|
Over-medication and vulnerability
First, I need to
make a couple of general points about labelling what people do when they
overuse or over-do anything as an “addiction”. The same goes for
labelling the person as an "addict" This is too easy a way out. What
we should be doing is describing the person more accurately as someone who:
1. Is
suffering from deep emotional pain, or emotional wounding
usually
carried from childhood. What they are doing in the short term is medicating,
usually over-medicating, their emotional pain, as I explain below. There are
some who claim that addictions are inherited and that is true in a small
number of cases. But I have never yet met a person in an addictive cycle who
deep inside wasn't greatly troubled by emotional pain or emotional wounding.
What is described as their addiction is whatever they find helps medicate
their
wound or reduce their pain.
Your notice that when I write about addictions I use the term "medicating" a
lot, mainly because this describes what is happening inside that person
far more accurately and secondly because that gets away some of the shame that
they feel whenever they are labelled as a person suffering from a bad
disease, a bad habit or lack of willpower. It is no coincidence that usually
the deep emotional pain or wounding as a very strong shame element within
it, so shaming makes the pain worse.
2. Is in denial.
Which is a rather judgemental way of saying that while they are under the
influence of their particular medication (their addiction) and, or while they are
suffering from deep emotional pain, it is impossible for them to see clearly
what others can see them
doing.
Usually
they are in one or the other state, which is why it's often said that all
addictions involve denial.
3. Is trapped in "an addictive
cycle"
because this is really what is happening inside them.
Below, I describe the various
stages in the cycle which people we like to call "addicts" are really going
through as they get trapped further and further into their addictive cycle.
.
As I
explain there someone trapped in an addictive cycle is not a
"bad" person, even if the things they do are very wrong. They are not
giving in to a "bad habit" which they could easily overcome with a little
willpower. Even if they could stop medicating they would still have the
emotional pain and in many cases that is unbearable.
I also have a personal rule that no one has the right to label anyone else
an "addict" unless they acknowledge that they too are one and therefore have
some real understanding of what is going on, so at that point I need to go
on record here and acknowledge that I too am a recovering addict, from not
one but several different forms of medication. I too spent many years
trapped in my own addictive cycles. It and it took some amazing people in a
number of different Twelve step groups, and some absolutely wonderful
addiction counsellors to teach me how to get out of the trap and free myself
from the cycle. By the way, as any recovering addict will explain to you I
may be in recovery but I will never be free of the addictions themselves.
The day I believe that I am free of them is the day they will return.
What is medicating?
1. Using external substances
like
alcohol, nicotine, sugar or illegal substances which in turn produce brain
chemicals which relieve the emotional pain. Go to
Overview
of Addictive Substances and Activities
2. Medicating on internal
substances.
These are
brain chemicals and hormones produced by the body as a result of physical
activities, for example gambling, excessive exercise, work-holism, anorexia,
bulimia, co-dependency to name a few. In each case the person
has found that for them one specific kind of activity encourages their body to
produce special, make that very special chemicals which help reduce their
emotional pain. It's important to note that these do-it-yourself body chemicals
relieve emotional pain far better than any external substance. They are also
highly addictive. Go to
Overview
of Addictive Substances and Activities
It is normal for peo ple to try to reduce their pain so
there is nothing essentially wrong if someone is trying to reduce their
emotional pain. A person experiencing severe emotional
wounding or anxiety is extremely vulnerable and will do whatever they can
to block it. When the helpful protector characters in your inner village
(inner selves) run out of ways to reduce the hurting and the next thing is to try substances or processes from outside the village. At first these often seem to work almost
miraculously, so the process is repeated more and more often. But sooner
or later the treatment starts to lose its effectiveness.
What is described as "an addiction" exists
when someone finds themselves trapped in a cycle in which he or she keeps
increasing the amount of their (external) emotional pain reducing medication.
They are doing this primarily
because they are chosen medication is not working as well as it did at first.
One of the features of all addictive cycles is that at first their pain
reducing powers appears so miraculous that even when this starts to lessen
the individual or fully expects it
will soon start performing miracles again. So, rather than the term ‘addiction’ it would be more accurate to describe
what is happening as a cycle that is happening inside a person in the
place we describe as their inner village.
