by Steve Rose | May 16, 2020 | Addiction and Recovery
On the go? Listen to the audio version of the article here:
During my time working in a withdrawal facility, I quickly came to realize that crystal meth is likely the most dangerous drug.
Although crystal meth is not nearly as likely to cause an overdose compared to fentanyl, and the physical withdrawal symptoms are mild in comparison, crystal meth is the most psychologically dangerous drug in widespread use.
Crystal meth is probably the drug that is most likely to destroy your life in the shortest amount of time. Although users are more likely to stay alive, compared to opioids, many people describe it as feeling like they are dead, while still being alive.
This drug has the potential to cause rapid mental and physical deterioration, turning someone into a shell of their former selves.
So why is crystal meth so dangerous?
Crystal meth provides a dopamine spike more powerful than any other drug. This initially makes a person feel invincible, seducing them into centering their life around the drug, leading to extreme paranoia, hallucinations, and an inability to function in day-to-day life.
In order to understand why crystal meth is so dangerous from a first-hand perspective, I interviewed a fellow recovery advocate named Launa. Her experience using crystal meth powerfully illustrates why this drug is so destructive.
Here’s Launa’s story of addiction to crystal meth, in her own words.
Crystal Meth Is Psychologically Dangerous
From the first day, I smoked meth, I never went without it until the day I quit.
When I was using crack, there were days to weeks in between where I just took pills instead, but when I started using meth, it consumed my thoughts and I was just focused on getting more before it was gone. There were very few days that I didn’t have it, and nothing else appeased me.
I’m grateful that during my time using drugs, the fentanyl wasn’t popular, to my knowledge. Meth is harder to overdose on compared to other drugs, but I feel it is probably the worst drug I have done for my own safety because of the lost days and focus on things.
Crystal Meth Is Powerfully Seductive
When I first smoked meth, I felt on top of the world. I instantly labeled it my best friend and knew I would never go without it. I felt like everything in the world made sense. All my senses were enhanced. I felt smarter, like colors were brighter, and sounds were clearer.
As crazy as it sounds, I felt prettier, and I liked the person who looked me back in the mirror—in the beginning. Every other drug I did was on a different level, and I never felt any other drug was my best friend.
The world seemed like a greater place like a fog was lifted off my eyes, and all was beautiful. I had more energy and wanted to go out and do things, whereas other drugs had me wanting to hide and not be seen.
In the beginning, I was able to maintain all my responsibilities as a single mom. I would be on the go, cleaning, cooking, dropping my daughter off at daycare, taking her out to parks, walking everywhere, and reading her books.
I attended playdates and was full of energy. I enjoyed reading on many different subjects and felt that I was gaining much knowledge. I could sit and be completely focused on the topic of interest, often reading completely through the night and was able to be awake for my daughter when she awoke.
I would help people with their yard work or house cleaning and began cooking many different foods from different countries. It felt as though I could do everything everyone wanted me to do, fulfill all my obligations, as well as have the energy to do everything I wanted to do.
The lure of this short-lived top-of-the-world experience was insane, and I still feel it to this day.
The Downward Spiral of Crystal Meth
Sadly, this top-of-the-world phase was short-lived a couple months max. My activities soon became much more self-focused but it happened in such a way that I didn’t even realize it was happening.
I still maintained taking my child to her activities; however, when she was in school, I would try and force myself to sleep, and I couldn’t because I was high, and I became nervous people knew. I spent hours trying to make myself sleep or showering trying to not look high.
All the positives quickly became very negative high anxiety, total dependency, hearing voices. I would hide on myself in the closet and actually argue with myself.
It was a very steady progression into a living hell.
I would become paranoid people knew, but when my children’s aid worker would come by and didn’t notice, I felt no one knew and would actually begin conversing with myself from both sides.
In the moment, I didn’t realize that I was so crazy. I’m so grateful nothing horrible happened to my child at that time. I would drive her in the car to activities and didn’t realize at the time that it was unsafe. After I had given my daughter to a kin program, I began smoking an obscene amount and became completely different.
At one point, when I was on meth, I stopped paying bills and became homeless. It was like I didn’t even care.
Losing Track Of Time On Crystal Meth
I would spend hours that were lost, unaware of what I was doing. Sometimes I thought I had fallen asleep, only later to hear that I was literally standing by a tree, arguing with a squirrel who had stolen my pants, and well… there were no squirrels.
I found there were many time-lapses like this.
I would sit in front of a mirror and used knives to get out blackheads that I thought I saw, and hours later, I would still be doing it. I didn’t realize I had been doing it for that long, and in the end, I would have peeled off layers of skin.
I would also pick at an ingrown toenail until I had nothing but a nub of the nail left, causing a great deal of infection.
It’s horrible—the time-lapse and total deep focus on an activity that is quite destructive.
I fell out of any form of reality and didn’t realize that it had happened. With my daughter around, I was semi-coherent, but now that was gone, and I didn’t function in any realm of normalcy at all.
I would set out to clean, pulling apart everything and not seeming to comprehend how to get it back together.
