Tag Archives: addiction

addictions counselling and employment counselling

i am currently taking a course on “core addictions practice”, a soon-to-be required course for people wanting to practice in the addictions field in our health authority. since i also work in the field of employment counselling, i thought it would be interesting to think about how ideas from addictions counselling can be applied to the work of a career practitioner. here is an example:

one “checkpoint” in addictions counselling is to consider “set, setting, dose”. “set” refers to mindset, “setting” refers to the physical and social setting, and “dose” refers to the type and amount of a substance used or behaviour practiced, and considerations of how set and setting affect dose. for example, if sue, who just had a fight with her parents and is upset over it (“set”), is going to a party with her friends where there is much drinking (“setting”), then before going to the party, she could think about setting a limit on how much she is going to smoke and drink (“dose”), because she knows that alcohol has a stronger effect on her when she is upset.

an interesting question here is, what is the equivalent of drinking in job search? excessive drinking is harmful. what are harmful/unhelpful behaviours in job search? possible candidates:

  • using only the computer for job search
  • doing many non-job search related activities on the computer during the job search
  • avoidance: excessive TV watching, eating, sleeping, etc.
  • distraction: cleaning, shopping, etc.

examples of helpful behaviours:

  • knocking on doors
  • staying in regular contact with networks
  • actively limiting non-job related internet use
  • learning about writing effective cover letters

mindsets – examples:

  • happy, serene, hopeful, positive, etc.
  • neutral, realistic, up-and-down, etc.
  • negative, depressed, hopeless, angry

settings – examples:

  • home (bedroom? office?)
  • knocking on doors
  • employment resource centre
  • coffee shop

an example might be: joe is sitting in a coffee shop where he reads that job openings in his industry are rising and feels hopeful. this prompts him to phone up an ex co-worker and invite him to have coffee.

questions for career practitioners:

  • would it be helpful for clients to know about set, setting, dose and how they influence each other?
  • we do a lot of work around positive behaviour, a little less about positive mindset, and very little about setting. what would it look like if we turned that on its head?
  • how about an exercise where we ask clients to physically visit a place that makes them feel happy?
  • at the most, our clients’ lives are 12% about job search (if they spend 20 hours a week on it); the rest is other things (at least overtly; they may spend quite a bit more time thinking about it). how are the remaining 88% influencing them? what would it be like if we thought about helping there in addition to with their job search, just like sue might be helped with her drinking if she had a better handle on how to approach conflicts with her parents?

arrest them! no, not the drunk guys

i’m doing NaNoWriMo again this year, this time determined to do all i can to make it to the 50,000 word count. so my blog posts may be sporadic, or short and sweet, or both. like this one. only it’s not sweet.

at a walmart in lethbridge, told by a friend:

a drunk native fellow ahead of me was buying 10 bottles of alcohol-containing hair treatment. i asked for the manager and asked him whether he was going to let that sale go through. he said there was nothing they could do. i checked the shelves and saw that this product was vastly overstocked compared to the non-ethanol products. i called the cops. they just took my name and address.

the week before a bunch of guys had been sitting on the bench in front of walmart drinking hair product. walmart restocks the shelves according to the rate of product sales.

they should be arrested.

not the native guys.

meaningful stories and idle chatter

conversationa theme for me in the last little while has been to hear from others, “i don’t want to talk about this because i don’t want to be a burden.”

i honestly think i’m wired differently than most people. hearing people’s meaningful stories, whatever they’re about, is rarely, rarely a burden for me. and when it is, i have no problem dealing with it.

cancer, childhood sexual abuse, addiction, death, mental illness, unemployment – this is the stuff of life just as weddings, pregnancy, promotions, travel and enlightenment.

whatever is meaningful to you, my clients, my friends, family and acquaintances, actually, i can hardly get enough of it. when someone tells me what’s going on for them, they let me into their lives. it’s an honour and frankly, it’s fascinating. why go to the movies?

so i’m a very willing listening ear, and when my listening and our conversation help someone along, i am deeply grateful.

what i do have limited patience for is meaningless idle chatter. idle chatter can be meaningful (otherwise i wouldn’t be so happy on twitter, i guess!). not everything has to be important with a capital I every time we open our mouths. i’ll never forget many years ago, when my first husband overheard a conversation i had with my best friend from school (we’re still close after almost 50 years, imagine that!), where we were talking about detergent. “how can you have such a banal conversation!” he exclaimed. he didn’t understand. the connection i have with ava is so deep and meaningful, we could spend a whole year talking about nothing but tide, and it would still be lovely.

