Episode 187: Finding Optimal Recovery after Addiction

TRANSCRIPT: Finding Optimal Recovery after Addiction

Hi everyone, welcome to Thanks for Sharing. I’m your host, Jackie Pack. So I’ve been going through my filing cabinet lately and condensing materials, throwing away, shredding, recycling what I don’t need, and recycling things that I do need that I do like, and I found some things that I used to use earlier in my career, and for some reason I forgot about them. I stopped using them. I’m not sure, I learned something else and just kind of evolved in my process of doing therapy, and so as I’ve been going through some of these file folders and I’m pulling out some of these papers and exercises that I had gotten or created myself,

I have been looking at them again and wondering why did I stop using this? This was good. So one of those I shared with you on our previous episode on strategies for getting what we want. This one is one… you know that saying how there really is no original thought? I don’t really know what the saying is, but it’s something to that effect, about how there really is no original thought, especially today in our society when there are so many avenues for taking in information and for learning things, whether that’s reading books, listening to books, listening to podcasts, watching TED talks, there’s all sorts of avenues for information to come into our brain, and our brain organizes this kind of information, and it may not be original thought, but it’s a way that our brain puts it together that is somewhat unique or at least somewhat personal. I won’t go so far as to say that it’s original.

So this was something that I used earlier in my career, and again this would be something that maybe I picked up bits and pieces along the way working with clients, and then I was trying to make a map somehow or make sense of what I was seeing as a new therapist or as a fairly young therapist, and some of this I remember developing with my supervisor who supervised me for my licensing hours, and he had some input into it as we talked things through, and that’s all about I remember of where kind of that came from. I mean I was doing trainings, I was fresh out of grad school, I was doing a lot of training, so I’m sure some of this would have come from various resources. This would have been in the late 90s.

So it’s kind of a way for me to process what I call critical events, and when I look back I can see that I was making sense also of trauma and trying to make sense of resiliency. I remember I was telling one of the therapists that I supervise currently, I was talking to them a month or so ago in one of our supervision sessions, and I mentioned that when I was a new therapist, we would talk about situational depression, and then we would talk about chemical depression, and I remember this would be towards the end of my licensure hours in social work. In the state of Utah, you have to have 4,000 supervised hours in order to get your full license, so this would have been kind of towards the end of that time period, and so I would have been working about two years full-time work, and I said to my supervisor, so I keep hearing about like chemical depression, which is maybe genetic or just something chemically gets off in the body and results in chemical depression. That’s at least how we talked about it back in the 90s. And I said and then there’s situational depression that isn’t chemical depression, and chemical depression isn’t situational depression, and I said to him, but I in all of the cases that I’ve worked with where somebody is dealing with depression, I always find a situation, so I don’t know what chemical depression is.

Now looking back 20-some odd years, almost 27 years, I can look back and I don’t know how much of it was the thinking of the time. About that time we were maybe 10 years into looking at trauma and the impact on the brain and the body from trauma vs. how much I just knew coming out of grad school and the trainings that I was attending vs. what I was seeing with clients, and what I was seeing with clients is I could always find a situation that could account for the symptoms that they were coming into therapy for. So this is some of what was going on when I was trying to map this out.

So I put down, I’m going to put in the thumbnail, I’m going to put a little smaller blueprint of this, what’s it called? Of this formula maybe. But at the top, we have a critical event, so this is something that happens. Again as I’ve talked about trauma multiple times on this podcast, it can also be something that doesn’t happen but should have. So we have this critical event that kind of starts things off in this model or in this blueprint, and that critical event results in feelings of shame, rejection, fear, or abandonment.

Now based on what happens from that critical event, on the one hand, this critical event is discussed. The people around this person know what happened. They’re willing to sit down and talk about it, and that critical event is discussed. The feelings are expressed and they’re validated. The people around them are validating those feelings that that person who experienced a critical event has, and because those feelings are expressed and they’re validated, those feelings are normalized, support is given and received, and resiliency skills are developed, and as a result of that, this individual who experienced this critical event develops healthy coping skills and a healthy support system. They learn that it’s safe and helpful to turn to relationships to talk about what happened, to have a support system, and that all of that helps build resiliency skills.

Now this person is not going to forget about this critical event. It’s a critical event that was part of their life, but instead of it becoming a stumbling block, they will talk about it in terms of resiliency, so they may talk about it and say something like, “I really learned that I was stronger than I gave myself credit for” or “I really learned who my friends were at that time in my life” or “I really learned that I could count on the people around me” or “It was helpful to talk about my emotions and to process what was going on inside of me as well as what happened to me.” So that’s kind of how something is processed in a way that this person ends up with resiliency skills.

