Addiction Recovery Is About Discovering New Layers

Figuring out how to live a life without drugs and alcohol requires new information.

This should be evident to anyone who is trapped in a cycle of addiction and has tried every which way in order to try and keep drinking successfully. The alcoholic just cannot do it for any length of time…..eventually we screw up again, go off on a huge bender, get into trouble, and so on. Lack of control defines our addiction, obviously. If we could control it there would be no problem.

Every person who has wrestled with alcoholism tries to overcome their problem on their own. They use known solutions to other similar problems they have experienced in their lives. For example, they might simply try to cut back on drinking. Or they might say “I know….I will just drink on the weekends.” These ideas make sense because they have worked for other types of problems. Why would you not try these approaches?

Our experience in life is that we will apply ideas that may have worked for us in the past to a new problem.

But we all know what happens to the struggling alcoholic at this point: none of their ideas work. Nothing that they attempt on their own seems to help their drinking or drug problem. This is almost always because of either one of two possibilities:

1) The person is trying to moderate rather than to stop entirely, or

2) The person is trying to stop entirely, without also trying to change their entire life around to support a sober existence.

Both approaches lead to failure.

So what is the secret to sobriety?

The secret is counter-intuitive. If it were intuitive, then getting sober would be easy and natural for any alcoholic. But of course it is not.

The reason that the solution is counter-intuitive is because it involves surrender. Almost every other (tough) problem in our life involves fighting hard for the solution. But peeling back the first eye-opening layer of information in recovery is not about fighting harder, it is about giving up. You have to let go of everything in order make a fresh start in recovery. You must surrender.

Surrender to what?

I think you have to surrender to 2 things:

1) You have to surrender to the fact that you cannot control your drinking. You have to accept total abstinence. This is a crushing defeat that has to be embraced before you can achieve serious recovery.

2) You have to surrender to the fact that you need help from outside of yourself. Surrender to the idea that you cannot defeat addiction alone. In my opinion, this is one of the biggest reasons that alcoholics and addicts should go to rehab. They need help.

So if someone is in the process of getting clean and sober then they have to grasp this about surrender. It is vital information. Without it, you cannot recover.

But some people who do surrender still manage to relapse. What other layers of information are critical for recovery? What has to be learned in order to maintain sobriety?
New layers of information

In my opinion, there are a number of things you have to learn if you are going to remain sober. The thing is, you may not learn them in a specific order. For example, one thing you might learn is how to have fun again in recovery without drugs or alcohol. Yes, this is a learning experience, and it might take some time for you to discover this new information.

Likewise, you may have to rediscover how to communicate your feelings honestly with other people, rather than simply covering those feelings up with alcohol or getting angry and being verbally abusive.

You may have to learn how to forgive. How to forgive yourself, or how to forgive others. There are people in recovery who fail to do this, and it ends in relapse. So for some, this is critical information. It must be learned.

I know a person in recovery who died young because they failed to embrace holistic health. They were overweight, continued to smoke cigarettes, and failed to heed several warning signs. We learn through experience, by doing stuff. If this person had learned to live healthier, and embrace an holistic path in life, then they might still be here.

Lessons to be learned in recovery

One of the mysteries of recovery is that you have to keep learning new things. It is pretty tough to explain why exactly, but it is true. If you stop learning in recovery you will relapse. The ultimate form of relapse prevention in recovery is continuous learning about holistic health.

Why is this the case? Probably because:

1) Life is cyclical – old issues that you may have dealt with in the distant past will pop back up “to haunt you” eventually. The same is true for people you may resent, etc. So just because you think a certain issue in your life may be dead and buried, it almost never is. The nature of life is that we have to keep revisiting our past, over and over again. This requires us to constantly be on our toes, learning new things, so that we can effectively remain sober through these cyclical swings that we will eventually experience.

2) We forget idle information – even if you have a mind like a steel trap, you will forget the important parts of how you actually stay sober through certain events. “If you don’t use it you lose it.” This is true for remaining sober through a wide variety of different life experiences. In other words, we have to keep relearning how to live sober, over and over again, because it is the experience of doing so that we need to learn, not the information itself. In other words, we need to keep relearning the application of knowledge about recovery, not about recovery itself. Memorizing a whole book about overcoming addiction is useless. The knowledge we need in recovery is applied knowledge. It is experiential knowledge. And we have to keep building that as we go along, or we fall out of touch with how recovery actually works.