In the same way, the person we typically call an addict
could be more accurately described as someone who is ‘trapped in an
addictive cycle’. The addictive nature of the cycle is made worse as he
or she starts suffering side-effects caused by their emotional
pain-reducing "medication", yet is unable to stop taking it and
is still expecting that soon it will soon begin performing miracles
once again.
The last thing needed at any point is for anyone to use
a shaming and inaccurate term that labels the individual as for example an
‘addict’; "substance abuser" an ‘alcoholic’ or judges
them as a ‘bad’ person who has selfishly adopted a ‘bad habit’ . Worse still is the
shaming assertion that if the individual was a "good" person
they would easily be able to get rid of their "bad habit".
Shaming of this kind often does irreparable harm and makes the addiction
much harder to handle.
It would be far more helpful, for instance, to
recognise that they are a person who is trapped in the grip of an
addictive cycle, and, at the same time, help them to become aware just how
much they are suffering serious side-effects from over-using their
emotional pain reducing medication.
The addictive cycle
A person who is likely to get into an addictive cycle
goes through several distinct stages:
Stage 1 - Moderate medication
- not yet an addictive cycle (trial period)
1. Increased
emotional pain -
Something happening in the person’s life triggers their emotional pain
and their need for some way of reducing it. Examples include increased
feelings of anxiety or vulnerability, resulting from the loss of a job
or a failed relationship. The event may also lead to feelings of
increased guilt, fear, loss, shame or a deeper sense of being to blame.
Any experience that leads to loss of self-esteem or spirit, or a
connection to polarised negative core beliefs will have the same effect.
2. Failure of
previous ways of adapting
- the individual’s usual protection by adapting or changing in
functional ways is failing or is losing effectiveness. The inner
protector characters, inner villagers or inner selves are no longer
doing their usual jobs effectively enough.
3. Trying
something outside me -
discovery that when our
inner characters (inner selves) seem to be losing their power that
using a substance, an activity (or another person) instead seems to work
better than trying to cope from within. This new external form of
adaption or ‘medication’ usually does work better for a while.
The initial
effect of all medications is to provide some alteration in mood or
energy levels. This can include:
* Relaxation
* Stimulation
* Mood
moderation (more relaxed, more joy, less shy, more confident)
For some
fortunate people this is as far as the external medication process goes.
They find an acceptable dose rate and follow it. Their medication might
be a cup of coffee at morning tea time, a glass of wine in the evening,
a sedative to help with occasional sleeping problems or a few drinks at
a party.
Unless they
progress to Stage 2 they will not become trapped in an addictive cycle.
They may still have to face two problems associated with any medication
- one, they need the help of something outside them to cope with
something inside them; so if they run out of it they will have problems
and two - using even moderate amounts of the medication may have unseen
side-effects.
If however, using
moderate amounts appears to produce "improvements" like those below, the
person will connect these with their use of the medication. This in turn
will encourage them to increase their use of that medication. (If two
drinks make me feel less sad, six should make me really happy.)
Early changes
during the Stage 1 or trial period that encourage heavier use include:
* Mood reversal
(Example - low to high, nervous to super-confident, sad to
super-happy, shy to over-confident))
* Feeling much
higher self-esteem, great happiness and joy or just ‘so much better’
* Changed
perception (my life/friends/work/relationships/driving etc. suddenly
got so much better)
* Reduced
emotional pain or anxiety
Stage 2 - Increasing use of medication
4. Increasing
need to use their medication combined with build-up
of tolerance
-
If a medication works well and
people feel much better whenever they use it, it’s normal to develop an
increased appetite for it. At the same time, as with any pain reducing
medication, used repeatedly, a tolerance develops. The longer you use
it, the more you need and the more often you need it, in order to get
the same reduction in pain or anxiety.
Stage 2 is
triggered by growing feelings of anxiety or vulnerability, more guilt,
fear, shame, blame, greater loss of self-esteem or spirit. Pia Mellody
describes the pain at this stage as becoming ‘intolerable’.
5. Rationalising
- The person using the
medication suggests reasons that (to them) appear to be completely
logical and rational. Their "reasonable" arguments are often presented
to support or justify their increasing use of their chosen medication.
Example: "I just enjoy the taste of it" "It just helps me relax"
"Everybody needs at least one little vice" "There is no evidence to show
that it does any harm." "Other people might be addicted but I am not
like them." To the outside observer these reasons may not be nearly
as convincing as they are to the person who expresses them.
