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As a chemical dependency counselor in a detox facility, I watched many people go through withdrawal from substances. Coming off opioids is the most painful, coming off stimulants leads to a lot of eating and sleeping, but coming off depressants like alcohol is the most dangerous. Although it is difficult, I’ve seen many people successfully go through the process and see the benefits of living a sober life.
Many people underestimate the danger of alcohol withdrawal since the substance is so widely available and socially acceptable.
The reason why alcohol withdrawal is so dangerous is because it can lead to severe seizures. While working with individuals coming off of alcohol, I had to keep a close eye on them, regularly monitoring their symptoms in case emergency medical support was required.
Alcohol withdrawal symptoms range from mild shaking in the hands to severe anxiety, restlessness, and full-body trembling, depending on the severity of the substance use.
If you or someone you know has been drinking daily for an extended period and wants to stop, it is important to seek medical direction from a family doctor or support from a local withdrawal facility.
What is Alcohol Withdrawal?
Alcohol withdrawal happens when a person dependent upon alcohol suddenly stops drinking or drastically reduces their intake.
Alcohol withdrawal is the result of a neurological rebounding effect. The process is initiated by two categories of neurotransmitters: excitatory (stimulating) and inhibitory (relaxing).
Excitatory neurotransmitters increase the likelihood that a neuron will fire an action potential. Inhibitory neurons are the exact opposite, and their effect decreases potential neural firing. Alcohol consumption increases inhibitory neurons and decreases excitatory neurons.
The brain’s main inhibitory chemical is GABA (gamma-aminobutyric acid), and the main excitatory chemical is Glutamate. When a person drinks alcohol, the brain signals GABA to increase, and Glutamate decreases, resulting in the sedating effect. Over prolonged use, your brain adapts to the sedation by boosting Glutamate, resulting in tolerance to alcohol. Therefore, you need more alcohol to get the same sedating effect since your brain’s Glutamate system is on overdrive to counterbalance the increased GABA.
If you suddenly stop consuming alcohol after your brain habituates to being sedated by its effects, your brain is pushed off balance into a hyper-stimulated state. As described before, this can mean shaking, anxiety, restlessness, or seizures.
Alcohol Withdrawal Severity
According to a person’s level of physical alcohol dependence, symptoms will vary. This dependence severity includes the amount of alcohol, the frequency of consumption, and the length of time this level of consumption has been occurring.
This is the beginning of alcohol withdrawal symptoms such as hand tremors, gastrointestinal issues, mild anxiety, headaches, and insomnia. This may be the extent of the symptoms for many people experiencing withdrawal.
Stage two (moderate):
Along with the symptoms of stage one in mild frequency, stage two symptoms will include increased abnormal rapid breathing, increased blood pressure, and mild hyperthermia. This stage is from 1-3 days after discontinuing alcohol.
Stage three (severe):
Stage 3 includes symptoms of stage two and may also cause hallucinations, seizures, attentional issues, and disorientation. This stage can start at a week and can last up to several weeks.
While the specific alcohol withdrawal symptoms will vary from person to person, these stages are a rough guideline to categorize severity. If you are experiencing symptoms, it is important to seek immediate medical support.
Although most people recover from their symptoms without medical detox, support from a medical professional can minimize risk.
A Timeline of What to Expect
Alcohol detox symptoms can occur for up to 5-10 days after your last drink. Most detox facilities offer 24-hour supervision for five days, covering the period when you are most at risk. Although it is different for everyone, here is a general timeline of what to expect:
6-12 hours after last drink
The mild symptoms of stage 1 may start to appear, including mild anxiety, headaches, insomnia, and upset stomach.
24 hours after last drink
Some people start to experience hallucinations at this point, including visual, tactile, and auditory hallucinations. However, this is not common for persons going through mild withdrawal.
24-72 hours after last drink
At the 24-48 hour mark, seizure risk increases. Again, seek medical supervision if the shaking in the hands becomes severe or you have a history of seizures. From 48-72 hours, withdrawal delirium may also appear.
After the acute symptoms subside, some people may experience fatigue, mood changes, and sleep disturbances for months as the brain continues to adjust.
Treatment for Alcohol Withdrawal
Detox is the first step in treatment if you are experiencing alcohol withdrawal. It is essential to talk to your doctor or seek support from a local withdrawal facility during this stage of the process.
A standard prescription protocol given by medical doctors for alcohol withdrawal consists of a benzodiazepine taper. In plain language, this generally consists of being prescribed an anti-anxiety medication like Valium over five days, slowly lowering the dosage each day.
The benzodiazepine taper can be ordered for a person to do at home with constant supervision or in a withdrawal facility under the supervision of nursing staff or chemical dependency counselors.
Other commonly prescribed medications include clonidine to manage acute high blood pressure and extra strength ibuprofen to manage the discomfort.
Although treating the physical symptoms is the first step, there is a high likelihood of relapse if it is not immediately followed by counseling or residential programming. This is because the detox only addresses the physical aspects of withdrawal and not the cognitive or behavioral characteristics of the addiction.
Inpatient or residential treatments
Inpatient treatments involve around-the-clock support and programming. Some residential treatment facilities offer medical detox, and most offer group therapy, individual therapies, and other recreational activities. Some may also provide aftercare groups or more intensive aftercare programming such as a sober house.
Outpatient treatments consist of individual counseling, such as the service I offer. This includes having weekly or bi-weekly conversations about the cognitive and behavioral elements driving the addiction and developing a plan to navigate challenging situations, reducing the risk of relapse effectively.
Outpatient group therapies can also be another option for treatment. This generally consists of attending a regularly scheduled group program. One of the benefits of outpatient treatment is that you can practice skills in your real-world context between sessions, integrating them into your daily life.
Another resource that can be drawn on after detox includes peer-support groups such as 12 step AA meetings. The benefit of 12 step programming is that it is free and widely available.
The 12 step process also allows individuals to gain a mentor in the form of a “sponsor”. This person helps guide you through the steps, often offering immediate peer-support when thoughts of relapsing occur. This kind of programming gives a sense of belonging, connection, structure, and the sense of not being alone in one’s struggles.
Recovery can be challenging at times, but with the proper support, you can safely make it through the process. The initial stage of withdrawal can be physically demanding, and the long-term process can be psychologically challenging.
If you notice signs of alcohol withdrawal, it is crucial to seek immediate medical support. Talk to your doctor if you plan to discontinue alcohol after a sustained period of regular use. This is especially important if you have a history of seizures.
Getting over the initial physical symptoms allows you to seek ongoing forms of psychological support where you can delve into what drives your addiction and how to move forward more effectively, gaining long-term freedom from addiction.
If you have a love-hate relationship with food, you may find yourself constantly thinking about it, depriving yourself of it, or compensating for foods you’ve eaten.
Like the cycle of an abusive relationship, food seduces you with its charming lure of comfort, often resulting in shame, regret, or physical pain.
You tell yourself you’ve had enough, and this is the last time, but you keep going back to old patterns. This can manifest as food addiction or eating disorders such as anorexia, bulimia, or orthorexia—an addiction to dieting.
If you have an unhealthy relationship with food, there is a way to heal.
In this article, I will illustrate how diet-culture perpetuates counterproductive messages about eating. When these cultural messages result in shame, they fuel the problem they were intended to solve.
Diet-culture moralizes food, resulting in a constant sense of resisting temptations. As psychologist Carl Jung states, “What you resist persists.” In constantly resisting food, it gains more power over your life.
This article will highlight the sociological and psychological forces keeping millions of people stuck in this unhealthy dynamic.
By healing your relationship to food, you can break free from these messages and reclaim your mental and physical health.
What is an unhealthy relationship with food?
If you struggle with an unhealthy relationship with food, you are not alone.
This is an invisible issue affecting the mental health of millions of people, perpetuated by well-intentioned health professionals and diet gurus.
It comes in many different forms and severity, ranging from relatively benign to severe and life-threatening.
Here are some signs you might have an unhealthy relationship with food:
You classify certain foods as good or bad.
Although certain foods are better for nutrition than others, a strong moralizing stance focuses on weight or willpower, making the body something to be overcome rather than nourished.
By labeling foods as “bad,” we feel the need to constantly resist them, fueling even further desire. The sense of deprivation and forbidden nature of “bad” foods amplifies their allure. When succumbing to the temptation, eating “bad” foods leads to shame, fueling even further binging or strict food avoidance, adding to the vicious cycle of unbalanced eating.
You are overly preoccupied with food.