3) If you stop learning, for any reason, you have the wrong attitude for recovery. You are setting yourself up for failure.
The lifelong solution

Always be learning.

But even more than that, always be open to peeling back that next layer of information. For example, maybe a friend of yours just experienced a huge breakthrough in their life when they learned about forgiveness. So they get excited about their new found freedom and they tell you all about it and you have this great little discussion.

Now the key is to take that information and apply it to your life. Does it apply? Do you have issues in your own life that might benefit from this insight? Do you have anger or sadness or frustration because you cannot let something go? Are you beating yourself up, over and over again, over the same things?

So maybe it applies to you and maybe it does not. Fine. The key is to be ready for the lesson, in every interaction. If you want to see learning in action, read through some of the comments on this thread. People there help each other to make real progress in taking the first steps towards overcoming addiction.

Ask yourself: What do I need to learn today?

Am I ready to see the lesson that is in front of me?

Lost in Woonsocket (see trailer below), directed by John Chester, documents the story of two addicts living together in the woods, and follows their unlikely journey to recovery thanks to the help of strangers. The resulting film is a testament to our power as individuals to make a difference in the lives of one another. Lost in Woonsocket offers two distinct messages to its audience – one person can make a difference and there is hope for those who appear hopeless.

To find a screening near you, please check the map at www.lafia.org.”

Change Your Mind, Your Brain and Your Life!

Here’s a formula: Thoughts form actions, and actions form consequences. One of the consequences is the formation of neural connections in our brains which make it easier for neurons to fire in a particular direction the next time. If the mind automatically reacts to being complemented by shutting down, then that continues to strengthen those connections so that happens again and again the next time. Why is this and what can we do about it?

One of the ways we can understand this is with Donald Hebb’s quote, “neurons that fire together wire together.” However, it’s not as if we can do anything initially about those neurons that are firing because they happen so quickly. The judgment that the complement is dangerous or bad in some way doesn’t come up consciously; we just notice a sense of wanting to retreat from the situation. So now what?

Well, it’s important to understand that what we learn, practice and repeat becomes automatic after some time. That’s how we are who we are today. At some point we learned how to ride a bike, we practiced and repeated it and now we don’t have to think about it. In the same way we learned right and wrong, good and bad, and fair and unfair, we practiced it and repeated it and now it just comes up automatically. Sometimes these snap judgments are healthy and sometimes they are unhealthy.

There is a way to influence these snap judgments and one of the ways is through changing our minds and brains through intentional priming.

Priming means setting up the mind to be in a place to see things a particular way.

Mindfulness practices seem to correlate with the 9 functions of the middle prefrontal cortex of our brains.

1. Body regulation: Balance of the sympathetic (accelerator) and parasympathetic (brakes) branches of the autonomic nervous system.
2. Attuned communication: Enables us to tune into others’ states and link minds.
3. Emotional balance: Permits the lower limbic regions to become aroused enough so life has meaning, but not too aroused that we become flooded.
4. Response flexibility: The opposite of a “knee-jerk” reaction, this capacity enables us to pause before acting and inhibit impulses giving us enough time to reflect on our various options for response.
5. Empathy: Considering the mental perspective of another person.
6. Insight: Self-knowing awareness, the gateway to our autobiographical narratives and self-understanding.
7. Fear extinction: GABA (an inhibitory neurotransmitter) fibers project down to the amygdala and enable fearful responses to be calmed.
8. Intuition: Being aware of the input of our body, especially information from the neural networks surrounding intestines (a “gut feeling”) and our heart (“heartfelt feelings”) enables us to be open to the wisdom of our non-conceptual selves.
9. Morality. The capacity to think of the larger good, and to act on these pro-social ideas, even when alone, appears to depend on an intact middle prefrontal region.

So in practicing how to intentionally pay attention, without judgment, we activate the part of our brains that over time, with practice and repetition will allows to more automatically see a situation with greater balance, empathy, response flexibility, reliable intuition, and less fear, among other things.

So we can positively influence the thoughts that automatically happen which go on to change the actions and consequences toward a healthier life.

As always, please share your thoughts, stories and questions below. Your interaction provides a living wisdom we can all benefit from.

Many of us have known or seen people who seem to be able to drink far more than others without ever seeming to get drunk. Some people even aspire to being able to drink a lot without getting drunk — in other words, building up their tolerance.  But the bottom line is that the impacts on a person’s brain occur whether they appear/feel drunk or not. This is because it still takes their bodies approximately one hour to metabolize one drink.