6. Early denial
- This is really just a more
extreme version of rationalising as described above. The reasons offered
are often quite bizarre and to observers even less convincing. In
extreme cases the individual may deny that the events that took place
ever occurred or claim that they have been exaggerated out of all
proportion by biased observers. Example: "So what? It didn’t do any
harm and nobody got hurt." "No, that never happened." "Somebody is
making up stories about me." "I am totally in control, I can take it or
leave it." "I can give it up any time I want to." "It’s because you nag
me about it so much. That only makes me need it more often!"
7. Withdrawal
Issues - If a person can’t
get their medication they are going to have to face their ‘intolerable
pain’ again.
Withdrawal
symptoms when the person is unable to get their medication are among the
first observable signs of a developing addictive cycle.
8. Stashes and backup supplies
To avoid the pain of withdrawal they start to
organise a secondary source they can rely on if their usual supply runs
out. This stage in the cycle is another of the first noticeable signs
as the individual starts organising ‘backups’ or ‘stashes’ (open or
hidden) in case they cannot access their usual supply.
9. Side-effect
problems - The more I use any
medication the more serious the side-effects. Typical effects from
overuse or extended use of emotional medication include:
ę
reduction in everyday skills and
abilities
ę
reduction in moderation and
ability to balance polarised inner protector characters, inner
villagers (inner selves)
ę
health problems directly due to
overuse of the medication
ę
losing touch with reality
including increased denial about these side-effects
ę
less awareness, inner protector
characters (inner selves) more in control of life
If someone you
know (or if you) reach this stage, (pointers 7 to 10 above) it is time
to start describing the process as ‘addictive’ because from here on it
becomes much harder to stop the cycle.
Stage 3 - Over medication
10. Problems
from over-medication now make original problem worse
-
The side-effects listed above cause
an upsurge in the original feelings of anxiety or vulnerability, guilt,
fear, shame, blame, loss of self-esteem etc. that led to the use of the
medication. The worse these feelings, the more medication is needed and
the greater the damaging side-effects. The addictive cycle now tends to
move faster and is much harder to stop.
Stage 4 - Major breakdown or recovery
If the person continues to increase their rate of
medication the cycle goes one of two ways from here. Either they
reach a point of total breakdown (often called hitting rock bottom)
followed by recovery or they continue the cycle until it ends in an
early death.
11. Increased
overuse of medication results in major losses
- Additional side-effects
(listed above) all become worse. In particular reduction in everyday
skills and abilities; loss of ability to balance polarised selves and
health problems all become severe.
12. Deception, intentionally dishonest denial
The loss of touch
with reality becomes more extreme. Shame about what is happening leads
to a round of deception. Denial now becomes deception (intentional
dishonesty).
Regardless of the
substance or process involved these three pointers are almost always
present and so help identify the stage the person has reached in their
cycle.
Relationships
with friends and family start to suffer severely. A person in the grip
of their medication at this stage in the cycle is unable to have a
functional relationship with any other human being. Their only
significant "relationship" is with their medication. No one else really
matters. This leads to massive problems including loss of jobs, loss of
family and ultimately threatens their life.
Friendships are
lost too, with the exception of fellow medicators who stay on, though
there is no way at this point, that they can be classed as true friends.
Treating addictive cycles - do’s
and don’ts
Do’s – there is only only one
There s only one effective
treatment for any addiction where the individual is medicating their
deep emotional pain, shame, guilt, fear, loneliness or any strongly
negative emotion. That is to
increase the person’s ability to reduce, (and that means to reduce
permanently) the pain, shame, guilt or whatever it is that is the
driving their need for emotional pain reducing medication and their
over-use of that medication.
Twelve Step
programs such as Alcoholics Anonymous deserve to be recognised as one of
the foremost successful treatments for all addictive cycles. Although
their format remains incredibly simple and each group is conducted
entirely by untrained volunteers, that group will include a number of
people who do understand a great deal about teaching addicts how to
reduce their emotional pain or wounding. And that is because they have
had to do the same thing themselves and have managed to do it with some
long term success.
The 12 Step
program is effective because the group members are the best of all
models and teachers for recovery - they are all people who have
acknowledged their own problems with over-use and are successfully
recovering from their own addictive cycles.
