Stopping Your Behavioral Addiction
Stopping Your Behavioral Addiction
Marc Kern (Addiction Expert, Director of Addiction Alternatives) gives expert video advice on: Can I stop my behavioral addiction on my own?; Where should you go for help with a behavioral addiction?; What does it mean to "hit bottom" in behavioral addiction? and more...
Can I stop my behavioral addiction on my own?
Absolutely. I think the research suggests that most people, in fact more than 5% of people do stop it on their own. That means without a self-help book, without a therapist, without a support group, without anything. People evolve; see the severity of the problems. They don't necessarily stop in one fowl swoop but overtime there is subtle course correction. Yes, I think that is step one. When someone sees themselves having a problem they should try to initiate changes before they sort of bring in the big guns, the professionals, and see if they can stop on their own. They have much more power than they might assume. One of the problems again with the disease model, is there is an assumption, or the twelve step model, there is a powerlessness concept and thereby suggesting you cannot do anything on your own. I feel that is a very dangerous method, to be frank. That saying the addict cannot initiate self-corrective behaviors.
If I want to stop my behavioral addiction on my own, what should be my first step?
The answer to what your first step in stopping your behavioural addiction should be lies in the addiction itself. What is it all about? As we've spoken about before, the first thing I would recommend is, without shame, without blame, and without putting yourself down, stand back, get out a spreadsheet or a piece of graph paper and start to just graph how often and the frequency of when you engage in this particular behaviour. Beyond that, there's a substantial amount that you might do. That is, figure out what times you typically engage in the behaviour. If you look at an addict, generally speaking, they engage in their destructive behaviour in a slice of hours. Let's say 5:00 to 7:00, or early in the morning, or something like that. Those are the hours that the body has been taught (sort of like muscle memory) to go and to engage in these sort of behaviours, and the individual should try to find activities that are inconsistent with the destructive addictive behaviour. Another sort of strategy: they may go to the self-help book section at their local library or bookstore, they might go on the Internet and try to get some basic knowledge about what might be going on, they can consult a professional; a psychologist or a physician who is specializing in addiction. Let's just be frank. Most physicians have no idea about addictions. They have a very pessimistic view on being able to cure an addiction. So, you need to seek out somebody who really knows something about it, and don't be sort of duped just because they have the name “addiction specialist”; they may not know anything other than one philosophy of addiction recovery. An addiction specialist may only know 12-Step recovery. Another addiction specialist, like myself, only knows cognitive behavioural methods. So, you want to shop around, if that's how far you go, and look for methods that make sense to you; that you think you can integrate into your lifestyle, that your family can accept, and that you could hold onto well past sort of the action stage where you're actually doing something. This is a lifetime evolution you have to conceptualise. This is not a little sprint where you're just going to do a few little things here. This is sort of a reformatting of what I do this hour, that minute, when this happens. It's a way of coping in a much broader sense than you might expect; much broader than just the addiction itself.
Where should you go for help with a behavioral addiction?
The unfortunate thing is that in this country there are very few treatment resources for behavioural addiction. There are some, but there are not a lot. If you had a chemical addiction you'd find a treatment resource, probably, on every corner. However, for behaviour addictions, they're quite difficult to find. If you're going to go about finding a recovery programme and a more cognitive behavioural one, probably the easiest one to identify is a private clinician, private psychologist, social worker, or mental health professional in your community. The best place to find that is in your phone book or information. You call up and you ask your local psychological association as well as call up the National Organization of Cognitive-Behavioural Therapists or go online and look for a professional within your community. Beyond doing private one on one or private group, there are a few inpatient facilities (not a lot) around the country. There are some outpatient facilities; that means that you don't go in, you don't check yourself in, and you don't sleep there. There are support groups, although not a lot. There's smart recovery, where the individual wants an abstinence goal. There's moderation management, which is for harm reduction goal, but there are not a lot of support groups on that level. However, there are Internet chat rooms and there are Internet resources that aren't exactly formalised support groups but you can get some accurate and solid information on approaching it from a cognitive behavioural standpoint.
What is "Moderation Management"?
Moderation Mangement is a 51C national self help support group primarily dealing with alcohol problems. But the principles of moderation management can be applied to any behavioral problem and any behavioral addiction. There is an internet chat room and internet support and tools and strategies that are available for someone to look up online. It's free of charge. It's a new paradign in the self help movement and the only one I know of that approaches it from a harm reduction standpoint.
What is an "intervention" in behavioral addiction?
