And then what?" (I'll get depressed because I let myself down.) ".....And then what?" (I'll sink into depression.) ".....And then what?" (Oh man, I don't even want to go there!)

Any addictive or compulsive disorder distorts the ability of the brain to effectively regulate the neurochemicals that are responsible for managing pleasure and survival. This is true whether the emotional dysregulation stems from drugs, lust, gambling, or any other behavior that sets into motion the brain's faulty neurochemical reaction.

One inevitable result is that an abstinent addict is occasionally going to fantasize about reclaiming his or her familiar altered mood. Usually the fantasy is one that stops at the moment of the "high". The cigarette addict thinks about the immediate satisfying relief of that first puff. The crack addict remembers the rush when the hit reaches the brain a few seconds after inhalation. The sex addict's fantasy terminates at the point of orgasm.

In all of these cases the addict doesn't "complete the arc" of the fantasy: he or she doesn't spend much time reflecting on what happens when the rocket invariably crashes (and what comes up always comes down). This is where "....And then what" can be of immense service in connecting the temporary high with the lasting bottom that follows.

There are many other ways an addict can compensate for his or her inevitable central nervous system deficits. Connecting with other addicts, either in group formats such as A.A. or individually with a "sponsor", helps by strengthening the ability of the impaired neocortex to properly evaluate the uncontrolled impulses of the limbic system. No one strategy will be completely successful by itself, but "....And then what?" can be extremely useful in maintaining long-standing success in recovery over addiction.

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12 Step Groups: Twelve Objections and Twelve Responses

Thank you for wanting to read my description of typical objections to attending 12-step groups, along with 12 responses!  I have moved it one quick click away to my primary website which I hope you will visit for the many articles there.  Thanks, Bill

Why "Better" is Better Than "Best"

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Bill

Sex Addiction: Three Drugs In One

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Consequences

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Uncover to Recover

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Bill

Progressive Recovery

This brief thought is dedicated to everyone dealing with some aspect of addiction recovery, whether for alcohol, drugs, sex, gambling or any of the many other mood-altering behaviors that can take over a person's life.

It's a well-known rule of thumb that addiction tends to be progressive, meaning that it inevitably becomes more severe over time. Even when a person stops abusing a mood-altering substance or behavior, the potential damage inherent to the addictive process continues its downhill process. It's typical for a formerly sober addict who relapses to pick back up not where he or she left off but instead to quickly descend just as far down the destructive spiral as if the period of abstinence had never happened. This is a staggering prospect of pain and loss.

However, recovery from addiction is more than just playing tug-of-war against the enemy of relapse. For a person who is truly committed to sober emotional growth, recovery is progressive as well: it gets increasingly better over time. Even with a "slip" (a brief resumption of addictive behavior), it is quite possible to return to the promises of recovery without losing all forward progress. People actively involved in 12-step programs often continue a steadily upward trend in emotional, cognitive, behavioral and spiritual growth in which they feel, think, act and exist along an increasingly healthy, productive and balanced manner of living.

In this sense there is little stagnation in recovery. A person is generally going either forward or backward. While some people can appear to "coast" and do quite well, ongoing application of the principles of recovery can allow continued benefits to unfold for the entire length of a person's life. This is the priceless promise of progressive recovery.
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The Value Of 12-Step and Support Groups

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Cybersex: The Crack Cocaine of Sex Addiction

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Picking Up The 500 Pound Telephone

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Sex Addicton And The 3 Second Rule

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Post-Acute Withdrawal Symptoms

I haven't written much about addiction issues, which is surprising since I've worked long and often with people who struggle breaking free of addictive behaviors. I had a conversation with a client today about Post-Acute Withdrawal Symptoms (PAWS), so I thought it would be a good thing to write about.

The immediate symptoms that occur when breaking free of an addiction typically include withdrawal, craving, anxiety, depression, mood swings and so forth. These will gradually and eventually lessen in intensity. What some people fail to appreciate is that more subtle symptoms can remain in force for many months after the addictive behavior stops. These are the post-acute symptoms and in my experience they occur along two dimensions: thoughts and emotions.

1. Thoughts. A brain that is no longer being clouded by drugs or other addictive input is going to think more clearly.....eventually. Especially for long-term addicts, the brain has become quite accustomed to operating in a state of impairment. When the source of the addiction is removed the brain must re-adjust, and like an out-of-tune car engine it will sometimes rev and sometimes stall. This means that a person may have periods of exceptionally sharp thinking alternating with times when it is hard to put two thoughts together.

2. Emotions. Similarly, a person in the initial months of recovery may find times when his or her emotions are experienced very intensely (whether positive or negative). At other times that same person may feel very emotionally numb for a period of time.

When these two dimensions are put together it creates four quadrants. The first is a period of sharp thinking and intensely positive emotions. This can lead to what people in A.A. often call a "pink cloud" or a feeling of being "happy, joyous and free". The opposite is when negative feelings predominate, which people in A.A. often refer to as "restless, irritable and discontent."

It's also possible that the same person can go though times when his or her mind is cloudy or negative and the emotions are intensely experienced. This can lead to rash decisions that are later regretted. There is also what I call the "dead zone" when it is very difficult to either think or feel effectively.

Eventually both thoughts and emotions will level out and become more consistent, but from time to time it is likely that a "revving" or "sagging" will occur along either dimension. This is a physiological effect of recovery, not merely a psychological sense of distress.

The importance of this concept is for a recovering addict to check out his or her thoughts and emotions regularly with trusted resources such as a sponsor or other 12-step members. There is a saying in A.A. that "my best thinking got me here" which warns against relying too much on self-assessment as a basis of decision making.

Eventually, usually within a year or so, PAW symptoms will diminish in frequency, intensity and duration. Until then, it's important to give the brain time to adjust to healthy living after having been beaten up for so long by alcohol, drugs or other addictive influences.
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Atlanta Sex Addiction Resources

Thank you for wanting to read the "Guide to Atlanta Sex Addiction Resources", which has been moved just one quick click away to my website, where you will find much information to help you or a loved one along the road to recovery, growth, healing and happiness.