3rdEditionHandbookSmartRecoveryDocumentUpdateTeamRosemaryHardin,EditorSMARTRecoveryCentralOffice7304MentorAve.,SuiteFMentor,OH44060Copyright©2013bySMARTRecovery,Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,ortransmittedinanyformorbyanymeans,electronic,mechanical,photocopying,recording,orotherwise,withoutthepriorwrittenpermissionofthepublisher.PermissionsmaybesoughtdirectlyfromSMARTRecoveryCentralOffice.

TableofContentsIntroductionTheSMARTcommunityAcknowledgementsDisclaimer

Chapter1:WelcometoSMARTWhatisSMART?HowSMARTworksThe4-PointProgramRationalEmotiveBehaviorTherapyHowisSMARTdifferentfromotherrecoveryprograms?CanSMARThelpme?SMARTRecoveryOnlineBasictermsTools,exercises,andstrategies

Chapter2:GettingStarted“WheredoIstart?”UnderstandingaddictivebehaviorsTheProblemofImmediateGratificationFigure2.1.ThePIG’smethod.HowtodefeatanaddictivebehaviorIsaddictionadiseaseorbehavior?

UnderstandingrecoveryUnhelpfullabelsThejourneytorecoveryAbstinencevs.moderation

StagesofChangeEXERCISE:JournalingSummary

Chapter3:Point1:BuildingandMaintainingMotivation

WhyareyoureadingthisHandbook?TOOL:HierarchyofValuesFigure3.1MyHierarchyofValuesworksheet

EXERCISE:TheThreeQuestionsFigure3.2MyThreeQuestionsworksheet

TOOL:Change-PlanworksheetFigure3.3Change-Planworksheet(example)MyChange-Planworksheet

TOOL:Cost-BenefitAnalysisThecostsandbenefitsofusingFigure3.4.Cost-BenefitAnalysis(example)ThecostsandbenefitsofusingBenefits(advantagesandrewards)Costs(risksanddisadvantages)

ThecostsandbenefitsofnotusingBenefitsCostsMyCost-BenefitAnalysis

Shortandlong-termbenefitsSummary

Chapter4:Point2:CopingwithUrgesScratchinganitchBeliefsabouturgesEXERCISE:IdentifyingyourtriggersWhatisatrigger?Figure4.1Identifyingtriggers(example)IdentifyingmytriggersTriggerriskFigure4.2.TriggerrisksFigure4.3Triggerworksheet(example)Mytriggerworksheets

UrgesEXERCISE:Urgelog

Figure4.4MyurgelogDistractingyourselfFigure4.5.IdentifyingdistractionsFigure4.6WeeklyPlanner

STRATEGY:CopingwithurgesBasicstrategiesAdvancedstrategies

STRATEGY:DefeaturgeswithDEADSFigure4.7DEADSworksheetThinkingStrategiesTOOL:DISARM(DestructiveImagesandSelf-talkAwarenessandRefusalMethod)DealingwithdiscomfortWhatisdiscomfort?

TOOL:TheABCsforcopingwithurgesABCsofRationalEmotiveBehaviorTherapyFigure4.9ABCforcopingwithurges(example)

Summary

Chapter5:Point3:ManagingThoughts,Feelings,andBehaviorsManagingthoughtsThephilosophyofunconditionalacceptanceDowningbeliefsUnconditionalself-acceptance(USA)Unconditionalother-acceptance(UOA)Unconditionallife-acceptance(ULA)Rationalandirrationalbeliefs

EXERCISE:DisputingIrrationalBeliefs(DIBs)DisputingirrationalbeliefsFigure5.1DisputingIrrationalBeliefs(example)Disputingmyirrationalbeliefs

STRATEGY:Changeyourvocabulary,changeyourfeelingsFigure5.2WordexchangeFigure5.3Statementexchange

Figure5.4EmotionvocabularyexchangeManagingfeelingsTOOL:TheABCforemotionalupsetsFigure5.5ABCfordealingwithemotionalupset(example)WorkingthroughanABCFigure5.6Replacingexcessiveemotions

STRATEGY:CopingstatementsduringacrisisSolvinglife’sproblemsEXERCISE:FivestepsofproblemsolvingSTRATEGY:RelapsepreventionDangersituations

Summary

Chapter6:Point4:LivingaBalancedLifeEXERCISE:CreatingbalanceLifestyleBalancePieFigure6.1LifestyleBalancePie(example)MyLifestyleBalancePie

TOOL:Vitalabsorbingcreativeinterest(VACI)VACIlistFigure6.2VACI“beforeandafter”list

SettinggoalsEXERCISE:Values,goals,andplanningSettingrealisticgoalsFigure6.3GoalsettingMygoalsettingOthergoal-settingtips

LivingwithemotionsAwarenesstechniquesRelaxationProgressiveMuscleRelaxationFigure6.4PMRexercisesVisualizationFigure6.5Visualizationexercise

MeditationFigure6.6Meditationguide

RegainingyourhealthNutritionExerciseSleepMedication

ProcrastinationSummary

Chapter7:SMARTScienceHowweusescienceDSM-V

Chapter8:SMARTToolsandStrategiesMatrixTable8.1Matrix:StagesofChange,strategies,tools

Chapter9:Family&FriendsCRAFTOnlinemeetingandforumPublications

Chapter10:AboutSMARTPurpose,Mission,andVisionHistorySMARTvolunteersandsupportDonationsSMARTPoliciesMedicationDiseasemodelConfidentialityPersonalresponsibilityRespectSpirituality

APPENDIXA:DefinitionsofTermsAPPENDIXB:WorksheetsAPPENDIXC:RecommendedReadingandResources

IntroductionYoumaybereadingthisHandbookbecauseyou’resufferingfromanaddictivebehaviororsomeoneyouloveis.Whateverreasonyou’rehere,wewelcomeyoutoSMARTRecovery.SMARTstandsfor“SelfManagementandRecoveryTraining”.SMARTisanonprofitorganizationwithamissiontoofferfree,self-empowering,mutual-helpgroupsforabstainingfromanysubstanceoractivityaddiction.You’renotalone.Manypeoplewillstrugglewithaseriousaddictivebehaviorduringtheirlife.Whetheryou’redealingwithaddictiveorcompulsivebehaviorsorsubstanceabuse,SMARThasinformation,tools,andtechniquesthatmayhelpyoureplaceyourself-destructivebehaviorswithhealthieroptions.Peoplewithdrinkingandsubstance-abuseaddictivebehaviors—includingsmoking—andbehavioralissues,suchascompulsivegamblingorsexualactivity,self-harm,andeatingdisorders,findthatSMARTprovidesthesupportandtoolsthathelpthemrecover.Recoveryisdifficult,butwithpersistence,effort,andsupport,youcantakebackyourlife.Experienceshowsthatpeopleinrecoveryaremoresuccessfulwhentheyreceivesupportfromfriends,family,andmentalhealthprofessionals.Ifyou’reaconcernedsignificantother—parent,partner,friend,orrelative—ofsomeonewhoabusessubstancesorengagesincompulsivebehaviors,thisHandbookmayhelpyouunderstandyourlovedone’sissues.SMARTalsohasaFamily&FriendsHandbookthat’savailablefromouronlinebookstore.Ifyou’reateenager,theTeenHandbookisforyou.ThisHandbookiswritteninsimple,straightforwardlanguage.While

it’swrittenwiththerecoveringpersoninmind,it’salsoavaluableresourceforanyonetouchedbyorinterestedinaddictivebehaviors.Therearefewabsolutesinrecovery.Whatworksforonepersoninonesituationmaynotworkforanotherinthesamesituation.Withthatinmind,weavoidwordslike“must”and“should”andinsteadpresentideasthathavehelpedmanyofourparticipants.SMARTisascience-basedprogram.It’sbuiltuponwell-establishedscientificapproachesusedtohelppeoplemanagebehavioralproblemsandachievesuccessfulchange.Whennewinformationbecomesavailable,SMARTRecoveryadjustsitsprogram.There’samorein-depthdiscussionofthesciencebehindSMARTinchapter7.InthisHandbook,you’llfind:

SMART’s4-PointProgram®Tools,strategies,andexercisestohelpyouinyourrecoveryInformationforfamilyandfriendsThesciencebehindSMARTReading,websites,andotherresources

TheSMARTcommunityWeofferface-to-facemeetingsinmanycountriesincludingtheUnitedStates,Australia,UnitedKingdom,andCanada.Volunteerstranslatedour2ndeditionHandbookintoSpanish,German,Portuguese,Farsi,MandarinChinese,andDanish.Wehopetohavethiseditiontranslatedbyvolunteers,too.Ouronlinemeetingsreachaglobalcommunity.Ourmeetings—face-to-faceandonline—areforpeopleinrecovery,butthereareFamily&Friendsmeetings,too.Anyonemayattendanyofourmeetingsexceptforthoselistedas“closed.”Wearen’tamembership-basedorganizationsothere’snothingtojoin.Trainedvolunteersfacilitateallofourmeetingsandserveinmanyotherroles.Theygenerouslysharetheirexperience,knowledge,andcompassion,andarethebackboneoftheSMARTcommunity.BybuyingthisHandbook,yousupportourworkof:

Providingfreeface-to-faceandonlinemutual-helpmeetings.Providingforumsforlearningaboutanddiscussingaddictivebehaviors.Advocatingforchoiceinhelpforaddictivebehaviors.