All of us are going to have bad things that happen to us in life. That’s just part of life. And when I talk to parents sometimes, when I talk to some of my friends and they may express this like how do I protect my kids? And I will often say, yes, we can go to the extent that we can to make sure our kids are safe and that they’re secure and that they’re protected, and life sometimes is still life, and we can’t hold ourselves responsible for things that happen that maybe are out of our control or out of our kids’ control. Instead, we need to focus on how do we respond appropriately so that this experience is one that can be adaptively stored and integrated as they move forward and understand the world that they live in and the role that they play in the world that they live in?

Now on the other hand, and when I developed this, remember I was working with mostly court-ordered drug and alcohol clients, so they weren’t necessarily coming into therapy because they wanted to examine their life or because they had an issue that they wanted to find growth and healing around. They were coming to therapy because the court was mandating that they come to therapy, and one of my jobs as a therapist was not only to fulfill the court requirements, but hopefully to also engage them in a therapy process that would benefit them and lead to improved behavior.

So on the other hand, we have a critical event that happens. Again this results in feelings of shame, rejection, fear, or abandonment. On this side, the critical event is not discussed, which means the feelings can’t be expressed and they’re not validated or normalized. So what ends up happening is these feelings get buried. They get stuffed down. They get avoided, and this can lead to issues with drugs and alcohol, with eating disorders, it can lead to sexual acting out as a way to deal with what’s happening. That’s how I would talk about and I would say this is like acting out behavior, so things we can put our finger on and say something isn’t going right here.

On the other hand, it could also lead to what I would refer to as acting in behaviors. So again this is an indication that something may not be right, but it’s not necessarily something we can put our finger on or that we can see, so this may be depression. It may be self-harm. It may be negative thinking. It’s going to be low self-esteem, and it may lead to toxic or self-destructive relationship patterns.

Now on this side where the critical event is not able to be processed adequately, there’s this other cycle that’s going on within that that starts with feelings of isolation. Because this person had something that happened to them and they weren’t able to process this in a supportive relational way, there’s feelings of isolation, which can fuel acting out behaviors, whatever that may be. I mean it could be a bout of depression. It could be self-harm behaviors. It could be drug and alcohol. It could be eating disorders that flare up. It could be sexual behaviors.

So there’s going to be these acting out behaviors that happen fueled by the feelings of isolation. That would then be followed by feelings of despair or self-hatred, which then is usually covered by acts of concealment, so this person goes in to kind of cover up what’s actually going on, and I’ve worked with a lot of clients where they’ve covered up what’s going on even to themselves. They no longer are able to connect the dots and see kind of this linear fashion of behavior happening and being connected to the critical event.

Now that cycle that I just talked about is similar to what we talk about in the addiction field. We talk about an addiction cycle. We also talk about an addictive system. But even for those who don’t have addiction, I often find that there’s a cycle to their behavior, and it usually starts with feelings, even if they’re not aware of that, it starts with feelings, followed by some thoughts about the feelings, which usually leads to a behavior, in this case acting out in whatever way this person acts out, then followed by more negative emotions about the self and then covering or hiding that up, which is only going to fuel the feelings of isolation because I’m hiding who I am from people.

This process of hiding and concealing and not expressing or talking about what happened can start at some very young ages. As this individual grows into adulthood, this cycle can get more intense. It can start to spread into other areas and behaviors. I will often talk with my adult clients and I may say like it’s one thing to have kind of this dysfunctional cycle going when you’re young and you don’t have access to a lot of things, but adults have a pretty wide range and unlimited access to some pretty dangerous behaviors. They also have much more access to drugs and alcohol than they may as a child. Even teens have more access than a child, so again the ways that we cope with what happened or didn’t happen can change and intensify and kind of flourish as we get older and have more options to choose from.

Often too traumatized people want an object on which to project their pain. An addiction is a “good thing” to project deep wounds on because addiction leads to even more pain, and it can intensify the feeling of the wound while disconnecting it from the original wound. On the other hand, when we’re able to talk about and have support and validation about what happened to us and we develop this healthy coping skill, we develop an ability to be emotionally sober.

