ADDICTION VERSUS SELF-CONTROL ......... Ch. 10
Chapter 10
MAINTAIN SELF-CONTROL
AGAINST ADDICTION
Outline of the Chapter
Session 10-1 AN OVERVIEW OF ADDICTION
Living with more self-control
Use-habituation-abuse-addiction
The current addiction model (Stanton Peele)
Session 10-2 MULTIPLE FORCES CREATING ADDICTION
1. The ego's Little Professor (Pleasure principle)
2. Desire for pleasureful catecholamines
3. Need for pain killing endorphins
4. Social pressure
5. Genetics/biology
6. Psychological need
7. Low self-esteem
8. Low socio economic status
9. Stressors that overwhelm coping
10. Irrational values (narcissistic)
Session 10-3 THE ADDICTIVE PERSONALITY
Multiple addictions
Concurrent addictions
Serial addictions
Session 10-4 THE ALCOHOLISM—DISEASE DEBATE
An addiction as a disease reduces guilt
The disease model as valid
Personality and alcohol consumption
Newer models bypass the disease model
A behavior with medical consequences
Session 10-5 NEW SKILLS FOR SELF-CONTROL
People quit even without help
Learning to find strokes from people
A person needing people-help to quit
Networking skills for addiction control
Networking to regain self-control
Networking to expand social relations
Networking to expand Positive Strokes
Living with less addictiveness
and more self-control
This chapter investigates the psychological research that has been done on addiction and its counterpart—self-control. The predominant theme of that research suggests that a person becomes addicted more easily when there are certain psychological deficiencies and dysfunctions. There are obvious problems with uncontrolled self-indulgence in alcohol, cocaine and heroin. In some persons, extreme self-indulgence in excessive caffeine, excessive nicotine, excessive food, excessive gambling, excessive spending, etc., produces an equally destructive end result.
On the other side, some problems exist with persons who are excessively self-controlled. Certain persons with excessive self-control become overly demanding on others and can become harsh bosses and mean marriage partners.
The debate is over degrees of addiction and degrees of self-control. The debate is about freedom, autonomy and its limits. The debate is about catering to narcissistic self-indulgence versus finding deeper fulfillment in making someone else have a chance at fulfillment. Its a debate a bout rights and social responsibility.
Stanton Peele is a psychological researcher. He has pulled together enormous amounts of research. This chapter is structured around Stanton Peele’s understanding of addictive processes.
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Psychological research shows nothing good coming out of excessive self-indulgence with addictive substances. However, one cannot stop with that simple statement. Cultures all over the world allow a person to use certain potentially addictive substances. These cultural permissions give all persons the freedom to be excessively self-indulgent, even to the person’s own self-destruction. When does nicotine and marijuana use become a problem? When does a stimulant like caffeine become an addiction? When does a medicine prescription become a substance that is abused? When does an over-the-counter drug become a substitute for a happy relationship, and/or destroy it? It happens and it is very destructive. Are substances addicting, or are people addictive? These are questions psychologists are trying to answer.
Most people have enough Positive Strokes and Warm Fuzzies to prevent them from letting their self-indulgence get out of control. Most persons have enough positive nourishment for their emotions that they do not want or need the costly and addictive substitutes.
Addiction is defined by the use of a behavior for enjoyment, over which people lose control, and develop craving for its repeated use and reward. This is followed by moderate to intense suffering when the behavior is discontinued. Addiction is not so much a diseased state of being which you enter, but addiction is on a continuum from slight to serious, with increasing numbers of forces creating potentially strong addictions with destructive results. Most addictive behaviors take their control of a person by a process of habituation. A few chemical substances are powerfully addictive with their initial usage. Repetition of behavior, when reinforced by consequent enjoyment, becomes habitual.
Session 10-1 OVERVIEW OF ADDICTION
An overview of addiction and self-control in psychology reveals that when researchers investigate addiction, they also investigate self-control. Psychologists also do the opposite. They investigate self-control and analyze it in relation to addiction. The following box is designed to help the student see that relatively few sources of human pleasure are a problem in moderation. How people let pleasure control themselves is the problem. The central column is a list of a large number of sources of pleasure, a person can become obsessed with pleasure from any one or all of these.
THE ADDICTIVE STYLE
Most things in the center column can be overdone, and then it can become an addictive behavior.
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THESE ARE SOME OF PEOPLES' BASIC CHOICES FOR PERSONAL PLEASURE.
Food
Music
Work
Sex
Reading
Hobbies
Sports
Exercise
Child care
Television
Religion
Helping others
Karate
Art - Writing
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SELF-CONTROL STYLE
Solve problems and use self-discipline to get the proper amount of Positive Strokes out of center column.
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Living with more self-control than addiction
Life is lived in the middle, and when people's lifestyles become excessively indulgent or excessively self-controlled, there are potential problems attached to those excessive behaviors. People may be required to pay heavier penalties, the farther left or the farther right they decide to go. With some exceptions both the so-called good behaviors and the so-called bad behaviors can be problematic when carried too far.
Use—habituation—abuse—addiction
Pete Rose, Cincinnati Reds Baseball manager, was banned from baseball for illegal gambling, August 29, 1989. He didn't just get caught the first or second time.
“I just did something that risked (a baseball career) and I did something that really I did too much in the off season. . . Now I have to eliminate it completely. And I'm doing pretty good, but I have to keep on it" (AP, Nov. 9,1989)
By his own admission he became excessively involved, so that when it was time to put gambling aside and go back to managing the Reds in baseball, the pull of gambling kept tugging. His “use” of gambling to have fun, went to habituation. The habituation was at least strong enough to pull him back to the race tracks when he knew that this endangered his career. In addiction one's rational thoughts turn irrational and a person does not do what he ought to do or ought not to do. It would be difficult to say that Pete Rose was addicted, but certain evidence says he at least was close to being addicted.
The current addiction model
The model used here is essentially the model that Stanton Peele develops in The Meaning of Addiction; Compulsive Experience and Its Interpretation (Peele, 1985). His review of the current published research covers the broad scope of the addictive process. He cites research of stimulant user's tolerance of drugs, as well as studies of user's problems. He cites evidence of eminent persons who were at the same time narcotics addicts (Breecher 1972: p. 33). Also, studies (Winick 1961, Zinberg and Lewis 1964) reveal that people have been able to use certain drugs without the drugs becoming destructive in their lives. Soldiers who had used drugs in Vietnam were studied. Most Vietnam veterans who used drugs in Vietnam put them aside when they came home. Reports (Robins et al., 1974: p. 236) show that “contrary to conventional belief, the occasional use of narcotics without becoming addicted appears possible even for men who have previously been dependent on narcotics.” Likewise, some alcoholics have the ability to shift to controlled drinking, even though many clinicians as well as Alcoholics Anonymous do not believe this is possible (Peele 1983; Valliant 1983).
