First Segment - SMART Recovery Handbook Chapter 2 (Part 1)
Chapter 2 - Getting Started
'Where do I start?'
When you decide to change your life, especially after years of unhealthy behaviours, it can seem intimidating and overwhelming. We know - most of us involved in writing this Handbook have first-hand experience with recovery.
It may seem like the problems you created for yourself are beyond your ability to fix. One strategy for dealing with such daunting problems is to break them down into smaller pieces or goals so that you can deal with one or two parts of an issue at a time. This Handbook starts by helping you understand some new ideas, which may help reduce some of the fears and anxiety you may have about recovery.
Understanding addictive behaviours
If we engage in a behaviour once in a while and don't do it to excess, then we don't need to worry about it, analyse it, or stop it; however, if a behaviour - even one that starts out as a healthy one - causes too many problems in our lives, it may be time to change.
Behaviours become addictive when they:
- Are the result of a pattern that becomes a ritual or habitual.
- Become stronger each time you do them.
- Involve short-term thinking in the pursuit of immediate pleasure, to feel "normal," or to relieve discomfort or distress.
- Incur long-term costs, such as damaged relationships or serious financial hardship.
We reinforce and strengthen our addictive behaviour when we are caught up in the repeating pattern of giving into urges to get relief.
- Before entering recovery, what were your views and opinions on addiction? Was it something you ever gave much thought to? Did you view people with an addiction differently? Did you ever think it would be a problem for you?
The Problem of Immediate Gratification
It is important for you to understand that you weren't born with an addictive behaviour and nobody gave it to you, however difficult your situation; it took you a lot of effort and practice to get trapped by such a bad habit. Understanding how this happened will help you overcome this behaviour.
A trigger leads to a thought or craving (I want a drink, some cocaine, to gamble, to have sex, to eat), which builds into an urge (I must have a drink, some cocaine, etc.). Once we use or do, we feel better or normal, but only for a while. This relief or pleasure reinforces this pattern and strengthens the habit. This is the Problem of Immediate Gratification, or PIG.
- Now you have been in recovery for a period of time, do you understand how you got trapped by gambling? Did understanding this help you overcome the behaviour of placing a bet?
The PIG’s method
Trigger - An event > Craving - I want to use > Urge - I need to use > Act out/use - I feel better now
The problem with the PIG is that immediate gratification often appears to be much more desirable than healthier, delayed rewards. Repeating the pattern reinforces the PIG. Every time we give into an urge, we strengthen the pattern. The next urge comes more quickly and more forcefully. More - and less important - events, thoughts, feelings, and other life stuff cause you discomfort, which triggers more cravings, resulting in more urges, which leads to more using.
The minor stresses that earlier in your life you dismissed as annoying are now major issues in your mind, giving you a "reason" to use. Over time you need more of your addictive behaviour to find relief, so you may start looking for or inventing triggers to have an excuse to use. You may even create urges so that you'll have an excuse to act out.
The more you repeat this pattern, the bigger the PIG grows.
You may feel like you can't escape this cycle of addictive behaviour and that you're doomed to repeat it forever. But there is hope; millions of people have permanently stopped their compulsive behaviours and moved on to live satisfying lives. It happens every day!
- In recovery have you seen a reversal and those major issues that gave you a reason to use are now back to minor stresses that you dismiss as annoying? How easy is it for you to dismiss those minor stresses and what do you do to prevent them developing into major issues?
How to defeat an addictive behaviour
It all starts with stopping. If you don't give in to urges, they become less intense and occur less frequently. Fewer things will serve as triggers so you'll have fewer urges. The PIG shrinks!
Learning to tolerate short-term discomfort, and accepting that urges will only feel bad for a few minutes, will help you to control your behaviour. Within a relatively short time - a few days or weeks - you'll learn to accept short-term discomfort as part of living a healthier life and urges will fade away. Your addictive behaviour will lose its grip on your life. You'll understand that using is a choice. Just by understanding that using is a choice and not an inevitable reaction to discomfort, you're already retraining your brain.
Your recovery can be a realistic and self-directed journey; SMART can help you:
- Identify and understand the triggers that lead to your cravings and urges, and that they don't have to result in acting out.
- Recognise and understand your unhealthy patterns (rituals, triggers, and behaviours), and stay motivated and focused, even when recovery seems overwhelming.
- Cope with your urges, change how you think about the events in your life, and make better decisions.
- When it comes to short-term discomfort, describe how you learned to accept it was a part of living a healthier life? Is your life as healthy as you want it to be or are you striving for more?
What is recovery?
You might think recovery is just about stopping the addictive behaviour and maybe twenty years ago most organisations and governments would have agreed with you! More recently, thinking has moved toward a much broader way of thinking about recovery, recognising that changes to lifestyle and health are also important to long term success.
There are lots of definitions of recovery, with that put forward by SAMHSA (Substance Abuse and Mental Health Services) being typical: "A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential."
So recovery is different for everyone. In addition to abstaining from unwanted behaviours, you also may commit to trying new activities that challenge you. Recovery is partly about filling that void - once occupied by your addictive behaviour with healthier thoughts, emotions, activities and challenges that lead you to a more balanced and satisfying life.
Abstinence without recovery will not fill the addictive behaviour void, which is why 'Living a balanced life' is such an important part of our programme. Recovery is a personal journey. It's what you make it and can be how you want it to be. After all, you're the boss!
- Is your recovery a realistic and self-directed journey? Is it what you make it and is it how you want it to be? Has it always been that way?