As you may recall reading other posts on this site, alcohol is metabolized by the liver. Alcohol enters the bloodstream through the walls of the small intestine. Because alcohol dissolves in water, the bloodstream carries it throughout the body (which is 60-70% water) where it is absorbed in body tissue in proportion to the body tissue’s water content. Contrary to popular belief, we cannot rid our bodies of the alcohol we drink by peeing or sweating or vomiting it out. It’s our liver that rids our bodies of the alcohol we consume.

“So, what does that have to do with being able to drink a lot and not appear drunk?” you might ask. The brain is mostly water and highly vascularized (lots of blood vessels). When a person drinks more alcohol than their liver can metabolize, the excess alcohol stays in their bloodstream and suppresses certain brain functions — especially those related to judgment, learning, memory, pleasure, motivation and emotion.

Additionally, “too much to drink” is relative. The impact of alcohol on the brain and body depends on a number of factors beyond this very general rule of thumb that it takes the liver about one hour to process one standard drink. Weight, stress, gender, medications, tolerance, stage of brain development, lack of sleep, amount of food eaten and how quickly the alcohol is consumed are a few of the factors. Additionally, some people have lower amounts of the enzyme ADH in their livers, so their liver doesn’t process the alcohol the same way as someone with normal levels, and thus the alcohol remains in their system longer. Some people have genetic differences, such as a genetic predisposition as a result of having a parent or sibling with the disease of alcoholism. [Alcoholism is one of the diseases of addiction. Addiction is a chronic, often relapsing brain disease.] Other people have brain changes caused by early use of alcohol and/or having experienced one or more of the other risk factors for developing alcohol misuse problems.

But specifically to the issue of tolerance — the ability to drink a lot without seemingly having any consequence — is a problem. It is not good. In fact, tolerance can contribute to a person developing the disease of alcoholism and/or problems related to alcohol misuse. Please find the following links for more information on tolerance and alcohol.

University of Rochester Health Services, “Tolerance and Beyond”

National Institute on Alcohol Abuse and Alcoholism, “Alcohol and Tolerance,” Alert  No. 28 PH 356 April 1995

© Lisa Frederiksen. For this and similar information, order Lisa Frederiksen’s 20-page booklet, titled: “Seven Myths That Can Kill…,” available September 2010.

Inevitably I have someone come up after a recovery meeting to ask me what is the secret to long term sobriety and recovery. It is usually someone new to the program, that has attended meetings routinely on the weekends for a while, and has decided that now they are “really serious” about recovery. I know I did the same thing many years ago, asking my temporary sponsor as he explained his thoughts on the twelve steps, “but how do you do it for the rest of your life?” Apparently I didn’t get an exactly inspirational answer since I can’t remember his response. Neither did I stay in AA after I had finished my ninety meetings in ninety days after rehab, but I still credit much of my successful recovery program to the things I learned in those meetings.

In retrospect it is easy for me to see why my sponsor didn’t exactly wow me with a response to my question because I was already doing what it took to stay sober. I just needed to keep doing for the rest of my life, but oh how I craved that there was something more. There had to be some kind of ancient magic, secret society, or a mystical panacea that was necessary- I mean surely it had to be a pretty complex solution to solve this problem I had battled over the years… but it’s not.

The recovering alcoholic is no different than the professional athlete or concert pianist in the fact that we must train every day. Practice. Practice. Practice. Same workout, same practice routines, and an unending dedication to the single purpose of improving one’s life- we must constantly train our brains to respond quickly to temptation, instinctively avoid dangerous situations, and maintain a solid emotional balance.

Regardless if it is NA, AA, or a personal recovery program the key to its effectiveness is action and dedication. Like the back of the shampoo bottle- wash, rinse, repeat. If the routine becomes too monotonous, mix it up! There is only one person responsible for recovery and that is you. NO program will keep you sober; no counselor can keep you safe.

What is TDA’s secret of long term sobriety? Find a program, make a program, any program… and just do it.

The following is another  excerpt from our upcoming booklet, Seven Myths That Can Kill… If you’d like to purchase a copy for your college student, high school student, of if a parent, yourself, so that you’ll be prepared with what to say to your middle school student, use the Contact Us link. The booklets are $1.95 each (does not include CA sales tax or postage/mailing), and should be available by September 1, 2010.

