For the next 10 seconds, try not to think of a pink elephant…Impossible, right?! The fact is, the more you try to suppress an impulse to use drugs or alcohol the more fixated your mind becomes on that very impulse, and this is bad news for anyone serious about maintaining their sobriety. Fortunately, you don’t have to drink or use and you don’t have to fight or suppress your cravings, all you have to do is surf over them and they’ll disappear – using a proven mindfulness technique known as urge surfing.

Trying to ignore or suppress your cravings doesn’t work very well – the more you try not to think about having that drink or hit, invariable the more you do think about it!

So you don’t ignore them… you fight them, right?

Well, battling against your cravings doesn’t always work that well either. Sometimes your cravings are just too strong for you to fight, and you relapse. Other times you are able to resist your urges for a while, but you find yourself spending a lot of time and energy each day engaged in an internal back and forth debate about whether or not to give in to your cravings – it’s like by resisting your cravings you feed them with your mental energy and in response they grow stronger and occur with more frequency.

So, if fighting against the craving doesn’t always work either - what can you do?!

Try just going with your cravings using a mindfulness technique known as urge surfing and you might find that though you still experience cravings, they no longer have the power over you they once did and you can literally glide over and down a craving as naturally as if you were surfing a wave on the ocean.

Urge Surfing

As the intensity of a craving builds it feels like it is going to keep on getting worse and if you don’t give in to it, it will last forever. In actual fact, if you can just wait it out it will peak in intensity after a few minutes and then gradually subside into nothingness; just as a wave crests and falls. Cravings very rarely last for longer than half an hour and are generally briefer in duration.¹

The trick is to forget fighting or suppressing cravings but instead to learn a technique that asks you to experience a craving fully so that you rob that craving of its power over you.

Mindfulness

Urge surfing is a relapse prevention technique based on the principles of mindfulness meditation. By paying great attention to what a craving actually feels like, by maintaining awareness on the craving on a second by second basis and by avoiding passing value judgments about what you are experiencing (this is good, this is terrible, this will never end etc.) you learn to ride over waves of cravings and you rob these cravings of much of their power.

To get started with urge surfing try these three steps:

1. When you feel a craving coming on, sit down in a  comfortable chair (ideally in a place where you won’t be disturbed), put your feet flat on the floor and take a few deep breaths to relax yourself. Close your eyes and look inward into your body. Try to feel where in your body you experience sensations of cravings and describe to yourself what these cravings feel like in different parts of your body (for example "I feel a tightness in my legs and my stomach is kind of jumpy…").
   
2. Pick one area in your body that seems most affected by sensations of craving and focus deeply on these sensations as they pass by. To keep your mind from wandering, describe the sensations you experience in your chosen part of the body as they arise (for example "my arm is kind of itchy, now it’s almost like a pins-and-needles sensation just below my elbow in my inner arm…It feels warm too now…")
   
3. Next move to another affected part of the body and repeat the focused attention there, and then repeat with another part of the body. After a while, you will notice that the craving will have passed by.²
   

By learning a new way to experience cravings you learn a valuable skill in overcoming them, and as you learn to experience your cravings in a mindful way, without judging and without giving in, you will find that in time the frequency and intensity with which you experience them will diminish.

Image Copyright: DavidRphoto

Don’t wait for your son or daughter to come to their senses - teens almost never self-recognize addiction and they rarely ask for help. Learn why they can’t see the truth and why this matters when picking treatment.

Fact: teens rarely admit to a substance abuse problem and almost never ask for help on their own.

Teens rarely see themselves as needing help since:¹

• They don’t connect negative consequences with their substance use.
• They don’t usually experience withdrawal symptoms.
  
• Parental protection shields them from many natural consequences.

This complicates recovery as:

1. Though teens are more predisposed to addiction and to a quicker progression from experimental use to addiction, teens almost never seek help on their own.
2. People who don’t believe they have a problem don’t tend to engage in the treatment process - and though you can sometimes force an adolescent into treatment, you can’t force a new way of thinking.

This is why you need to make sure you find quality adolescent-specific treatment.

• Effective adolescent addiction treatment programs are designed to help teens gain a more accurate picture of their behaviors and their consequences and structured to keep teens engaged in the treatment process for long enough to start seeing the benefits.
• Sending a teen to an adult treatment program rarely works, since adult programs rely on self-awareness and self-motivation that adolescents just don’t have.

Why Teens Can’t Self Recognize Addiction

1. They don’t usually get withdrawal symptoms.

Popular culture presents an addiction portrait that rarely corresponds to adolescent reality – for example the desperate opioid addict doing ‘anything’ to get a fix – or the alcoholic needing a drink in the morning to quiet their shaking hands.

While some adults with substance use disorders progress to this type of dependence, adolescents rarely do.

• Teens most commonly abuse alcohol and marijuana. When drinking they tend to binge drink (rather than necessarily drinking each day) and they rarely experience withdrawal symptoms when going a few days without use – largely due to a shorter use-history.

But though teens may not experience withdrawal symptoms, they can experience other telltale addiction symptoms, like losing control over use and continuing to use despite serious consequences.

2. They don’t experience as many adverse consequences.

It often takes years of addiction and addiction-related consequences (divorce, financial problems, legal problems, etc.) to convince an adult to seek help. A teen with a shorter use history wouldn’t have experienced the same level of ‘wreckage’ and might also have trouble connecting actions with their consequences.

Also, adolescents, especially teens living at home, enjoy a degree of protection from the outside world that can insulate them from some of the natural consequences of drug and alcohol abuse.

• An adult who spends all their money on drugs might face eviction – an adolescent living at home wouldn’t have the same problems.

Unfortunately, research suggests that one of the greatest predictors of adolescent incentive for change is the degree of negative consequences experienced: teens who can recognize that drinking or drug use has led to severe consequences are more likely to engage in treatment than teens who cannot self recognize this association.²

Treatment Implications

One size fits all treatment doesn’t work – and treatment that helps adults doesn’t necessarily help teens.

Because teens rarely perceive a need for treatment (even when everyone else can see it clearly) quality adolescent treatment is designed to keep teens engaged in the process and to help them see the true consequences of their actions (as well as the consequences to come.)