Although it is effective to plan for healthy meals to maintain your energy and nutrition, becoming overly preoccupied with food gives it power over your life. Rather than food serving you, you begin serving it.
Like an addiction, preoccupation with food takes away from your ability to focus on other important areas of your life, resulting in a constant state of vigilance and energy depletion.
You restrict food and or binge on food.
This is the core problem with diet-culture. Since dieting emphasizes restricting certain foods, it gives these foods power. As described above, “What you resist persists.” Although the nutritional science backing a specific diet may make sense, diets don’t work psychologically.
Food restriction often results in food binging, perpetuating the yo-yo dieting cycle.
You eat based on rules rather than internal cues.
Diets are also counterproductive because they disconnect you from your body. Rather than eating based on internal hunger and satiation cues, diets reinforce mistrust of the body’s cues.
Eating based on these external rules keeps dieters in their heads rather than in tune with their bodies, resulting in a sense of deprivation, fueling the desire to rebel against these rules.
You feel guilty when enjoying food.
When enjoyment is synonymous with guilt, it takes away a genuine sense of satisfaction. When genuine satisfaction is lacking, binging on one’s “guilty pleasure” replaces natural satiation.
Like the cycle of deprivation and binging, guilty pleasures become scarce resources. This scarcity fuels binging rather than genuine enjoyment.
You become obsessed with numbers and nutritional labels.
Although it can be helpful to be guided by a food’s nutritional value, an over-fixation on numbers and labels can keep you trapped in a form of preoccupation with food, resembling addiction at an extreme end.
This unhealthy obsession with healthy eating has been called orthorexia. It can result in compulsive label checking and nutrition tracking, resulting in long-term damage to one’s mental and physical health. Like an addiction, the perceived solution is actually the problem in disguise.
You eat for the primary purpose of changing your body.
Although your body can change based on your eating habits, punishing your body to achieve your weight goals sets you up for long-term mental and physical instability.
If changing your body comes from a place of self-loathing, progress becomes about the numbers rather than your mental wellness. This definition of progress can only be sustained for a limited period of time since the underlying strained relationship with your body is increasingly reinforced.
You restrict food to gain a sense of control.
Eating disorders are often an attempt to gain a sense of control in one’s life. If you have been in a chaotic environment or an overly strict environment, your sense of control may have been taken away. Restricting food or binging on food are ways to gain a sense of control.
Like an addiction, this is an illusion of control. When discovering the reality of one’s relationship to food, one may realize how they paradoxically give away further control, allowing food to dictate their lives.
You use food to cope with difficult emotions.
Although many people use certain foods to relax, like alcohol is used to unwind, it becomes a problem when it becomes a person’s go-to solution to underlying problems, resulting in increasing use despite negative consequences in one’s life.
Difficult emotions such as fear or guilt from the past can trigger emotional eating or food restriction to escape the pain or gain a sense of control. As stated above, these are short-term solutions resulting in more significant problems in the long-term.
You hide certain eating behaviors from others.
Moralizing food can lead to shame and secretive eating to avoid further shame. Like an addiction, someone can present as highly functional while hiding their use of a specific substance or behavior.
Rather than reducing the shame, these secretive eating sessions further contribute to a sense of shame, making a person feel even further disconnected from others.
What causes an unhealthy relationship with food?
Diet-culture causes an unhealthy relationship with food. This unhealthy relationship is further reinforced by psychological triggers such as habitual emotional coping through food restriction or binging.
As a former personal trainer, I learned about the toxic side of fitness and diet-culture from within the industry. During my time as a trainer back in 2010, it was also the height of the weight-loss television genre.
It seemed like everyone and their workplace was developing some kind of Biggest Loser challenge. I had even unknowingly participated in this fat-centric fitness focus, creating my own Bootcamp fitness program called “The Last Ten Pounds,” which I ran out of a local facility.
I preached the standard gospel of avoiding sinful foods and exercising to lose weight. Although it made biological sense, I didn’t realize how it was counterproductive psychologically.
Sensing something was wrong with this body-transformation-obsessed fitness culture, I conducted research on the popular weight loss genre in my Master’s thesis in sociology. Completed in 2011, you can find the full thesis here.
In short, I demonstrated how transformation narratives in the weight-loss genre are a warped version of Christian morality, demonizing fat and idealizing reason and rationality as the way to overcome the body and its desires.
In my research, I did a discourse analysis of MTV’s “I Used to Be Fat,” a show where recent high-school graduates are subjected to intense body transformations in the summer before college. Gaining control over their bodies by getting one’s weight down to a specific number on the scale was the sign of overcoming adolescent immaturity and gaining entry into adulthood.
Each episode begins with a confession by the participant standing in front of a mirror, talking disparagingly about their body, reinforcing their underlying self-loathing.
Next, the participant is subject to a penance whereby they “cleansed” their body of “toxins” through an overly intense first workout.
During each episode, temptations such as cookies are presented, generally from a maternal figure. Inversely, a mentor emerges, generally from a paternal figure, who helps them along their hero’s journey.
Lastly, salvation is achieved when the body is overcome through intense discipline, and the final number on the scale is revealed.
Normalizing extreme body transformations sets people up for long-term yo-yo dieting and mental health issues. Rather than focusing on their long-term relationship to food and their bodies, the show normalizes a toxic diet-culture focused on food restriction for weight loss.
The underlying message is that arriving to college without a slender body would result in further shame and lack of belonging.
By focusing on fitness as the cure for low self-esteem, the psychological issues are left unaddressed, leaving a person more vulnerable to disordered eating.
Diet-culture preaches problematic messages about willpower and discipline. Although these may be noble traits at times, they are ineffective when portrayed as the only psychological tools.
As an addiction counselor, I now understand the true shortcoming of willpower. It can get someone over a craving momentarily, but it quickly depletes, leaving a person more vulnerable to temptation if there are no other psychological coping strategies in place.
Although discipline can be an admirable trait as well, it is necessary to question the source of this discipline. The Latin root of the word ‘discipline’ comes from ‘disciple,’ or follower of Jesus. In the modern weight-loss context, we are disciples of diet-culture, disciplining our bodies to overcome their desires.
Accepting the gospel of diet-culture puts you at constant war with your body. It implies the body cannot be trusted and needs strict rules to keep it in check.
By getting out of your body and into your head, your body is put into a constant state of deprivation, resulting in intermittent rebelling, fueling the cycle of shame and disordered eating.
This critique of diet-culture goes beyond a social justice lens. Diet-culture is stigmatizing and psychologically ineffective at achieving its own goals.
How to have a healthy relationship with food
If you are tired of being constantly at war with your body, there is a better way forward.
If you want evidence-based practical advice on how to heal your relationship with food, I highly recommend checking out Intuitive Eating by Elyse Resch and Evelyn Tribole.
This book is written by two registered dietitians whose approach to healthy eating is based on psychological evidence about what works in the long-term.
Their revolutionary anti-diet approach to healthy eating is based on getting in touch with your body’s needs—the exact opposite of diet-culture’s focus on disconnection from one’s body through rules, restriction, and willpower.
Intuitive eating does not mean throwing caution to the wind and engaging in massive fast-food binges. This potential criticism of removing food restriction is steeped in the logic of diet-culture. Instead, intuitive eating sidesteps this the deprivation-binging cycle by not restricting any foods. Taking the morality out of food takes away its power over your life.
Instead of following a strict set of diet rules, intuitive eating rebuilds trust in your body as you listen to its needs and eat according to its hunger cues and responses to food.
Although this approach sounds counter-intuitive, it resonates with my understanding of the psychology of addiction.
Persons struggling with dieting resemble someone struggling with an addiction. Dieting is a short-term solution to a long-term problem. It provides temporary relief, with long-term harms. It gives you the illusion of control, but actually takes away your control in the long-term. It preoccupies your mind, taking away your ability to focus on things that matter. Lastly, it is a process fraught with constant instability and relapse.
Like how someone struggling with an addiction needs to give up the substance to regain control, the intuitive eating approach advocates complete abstinence from dieting.
By giving up dieting, you can end the war and make peace with food. By making peace with food, it takes away its forbidden allure. If everything is allowed, nothing takes on the psychological specialness of being a forbidden fruit. Just as marketers and economists know very well, when something is scarce or rare, its value increases.
By making peace with food, you can focus on satisfaction when eating, increasing your ability to stop eating when your hunger is satiated because you are not operating in a state of deprivation.