Sometimes the way that we talk about emotional sobriety is we can go from 0 to 10, so we can feel all of the emotions and we have a range of feeling emotions, so we can go from 0 to 10, and we also have the ability to come from 10 back to 0, and we often add with no speed bumps, so we don’t hit these big speed bumps as we’re moving through that process of 0 to 10 up to intensely feeling my emotions, and then back from 10 to 0, regulating, claiming, and soothing myself.

I’ve talked before about emotional sobriety. In the AA big book, in the first paragraph talking about step 12, Bill W. wrote, “If we practice these principles [meaning the steps] in our daily affairs, we soon discover that we and those about us discover emotional sobriety.” So again these steps that Bill W. identified, which are really just these steps for change, lead to emotional sobriety. They lead to an understanding of what’s going on inside as we clean up what’s going on externally. Sober suffering, a term coined by Fred Holmquist to describe the experience that many people experience at some point in their recovery, he talks about that people who are dealing with sober suffering share something in common to one degree or another.

Again the specifics or the details may be unique and personal to that person, but he found that when people are experiencing sober suffering, there was a similar theme, and the theme was that they belief life should happen on their terms. They got hung up on how life should be and put their energy towards what wasn’t happening that they believed should have.

So how does this happen? How do we end up putting ourselves in such a position as this? Number one, what is this position we put ourselves in? This position is absolutely dependent on external control. It’s also pretty black and white. I need life to go how life is supposed to be for me in order for me to be okay. Again, there’s a lot at play there that I may not have any control over, and I may be sober, but I’m suffering because I’m still trying to control my life, life in general, the people in my life, how all of that moves and goes about.

When we focus our energy on what should happen, we cannot use our internal resources to discover a creative adaptation or solution to whatever situation we’re facing. We get knocked off balance and find ourselves unable to regain or recover our balance. On the other hand, whole or optimal recovery is the ability to take 100% responsibility for my experience. That’s something that I can control. Optimal recovery allows for the best in you to do the thinking and talking for all of you. Optimal recovery provides a corrective emotional experience where there was pain.

Now when I would talk about this blueprint of the critical event and what happened, I found that for a lot of the clients who I was working with who were court ordered to come to therapy, there was usually critical events that had happened that put this person in a situation of maladaptively coping, and that’s what brought them to therapy. That’s what brought them into the legal system and the court system that ordered them into therapy. Part of my job as the therapist was to uncover this critical event that had not been processed and to provide what I would call a corrective emotional experience, meaning we talked about it. They were able to discuss what happened. They were able to talk about the feelings that they experienced. Sometimes they were feeling these feelings for the first time in a long time, and they were maybe feeling them at the intensity in which they actually happened instead of kind of tapping it down at the time that it happened.

As a therapist, I was able to validate their feelings. I was able to normalize what they were experiencing in their body. I was able to offer support, and they were able to receive that support and that validation and integrate that in as part of their experience. My goal was always for them to develop healthy coping skills and a healthy support system. This would allow them to not only move through the experiences and the feelings associated with those experiences that had happened to them, but also to be able to regulate themselves and to have ways of coping with the emotions that came up.

In my episode called “The Impact of Family Dysfunction”, I talked about the ACOA fellowship, and I’ve talked about ACOA before on this podcast. ACOA focuses on relational trauma, and it stems from the trauma literature that started in the mid-80s. It allowed us in the field to start to pinpoint the severity of the illness of PTSD. We came to understand that this trauma and pain can go underground for days, weeks, months, decades, and that it re-emerges when it’s triggered back into being by like circumstances.

Now relational trauma can be uniquely mind-bending to find our way out of. There’s a sense of no beginning, no middle, no end. Instead it’s this endless cycle of relational complication because we’re relational beings and we continually have relationships to one degree or another. Because we’re relational, this trauma can get triggered back into being at any time. Sometimes we have fights from the past in our present and we’re not able to connect it to our childhood dysfunction. We can get stuck in the past and not see what’s happening in our present.

In recovery, the relational aspect can be elusive. It’s not as concrete as stopping a behavior or starting a new behavior. Using 12-step terminology, I believe that working the relational issues is going all the way. We know that addicts can sober up, but emotional sobriety and working the relational issues is another layer of work, and it’s a lifelong part of recovery. How a person separates their past from their present again is a lifetime of work being able to tease out what pieces belong to the past and allowing clarity to come into our present.