Myth #4:  Drink lots of water and eat a big meal, and it will “absorb” the alcohol.

Reality: Surprisingly, this is not true – surprising in the sense that alcohol dilutes in water, so why wouldn’t that dilute the alcohol? And, it all goes to the same place – the stomach – so why doesn’t eating food absorb the alcohol?

It’s because alcohol is not digested like other foods, which are broken down by the digestive system into smaller molecules of nutrients to nourish cells and provide energy. Alcohol avoids the normal digestive process and goes directly to the bloodstream from the small intestine.

Drinking water, however, does help a person minimize hangover symptoms which are caused in part by the dehydration that alcohol can cause.

With regards to food – we are constantly told not to drink on an empty stomach, which is, by the way, excellent advice to follow. But it’s not because the food will absorb the alcohol. (Remember – food and alcohol are processed differently – food is digested by the body’s digestive system, alcohol is metabolized by the liver.)

Food is important because it slows down how fast the stomach empties its contents (in this example, alcohol) into the intestine, and from there to the small intestine, and from there into the bloodstream. And, it is this slowing down that can help a person stay in control of how much they drink. Having a couple quick drinks on an empty stomach, allows the alcohol to move quickly into the small intestine and from there into the bloodstream. And, as you read under Myth #1, alcohol dissolves in water, travels through the bloodstream to body tissue high in water content – the brain, for example. Alcohol “sitting” in the brain, while it “waits” to be metabolized by the liver, causes the alcohol to suppress normal brain functions. And it’s that that gets in the way of a person’s ability to think straight, act responsibly and/or behave “normally.” Instead s/he can tell him/herself things like, “I’m f-i-n-e, I’ll just have another, and then I’ll stop.” Or “No worries. I’m okay to drive.”

Bottom line: drinking water helps hydrate you, reducing hangover symptoms; food slows how fast alcohol enters the bloodstream. Neither water nor food, however, will keep you from getting drunk if you drink more than the brain and body can process.

So how much is too much? The rule of thumb for this is to follow what are known as “moderate” drinking limits:
•    For women, that’s no more than 7 standard drinks in a week, with no more than 3 of those 7 in any one day.
•    For men, that’s no more than 14 standard drinks in a week, with no more than 4 of those 14 in any one day.

[Note: Binge drinking was previously defined as 4 or more drinks on an occasion for women and 5 or more for men. The definition here, showing a per day limit of 3 for women and 4 for men, is to help people avoid rationalizing two “occasions” in the same day as a way to drink all, or a majority, of their weekly drink quantities at once.]

As you’ve gathered, the idea behind these limits is to help a person maintain brain and body control. Additionally, it helps a person avoid the chemical and structural changes caused by repeated alcohol abuse. And, these changes are real!

© Lisa Frederiksen, Excerpt from the 20-page booklet, titled: “Seven Myths That Can Kill…” by Lisa Frederiksen, available September 2010.

This is a common phrase repeated by many who have a loved one who drinks too much, as if it somehow excuses their loved one’s drinking too much, or more importantly for most, as if it some how “proves” their loved one is not an alcoholic. But the real issue is, “Do your love one’s behaviors change when they drink?” The label is irrelevant. Why?

“Too much to drink” is relative.  The impact of alcohol on the brain and body depends on a number of factors beyond the very general rule of thumb that it takes the liver about one hour to process one standard drink. When a person drinks more alcohol than their liver can metabolize, the excess alcohol stays in the bloodstream and suppresses certain brain functions – especially those related to judgment, decision making, learning, memory and pleasure. In other words, the very areas of the brain a person needs in order to think straight and act responsibly, which is why a person’s behaviors change so much when they drink too much.

Weight, stress, gender, medications, tolerance, stage of brain development, lack of sleep, amount of food eaten and how quickly the alcohol is consumed or the presence of anxiety or depression or some other mental illness are a few of the factors that determine “how much is too much” for a particular individual.

The less a person weighs, for example, the less body water s/he has and consequently the higher his or her alcohol-to-water concentration. This means a lighter weight person (e.g., a woman) will be more affected than a person who weighs more (e.g., a man) when drinking the same amount of alcohol. This explains why the “moderate” standard drink limits are lower for women than they are for men.