Rather than using the term “junk food,” the intuitive eating approach labels these as “play foods.” By changing the moralizing language around food, you take away its power over your life. Consider that we regularly use terms like “sinful, tempting, or cheating” when referring to food. This language only increases the forbidden fruit effect, giving food more power over your life.
Intuitive eating requires getting in touch with your body and its needs. It means honoring your hunger and feeling your fullness. When living in your head, you become out of touch with the body’s needs and are perhaps out of touch with hunger and fullness signals.
By respecting the body rather than treating it as an object to be overcome, you develop self-compassion. By treating your body like something you care about, rather than something to be beaten up and deprived, you heal your relationship with yourself, and therefore your relationship to food.
Healing your relationship to physical activity
Shows like The Biggest Loser often made the gym look like a chamber of punishment, with contestants puking, fainting, or falling off treadmills.
When you heal your relationship to food, you may consider your relationship to physical activity. Rather than seeing physical activity as a punishment, it becomes an opportunity to enjoy the feeling of physical movement.
Since COVID, we have all learned that the gym is not the only outlet for physical activity. Although some people like myself enjoy the gym, the key to long-term health is enjoying the process; otherwise, like dieting, the activity will be temporary.
Also, as a former personal trainer, one would imagine my gym routine would be rigid and numbers-focused, but this is quite far from reality. For the past few years before COVID, I would show up to the gym without a plan.
Walking through the gym, I started moving my body, feeling any soreness from previous workouts. If a particular muscle group was not sore from the previous workout, I’d consider which kind of exercise felt interesting for that muscle group and which type of movement or equipment I felt attracted to at that moment. Each next activity was decided at the moment, without regard for any rules or plans. The gym felt like my playground.
I actually stopped using weights and machines for about a year or so, just enjoying the pullup bars, TRX ropes, gymnastic rings, and other body-weight exercises such as pushups and pistol squats. This gymnastic-style workout kept me highly motivated due to the enjoyment of making progress with new forms of movement and the need to remain highly in tune with my body’s needs and limits.
In my days as a personal trainer, if someone asked me for exercise advice, I’d give them a basic circuit training routine or a more advanced split training routine with an 8-12 rep range. Although these plans may be physiologically adequate, they are often far from psychologically adequate. If going to the gym is a terrible experience, you’ll probably not go for too long. The most optimized exercise plan is worthless if it’s not being used.
These days, when someone asks for a workout plan, I ask them what they enjoy. I inquire about all of the outdoor activities they enjoy, sports they’ve participated in, and what things they’ve perhaps enjoyed doing at the gym. I also inquire about activities they may be curious about but have not tried. I then ask which of these enjoyable forms of movement are realistic, given their current lifestyle and schedule.
Like giving up a diet mentality, healing your relationship to exercise means not depriving yourself of genuinely enjoyable movement, focusing on function rather than numbers gets you in touch with your body, rather than trying to subjugate it to a form of rationalized discipline.
Recognize the six internal food voices
In Intuitive Eating, the authors highlight six food voices that are helpful to recognize when healing your relationship with food.
The Food Police
This is the familiar moralizing voice of diet-culture. Certain foods are forbidden, and the food police condemn the temptation to indulge in these sinful foods.
The food police may have initially been a parent, coach, or partner. Now, the internalized voice of the food police fills your head with “should’s” and “should not’s,” making you feel guilty when breaking a diet law.
The food police are punitive and may even lead to the compulsion to use exercise as punishment for “bad behavior.”
The food police is an unhelpful voice that separates you from your body. When it pops up, it can be acknowledged and gently reminded that its rules no longer apply because you no longer operate in its jurisdiction.
The Nutrition Informant
The nutrition informant feeds the food police up-to-date information on the latest diet fads. In the past, it cautioned against high-fat diets and counting calories. Now, it’s generally focused on counting macros and minimizing carbs.
The nutrition informant can be your ally if its information is used to help you understand the various nutrients and ways of eating so you can more carefully experiment with how your body responds to certain foods.
The Diet Rebel
The diet rebel is the voice that starts getting louder right before a binge. It tells you you’ve had enough deprivation, and you deserve to indulge. It can also appear as the apathetic voice of “screw it, you only live once.”
When you listen to the food police for too long, the diet rebel starts gaining strength. After a period of deprivation, it is only a matter of time before it shows up.
The diet rebel can be your ally when you direct it at diet-culture, body shaming, or other attempts to cross your food boundaries.
The anthropologist is the helpful voice of an observer perspective. Rather than merely reacting to the unhelpful food voices, you can step back and observe what is happening.
Like an anthropological researcher, you can observe the social dynamics of your inner food voices. In addition, you learn to observe your bodily cues, studying their subtle sensations of hunger and fullness.
The nurturer is the helpful voice of self-compassion. It talks to you the way you would speak to someone you care about. If the shame of diet-culture remains strong, this voice may not come naturally and must be ingrained over time.
The nurturer helps you recognize when difficult emotions are triggering the desire to cope by using food. It reminds you of helpful coping skills and encourages you to reach out to others for support during challenging moments.
The nurturer also reminds you to approach intuitive eating gently. It says, “progress, not perfection.” When you are tempted to beat yourself up for any perceived imperfection, it talks to you kindly instead.
The Intuitive Eater
The intuitive eater is the combination of the anthropologist and the nurturer. It draws on the allied version of the nutrition informant and the allied version of the diet rebel.
First and foremost, the intuitive eater trusts your gut.
Healing your relationship with food means healing your relationship with yourself and your body. It means taking the morality out of food, letting go of any attempt to impose rigid rules on your eating habits.
Intuitive eating does not mean throwing caution to the wind and living on a steady fast-food diet. This would be against the tenants of intuitive eating since listening to your body would likely tell you it does not actually feel satisfying choosing these foods in excess.
By taking back your body’s intuitions, you start listening to its cues and regaining its trust. If your relationship with food has been heavily affected by diet-culture, it may take time to regain your own trust. Like any strained relationship, patience is required.
Although intuitive eating sounds simple, many people find it just as difficult as dieting in the beginning. Not having strict rules and regulations around food means you have to constantly check in with your body to maintain balance.
Over time, this approach becomes natural. Healing your relationship to food allows you to take back control over your life and start focusing on what matters, regaining your health in the process.
If you want to learn more, I highly recommend checking out Intuitive Eating by Elyse Resch and Evelyn Tribole. Their approach is supported by a great deal of research and has been revolutionary for many people.
As an addiction counselor and former personal trainer, I believe the intuitive approach to eating is based on a deep understanding of the psychology of motivation.
If you struggle with yo-yo dieting or an eating disorder, I highly recommend checking out the book.
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If you’ve grown up feeling like something was missing, you may have been emotionally neglected. You may not identify as being neglected if your physical needs were met, but the lack of emotional support left you emotionally isolated.
You may have felt invisible, dismissed, or unaccepted the way you are. This is a commonly overlooked experience among children of emotionally unavailable parents. These children grow up suffering in silence, feeling empty but not necessarily knowing what’s wrong, often blaming themselves.
Being told they are too sensitive, these children often feel dismissed and rejected, learning to avoid going to their emotionally unavailable parents for support.
They learn their parents are a source of stress rather than support. They can be unpredictable, unreliable, or too self-involved to attend to the child’s emotional needs.
From an early age, these children may take on adult responsibilities or find themselves parenting their parents. As they grow up, this behavior can lead to self-neglect by constantly putting others first.
Finding themselves repeatedly involved in lopsided relationships, doing all of the emotional labor, with people who exploit their generous nature, the fantasy of emotional connection is withheld like the ever-elusive carrot on a stick.
“If I do more, maybe I’ll finally be enough, and they will meet my emotional needs,” you may tell yourself, as you run on the endless treadmill of others’ demands.
The starved need to be needed results in constant emotional repression, masking your true nature. Toxic shame leads to lowering personal boundaries and resentment of others who constantly cross them. This repressed anger is concealed by a mask of cheeriness and determination.
If you or someone you know is burnt out and looking to heal from the distress instilled by emotionally unavailable parents, there is a way out.
I recently discovered the following book, which gives powerful insights and practical tips on how to recover from this exact issue:
It has quickly become one of my favorite psychology books. Immediately after reading it, I was compelled to reread it and summarize the insights.
As a counselor, I talk to a wide range of people, and this has been one of the most common invisible injuries. Since I couldn’t find a good summary of this book, I thought I would create one.
If you’re interested in reading the full book but can’t find the time, you can check out the audiobook version I linked above and listen to it while you’re driving or doing household work.