These and other studies cited by Peele show there are many things that control whether a user becomes partially habituated or destructively addicted. You will see those factors in the following pages. The model being used to talk about addiction is not a “disease” model. Peele (1985) believes,
“Addiction is seen not to depend on the effects of specific drugs. Moreover, it is not limited to drug use at all. Rather, addiction is best understood as an individual's adjustment, albeit a self-defeating one, to his or her environment. It represents an habitual style of coping, albeit one that the individual is capable of modifying with changing psychological and life circumstances.” (p.2)
This model accomplishes several things. 1. It puts responsibility on the user. 2. It allows for multiple forces at work to produce deeper and deeper habituation processes. 3. It allows one to see that deeper and deeper addiction patterns can be understood and treated as a “disease.” 4. It is more realistic because everyone knows of persons who “use” but do not “abuse.” 5. It is truer to research that shows personality and stress factors combine with self-ingested chemicals to produce the final self-destructive addictions. 6. This model allows treatment programs not only to use counseling and group therapy, but to teach new values (Peele 1985, pp. 114-132) as a way to counteract habituation, abuse and addiction. 7. Finally, this model recognizes the constructive side of the habituation/addiction process. The pleasurable feedback people receive from highly prized behaviors is equally rewarding and equally addicting. Some more constructive addictions can be equally problematic when self-control is lost. The habituation / addiction process can be harnessed for one's own good.
Session 10-2 MULTIPLE FORCES CREATING ADDICTION
You will now be introduced to a number of forces that contribute to the self-destructiveness of the habituation/addiction process. You should understand at the beginning that each of the following forces has varying intensity or degrees of severity. Certain factors may combine with other factors to produce the addiction process. Researchers try very hard not to trace problems back to single causes, unless warranted. As you begin to understand these concept, apply the information to yourself or the one you wish to help.
Factor No. 1 -- The ego's Little Professor
The central core of the human emotional system is the ego. Very early psychology understood that the ego's nourishment came from “libido,” which is the Latin word for “love.” Sigmund Freud conceptualized the ego as able to obtain “libidinal” nourishment from a variety of experiences that were heart warming or thrilling. Almost any experience which enabled the person to feel a happy sense of “AAHHhhaa!,” was understood by Freud to be “libidinally nourishing.” With the coming of Transactional Analysis (Berne 1961; Steiner 1974) this concept was given a term that became quite popular. The psyche (mostly the id) was partially personified into “The Little Professor” whose job it was to find “Strokes” or libidinal nourishment for his master, the ego. “The id” is the libido's original source of strokes, and remains to some extent its headquarters” (Freud, 1949).
“It is difficult to overcome one's passions, and impossible to satisfy them.”
Marguerite De La Sabliere, Pensees Chretiennes, (Late 17th century)
Positive Strokes: There is an innate drive for feeding the ego those experiences that nourish it for growth and pleasure. The ego's survival is dependent on “libido” or “Positive Strokes,” like the body is dependent on food. Therefore “The Little Professor” is under continuous orders to search and find the largest amount of nourishment. “The distribution of libidinal flow is constantly changing. It may for example be directed outward or inward (object love or narcissism); it may be arrested in its outward flow (fixation); or it may flow to levels representing earlier stages of development (regression); it may become dammed up (repression); or it may be deflected into other more socially acceptable channels (sublimation)” (Healy et al., 1931). “The Little Professor” gets involved in all these activities and many more. He feeds and protects his master, the ego, to insure their mutual existence. He simply functions within the structure of the psyche. If messages come from the senses, through the mind, that certain “substances” are the source of pleasure, “The Little Professor” simply seeks them out. If the mind is not filled with any other information, and the need for acceptance is pleasurable, The Little Professor will pursue what is available. Sometimes alcohol, drugs and other substances are so prevalent, he simply stops there to fill up.
Education filling the mind: Healthier input into the mind with information about consequences of habituation and addictive processes gives The Little Professor alternatives. Education about escapes from social pressures opens up new possibilities. Opportunities to understand oneself better help The Little Professor decide on healthier lifestyles. The Little Professor needs training to understand the long-term rewards of high-value living. He and the spirit of a person need reorientation to values that help persons transcend the pull of human primal nature. For example, researchers evaluated children's growth of self-control, that is, their understanding of the value of delaying self-gratification. If a person does not have the strength of spirit to temporarily deny the self some gratification, The Little Professor will grab the first morsel of pleasure that comes along. Mind and Spirit need to be involved in the fight against the destructive habituation processes and turn The Little Professor toward more constructive habituation processes.
Little Professor control: People's inner primal instincts function to perpetuate the human race and make it survive. The primal instincts are automatic. They are basically narcissistic. Some psychologists and some religious persons say that The Little Professor is basically bad, and looks for all the bad things to feed his master, the ego. Actually The Little Professor is only as bad as the input (or lack of it) into the mind and the spirit. The Little Professor only has power to choose the happiness “potions” for the ego that the mind and spirit and superego know about and/or allow. If mind, spirit and superego are uninformed, uneducated and unguided there will be a tendency for The Little Professor to be limited in his choices. When the mind is taught about consequences and learns alternatives, and when the spirit has grasped the desire to transcend primal behavior, then The Little Professor will have a larger data base from which to make decisions about how to get bigger and better libidinal nourishment (positive strokes) for his master, the ego
Factor No. 2 -- Pleasureful catecholamines
The second force at work to produce the use, habituation, abuse and addiction process lies deep in the chemistry of the neurological system. Messages are transported throughout the body by way of neurotransmitters. Catecholamines are the neuro-ransmitters of pleasure. Norepinephrine and dopamine are the two major self-generated chemicals which are measurable at times of the “high” for runners and during times of euphoria in general. James Olds (1955, 1956) was experimenting with rats to learn more about “self-stimulation.” When Olds implanted an electrode in the medial forebrain bundle the rat would self-stimulate for enjoyment so much that it would ignore eating and mating. Olds illustrated the power of pleasure stimulation to dominate the attention of the entire biological system (including The Little Professor).
Norepinephrine and dopamine: Norepinephrine and dopamine increase within the body at various sites when amphetamines are ingested. These same chemicals decrease in quantity when chlorpromazine (Thyroxine) is prescribed and used by a person who is suffering from a psychotic episode (Akiskal & McKinney 1973; Routtenberg 1978). Running definitely elevates the level of cate-cholamines (Davis 1973; Howley 1976). Zuckerman (1978) concluded that all forms of sensation-seeking may raise norepinephrine levels. In some instances dopamine levels increase more than nor- epinephrine. For example, Smith and Schneider, of the Cornell University Medical College and Medical Center, (1988) did research on eating and dopamine function. They concluded “that the anticipation of eating and the ingestion of liquid or solid foods can produce an increase in dopamine metabolism within mesolimbic terminal fields.” They cite other research that reports increased dopamine levels from “ethanol,” “cannabis,” “nicotine,” “caffeine,” “phencyclidine,” etc. There is sufficient research to understand the direct connection between the use of certain substances and the chemicals generated to tell the self that pleasure is accumulating.