Common elements of effective adolescent treatment programs include:

• Motivational enhancement therapies – helping teens identify the pros and cons of continued use, so they can decide for themselves of a need for change.
• Rewards – providing rewards for meeting treatment goals helps keep teens engaged in the process, especially in the early stages, when they may not yet see a need for treatment or experience many rewards from abstinence (abstinence rewards come slower and later.)
• Skills training – providing teens with the skills they need to refuse drugs or alcohol and deal with cravings and temptation. Teaching problem solving and interpersonal skills.
• Replacing unhealthy behaviors – helping teens replace unhealthy behaviors with more constructive activities.

Taking Action and Finding Help

You don’t necessarily have to send your child to teen rehab (you’d almost always try counseling or outpatient treatment first) but when there's drug or alcohol abuse, you do need to take action, since drugs and alcohol affect teens more:

• Teens, with still-developing brains experience greater drug and alcohol related brain damage and structural alterations than adults. Even adolescent marijuana addiction can have a lasting impact,
  
• Drug and alcohol use in adolescence can lead to social and family problems and school performance issues, and left unchecked, these can have lifelong consequences.
• Teens who abuse drugs or alcohol may not achieve the essential developmental tasks of adolescence. By responding to problems, boredom and leisure time with intoxication they don’t explore and learn healthier living skills.
• Early drug and alcohol abuse is strongly correlated with later in life addiction issues.

So if your son or daughter uses drugs or alcohol, and you can’t get them to stop, you need to take action today. To learn more, read:

• The top 5 reasons why teens use drugs and alcohol.
• Selecting a level of addiction treatment that makes sense.
• A guide to trauma sensitive teen treatment.
  

How Mindfulness can overcome depression, teach us how to ignore unwanted thoughts and help us choose what is healthy for ourselves.

You've seen the advertisements. They say: "I've been on my medication for a long time and I still suffer from depression. So maybe I should add a second medication."

On the other hand, people say that one definition of craziness is when you are doing something that doesn't work, and you go on doing it. (One medication isn’t working so I’ll take another. That sounds like, "it's bad enough being depressed, they think I'm crazy also?")

I understand where these drug companies are coming from. They say that "depression is a real disease" so it necessitates a real medication. I agree that medication can be an important, and sometime critical, component of the fight against depression. But who says that medication is the only cure for a disease?

You know what depression is: That heavy darkness in which your mind gets stuck on dark thoughts. There is no strength or pleasure. Life seems to continue against your will.

We often find that even after medication helps, there is still no real joy in life. The pain might be gone, but there is still a lingering "stuckness." It seems like sooner or later there will be that inevitable hurdle in life, a wrench in the works, that can push you down again into that black abyss.

So you'll go running for the shelter of some sad little helper (to paraphrase the Stones).

But is there another way? Do you have to rely only on another chemical? What about dealing with the depression itself? Dealing with the thoughts that bring us down? Is there an effective way to move away from depressing thoughts?

CBT and Medication - Can They Bring You Back to Joy?

Many therapists will tell you about Cognitive Behavioral Therapy (CBT), which has been shown in research, when used with antidepressants, to be one of the most effective forms of therapy.

That means that it works about 60% of the time.

That's great if you are not part of the other 40% and you don't mind the side effects of the medication.

Also, CBT does not get you to a place of joy and happiness. While you might not be depressed, most of us still want to feel good and have a real sense of well-being. We would like to be one of those people who are happy to get out of bed in the morning.

While CBT is really on to something when it teaches us to attack depressive thoughts, there is an alternative that will work for many of the people who don’t succeed with CBT. CBT teaches us to confront, attack and change our patterns of thinking. But do we really want to attack, conquer and change our depressive thought patterns. That is a lot of work, and who wants to fight when you're depressed? That is where mindfulness comes in. Mindfulness is a technique that allows us to have thoughts and keep them from bothering us.

Feeling Better with Mindfulness

The main idea in mindful meditations is to look at your thoughts as fleeting curiosities. This is added to a perspective that we need to live in the present. Not to ruminate about the past or worry about the future. Now that already sounds good to people who suffer from depression. It is sort of like when I was a kid, and there was a big kid who would threaten me. My mother would tell me to ignore him. She said if you don't react he'll leave you alone. I said, "But he's going to beat me up!" She told me that he is looking for a reaction and I need to let him find it somewhere else. I said, "but he's picked on me in the past!" She said, "That's in the past. Let it go!"

That's the attitude you need for mindful meditation. You learn to ignore the threatening thoughts. Especially with negative, beating-you-up type thoughts, but also for any thought. In mindful meditation you learn how to observe your thoughts without letting them conquer you or control you or your emotions. You learn to detach yourself from your thinking in such a way that you can consciously decide whether or not the thought is worthwhile engaging or not.

So if you are living in the present, and monitoring your thoughts, what might happen? Let's say you’re eating dinner. Taking your time. Since everybody’s mind is constantly wandering, you might come up with a thought such as, "this is like the time we went out and I messed up." You didn't ask to think this thought. You don't even like it. Usually you begin to push it out. Or embellish it. Or think about how bad it is to think that way. But with a mindful perspective you are able to say to yourself, "Interesting that I have that thought. I wonder what thought will come up next." As you watch your thoughts flow by, sooner or later there might be one you like. You can then decide whether or not to hold on for a few moments or let that one go by also.

Mindfulness - The Two Basic Methods

There are two basic methods to achieve this goal:

One is a quiet training and the other is an active meditation. How are they done?