AcknowledgementsSpecialthankstothepeoplewhogenerouslygavetheirtimeandexpertisetocreatethisversionoftheSMARTHandbook:Dr.WilliamAbbott,RosemaryAlmond,JimBraastad,JohnFrahm,RandyLindel,andRichardPhillips.AveryspecialthankyoutoHenrySteinberger,theauthorandeditorofSMART’s2ndeditionHandbook,whichisthefoundationforthisversion.

DisclaimerOurprogramisn’tintendedtobeasubstituteforprofessionalhelportreatment.WhileSMARTdoeshelpmanypeoplewhoworktowardrecoveryontheirown,it’salsoausefulsupplementtoprofessionalhelp.Ifyouhaveseriousdifficultieswithalcohol,drugs,compulsivegamblingorsexualbehaviors,overeating,self-harm,orotherdangerousproblems,werecognizethatyoumaybenefitfromprofessionalhelpinadditiontoworkingtheSMARTprogram.TofindamentalhealthprofessionalinyourareawhosubscribestoSMART’sprinciples,visitwww.smartrecovery.org.OK,let’sgetstarted...

Chapter1:WelcometoSMART

WhatisSMART?SMARTRecoverystartedin1994.SMART,anacronymforSelf-ManagementandRecoveryTraining,emphasizes“self”—yourroleinyourrecovery.We’reanonprofit,science-basedprogramthathelpspeoplerecoverfromaddictivebehaviors.Whetheryouraddictivebehaviorinvolvessubstances—alcohol,smoking,ordrugs—orbehaviors—gambling,sex,eating,shopping,self-harm—SMARTcanhelp.Weunderstandtheworkaheadofyou.Nomatterwhatyouraddictivebehavior,you’renotalone.

HowSMARTworksSMARTRecoveryusestechniquesfromCognitiveBehaviorTherapy(CBT),RationalEmotiveBehaviorTherapy(REBT),andMotivationalEnhancementTherapy(MET,anon-confrontationalapproachtohelpingpeoplechangebehaviors).Ourorganizationhelpsyouapplythesetechniquestoyourrecovery,asguidedbyour4-PointProgram®.Here’showSMARTworks:

1. Wehelpyoulookatyourbehaviorssoyoucandecidewhatproblemsneedyourattention.Wealsohelpyoustaymotivatedifyoumakethedecisiontochange.

2. Ifyoufeelyouneedtoworkwithatherapistinyourrecovery,weencourageyoutodothat.Ifthisisn’tanoptionbecauseyoucan’tafforditorliveinanareawherehelpisnoteasilyaccessible,SMARTcanstillhelpyou.

3. WeencourageyoutoattendSMARTmeetings.Interactingwithothersinrecoverywillhelpyouunderstandyou’renotaloneasyoustrugglewiththechallengesofrecovery.Atthesametime,you’rehelpingothers.Manyofuswhohavewalkedthepathofrecoveryhavefoundgreatstrengthintheheartfeltwordsofothersovercomingsimilarissues.Ifyouchoosetopursuerecoverywithoutattendingmeetings,we’restillheretohelp.

YoucanuseSMART’stools,strategies,andresourcesfromthestartofyourjourneytolongafteryoureachyourrecoverygoals.

YoucanstayinSMARTaslongasyouwish.Youaren’tmakingalifetimecommitmenttotheprogram.ManyfindthatparticipatinginSMARTaftertheyrecoverhelpsthemavoidrelapses.SomevolunteertofacilitateSMARTmeetingsorlendtheirtalentsandskillsinotherways.OtherssimplycontinuetoattendmeetingstosharetheirexperienceswithpeoplenewtoSMART,likeyou.Wefocusonthepresent—andwhatyouwantforyourfuture—ratherthanthepast.Wediscouragetheuseoflabelssuchas“addicts,”“alcoholics,”“druggies,”“overeaters,”etc.becausewebelievetheyinterferewithahealthyself-image.Instead,wefocusonbehaviorsandhowtochangethem.Addictivebehaviorscanarisefrombothsubstanceuse(psychoactivesubstancesincludingalcohol,nicotine,caffeine,food,illicitdrugs,andprescribedmedications)andactivities(gambling,sex,eating,shopping,relationships,exercise,etc.).Mostofusexperienceanaddictivebehaviortosomedegreeinourlives.Manypeoplehavemorethanone,eitheratthesametimeortheyovercomeoneonlytofindthemselvesdealingwithanotheronelater.It’simportanttorememberasyoubeginyourjourneythatthereisnotasingle“right”waytorecovery.Wealldoitalittlebitdifferently.

The4-PointProgramThe4-PointProgramistheheartofSMART.Eachpointprovidesyouwithtools,techniques,andstrategiesthatcanhelpyouonyourjourney.Manyofthesetoolsandtechniquesareskillsyoucanuseafteryouhavefullyrecoveredtohelpyoudealwithfutureproblemsandachievemoresatisfactionandbalanceinyourlife.Thesepointsarenotsteps.Forsomepeopletheyaresequential,forotherstheyarenot.Forexample,somepeoplecometoSMARTwhentheyarecopingwithurges,havingbuilttheirmotivationontheirown.Thefourpointsare:

1. BuildingandMaintainingMotivation2. CopingwithUrges3. ManagingThoughts,Feelings,andBehaviors4. LivingaBalancedLife

RationalEmotiveBehaviorTherapyREBT,generallyrecognizedasthefirstformofCognitiveBehaviorTherapy(CBT),waspioneeredbyDr.AlbertEllisinthe1950sandwasoriginallyknownasRationalTherapy.ManyofthetoolsandtechniquesthatSMARTusescomefromCBT.Epictetus,anancientGreekphilosopher,wrote,“Peoplearedisturbednotbythingsbutbytheirviewofthings.”Peoplesometimesexaggeratetheirthoughtsabouteventsintheirlives.Thesethinkingerrors,inturn,influencehowtheyfeel.ThisconnectionformstheunderlyingprincipleofREBT:Rational–Howwethinkinfluences...Emotive–Howwefeel,whichinfluences...Behavior–Howweact.Therapy–Thetrainingtohelpuslearnhowtochangeourthinkingtofeelandbehaveinhealthierways.

Manyofourproblemsseemtostartwithhowwereacttolife’sevents.Ifsomeoneisrudetous,wefightwithourspouse,orwedon’tgetthejobwewanted,ourirrationalthoughtsandexcessiveemotionsmaytakeover.Youmayhaveusedanaddictivebehaviortodealwithirrationalthoughtsandexcessiveemotions.Wecallthisthe“usingstrategy”forcopingwithdiscomfort.Somehow,weadoptedtheunrealisticbeliefthatlifeshouldbefreefromdiscomfortandpain,andthatweshouldn’thavetotolerateit.Thisunhelpfulbeliefleadstofurtherdistress,whichdrivestheurgetoengageinaddictivebehaviortoescapethediscomfort.

HowisSMARTdifferentfromotherrecoveryprograms?WhileSMARTcanhelpyouasastand-aloneprogram,italsocanworkasacompaniontoprofessionaltherapy.Ifyou’reworkingwithamentalhealthprofessional—counselor,psychologist,orpsychiatrist—SMARTcanaugmentthatworkbyreinforcingcommontherapeuticprinciples.Youalsomaybeworkingothermutual-helpprograms.WhilesomeoftheSMARTprinciplesmaybedifferentfromotherprograms,manypeoplefindthatworkingmorethanoneprogramatthesametimebenefitstheirrecovery.Wedon’ttakeapositiononanyotherprogramortherapy.Anygiventherapyorprogramdoesn’thelpeveryperson.WhilethousandsofpeoplearoundtheworldfindSMARTtobebeneficial,somedon’tfindourprogramtobehelpful.Onlyyoucandecidewhatworksbestforyou.Weencourageyoutofindthehelpthatworksforyou.Yourrecoveryiswhat’simportant,notwhichprogramhelpsyougetthere.

CanSMARThelpme?Theonlywayyou’llknowforsureistotry.Ourmeetingsaredesignedtodealwiththepressingneedsofparticipants.Trainedfacilitatorsleadallofourmeetings.Ourfacilitatorseitherhavegonethroughrecoveryorhaveastrongdesiretohelpthosewhoareinrecovery.Allmeetingshavevolunteermedicalormentalhealthadvisors.Theydon’tattendmeetingsbutareavailabletohelpfacilitatorswithdifficultmeetingissues.

SMARTRecoveryOnlineYoucangetconfidentialsupportandinformationfromtheSMARTRecoveryOnline(SROL)communitywhenyoucan’tordon’twanttoattendaface-to-facemeeting,oryoujustwantanotherwaytoconnecttoothersinrecovery.Wehaveanactiveandrobustonlinepresence.Therearemeetings,achatroom,andamessageboardthataremonitoredbytrainedvolunteers.TherealsoisextensiveinformationaboutSMARTandourtools,andcurrentinformationforparticipants,familyandfriends,teens,andforvolunteersandfacilitators.TosignupforSROL,gotoourwebsiteandclickonthe“messageboard”linkonthehomepage;followtheinstructions.Messageboard—AfteryousignupforSROL,weinviteyoutointroduceyourselfinthe“WelcomeArea”messageboard.Themainpartsofthemessageboardare“Discussions”and“ToolsandResources.”The“ClassicPosts”sectionisanarchiveofsomefavoritepostsfromthepast.Manypeoplejoinoneormoreofthedailycheck-ingroups.Therealsoareforumsforspecificsubstancesandbehaviors—opiates,smoking,eatingdisorders,self-harm,etc.—aswellasforspecificsituations—familyandfriends,dealingwithgrief,recoveringtoparenthood,healthcareproviders,etc.