Quick-fix or long-term: The Little Professor tries to decide whether to increase the norepinephrine levels and the dopamine levels for the ego by quick-fix means or long-term solutions. Obviously, persons without permanent employment, without education, without friends who delay gratification, and without a passion for higher values, will become a victim to the quick-fix lifestyle. Such persons have deficiency levels of the pleasurable catecholamines so they find drug substitutes. Many of these substitute pleasures, or artificially induced pleasures are illegal because society sees their harmful effects. So people who indulge will get caught breaking the law in their schemes to find stimulants to trigger the self-generating pleasure chemicals. Jails, mental hospitals, dry-out programs and treatment centers all house persons whose Little Professor has made some wrong decisions.
Libidinal nourishment: The Little Professor sees norepinephrine and dopamine as libidinal nourishment or positive strokes for the ego. It is his job to secure an adequate supply to insure the survival of the ego, as well as to feed the ego sufficiently so that it is strong enough to tolerate stressors. Living is stressful. Living means that a person finds enough energy for the body or it dies. Living also means that a person finds enough energy (libidinal nourishment) (positive strokes) or life is no longer worth living (depression). It is not surprising then, that people become habituated and/or addicted to some artificial stimulants to help them think that life is worth living, even though it is temporary and potentially self-destructive.
Factor No. 3 -- Pain killing endorphins
Endorphin stimulation deadens painful experiences. Endorphins are the body's natural pain killers. They are generated by the body; endogenous, generated from within or by natural means. It acts like morphine to deaden the sensation of pain. Endorphins are “endogenous morphine.” The “high” experience of drug-induced catecholamine production is sought out by some, but other persons want to deaden emotional pain, withdraw and escape. They use alcohol and narcotics, which mimic the body's own endorphins in reducing pain. The discovery of the body's opiate receptors took place in 1973 in the United States and Sweden. Having found the receptor sites in the thalamus, the amygdala, and the spinal cord (Snyder 1977a, 1977b) they searched and found the molecule, which they called the “endorphin.” These discoveries help us understand habituation, abuse and addiction. The body has its own mechanisms, which, if stimulated by drugs, can have an analgesic or pain reducing effect. Under extreme stress, or with poor coping skills, people can self-medicate by using heroine, morphine, methadone and/or alcohol.
Imitation endorphins: Sadly though, habituated abusers of these drugs do not use the fairly abundant supply of physicians and counselors to help ease the pain from the stress of living. Seeking physicians and counselors would be cheaper in the long run. Persons using endorphin look-alikes, which mimic or imitate the endorphin-to-opiate receptor response, produce a cycle of further increased stimulation or withdrawal, further isolation and/or dependency. Their narcissistic search for stimulation and/or passive handling of emotional and physical pain only produces more alienation, loneliness, guilt and the ills they bring.
Natural endorphins: Since endorphins are self-generated opiates to reduce pain, what normally functions to activate them, and how can we activate them without drugs? In some instances the human body responds automatically and subconsciously. War stories and emergency room tales tell us that people have experienced loss of body parts and did not feel the pain. Athletes have played with broken bones that did not produce pain. The body has some natural endorphins working for it, and every pained and traumatized person needs to appeal to his highest internal functions to make them work. Due to the fact that some persons have used opiates without becoming addicts, specialists have theorized that such non-addicted persons were born with an endorphin deficiency and the opiates they ingest simply bring them up to where others normally function (Snyder 1977). The endorphin system has been stimulated by experiments with acupuncture, focal brain stimulation, prolonged stress, and some drugs (Malick and Bell, 1982, p.171). “Strong evidence exists to indicate that they (endorphins) may play an important modulatory or homeostatic function in almost every major system in the body in addition to their role in the central nervous system.” (Malick and Bell, 1982, p. 223). It is not surprising then, that people use the analgesic effect of endorphin stimulation with drugs when their lives are more dysfunctional.
Values controlling endorphin sources: If so few of the former heroin addicts of the Vietnam war have become re-addicted, there must be some other value, goal, reason, or explanation for their avoidance of heroin upon returning home. Probably they now live with less internal fear, less hate, less loneliness, less alienation and less loss. The answer to habituation, abuse and addiction is generally understood to lie within that formula. Deal with fear. Forgive the hate. Find social relations. Use self-discipline for delayed gratification. Act in such a way as not to alienate. Find love to heal the hurts of loss. Researchers, poets, psychologists and religious persons have known that these lifestyles prevent problems.
Factor No. 4 -- Social pressure
Humans are social creatures and they find reasons to socialize. A “drink” offered to a guest is a gesture of kindness. A “joint” smoked with a friend can be a social encounter. A “hit” experienced with an acquaintance is a social experience. Social settings often determine the kind of drug experience people offer and receive. By a process of association people learn to enjoy a stimulant along with the enjoyment (libidinal nourishment) of the friendship. Then, later, they cannot enjoy the friendship without the stimulant. That triggers the need in the habituated user.
Identity search and pressures: Adolescents experience much anxiety in their search for their own identity. To reduce anxiety some turn to sources of pleasure which help cope at the time but become habituating or addicting (UCLA, 1969). It appears that there is a strong connection between a deficiency of social nurturing that drives teenagers to find a substitute source of satisfaction in using marijuana. In the 50's most drug usage took place in city ghettos and was considered a pleasure search of the poor. Today, with drug usage in every level of society, the social pressure is even greater. Social pressure prods people to find thrills and anxiety reduction schemes from drugs rather than past traditional family time, parties, dances, skating, social outings, holiday and religious get-togethers.
Pseudo-independence from pressures: People's social environment has power over them. People will take drugs on a “dare,” because they do not want to be excluded. They do not want to be called “chicken.” They do not want to appear “square.” Adolescents feel the need to be emancipated from their parent's control and use various substances to declare their independence. There is blending of social and psychological forces that drive many, but not most persons into habituating patterns. Indeed the variables that set up habituating and addictive patterns are include poor school performance, perceived use of drugs by adults, psychological disorders such as depression or sociopathy, low self-esteem, perception of parental drug use, low religious involvement, conflict with parents, sensation seeking, absence of a sense of purpose and reduced social responsibility (Newcomb et al., 1986). However, the “most dominating factor in drug abuse is the peer cluster, and other psychosocial characteristics influence drug use primarily through their effect on peer clusters.” (Peele, 1988)
Factor No. 5 -- Genetics/biology
A variety of biological factors further complicates the vulnerability of someone to alcohol and drug abuse. These factors include low platelet monoamine oxidase levels, neurophysiological abnormalities, hormonal reactions, antisocial behavior, childhood hyperactivity combined with psychosocial immaturity, left-handedness (Peele, 1985). The studies Peele cites underscore the need to see addictive processes as a result of Peele's (1985, p.49) review of research studies indicates “no research of any type” supports the suggestion that some problem drinkers are “born with a physiological abnormality, either genetically transmitted or as a result of intrauterine factors.”
