Thursday, April 8, 2010

First Steps in Getting Better

Addiction is, by definition, physical or psychological dependence that causes damage to a persons life and environment. That is how it looks from the outside. From the point of view of the addict, however, it is an entirely different story. Addiction is about love, love that sustains itself at any cost, love that doesn't care if Rome burns, love that feels like death in the absence of the loved one. This is precisely what makes addiction so difficult to treat since the therapist and the client are using two different reference points, two different languages, coming from two different planets altogether.

Addiction can involve substances, like drugs or alcohol, as well as behaviors, gambling, shopping, food, sex, pornography, the works. Even relationships with other human beings can take the form of an addiction once it crosses into the realm of dependency at the cost of damage to life and environment. The behavior makes the person feel complete (be it drug-taking or gambling or whatever) and this feeling of completeness is so precious to the self image of the addict that the mind sets up a defense system to block out any attempt to interfere with the behavior. This is called denial.

The food that feeds addiction is shame, guilt, fears, hopelessness, and the addictive behavior simultaneously strengthens these feelings as well as suppresses them with the feel-good factor of the behavior. The first task of an addict who wishes to break out of the addictive cycle is to recognize that the problem is less in the behavior (drug taking or drinking or masturbating or whatever) and more in the food that feeds it. Once the diet is addressed, the need to indulge in the behavior and the fear of withdrawal will be eliminated.

Even in the most drunken or lovestruck state, one can usually come up with a rational list of things that are going wrong in his or her life because of the addictive behavior. If this seems difficult, try the other way round, list out the reasons why the addiction needs to be indulged in. To a large extent the lists will be the same. Addiction makes us feel that the consequences of our addiction are actually the causes of our addiction. This mystic insight can often break the back of the monster called denial. A zen moment for those who upload the correct teaching. I accept that I am in denial!!

Once that is done, and the cost of continuing with the addiction is weighed against the cost of bringing it to an end, the most painful part of recovery comes into play. That of initiating abstinence. I recently had a chat with Shashi Singha, a therapist I hold in high esteem, and we were talking about total abstinence and harm reduction. To the concept of social drinking by a recovering alcoholic, she pointed out that the risk of allowing an addictive behavior to remain present in one's life reinforces the subconscious association of the feeling of well-being and powerfulness with that behavior. She and I have never been able to agree on a host of things but that has not detracted from the respect I have for her.

The first task is to totally put a break to the behavior. This may need medical or psychological supervision. It is best to consult with a qualified professional before attempting this. Qualified professionals come in varied shapes and sizes, and the tragedy of addiction treatment is that most of the professionals are in the profession by virtue of their being recovering addicts and not by virtue of professional training. Of course, most of them are highly qualified as addicts, but walking gulf wars as far as being treatment professionals. Even in the business of recovering from their addictions, like me, they can at best be called trainees. It is often wiser to seek counsel with the mentor within us. For those who are part of a religious or spiritual discipline, prayer for wisdom and strength to do the right thing is often helpful.

The detoxification from an addiction can take anywhere from weeks to months. This is a very vulnerable time, and it is most advisable to stay as supported as possible by loved ones (who will support recovery and abstinence, not enable relapse or substitution with another addiction), to keep one's task list as low-stress as possible, to spread out and defer immediate responsibilities or decisions, to eat and drink healthy, to sleep well and get in moderate but regular exercise.

The predominant feeling as one emerges from the initial pain of stopping an addiction are the very same feelings that drove one into addiction, shame, guilt, fears and remorse. Having to look at the mess that one has made of one's life in the stupor of addictive behavior is very painful. Yet, it is a fact that cannot be wished away. Getting a grip on this reality can prove stressful and often is the cause of a return to the addiction. Being in a protected environment for the first few weeks or months is not a luxury all can afford, and one might actually be forced to look at and address these issues early in recovery. It is essential to do this systematically.

The body and physical discipline comes first. Get back to a regular lifestyle even if it hurts like hell. Sleep regular hours, do not oversleep (the body and mind will crave for the restorative medicine that sleep is, but don't worry, you will catch up on it), go to bed at a fixed hour, stay in bed even if not sleepy, read or listen to music or an audio book if you must. Eat full meals, at regular times every day, and try and get a well balanced diet. Don't worry about food cravings for particular things, if your body needs something, it will ask for it. Stay away from fried stuff and empty calories, get enough fiber, and try and stick a couple of helpings of vegetables with every meal, and at least one helping of fruit a day. Yogurt is a miracle drug at this time. Throw in some exercise as it suits you. A 30 minute brisk walk is better than no exercise. Fix a time for rising, for getting outdoors, for having a bath, for meals. Stick to this physical discipline no matter what. With time, you will no longer need to make an effort.

The mind is next. This is a long story, and will take a long time to address, but remember that the mind is the devils favorite target. When all ways of thwarting your determination fail, he targets your mind and you yourself will start telling yourself that the effort is not worth it. This is the most dangerous moment, when you start wondering if getting well is worth the trouble, when you start saying, now I have it figured out, this time I will walk the razors edge and not get hurt. Beware. This will happen to you. Zen moment again, I know can't get hurt because I know I can get hurt. Start keeping a journal, however rudimentary. There is a vast ocean of things that you will need to sort out, start getting into the habit. Write about yourself, your thoughts, your feelings, your secrets, your regrets, your desires, your debts, your earnings, your commitments, your health, your madness, the list is endless. But getting into the habit of getting your thoughts out of your head and on to paper helps a great deal. What do you think I am doing out here? :)

The body and mind healing is an ongoing process, and as time passes, newer issues will surface and need to be addressed. Having a strong spiritual (you can use the word social or psychological or religious or whatever) discipline is integral to sustaining the recovery that has been achieved in body and mind. It helps to be able to see that the strength for the initial journey was neither from the body nor from the mind but from the desire to become that which we are destined to be. It is not important how you label it or understand it. What is important is to acknowledge it and to strengthen it.

When I started writing this post, I was intending to write about the process of bringing an addiction to a stop and to look at the grief of letting go of something that we are accustomed to, something that we believe is integral to our well-being, but it took on a life of its own and touched on a host of other things.

If you are looking at any issues that you would like to know about or share about, feel free to email me at subhorup at gmail dot com. All the best in your efforts to become who you were meant to be.