Otherwise, enjoy the summary!
What is Emotional Immaturity?
Throughout the book, Lindsay C. Gibson PsyD demonstrates how emotional immaturity among parents leads to emotional neglect among children. She proposes several traits associated with emotional immaturity, which can be summarized as the following:
Emotional Immaturity is characterized by a fear of emotional involvement resulting in emotional distance, emotional instability, psychological inflexibility, and self-centeredness.
Emotional distance often presents as holding back from emotional closeness, fear of emotional involvement, and lacking the ability to provide emotional support to persons in need of genuine connection.
Emotional Instability presents as unpredictable emotional states and unreliability. A person may fluctuate between anger, engagement, and coldness, keeping others walking on eggshells.
Psychological Inflexibility presents as having rigid beliefs. Rather than dealing with reality, a person relies on coping mechanisms that resist reality.
Self-centeredness presents as blindness to the needs of others, using others, boundary issues, and emotional manipulation. At the extreme end, there may be diagnosable narcissism or sociopathy.
Emotional Immaturity Test
In her self-assessment tool, Lindsay C. Gibson PsyD lists the traits of emotionally immature parents, which I organized into four clusters for ease of use.
She states that you may be dealing with an emotionally immature parent if you can check off more than one of the following statements.
My parent didn’t express much empathy or emotional awareness.
When it came to emotional closeness and feelings, my parent seemed uncomfortable and didn’t go there.
I didn’t get much attention or sympathy from my parent, except maybe when I was really sick.
My parent often overreacted to relatively minor things.
My parent was inconsistent—sometimes wise, sometimes unreasonable.
If I became upset, my parent either said something superficial and unhelpful or got angry and sarcastic.
My parent was often irritated by individual differences or different points of view.
Even polite disagreement could make my parent very defensive.
Facts and logic were no match for my parent’s opinions.
My parent wasn’t self-reflective and rarely looked at his or her role in a problem.
My parent tended to be a black-and-white thinker, and unreceptive to new ideas.
When I was growing up, my parent used me as a confidant but wasn’t a confidant for me.
My parent often said and did things without thinking about people’s feelings.
Conversations mostly centered on my parent’s interests.
It was deflating to tell my parent about my successes because it didn’t seem to matter.
Types of Emotionally Immature Parents
Emotional immaturity tends to manifest as four general types:
The emotional parent
The driven parent
The passive parent
The rejecting parent
One or both of your parents may fall into one of these general categories. Let’s take a deeper look at what each of these types entails.
The emotional parent instills feelings of instability, producing nervousness and anxiety for all those who have to walk on eggshells. They have “stormy emotional weather,” and you never know the forecast.
Intoxication amplifies the instability, perhaps leading to intimidation. These individuals are easily thrown off their emotional balance by mild distress and are primarily governed by emotional impulsivity.
The driven parent stays busy trying to make everything and everyone perfect. They appear to be quite normal and well-adjusted, but under the surface, they show their emotional immaturity by believing they have all the answers and they know what others what.
They appear supportive of your success but make assumptions about your desires, often pushing things on you. Their driven support comes from their own need to live up to high internal standards rooted in their own emotionally deprived upbringing. They may fear embarrassment if you underperform, leading to you feeling constantly evaluated in school or hobbies.
Driven parents are always keeping busy and worrying about getting things done. This added pressure makes you feel like you should always be doing more or doing something other than what you are currently doing. This can lead to thoughts of not being enough or insecurity regarding evaluation.
Driven parents often cross personal boundaries. Making assumptions or invalidating your interests, they often do things for you without asking for permission and become overly involved in your life, extinguishing a sense of independence.
The passive parent avoids dealing with anything upsetting. They can be easygoing, playful, affectionate, and often in good spirits but fail to protect their children when they need it emotionally.
If a passive parent gives you affection, it often comes from a self-centered place of using you to feel loved or needed, meeting their own emotional needs. Without recognizing this, you may naturally gravitate to the attention given by this parent, perhaps thinking of them as the “favorite parent.” Despite potential positive experiences, you may feel like this parent is not there in an essential way.
Passive parents turn a blind eye to abuse or neglect, retreating when times are tough. They may even leave the family if they get a chance at a better life, leaving their children feeling deeply rejected.
The rejecting parent is withdrawn, dismissive, and derogatory. They openly reject attention from their children, appearing irritated and dismissive of children in general.
They constantly have a wall around them, lack empathy, and can appear menacing and aloof. At the extreme end, they may have sociopathic tendencies and are capable of physical attack.
If you have a rejecting parent, you may find it hard to ask for what you need, resulting in an avoidant attachment style.
The Two Reactions to Emotional Immaturity
Children of emotionally immature parents commonly react in two general ways, depending on the child’s temperament:
Externalizers have an external locus of control when things go wrong, whereas internalizers have an internal locus of control. In simple terms, externalizers blame others, and internalizers blame themselves.
Although you may generally fall into one of the two categories, there may be mixed reactions since it is a spectrum rather than a binary.
Let’s take a closer look at what each of these reactions entails.
Externalizers blame others when things go wrong. They may act out, and people generally label these children as having behavioral problems. This may involve substance use, reckless behavior, or rebellion.
These children may also take on characteristics similar to emotional immaturity. Growing up, they force their needs on others, using emotional manipulation such as guilt and blame.
Externalizers present as having a visible issue, and their struggles are not easily overlooked, causing others to recommend treatment. Although they are the most likely to be confronted by others to seek treatment, they are often the least likely to get support because they tend to externalize blame.
Internalizers look within themselves for why things go wrong. They are highly sensitive and attuned to their environment, keeping strong emotions bottled inside. Wearing a mask when engaging with others, they fear truly opening up and being genuine because they believe their very nature is a problem.
Internalizers have a deep need for connection and feel painfully lonely, constantly seeking genuine emotional connection. They believe the best way to find connection is to become a likable person, putting others first, constantly over-extending themselves for others. Self-neglect is seen as the cost of connection.
Fueled by the thought of “not being enough,” internalizers seek to make up this lack of “being” through constant “doing.” They believe their value depends on how much they do, not who they are. The fantasy of winning the affection of others keeps them on this treadmill of self-neglect.
Unable to say “no,” internalizers do most of the emotional work in relationships, often feeling resentful of those for whom they have taken responsibility. Instead of expressing their anger, they wear a mask of cheeriness or a determined can-do attitude.
Since emotionally immature parents rejected their feelings, they internalize the voice of rejection, taking a rejecting attitude toward their own feelings. They downplay their suffering, often apologizing for their emotions. Feeling guilty for taking other people’s time, they feel like a burden when asking for help.
Internalizers may also internalize the voice of judgment. Harshly criticizing themselves, they remain closed off to sharing their needs or struggles, fearing judgment by others for being inadequate. This leads to feeling further isolation and embarrassment if requiring support.
If an an internalizer’s emotions are taken seriously, they are often surprised since they are used to “getting by on vapors” regarding affection from others.
Unlike externalizers, internalizers can go unnoticed. They are often high-performing and focused on achievement. Therefore, an emotionally immature parent may see them as having no needs. If an internalizer has an externalizer sibling, this may also cause jealousy or criticism from the externalizer, due to the social comparison.
Internalizers focus a great deal of their energy on fixing and rescuing others. The greater the difficulty, the more they try. The more they try, the greater the difficulty. This spiraling effort is often spent trying to change people who don’t want to change themselves, leading to burnout and resentment.
Healing from Emotionally Immature Parents
You were not born to fix your parents’ unhealed trauma.
Healing from emotionally immature parents requires discovering your healing fantasy, stepping out of your role self, clarifying your values, setting personal boundaries, taking an observational perspective, and engaging in self-care.
The healing process may take time since old habits are deeply engrained, but there are things you can start doing today to begin the process.
Discover Your Healing Fantasy
Throughout the book, Lindsay C. Gibson PsyD uses the concept of the “healing fantasy” to describe an internalizer’s attempt to win the affection of their emotionally immature parent.
The healing fantasy generally consists of thoughts that perhaps they will change if only you can do more. This can lead to the ineffective helping behaviors described above, overachievement, perfectionism, or falling into old patterns in relationships with romantic partners.
The first step to healing from an emotionally immature parent requires identifying your healing fantasy.
Where are you acting like a gambler chasing their losses, holding out for a jackpot that will fix everything? Take a moment to reflect on where you hold onto false hope.