Perhaps you've been told, "You're an alcoholic"; "You're a drunk"; "You're weak"; "You're different from normal people"; "You will battle this for the rest of your life"; "You must stop right now and forever"; to which you may have responded, "I'll never beat this so I might as well (act out, get drunk, get stoned, smoke a pack of cigarettes, eat cookies, go shopping, harm myself) because I can never be healthy. Why bother?"
You may feel trapped in your behaviour with little hope. Hopelessness often fuels addictive behaviour. This is why SMART discourages the use of labels which can lead to hopelessness.
(Second Segment - Topic of The Week) Q. The opposite of hopelessness is, quite clearly, hope. Is hope an important part of your recovery?
The journey to recovery
Like any long journey, recovery starts with one step. Changing behaviour patterns takes time and effort, trial and error.
If you have ever thought, "I'm a hopeless addict with a disease that I will never beat"; "I have no choice but to fight this forever"; or "I have no choice but to keep using"; try changing your thoughts to, "I used to have an addictive behaviour but I choose not to act that way any more." Those words may help you feel more confident, especially in the beginning of your recovery.
If you can feel that you will triumph over your unwanted behaviour, then it's likely you will. If one of SMART's tools, strategies, or exercises doesn't work for you, try a different one until you find what makes you successful. Recovery is possible. Urges fade away. Abstinence gets easier. Your addictive behaviour becomes a thing of your past. You find meaning and enjoyment in your new life.
- How open minded have you been to the idea that other people may work a programme that is different to yours? Are you now, and have you always been, patient with others using trial and error to see what works for them. Have you ever thought “they’ll never get it” only to be proved wrong? What did you learn from that?
Abstinence vs. Moderation
SMART is an abstinence-based programme. The idea of abstinence may be intimidating to you - as you begin your recovery. Even if you're unsure about abstinence, you're still welcome at our meetings.
For alcohol and drug use, the meaning of abstinence is usually obvious: stop drinking or using. It is however important to realise that the goal of abstinence can mean different things to different people. For example some people are on opiate substitution therapy (such as methadone) and they might use SMART Recovery to stick to their medication and not use on top. For others, SMART Recovery might help them reduce and stop their medication. In either case, these goals are welcome at SMART meetings because both are about abstaining from addictive behaviour.
But what about other activities such as eating, shopping, and sex? People with eating disorders still need to eat. Compulsive shoppers still need to buy things. For these, we can define abstinence as stopping the compulsive or self-destructive aspects of the behaviour: Buying one watch instead of five, eating a cup of yogurt instead of a gallon of ice cream, being intimate with your partner instead of engaging in anonymous sex with others.
If your addictive behaviour is of this type, you may need professional help setting boundaries, defining abstinence, and developing skills to moderate your behaviour to keep it from becoming compulsive.
If you're considering the benefits of abstinence, think about this: The more years you engaged in addictive behaviour and the more serious the compulsion, the more likely abstinence - rather than moderation - will help you reach your goals.
If you're thinking about moderation, here are some points to ponder:
- Programmes aimed at controlled use or moderation usually recommend an extended period of initial abstinence. Stopping completely for a period can be a healthy choice, even if moderation is your long-term goal.
- Most people find it is easier to abstain rather than control or moderate their addictive behaviour because it's difficult to know where to set the limit and then stick to it. Even people with the most committed intentions often find their behaviour inches back to the point where it causes problems again.
- Instead of applying your efforts to control and moderate the addictive behaviour, you can focus that energy on dealing with other aspects of your recovery.
- Do you think you could have moderated your gambling use to control your addiction? Did you ever believe that was possible, even when still in active addiction? How long did you spend trying to moderate it instead of coming into recovery?
Why you might prefer abstinence as a goal:
- It's a safe choice.
- It's simple - no counting, no precise decisions, and it's good for all situations.
- Any level of using may aggravate existing medical conditions.
- Even moderated use of a substance may worsen psychological or psychiatric problems.
- Some medications become hazardous or are rendered ineffective when combined with alcohol or other drugs.
- There may be strong social (family, friends, employer) and legal (courts) demands to abstain.
- You believe it will be easier to abstain because of your long or severe history of use, or because of background risk factors (family history, seriousness of related problems such as depression, violence, etc.).
- A significant period of abstinence will help you feel better and may:
- Enable you to find out what abstaining is like and how you feel without mood-altering substances or behaviours.
- Help you understand how you became dependent on substances or behaviours.
- Help you break other old habits.
- Allow you to experience significant life changes and build confidence.
- Please others such as your spouse, partner, children, employer, parents, and friends.
- How difficult was it for you to accept abstinence as a part of your recovery? Although we practice “A Day At A Time” how did you deal with the inevitable thought of “I can never gamble again?”
If you're considering moderation because you've tried to abstain but it didn't work, it doesn't mean you won't maintain your abstinence now. Previous attempts and lapses or relapses aren't failures. You can learn from them and they will provide you with valuable insight to help you in future attempts.
You might be ready to abstain right now, or you may want more time to decide. Don't make that decision until you're ready. Abstinence is not a commitment to be perfect. Many people do lapse or relapse in their efforts to abstain; however, some people never do - and that may be you. Committing to abstinence means that you are committing to change. It requires patience, persistence, and practice. Breaking a commitment to abstinence is not the same as giving up on it.
You may find abstinence easy. If you have reached a point in your life in which you have had enough of the problems and disappointments from your addictive behaviour, abstinence may be easier than you think. For most, however, it's more difficult than that.
- A typical phrase trotted out in recovery circles is “you haven’t had enough pain”. Do you believe people have to suffer a certain level of pain for recovery to be successful and work for them?
Please note: If you have been drinking or abusing drugs heavily for some time and are planning to stop, consult your doctor first. It may be dangerous, even life threatening to stop "cold turkey" after a long period of continual heavy use.