Pro- and anti-genetic arguments: Overweight eating has been the focus of pro-genetic and anti-genetic theoreticians. Schachter (1968) compared rat obesity and human obesity, determining that external cues for eating had larger influence than somatic (physical body) or genetic cues. This reasoning and research traced the source of obesity to a somatic defect, but could not be proved. Later Schachter (1982) found that 62.5 percent of formerly obese persons were back to normal weight, many by natural remission. “Schachter's serendipitous (surprise accidental) finding disputed the entire thrust of over a decade's research -- namely, that people were locked into obesity by biological forces” (Peele, 1985, p.53). Overweight eating may be complicated by multiple factors but responsibility for overweightness still lies with the individual.
Factor No. 6 -- Psychological need
The research showing that people's psychological deficiencies and stresses contributes to addiction is voluminous. Franken (1982, 1988) reviews the literature for the association between alcoholism and personality and shows evidence for seven basic problematic personality factors which are associated with alcohol addiction. 1. Dependency 2. Depression 3. Sex-Role Identity Problems 4. Defensive Denial or Ambivalence 5. Inadequate Impulse Control 6. Personal Dissatisfaction 7. Need for Power. Narcotic addicts tend to be “immature,” “insecure,” “irresponsible,” and “egocentric.” (Franken 1988) Psychedelic drug users had these traits: 1. tendency to live in the present, 2. passiveness in interpersonal relations, 3. cognitive difficulties, 4. depression, 5. study difficulties, 6. unrewarding sexual behavior, 7. tendency to use repression, 8. tendency to use intellectualization and rationalization (defense mechanisms) (Kuehn 1970). Again, it appears that substance abuse is associated with a personality need or deficiency.
Adolescent needs: Kandel (1978) identified four basic personality factors common to adolescents involved with marijuana abuse: rebelliousness, independence, alienation, and low self-esteem. Another study (Jessor and Jessor, 1977) accounted for more variables than just personality factors. They saw three interacting systems; 1. the Personality System, 2. the Perceived Environment System, and 3. the Behavior System. “Lack of achievement” and was also identified as a cause of drug abuse (Jesor, 1979). Another observer and researcher says,
“Briefly stated, problem behavior, and substance abuse as one aspect of problem behavior, is likely to occur when a Personality System characterized by low academic interest, independence, low religiosity, and tolerance of deviance, interacts with a Perceived Environment System characterized by weak parental and peer controls, incongruence between peer and parent expectations, and a dominance of peer over parental influences” (Bennet, 1983).
These are heavy statements. Basically, they agree that, statistically speaking, more youthful substance abusers are person's who don't obtain enough Positive Strokes from family, friends, school and community, so they turn to substance abuse (the group of abusers) to fill certain unmet psychological needs. Substance abuse for adolescents is complex. Different youths get into substance abuse for different reasons, and for different needs. Some substance abusers do not fit the above profiles very much, or at all. Essentially, substance abusers, perhaps more than others, need to feel accepted, loved, respected for the things they do well. Leaning their names, greeting them by their names, smiling at them when meeting them, and other gestures of good will are important. Rejecting them drives them further into substance abuse. Loving them draws them out of it.
Factor No. 7 -- Self-esteem
Self-esteem is the sum total of all positive experiences, minus the sum total of all negative experiences that affect the ego up to the present moment. Freud's essential contribution was the notion that the ego needed “libidinal” nourishment (love, strokes, Warm Fuzzies) in order to grow and remain strong. A large supply in childhood sets up increased self-esteem and tends to predict larger amounts in later years. However, at any time, failures and overwhelming traumas can reduce one's sense of self-esteem. During these depressed times persons are more vulnerable to addictive processes (Newcomb et al., 1986).
Grades, conflict, abuse: Poor performance in school has major consequences on self-esteem in the elementary and secondary school systems. Combined poor performance with home conflict or abusive treatment by one or both parents, is highly correlated with drug abuse (Kandel, 1975; Svobodny, 1982; Clayton and Voss, 1982). “Anger,” which is a negative experience for the psyche, is a destroyer of self-esteem and is “moderately” correlated with drug abuse (Peele, 1988, p. 152). Poor performance in academic pursuits after high school appears to have less impact on self-esteem. This may be due to a reduction in “peer cluster” demands for conformity.
Factor No. 8 -- Low socio economic status (SES)
Valliant (1983) demonstrated from his survey that core-city working class people had 3 times the number of alcoholics as people in his college sample. Another sampling showed obesity rates 9 times higher in low SES girls (Stunkard et al., 1972). Peele (1988) noted a high level of abstinence among low SES persons, as well as a higher level of treated persons. It is unclear at the present time whether the abuses are the result of the addiction process or whether they represent value differences.
People do transcend: Addiction is traceable to combined factors, not just to poverty (Figure . Anorexics and compulsive runners come from predominantly middle class backgrounds. This suggests that perhaps not only does a person's SES determine the type of use and abuse patterns, but also a person's value system and his or her coping strengths. The energy people spend to gain some nourishment for the psyche, can go in several directions. That energy can have negative or positive consequences, depending on whether people maintain their self-control. There is no evidence that a person falls into an addictive pattern simply because of a high or low SES. Multiple factors generally combine to form first the use, then the abuse and finally the addictive nature of the habituation process. People rise above their SES. They envision their goals, enlist the local resources and ideas. They borrow faith, value systems and money. Then they win.
Factor No. 9 -- Stress factors
An altered state of consciousness, produced by amphetamine (stimulant, “high”) substances, or by narcotic (pain killing) substances, does not automatically make a person an addict. The potential for addiction is increased by an increase in stress factors. Smokers increase their use during times of stress. Situational stress overloads are the primary factors that prompt relapse into smoking, overeating, gambling, drinking and narcotic usage (Marlatt, 1982). It is important to understand that stress factors come upon all persons at random due to political, social, accidental and natural events. No person can excuse their habituated behaviors to stress. Options for handling stress are open to each person who is willing to seek them out. Self-excusing rationalizations, based on the self-depreciating processes are more like “Poor Me.”
Stress; no excuse: Entire cultural systems and political regimes can be very oppressive, very stressful, and yet individuals have been able to cope. Slavery has existed worldwide from the beginning, and only in recent decades have some of its systems been suppressed. Yet, people have risen above that stress, and lived above that bondage, without having to secure addictive pleasures and pain-killing drugs.
Escape; not solving: Addictions take place in the addicts attempt to escape from stressful events, which are overloading their coping skills. “The neurotic and the psychopath receive from narcotics a pleasurable sense of relief from the realities of life that normal persons do not receive because life is no special burden to them” (Kolb, 1962, p.85) “Opiates are desired because they bring welcome relief from other sensations and feelings which the addict finds unpleasant, “including” a distasteful consciousness of . . . life” (Peele and Brodsky, 1975, pp. 51, 61). Persons who have less desire to use substance abuse as an escape generally have an ego which is better nourished by love, friendship, success and correct perceptions of reality.