i do have difficulty with certain types of idle chatter. i actually find it painful; perhaps as painful as others find listening to people’s harrowing lives and experiences. how might i describe this type … perhaps it would be the type of chatter that is marked by disinterest and/or unwillingness to at least contemplate engagement. someone talking about all the stores in the mall they went to last week, for example, without giving an interesting description (=engaging the other as listener), talking about what they thought/felt/remembered during the shopping trip (=engaging themselves), or asking questions or opinions (=engaging the other as conversation partner). in such situations, i tend do try to follow the talk (can’t really call it a conversation) and imagine the trip, ask questions, or, last resort, tune out – all of which i find quite exhausting. as i’m writing this, the image of a closed circuit comes to mind, one that may have a few openings here or there, but only for highly specific input, which will then immediately be reintegrated into that closed circuit. mine or other circuits are of no interest. does that make sense? i’m exploring this as i’m writing along …

but what you have to say about your marriage, your struggle with addiction, your sorrow and confusion over being an empty nester, your fears around your chronic illness – i will always be interested, and, oddly enough, i will always be invigorated. it might be the invigoration of a forest fire; perhaps we’ll have to wait a while until the ashes fertilize new life. more likely it will be the invigoration of a thunderstorm, or the awe that comes from walking the desert. i am, truly, grateful for your stories.

image by closely observed

addiction, genetics and early brain development

image of a fetus.  what is its brain development?in a comment yesterday on my article on some research on adult children of alcoholics, CP stressed the importance of genetics in alcoholism.

i would like to contrast that with another point of view. gabor mate offers this theory in his book in the realm of hungry ghosts: close encounters with addiction

brain development in the uterus and during childhood is the single most important biological factor in determining whether or not a person will be predisposed to substance dependence and to addictive behaviours of any sort, whether drug-related or not.

this is shown, among others, by dr. vincent felitti, chief investigator in a landmark study of over 17,000 middle-class americans.

mate goes on to say that

to state that childhood brain development has the greatest impact on addiction is not to rule out genetic factors. however, the emphasis placed on genetic influences in addiction medicine … is an impediment to our understanding.

he makes the case that there are four important brain systems in addiction, and that they are all exquisitely fine-tuned and changed by the environment – and particularly by the environment that a human being experiences in the womb and in the first few years of life:

  • the opioid attachment-reward system (involving endorphins)
  • the dopamine-based incentive-motivation apparatus
  • the self-regulation areas of the prefrontal cortex
  • the stress-response mechanism (involving a decrease of opioid and dopamine receptors)

in other words, during pregnancy and the first years of life – and to some degree, on to teenage years – the brain grows and develops, sometimes at a dizzying rate (at times 250,000 neurons are added every minute!) the vast majority of brain development occurs during pregnancy, however. so what is often attributed to genetics can already have happened during pregnancy.

attachment – how we bond with others – is intimately linked to our reward system. going for addictive substances or activities is a misplaced attempt to reward oneself.

motivation is what gets us going. most of the time, we need an incentive to motivate us. if the right connections weren’t made in the brain when we were small, we might find addictive behaviours or substances more motivating than anything else.

our mood, levels of motivation, energy levels, and ability to withstand adversity need to be in a certain, well-tuned balance in order for us to function well. this is related to homeostasis, a type of inner thermostat or self-regulator that keeps all of these elements on a relatively even keel. again, this homeostasis depends on the brain having “learned” about it. if it’s out of kilter, we can do things like self-medicating with drugs – a (usually unconscious) attempt at reaching homeostasis. this is also closely related to our stress response mechanism.

(image by hive)

blogathon: compassionate curiosity, knowledge and objectification

posed in a tone of compassionate curiosity, “why?” is transformed from rigid accusation to an open-minded, even scientific question. instead of hurling an accusatory brick at your own head (e.g., “i’m so stupid, when will i ever learn,” etc.), the question “why did i do this again, knowing full well the consequences?” can become the subject of a fruitful inquiry, a gentle investigation.

this is a quote from the chapter entitled “the power of compassionate curiosity” in gabor mate’s in the realm of hungry ghosts: close encounters with addiction

the idea of therapy as a research project has always intrigued me, and it’s something i’m still working towards. it’s a very delicate thing; where is the fine line between such compassionate curiosity and the wild power that comes with acquiring knowledge? knowledge is intimately connected with power, and knowledge-about is very similar to power-over. it objectifies. in both, there is a sense of grasping. i “have” power. i “have” knowledge.

by the very nature of things, the therapist always knows more about the client than the client does about the therapist. even in a situation where both parties strive for as egalitarian a relationship as possible, an equalization of that knowledge would end the therapist-client relationship.

talking about the nature of that knowledge, the nature and amount of knowledge about one another, can help. bringing difficult relationship dynamics out in the open always helps.

transforming the nature of that knowledge can be even better: turning knowledge about into knowledge with. knowledge about is a one-way affair. in “i have knowledge about you”, one is the subject, the other is the object, and that’s it.

in knowledge with, knowledge changes from a one-way street to an open and shared field. this is where curiosity comes in and is so important. curiosity is about openness, about allowing possibilities. curiosity is not linear, it is not one-way. it is 360-degree.