Where do you tell yourself, “if only…”?
Where are you tapping the metaphorical slot machine button, constantly hoping for a different result?
What forms of endless striving are you engaged in to win the approval of others?
Letting go of your healing fantasy, you recognize their rejection is more about their past trauma or experiences with an emotionally immature parent than about your worth as a person.
It is helpful to view emotionally immature parents as emotionally phobic. If you have a fear of spiders, snakes, heights, or public speaking, consider how you would feel if someone told you that you had to engage with one of these things. This is the experience of the emotionally phobic person.
Discarding the healing fantasy requires accepting your parents for their emotionally phobic selves. This does not excuse their behavior; instead, it allows you to manage your expectations and work with reality.
Emotionally immature people may appear distressed, cynical, and constantly complain, but perhaps they don’t want to change. And in your own experience, how have attempts to change them worked out so far?
Once you have identified your healing fantasy, you can let it go and accept you are dealing with someone who is emotionally phobic.
Step Out of Your Role Self
The role self is the role you played within the family dynamic. Were you a fixer, an avoider, a comedian, an overachiever, or a rebel?
In enmeshed families where emotions are not discussed, playing rigid roles holds the family together. It is a form of dysfunctional homeostasis. By playing your role, you have a place in the family system, but your belonging comes at the cost of your genuine feelings.
Like a stage performance, everyone puts on their costume and stays in character. Talking about the deeper issues requires breaking character, threatening the tenuous sense of belonging provided by the enmeshed system.
Stepping out of your role-self requires noticing the role you play and making a conscious decision to be your true self. This does not mean opening up emotionally to emotionally phobic people. Instead, it means clarifying your genuine values and acting in alignment with this true self.
Clarify Your Values and Your True Self
Stepping out of the role self and into the true self requires trusting your gut feelings and intuition. When do you find yourself in a flow-state where time disappears? What were you like as a young child? What types of things did you naturally gravitate to? What did you enjoy doing? When do you experience moments of true joy? Clarifying your true values provides a compass for how you want to engage with others.
When stepping out of the role self, you may uncover suppressed anger. If you’re an internalizer, you may be perceived anger as unacceptable and dangerous. Since our emotions are like internal check-engine lights, repressed anger leads to unmet needs. The sense of “getting by on fumes” fits well with this metaphor.
Allowing yourself to feel anger does not mean switching into rage and resentment. Anger can focus your attention on unmet needs and motivate action to meet those needs through assertive communication or personal boundaries.
You may have grown up believing certain emotions are “good” or “bad.” Instead, viewing emotions as information, you step outside the need to repress the “bad” ones. There are comfortable and uncomfortable emotions, but they are all there to convey useful information regarding your underlying needs.
Set Personal Boundaries
Setting personal boundaries means saying “no” when you find yourself helping others at the cost of your health. It means recognizing and communicating your needs through assertive communication. Lastly, it means disengaging from toxic relationships.
In another great book on the subject, When the Body Says No, Dr. Gabor Maté says when given a choice between guilt and resentment, choose the guilt. This means noticing when guilt drives your decision to do things for others that you will eventually resent them for.
Choosing guilt means caring for yourself enough to say no. Although there may be a temporary deeply engrained guilt response, this step toward self-care heals underlying shame.
Choosing short-term guilt heals long-term shame. This allows you to gain a sense of self-worth, in turn, healing the constant guilt.
As you build momentum, notice the amount of “shoulds” you tell yourself. Notice how this is potentially the internalized critical voice of a parent. Setting boundaries with your parents means setting boundaries with your own inner-critic, as well.
You can give yourself the compassion you never received. Practicing self-compassion may consist of imagining what you would tell someone you care about who is going through the same situation. Being kind to yourself allows you to heal underlying shame and step back from your thoughts during moments where the inner-critic tries to lower your personal boundaries through the “shoulds” that lead to guilt.
Take an Observational Perspective
After gaining some perspective regarding the nature of underlying shame, guilt, and the inner-critic, it can be helpful to use an observational perspective when engaging with an emotionally immature parent.
An observational perspective means stepping back from interactions within your family system and viewing the situation like a scientist. Perhaps you can imagine you’re an anthropologist like Jane Goodall, studying primate interactions. Get curious about the various roles, reactions, and scripts being acted out. How is everyone falling into their usual role selves?
With this new perspective, you can gain emotional distance from heated situations, noticing your conditioned thoughts and emotions rather than merely reacting. Rather than reacting, you now have space to respond appropriately.
Perhaps this means taking a timeout, politely saying you cannot do something, or maybe it means just doing nothing, accepting you are dealing with an emotionally phobic person stuck in a role self. Whatever the situation calls for, you are free to choose your response based on your core values.
Taking this observational perspective breaks old reactive emotional habits that keep you locked into a toxic dynamic. It allows you to step back and recognize what is really going on. Lastly, it allows you to manage your expectations and deal with reality rather than a non-productive healing fantasy.
Engage in Self-care
Many people have heard about the common self-care tips such as diet, nutrition, sleep, and making time for things you enjoy. These are pretty obvious, and if someone is an internalizer, they’ve probably been told to do these things many times. So why isn’t it enough to simply give this advice?
As you may have noticed by now, internalizers prioritize helping others over helping themselves. The ability to engage in self-care is perhaps part of the healing fantasy, perpetually postponed because there are more urgent matters regarding the needs of others. You may unconsciously tell yourself you’ll deserve self-care when you can finally fix everyone else.
Getting into the classic list of self-care tips is irrelevant if these underlying issues block motivation to engage in self-care. So why would someone continue to engage in self-neglect, even after recognizing this fact?
The most simple answer is because familiarity feels safe. We are creatures of habit, and it is very common to take self-destructive paths because they feel familiar. The sense of uncertainty and fear of the unknown keeps people stuck in suboptimal situations, settling for the scraps rather than taking the bigger, better offer of a new way of life.
If you grew up with an emotionally immature parent, emotional immaturity feels familiar. As a result, you may find yourself attracted to these types of people in other areas of your life. The people we find most charismatic are often triggering us. Therefore, instant chemistry might be a red flag that you are falling into old family patterns.
Before you can think about self-care, you’ll need to let go of these underlying attachments to unhealthy relational dynamics.
Whose validation are you seeking? Do you really need their validation, or do they need you to need their validation? Do you need to be needed? If so, are your attempts to meet this need getting you closer to genuine belonging, or are they keeping you meeting someone else’s need to be needed at your own expense.
If you’ve made it this far, you can probably relate to the sense of feeling trapped in constant emotional turmoil and unhealthy relational dynamics. Once you’ve applied some of the principles listed in the previous section, you may realize these patterns are so familiar and deeply ingrained, it is challenging to spot emotional maturity.
Although we’ve covered the red flags indicating emotional immaturity, here are the positive signs of emotionally mature individuals:
Emotional maturity consists of being realistic, reliable, flexible, non-judgmental, respectful, empathetic, level-tempered, genuine, reciprocal, and having an overall positive vibe.
Emotionally mature people are like a well-designed house. When everything is working the way it should, you almost don’t even know it’s there. If you’re used to constant flooding and leaking, you may initially feel a sense of calm and ease.
Interactions with emotionally mature people are lighter and more effortless. They are generally even-tempered, reliable, consistent, and can meet your basic emotional needs.
They are psychologically flexible and work with reality rather than fighting against it. If you decide to change plans, they respond flexibly, sharing their input and working out a mutually beneficial way forward.
They can use both reason and emotion in a balanced way, depending on the needs of a specific situation.
Emotionally mature people are not perfectionistic and recognize everyone is imperfect. This perspective allows them to demonstrate genuine compassion for others and themselves.
They treat others with respect, honoring your boundaries, and maintain your individuality.
When you need their emotional support, they listen non-judgmentally and empathetically, not assuming they know you better than you know yourself.
They approach life with a win-win mentality. They don’t want to use others, nor do they want to be used by others.
When conflict arises in a relationship, they are willing to deal with it effectively and bring it to a close rather than using emotional manipulation or long-term silent treatment.
Emotionally mature people are willing to consider your perspective and have a secure sense of self, allowing them to approach others with a non-defensive natural curiosity.
They are truthful, genuine, and forthcoming about their thoughts and intentions.
When they make a mistake, emotionally mature people are willing to genuinely apologize, demonstrating careful attention regarding your concern and describe how they intend to do things differently next time, following through with these intentions.