Additionally, some people have lower amounts of the enzyme ADH in their livers, so their liver doesn’t process the alcohol the same way as someone with normal levels, and thus the alcohol remains in their system longer. Some people have genetic differences, such as a genetic predisposition as a result of having a parent or sibling with the disease of addiction. [Alcoholism is one of the diseases of addiction. Addiction is a chronic, often relapsing brain disease.] Other people have brain changes caused by early use of alcohol and/or having experienced one or more of the other risk factors for developing alcohol misuse problems. All of this described here adds to the variables that impact how alcohol affects one person as compared to another.

Bottom line: protect your brain, and if you have any of the risk factors (see below), be especially careful. Above all, know that the brain can change. Stopping substance abuse allows the brain to rewire and/or repair neural networks.

Risk Factors for Developing the Disease of Addiction (in this discussion, alcoholism), include:
- genetics
- early use
- social environment
- childhood trauma
- mental illness (such as depression, anxiety, bipolar, PTSD, ADHD).
The more risk factors a person has, the more they need to be wary of drinking too much. Addiction (e.g., alcoholism) is a developmental disease. It doesn’t just happen.  The chemical and structural changes in the brain caused by repeated alcohol abuse make a person especially vulnerable to his/her risk factors. In turn, a person’s risk factors make them vulnerable to repeated alcohol abuse.

Cover Design Irene E. Yu

© Lisa Frederiksen, Excerpt from the 20-page booklet, titled: “Seven Myths That Can Kill…” by Lisa Frederiksen, available September 2010.

Ever asked a family member that most assuredly does have a drinking problem if they are thinking the same? Well unless they are at the rock bottom step of a devastating spiral then be prepared for dogged denial, obfuscation, and feigned indignity. Be warned, those nursing an addiction can be wickedly convincing about this subject having already mastered the talent of lying first to their self. They will define the issue using a grey dictionary from the vague area of the bookshelf so that you leave the conversation with all the answers to none of the problems.

Even if offered a straight answer, what really has one gained by making the alcoholic plead guilty to the charge? My suggestion to family members who want to make actual progress is to try a different question (see the flip side of this issue here). Ask about the repercussions of the family member’s drinking instead. Ask where has the money gone? How much time did you spend with your children? Why did you not come home last night? The answers to these questions are black and white, not subject to the alcoholic’s rationalization and an instant veto of the I’m not hurting anyone but myself campaign.

This helps in two ways. One, it lets the alcoholic know that even if they refuse to realize they have a problem drinking- there is no doubt there are still problems galore. Two, the family can’t help the problem drinker until they are ready to help them self… but by identifying the problems caused by this drinking they can move forward* implementing their own plans of how to recover.

*serenity to accept the things I cannot change; courage to change the things I can

One of the most difficult aspects about trying to find a treatment center and/or program that is “right” for you and/or your loved one is the frustration over the inability to actually “measure” how one program works vs. another. This Opinion, by Bankole A. Johnson, Chairman of the Department of Psychiatry and Neurobehavioral Sciences at the University of Virginia, appearing in the August 8, 2010 The Washington Post and titled, “We’re Addicted to Rehab. It Doesn’t Even Work,” does an excellent job of presenting the issues. I’ve included an excerpt below:

Last week, Lindsay Lohan left jail and entered a drug and alcohol rehabilitation facility. If the scene inspired deja vu, it wasn’t just because it was the fourth time she had headed to rehab in four years. It was because the spectacle of a celebrity entering a drug and alcohol treatment center, relapsing, then heading to rehab again — and again and again — has become depressingly familiar.

For decades, Americans have clung to a near-religious conviction that rehab — and the 12-step model pioneered by Alcoholics Anonymous that almost all facilities rely upon — offers effective treatment for alcoholism and other addictions.

Here’s the problem: We have little indication that this treatment is effective. When an alcoholic goes to rehab but does not recover, it is he who is said to have failed. But it is rehab that is failing alcoholics. The therapies offered in most U.S. alcohol treatment centers are so divorced from state-of-the-art of medical knowledge that we might dismiss them as merely quaint — if it weren’t for the fact that alcoholism is a deadly and devastating disease.

And the way we attempt to treat alcoholism isn’t just ineffective, it’s ruinously expensive: Promises Treatment Centers’ Malibu facility, where Lohan reportedly went for her second round of rehab, in 2007, has stunning vistas, gourmet food, poolside lounging and acupuncture. It costs a reported $48,000 a month….

To finish reading the Opinion piece by Bankole A. Johnson’s piece, click here…