This is where all the alter egos came in. I felt that I was three people in my brain. I had one that was fearless, wanting to drive fast, and do crazy things. We’d laugh and laugh. I also had the boss personality who was very mean, and I was always fearful it would come out. I felt like I was afraid of myself and this personality that wanted to hurt me and wanted me to hurt people.
The Sexual Allure of Crystal Meth
There was another alter personality that was childlike. As much as it was childlike, it seemed to act out inappropriate sexual activities that were done to me as a child. I wanted to reenact the traumas of my life.
I would lose hours in masturbation and would have hours-long sexual exploits with the guy I was with, and we reenacted the traumas.
In the moment, you don’t feel the time or intensity of the activity. I do know I was often frustrated that I was not reaching the ecstasy I was seeking when my partner was complete, and I would carry on until I felt complete.
The man I was with was clearly also using the drug and desired to help me reach my level of desired satisfaction with similar intensity and focused on that one outcome.
I can’t recall the exact number of hours it took; however, I recall watching the sun come up many times.
We also became crazy about having sexual experiences in public places. At night, we would smoke, have sex in parks, and in a car downtown Toronto.
Recovery From Crystal Meth Is Possible
I didn’t want my daughters to have my legacy of a dead mom because of her addictions.
I knew I was dying, and I had a 3-year-old. I figured the only way I could help her NOT be like me was to stop. I didn’t think I could stop, and I didn’t think anything could work since I thought I was too far gone.
I decided to try stopping one last time.
Several treatment centers turned me away, but Windsor Life Centre actually gave me a chance. I graduated from their 12-month treatment program and am now four years clean. I am now working full-time within this treatment centre, helping others like myself.
I want them to know there is a person inside that craziness they see. Also, no matter how bad things get, there is always a way out.
I started drugs at 8, taking my mom’s prescription painkillers. By 14, I was on cocaine. At 21, I went back to painkillers. At 35, I was on crack, and I got into Heroin at 40.
I started doing meth at 43, and this whole crazy downward spiral only took a year and a bit. Although it ruined my life fast, it actually quickened my recovery.
I was drugging my whole life, through pregnancies, college, and great jobs. Until I Started smoking meth, I never really felt despair. Before starting meth, I had been to prison, and it didn’t affect me like the depth of self-hatred and the demonic realm I felt with meth. I was never afraid of death, but I felt dead for the first time on meth.
Yet, if any drug was to suck me back in, meth would be it. That is the messed up thing. As much as I know the craziness, I can still remember the on top of the world feeling it first gave.
I won’t go back because I am way too stubborn, but sometimes the mind wants to remember and glorify that small window of time in the beginning.
Adjusting To Life After Crystal Meth
Sobriety is not exciting like drug life. I don’t have to live in constant high alert. I’m not chasing after a high or experiencing the thrill of the adrenaline rush of getting caught.
But now, I get to experience love and true joys. I find my own happiness, and I can look into my children’s eyes and love what I see looking back at me.
I laugh now and feel things that aren’t just negative feelings. I do miss the rush and the craziness at times, but I am experiencing many new and wonderful things now. I still love speed now, I just get it in a go-cart or as a passenger in a car.
It is hard to not live in chaos when that is all you have ever known. The excitement is definitely a hard thing to let go of. You just have to find within yourself ways to find the joys and embrace the change. Life is not meant to be a heartbeat away from a heart attack, and constant chaos, and turmoil.
My best comparison for someone who has never used drugs would be the COVID-19 lockdown. You go from the hustle and bustle to nothing. It’s quiet days at home, no traffic, no hustle, no bustle, and no excitement… just quiet.
You can sit in the quietness and feel sorry for yourself, or you can paint the house, learn to cook, and find enjoyment.
I love to tell women who feel hopeless that there is hope. Life is now what I make of it, and I don’t have to hate myself anymore.
If you want to reach out, you can connect with me on Instagram here, or on Facebook here.
by Steve Rose | May 13, 2020 | Addiction and Recovery
On the go? Listen to the audio version of the article here:
In my previous article, What Does Addiction Feel Like, I shared Stephanie’s experience of addiction. Here, I want to share her story of recovery.
Her recovery was a six-year process. She spent two years continuing to use substances off and on, three years with an opioid substitute, and she will be one year off of the substitute in August.
I share her story of recovery to show that despite the extreme lows she faced, recovery is possible. See the previous article for more perspective on the depth of pain she encountered while trapped in addiction.
If you know someone struggling to recover from an addiction, I hope this article will help you better understand what they are going through and how to be supportive.
If you are struggling with an addiction, I hope this article helps you feel like you are not alone and recovery is possible.
Here is Stephanie’s story of addiction and recovery, in her own words.
Recovery Starts Before You Stop Using
You don’t just wake up and stop using.
Recovery starts before you actually get clean. It was the biggest mind war I ever went through. You know what your doing is hurting you but can’t stop. It’s like watching a bad movie you are the star of.
I was getting tired of chasing money and pills just to feel normal.
I started thinking about recovery when I had gotten an abscess and had to carry around a machine for five days. The whole time I was lying and telling everyone it was a spider bite.