Chatroom—It’sopenallday,everyday.Becausethereareonlineparticipantsfromallovertheworld,thereisusuallyalwayssomeoneinthechatroom.Uponentering,youmayfindtheconversationcasualandlight-hearted,butifyouhaveanissueorwantinformation,lettheroomknow.Recoverycomesfirstandthefocusofthediscussionwillchangetohelpyou.

Meetingrooms—Thesearewhereouronlinemeetingshappen.Therearemanymeetingseachday.Checkthedrop-down

menuatthetopofeverySMARTwebpageforameetingschedule.Someofthemeetingsaretextonly,andsomeareinthevoicemeetingroomwhereyoucanparticipateeitherbytalkingoveryourcomputer’smicrophoneorbytypinglikeyoudointext-onlymeetingroomsandinthechatroom.You’rewelcometoattendanyonlinemeeting,andbecauseyou’renewtoSMART,weencourageyoutotryoutoneofthemeetingsgearedtowardnewparticipants.EachSROLmeetinglasts90minutesandishostedbyatrainedvolunteerfacilitator.

Onlinelibrary—ThisisanexcellentplacetofindSMART’stools,worksheets,strategies,andmethods.ManynewcomersprintandcompletetheCost-BenefitAnalysis(CBA)worksheet.YoualsowillfindlinkstoourpodcastsandYouTubevideos,andtotheSMARTRecoveryblog,whichwecontinuallyupdatewithrelevantarticlesandposts.

BasictermsSMARTusesalotofacronymsandphrases.Herearethemostcommon.Abstinence:Stoppingalluseofasubstancesuchasalcoholordrugs,oracompulsivebehaviorsuchassexorovereating.Obviously,ifyoucompulsivelyovereat,youcan’tgiveupfood,butyoucandefineabstinenceasnotengagingincompulsiveovereating.Chapter2addressesthisinmoredetail.

Actout:Engaginginthecompulsivebehavioryouwanttostop.Ifyoucompulsivelycutyourself,thenyou’reactingoutwhenyoucutintoyourbodywithasharpobject.Ifyouspendmoneycompulsively,signingupforanewcreditcardorspendinghoursonshoppingwebsitesmaybehowyouactout.

Addictivebehavior:Anysubstanceuseoractivity(gambling,sex,spending,etc.)thatyouareabstainingfrom,orareconsideringabstainingfrom.

Craving:Thethoughtofdoingthebehavioryou’retryingtogiveup.

Lapse:Sometimescalledaslip.It’sabriefreturntooldbehavior.Someonewho’sabstainedfromgamblingforseveralyearslapseswhensheplaysanonlinegamblinggameorspendsanhour—maybeevenaweekend—gamblinginVegas.

Relapse:Asustainedreturntotheoldbehavior.Ifshegoesbacktoheroldgamblingbehaviorbyrepeatedlyplayingonlinegamesormakingtripstothenearestcasino,that’sarelapse.

Trigger:Anycue—asmell,image,event,sound,timeofday,etc.—thattriggersanurge,whichdrivesapersontoactout.Thisdoesn’tmeanatriggerautomaticallyleadstoactingout;however,manyofourirrationalthoughtsandexcessiveemotionsmaybeconnectedtothesetriggers,especiallyintheearlystagesofrecovery.Triggers(alsocalledcues)areassociationsthatsparkurges.Forexample,drivingpasthisfavoritebarmaytriggeranurgetodrinkforsomeonewhohasaproblemwithalcohol;awomansufferingfromcompulsivesexualbehaviorsmayfeelanurgetriggeredbythesmellofacertainbrandofaftershave.

Urge:Astrong,compellingdesiretodothebehavioryouwanttoabstainfrom.

Using:Acommontermthatreferstosubstanceabusebutcanapplytoanyaddictivebehavior.Weusewhenweengageinanycompulsivebehaviortoescapeourdiscomfort.

Tools,exercises,andstrategiesThroughoutthisHandbook,thereareitemsmarkedTOOL,EXERCISE,orSTRATEGY.TheseareSMARTaidesthatmaybeveryhelpfulinyourrecovery.

Chapter2:GettingStarted

“WheredoIstart?”Whenyoudecidetochangeyourlife,especiallyafteryearsofunhealthybehaviors,itcanseemintimidatingandoverwhelming.Weknow—mostofusinvolvedinwritingthisHandbookhavefirst-handexperiencewithrecovery.Itmayseemliketheproblemsyoucreatedforyourselfarebeyondyourabilitytofix.Onestrategyfordealingwithsuchdauntingproblemsistobreakthemdownintosmallerpieces,or“chunk”themsothatyoucandealwithoneortwopartsofanissueatatime.ThisHandbookstartsbyhelpingyouunderstandsomenewideas,whichmayhelpreducesomeofthefearsandanxietyyoumayhaveaboutrecovery.

UnderstandingaddictivebehaviorsIfweengageinabehavioronceinawhileanddon’tdoittoexcess,thenwedon’tneedtoworryaboutit,analyzeit,orstopit;however,ifabehavior—evenonethatstartsoutasahealthyone—causestoomanyproblemsinourlives,itmaybetimetochange.Behaviorsbecomeaddictivewhenthey:

Aretheresultofapatternthatbecomesaritualorhabitual;Becomestrongereachtimeyoudothem;Involveshort-termthinkinginthepursuitofimmediatepleasure,tofeel“normal,”ortorelievediscomfortordistress;Incurlong-termcosts,suchasdamagedrelationshipsorseriousfinancialhardship.

Wereinforceandstrengthenouraddictivebehaviorwhenwearecaughtupintherepeatingpatternofgivingintourgestogetrelief(Figure2.1).

TheProblemofImmediateGratificationAtriggerleadstoathoughtorcraving(Iwantadrink,somemeth,togamble,tohavesex,toeat),whichbuildsintoanurge(Ineedadrink,somemeth,etc.).Onceweuseordo,wefeelbetterornormal,butonlyforawhile.ThisistheProblemofImmediateGratification,orPIG.

Figure2.1.ThePIG’smethod.

TheproblemwiththePIGisthatimmediategratificationoftenhasgreaterinfluenceonusthanhealthier,delayedrewards.RepeatingthepatternreinforcesthePIG.Everytimewegiveintoanurge,westrengthenthepattern.Thenexturgecomesmorequicklyandmoreforcefully.More—andlessimportant—events,thoughts,feelings,andotherlifestuffcauseyoudiscomfort,whichtriggersmorecravings,resultinginmoreurges,whichleadstomoreusing.Theminorstressesthatearlierinyourlifeyoudismissedasannoyingarenowmajorissuesinyourmind,givingyoua“reason”touse.Overtimeyouneedmoreofyouraddictivebehaviortofindrelief,soyoumaystartlookingfororinventingtriggerstohaveanexcusetouse.Youmayevencreateurgessothatyou’llhaveanexcusetoactout.Themoreyourepeatthispattern,thebiggerthePIGgrows.Youmayfeellikeyoucan’tescapethiscycleofaddictivebehaviorandthatyou’redoomedtorepeatitforever.Butthereishope;millionsofpeoplehavepermanentlystoppedtheircompulsivebehaviorsandmovedontolivesatisfyinglives.Ithappenseveryday!

HowtodefeatanaddictivebehaviorItallstartswithstopping.Ifyoudon’tgiveintourges,theybecomelessintenseandoccurlessfrequently.Fewerthingswillserveas

triggerssoyou’llhavefewerurges.ThePIGshrinks.Learningtotolerateshort-termdiscomfort,andacceptingthaturgeswon’tfeelgoodforsecondstominutesuntiltheyfadeenablesyoutocontrolyourbehavior.Withinarelativelyshorttime—afewdaysorweeks—you’lllearntoacceptshort-termdiscomfortaspartoflivingahealthierlife.Youraddictivebehaviorwillloseitsgriponyourlife.You’llunderstandthatusingisachoice.Justbyunderstandingthatusingisachoiceandnotaninevitablereactiontodiscomfort,you’realreadyretrainingyourbrain.Yourrecoverycanbearealisticandself-directedjourney;SMARTcanhelpyou:

Identifyandunderstandthetriggersthatleadtoyourcravingsandurges,andthattheydon’thavetoresultinactingout.Recognizeandunderstandyourunhealthypatterns(rituals,triggers,andbehaviors),andstaymotivatedandfocused,evenwhenrecoveryseemsoverwhelming.Copewithyoururges,changehowyouthinkabouttheeventsinyourlife,andmakebetterdecisions.

Isaddictionadiseaseorbehavior?Thisquestionisdebatedwithintherecoveryandtreatmentfield.SMARTRecoverytoolscanhelpyouwhetherornotyoubelieveaddictionisadisease.