1. Quiet Mindfulness Training

To train your brain to refrain from unhealthy engagement in its own thoughts you need to practice on a daily basis. Here are the basic steps:

1. Get comfortable. You do not need to be sitting cross-legged on a mat. Any comfortable position is fine. You can even lay in bed, but not if you are going to fall asleep.
2. Make sure that you won’t be disturbed. Shut off your phone. Close the door. You do not really need quiet, since you want to learn to use extraneous noises for your meditation also.
3. Most people find it necessary to close their eyes. This helps you tune into you internal processes. Some people can do this with their eyes open. In the long run it is helpful to gain the skills to be mindful when you are engaged in other activities.
4. Use your mind to focus on your internal processes. “Watch” yourself breathe. Notice the flow of air going gently through your nostrils and into your lungs. Observe the other sensations of your body like the pressure of the chair, the sounds in the air, etc. Breathe normally, and continue to breathe normally.
5. As your mind begins to wander gently bring your attention back to your breath. This is the most important step. This is the actual skill you need to practice. You can note that your thinking has wandered, but don’t engage in the thought. Just say to yourself something like, “Oh, my mind wandered off. OK. Let’s go focus back on the breath.”
6. Continue for at least ten minutes. Some recommend at least 20 minutes. I think everybody is different. Find you own optimal time.
7. Repeat every day.

 2. Active Mindfulness Training

The second method of mindfulness is based on connecting actions with specific thoughts. You take some normal activity and infuse it with a mindful purpose and direction. It should be a normal daily activity and a positive thought that is generalizable to your whole life. 

I want to share with you one of my favorites.

We all wash our hands multiple times a day. We do it without thinking or at least while thinking about something else. We think about the food we are about to eat, or the meeting we are getting late for. Washing hands is a healthful activity which we waste as either protective or preparatory. Why not make it healthful for the emotions and spirit?

This is the suggestion: Take time to notice how the water flows over your hands. Think of this as a metaphor for life. Life flows by, and all things pass. Good and bad. Life just flows on by, and we can catch the opportunity to savor the good parts and allow the bad parts to flow by.

Since you have opportunities to practice this a few times a day, you will begin to train yourself to adapt this perspective.

Give it two weeks of consistent practice, I assure you, you will feel better.

Image Copyright: Premasagar

Getting someone to agree to accept help for a serious substance abuse problem and/or mental illness is really just the beginning of the journey into recovery for everyone involved in the process.

After working with people in crisis all over the country and throughout the world as a professional interventionist for almost the past 20 years, I can completely understand how difficult it might be right now for anyone out there reading this with a loved one currently struggling with substance abuse and/or mental illness to try and think about about life after an Intervention, especially when you can’t even get your loved one to talk about the underlying problem, let alone accept help for it!

However, the simple truth is that getting someone to agree to accept help for a serious substance abuse problem and/or mental illness is really just the beginning of the journey into recovery for everyone involved in the process. And I call recovery a journey because from my personal professional perspective, most people end up going down a whole bunch of long and winding roads before they finally end up on their Freeway Forward, the one that actually helps them heal, especially when it comes down to healing from within.

I have always said that the success of an Intervention lies heavily within the collective loving power of caring friends and family to establish, hold, and then uphold strategically significant healthy boundaries that support the foundation of the recovery process. As a result, my belief is that it is imperative to not only be able to lay down the law with love during an Intervention, but equally as important, to be able to hold the line after it. Therefore, planning a successful Intervention also includes having a recovery-centered plan of action to help you meet your emotional needs, while your loved one is simultaneously getting help to meet theirs in treatment, thereby creating a powerful therapeutic counterbalance.

So, when it comes down to actually drafting your very own Post-Intervention Care Plan, it’s important to recognize that by the time you finally decided to plan an Intervention, you were probably pretty close to hitting your very own emotional rock bottom, well in advance of your loved one in crisis. And if you can accept that premise, once you finally see your loved one head out on the road to recovery after an Intervention, you will probably feel like it’s the perfect time to tend to your own emotional welfare so that you will hopefully never having to go through that experience ever again!

Set Realistic Goals

The first step in any plan is to identify exactly what you want to accomplish, or your objectives. The same holds true when creating a solid Post-Intervention Care Plan for yourself. Start off by identifying what you want to accomplish for yourself as a result of the Intervention, both before and after your loved one is finally out on the road to recovery. Look closely at improving your quality of life as well as your ability to effectively cope and process issues that may have been impacting you the most, such as stress, anger, anxiety, resentment, and depression.

Although you may not have been the one in need of inpatient residential care, I suggest that you start planning your Post-Intervention Care Plan as soon as you actually decide to move forward with the Intervention, if not sooner. It will help you gauge your own interpersonal growth, while building on your strengths, and helping you learn from your weaknesses. As a matter of fact, unless you are already doing so, start taking care of your emotional welfare right now! Why wait any longer? As one of my unsuspecting mentors once told me, “people don’t plan to fail, they fail to plan.” While your loved one is taking care of themselves in treatment, do the same back home so that you can also benefit from the recovery process.

Reinforce Your System of Support

First and foremost, don’t try to go through it all alone. No matter how tough you think that you are, or how powerful you may actually be, your life has been impacted in one way or another by substance abuse and/or mental illness right along with your loved one in crisis. Now, in the same way that you wanted your loved one to reach out and accept help, if you are ready to experience the long-term and life-changing benefits of an Intervention, you will need to do the same.

Right out of the box, I recommend that you attend a support group meeting within in your community, such as Al-Anon or NAMI, so that you can connect with other people who have also been where you are and who are willing to freely share their experience with you. Don’t misunderstand me, there’s nothing wrong with reaching out to your close friends and family for support, it’s that they just may not be able to relate to your particular situation, not to mention the fact that they may also want to avoid giving you the wrong advice. Beyond support group meetings, whether before or after all of the emotional dust finally has a chance to settle, I strongly suggest that you set aside at least one hour a week for individual therapy so that you can effectively process all of your feelings with a well-trained professional counselor.

Redefine Your Role

Arranging  all of the pieces of the Intervention puzzle was no easy task. More than likely you had to mediate a whole host of inter-family squabbles, while simultaneously and secretly putting out all of those unexpected logistical fires. Maybe you have always been the one who was expected to somehow fix all of the problems, come up with the solutions, and make the peace.

After the Intervention, you may want to look at redefining your role, not only within your family, but in every other aspect of your life. Along with everyone else who participated in the Intervention, including your loved one who was struggling with substance abuse and/or mental illness, now is the perfect time for you move on and grow.