They are genuinely interested in you, remembering specific details regarding your interests and passions, referencing these topics in future conversations. They celebrate your individuality rather than expecting you to conform to their interests.
Emotionally mature people see you positively, allowing you to be yourself, free of the fear of judgment. When you share your emotional needs or discomforts, they take you seriously.
If you share personal details, they reciprocate, building mutual intimacy.
Although they are generally even-tempered, they can laugh and be playful. Their sense of humor is used to connect and bond rather than using it to gossip and ostracize others.
In general, they are enjoyable to be around and have an overall positive vibe.
Most importantly, they make you feel seen and understood for who you really are, not who you pretend to be.
How to Build Genuine Relationships
If you’ve never experienced a deep relationship with emotionally mature people, this kind of relationship may seem like a pipe dream.
You may be conditioned to settle, take emotional scraps, or be led on by a trail of emotional breadcrumbs. Besides the healing fantasy, it can be hard to let go of these relationships because you may think it’s all you’ll ever get. The thought of being alone forever induces fear, keeping you locked into familiar patterns.
Before letting go of toxic relationships, it can be helpful to assess those in your life, considering who fits the description of emotional maturity. Of course, no one is perfect, but the above description can offer guidance in making this assessment.
If you’ve determined there is someone in your life who is relatively emotionally mature, and you’ve been afraid to reach out for support, notice how the fear of judgment, rejection, or feeling like a burden is keeping you from doing so. Notice how although these reasons may have served you growing up, they are no longer useful when engaging with emotionally mature people.
Taking off the mask and opening up to emotionally mature people helps build an emotional safety net, allowing you to let go of unhealthy relationships.
Emotionally mature people can help you practice being yourself, so you can take this practice into interactions with others who are less emotionally mature. Rather than reacting based on old patterns, you can pause, maintain self-composure, and be true to yourself, whether people accept it or not.
You are not responsible for being parented by an emotionally immature parent, but you are responsible for the recovery process. This means recognizing others are responsible for their own feelings and communicating their needs, just as you are.
Trusting your emotions as offering useful information regarding unmet needs, you can have compassion for yourself. You can then accept that emotionally mature persons will likely respond to you with this same compassion if you reach out for support.
Letting go of old mental habits instilled by an emotionally immature parent gives you the freedom to live by your genuine thoughts and feelings. With this newfound sense of empowerment, wholeness, and self-reclamation, life feels lighter and easier.
Although you can’t make others change, you can change. You do get to start over, almost as if you’re rebirthing yourself, giving yourself the gift of living twice in one life.
As you can probably tell, I have been pretty obsessed with her book, given the time it took to write this summary. As a counselor, this is one of the most common themes I encounter in my conversations with clients.
This issue can often go unnoticed since there may not necessarily be a specific event identified as “traumatic.” Adverse childhood experiences do not need to be physically abusive or neglectful. As you can see, emotional neglect can have significant negative consequences and is often perceived as “normal” by those who have experienced it.
The issue is often made even more invisible because internalizers often blame themselves, carrying significant guilt or shame regarding unhealthy dynamics.
The book provides an insightful perspective, allowing the reader to see the bigger picture, giving practical tools to heal from emotionally immature parents. In the near-perfect 5546 reviews, many people share they found it life-changing, and I can see why.
If you know someone struggling with the issues outlined in this article, feel free to share it with them. Healing invisible wounds starts with awareness of the problem.
I’ve been on an audiobook binge over the last few weeks and have read a series of great books that would make the perfect follow-up to this article, so I’ve listed them below—in addition to a few others.
If you find yourself struggling with the inner critic, causing you to experience guilt and beat yourself up over “not being enough,” here are my best book recommendations:
On the go? Listen to the audio version of the article here:
Over the last couple of months, I have been busy sharpening the tools in my counselling toolkit. Due to the pandemic, there has been a high demand for mental health services, leading me to take a new role doing virtual counselling for clients across Canada.
Although I had to take a step back from regular writing, I’ve been getting the opportunity to help many people, gaining valuable lessons along the way.
Thus far, throughout my career in addiction and mental health, I’ve enjoyed collecting and sharpening new counselling tools, learning that having multiple tools at one’s disposal is critical. As they say, when your only tool is a hammer, every problem looks like a nail.
In my experience, effective counseling requires using the right tool, at the right time, in the right way. This does not mean you need to have every single tool in existence. It’s more effective to be a master of a few different tools than to have a rudimentary understanding of many.
My counselling toolkit can be divided into three different sections:
Sticking with the construction metaphor, a person’s thoughts, emotions, and actions are the wood, support beams, and concrete. They are the primary raw materials in counselling.
But before you start building, you need a foundation.
Start with a Foundation
You may be hired to renovate a room, construct an addition, or perhaps just knock down a kitchen wall. Either way, you can’t make assumptions unless you ask your client. This is the foundation of a person-centered approach.
Making assumptions without first asking the client what they want is like a friend asking your opinion on a paint colour, and you tell them how to remodel their home.
You won’t be very helpful if you start making assumptions.
“But what if my friend’s home is falling apart?” you may ask.
If you think someone requires more than they are asking for, there is a time and place to introduce the subject. Perhaps deep down, they realize they need a lot more help but are not ready to address these other areas right now. If they need to paint a room to brighten their day before taking on the rest of their renovations, simply help them choose the paint colour.
Meeting a person where they are at is the foundation of an effective counselling relationship. Like the foundation of a home, the concrete needs to set before you can start building on it.
The Open-ended Question
Laying the foundation to a strong counselling relationship by meeting someone where they are at does not require fancy tools, but it can be easily overlooked.
When someone presents a set of problems, it might be tempting to try to address what we perceive to be the most important issue first.
Rather than starting with an assumed priority, I like to get a sense of what is going on, then directly ask an open-ended question like the following: “what would you like to get out of our work together?”
This is the core of solution-focused counselling and single-session counselling. There is often a misunderstanding that counselling has to be a long and drawn-out process that explores every aspect of someone’s past. This might be helpful in certain situations, but it is not necessarily what everyone needs during a session.
Another open-ended question might include the following: “By the end of this session, what would tell you this has been a helpful conversation?” or “If you get what you want out of this conversation, what would it allow you to do tonight or tomorrow?”
By starting with the end in mind, I can quickly determine what kind of conversation this is going to be. In my experience, counselling conversations generally fall somewhere on a spectrum between two broad categories: 1) conversations for support and 2) conversations for advice.
Conversations for support generally involve persons simply looking for someone who will listen with compassion, facilitate a sense of connection, and offer validation that they are doing the best they can. Clients often express this as “just wanting to know I’m not crazy” or “I just need to vent.”
Let’s take a closer look at the best tools for these types of conversations.
When determining the primary goal is to support a client who simply needs a compassionate ear, I immediately switch to my set of connection tools for holding space. These tools are the essence of a humanistic counselling approach.
Many clients, especially those in crisis, just want to feel heard. They have often felt dismissed or not understood by friends, family, colleagues, or other professionals. This leads to a sense of isolation or perhaps even shame.
The best way to hold space is to simply listen.
I originally learned about holding space from Heather Plett in this article:
It means that we are willing to walk alongside another person in whatever journey they’re on without judging them, making them feel inadequate, trying to fix them, or trying to impact the outcome. When we hold space for other people, we open our hearts, offer unconditional support, and let go of judgement and control.
To continue with the construction metaphor, it’s like adding strong supportive beams in a building. They are non-imposing and usually invisible, but their strength allows a structure to hold space, keeping the occupants inside safe.
In counselling terms, this means compassionately being with another person with complete acceptance, allowing them to feel held by your presence, and safe to express whatever they need to.
Let’s consider a few other tools that can help hold space more effectively.
Reflective listening means showing the other person you understand rather than simply saying, “I understand.”
How do you do this?
Although we can never really understand exactly what another person is going through, we can do our best to show we get it, on some level. We may not have been through the same experiences, but we all feel the same emotions from time to time and can connect with another person’s experiences through this shared humanity.
Even if your understanding is imperfect, just showing you are trying to understand can be enough. This is the core of empathy.
Reflecting back what you understand the other person is saying demonstrates this empathy.
It can be as simple as saying, “wow… you’ve been through a lot recently.” or it could be a brief summary of everything they’ve shared. The key is that it comes from a place of genuine compassion.
Here is an example of a more complicated form of reflective listening whereby you prompt the person to continue by saying the statements you believe they may say next:
Person: “I’m here because I find it difficult to control my drinking.”
You: “…and you’re looking to gain back some control.”