You want to be clean but you’re not sure how or what that looks like. It takes planning and finding the right supports while still using.
I woke up for months saying, “today I will not use,” and be using by noon.
Recovery requires taking a leap of faith and reaching out for support, but not expecting perfection the first time. I would often miss counseling appointments because the dopeman showed up first. I then had the excuse that I couldn’t go to the appointment high because they would know I was using.
A Turning Point
Despite my using, I still cared about my kids and didn’t want my using to be the thing that took me away from them.
My oldest told me his biggest fear was Childen’s Aid Society coming in and taking them away. That hurt. He told me this while we were playing a board game called Nightmare where you have to share your biggest fear. I had to hold it together for the rest of the game.
It didn’t make me quit, but it made me work harder to hide my addiction.
What really pushed me over the edge was a story I saw on Facebook about a mother who overdosed in her home alone with her baby and the baby died of starvation. I had a toddler at the time, and all I could picture was him trying to wake me up and me not responding. I went to Dr. Farago the next day.
Recovery took a very intricate plan involving lots of pieces.
Having to Sever Destructive Social Ties
I had to cut my ex out in order for my recovery to work.
While I was living with my ex, he was in active addiction as well, so there was no chance I could stop with him there. He was my biggest trigger and would regularly bring drugs home. Three weeks after I got on suboxone, I had to use his addiction against him with the help of Childen’s Aid Society.
He then went on a meth bender, and I had grounds to put a protection order on him. That forced him to move out. Mind you, he is still homeless and using, so it took me a year and a half to get over the guilt. I still feel it sometimes.
He was broken, and I loved him. I felt like I was putting a baby out in the street in the cold and rain. I knew I was the only thing holding him together and that losing me would make it worse. But I also told him that if it came down to it and I had to choose between him or the kids, they would win.
I dropped a lot of friends that still used. My best friend used cocaine, and I had to distance from her, too.
No one ever wants to be alone, but the first bit of recovery is just that. It about tearing down the social network and rebuilding it with people that aren’t involved in that life
Adjusting to Social Life Outside Addiction
In addiction, your friends are the people you buy from and use with. You feel isolated from the normies. In recovery, you are trying to enter the normie world and be a part of that, but it is tough because you been in the underbelly for so long.
I couldn’t hold eye contact or a normal combo with someone when I first got into recovery. I felt awkward all the time, so I just muddled through it.
I had a really good counselor at House of Sophrosyne that really understood all of this, so she walked me through it. The social skills came when I started volunteering with the AIDS Committee of Windsor. I entered their peer program and attended their training series on active listening, public speaking, conflict resolution, and storytelling. These helped me to be able to speak about my experience and communicate effectively in other areas of my life.
They helped me build confidence. I’m still rough around the edges sometimes. The addiction world took away my ability to sugar coat things and gave me a very different perspective on the world I live in.
Dealing With Stigma
After finding out about my drug use, my family doctor treated me differently. He stopped taking me seriously, or at least that’s how I felt.
I had gone to several counselors at CMHA that had no knowledge of drugs and I found myself teaching drug 101 to them.
My family members would ask “how that drug thing was going” at family get-togethers, as well as monitor my drinking at these events. I was never an alcoholic but a social drinker.
Later on, in my working life, I was talking to a woman about the stigmatizing language she was using. When I told her I was in recovery, she instantly shut the conversation down and told my boss I had threatened to come to her home—none of which I said, and thank god my boss knew that. She was trying to get me fired from my job as an outreach worker.
Every time I posted on Facebook about my recovery, there would always be at least one person who made a stigmatizing comment or remark.
I have been told that “once a junkie always a junkie,” and have been called “junkie: more times then I’d like to say. A lot of people treated me like I was about to go off the deep end at any given second.
My dentist was the worst. She gave me shit because of the damage to my teeth and how much money my parents spent to get me braces and such. When I told her I couldn’t afford to fix them properly, she said I need to better manage my money and take care of my teeth. I changed dentists and have an awesome one now.
Generally, I was treated like I would relapse at any given second, so why have faith in me and try to build me up. I had to stop taking all that in and focus on the people that supported me, instead.
It’s taken years to get past all that and learn to navigate those that still have a stigmatizing opinion of me.
Finding Helpful Social Supports
I’m thankful for the friends and family that understood and still treated me like me. My mom knew nothing about addiction but has learned and listened to me and tried hard to understand.
My counselor at House of Sophrosyne didn’t require me to teach her, and she explained some of the stuff I was going through that I didn’t understand. She helped me find my worth and made me realize that relapse was not a failure but only a setback.
My addictions Doctor treated me like a person and emphasized that relapse is not a failure but a mental setback. He helped with other medical issues I was having as well but didn’t make my addiction a determining factor in my care. He gave me control over my program and let me do things when I was ready.
My counselor also met me where I was at and didn’t condemn me if I wasn’t ready to move to the next step. They both encouraged me to speak about my experience and helped me find the qualities that I didn’t know I had. They helped me educate my family so they could be a part of my support system rather than a hindrance.