UnderstandingrecoveryWhatisrecovery?Youmightthinkthisisanobviousquestionwithaclearanswer;however,itreallyisn’t.Infact,it’srathercomplex.SAMHSA(SubstanceAbuseandMentalHealthServicesAdministration)definesrecoveryas“Aprocessofchangethroughwhichindividualsimprovetheirhealthandwellness,liveaself-directedlife,andstrivetoreachtheirfullpotential.”SMARThaslongrecognizedrecoveryasthemostimportantpartofsuccessinmanagingaddictivebehavior.Manymentalhealthprofessionalsconsiderrecoveryasaseparatefocusintheoverallmanagementofaddictivebehavior.Somecurrentandrecentgovernment-supportedresearchinthisfieldfocusesonrecovery.IntheUnitedStates,eventssuchasRecoveryMonth,designatedaseverySeptember,raiseawarenessaboutrecovery.Recoveryisdifferentforeveryone.Yoursmaybeaboutchangingnegativethinkingpatterns.Inadditiontoabstainingfromunwantedbehaviors,youalsomaycommittotryingnewactivitiesthatchallengeyou.Youmaychoosetocreatemoretimeforyourlovedones.Recoveryhelpsyoufillthevoid—onceoccupiedbyyouraddictivebehavior—withhealthierthoughts,emotions,activitiesandchallengesthatleadyoutoamorebalancedandsatisfyinglife.Abstinencewithoutrecoverydoesn’tprovidepeoplewiththetoolsandinformationtheyneedtofilltheaddictivebehaviorvoid,whichiswhylapsesandrelapsesaremorecommonthaninabstinencewithrecovery.Recoveryisaboutlearningtoreplaceunhealthybehaviorswithhealthieractivities,leadingtoamorebalancedlife.Recoveryisapersonaljourney.It’swhatyoumakeitandcanbehowyouwantittobe.Afterall,you’retheboss!

UnhelpfullabelsPerhapsyou’vebeentold,“You’reanalcoholic”;“You’readrunk”;“You’reweak”;“You’redifferentfromnormalpeople”;“Youwillbattlethisfortherestofyourlife”;“Youmuststoprightnowandforever”;towhichyoumayhaveresponded,“I’llneverbeatthissoImightaswell(actout,getdrunk,getstoned,smokeapackofcigarettes,eatcookies,goshopping,harmmyself)becauseIcanneverbehealthy.Whybother?”Youmayfeeltrappedinyourbehaviorwithlittlehope.Hopelessnessoftenfuelsaddictivebehavior.ThisiswhySMARTdiscouragestheuseoflabels.

ThejourneytorecoveryLikeanylongjourney,recoverystartswithonestep.Changingbehaviorpatternstakestimeandeffort,trialanderror.Ifyouhaveeverthought,“I’mahopelessaddictwithadiseasethatIwillneverbeat”;“Ihavenochoicebuttofightthisforever”;or“Ihavenochoicebuttokeepusing”;trychangingyourthoughtsto,“IusedtohaveanaddictivebehaviorbutIchoosenottoactthatwayanymore.”Thosewordsmayhelpyoufeelmoreconfident,especiallyinthebeginningofyourrecovery.Ifyoucanfeelthatyouwilltriumphoveryourunwantedbehavior,thenit’slikelyyouwill.IfoneofSMART’stools,strategies,orexercisesdoesn’tworkforyou,tryadifferentoneuntilyoufindwhatmakesyousuccessful.Recoveryispossible.Urgesfadeaway.Abstinencegetseasier.Youraddictivebehaviorbecomesathingofyourpast.Youfindmeaningandenjoymentinyournewlife.

Abstinencevs.moderation

SMARTisanabstinence-basedprogram.Theideaofabstinencemaybeintimidatingtoyou—perhapsevendistasteful—asyoubeginyourrecovery.Evenifyou’reunsureaboutabstinence,you’restillwelcomeatourmeetings.Foralcoholanddruguse,themeaningofabstinenceisclear:Stopdrinkingorusing.Thatalsoworksforsomecompulsivebehaviors,suchasgambling,becauseonedoesn’tneedtogambletosurvive.Butwhataboutotheractivitiessuchaseating,shopping,andsex?Peoplewitheatingdisordersstillneedtoeat.Compulsiveshoppersstillneedtobuythings.Forthese,wecandefineabstinenceasstoppingthecompulsiveorself-destructiveaspectsofthebehavior:Buyingonewatchinsteadoffive,eatingacupofyogurtinsteadofagallonoficecream,beingintimatewithyourpartnerinsteadofengaginginanonymoussexwithothers.Ifyouraddictivebehaviorisofthistype,youmayneedprofessionalhelpsettingboundaries,definingabstinence,anddevelopingskillstomoderateyourbehaviortokeepitfrombecomingcompulsive.Ifyou’reconsideringthebenefitsofabstinence,thinkaboutthis:Themoreyearsyouengagedinaddictivebehaviorandthemoreseriousthecompulsion,themorelikelyabstinence—ratherthanmoderation—willhelpyoureachyourgoals.Ifyou’rethinkingaboutmoderation,herearesomepointstoponder:

Programsaimedatcontrolleduseormoderationusuallyrecommendaninitialperiodofabstinence.Stoppingcompletelyforaperiodisahealthychoice,evenifmoderationisyourlong-termgoal.Mostpeoplefinditiseasiertoabstainfromratherthancontrolormoderatetheiraddictivebehaviorbecauseit’s

difficulttoknowwheretosetthelimitandthensticktoit.Evenpeoplewiththemostcommittedintentionsoftenfindtheirbehaviorinchesbacktothepointwhereitcausesproblemsagain.Insteadofapplyingyoureffortstocontrolandmoderatetheaddictivebehavior,youcanfocusthatenergyondealingwithotheraspectsofyourrecovery.

Whyyoumightpreferabstinenceasagoal:

It’sasafechoice.It’ssimple—nocounting,noprecisedecisions,andit’sgoodforallsituations.Anylevelofusingmayaggravateexistingmedicalconditions.Evenmoderateduseofasubstancemayworsenpsychologicalorpsychiatricproblems.Somemedicationsbecomehazardousorarerenderedineffectivewhencombinedwithalcoholorotherdrugs.Theremaybestrongsocial(family,friends,employer)andlegal(courts)demandstoabstain.Youbelieveitwillbeeasiertoabstainbecauseofyourlongorseverehistoryofuse,orbecauseofbackgroundriskfactors(familyhistory,seriousnessofrelatedproblemssuchasdepression,violence,etc.).

Asignificantperiodofabstinencemay:

Enableyoutofindoutwhatabstainingislikeandhowyoufeelwithoutmood-alteringsubstancesorbehaviors.

Helpyouunderstandhowyoubecamedependentonsubstancesorbehaviors.Helpyoubreakotheroldhabits.Allowyoutoexperiencesignificantlifechangesandbuildconfidence.Pleaseotherssuchasyourspouse,partner,children,employer,parents,andfriends.

Ifyou’reconsideringmoderationbecauseyou’vetriedtoabstainbutitdidn’twork,itdoesn’tmeanyouwon’tmaintainyourabstinencenow.Previousattemptsandlapsesorrelapsesaren’tfailures.Theycanprovideyouwithvaluableinsightifyouletthem.Youmightbereadytoabstainrightnow,oryoumaywantmoretimetodecide.Don’tmakethatdecisionuntilyou’reready.Abstinenceisnotacommitmenttobeperfect.Manypeopledolapseorrelapseintheireffortstoabstain;however,somepeopleneverdo—andthatmaybeyou.Committingtoabstinencemeansthatyouarecommittingtochange.Itrequirespatience,persistence,andpractice.Breakingacommitmenttoabstinenceisnotthesameasgivinguponit.Youmayfindabstinenceeasy.Ifyouhavereachedapointinyourlifeinwhichyouhavehadenoughoftheproblemsanddisappointmentsfromyouraddictivebehavior,abstinencemaybeeasierthanyouthink.Formost,however,it’smoredifficultthanthat.Pleasenote:Ifyouhavebeendrinkingorabusingdrugsheavilyforsometimeandareplanningtostop,consultyourdoctorfirst.Itmaybedangerous,evenlifethreateningtostop“coldturkey”afteralongperiodofcontinualheavyuse.

Youmaywanttodoanassessmentofyouralcoholuse.TheDrinker’sCheckup—www.drinkerscheckup.com—isafree,confidential,professionallydevelopedandtestedself-assessment.Itconsidersmanyriskfactorsandprovidesmeasuresofrisk,tolerance,dependence,andconsequencesonseveralscales.Whereveryouareonthisdecision,you’realwayswelcomeatSMARTmeetingsandonSROL.

StagesofChangeIt’sdifficulttochangelong-standingbehaviors,evenwhennewonesarebetterforyou.Changingaddictivebehaviorisespeciallydifficultbecauseofitscompulsivenature.JamesProchaskaandCarloDiClementedevelopedtheStagesofChangemodelinthe1970s.Theyfoundthatpeoplewhostoppedsmokingusuallytriedtostopseveraltimesbeforetheypermanentlychangedtheirbehavior.Thismodelisn’talinearjourney.Manypeoplegoinandoutofdifferentstagesuntiltheyfinallyexit;eventhen,there’salwaystheriskofrelapse.Asyoureadeachstagedescriptionbelow,thinkaboutwhichoneyou’reintodayandrememberthattomorrowyoumaybeinadifferentstage.Forexample,ifyou’reinthepreparationstagetodaybecauseyou’resureyouwanttochangeyourbehavior,tomorrowyoumaybeinthecontemplationstagebecauseyouhavedoubtsaboutchanging.It’shelpfultoknowwhereyouareinyourrecovery.Identifyingthestageyou’reincanprovideclarityinthisotherwiseunchartedjourneyintothefuture.