Engage in the Process

As I am sure that your are already well aware, addiction and mental illness touches everyone in the family in one way or another. As a result, when the time is right, perhaps like right now, look for a treatment center that strongly promotes family work as part of their core curriculum.They may even sponsor a Family Weekend, in which families are welcome and encouraged to visit their loved ones in treatment and then actively participate in the treatment experience while they attend workshops designed to promote greater insight, understanding, along with constructive communication skills. Whether in person, over the phone, or by Skype, engage actively in the process. Go. Call. Make the time.

Remain in the Solution

Think positive. Good times are ahead. Things are going to get better for both you and your loved one struggling with substance abuse and/or mental illness. Although you cannot actually control your loved one’s progress in treatment or the speed of their recovery, as long as you remain steadfast in the solution you can definitely help to improve the prognosis by continuing to hold healthy boundaries introduced during the Intervention. After hitting your very own emotional rock bottom, you should be more than ready to thrive in the solution, now guided by a tangible plan of action rich in support, and full of demonstrative opportunities for interpersonal growth. Unfortunately, however, rest assured that more unwelcome and unexpected twists and turns are also on the way. Even after a successful Intervention, the proverbial coast may be far from completely clear. When dealing with substance abuse and/or mental health disorders, just when you think that things are moving in the right direction, something as simple as a small disagreement can end up moving months of progress sideways. Stay cautiously optimistic and remain in the solution at all times!

The Intervention is just the beginning of the recovery process. As is the case when battling any other progressive illness or disease, overcoming substance abuse and/or mental illness takes a lot of hard work and determination by everyone involved. Furthermore, the results of an Intervention have the potential to go far beyond sobriety alone. Although I have to admit that it took me a while to accept the fact that most people end up reaching out to me at the very bottom, as a sort of last ditch effort to try and break through seemingly impenetrable walls of resistance and denial, I take great pride in the fact that the bottom is exactly where true healing begins. After the Intervention, you will have the unique opportunity to thrive in the solution, right along with your loved one in recovery.

Coping cards filled with coping statements can help you trade negative self talk with healthier, more positive replacements. Writing coping cards is an easy, no-cost intervention that might just help you. Read on to learn how to get started.

Negative self-talk doesn’t help. You can try to thought-stop but unless you’ve got a ready replacement, it probably won’t work (the mind’s not so good at staying quiet).

That’s why preparing coping statements and writing them onto coping cards that you carry with you makes sense.

Whenever negative self-talk gets you down, pull out your coping card and read your positive affirmations until you feel better.

It sounds too simple to work, but it does work, and since it’s so simple, you can make your own cards right now.

What Are Coping Statements?

Coping statements are truthful positive statements used to replace the negative and untrue thoughts that take-over when you feel anxious, stressed, angry and/or when facing other overwhelming situations.

For example:

• Replace, "I can't take it anymore." With, "This is uncomfortable, but I can handle it if I take slow and deep breaths."
  

Verbalizing your coping statements can help you calm down and stay in control. They offer reassurance that you can make it through any difficult period.

An example coping statement that a person with panic might use is:

• “I am safe and this will pass. I have survived this before. I am just going to let this pass through my body.”

Writing a Coping Card

It’s all well and good to write out coping statements – but who can remember to use them, or even remember them at all – in the heat of the moment?!!

• Because it is difficult to remember your coping statements once you start feeling overwhelmed, it is helpful to write out a number of statements on a small card that you can carry around easily in your wallet at all times.

With this card on your person at all times, you can pull it out and read the statements to yourself whenever you need to – no memory required.

You may want to write out different cards for different situations that provoke anxiety, or panic, or urges to drink – or whatever you struggle with. The cards work best when filled with statements that are specifically applicable to you and to the situations you face.

Tips for Writing/Using Effective Coping Statements

According to social anxiety specialist, Dr. Barbara Markway, Ph.D., to get the most out of coping statements, make sure to:

1. Write the statements in your own words – not in language you wouldn’t use or don’t feel comfortable with (avoid formal or academic language.)
2. Write statements that specifically target your problem – if you have anxiety about incontinence, write specifically about that.  
3. Write statements that are reassuring, but also realistic and truthful. If you struggle with pain, repeating, “I don’t feel pain” probably won’t help (you won't fool yourself.) A more accurate and thus more useful statement, might be, “This pain won’t last forever.”
4. Keep statements brief and easy to memorize – so you won’t have trouble remembering and repeating your statement when feeling overwhelmed (when you need them most.)

How to Use Your Coping Statements

Use your statements whenever you feel anxiety, panic, feelings of being overwhelmed, etc., coming on.

If using your statements to preempt negative thoughts in a crisis situation:

1. Read them out loud (if possible) and repeat them until you start to feel better.
2. If one statement in particular helps calm you most, just continue to repeat that statement to yourself – like a mantra.
3. Try to breathe slowly and deeply – into your diaphragm – as you read your statements.

Example Coping Statements

Need a little inspiration before getting started with writing your own coping statements?

Well then, review the following example coping statements, and get some good ideas for own unique and personalized coping cards.

Coping Statements for Anxiety

• Fighting this doesn’t help – so I’ll just relax and breathe deeply and let it float away.
• This feeling isn’t comfortable, but I can handle it.
• By relaxing through these feelings I learn to face my fears.
• I can feel anxious and still deal with this situation.
• This is not a real emergency. I can slow down and think about what I need to do.
• This feeling will go away.
• By staying present and focused on my task my anxiety will decrease.
• These are just thoughts – not reality.
• Anxiety won’t hurt me.
• Feeling tense is natural. It tells me it’s time to use coping strategies.
• Things are not as bad I am making them out to be.
• Don’t discount the positives.

Coping Statements for Fear - Preparing for Stress/Anxiety

Overwhelming anxiety and stress is not only unpleasant; it can also reduce your performance (think test anxiety!) Coping statements can calm you down and keep you at your best.

Researchers at West Virginia University found that coping statement training helped speech-anxious subjects reduce their public speaking anxiety – and the effects lasted beyond the training period.

• I’ve done this before so I can do it again.
• I’ll be glad I did it when this is over.
• I’ll feel better when I am actually in the situation.
• I’ll just do the best I can.
• By facing my fears I can overcome them.
• Worry doesn’t help.
• Whatever happens, happens. I can handle it.