Factor No. 10 -- Values tending toward narcissism
Peele (1985) also understands addiction in terms of people's values. Peele says, “People's values do not cease to operate in the face of physiological forces” (p. 59). People's values determine their behaviors. Drug and alcohol abuse is associated with “antisocial acting out,” “non-conformity,” “deviance proneness,” “rebelliousness,” “disturbed family backgrounds,” “aggressive and violent behavior,” etc. (Peele, 1985, p. 117). “Social disturbance,” which means a type of withdrawal from others, is an essential feature of narcissism, when the psyche turns in on the self rather than fixes on reality outside itself. Narcissism says “I am so important that I do not care a lot about what others think or do, or what may happen in the future. There is a strong emphasis in psychotherapy to get persons to affirm themselves as “No. 1.” This has merit within the framework of therapy, but not within the framework of the addiction process, that is already an out-of-control self-indulging process. While it is important for one's Little Professor to find Warm Fuzzies and Positive Strokes for emotional nourishment, to prevent dependency, a person cannot disregard others in the process of obtaining one's own emotional nourishment. A person may strive to be No. 1, but s/he can't hurt No. 2 in the process. To disregard others in the process of obtaining one's own nourishment is strong and excessive narcissism.
Give to get: Sometimes a person has to initiate a good deed toward someone else, in order to get one back. Obviously, adopting the practice of doing good deeds regularly, will probably insure enough good deeds coming back that will nourish one's self and one's autonomy. Some altruism can be very effective in giant cycle of rebuilding one's supply of Positive Strokes that block the need for an addiction that is destructive. Each person who wishes to prevent or conquer a habituation process (addiction) needs to understand the power of higher values, such as altruism (doing too others). If a person seeks achievement, then he must have self-control “values” in order to become involved in constructive processes (Jones and Berglas, 1978).
Session 1–3 THE ADDICTIVE PERSONALITY —
MULTIPLE ADDICTIONS
Concurrent usage
Multiple addictions may be more apparent in a smoke-filled cocktail lounge where alcohol, cigarettes, good food and caffeine are abundant. Over 90 percent of alcoholics smoke. (Istvan and Matarazzo, 1984). There is a high incidence of cancer of the throat among excessive users of these three in combination. Alcoholics second largest concurring substance abuse is amphetamines (Cadoret et al., 1984). Other concurring uses are opiate (relaxing, sedative) abuse (Kosten et al., 1985), and benzodiazepene (stimulant) abuse (Valliant, 1983). Clinics and hospitals started to use multiple DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 1994) codes when admitting persons to treatment programs in the later part of the '80's. Repeated findings suggest that the same individuals become addicted to many things at the same time or one after another (Peele, 1983; Smith, 1981). Availability, cost and social expectations determine the choice. “The fact of multiple addictions to myriad substances and non substance - related involvements is primary evidence against genetic and biological interpretations of addiction.” (Peele, 1985, p.55). Rather than understanding addictive substance abuse as only a biochemical dependency, the majority of evidence affirms a concept of addiction that understands the interplay of biological, psychological, social forces and personal needs.
Serial usage
Some persons only allow themselves to indulge in one addiction after another (serial). Serial addictions means that a person indulges in the usage of only one of the addictive habits in sequence. For a few months (or years) some persons may shift toward alcohol. Then after that, for a few months (or years), a person may shift to the so-called harder drugs. This indulgence may be followed by an addiction to sexual imagery and sexual pursuits. A cycle of behaviors like these may develop and repeat from year to year. Apparently there is some wisdom or fear in the depths of such a person that limits involvement.
Example: Think again of Pete Rose, former manager of the Cincinnati Reds baseball team. We know Rose loved baseball. We know he enjoyed it. We know he was very successful as a player, and quite successful as a manager. These were sources of his pleasure too. Between baseball and race track gambling he developed two sources of pleasure and enjoyed them serially until he was apprehended.
Example: Kitty Dukakis, wife of Michael Dukakis, candidate for President of the United States in 1988, was hospitalized for alcohol and depression after Michael lost his bid for election. Kitty had been consuming alcohol somewhat excessively after the election loss. Earlier, Kitty had confessed to a 26 year reliance on amphetamine diet pills, which she said she had overcome. “Increasingly, counselors recognize that dependence on one substance increases the risk of abusing others. This phenomenon is known as cross dependence, or cross addiction. Researchers estimate that between 40% and 75% of people in treatment programs are multiple-substance abusers (Time, Feb. 20, 1989).
Dave, a lesser known counseling client, was a very smart owner of a thriving business. Dave grew up with people who spent quite a lot of time socializing around low alcohol content drinks. Dave and his friends all smoked. While Dave was not into drugs, some of his friends were. Sex was a very important part of their lives, and XXX-rated magazines were only slightly less common than XXX-rated conversation. Dave was an inventor too. He held patents. That gave him the freedom to sell his thriving business and lean on money from that sale and from royalties. Within 6 months alcohol so dominated Dave’s thinking that he indulged more freely than ever before. When payments for the business slowed and income was slow, Dave became highly irritable. He became violent with his wife. She wanted to leave him. She investigated various possibilities. In counseling Dave decided that alcohol had become a problem. He quit drinking cold-turkey. He hung on to smoking and caffeine and sex. Dave becomes an illustration of multiple excessive indulgences (possibly addictions). He also becomes an illustration of a person who indulged his addiction more as stress increased. Dave still runs a higher risk of heart attack and stroke as a result of extremely high levels of aggression, extremely high levels of nicotine consumption, quite high levels of cholesterol-containing foods, and higher than average level of interest in skinny-dipping with his wife in their back-yard swimming pool. Dave could be benefited by expanding his sources of other kinds of Warm Fuzzies in life.
Session 10-4 THE ALCOHOLISM—DISEASE DEBATE
There is a debate about whether alcoholism is a disease or a behavior problem. Until about 1970 insurance companies were hesitant to pay for treatment of behavior problems. As treatment approaches improved and the number of substance abuse problems increased, insurance payments for behavior problems, became more urgent. In the last two decades of the 20th century, insurance companies began to sell medical insurance that covered substance abuse problems. In the mid 1990's there did not seem to be a very strong debate about whether substance abuses are diseases, now that more Americans have insurance to cover both diseases and behavioral problems.
An addiction as a disease reduces guilt
One major reason for calling something like alcoholism a disease is that it removes some of the guilt of past excessive drinking. Guilt is very destructive to emotions. Guilt makes people adopt many behaviors that are a problem. Guilt makes a person lie. Guilt makes a person withdraw and become more introverted. Guilt makes a person deny, blame and rationalize. Guilt causes a certain amount of depression. If a person is going to rise above a problem, s/he needs some release from guilt. Therefore, identifying the cause of a problem and being able to trace that cause to something outside the person's control, frees a person up to put energy into solving the problem.