Pre-contemplation:Peopleatthisstageusuallyarenotintendingtotakeactioninthenearfutureandmaynotbeawaretheirbehaviorisproblematic.Theymayshowupintherapyormutual-helpgroupsunderduress—pressurefromspouses,employers,parents,orcourts.Theyresistchangeandusuallyplaceresponsibilityfortheirproblemsonexternalfactorssuchasgenetics,family,society,thelegalsystem,etc.Theydon’tfeeltheycandomuchaboutthesituationandreallydon’twantto.Contemplation:Peoplestartweighingthebenefitsandcostsof

changeandmayexperiencethemixedfeelings—ambivalence—thatpeoplenormallyhaveaboutchange.Manyfindthatwritingdownthecostsandbenefitsofchangehelpthemtodecide.Preparation:Inthisstage,apersonhasdecidedtheirlifeneedstochangeandareseriouslyconsideringoptions.Theygatherinformation,evaluatealternatives,andtakesmallstepstowardchangingtheirbehavior.Theystartlookingtowardthefutureandlessatthepast.Action:Here’swhereapersontakestheplunge.Actioncantakemanyforms,fromthecontrolledenvironmentofinpatienttreatment,toworkingwithaprofessionalcounselor,toattendingmutual-helpgroups,toworkingontheirown—orsomecombinationofthese.Here’swherepeopletrynewwaystohandleoldsituations,uncomfortableemotions,urges,andotherchallenges.Thisstagerequiresthegreatestcommitmentoftimeandenergy,butalsoiswherenewchangesstarttobevisibletoothers.Peopleinthisstageusuallyneedsupportiverelationships.Theystartsubstitutingsomenew,healthieractivitiesforoldones.Somepeopleexperienceanxietyatthisstage,butlearntoacceptacertainamountofdiscomfortinreturnforachievingtheirlong-termgoals.Maintenance:Peoplecontinuebuildingconfidenceastheyprogressonthenewdirectionoftheirlives.Butchallengesremain;unexpectedtemptationsmayrequirenewthinkingorapproaches.Peopleusuallykeepseekingsupportfromthosetheytrustandkeepdoinghealthyactivitiestocopewithstress.Exit:Afteralongperiodofmaintenance,mostpeopleadoptanewlifestyleconsistentwiththeir“newnormal”behavior.Old,harmfulbehaviorsnolongerhaveaplaceintheirlives.Theyexpressconfidenceandself-control,andlivehealthier,happier

lives.

Lapseorrelapse:Whilenotastageornecessarypartofchange,theyarecommonandmayoccuratanystage.Theyareneveranexcusetocontinueaddictivebehavior.Ifalapseorrelapseoccurs,itdoesn’tmeanapersonhastorestarttheirjourney.Theycanidentifywhichstrategieshelpedthemandwhichonesdidn’t,andusethatknowledgetomoveforwardwiththeirrecovery.

Ifyoulapseorrelapse,don’tletitleadtocrushingself-reproachandguilt.It’sbettertoacceptthetemporarysetbackasanormalpartofchangeandgrowthratherthantocallyourrecoveryafailureandgiveup.Handledwell,alapseorrelapsecanbebriefandprovideanotheropportunityforself-empowerment.Afterall,whenwelearnedtorideabike,wefellmanytimesbeforeweknewhowtocontrolthebicycle.

EXERCISE:JournalingKeepingajournalofyourrecoverymayhelpyouduringeverystageofchange,ineachpartofthe4-PointProgram®andbeyond.It’sarecordofyourprogress,accomplishments,setbacks,stages,etc.,andaprivateplacetodocumentyourexperiencesandemotionsastheyhappen.Therearenorulestojournaling.Somepeopleliketowriteinjournalswithfavoritepens,somekeepthemontheircomputers,someusespiralnotebooks,somedon’tlikelinedpaper.Somepeoplewriteeverydayasadiscipline,someonlywritewhentheyneedtoworkthroughanissue.Youcandrawpicturesanddoodle.Youmaywanttokeepyourjournalsforever,oreventuallythrowthemaway.It’scompletelyuptoyou.Ajournalofyourrecoverycanservemanypurposes.Itremindsyouwhatstageofrecoveryyou’rein,whatyou’vebeenthrough,whataccomplishmentsyou’vemade,andwhatchangesyoustillwanttomake.Youcan:

Keepdailynotesaboutwhatyou’rethinking,howyou’refeeling,andwhatyou’redoing.Breakdownoverwhelmingcomplexproblemsintosmallerparts.Planactivitiesandsetshort-termgoals.Identifywhat’shelpingyourecoverandwhat’snothelping.Chartyourprogressalongyourrecoveryjourney.

Awordaboutprivacy:Yourjournalisyourspace.Youmaychoosetoshareitortokeepitprivate.Ifyou’reafraidtokeepa

journalbecauseyouthinksomeonewillreadit,makeitclearyourjournalisofflimits.Youmayfeelmorecomfortablekeepingitwithyouatalltimes,orfindingasecurehidingplaceforit.Readingsomeoneelse’sjournal—unlessyouthinktheyareineminentdangerofhurtingthemselvesorsomeoneelseandtheirjournalmightprovideinformation—isneverOK.

SummaryBehaviors,evengoodones,becomeaddictiveinnaturewhentheybecomeourpriority,throwingourlives—andourthinking—outofbalance.Addictivebehaviorcancostdearlyintermsofrelationships,careers,freedom,andindependence.Recoveryisajourneyinwhichyoulearntosubstituteshort-termgratificationandirrationalthinkingwithrationalperspectivesandafocusonyourlong-termgoals.Keepingajournalcanbeveryhelpful.It’syourplacetorecordyourachievements,setbacks,thoughts,andemotions.Youmaybereadytocommittoalifeofabstinenceandbalance,oryoumaybequestioningwhetherornotyouhaveaproblemwithsubstanceorbehaviorabuse.Whateverstageyou’rein,wewelcomeyoutoSMART.WhileSMARTisanabstinence-basedrecoveryprogram,youmaynotbesureyetifabstinenceisyourgoal.You’rewelcometoparticipateinSMARTwhileyoudeterminewhat’sbestforyou.

Chapter3:Point1:BuildingandMaintainingMotivation

WhyareyoureadingthisHandbook?Somethingcausedyoutopickupthisbookandatleastentertaintheideaofchangingyourlife.Areyouridinganemotionalwavefromsomecrisisinyourlife?Whathappenswhenthecrisissubsidesandlifereturnsto“normal?”Willyoustillwanttochangeyourlife?It’seasytomakealistofannualNewYear’sresolutionsandworthygoals—loseweight,savemoney,becomeabetterparent,stopthisorstartthat.Thinkofthelasttimeyoumadesuchalist.Howlongdidittakebeforeyourlifefounditswaybacktowhereitwasbefore?So,howdowestaymotivatedtomakethechangewesincerelywant?Oneofthebiggestchallengesmostpeoplefaceinrecoveryismaintainingtheirmotivation.“Wishing”isnotareliablestrategy.Someofustalkaboutthechangeswewanttomakeasifjusttalkingaboutthemwillgetusthere.Motivationiskeytoyourrecovery;it’swhatdrivesyoutomeetyourgoals.Withoutit,you’renotlikelytochangeverymuch.Youmaynotrealizeitbutyou’realreadymotivatedtochange.Ittookmotivationtobuythisbookortoattendyourfirstmeeting,evenifsomeoneforcedyou.Youcouldhavesaidno,butyoudidn’t.Thissectionwillhelpyoubuildonthosefirstseedsofmotivationandhelpyoustaymotivatedduringthechangeprocess.YoumayhaveheardthatSMARTisaself-empowermentprogram.Itmaysoundabitlikepoppsychology.Itisn’t.Thisconceptisimportantasyoupreparefortheworkahead.Youhavepoweroverthechoicesyoumake,howyoubehave,andthegoalsyousetforyourfuture.

TOOL:HierarchyofValuesWeallhavevaluesthatmotivateus,whetherwe’veidentifiedthemornot.Chancesarethatyouhaven’trecentlythoughtaboutyourvalues.TheHierarchyofValues(HOV)willhelpreintroducewhatismostimportanttoyou.Startbywritingdownasmanyofyourvaluesasyoucanthinkof.Therearenorightorwronganswersastheseareverypersonal.Onceyouhavewrittenasmanyasyoucan,groupthemintomaincategories,ultimatelynarrowingyourlisttofive.InFigure3.1,listtheminorderofimportance.

Figure3.1MyHierarchyofValuesworksheet

Yourlistmaylooksomethinglikethis:

Lookoveryourlistagain.Doyounoticeanythingmissing?It’srarethatapersonliststheiraddictivebehaviorasavalueeventhough

it’slikelythemostimportantpriorityintheirlife.Anaddictivebehaviorcanbecomethemostimportantpriorityinyourlife,withoutyouevenrealizingit.Now,thinkabouthowyouraddictivebehaviorimpactseachofyourvalues.Everytimeyouengageinyouraddictivebehavior,youchooseitoveryourvalues.Yougamblewithwhatyoutreasureandholddear;youcompromiseyourvaluesystem.Asuccessfulrecoveryrequiressobrietytobeavaluedpriorityinyourlife.Whenpeopledothisexercise,theyoftencomeawaywithan“ahha”moment.AtoneSMARTmeeting,awomanwhowasnewtorecoverydidthisexercisewiththehelpofthefacilitator.Whenheaskedherwhyalcoholwasn’tonherlist,sheburstintotears.Shehasn’thadadrinksince!Youmaynowhaveaclearerpictureofhowyouraddictivebehavioraffectswhatyouvaluemost.Thesenexttwoexerciseswillhelpyoulookdeeperintowhatyouwantforyourselfandhelpyouidentifyspecificandimportantgoalsyouwanttoachievetobringmoremeaningtoyourlife.