Coping Statements for Feeling Overwhelmed

• Stay focused on the present. What do I need to do right now?
• It will soon be over.
• It’s not the worst thing that could happen.
• Step by step until it’s over.
• I don’t need to eliminate stress, just keep it under control.
• Once I label my stress from 1 to 10 I can watch it go down.
• Take a breath.

Coping Statements for Phobias

Researchers at the University of North Carolina at Greensboro found that coping statements helped subjects feel significantly less anxiety during hierarchical desensitization therapy (exposure therapy) and resulted in significant behavioral change (for the better.)

• I can always retreat out of this situation if I decide to.
• There is nothing dangerous here.
• Take deep breaths and take your time.
• This feeling is just adrenaline. It will pass in a couple of minutes.
• These feelings are not dangerous.

Coping Statements for Panic

• This isn’t dangerous.
• I will just let my body pass through this.
• I have survived panic attacks before and I will survive this as well.
• Nothing serious is going to happen.
• This will pass.

Coping Statements for Pain Management

The way you look at pain makes a significant difference.

In one study, published in The Journal of Pain Research, subjects faced an experimental pain task that measured their ability to tolerate discomfort. Half the study subjects repeated negative ‘catastrophizing’ statements during the pain task and the other half repeated positive coping statements during the task.

Subjects verbalizing positive coping statements during the pain task endured extreme pain for more than twice as long as subjects verbalizing catastrophizing statements.⁹

So consider trying out one or more of the positive coping statements from the experiment, such as:

• I can control the pain.
• One step at a time - I can handle this.
• I need to stay focused on the positives.
• It won’t last much longer.
• This isn’t as bad as I thought.
• No matter how bad it gets, I can do it.
• It will be over soon.

And definitely avoid using any of the catastrophizing statements that halved pain endurance, such as:

• I can’t stand this anymore.
• This is overwhelming.
• I can’t control this pain.
• This is worse than I thought it would be.
• I feel like I can’t go on.
• This is terrible.
• This is never going to get better.

Coping Statements for Disordered Eating

• Food is fuel. Food is medicine. Food makes muscles.
• Don’t think, just eat.
• I am not my illness.
• Strong, healthy, smart.

Coping Statements for Anger Management

• It’s not worth getting mad about.
• I won’t take this personally.
• I am in charge not my anger.
• I am going to breathe slowly until I know what to do.
• Getting angry isn’t going to help.
• I can handle this and stay in control.
• Remember to breathe. Remember to breathe.
• People aren’t against me – they’re for themselves.

Change Your Thoughts – Change Your Feelings

Your inner voice sometimes lies to you, and those lies can provoke powerful anxiety, anger, depression, panic and pain.

Fortunately, since you know that thoughts create feelings and behaviors, you can retake control over your wandering mind with coping statements that bring truth and positive thinking back to the forefront. And once you start thinking right – you’ll start feeling right.

If you struggle with overwhelming thoughts, coping statements can help you. They’re easy to create and they don’t cost you anything but a few minutes of your time. Why not give them a try?

Learn how setting personal boundaries and demanding accountability works better than trying to manipulate behavioral change.

Part 1 of a 3 part-series on living with and loving an addicted significant other:

There are circular patterns that Affected Others find themselves in when their partner or spouse remains active in addiction. Ultimately that pattern becomes either a progressive move toward acceptance or a downward spiral of destruction. When we focus our energies on saving those we love, we most often lose ourselves.

For the actively addicted, we hope that they receive the 'gift of desperation.' This counter intuitive concept dictates that when one has suffered sufficiently, they change and new possibilities are created. For the affected other, desperation comes more readily and quickly. It’s not seen as a gift. It’s more likely a point at which we stop investing and come to terms with the reality that they can’t just stop, we can’t make them stop, and we need to determine what we are and are not willing to do.

Living in a Fishbowl

The fishbowl affect dictates that when you’re surrounded by something, it’s impossible to step outside of it to gain a different perspective. It’s all you can see. The non-addicted partner often feels responsible – not only for outcomes but for how the family is perceived by others.

We often feel that our partner’s behavior is a reflection on ourselves and our family as a whole. We feel judged by others. Shame prevents us from sharing our struggles with others and too often, reaching out to loved ones, Al-Anon, Nar-Anon and/or professionals becomes a last resort.

Why Can’t They Just Stop?

It’s always striking when I meet people who don’t know they’re angry. She’s a smart woman, good mother, and she doesn’t understand the first thing about addiction. The first thing she asks me is, “Are you sure he has a disease and that he’s not just being selfish?”

In our first couples session she asked him, “Why can’t you just stop?” His shame was palpable as he explained, “I …can. Stopping is hard but I can do it for a while. The real problem is staying away from it. That seems to be impossible for me.” She stared at him with disbelief and asked me, “What do I need to do?”

Over the coming year I gave her a lot of information and suggestions. She didn’t care for any of it, which was understandable as her husband’s prognosis was poor. What annoyed her the most was my ongoing suggestion that she take care of herself. She assured me repeatedly, “I’ll take care of me when all of this (her husband’s active use ending and recovery beginning) is done."

When we go through hell alone, it’s lonely.

How Do I Make Them Stop?

When we’re unwilling to accept powerlessness, we live on an emotional roller coaster. Our hopes climb, only to be dashed. Our anger ebbs and flows. All the while, too many of us are stuck seeking ways to control what we cannot control.

She took him to church. She believed the preacher when he told her that all her husband had to do was confess and leave his addiction at the altar. He went faithfully. He went high. Nothing changed.

She sent him to their family doctor. With all good intentions, the doctor prescribed pills that were addictive and easily abused. She sent him to the methadone clinic. He received progressively larger doses until all he did was sleep and eat. 

She sent him to NA and hoped he’s meet some good folks. He did. Then he bought pills on the ride home. For all that she tried, he continued to see being clean as an impossibility.

She despaired, “Nothing I’m doing is working! What am I supposed to do?”

Stop. As long as you’re working harder than he is, nothing changes!

The distance between what she knew and could accept was a chasm. She faced what seemed like a paradox – how to accept what she found to be unacceptable?

The answer: by accepting that you’re powerless to change it and turning the focus toward what you can do.