Person: “yeah… I miss the way things were with my family before I started drinking.”
You: “… spending quality time with the ones that matter.”
Person: “That’s right…”
Reflective listening is the primary tool I use to hold space. It allows the other person to feel safe and understood.
Although reflective listening is a tool, holding space goes beyond one’s words. It is an attitude and way of being with the other person. There is no need to change anything or fix anything in these moments. Just simply being with the other person during these difficult moments is often all they need.
If a client is ready to start developing new coping skills, I take out a different set of tools to work with their underlying unhelpful thoughts. This is the foundation of a cognitive-behavioural approach.
At the core of self-destructive actions, there are often unhelpful thoughts. For example, a person struggling with an addiction is not simply chemically hooked to a substance. Although there may be physical dependence, it often goes much deeper.
Past traumas or chronically unmet needs can result in distorted perceptions of oneself and the world. For example, this is common for people who grew up with emotionally unattuned parents struggling with mental health or addiction issues. Growing up in this environment can lead to distorted beliefs and habits that were adaptive in this early environment but become maladaptive in adulthood.
Common distorted self-perceptions include thoughts such as the following:
I am not enough
I will be a burden if I ask for help
I’m bad/ broken/ hopeless
Continuing with the construction metaphor, these thoughts are equivalent to a distorted wall, throwing off the alignment of a room. This would require reframing some of the walls, but the walls need to be deconstructed before reframing can be done.
In conunselling terms, this means getting to the root of unhelpful core beliefs.
Identifying Core Beliefs
Deconstructing one’s thought processes to identify core beliefs should be done carefully. Like knocking down a wall, getting too reckless with the hammer could indirectly affect other areas of the house.
I generally ask what thoughts are going through their head during a challenging moment. For example, if someone is anxious every time they walk into work, I may ask them to imagine they are in that situation and share what might be going through their head at that moment.
If they are struggling to think of something or they begin to notice discomfort in their body, I will ask them to describe this discomfort in detail. Where is it located in the body? What does it feel like? I then ask if this discomfort had a voice, what would it say?
Responses might often include, “You’re going to mess up.” I would then go further, asking if this were true, what it would mean about you as a person. A response might include, “I’m going to lose my job.” Since this does not directly answer the question, I might ask what this would mean about them as a person. A common response might include, “I am not enough.”
Unhelpful core beliefs are distorted ideas about oneself, often extending into many areas of one’s life. For example, the core belief of not being enough often extends beyond isolated events such as worries about one’s work performance. It can affect one’s level of self-worth in all relationships, leading to frequent feelings of fear and unhelpful behaviors such as avoidance or overcompensation.
Unlike reframing a room in a house, reframing core beliefs does not merely require knocking down the old one and constructing a new one. Since core beliefs have often been around so long, they tend to pop back up frequently.
There is no process of unlearning in psychology. There is only new learning. You can’t just knock down the wall and burn the lumber. You have to use the same lumber to reconstruct the new wall.
In counselling terms, reframing these beliefs often requires putting them into a new context. For example, rather than unconsciously going through life with “I’m not enough,” we can identify where it may have come from and how to let go of it when it returns.
In this particular example, a person may share a highly invalidating upbringing with parents who frequently criticized them for not being good enough. Bringing this core belief to light and tracing its origin gives it a new context. It can then be held as an unhelpful thought that has been learned from one’s past experiences.
Gaining this perspective allows a person to step back from these unhelpful thoughts and reframe their meaning.
This is a fancy-sounding concept in Acceptance and Commitment Therapy (ACT), referring to one’s ability to step back from one’s thoughts.
When we are fused with unhelpful thoughts, they become heavy and weigh us down. We identify with the self-critical thought rather than noticing it’s just a thought and letting it go.
A popular metaphor in ACT includes the leaves on a stream visualization. It consists of imagining you are sitting beside a stream with leaves floating down it. Bringing your attention to your physical sensations, you step out of overthinking and into the present moment. If a thought comes in, place it on a leaf and watch it float by. If you would like to try this exercise, you can find a guided version of it on YouTube here.
The goal of this exercise is not to merely float into a dreamlike bliss where you stop identifying with every thought, going through life in a state of idyllic apathy. The goal is to practice stepping back from unhelpful thoughts, allowing you to focus on things you value.
For example, when “I’m not good enough” shows up, it can be used as a reminder that you care about a particular situation, such as doing quality work. You can then thank your mind for the reminder that you value your job and that you will not get hooked by this unhelpful thought right now.
Although you are working with the same lumber, you now have the blueprint. Having a broader perspective on the situation allows you to respond in ways that are more self-compassionate, increasing the chances you will act effectively.
This is another major tool I tend to use in reframing.
If people talked to their friends how they often talk to themselves, they wouldn’t have many friends for long.
People often beat themselves up with phrases such as, “I’m bad, I’m stupid, I’m crazy….” This lack of self-kindness cuts a person off from common humanity, making them feel uniquely defective and isolated. It then reinforces unhelpful worries and behaviours, decreasing the odds of effectively handling difficult situations.
After identifying and reframing core beliefs, I find it helpful to bring up the concept of self-compassion.
I often introduce self-compassion by asking how a person would talk to someone they care about going through the same situation. I then have them confirm this is the most helpful way to engage with someone and that harshly criticizing this person would be counterproductive.
I would then draw attention to the interpersonal process we’ve been engaged in over the session. If I were to constantly criticize them through the session, would this improve their chances of changing? They often immediately resonate with how unhelpful this would be.
After getting their full agreement on these examples, I suggest the same applies to how they talk to themselves. I then inquire into their thoughts after noticing this tendency and ask if it would be possible to pretend they are talking to a friend, next time they notice a lack of self-compassion.
When designing a room, the space can look very different, depending on your perspective. Perhaps we’ve become more familiar with this idea, given the increased use of videoconferencing from home. From the frame of a carefully placed webcam, a space can look clean and organized, but it can look very different from another perspective.
For me, perspective-taking has been a powerful reframing tool. I find it to be most beneficial among persons who are caught up in their view of a situation, unable to empathize, or have rigid beliefs about someone else’s intentions.
For example, if someone rigidly projects specific intentions onto their partner’s actions, perspective-taking can help determine a more accurate interpretation of events. This is particularly helpful if these unhelpful interpretations include concerns about one’s adequacy. In this way, perspective-taking can be a multi-purpose reframing tool that can also initiate cognitive diffusion.
This kind of reframing should be done carefully since you can unintentionally break the foundation. For example, asking how the other person views the situation can be interpreted as invalidating and appear as if you are supporting the other person’s behaviour.
When using perspective-taking, it is helpful to have a solid foundation of trust and approach it carefully, inviting the person to see the situation from behind the other person’s eyes. If approached with a spirit of curiosity and openness, it can lead to significant insights.
My goal in this article has been to reflect on my counselling toolkit. Hopefully, this has also been beneficial for you.
If you are a fellow practitioner, perhaps it has offered some ideas for your toolkit. If you are someone who is looking for support, perhaps it has debunked some myths about counselling and provided a few insights.
When sharing my role with others, people often ask, “what do you tell people?” As you can see in this article, the answer is always, “it depends.”
Asking me what I tell people is equivalent to asking a home builder what tool they use. It depends on what needs to be done at that moment.
But unlike construction, counselling can often be most productive when doing less. I heard a great quote recently by Judson Brewer in his new book, Unwinding Anxiety. He says, “don’t just do something… sit there.”
People who value compassion often feel compelled to rush in with their shiny well-stocked toolbox and try to fix things. I have to remember this every time I begin a conversation.
Although I used a repair-oriented metaphor throughout, the metaphor has its limits. Counselling is not about “fixing” people.
Taking a “fixing” orientation assumes people are broken and puts them into a passive role within the dynamic. This disempowers them in two ways. Implying they are broken can reinforce unhelpful self-critical thoughts. Also, placing someone in a passive role takes away a core ingredient of motivation; it takes away their sense of autonomy, self-efficacy, and sense of incremental mastery.
I’ve written about this collaborative approach to counselling in my article on how to do motivational interviewing here.
While exploring my counselling toolkit, I also realized there are way too many tools to fit within one article. If you are interested in taking a more detailed look inside my ACT toolkit, check out my article on how to improve psychological flexibility, here.
Looking For Your Feedback
One of the most common questions I’ve been hearing is, “how do I stop overthinking?”
That is why I’ve recently started developing an online course designed to help people stop overthinking and start living the life they want.