EXERCISE:TheThreeQuestionsYourgoalistostopusingoractingout.Yourdesiretochangeisyourmotivationtostopyouraddictivebehavior.Itissometimeshardtoseeadifferencebetweenwhatyouaredoingandwhatyoucoulddodifferentlytoachieveyourgoals.Thisexercisecanhelpyoubringthesetwoperspectivesintofocussoyoucanidentifythediscrepancybetweenthem.Askyourselfthesequestions:

1. WhatdoIwantformyfuture?2. WhatamIcurrentlydoingtoachievethat?3. HowdoIfeelaboutwhatI’mcurrentlydoing?

Anexampleofanswerstothesequestions:

1. WhatdoIwantformyfuture?Tobeagoodpartner,parent,employee.

2. WhatamIcurrentlydoingtoachievethat?Nothing,becauseI’mdrunkandstonedallthetime.

3. HowdoIfeelaboutwhatI’mcurrentlydoing?Guilty,ashamed,depressed,frustrated,stressed,trapped.

Now,answerthenexttwoquestions:

1. WhatcouldIdodifferentlytoachievethefutureIwant?2. HowwouldchangingwhatIdoorgettingwhatIwant

makemefeel?

Onceyouseethediscrepancybetweenyourfeelingsaboutwhatyou’recurrentlydoing(2)andyourfeelingsaboutchangingyourbehavior(5),youcanusethatdifferenceasfurthermotivationtostopusing.Asyoustarttofeelbetteraboutbeingabstinent,youfeelmoreempoweredtoachieveyourgoalin#1:Beagoodpartner,parent,andemployee.

Figure3.2MyThreeQuestionsworksheet

TOOL:Change-PlanworksheetNowthatyouidentifiedwhatyouwantforyourfutureandwhatyouneedtodotogetthere,youneedaplan.IntheChange-Planworksheet,identifystepsyoucantaketowardyourgoal(envisionedfuture)andconsiderpeoplewhocanhelpyougetthere.Createstrategiestohelpyouprogressandidentifysignsthatshowyou’remakingprogress.Ifastrategydoesn’twork,don’tgiveup;useitasanopportunitytotrysomethingdifferent.Youalsomayusethistoolasaproblem-solvingworksheetbecauseitcanhelpyoubreaklargeproblemsintosmallerstepstofocusyoureffortssothatyoudon’tgetoverwhelmed.

Figure3.3Change-Planworksheet(example)

MyChange-PlanworksheetDate_____________

TOOL:Cost-BenefitAnalysisSofar,you’veidentifiedyourcorevaluesandwhatyouwantyourfuturetolooklike.Youalsohavecreatedaplantogetthere.Remember,though,youraddictivebehaviorwillbewaitinginthewingsfortheslightestopportunitytohijackyourplansandmotivation.Haveyoueveraskedyourselfwhatyougetoutofyouraddictivebehavior?Youmustbegettingsomething—it’shardtoimagineyou’ddoitifyoudidn’tgetsomethingoutofit,evenifthebehaviorcausesyouorothersharm.Doyoudrinkbecauseithelpsyoucopewiththestressofbeingaparentorthechallengesofyourjob?Doyoufindanonymoussexpartnerstomakeyoufeelmoreattractiveandwanted?Doyouharmyourselfbecauseitcalmsyou?CompletingaCost-BenefitAnalysisorCBAwillhelpyouanswerthesequestions.Atsomepointinourlives,wetoldourselves—eitherconsciouslyorunconsciously—thatthebenefitsofourbehavioroutweighedthecosts.Buthaveyoueverlookedatyourbehaviorunderamicroscopeandreallyexaminedallthebenefitsandallthecosts?Peoplewhowanttostopanaddictivebehaviorhavetwotypesofthinkingabouttheirbehavior,butneveratthesametime:Short-termthinkingandlong-termthinking.Short-termthinking:Usingmakesyoufeelimmediatelybetter.Long-termthinking:Youwanttostopthebehaviortoleadahealthierlife.Becauseshort-andlong-termthinkingdon’thappensimultaneously,theCBA(Figure3.4)bringsthemtooneplacetohelpyouidentify

andcomparethefar-reachingconsequencesofyourbehaviorwithits“rightnow”benefits.TheCBAalsowillhelpyoucomparelong-andshort-termbenefitsofabstinence.Tostart,considerthecostsandbenefitsofyouraddictivebehavior.

ThecostsandbenefitsofusingUsingthefollowingexampleinFigure3.4,startbylookingatwhat’spleasurableaboutyouraddictivebehavior.Beasspecificaspossible.Forexample,insteadofwriting,“Myaddictivebehaviorhelpsmecope,”writehowithelpsyoucope.“MybehaviormakesmebraveenoughtosaywhatI’mreallyfeeling,”or“Actingouthelpsmeforgetmyloneliness.”

Figure3.4.Cost-BenefitAnalysis(example)

ThecostsandbenefitsofusingUsingtheFigure3.4example,startbylookingatwhat’spleasurableaboutyouraddictivebehavior.Beasspecificaspossible.Forexample,insteadofwriting,“Myaddictivebehaviorhelpsmecope,”writehowithelpsyoucope.“MybehaviormakesmebraveenoughtosaywhatI’mreallyfeeling,”or“Actingouthelpsmeforgetmyloneliness.”

Benefits(advantagesandrewards)

Whatpleasures,benefits,oradvantagesdoesitbringtomylife?Withwhatfeelingsormoodsdoesmyaddictivebehaviorhelpmecope(frustration,anger,fear,

boredom,depression,anxiety,loneliness,stress,etc.)?Howdoesithelpmecope?Whatpositivefeelings,moods,orsituationsdoesmyaddictivebehaviormakeevenbetter?Whatthingsdoesmyaddictivebehaviorhelp,oratleastseemtohelpmedobetter?Doesithelpmeavoidrealityorescape?Doesiteaseorreducephysicaloremotionalpain?Doesmyaddictivebehaviorhelpmesocializeandfitin?DoIneedmyaddictivebehaviortoseemmorefun,charming,interesting,ormoreconfident?DoIneedmyaddictivebehaviortofeelnormal?

Costs(risksanddisadvantages)

WhatisitthatIdislikeaboutusing?Howisitharmingme?WhatwillmylifebelikeifIcontinuetouse?HowmuchtimehaveIlosttomyaddictivebehavior?HowmanypeopledoIlietoinordertohidemyaddictivebehavior?HowdoIfeelaftertheeffectsmyaddictivebehaviorwearoff?Howisusingaffectingmyhealth?Doesusingaffectmyenergy,stamina,andconcentration?HowmuchmoneyhaveIlosttomyaddictivebehavior?WhatlegalproblemsdoIfacebecauseofmybehavior?Howdoesusingaffectmyrelationships?

Howdoesusingaffectmyworkperformance?Whateffectshasithadonmyself-respectandself-confidence?

ThecostsandbenefitsofnotusingNow,dothesameexerciseforyourlifewithoutaddictivebehavior.Behonestandrealistic.

Benefits

Howwillstoppingaffectmyhealth?HowwillstoppingaffectmyrelationshipswiththeonesIlove?Howwillstoppingaffectmyjob?HowmuchmoneycanIsave?Whatwillstoppingdotomyself-respectandself-confidence?Willstoppingaffectmyabilitytodealwithmyproblems?WhatwillIdowiththetimefreedupbecauseI’mnotpursuingmyaddictivebehavior?WhatgoalshaveIabandonedthatIcouldaccomplish?

Costs

WhatwillImissaboutusing?WhatissuesinmylifewillIhavetofindnewwaystodealwithwhenIstopusing?WhatthoughtsandemotionswillIhavetolearntoaccept?WhatwillchangeaboutmylifethatIlikenowbecauseIuse?

MyCost-BenefitAnalysisThesubstanceoractivitytoconsideris:____________________Date:______________

Shortandlong-termbenefitsOnceyouhaveyourlistofbenefitsandcostsforeachsection,identifyeachoneaseithershort-termbenefitorlong-termbenefit.Areyousurprisedthatmostofthebenefitsofusingandcostsofstoppingareshort-termwhilethecostsofusingandbenefitsofstoppingarelong-term?InSMARTmeetings,weoftenheargaspsfrompeopleastheyrealizetheiraddictivebehaviorhasonlyshort-termbenefitsbutlong-termcosts.Thismaybethefirsttimeyou’vetakenahardlookatthepriceyou—andthosearoundyou—havepaidforyourbehavior.Nowthatyou’reconsideringyourbehaviorintermsofimmediateandlastingbenefits,thedecisionwhethertouseorstopisclearer.KeepyourCBAhandyandrefertoitwhenyouhaveanurge.Makecopiesandkeepthemwithineasyreach.Makeitalivingdocument:Reviseandupdateitwheneveryouneedto.TheCBAisagreattooltouseforanychangeordecisionyouwanttomake.

SummarySofar,you’vedonesomewonderful—anddifficult—planning.Congratulations.Youidentifiedyourvalues,whatyouwantyourfuturetolooklike,what’simportanttoyou,andhowyourcurrentbehaviorunderminesyourgoals.You’vemadeaplantocreateyourfutureandhonoryourvalues,andyouidentifiedyoursupportsystem—thepeoplewhocanhelpyoualongyourjourney.Youalsoidentified,possiblyforthefirsttime,thelongandshort-termcostsandbenefitsofyouraddictivebehavior.Thesearepowerfulinsights.Youmayfindyourselfreferringtothesepagestohelpyoustaymotivated,especiallyasyoumoveintoPoint2:CopingwithUrges.