"I’ll Leave If You Don’t Stop"

Ultimatums are easier than acceptance. She told him to get clean and get help or get out. He got out. To set this boundary was healthy. Unfortunately she had used it as a form of manipulation, believing that he would feel compelled to change.

She overlooked a painful truth: Manipulating an addict is very hard to do because they are master manipulators.

Note: Unfortunately, addicts are master manipulators!

The active addict/alcoholic will often use shame and self deprecation as a means to avoid accountability. Evoking pity or even disdain is both an attempt to absolve themselves and to seek absolution. She crumbled. She took him back time and again. Always there was the promise of change, never did it last.

The relationship became progressively toxic.

The First Word In Recovery

Accountability is the most important word for those entering recovery. If we don’t have it then we don’t get better. This is also true for the affected other. While we don’t have control over the choices of an active addict; we do have control over how we choose to respond to their behavior.

Her anger was so righteous and so focused on his continued use that she overlooked the impact of her own choices on herself and her children. Progressively the man she once loved was claimed by his disease. The decision was made for her when at last he overdosed.

Part 2 of this series looks at options for ending an addiction-compromised relationship. In part 3, find tips on rebuilding a healthy and happy relationship through early and mid recovery.

Image Copyright: Luke Hayfield Photography

Learn how to plan an intervention for yourself. There are countless pathways to recovery but none of them are walked alone. Find out what needs to be done, based on what's possible - not on what's comfortable.

The first question I ask of anyone who wants to break free of addiction is, "Are you willing to do whatever it takes?" Conditions and contingencies get us killed. What we're unwilling to do becomes something our disease will use against us.

In a very real sense it doesn't matter what we want, feel, or know. It's about what we need and in this context, willingness is everything.

There are countless pathways to recovery but none of them are walked alone. Shame and fear are our biggest obstacles. Too often we struggle alone based in the misguided notion that we are protecting our loved ones. I've sat with no small number of folks who wished they could break through, stop pretending, and reach out for help.

In the following model you will find out how to plan an intervention for yourself - what needs to be done based on what's possible and not at all on what's comfortable.

Changing How We Conceptualize Intervention

There are only two ways recovery gets initiated:

1. An individual seeks help
   
2. Concerned people in their life intervene
   

In an intervention, folks come forward and typically offer some level of support. When we come forward ourselves, we generally do so without supportive others, without plans, and generally with very few resources.

Treatment professionals offer strategies for attaining abstinence and preventing relapse. We typically find that the more people we involve, the better our chances of success. My experiences as an addictions interventionist left me wondering: What if the individual seeking help could receive all the benefits of an intervention?

First Things First

See your Primary Care Physician (PCP). We always urge folks to err on the side of caution. Determine what risks are involved in withdrawing and what steps need to be taken to ensure your medical needs are met. Talking with your PCP is a starting point to determine what level of care options are available:

• outpatient addiction treatment
  
• intensive outpatient
• medically supervised detox
• residential rehab

Developing a Plan

The most effective interventionist I ever worked with taught me to keep it simple, "It starts with accountability and responsibility. If you don't have those you don't have anything. Make a plan and share it with good people. Do whatever you have to do to ensure that you stay clean and sober."

The only "must have" to start the process of building your own intervention is at least one person who truly understands both addiction and recovery. This person can be a friend, family member, a peer in a 12 step community, a recovery coach, or a professional addictions counselor/interventionist. The choice of these should be based on who you believe will do the most to hold you accountable. I favor 12 step folks and professionals because they'll be the least conflicted emotionally about calling us out on our self deception in no uncertain terms.

Take Stock of Your Resources:

• Family (immediate and extended)
• Friends (current and old)
• Religious Community
• Community Resources (Grassroots Movements, Civic Organizations & Health Clinics)
• Local Recovery Communities (12 Step Meetings & Fellowship)
• Workplace (coworkers, supervisor/manager/owner)
• Health Insurance Benefits
• Financial Options regarding treatment
• Past experiences in recovery

Keep It Simple

The purpose of examining resources is two fold:

• Who are the stakeholders (people invested in attaining the solution)
• What can they contribute to the process (emotional, financial support and pragmatic support like transportation and child care).

These determinations will allow you to share with folks how (if they're willing) they can best be supportive. Good intentions and vague offers of support are not sufficient. We won't be asking folks to commit in the moment but offering them clarity will ensure they understand what they're agreeing to and give them an active role in supporting our recovery.

Plan the Gathering

Choose a date and time in which folks won't be rushed. An intervention doesn't need to be an all-day event. It's best to allow a minimum of two hours and a maximum of four. Pick a site that has enough room and is accessible to folks you most want present (consider driving distance and basic facilities).

Invitations

Phone-call invitations tend to yield a lot of questions. One of the benefits to staging your own intervention is that you tell the story fewer times. I suggest sending invitations via email or social media if you're confident folks check them often enough. If any of your guests are elderly or not techno friendly, mail a card or letter.

Share a short sentiment that you need their support in making a major life change. Ask that they hold their questions until the event. Thank them for their patience and understanding and for being a part of your life.

Choose a Facilitator

Having a neutral facilitator is key. Emotions are likely to run high and the folks you'll be talking with all have a personal history with you. Ideally, a professional interventionist or experienced addictions counselor will fill this role. More affordable options include hiring a recovery coach or life coach. If finances do not allow for hiring a professionals or paraprofessionals, asking someone with long term recovery experience is still a very strong option. Ideally, this would be a sponsor or other strong supporter from a local 12 step program.

Follow Through

It's impossible to predict how the intervention itself will unfold. You can guarantee success if your expectations are simply to:

• Share the truth about your addiction.
• Ask for what you need.
• Seek accountability and support from the folks in your life who matter to you.

After the intervention you will be free to schedule time one-on-one and fine-tune plans. If we maintain contact, honesty and consistency, we are going to experience unprecedented success. Addiction affects every life, directly and/or indirectly. Allowing others to be part of the solution strengthens community and weakens the grip of addiction on us all.

Feeling stressed and anxious after a disaster is normal. Here is some information on what feelings are normal after a disaster, with tips on managing and reducing feelings of stress and anxiety - and also, information on when to get professional help for serious stress or mental health symptoms.