The disease model as valid
Adherents of the disease model of alcoholism in particular have some good arguments. Disease is more than just catching someone else's bug, germ, bacteria or virus. Disease is a weakening and a breakdown process. Heart disease does not mean that a person caught a bug and now suffers from that bug's effect. Heart disease, rather, is a larger name for a number of constrictions of vessels in the heart and/or malfunctioning valves in the heart, etc. Heart disease occurs from genetic programming, but also from lifestyles that include excessive fats and deficits of proper nutrition.
In reasoning that alcoholism is a disease, certain persons argue that the various elements of deterioration in biological, neurological and mental functioning, resemble any other deterioration of any other bodily and mental process. This reasoning has a lot of merit.
Personality and alcohol consumption
Excessive alcohol consumption is more a problem behavior with destructive consequences, than a disease, but not exclusively so. It is difficult for a researcher to determine whether certain personality features make a person more prone to drink, or whether excessive consumption of alcohol makes changes in personality features. That debate is not settled. However, here is some research information that examined 13 characteristics of high-consumption alcohol drinkers. The following is a list of the results of the comparison between 20 out of 100 whose alcohol-stress scores were 400% or more above the 80 others, and/or who reported they consumed an average of “1 drink per day” (7 per week average).
Intrapsychic personality factors
from the Michigan 13 Personality Profile
PERSON- 80 low-level 20 alcohol % more or less
ALITY or non- alco- high-level
FACTORS hol drinkers drinkers
(Scores are percentiles; their standing among 100 persons.)
Higher-level alcohol consumers;
Social 43.4 27.4 average 36% less Social
Cheerful 44.3 35.7 average 19% less Cheerful
Peaceful 44.1 31.4 average 29% less Peaceful
Tolerant 47.9 29.9 average 38% less Tolerant
Sympathetic 47.2 42.4 average 10% less Sympathetic
Generous 53.1 36.1 average 32% less Generous
Trusting 47.7 28.8 average 40% less Trusting
Assertive 54.1 49.2 average 9% less Assertive
Self-controlled 48.2 45.2 average 6% less Self-controlled
Self-confident 41.9 29.9 average 29% less Self-confident
Communicate 50.2 34.0 average 32% less Communicating
Leading 40.2 40.5 average the same.
Autonomous 43.8 27.6 average 40% less Autonomous
TOTAL AVG. 46.6 35.2 AVERAGE 32.4% LESS
OF 13 CORE VALUES
High-level alcohol consumption is associated with a 30% below (national) average value system, and a 24.6% below the average of the controls. (The above personality factors were synthesized from 342 factors in 39 major published tests. The total data base is 1900> persons from U.S., Canada and Australia.) In the research (Franken, 1990 ) it was established (statistically) that persons with lower scores in the above personality factors averaged more days of hospitalization, more surgeries, more colds, more days of absenteeism, and generally made less money at lower skilled jobs and professions.
We can see that low-score personality factors exist in higher levels of alcohol consumption. Do low score personality factors make one drink? Not necessarily, because a lot of low-score persons do not consume alcohol excessively or become abusers of any other substance. Ask the question in reverse. Does higher consumption of alcohol put one into the lower-scoring personality factors? Again, not necessarily because lower scores may be due to something else, like higher-alcohol consumption may be due to something else, neither of which is known at present.
Substance abuse: A behavior with medical consequences
Whatever the cause or no-cause, disease or no disease, higher-level alcohol drinkers are in a group of people who average from 25% to 30% lower scores in some personality factors and those people have more illness. The higher-level alcohol drinkers average 20% more days in the hospital, 235% more surgery, etc. Substance abuse is behavior with medical consequences. Marc Galanter, M.D. (Alcohol and Drug Abuse, 1993) in reviewing the research says,
“By and large, people are more likely to show dependent or sociopathic traits as a result of chronic substance abuse than they are likely to have been dependent people or sociopaths when they were young."
Simply having lower scores in personality traits does not make one a higher-level alcohol consumer. It is more logical to understand higher alcohol consumption as one of many possible attempts to neutralize certain pains of living, when a person is uneducated in other ways of solving problems and reducing those pains. For many persons, then, substance abuse is a result of inadequate training in life-skills, producing medical consequences.
Newer models bypass the disease model
Several models of addiction are now available, that are not disease models. Stanton Peele (Editor) assembled the various models (including the disease model) under the title of his book Visions of Addiction: Major Contemporary perspectives on Addiction and Alcoholism (Lexington, 1988). Each of the models, sometimes called metaphors, is described. These models are different views, much like people looking at the elephant, but only able to describe one part from one view. It would be unnecessary to expect a student to remember all the different model names exactly. Just understand that each model focuses more on one of the following causes for higher-level alcohol consumption than the others; genetics, biology, vulnerability, peer pressure, conditioned-response learning, guilt resolution and values. With models like these, the alcoholic can begin to see what s/he needs to do in each of these areas in order to conquer the problem.
Session 10-5 NEW RELATIONSHIPS FOR SELF-CONTROL
People quit even without help
Persons will experiment, become habituated, then suddenly stop and never return to their drug, alcohol or other abuse. What makes some persons never indulge and some persons indulge and stop, never to become addicted? People who quit addictions without help have had a change of attitude, sometimes resulting from traumatic events and non-traumatic increases in knowledge. Whether dramatic or not, an episode “triggered a powerful psychological reaction . . . former addicts usually made changes in their work lives and personal associations that supported their new drug-free identities” (Peele, 1985, p.222). They made value changes, that required lifestyle corrections. If they experienced something traumatic like the possibility of a marriage and family breakup, fear would make them decide to re-prioritize and put marriage first.
Some persons have a stronger superego, ego, mind, spirit, and body. They absorb ideals and heros in the mind. They have a superego, a conscience which is committed to truth and guided by that spiritual value. They read and go to Community Education classes to learn the skills of conquering and winning. They meditate; they dream; they pray; they risk; they believe; they reach out; they strive; they want to rise above a primal state of existence. Their constantly updated reservoir of information helps them achieve their higher goals.
Learning to find strokes from people
Some reformed addicts have learned to change their associations and their social networks. They change friends and organizations to which they give their allegiance. They join secular and religious support groups. (Waldorf, 1981; Wille, 1983). Support groups like AA are increasing for people to use as they chose a new lifestyle. Religious groups are active in providing leadership for some of these groups. When the commitment to these groups is firm, the psyche derives similar satisfaction of needs for itself from positive relationships. The needs of the psyche may be so sizeable that the psyche forms another dependency on the group, perhaps even to the point of addiction to it. This may be necessary on a temporary basis. Loving relationships are addictive according to Peele and Brodsky (1975). Considering that poor social and interpersonal relations are one of several underlying elements of almost all addictions, all prevention and treatment programs urge participation in on-going group (therapy) work.