Chapter4:Point2:CopingwithUrgesNowthatyou’recommittedandmotivatedtochangeyourbehavior,let’slookathowyoucandealwithanyurgesyoumayhavetouse.Learningtocopewithurgesisthedifferencebetweenabstainingandusing.Itcanbedifficult.Thefeelingscanbeintense,andyou’reusedtogivingintothem.Ittakesstrongmentalandemotionalcommitmentonyourparttochangethesepatterns.Somepeoplereporthavingnourgesaftertheymakethechoicetostop.Somereporttheyhaveurgeslateron.Dealingwiththemmaybementallydifficult;itmaybephysicallyandemotionallyuncomfortable,butit’snotimpossible.Youcandoit.AccordingtoWebster’sDictionary,anurgeisanaction“topress;topush;todrive;toimpel;toforceonward.”Italsosaysanurgeis“topressthemindorwillof;toplywithmotives,arguments,persuasion,orimportunity.”Urgesarepsychologicalinnatureandnotthephysiologicalwithdrawalsymptomsyoumayexperiencewhenyoufirststopusing(behaviororsubstance).However,resistingurgesmaycausephysicaloremotionaldiscomfort.Themoreyouknowabouturgesandunderstandwhytheyhappen,thebetterequippedyouaretocopewiththem.Ratherthananexcusetoescapeintoyouraddictivebehavior,you’llbeabletouseurgesasacatalystinyouremotionalgrowth.Youcanlearntorecognizeurgeswithoutactingonthem.Themoreyoudothat,theeasieritgets.Mostpeoplewhorecoverfromaddictivebehaviorsaythat,afterawhile,theurgesgoawaycompletelyastheyreplacetheunhealthybehaviorwithhealthy

alternatives.Inthefirstfewdaysandweeksofyourabstinence,yoururgesmaybeverystrongandmaygrowstrongerforawhile.

ScratchinganitchIfyou’veeverhadarashfrompoisonoak,poisonivy,chickenpox,orallergies,youknowhowintensetheitchcanbe.Itfeelsliketheonlyrelieffromthediscomfortistoscratch—longandhard.Scratchingtherashmaymakeitfeelbettershort-term,butthelong-termconsequencesareslowerhealing,permanentscarring,andvulnerabilitytoinfection.Thereareotherwaystocopewiththeitching.Atfirst,soothingremediessuchasanti-itchcreamandoatmealbathsdon’tseemassatisfyingasusingyourfingernails,buttheyproducethelong-termbenefitsyouwant:toberashfreewithnolastingscars.Inthatsameway,youmayfeelliketheonlywaytostopanurgeistouse.Butliketheitch,therearehealthierwaystocope,eventhoughtheymaynotseemasimmediatelygratifying.Learningtocopewithyoururgesenablesyoutoachieveyourlong-termgoals.There’snowayaroundthis.

BeliefsabouturgesIt’slikelythatyou’vebeenfeedingyoururgesforsolongthatyoudon’teventhinkaboutthem.Theyfeellikethey’repartofwhoyouare.Youmayholdbeliefsaboutyoururgesthatareunrealisticoruntrue,andthatactuallymakethemworse.Whenyourbeliefsabouturgesareaccurateandtrue,it’spossibletoeasethemorevenpreventthem.Herearesomeopposingbeliefsabouturgesthatmayhelpyouunderstandthem:Unrealistic:Myurgesareunbearable.Realistic:Urgesareuncomfortable,butyoucanbearthem.Ifyoukeeptellingyourselfthatyoucan’tbearthem,you’resettingyourselfuptouse.Urgeswon’tkillyouormakeyougocrazy;they’lljustmakeyouuncomfortable.

Unrealistic:MyurgesonlystopwhenIgivein.Realistic:Urgesmaylastonlysecondstominutes,butrarelymuchlonger.Sometimesurgescomeinbatches,severalshorteronesratherthanonelongurge.Urgesalwaysgoaway.Here’swhy:Yournervoussystemeventuallystopsnoticingstimuli.Ifitdidn’t,youcouldn’twearclothingbecauseitwouldbetoouncomfortable.Ifyoufast,youknowhungereventuallyfadesaway.Thedentist-officesmellthatwassostrongwhenyouwalkedthroughthedoorisn’tevennoticeablebythetimeyouleave.

Youcanteachyourselftorideouturges.Itdoesgeteasierovertime.

Unrealistic:Myurgesmakemeuse.Realistic:Usingisalwaysachoice.Whenanurgehits,youhave

twochoices:touseortorideituntilitsubsides.Unrealistic:Urgesareasignthatmyaddictivebehaviorisgettingworse.

Realistic:They’reanormalpartofrecovery.Theymaybestrongeratfirst—ormaybelaterinyourrecovery—buttheyweaken,andeventuallydisappear.Youcanhavealifewithouturges.

Unrealistic:Givingintoanurgeisn’tharmful.Realistic:Givingintourgesprolongstheirpresenceinyourlifebecauseitreinforcesthebehaviorpattern.Itwillmakestoppingharderasthenexturgewilllikelycomemorequicklyandbemoreintense.Liketherash,ifyouscratchitoccasionallybutusehealthyremediestherestofthetime,theoccasionalscratchingstillincreasesthehealingtime.

Ifyouoccasionallygiveintoyoururges,yousimplyprolongyourdependenceonthesubstanceorbehaviorasawayoutwhenyoubelievethepainisunbearable.

Whathappenswhenachildnagsforhoursforanewtoyandyousaynountilyoutireoftheirwhiningandsayyesjusttogetthemtostop?Youstoptheimmediatewhining,butyouteachthechildthatiftheywhinelongenough,you’llgivein.Inthesameway,youstrengthenyoururgeseverytimeyoumakethechoicetogiveintothem,evenifit’sjustoccasionally.

Unrealistic:Imustgetridofurges.Realistic:Yoururgesarenormal.Addictivebehaviorscausechangesinyourbrainthatmakeurgesverypowerful,so“getting

ridofthem”isanunrealisticexpectation.Youcan’tcontrolurges,butyoucancontrolhowyourespondtothem.

Ittakestimeandpracticetoreplaceoldthoughtsandbehaviorswithnewones.Don’texpecturgestoendimmediately,don’texpecttobeperfect,anddon’tgiveup.

Unrealistic:I’mself-destructiveorIwouldn’tdotheseself-destructivethings.

Realistic:Ourbrainsarehard-wiredtoseekoutthingsthatprovidepleasure.Substancesandbehaviorsthatlightupthepleasurecentersinourbrainscanbedestructiveifthedesireforthemturnsintoaneed.Oh,andashumanbeings,wealldostupidthings.

Unrealistic:IusebecauseIliketo.Realistic:Whilethatwasprobablytrueinthebeginning,it’sprobablymorecomplicatedthanthatnow.Whileusingcontinuestolightthepleasurecentersinyourbrain,yourrationalbraincan’tignorethattheshortterm“pleasures”areincompatiblewithyourlong-termgoals.Withmoreexploration,youwillprobablyfindthatyouhavefallenintothe“addictivebehaviortrap,”inwhichyouignorethebenefitsofstoppingbecauseyoumaybepreoccupiedwithhowdifficultitwillbe.

SMART’stoolsandstrategiesgiveyouanedgeindealingwithyoururges.Thetoolsandstrategies—alongwithyourmotivation—canmakeitpossibleforyoutosuccessfullycopewithurges.

EXERCISE:Identifyingyourtriggers

Whatisatrigger?Triggersarethethingsthatleadtocravings(Iwantto),whichcanleadtourges(Ineedto).Theymaybeyouremotions;somethingyou’vedone,aredoing,orwanttodo;atimeofday,week,oryear;somethingyoutouch,hear,see,smell,ortaste;oranythingelsethatleadstourges.Eachofushasourowntriggers.Theyarenotexcusestouseandtheyarenotunpredictable.Addictivebehaviorteachesyourbraintoassociatesomethingswiththepleasureorreliefyoufeelwhenindulgingintheaddictivebehavior.Evenwhenyoustop,yourbrainwillberemindedabouttheaddictivebehaviorwhenyouencounteryourtriggers,orallowyourselftoconjureuptriggers.Yourbraincanunlearnthisthinkingreaction(Iwantto)toatrigger.Thesereactionsmaylastawhilebutwilleventuallydecreasetobethebriefest(milliseconds)ofunhelpfulthoughts.Ashumans,brief,ridiculous,andunhelpfulthoughtscomeintoourheadsallthetimeaboutthingswequicklydismissforwhattheyare—sillythoughtsandnomore.Themoreseriousurges(Ineedto)usuallysubsideinafewdays,weeks,ormonths.Toidentifyyourtriggers,thinkaboutthesubstancesorbehaviorsthatstimulateyoursenses:Sight,smell,hearing,taste,andtouch(Figure4.1).Makealist.Youmaynotbeawareofhowmanythereare.Howmanycanyouidentify?Behonestandlistthemall,eveniftheyseeminsignificant.