It’s normal to feel stressed or anxious after experiencing or even witnessing a disaster. Feelings of stress may emerge very quickly after the event, or they may emerge in the days, weeks and even months after the fact.

What Are Some Normal Reactions to a Disaster?

Although feelings of stress and anxiety are unpleasant, they are normal reactions to abnormal events, and in most cases, stress and anxiety will subside in time.

According to SAMHSA’s National Mental Health Information Center, some normal stress reactions to a disaster or traumatic event can include:¹

• Feelings of anxiety, tension and nervousness
• Finding yourself crying easily
• Excessive drug or alcohol use
• Emotional numbness
• Feelings of anger or irritation
• Social isolation
• Insomnia
• Fatigue
• Problems of attention and memory

How to Cope with Post-Disaster Anxiety and Stress

Stress reactions after a disaster may be normal, but they are mostly unpleasant and can interfere with your quality of life and your interactions with friends, family and co workers.

Here are some techniques that you can use to help manage and minimize the post disaster stress and anxiety you may be feeling.

• Get back into a ‘normal’ daily routine. Although you may not feel much like attending to the groceries and the kids’ soccer practice, by keeping busy and ‘back to normal’ you accelerate your recovery.

• Stop your news vigil – If you’ve been pouring over the internet and glued to the TV for latest breaking disaster news, you may only be feeding your feelings of anxiety. It’s unlikely that your vigilance will do any good, so give yourself a breather.

• Take care of your physical health. Eat nutritious meals, get out and do some vigorous exercise and try to get enough sleep every night. You are far less able to manage stress when you let your body get run-down.

• Try to find a way to genuinely help – feelings of helplessness can stoke the fires of anxiety, so take back some control and make a productive difference. Volunteer your time and energy with an organization that’s helping in the rebuilding process – burn off your restless energy to good purpose!

• Don’t bottle-up the feelings you have – Talk with others in your family and community about how you, and they, are feeling and coping.

• Don’t dwell on the negative – although it’s normal to feel overwhelmed in the face of death and destruction (especially when it’s close to home) you can start feeling better faster by remembering what is good in your life and what you still have to hope and live for.

When to Seek Help for Post-Disaster Stress and Anxiety

Although for most people, feelings of stress and anxiety will subside in time, for some people, disaster exposure can cause PTSD and other mental disorders – conditions that do not necessarily get better or go away on their own.

Talk to a mental health professional if:

• You can’t get back into a normal routine, can’t function normally on the job or at home
• You are abusing drugs or alcohol to cope with your feelings
• You’re worried that you are going to hurt yourself or someone else
• You notice symptoms of mental illness
• You have feelings of sadness or depression that persist beyond 2 weeks

Image Copyright: seyed mostafa zamani

Learn about protracted withdrawal, why you might experience unpleasant symptoms and what to do if your symptoms just won’t go away.

What do you do if your withdrawal symptoms don’t end when they’re supposed to?

Well, firstly, know that protracted withdrawal are normal and they will pass in time …you will get better eventually!

But when you’re unprepared and you get blindsided by symptoms that just won’t quit – or by symptoms that come back even months after you think you’re in the clear, it’s easy to get discouraged and relapse back to drinking or drug use.

So get prepared - read on to learn more about the second phase of the withdrawal process, something that can last for many months or even years after your quit date – and be ready to make it through to the other side.

Acute vs. Protracted Withdrawal

Acute Withdrawal

When you suddenly stop using a drug you’ve become addicted to you experience a brief period of generally unpleasant withdrawal symptoms.

The time frame can vary a bit, but in general, acute withdrawal will endure:

Acute withdrawal symptoms should largely disappear by the end of the predicted withdrawal duration.

Protracted Withdrawal (Post Acute Withdrawal Syndrome - PAWS)*

So withdrawal symptoms are supposed to end at the end of the acute withdrawal period – but sometimes they don’t!

When your withdrawal symptoms continue on for longer than they’re supposed to and/or when you also start experiencing more general (non-substance specific) withdrawal symptoms that persist for longer than the acute withdrawal period - you are in protracted withdrawal.

* Another common name for protracted withdrawal is post acute withdrawal syndrome (PAWS).

Does Everyone Get Protracted Withdrawal Symptoms?

No.

1. Some people experience no withdrawal symptoms after the end of the acute withdrawal phase
2. Some people find that acute withdrawal symptoms last for far longer than they’re ‘supposed’ to
3. Some people feel a lot better at the end of the acute withdrawal period and then a month or two later withdrawal symptoms come back, as if out of nowhere

Common Protracted Withdrawal Symptoms

Not everyone will go through protracted withdrawal and individual symptoms will vary depending on the drug(s) of abuse, your physical and mental health and other factors.

But that being said, some common protracted withdrawal symptoms include:

• Insomnia and other sleep problems
• Chronic fatigue
• Irritability
• Anxiety
• Anhedonia (an inability to feel pleasure, or as much pleasure as you used to)
• Short term memory problems
• Drug or alcohol cravings
• Concentration problems
• Depression
• Aches and pains
• A loss of libido

Why Do You Get Protracted Withdrawal Symptoms?

When you use drugs or alcohol for a long time your brain changes (an adaptation) and researchers can see these changes at the molecular and cellular levels and through changes to neurocircuitry (how the brain communicates).

These changes can affect your emotions, thinking capabilities and ability to resist impulses, and it can take a long time for your brain to revert back to a pre-addiction state of functioning.

Basically – through a long period of heavy use you induce some significant changes to your brain’s structure and functioning, so it’s not totally surprising that your brain needs a few months or longer to get back to normal!

Getting Through Protracted Withdrawal

Even if there is full recovery from the withdrawal symptoms, the actual devastation to a person's life during a long withdrawal, lasting for months, can be ruinous. 

What's more, protracted withdrawal increase your risk of relapse – so to keep your recovery on the right track, even when passing through the doldrums of post acute withdrawal symptoms, make sure to:³

Understand that things will get better – Though it may seem like you’ll never feel like your old self again, even protracted withdrawal will pass and in time. Understand that brain healing occurs slowly, but surely, and with patience and perseverance you will make it through.