Addiction substitutes: If addictions are nearly destroying a person, there may be a need for the person to devalue and destroy the old addiction by replacing it with an equally strong but opposing addiction. The psyche will cry out for the pleasure of the previous addiction unless it is sufficiently replaced or reeducated into non-existence, or both. After treatment, reeducation and some initiation of self-reward systems, the person should be able to take more control. It is possible for a person to develop new obsessions and compulsions such as prayer and other forms of meaningful experiences which feed the emotions and make life worth living (Wishnie, 1977). The expenditure of energy and income to develop positive addictions to constructive lifestyles is seen as the solution for many persons.
A person needing people-help to quit
Treatment programs exist in growing numbers. There is still some debate about whether an addiction is a “disease” or a moral failure. However, both the World Health Organization and the Diagnostic and Statistical Manual of Mental Disorders, 1994, (DSM-IV) now have categories for treatment of addictive behaviors, so the medical world accepts addictions as treatable dysfunctions. The World Health organization uses a definition of drug addiction that understands addiction as both a “psychic” and “sometimes physical” state. The DSM for Mental Disorders of the American Psychiatric Association (1983) lists all the abuse, addiction and withdrawal problems under “Organic Mental Disorders whose etiology and pathophysiological process is listed below.” This reflects a strong awareness from a great deal of research that the addictive process lies in the substance, rather than in the person taking the substance. There is a paradoxical middle ground, which understands a both-and (instead of either-or) basis for addiction, even though the poles of the paradox seem to be in conflict with each other.
Treatment programs are usually geared to deal with both the physio-chemical as well as the psycho-chemical aspects of the “disease.” There is also a spiritual dimension which becomes part of certain treatment programs. AA includes this dimension, and appeals to people's sense of a “higher power.” Other support groups have adopted the 12-step approach of AA and found it helpful to their particular form of abuse.
Choices to improve self-control
Choices determine destiny. As addiction occurs in ever increasing stages of loss of self-control, prevention and cure occurs in ever increasing stages of maintaining and increasing self-control. Art Schlichter, a professional football player, was suspended for gambling. He was duly treated for his compulsive gambling and reinstated after thorough examination by qualified medical specialists who felt his compulsive gambling behavior was under control. Schlichter describes his behavior this way: “There are choices in everybody's lives. There is a bad side of the road and a good side of the road. The bad side is easier to take, but it will lead you to trouble. Do it the difficult, the good way” (People, 1984:B9). Here is another way to look at it. There are some less self-destructive lifestyles, and persons who deviate from those lifestyles will pay some penalties, somewhat in proportion to the percentage of their deviation.
Remission, or freedom from the abusive habituation process, is complete when the psyche receives rewards that are stronger and more fulfilling from other experiences. This is a time when readjusted values and augmented coping skills combine with an altruistic (other oriented) spirit. Former addicts revise their self-perceptions and visualize themselves having new potential. The remorseful addict, like the great bird Phoenix of Egyptian mythology, which had consumed itself by fire, rises renewed from his ashes, and is once again a thing of beauty.
Networking skills for addiction control
Networking is a skill. Networking is done with people. Networking is following leads as one pursues a goal. Salesmen do networking to follow leads in selling. Management persons do networking in exploring numerous avenues in building a business. Networking is healthy for sales and business. A person can use networking to get out of unwanted behaviors. Networking is healthy for people. Networking is relationship oriented, and relationships are nourishing when they are positive.
History of networking
Networking is ancient in origin and almost instinctual. Networking is simply asking your family and friends for help. Immigrants to the United States used networking with their friends to find houses and jobs. Early farmers who didn't have the money to own all kinds of machinery networked with others to bring in their harvests. Some of the first analyses of social networks took place in the early 1950's in Norwegian fishing villages. A theory of networking developed among social scientists that helped analyze and treat diseases. More recently the idea of networking is being fashioned into a therapeutic process for treating the most difficult cases in therapy. Strongly addicted persons are gaining more long-term help through a network of family and friends, who both confront but also support the addict with their love.
Professional networking as a treatment
Marc Galanter, M.D., (1993) New York University School of Medicine, is advocating Network Therapy for treatment of substance abuse clients.
“Addictive illness is among the most prevalent psychiatric disorders. . . I have developed an approach that engages the support of a small group, some family, some friends, to meet with a substance abuser and therapist at regular intervals to secure abstinence and help with the development of a drug-free life. . . I call it Network Therapy. . . . Social supports are necessary for overcoming the denial and relapse that are so compromising to effective care for the substance abuser.”
Galanter uses formal written agreements, group meetings, follow-up conferences, and personal interviews, along with medication management. Prior to this Galanter says there was no known office treatment for an addiction problem. Now, with the therapist engaging the network, that therapist can educate, medicate, re-evaluate, and deal with a support system that is more in touch with the substance-abuser's problems and behaviors.
Confrontation and therapy by a 70 member network: Mark Sirkin and Uri Rueveni, Yeshiva University Albert Einstein College of Medicine, Bronx, NY, (1992) used network therapy with a cult member whose leader claimed to be the Messiah. They involved 70 family members and friends who met in a network meeting for 4 hours, and in smaller follow-up groups, with the cult member. The intervention was successful. Tough cases require strong medicine, and that medicine is relationship; confrontive and loving.
Networking to expand social relations
Before you started this course, did you have any idea of the importance of having a lot of good friends? Did you ever consider that living a hostile, conflict-prone and withdrawing is about the worst thing that can happen to a person. Now, can you understand that when a person has an addiction problem, the best medicine is the confrontation and love of one's friends? Nearly everything in this book is geared to generating good relationships. The opposite is that the worst thing that can happen to make life miserable for oneself and everyone around oneself, is to fight, and drive everyone away from oneself.
Join clubs, community services, self-help groups: Addictions are narcissistic. Addictions manipulate the body and mind into some state of enjoyment that really has very little to do with social relations. Substance usage may get started in a group, but when it reaches addiction proportions, the person is usually involved with the substance much of the time in private. That is withdrawal, a facet of problematic narcissism. To break out of one's addiction is to break out of one's narcissistic withdrawal from persons. An encouraging step along this line would be to join one or more groups.
Alcoholics Anonymous
Al-anon – Ala-teen
Am. Ca. Soc. (Volunteer)
Arts Council
Audubon
Am. Assn. Univ. Women
Church/worship
Political Party
Fitness
Garden Club
Hunters
League of Women Voters
Literary Society
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Newcomers
Overcomes
Photography
PTO (Volunteer)
Recovery
Republican Party
Rifle Association
Rotary
Single Parents
(Many others)
(Local newspapers often print a list of local self-help, service, and social groups.)