An intervention is a outgrowth of what's called the Johnson Model of Addiction or the Johnson Model of Treatment. It was developed about 45 years ago. Basically, there's an assumption in an intervention that the individual is diseased and therefore, does not know what they say or does not know what they do. Intervention is usually orchestrated by a trained professional in intervention processes where they will orchestrate the close family members, close business people, friends—where they will come in and sort of like surprise the addict and confront them with issues revolving around their behavior. Post that and, ideally in the intervention model, the individual is willing and able to immediately go directly to an inpatient facility. Immediately. There's usually no postponement, and that's usually set up even before the intervention. So a professional comes in, has a couple of sessions with the families and his friends, and then it's sort of like a surprise party where they come in, and the addict walks in, and they say, “Why don't you sit down?” And there's a rehearsed sort of set of dialog followed by a set of heartfelt emotional expressions by loved ones about the problem and trying to break through the denial that is seen or that is categorized as denial in the disease models formulation. And hopefully the addict will agree to go into a residential type program.
How effective are interventions in dealing with behavioral addiction?
I'm very sceptical about interventions in dealing with behavioural addiction. I've worked at several residential treatment centres. I believe that some people really do respond well to interventions, but the vast majority find them as providing more reasons to put their heels into the ground and say: "I'm not going to do what you tell me to do; I think it's your problem, get off my back". Many people I've seen in these residential centres may go in to acquiesce to the family's requests. Then, two or three days later, they accidentally find a way of checking out, and two or three hours after they leave the treatment centre, they're actively involved in their addiction again, because they were not sincerely involved in the choice of treatment. They were not sincerely ready to involve themselves and get serious about it, even though the family feels it's time; it's time, it's gotten bad enough. If the individual isn't ready, they're not going to integrate. They're not going to take in the best, even the very best, of treatment.
What is the most effective way to intervene in behavioral addiction?
There are many ways to effectively intervene. Please don't believe that you're powerless in the face of your loved one's addiction. But my recommendation is a much more soft approach, a much more subtle approach, where maybe you sit down on a Sunday afternoon and have sort of a heart-to-heart discussion. You sort of say, "Maybe the two of us should go and talk with a professional." Don't make them feel guilty. Don't make them feel diseased or they're mentally ill. But rather help them see the cost benefit analysis. Help them see that it's not a crisis yet but it's a building up to a point. Some other organizations, like Al-Anon, there's tough love approaches where the individual is sort of like disengaged from if they don't involve. Now, that's a strategy for intervention that I'm not particularly supportive of. Can you imagine your child having an internet addiction and saying the tough love method, which means putting them out on the street. I have met very few parents that are willing to, you know, put the child out, put the husband out of the house. But that is the tough love approach. That is, again, another way to intervene. For some adult males, it does seem to motivate them and help them see that their behavior has gone beyond what the spouse is willing to tolerate. You shouldn't, on the other hand, endorse or make light of how you really feel about the addiction. So there's many ways of intervening.
What are the cognitive-behavioral types of intervention?
There are several new cognitive-behavioural types of intervention. They are not quite as dramatic and drastic as the original sort of Johnson formulation now available. One is called the Arise method, one is called the Kraft method. These are acronyms, and you could probably look them up on the internet and find out further information. They approach it from a very different standpoint. It's not all about them being diseased, or about them being bad, but rather approaching them from a much more gentle, softer approach where there's much more cooperation. For example, in the Kraft method, between the husband and wife, there's more focus on getting a job and using a certain sort of pharmacological intervention. It's not all about running off and getting fixed in that place called rehab only to return to the same place. It's a much more integrative approach. There may be certain communities and community hospitals that have a very distinct method that fosters more communication that comes from a really loving position where they want the relationship to continue.
Who should intervene to stop a behavioral addiction?
Generally speaking a formal intervention is always done by a professional. So it would be the spouse, it would be the parent that would retain the interventionist and they would pay a fee. The interventionist could arrive a few days earlier and have these mock plays to go through. They would sort of orchestrate the entire thing from A to Z. From how the sequence of events happens and who says what first and who says what second. So it's never done by, or it's rarely done by the actual loved one, it's done by an outside professional, but initiated by a spouse or a parent.
What does it mean to "hit bottom" in behavioral addiction?
The way one "hits bottom," or what "bottom" looks like for person A versus person B, might be very, very different. "Bottom" is nothing more than a place, an activity, a time, where someone comes to the realization that "this is as much pain and suffering as I want to go through, and I want to change. I'm willing to do whatever it takes." For some people, it means getting in a car accident or a DUI, or being diagnosed with liver failure. For others, it's substantially less. I'm a big believer that, yes, there is a bottom for everyone. I wish that it wasn't so. Sometimes the bottoms are really low bottoms. "Low bottoms" are: you lose your wife or family, you lose your career, and you find yourself out on the street. Or worse, your health has deteriorated to the point where there's no recoverability. Now hopefully no one waits to that point, but often, many people do. There's also "high bottom" people, and those are the people that I really want to nurture to get the ball rolling. Where things haven't come to the black-and-white "If I don't get help now I'm going to die," but rather, see the bottom coming, see the motion in that direction, and sort of start reaching out for help or start looking inside themselves, to start course corrections, way before they get to that bottom phase.