Maintain good sleep habits – Since protracted withdrawal can lead to sleeping problems and sleep deficits can lead to relapse it’s important to make a good night’s sleep a priority. If protracted withdrawal has you tossing and turning, lean more about good sleep hygiene and habits and make a few simple but effective changes to improve your odds of a restful night’s sleep.

Stay involved with community support groups (like AA) – The support, encouragement and knowledge you find at community mutual self help groups can help you to stay on the right track and to identify dangerous habits before the pull you down to relapse. At community meetings, you’ll also get advice and encouragement from a group of people who understand exactly what you’re going through.

Stay active – Exercise relieves stress, increases positive emotions, promotes healthy sleeping and helps distract you from triggers and cravings…all in all, exercise is a must-do

Reduce stress – Getting through the initial recovery period is tough enough, so give yourself some room to breathe by minimizing your outside commitments and responsibilities for a while. This way you can take care of the most important thing…yourself.

Consider medications – Certain medications, like acamprosate for alcohol and methadone or Suboxone for opiates, can alleviate some or all of the protracted withdrawal symptoms you may experience. Talk to your doctor or therapist about the pros and cons of adding medications to your recovery program.

Consider therapy – certain therapies, like cognitive behavioral therapy, teach skills that help you to compensate for the diminished cognitive functioning and poor impulse control that are typical to many recovery efforts.

Warnings and precautions about protracted withdrawal must be part of any pharmacological treatment plan. Don't go through protracted withdrawal without medical support.

Image Copyright: Sherman Geronimo-Tan

If you aren’t meditating already, here are 8 very good reasons for you to consider taking it up. Whether you’re still drinking or using and trying to control yourself, just starting off with treatment or long down that winding and difficult recovery journey, stopping yourself from taking that next drink or line or hit is always going to be a challenge. Fortunately, while you may never be able to erase temptation from your life, you can take some steps to build up your resilience against cravings as you also build up your overall levels of health and happiness.

If only there was something we could do that didn’t take much time each day and didn’t cost any money and almost magically removed much of the stress from life as it also brought more joy and equanimity and a better ability to manage temptations… Hey wait a minute – meditation can do all that!

If you’re trying to control your urges to take drugs or drink alcohol, there are a number of very compelling reasons to add a session of meditation into your daily routine, and not very many valid reasons for not doing so.

Not convinced? Here are 8 reasons why you should consider learning to meditate!

8 Fantastic Benefits of Meditation

1. Meditation reduces your stress level

This alone is reason enough for most of us to get started. Meditation won’t do much to remove stressors from your life (your boss may still be a difficult person even after you meditate) but it will help you to respond to stressful events in your life without feeling as frantic on the inside – and since stress is a major cause of relapse, for those in recovery, eliminating any stress is a very good thing.

Stressful life events can trigger your sympathetic nervous system into a ‘flight or fight’ response which causes an increased heart and respiration rate, a narrowing of the blood vessels and other physical changes – the body gets ready to run or fight in response to a threat. Meditation increases the activity of the sympathetic nervous system’s opposite, the parasympathetic nervous system. The parasympathetic nervous system controls bodily functions in moments free from danger or stress. Increasing the activity of the parasympathetic nervous system results in lowered respiration and pulse rate, improved blood flow and lower blood pressure, better digestive function and a better ability to handle stress without feeling your blood pressure rise.

2. Meditation improves immune function

The abuse of opiates and some other drugs can decrease the effectiveness of the immune system, and few people emerge from drug or alcohol abuse in pristine health. Fortunately, research shows that just a few weeks of daily meditation can improve immune function and keep you feeling as good as you should.¹

3. Meditation can control pain and keep you off opiate analgesics

Meditation is a proven pain management technique that may help you to avoid, or minimize your use of, problematic and addictive opiate drugs.

4. Meditation can lower your blood pressure and stave of heart disease

Anyone who has abused drugs or alcohol for long could do well to treat the heart with a little TLC; after all, all those nights of whiskey and cigarettes and cocaine and whatever else can do a lot of damage. Fortunately, research shows that regular meditation practice can lower blood pressure and even prevent the onset of heart disease.  You can’t go back in time, but you can start taking better care of yourself, starting from today.³

5. Meditation increases your empathy and compassion for others

The behaviors of addiction are necessarily selfish, and this can wreak havoc on relationships with the people we care about most. Fortunately, with kindness and right actions you can rebuild most relationships, and meditation is a great way to improve your relationships with those you love as the practice transforms you into more generous, compassionate and empathetic person.

It’s not only anecdotal evidence which illustrates how meditation can transform you into a nicer-to-be-around person, brain imaging scans done on experienced meditators shows that meditation leads to a greater neural response when confronted with the negative emotions of others. Basically, brain scans show that meditation really does amp up compassion and empathy!⁴

6. Meditation may slow down the aging process

The bad news for those of us who’ve drank more than our fair share over the years is that drinking alcohol has been implicated as something that shortens the length of telomeres, which are the protective caps situated at the end of chromosomes. Shortening telomeres are thought to influence the cellular aging process so anything you do to make your telomeres shorter increases the rate at which you age.

Fortunately, although you can’t undo what’s done, you can take steps now to preserve your telomeres. Preliminary research indicates that meditation may be something that protects against telomere shortening by decreasing things like chronic stress and emotional reactivity that are also thought to accelerate the aging process by shortening telomeres.⁵

7. Meditation can help build up your sense of spirituality

For thousands of years Buddhist monks, Hindu Yogis, Christian mystics and people from a thousand other spiritual traditions have used meditation as a way to connect with the divine and enhance a personal spiritual understanding.

Whatever your religion or spiritual take on the world, meditation can probably help you too become more connected to the powers, joys and mysteries of life. And whether you’re still drinking or using, trying to stop or on an ongoing journey of recovery, building a personally relevant spirituality is a very useful thing to do.

8. Last but certainly not least…meditation will bring joy into your life

MRI scans show what meditation enthusiasts preach to anyone who’ll listen, meditation brings more joy into your life, and it’s pretty hard to argue against more happiness in life, right?

Image Copyright: clearwisdom.net