I am super thankful to them today and still speak with both from time to time if I am having a hard time. Triggers still happen and sometimes I still want to use, but they help me to navigate that.
My counselor is the reason I want to become a counselor.
I also had some very supportive friends. My anxiety got really bad in those first months and my friends put up with me not going to birthday parties and Christmas parties because I couldn’t handle crowds. They understood and didn’t push me.
All of the supportive people in my recovery understood and met me where I was at. Those two things are the greatest things you can do for someone in recovery.
Learning New Coping Skills
Throughout recovery, I learned to navigate the feelings I was using substances to control.
I learned to not take everything personally. My counselor taught me I deserve a good life and that my past doesn’t define my future, but empowers it.
But most of all, I learned self-worth. They helped me see I was worth more than a life of drugs. That was a real turning point. Learning self-talk was helpful for this. At one point I would get up, look in the mirror, and just tell myself I was worth it.
Mindfulness was also helpful, but a bit harder for me since my mind doesn’t stop talking. The radio was my enemy at one point. I love music, but every song was linked to some memory of my ex, my substance use, or both. I would hear a song in Walmart and have to fight back tears. In some cases, I had to walk out.
I was able to “untrigger” some songs and items that used to trigger me by exposing myself to them in a safe situation. I started playing those songs while in a safe place with the support of my husband nearby and was able to change the memory attached to the stimulus. I’m still working on that but I have my radio back for the most part.
Breathing is also huge. When I get anxious I forget to breathe. Taking a minute to do that has greatly helped me process difficult feelings.
Learning to see the positive work I’m doing and not nitpick it apart is another challenge I’m working on.
Healing Family Wounds
I grew up in a home where being pushed to do better was how you were raised. I would get an A on a test and be asked why it wasn’t an A+. I felt like I was always just behind the ball and I lost motivation to try.
Once I was on my own, I struggled with housing stability and was always behind on my bills. This led me to believe I wouldn’t be able to handle life. The kids just blew that up for me because if I couldn’t take care of myself, how was I going to take care of these little people who relied on me for everything.
When using, all those thoughts stopped for a few minutes.
I’m lucky I have amazing kids, and today we are good, but in the beginning, my older three didn’t trust me. I had let so much bad go on around them. They had food, basic needs, love, and support, but the opiates damaged a lot. I couldn’t erase what they saw.
They never saw the drug use, but saw the people that came to our house and they saw us high. A program through House of Sophrosyne called “Mothers in Mind” helped me rebuild the relationship with them and earn back that trust as well as be able to talk to them about what they saw or felt.
My youngest was the worst off. When he was born it was probably the most chaotic time. I was using crack and was able to quit for eight months during the pregnancy, but in the last month, I relapsed. During that last month, I regularly used crack and occasionally used opiates. I even googled to find out what would happen to the baby if I used.
The ex was still using and bringing it home. I watched him use for eight months. I think I did pretty good going eight months at the time, since it was in front of me every day. A big part of my use was the thought, “if you can’t beat them join them.”
The day I had delivered him, I was using crack when I went into labor. This isn’t something I usually talk about.
During the pregnancy, I wasn’t connected to him like the others. He was “a thing” growing inside me. I didn’t want a baby at the time, but abortion was not an option. A program at Hiatus House specifically made for trauma damaged connections with babies helped me find that connection with him. He was about 2 when we went and now you would never know there was an issue.
Throughout this time, I wanted to stop, but couldn’t. I was in contemplation, trying to find ways to stop without having to get rid of the ex. I eventually stopped using crack, but relapsed and got hooked on opiates for two more years.
Relapse is a Normal Part of Recovery
In the beginning, I relapsed a lot, mostly with coke because the suboxone kept me off the opiates. Two years in, I went to a place I knew would have coke, thinking I could control it, but I couldn’t. I tried that experiment again three years into my recovery and had the same result.
I now know that certain places in the city are off-limits to me. Just because I’m in recovery doesn’t mean I can completely control my use. I’m always going to have that tendency to use. I have learned not to play with fire, so to speak. I stay away from people places and things that can trigger me and put me at risk
At my current job as a harm-reduction worker/peer engagement coordinator, I’m not tempted to use since I’m not around the actual drugs. I’m around paraphernalia. It can cause me to have fleeting thoughts about use, but I’m able to mentally squash the trigger by telling myself what happens if I relapse. It would be very different if I had a bag of coke and a needle.
What keeps me from relapsing is my children, my husband, and memories of what using did to me and the person I became.
My children are the biggest part though. I put them through enough already and I want to be the mom they need me to be. I can’t do that if I am using and I will lose them. I don’t have another stint in me. The next relapse will kill me. I’ll lose everything I have worked so hard for and I’ll have nothing left.
Becoming a Whole Person
During my substance use, I was a no one. I was just another substance user. Today, I’m a person.
Many people describe recovery as boring in comparison to using, but I love the boredom. I love the quiet. I don’t miss the drama. Sometimes I miss the party, but I don’t miss what comes with it.
I am happier today because every day something shows me I am worth being clean and that I have purpose like this.