“hmmm, i wonder what happened there?” as opposed to “why did you forget again?” “let’s see what we can try to do differently next time” as opposed to “you better learn this once and for all!”

compassionate. curious.

canadian mental health association

this is an entry for my participation in the 2008 blogathon, a 24-hour marathon of blogging. please support the cause and donate – however much, however little – to the canadian mental health association (vancouver/burnaby branch). to donate, email me or use this URL: www.canadahelps.org/CharityProfilePage.aspx?CharityID=d2252. you should be able to get there by clicking the link; if not, just copy and paste the link into your browser. it will take you to the appropriate location at canada helps.

thank you for visiting, reading, commenting and, if you can, donating!

blogathon: psychology on stumbleupon

canadian mental health association

this is an entry for my participation in the 2008 blogathon, a 24-hour marathon of blogging. please support the cause and donate – however much, however little – to the canadian mental health association (vancouver/burnaby branch). to donate, email me or use this URL: www.canadahelps.org/CharityProfilePage.aspx?CharityID=d2252. you should be able to get there by clicking the link; if not, just copy and paste the link into your browser. it will take you to the appropriate location at canada helps.

thank you for visiting, reading, commenting and, if you can, donating!

the two social media sites i like the most are twitter and stumbleupon. i just realized that it’s relatively easy to post excerpts from my stumbleupon site. here are some internet gems i’ve found recently that i tagged “psychology”

why play a losing game? study uncovers why low-income people buy lottery tickets
“some poor people see playing the lottery as their best opportunity for improving their financial situations, albeit wrongly so,”

lord of the dark side
a great story about my good friends, resistance and procrastination

we are a gentle, road rage people – at making chutney
a new study shows that a penchant for bumper stickers, no matter how peaceful and progressive, indicates a tendency to road rage.

gifted, talented, addicted
a well-researched article on the connection between addiction and creativity. among others, a little foray into how coca-cola came about and what happened to its inventor.

humor, sex and verbal jousting
a very thoughtful look at humour and gender differences

educational psychology interactive: internet resources
great list of links re education, psychology and research

a drug treatment for chronic pain and erasing its memory
the reason why chronic pain is chronic appears to be linked to its persistent memory in the prefrontal cortex.

faces give away giveaways – psych profs amazing claim

“we may be subtly aware of other people’s attitudes to sex,” says dr lynda boothroyd of durham uni, lead author of the groundbreaking slapper-spotting research. “what is far more interesting is that despite the subtlety of the explicit awareness… there is a very strong tendency for women to be attracted to… men who are less interested in casual sex.”

new thoughts on language acquisition: toddlers as data miners
… studying a ground-breaking theory that young children are able to learn large groups of words rapidly by data-mining.”

the definition of addiction

in the last few weeks, a radio interview and two articles have encouraged me to again look at the nature of addiction. one of them is a discussion we are having on this blog here about alcohol use and art, with contributions by danish composer skovgaard danielsen and zen practitioner and painter eden maxwell. another was an article by trisha gura about chocolate addiction. the radio interview was with dr. gabor mate, well known for his work in our inner city, vancouver’s downtown eastside, as well as on stress and ADD.

so let’s look at some definitions of addiction.

cynthia jane collins in her book the recovery spiral has an interesting definition:

if we habitually or compulsively – with or without awareness or intention – use any activity, substance or person[s] to move us away from our true selves, we are practicing addictive behaviours.

gerald g. may proposes that

addiction is any compulsive, habitual behaviour that limits the freedom of human desire.

ben furman and tapani ahola, two scandinavian therapists known the world over for their imaginative work with therapeutic conversations once playfully gave addictions a name: “the muluttaja”. it derives from fascist times in finland and personifies the idea of “oppression and tyranny.”

virginia satir, one of north america’s foremost “elder” in family therapy, and another of my favourite models for therapy, talks of addiction as a coping mechanism for a rule that says, “i can’t feel what i feel.”

aviel goodman of the minnesota institute of psychiatry, who writes quite a bit about sexual addictions says that

addiction designates a process whereby a behavior, that can function both to produce pleasure and to provide escape from internal discomfort, is employed in a pattern characterized by (1) recurrent failure to control the behaviour (powerlessness) and (2) continuation of the behaviour despite significant negative consequences (unmanageability).

finally, gabor mate, whose absolutely fantastic book, in the realm of hungry ghosts: close encounters with addiction has this to say:

in the english language, addiction has two overlapping but distinct meanings. in our day, it most commonly refers to

a dysfunctional dependence on drugs or on behaviours such as gambling or sex or eating.

surprisingly, that meaning is only about a hundred years old. for centuries before then … addiction referred simply to an activity that one was passionate about …

in the words of a consensus statement by addiction experts in 2001, addiction is a “chronic neurobiological disease … characterized by behaviours that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving” …

the issue is not the quantity or even the frequency but the impact …

he then gives his own definition:

addiction involves:
1. compulsive engagement with the behaviour, a preoccupation with it;
2. impaired control over the behaviour;
3. persistence or relapse despite evidence of harm; and
4. dissatisfaction, irritability or intense craving when the object – be it a drug, activity or other goal – is not immediately available.

he concludes his chapter, “what is addiction?” by saying

we need to avoid the trap of believing that addiction can be reduced to the action of brain chemicals or nerve circuits or any other kind of neurobiological, psychological or sociological data … addiction is a complex condition … we need to view it simultaneously from many different angles … to get anywhere near a complete picture we must keep shaking the kaleidoscope to see what other patterns emerge.

now my question to you – those of you who have experience with addiction, either personally, through friends or family, or professionally: what do you think of these definitions? do they define addiction? or do you have another definition that works better for you?