The groups are
far from perfect but they have the reputation of getting more people out
of addictive cycles than any other treatment.
There are now
nearly two hundred different kinds of Twelve Step groups (each based on
the particular substance or process involved - alcoholics anonymous,
gamblers anonymous, co-dependents anonymous, over-eaters anonymous,
debtors and spenders anonymous, rage-aholics anonymous, drama addicts
anonymous, to name just a few) All of them enjoy a level of success
seldom matched by treatment centres or expensive therapy.
A sample
‘Twelve Steps
for Dependents Anonymous’
is included on a separate page.
Recovery programs
such as those offered at the South Pacific Hospital in Sydney, the
Currumbin Clinic on the Gold Coast and The Meadows in Arizona, all
achieve very good results but need to be followed by regular work with a
therapist and group meetings for several years, perhaps for the rest of
that person’s life.
Recovery Don’ts
1. Do not shame,
do not blame and do not make the person feel guilty.
This one "don’t" stands out above all others. The person is over-using
their medication because they found that despite the negative
side-effects it at least gave them some temporary reduction in the their
overwhelming shame, guilt or pain. Instead of reducing the over-use,
increasing a person’s feelings of guilt and shame drives the addiction
cycle further and faster. An addictive cycle cannot be reduced by
shaming.
2. An addictive
cycle is not a ‘habit’ and it cannot be broken by "will power".
The only effective treatment is one
that heals the deep emotional core pain and that may need to continue
for the remainder of one’s life.
3. Never ask or
expect an addicted person to ‘promise to give it up.’
The cycle they are in renders them incapable of the adult behaviour
needed to honour such a pledge. I suspect the person asking for such a
promise is also being less than adult if they believe it.
4. There is no
‘fast treatment’. People may ‘sober up’ overnight, using will power, but
that just means that a more powerful one-above inner protector character
(inner self ) has stepped and taken temporary control the medicating and
enabling characters (inner selves).
Any ‘rapid’ recovery, that involves the individual simply switching to a
new medication, for example, from alcohol to chocolate or from gambling
to increased smoking and drinking for example is not sobering up at all.
In most cases it will only last for a few months. Or the new medication
will simply take over from the old one on a long-term basis.
5. Any reduction
in an addictive cycle based on punishment is only temporary.
It’s much the same as if you had a
really bad back injury and needed to take eight aspirin a day to block
the pain.
Some concerned
friends might consider this as evidence that you were addicted to
aspirin and with the very best intentions might use some form of
punishment to force you to stop taking aspirin. Your friends might then
congratulate themselves that with their dedicated help you had beaten
your aspirin addiction.
But you would
still have the backache and you would still have to cope with pain. As
long as the pain in your back is greater than the pain of the
punishment, understandably, you will soon be back on the aspirin again.
FOOTNOTE: All addictive cycles are connected in some
way to brain-altering chemical substances. In the case of process
addictions like gambling the only difference is that the chemicals are
produced within the body.
In both cases the end result is that adult awareness
and the more functional moderate protector characters in your inner
village are constantly being anaesthetised by the particular chemical
and so that they have no chance of helping.
See also
Overview of Typical
Addictive Substances and Activities
Inner selves and addictive Cycles
This could hurt a bit.....
The path and the
holes - a story about recovery from addictions
Sex addiction
Example of the
Twelve Steps (Dependants Anonymous)
Remember to H-A-L-T Hungry? Angry? Lonely?
Tired?
Feedback - please e-mail me John Bligh Nutting -
at
nutting@growingaware.com
Copyright
©
John Nutting 1996- - 2008 and
©
GROWING AWARENESS 1996- - 2008 All rights reserved World Wide
Saturday, 15 November 2008 13:10
Don't worry about these copyright notices at
the foot of each page. It just means I want to hang on to legal
ownership of what I write for use in future books. Until that day,
please feel free to copy and even adapt them for your own use and for
friends as long as you acknowledge me as the author and owner of the
copyright and you don't charge anyone for them. If you want to use them
professionally or commercially (charge a fee for them) or for clients,
each sheet you hand out must include full acknowledgment of copyright
ownership as above and if you are benefiting as a result, I would
appreciate an appropriate sharing.
RETURN TO HOME PAGE
|