I combat the boredom with things I never had in active use, such as friends, family, and my advocacy work. I am able to help people in a way that someone without my experience can’t. I have had some great experiences in recovery that showed me my voice was worth being heard.
Without being a counselor, I have helped others find recovery by telling them my story and letting them know they are not alone.
If you want to reach out, you can contact me on my personal Facebook page here.
by Steve Rose | May 6, 2020 | Addiction and Recovery
On the go? Listen to the audio version of the article here:
Many people who haven’t experienced an addiction may wonder what addiction feels like. Also, if you are going through an addiction, you may wonder if you’re the only one feeling this way.
This article dives deep into the experience of addiction.
As a qualitative researcher and addiction counselor, my goal here is to help shed light on the experiences of persons suffering from this often stigmatized issue.
So what does addiction feel like?
Addiction feels like a chaotic loss of control, a sense of being worthless, hopeless, isolated, and lost, all while having an intense craving, and only feeling fleeting pleasure.
To help understand this feeling in more depth, I interviewed a fellow addiction advocate who is in recovery from an addiction to several substances. Her name is Stephanie, and she has given permission to use her identity here.
Although everyone experiences addiction differently, I believe her experience resonates with some universal features of addiction.
The Loss of Control
The loss of control is a universal feature of addiction. As Stephanie states:
The biggest thing I feel people don’t understand is the lack of control. They think we start and can stop at will. It’s not like that.
Telling someone to just stop their addiction is almost like telling someone to just stand up and get over a broken leg. Addiction takes away someone’s normal level of control over their lives, making them feel powerless. Stephanie describes this experience in the following metaphor:
Addiction feels like a war in your head. You know what your doing is hurting you but can’t stop. It’s like watching a bad movie you are the star of. You want to yell “stop” at the screen, but it does no good. It’s watching everything around you fall apart because of a simple action you can’t stop. It makes you hate yourself and the person you’ve become. You watch yourself do things you would never normally do and your mind justifies them for you.
Addiction has been historically moralized, and persons with addictions have been stigmatized by being viewed as merely making selfish decisions. As Stephanie states:
People think we want to be selfish and that we are only thinking of ourselves and not our families or children. We are thinking about them, but addiction has us think they are better off without us. We are worthless and wastes because we don’t have the will power society says we should. This is never a choice. It’s a maze or a trap we get stuck in, and we can only get out of it with love and support.
Stigma only serves to further isolate persons suffering from addiction, deepening the sense of self-loathing.
Isolation and Self-loathing
As described in my article on The Impact of Isolation on Addiction, isolation and addiction go hand-in-hand. Isolation causes addiction, and addiction causes isolation. As Stephanie describes:
We isolate because no one understands and thinks we are being selfish… addiction to me is being lost. Not knowing which way is up.
The experience of isolation is combined with the shame of self-loathing. She goes on to state:
When I was using, I didn’t want anyone to know because I couldn’t handle any more people’s hate. I hated myself enough already. The loneliness made me have time to think and the more time I had to think the more I wanted to use because all my thoughts were about using or the horrible person I had become while using.
Using substances becomes a way to cope with this downward spiral of isolation and self-loathing.
A Need-hate Relationship
As described in another article on how addiction feels, the need-hate relationship is a common feature of addiction. Stephanie shares a similar experience, stating:
There were many times while I was using, I would try to stop, but I would still make the call, and pick up to use. I would bawl my eyes out because I didn’t want to be using, and I knew it was hurting everyone around me but couldn’t stop. I hated myself for not having enough strength to stop. I hated the substance for what it did to me but still treated it like a friend.
Throughout her addiction, this internal battle played out like an out-of-body experience. She watched herself go through the motions, tortured by her inability to stop.
Fleeting Pleasure
As described in my article on The Most Neglected Aspect of Addiction Recovery, addiction is about much more than mere pleasure. Stephanie describes the role of pleasure in the following words:
The pleasure is actually short-lived. It happens when we use but only lasts a few minutes. We feel the warm hug or the rush the substance gives us, but 5 mins later, we feel nothing except the need/ want for another dose. We feel the self-hate, and that compels us to find the next dose to make that go away.
Addiction is more about escaping pain than enjoying pleasure. Persons with addiction are using the substance as a way to avoid short-term pain, but this comes at a long-term cost.
Although pleasure is a small part of the bigger picture, addiction still causes intense craving.
Intense Craving
Stephanie describes it as the following:
A craving is a thought that gnaws at your brain and won’t go away. It doesn’t let you sleep, you cant think about anything else, you go over every scenario in your head on how to get your next fix. It is like wanting to crawl out of your skin. Like sitting in a bathtub filled with red ants.
In everyday life, we often hear people say things like, “I’m really craving ice cream.” So I asked Stephanie how she would compare addictive cravings to your average sugar craving:
I get cravings for sugar now because of the opiates but its nothing like the cravings I got with opiates or coke. It’s like the craving takes over your whole person! Sugar is a hankering in comparison.
If you’ve ever felt powerless when faced with desserts, consider this feeling amplified to the level of addiction. This helps put the experience of control in perspective.
How Different Substances Feel
Since addiction is primarily focused on coping with mental pain, how do different substances affect this experience?