In this program, my goal is to guide the client through each step of the process with self-guided video modules, worksheets, and practical exercises.
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The idea of an “addictive personality” is one of the biggest myths about the cause of addiction. Rather than explaining addiction, it reinforces popular misconceptions, often stigmatizing those who suffer from an addiction.
Regardless of one’s personality, addiction can affect anyone. Although specific personality characteristics can be correlated with certain types of addiction, the idea of a single “addictive personality” grossly oversimplifies addiction.
The underlying causes of addiction include trauma, unmet needs, or other emotionally painful experiences resulting in the desire to cope in the short-term through substances or behaviors that mask the pain, resulting in long-term harm.
With this in mind, let’s consider the various reasons why it is important to dispel the myth of the addictive personality.
There Is No Scientific Consensus
Researchers studying the correlation between personality and addiction have been unable to reach a consensus regarding a single “addictive personality.” Instead, many studies have found the importance of specific traits that may differ across each type of addiction.
Although there is no consensus regarding an addictive personality, one of the most significant traits observed in the research is low self-regulation. Low self-regulation means having difficulty controlling impulses, but it can also mean difficulty pulling oneself away from narrow areas of focus. On one end of the personality spectrum, low self-regulation can look like hyperactivity, while on the other end, low self-regulation can look like obsessive focus.
In Maia Szalavitz’s book, Unbroken Brain, she analyses the past twenty years of “addictive personality” research, in addition to sharing her own experience with an addiction to heroin and cocaine. As an anxious straight-A student who always followed the rules, no one suspected she would develop an addiction. She states:
“Children who ultimately develop addictions tend to be outliers in several measurable ways. Yes, some stand out because they are antisocial and callous—but others stand out because they are overly moralistic and sensitive.”
Rather than being about a single personality type, there are various personality types associated with increased risk. These personality types are generally found on opposite extreme ends of an impulsivity spectrum. As she states:
“While those who are the most impulsive and eager to try new things are at highest risk, the odds of addiction are also elevated in those who are compulsive and fear novelty. It is extremes of personality and temperament—some of which are associated with talents, not deficits—that elevates risk. Giftedness and high IQ, for instance, are linked with higher rates of illegal drug use than having average intelligence.”
We often think of persons with low self-regulation as lacking impulse control, as in the stereotyped image of ADHD. What is often neglected is how compulsiveness, at the opposite end of the personality spectrum, is also associated with low self-regulation. Maia Szalavitz shares her personal experience with this issue:
“I had trouble stopping intellectual engagement, not starting it.”
As someone with mild work addiction, I can personally relate to this issue. From the outside, completing a PhD and writing over 80 articles on this site looks like a high degree of self-regulated focus. However, I experienced it as quite the opposite. Not doing these things would be more difficult since it takes an active effort for me to stop doing them, similar to a person trying to stop using substances.
Luckily, this is something I have insight into, so I carefully monitor it to minimize negative impacts on other areas of my life. To learn more about this balance, check out my article on when something becomes an addiction.
Although I have been able to turn this tendency into an asset, it could easily cause destruction if it results in too much neglect in other areas. Also, this tendency can easily become fixated on other addictive substances or behaviors if not kept in check.
Addiction is found in the extremes of a spectrum. Too often, addiction is classified as something you either have or don’t have. Rather, you can be mildly addicted to something if it has minimal harm in your life or severely addicted to something if it has a significant negative impact.
In the same way that addiction is not merely something you have or don’t have, it is a complex issue that does not look the same for everyone. Addiction is strongly associated with low self-regulation, but the way low self-regulation manifests looks different for everyone.
A 2018 study on the personality profiles of addiction found that different types of addiction attract different types of personality. Regarding these trends, the study found the following:
• Alcohol use disorders identified by lower extraversion and openness to experience.
• Drug use disorders and compulsive sexual behavior have similar personalities.
• Gambling disorder has similar personality to healthy controls.
These correlations provide further evidence against the idea of a single “addictive personality.” It is also interesting to note that persons with an addiction to gambling did not differ from the personality of the general non-addicted population. Regarding gambling disorder, the study concludes:
“…treatment centers and counselors may need to address environmental issues in these individuals, rather than focusing exclusively on risky personality traits.”
I’d go even further to argue that although there are some general trends in personality differences between various types of addiction, it is always necessary to treat individuals based on their unique personality traits, character strengths, and personal histories.
Although the science is relatively clear on the importance of self-regulation in addiction, even this concept manifests quite differently across each individual. There is no substitute for a person-centered approach to addiction.
It Does Not Explain Addiction
Rather than clarifying why someone may have developed an addiction, the concept of the addictive personality obscures the underlying causes, reducing everything to a perceived personality defect. Like the myth of a single “addiction gene,” we tend to seek simple answers to complex questions. In doing so, we gain certainty at the cost of genuine understanding. Although an array of genetic factors may contribute to an increased risk of developing an addiction, there is no single addiction gene.
These simplistic single-origin explanations label persons with addiction as fundamentally different. This false certainty can give the illusion that one is immune from developing an addiction if one does not exhibit certain traits.
The concept of an “addictive personality” is a convenient way to package addiction’s messy reality into the black box of a pseudo-psychological label. The concept’s explanatory power is equivalent to saying, “they have an addiction because they are an addict.”
Addiction is caused by various factors and the concept of an “addictive personality” erases this reality by simply attributing all addiction to a single variable. As shared in my article on what drives addiction:
“Addiction is driven by neurological changes related to dopamine, the reward center, and the brain’s self-regulatory center. This produces a learned pattern of coping with underlying pain or unmet needs.”
This brief explanation does not even scratch the surface, so check out the full article for further detail if you are interested.
It Can Be Stigmatizing
Such superficial explanations are also stigmatizing. An example can be seen in the stereotyped concept of the “degenerate gambler.” Like the idea of the “addictive personality,” concepts like “addict” often carry the weight of judgmental attitudes. Although persons in 12-step recovery may choose to identify themselves as a “gambler, alcoholic, or an addict,” it is not anyone else’s place to bestow such a label.
I interact with “persons with an addiction” in the same way I would interact with “persons with depression.” I wouldn’t walk into a mental health rehabilitation unit and refer to the clients as “depressives.” The comparison is not perfect because the “addict” labels have become normalized in 12-step recovery, but using the label for oneself is a personal choice.
When these labels are appropriately internalized in the context of 12-step recovery, they can be empowering. When they are given to you by someone else, they can feel alienating. Introducing oneself as an addict at a Narcotics Anonymous meeting feels very different than someone else saying, “You’re an addict.” The former indicates acceptance and the desire to maintain abstinence, whereas the latter often suggests judgment and misunderstanding.
The concept of an addictive personality can serve as a permanent mark of “defectiveness,” taking away hope in a situation already marked by a lack of hope. As shared in my article on stigma, Stephanie described her constant fear of judgment while in active addiction.
“I was hopeless and believed that I would not be able to get help. In my own head, I was a lost cause.”
When someone feels judged, they are less likely to reach out for help, prolonging their struggle with addiction. The concept of the addictive personality may contribute to this issue when the label is perceived as a form of judgment.
The concept of the addictive personality has been one of the most stubborn myths in the addiction field. Although persons lacking self-regulation are at an increased risk of addiction, issues in this area range from hyperactivity and impulsiveness to obsessiveness and compulsivity.
Each type of addiction has a different general trend in personality traits. Although this is the case, these trends are still not necessarily useful in clinical settings where each individual brings their unique cluster of personality traits, character strengths, and personal histories.
Lastly, relying on the concept of an addictive personality can be stigmatizing since it tends to be an overgeneralization based on a set of stereotyped negative characteristics.
The concept of an addictive personality is not useful for explaining addiction, nor is it helpful in treating addiction. As described in my article on the root causes of addiction, the causes of addiction include trauma, pain, and unmet needs such as purpose, belonging, and self-esteem. As in the insightful words of Gabor Maté:
“The question is not why the addiction, but why the pain.”
For more on the root causes of addiction, check out my interview with Stephanie from Aegis Health Group:
As an addiction counselor, my approach to helping clients is based on recognizing these underlying factors. Recovery results from effectively turning toward the underlying pain in a self-compassionate way, uncovering core values, and building habits of committed action.
If you reside in Canada, I am currently taking clients for online counseling, in addition to in-person sessions for persons who live in the Windsor-Essex area. If you are interested in learning more, you can fill out the form below, and I will contact you for a free 15-min phone consultation.