I’ve worked with couples where like I said they’re having fights from the past, but it’s in their present relationship, and because they’re not able to connect the fight that they’re having with their childhood dysfunction and their childhood relationships, they’re stuck in their past and they can’t see what is actually happening in their present. So for example sometimes their partner actually does believe in them. Their partner loves them. Their partner wants to be there for them, but they continually have this fight declaring that they’re a good person with their partner who isn’t questioning that. So again some of these beliefs that we form in our childhood based on the dysfunction we experience and the trauma that we experience comes into our adult relationships and we cycle around those impaired thinking or those dysfunctional beliefs that we have from our childhood, and we get trapped in that cycle of fighting a fight from the past in our present.

Now what we learned as a child or a teen or an addict who’s in active addiction is that the pain and the emotions are too scary. If we allow them to surface, they will be unmanageable very quickly, and then our safety is compromised. In recovery and in functional adulthood, we begin to learn and we start to realize that when we experience the emotions, the gains are immediate. The relief is immediate. Now again, when I say immediate, I don’t mean the next second because sometimes experiencing our emotions at the level we need to experience them can take days, can take weeks, maybe even months. Hopefully not decades because we’re in a place of opening up and being able to allow the emotions to come and go within us instead of operating in a rigid way that gets them stuck or gets them going sideways.

So again, once we start to experience the emotions, the gains are immediate. The relief is immediate, even if that takes a while. Yes, we’re going to feel the emotions. Sometimes I will say to clients the good news about therapy or recovery is that the emotions come back. The bad news about therapy or recovery is that the emotions come back. However, after the emotions come, after we open ourselves up to experience the emotions in ways that are manageable because we have those skills to regulate ourselves, we then have an ability to have insight. We can open our hearts and allow for caring and nurturing from ourselves and from others. We will have shifts in feeling and shifts in our impaired thinking and our irrational beliefs that we hold about ourselves, about the world and about ourselves in that world.

Oftentimes we learned from our dysfunctional or traumatic childhood that we needed to live in extremes because that was how our family was or that’s how life in our house was. It was in extremes. Sometimes when I’m talking about this with clients, I’ll put it on a scale of 1 to 10. So when we talk about the window of tolerance… I’m not sure if I’ve talked about that specifically on this podcast before or not, so maybe I’ll make a note to do that in future podcasts. But when we talk about this window of tolerance, this place that we live where our nervous system is regulated, where we can come and we can go, we can act appropriately, we can feel appropriately because it’s managed, I’ll put this on a scale of 1 to 10 where a classic trauma response is typically shutting down, going into kind of a freeze mode or a numbness or a dissociation where there’s no feeling, so on this scale I would say that shut-down trauma response, that dissociated trauma response is a 1 to 3.

We might also go to the other extreme, 8 to 10, where we’re exploding or imploding with rage and tears, either on the inside, on the outside, or on both. So we live from 1 to 3, and then we jump to 8 to 10, and then we go back to 1 to 3. What we’re missing in the middle is 4 to 7. We’re missing this window of tolerance where things aren’t so extreme.

Emotional sobriety takes us out of projecting our pain. When I’m not able, when I’m living in 1 to 3 or 8 to 10, I’m not able to tolerate or manage my own emotions, so I tend to project that. I may say things like it’s my spouse or I move into blaming. It’s the kids. And I go from blaming into curiosity as I develop emotional sobriety, so instead I ask questions like, what am I brining to this dynamic right now? What might be the original wound here? Where or what is the invitation for healing? Emotional sobriety is about learning to live in 4 to 7. This is the window of tolerance.

Now sometimes when I’m talking to addicts, they may say, but that sounds boring. Recovery sounds boring. Well 4 to 7 is not boring. It’s an integrated, beautiful way of living that is not exhausting afterwards because again, when we’re living in 8 to 10, there usually is a time period when we have to go in 1 to 3, so we’re living in these extremes unless we find the ability and we learn the skills to live in 4 to 7. Like I said, 4 to 7 is not a boring way of living. It’s a way where we can manage multiple things at one time without sending us into extremes. We can think and chew gum at the same time. We can think and we can feel and we can do all of this on a mind-body-soul level at the same time.

Now our brain may have been trained in childhood to live in the extremes. Maybe we learned that the emotional triggers led to acting out, that when I started to feel emotional pain, I moved very quickly into addictive behavior or some type of dysfunctional coping mechanism. Now we can learn that this trigger, this same trigger, this emotional pain, this emotional feeling that comes up, is actually a window for healing. So instead of leaning out, instead of trying to push it down, instead of moving into acting out or acting in behaviors, instead we can lean in and we can learn and we can do it differently.

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