First, let’s consider stimulates. These include drugs like cocaine, amphetamines, and crystal-meth. As Stephanie states:
Stimulants make you feel ten feet tall and bulletproof. Nothing can be wrong cus you can take on the world and win.
Many people describe stimulants in these terms, crystal-meth being the most potent of the group. Despite the physical disintegration, users of this drug report feeling supremely self-confident in their appearance while using it.
Next, let’s consider the experience of depressants. These include substances like alcohol and benzodiazepines like Xanax. Stephanie states:
Depressants just numb you and all thought. You’re too messed up to think about all the issues around you.
This is why so many people use alcohol to relax, unwind, and “get out of their head.” This lack of care an impaired judgment is also what makes depressants so lethal while operating motor vehicles.
Lastly, let’s consider the experience of opiates. These include substances like heroin, oxycodone, and fentanyl. Stephanie states:
But opiates… opiates is the warm hug. The blanket that makes you feel safe and stops the pain in your chest. It helps stop your mind from feeling over and over again what’s wrong with you.
These substances are designed to mask physical pain, but they are also able to mask emotional pain, leading to this feeling of warmth.
It should be noted that these descriptions are not meant to glamorize the substances. These short-term benefits are fleeting, leading to far more severe costs in the long run.
Overall, the type of substance doesn’t necessarily matter as much as their ability to temporarily make the mental pain go away. Stephanie states:
I would have snorted drain cleaner at the time if you told me the pain would go away.
Conclusion
Addiction feels like chaos. It is an inability to control your life, leading to a sense of self-loathing, hopelessness, isolation, and being lost.
A person becomes trapped in a need-hate relationship with a substance or behavior that is having increasingly destructive consequences on every area of their life.
Despite the fleeting pleasure, addiction is mostly about escaping mental pain. Although each substance has a unique way of masking pain, they are all used as forms of short-term coping at a long-term cost.
Recovery requires community, connection, and the courage to reach out. Stephanie states:
The only time we can start to go up is when we ask for help. We can’t do it alone, and every failure we have when we try on our own makes it worse.
Stigma leads to shame and segregation. As Stephanie states:
When you see someone that is using, and your brain wants to think those horrible things about them, ask yourself what happened to them to make them use. What pain are they trapped in, trying to get out? And something as simple as a smile can mean the world to someone living in that dark place.
If you want to reach out to Stephanie, you can contact her on her personal Facebook page here.
Stephanie also works with a local anti-stigma campaign called Label Me Person.
All views expressed are hers and are not intended to represent any organization she is associated with.
by Steve Rose | May 4, 2020 | Addiction and Recovery
On the go? Listen to the audio version of the article here:
If you’re working in the helping professions like social work, addiction counseling, or the medical field, you’ve likely come across motivational interviewing and wondered how it works. If you’re not familiar, motivational interviewing is a collaborative counseling style, designed to evoke a person’s motivation for change.
Several studies confirm the efficacy of motivational interviewing, but many practitioners find it challenging to apply this technique and don’t understand how it works. Unlike cognitive-behavioral therapy, motivational interviewing appears much more passive.
On the surface, motivational interviewing is mostly invisible, yet it can powerfully facilitate change. Although motivational interviewing works, understanding how it works is just as important. It is not merely a set of techniques. Instead, it is a way of being with a client that facilitates change.
So how does motivational interviewing work?
Motivational interviewing works by supporting a client’s sense of intrinsic motivation, self-efficacy, and a sense of empathic connection to the counselor. Each of these factors leads to increased motivation to change.
Let’s take a look at each of these areas to understand more fully how motivational interviewing works.
Motivational Interviewing Builds Intrinsic Motivation
As described in my article on What Causes People to Change, intrinsic motivation is a leading cause of long term sustainable change.
Intrinsic motivation is the internal desire to make a change as opposed to extrinsic motivation, where external pressures or rewards cause change.
An example of intrinsic motivation would be having a deep enjoyment of playing a musical instrument. You feel drawn to practicing and enjoy the process.
If someone were to start paying you to practice (extrinsic motivation), then had authority over how and when you practiced, it could take away your intrinsic motivation, leading to less desire to practice in the long-term.
Motivational interviewing is designed to facilitate intrinsic motivation. Let’s take a closer look at how it does this.
Collaboration Rather Than Confrontation
Motivational interviewing emphasizes collaboration because it works. Collaboration works because it helps build intrinsic motivation.
Consider the classic example of your medical doctor telling you that you’ll need to lose weight. How many people can attribute significant life changes to this type of advice? This approach is not collaborative since it is advice from authority.
The medical field generally operates from the model of expert authority, giving direction to a passive patient. Expert advice and threats of health consequences are a form of extrinsic motivation, which is unsustainable in the long-term.
Motivational interviewing emphasizes approaching clients from a collaborative perspective, encouraging them to be active participants in their treatment plan, not merely a passive recipient.
Open-ended Questions
Open-ended questions are powerful tools for facilitating collaboration. These consist of questions that can’t be simply answered with “yes” or “no.”