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Networking to expand Positive Strokes
Replacement of the Warm Fuzzies and Positive Strokes that one obtained from substance abuse, is supremely important. The network needs to be guided to finding more non-self-destructive Positive Strokes. Chapter 1 described the nature of libidinal nourishment. It emphasized the importance of libidinal nourishment (like Warm Fuzzies) to energizing the emotions in a positive way (Like Positive Strokes). Ultimately, the Warm Fuzzies and Positive Strokes need to come more from relationship than from things or from inanimate objects. This theme keeps running through this textbook because this theme of Positive Strokes is fundamental to human sanity, happiness and health. When self-control is lost, addiction is in control, and one's future is at stake, part of a person's world has to open up and let friends and family come back in a confrontive but loving role.
Networking and volunteering
So I hear you say, “What kind of idiotic connection is there between my addiction problem, my loss of self-control, and volunteering?” Well, if you agree to enter the self-help system and join a therapy group, you agree to be a helper to someone else. You agree to volunteer when the next guy calls you on the phone in the dead of night. You agree to get up and go out for lunch with him. You just became a volunteer. Lambert Maguire, in Understanding Social Networks, (1983), at the networking of hurting people is fostering some concern for others. He says, “People are pulling out of their cynicism and reestablishing their commitment to others.” That's altruism and love.
There are many other contributing factors to alcoholism, and as many more values (Ch 1), behaviors (Ch 2), beliefs (Ch 3), ideas (Ch 4), etc and treatment programs. Addictions of various kinds affect many different kinds of persons at many socio-economic levels.
There is a large volume of research and statistical information regarding addictive behaviors. That information suggests that, on the average, persons who live by the higher levels of the values, behaviors and skills described in this textbook, are considerably less prone to addictions.
Enroll in an publicly provided classes for addiction treatment. Use the material in this textbook for lowering your risk of becoming a victim of the addictive process.
SUMMARY OF MAIN POINTS
1. The psyche needs to be nourished by positive experiences, and the satisfaction of the experience makes the psyche go back to it for reward for its effort.
2. Addictive experiences are excessively pleasurable experiences which serve as “libidinal” nourishment for undernourished and disturbed ego functions.
3. There are several important factors which blend together to create an addiction to an experience, rather than simply an addiction to a substance.
4. Catecholamines are the brain's self-generated pleasure chemicals, and they are triggered by amphetamines, sensation seeking, running, and other enjoyable practices.
5. Endorphins are the brain's pain killers, which are triggered by narcotics and other mind-over-matter processes.
6. Catecholamines and endorphins send their pleasurable messages which act like “libidinal” nourishment for the psyche.
7. Social pressure of “peer clusters” is the major force causing people to initiate use of an addictive substance, and the habituation process.
8. Genetic factors are believed to play a role in use, abuse, habituation and addiction, but current research has not been helpful in discovering their effect.
9. Psychological deprivation or negative input tends to show up in narcissistic, anti-social and aggressive behaviors, which are moderately connected with substance abuse.
10. The addictive personality is often habituated to multiple substance abuses, either at the same time, or one after another.
11. The best model for understanding substance abuse incorporates: (a) disease theory, (b) learning theory, © biological theory of catecholamines and endorphins, (d) psychological need theory, (e) perception/ cognition theory.
12. Substance abuse was heavier in the past among low socio-economic status persons until recent multi-tiered marketing practices have enticed higher socio-economic status persons to join up.
13. Substance abusers of all substances do quit by themselves without relapse, and spontaneous remission rates are high.
14. Treatment centers for addiction rely on the use of group therapy, role-playing, education, problem-solving and communication skills.
15. Prevention and cure of use, abuse, habituation and addiction rely heavily on dealing with inner aggression (hostility), and neutralizing its power inside the psyche.
16. Spontaneous remissions, when someone suddenly decides to quit drugs, are often preceded by an inner transformation of ideas as a result of sudden traumatic threats to their current behaviors (e.g., divorce, guilt).
17. There needs to be a balance of superego (conscience, ought-ness) with id (impulse, want-ness) to keep from becoming a user, abuser, habituated and addicted.
18. Regaining sufficient ego control over the addictive process is possible when the ego finds enough reward (love, strokes, Warm Fuzzies) to justify putting forth effort in that direction.
19. Regaining control, if a person is not totally devastated, requires finding the goals and the pleasure in achieving them on an hourly or daily basis.
SUMMARY OF OPTIMUM PSYCHO-SOCIAL LIFESKILLS
Preventing the dominating force of addictive substances is a wholistic task. You need a wholistic approach to Optimum Psycho-Social Lifeskills in order to make them work for your advantage. Wholistic approaches have greater effect in your continual increase in maturity, your growth in personal relations, and your rise to higher levels of influence.
LIFESKILLS FOR MOVING UP ORIGINATOR OF THE SKILL
or well-known user/promoter
Positive Stroking, libidinal nourishment (Ch. 1, 10) Eric Berne, Claude Steiner
Values clarification (Ch.2) Gordon Allport, Milton Rokeach
Self-actualization (Ch. 2) Abraham Maslow
Support groups (Ch. 2, 3, 10) Alcoholics Anonymous
Catharsis (Ch. 2, 4) Freud and Breuer
Rational replacement (refuting) of irrational ideas (Ch. 2, 5, 8) Albert Ellis
Focusing (Ch. 2) Eugene T. Gendlin
Owning feelings (conscience) (Ch. 2) Many psychologists & Marriage Encounter
Mentoring for accountability (Ch. 3) Alcoholics Anonymous
Aggression Replacement Training (Ch.4) Barry Glick & Arnold Goldstein
Assertiveness Training (Ch. 4) Wolpe, '58, Robert Alberti & Michael Emmons
Personal Growth Log (Ch. 4) Alberti and Emmons
Programming “Stages” of growth (Ch. 5) Erik Erikson
Fear reduction in Stress Management (Ch. 5, 8) Hans Selye
Relaxation (Ch. 5) Herbert Benson, Edmond Jacobson, Johannes Schultz
Systematic and In Vivo Desensitization (Ch. 5) Joseph Wolpe, Alan Kazdin
Self-disclosure (Ch. 5, 7) Sidney Jourard
Assertiveness Training (Ch. 6) Robert Alberti, Michael Emmons, Fensterheim
Touch (tactile contact) and bonding (Ch. 7) Ashley Montegue
Shyness reduction (multiple skills) (Ch. 7) Philip Zimbardo
Self-talk (Ch. 8 for cognitive restructuring) Emile Coue’, Ellis, Beck, Seligman
Written Rational Self Analysis (Ch. 8) Maxie Maultsby
Visualization, Guided Imagery (hoping) (Ch. 8) Coue’, Seligman, Patrick Fanning
Intensive Journal (or writing a note) (Ch. 9) Ira Progoff
Networking (for addict support) (Ch. 10) Lambert Maguire
Volunteering (replacing addiction) (Ch. 10) Ancient Wisdom
Written Rational Self Analysis (Ch. 8, 11) Maxie Maultsby
More coming .....
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