Most open-ended questions generally start with the word “what.” For example, “what is the issue you want to discuss?”
These types of questions facilitate collaboration by putting the other person in an active position. Their participation is encouraged by the need to further elaborate their reasons for seeking treatment, what they want out of the working relationship, and what they’ve been trying so far that hasn’t been working.
Developing Discrepancy
This technique works to build intrinsic motivation by highlighting the gap between someone’s actions and their values.
As you ask someone what they want and what they’ve been doing up to this point, a gap between their actions and values might emerge. For example, someone might value community, yet they are self-isolating due to fear of social rejection.
Collaboratively pointing out this gap might consist of asking a series of open-ended questions about what they value and what they are doing, then simply reflecting back, “…on one hand you value community, but on the other, it looks like something is stopping you from socially engaging.”
Gently bringing someone’s attention to the gap between their actions and their values builds intrinsic motivation since it is highlighting their own values rather than externally imposed values.
Motivational Interviewing Builds Self-efficacy
Self-efficacy is the perception of one’s abilities to effectively handle a situation or overcome an obstacle.
Research on self-efficacy demonstrates the critical role it plays in motivation. Persons with high self-efficacy are more likely to maintain high motivation for goal attainment, especially when these goals are self-directed.
Motivational interviewing works by facilitating high self-efficacy. It does this through supporting client autonomy, encouraging “change talk,” and through a collaborative approach to treatment planning.
Supporting Autonomy
Supporting autonomy means maintaining the independence of the client. Rather than taking control, directing the conversation, and doing things for a client, supporting their autonomy means keeping them in control.
Although it may be tempting to take control and start doing things for someone, this takes away their sense of control and accomplishment.
When someone accumulates small wins over time, they begin to gain a sense of self-efficacy. This increasing sense of competence builds confidence in one’s abilities to effectively cope with future challenges.
Facilitating Change Talk
Change talk can be defined as positive statements about change. The amount of change talk by a client generally predicts the likelihood of change.
The opposite of change talk is sustain talk. These are negative statements about change and language focused on being stuck.
Motivational interviewing works by amplifying the amount of change talk through focusing on these positive areas of competence and hope, rather than unnecessarily staying focused on what is not working. This is how evoking change talk builds self-efficacy.
Collaborative planning
Collaborative planning means being like a travel agent. This means working with the person to find out where they want to go and how they want to get there.
Travel agents work with you in a partnership rather than merely telling you where to go. Also, once you’re on the trip, the travel agent can be consulted, but it is not their job to go with you and carry your luggage.
A collaborative approach to treatment planning works by building self-efficacy. Making progress on a plan you create for yourself builds confidence in your ability to set goals and follow through.
Motivational Interviewing Builds Empathic Connection
Empathy involves deeply listening, showing an understanding of the other person’s perspective. Beyond sympathy, empathy requires fully being with the client and holding space for whatever they need to discuss.
The therapeutic relationship is one of the most important aspects of counseling, and empathy is fundamental to a strong therapeutic relationship.
Accepting Clients Where They Are
Acceptance is a core foundation of motivational interviewing. It means accepting a person where they are, recognizing their worth as a human being. We may not like every characteristic or behavior, but acceptance goes beyond these things.
Acceptance requires seeing a person’s common humanity, recognizing there are likely many reasons why they are in their current position.
Acceptance does not mean accepting bad behavior. Instead, it means treating someone with dignity while setting boundaries if lines are crossed.
Acceptance works to build an empathic connection since it allows you to see past surface characteristics so you can see the whole person in front of you.
Rolling with Resistance
Rolling with resistance works to build empathy, increasing the likelihood of change.
Rolling with resistance is like verbal judo. It means rolling with confrontational momentum rather than trying to stop the momentum through counter-confrontation. This means avoiding direct confrontation through argumentation.
If you think someone is wrong about something, does direct confrontation simply change their mind? If this approach worked, it would save the world many Facebook flame battles and frustrating political conversations over the holidays.
So how do you roll with resistance? When you feel like arguing with someone, hold back and keep listening… then listen some more. As Stephen Covey said, “Seek first to understand, then to be understood.”
How do you listen effectively, beyond merely not talking? The answer is reflective listening, one of the most important parts of motivational interviewing.
Reflective Listening
Reflective listening makes up the largest part of motivational interviewing and generally comprises around 75% of counselor responses.
Reflective listening works by building empathy, showing you understand, rather than simply telling someone you understand.
The most powerful form of reflection is the “complex reflection.” This consists of continuing the other person’s sentences or paragraphs by guessing what they mean. The key to this technique is that the dialogue should flow as if it were a single person speaking.
Example:
Client: “When I come to the casino, I find it difficult to control my spending.”
You: “the games are so engaging, and you lose track of time.”
Client: “yeah, and the other day I was here for six hours, and it only felt like one!”
You: “and before you know it, you’re spending a lot more money than you planned.”
Reflective listening is also a vital tool for rolling with resistance, collaborative planning, supporting client autonomy, and facilitating further change talk.
Conclusion
Motivational interviewing works because it uses various techniques and relational approaches that maximize intrinsic motivation, self-efficacy, and a sense of empathic connection. Each of these areas is associated with increased motivation for change.
If you are interested in further exploring how to use motivational interviewing, the British Medical Journal has a great free online course that gives practical video examples.
Hopefully, this article helped lay a foundation for understanding how motivational interviewing works and why it is an essential tool for conversations about change.
by Steve Rose | May 2, 2020 | Addiction and Recovery
On the go? Listen to the audio version of the article here:
As an addiction counselor, I’ve spent quite a bit of time looking at what causes people to change. Although relapse is a normal part of recovery, most people can find long term stability. Many people can make long term changes, but there is still a significant number who do not make these changes.
Digging into the research on what causes people to change, in addition to years of observing human behavior, I’ve come to an understanding of the motivations leading to change. Hopefully, this general theory of change will be helpful if you are trying to make sense of someone’s behavior.
So what causes people to change?
People change when motivated by a sense of independence, a sense of competence, and a sense of connection to others. These motivations can be sparked in moments of extreme frustration when a person realizes their current approach is no longer working.
This answer is based on the empirically derived self-determination theory. This theory explains intrinsic motivation, meaning people change based on internal forces. Although people can be forced to change through external forces, these changes are not sustainable and don’t often result in real long-term change.
Can People Change?
The simple answer is yes.
Research shows 40% – 60% of individuals in recovery from addictions will relapse. Although relapse is a normal part of recovery, most people can find long term recovery, even after several relapses.
People can change for the better, and people can change for the worse.
The idea that someone has a fixed set of personality traits that determines their behavior is a myth. Personality traits are generally considered to be relatively fixed, but they do not determine behavior.
Personality traits only increase the chances of certain types of behavior. For example, someone who is high in novelty-seeking may be more likely to travel, but it does not mean they will become an avid traveler.
The idea of an “addictive personality” is also largely a myth. Although there are certain personality traits often associated with addiction, there is no standard definition of an addictive personality in the literature.
Even if certain traits can be associated with addiction, they do not mean the person is destined to develop an addiction.
Therefore, people can always change. No set of personality traits or past behaviors completely determine how someone will behave in the future.
What Causes People to Change for the Better?
People often change for the better when they encounter a great deal of pain or frustration and realize the way they are behaving is not working.
In the case of addiction, this is often referred to as hitting rock bottom. Though everyone’s rock bottom looks different. One person may need to experience years of hardship before deciding to change, whereas others may only need to experience a single painful event.
When someone develops the humility to admit that their current behavior is not working, they are at a turning point where it is now possible to make the required changes.
The motivation to pursue a new direction comes from a sense of independence, a sense of competence, and a sense of connectedness to others.
As described in self-determination theory, a sense of independence means the person is making the decision to change for themselves, not due to external forces. This is also referred to as intrinsic motivation and is one of the major factors predicting long-term change.
External pressures, otherwise known as extrinsic motivation, can assist in the short-term, but the person eventually needs to develop their own internal desire before long-term change is possible.
Another major factor leading to change is a sense of competence. A person gains motivation by seeing the rewards of their efforts. Accumulating small wins kindles the desire to continue efforts to change. Building a sense of competence develops hope that change is possible.
Lastly, change is motivated by a sense of meaningful connection to others. In the case of addiction, many people join support groups, seek the support of family, or find support in a counseling relationship. Human beings are social creatures who thrive in supportive social contexts and deeply suffer in isolation.
To read more about this phenomenon, check out my article, The Impact of Isolation on Addiction.
How Do You Help Someone Change?
There is nothing you can do to make someone change, but there are several things you can do to increase the odds of someone changing.
Before helping someone change, it is important to have firm personal boundaries. We might be tempted to overextend out support to people who are not ready to change or who are merely taking advantage of our help.
When talking to someone about change, the first step is to listen. Listening builds a sense of engagement and trust, allowing you to understand where the person is coming from, in addition to understanding the underlying reasons for their behavior.
Seeking your own support is also important when helping someone change, especially if their behavior directly impacts you. Spouses of persons with addictions may participate in support groups like Al-anon, seek the support of friends or extended family, and even seek the support of a professional counselor.
If you are interested in an in-depth look at how to help someone change, you can check out my comprehensive article on the topic: The Ultimate Guide to Helping Someone Change.
In that article, I go into a great deal of detail on effective communication and interpersonal techniques, accompanied by personal examples.
Conclusion
People change when they come to a place of deep frustration and pain. When they develop the humility to admit their current approach is not working, they are ready to take the first steps to change.
Long-term change is motivated by intrinsic motivation. External forces can spark initial short-term change but is not sustainable in the long-term. Long-term change ultimately depends on a person developing their own internal reasons for change.
As change occurs, motivation is built through small wins and accomplishments, building a sense of competence and hope that change is possible.
Lastly, a sense of social connection supports long-term change.
If you or someone you know is thinking about change, just know that change is always possible. If you are suffering from an addiction, it is important to remember that relapse is a normal part of recovery.
Turning back toward your internal values and motivations requires a simple decision. Although it is simple, it is not easy.