Figure4.1Identifyingtriggers(example)

Identifyingmytriggers

Triggerrisk

Onceyouidentifyyourtriggers(andyoumayidentifymoreasyoucontinueyourrecovery),keeptrackofhowlikelythetriggersaretosparkanurge.Thehighest-risktriggersarethosethatmostoftensparkanurgeforyou.Rateeachtriggerfrom1-10(10istheriskiestormostlikelytotriggeranurge).Thiswillhelpfocusyoureffortssoyoucanworkonthehardesttriggersfirst.

Figure4.2.Triggerrisks

NowthatyouratedtheriskofeachtriggerinFigure4.2,applythetriggerstoyouraddictivebehavior.Foreachaddictivebehavior,list

everysituationyoucanthinkofthattriggersyoururgetouse.Startwiththeriskiest(10)totheleastrisky(1).Followthisexampleonthenextpage:

Figure4.3Triggerworksheet(example)

Mytriggerworksheets

UrgesIdentifyingyourtriggersisanimportantpartofyourrecovery.Awarenessgivesyouthepowertounderstandanddealwithurges;however,evenwithawarenessandplanning,youwillexperienceurges.It’sanormalandnaturalpartofrecovery.Anawarenessandunderstandingofurgesiscrucialtorecovery.Youidentifiedwhattriggersthem,butdoyouknowhowlongtheylast?Howintensetheyare?Howfrequent?Mostpeoplewithaddictivebehaviorsdon’trealizethaturgesusuallylastonlysecondstominutesandthenpass.Onewaytounderstandyoururgesisbyrecordingtheminanurgelog.

EXERCISE:UrgelogAnurgelog(Figure4.4)isatableinwhichyourecordspecificinformationaboutyoururges.Afterafewentries,youmaynoticepatternsandsimilaritiesaboutyoururges.Thelogthenbecomesaroadmapthatwillhelpyouanticipatesituationsandemotionsthatmaytriggerurges.Youalsomaynoticecertainthoughtpatternsassociatedwithyoururges,whicharehelpfulinself-managementandproblemsolving(Point3).Youmayfindthatyoucancreateanurgeloginyourjournal,ifyou’rekeepingone.Ifyou’renot,useFigure4.4.Keepitwithyousoyoucanimmediatelylogeachurgebeforeyouforgetit.Atfirst,youmayneedtowriteinitmanytimesaday.Whenyouidentifyurgestriggeredbycertaintimes,places,orsituationsthatyouencounterregularly,youcanplanwaystoavoidthosetriggersor,distractyourselffromtheurgeuntilitpasses.SeeFigure4.4onthefollowingpageforanexampleofthelog.

Figure4.4Myurgelog

DistractingyourselfAlthoughitmaybedifficultatfirst—especiallyduringintenseurges—distractingyourselfisoneofthebestwaystogetthroughanurge.Whenyou’reactivelydoingsomething,you’rethinkingaboutthatandnottheurge.Themoreyourefusetogiveintourges,thelessfrequentlytheyoccur,andthemorequicklytheypass.Theyalsowillbecomelessintense.SeeFigure4.5forexamplesofactivitiesyoucanusetodistractyourselffromanurge.

Figure4.5.Identifyingdistractions

Takeamomenttoidentifydistractionsthatwouldbehelpfultoyou.

ConsiderusingthefollowingWeeklyPlanner(Figure4.6)todocumentyourinterestsandactivities.Planactivitiesfortimesyouknowyoumaygeturges.Checkyoururgelogortriggerworksheetsfortimeswhenurgestendtostrike.

Figure4.6WeeklyPlanner

STRATEGY:CopingwithurgesOnthefollowingpagesisalistofbasicandadvancedstrategiesadaptedfromDr.TomHorvath’sbookSex,Drugs,Gambling&Chocolate:AWorkbookforOvercomingAddictions.Youcanpracticeandrefinethesesothattheyworkbestforyou.Thefirst14aretheeasiesttolearnanddo.Theadvancedstrategiesrequiredeeperself-knowledgeandmorepractice.It’simportanttodiscoverwhichonesworkforyouandthenpracticethemfrequently.Afterawhile,youwon’tneedtopracticethembecausethey’llbecomepartofyourlife;youwon’tevenhavetothinkaboutthem.

Basicstrategies

1.Avoid—Stayawayfromthetriggersthatleadtourges.Avoidsituations,sensations,orstimulationsthatmaybringonanurge.Theearlierinyourrecoverythatyouidentifyhigh-riskcuesthattriggerurges,theearlieryoucanstartavoidingthemorescapewhenunexpectedlyfacedwiththem(strategy2).

2.Escape—Getawayfromtheurge-provokingsituation.Ifyou

findyourselfthere,leaveimmediately.

3.Distractyourself—Concentrateonsomethingotherthanyoururge.Distractyourselfwithactivitiesyouenjoy,especiallyiftheurgeisintense.Simpleactivities,suchascountingobjectsorsayingthealphabetbackward,canfillupyourattentionsothatyouhavenothingfortheurge.FocusingonyourHierarchyofValuesisapositiveformofdistraction.

4.Developcopingstatements—Insteadofthinking,“I

deserveadrinkbecauseIhavetodealwithXproblem,”tellyourself,“EventhoughitsucksthatIhavetodealwithXproblem,drinkingisn’tgoingtohelpme.”

5.ReviewyourCBA—Itmaynotturnoffthediscomfort,butit

mayhelpyoumaintainyourmotivationtoresistyoururge.Itmayhelptoreviewitregularly,evenwhenyou’renothavinganurge.

6.Rateyoururge—Writeinyoururgelog.Putitin

perspectiveandlookforexaggeration.Onascalefromoneto10,rateitsintensity.Areyouexaggerating?Comparethediscomfortofresistingtheurgetootheruncomfortablethings,suchasbeingboiledaliveorhavingyourfingernailspulledout.

7.Recallmomentsofclarity—Thinkofamomentwhenyou

realizedusingwasaproblemforyou,oramomentwhenyouknewthatchangingyouraddictivebehaviorwas,withoutquestion,therightthingforyoutodo.

8.Recallnegativeconsequences—Whenyoufeelanurge,

youmaythinkonlyofthebenefitsofusing.Tocreateamoreaccuratepicture,carrythethoughtthroughtoincludethenegativeconsequencesthatfollow.Forexample,ifyou’vegivenupsmokingandacigaretteurgearises,youmayfantasizeabouthowgooditfeelstoinhalethesmoke.Carryingthatthoughtthroughmeansyoualsorememberhowbadlyyoucoughwhenyouwalkupaflightofstairs.

9.Pictureyourfuture—Visualizeyourselfinthenearfuture

feelinggoodaboutresistingtheurge.Forexample,paintamentalpictureofgettingupearlySaturdaymorningwithoutahangover.

10.Usethepast—Recallsuccessfullyresistingurgesinthe

past.Remindyourselfthattheurgewillpassandhowyouhaveroutinelyresistedthem.

11.Ridethewave—Observetheurgeandvisualizethatyou

aresurfingawavethatgrows,crests,weakens,anddisappears.

12.Callonrolemodelsandcoaches—Talktootherswho

havemasteredcopingwiththeirurgestolearnfromtheirexperiences.SMARTmeetingsandtheSROLmessageboardandchatroomarefilledwithpeoplefartheralongintheirrecoverywhoarewillingtoencourageandsupportyou.

13.Reachoutforsocialsupport—Talkwithanonjudgmental

andsupportiveperson.It’shelpfultohavealistofpeopleyoumaycallwhenyou’refeelingthediscomfortofanurge.Letthemknowhowtheycanhelpyoubecausetheymaynotintuitivelyknow.

14.Accepttheurge—Recognizethatitisuncomfortableand

holditatadistance.Experienceitasyouwouldanypassingthought.Observeitasanoutsideobject.Seeitbutdon’tevaluateit.Acknowledgeitassomethingthatusedtobeaproblem,thenreturnyourattentiontowhateveryouweredoing.Don’tturntheurgeintoabiggerissuebypretendingitdoesn’texist.

Advancedstrategies

15.Movebeyondavoidance—Whenyou’reintheearly

stagesofrecovery,it’swisetostayawayfromplacesthattriggerurgeswheneverpossible.Avoidance,however,isnotarealisticlong-termstrategy.Eventually,you’llbeinasituationinwhichsomeonewillofferyouadrink,drugs,etc.Youneedtohavetheconfidencetoresistsuchoffers.Itmayhelptobringalongatrustedcompanionforsupportandguidance.Putyourselfinasituationthatmaytriggeranurge,suchasarestaurantthatservesalcohol:

Usewhateverbasicstrategies(1-14)havehelpedyouresisturges.Practicerefusingoffersofyouraddictivebehaviorsothatyoucanhandlepeerpressurebyvisualizing:Someonetryingtopersuadeyoutouse,ormakingfunofyouifyourefuse.Yourselfconfidentlyrefusing.Someonewhostirsstrongemotionsinyouandisintentongettingtoyoutouse.Keepingyourfocusandmanagingyourresponses.

16.Bringoutyoururges—Afteryoudevelopsomemastery

ofcopingwithurges,youmaywanttoconfrontthemonyourtermsratherthanwaitforthemtohappen.Itmayhelpyougainconfidenceinyourabilitytocopewiththem.Tobringouturges:

Visualizeapastsituationinwhichyouhadastrongurge.Allowyourselftofeeltheurgeandvisualizegivingintoit.Letitpass.Now,visualizethesamesituationagain,onlydon’t

giveintotheurgethistime.Dothisforasmanysituationsasyouneedto.Usingthesametechnique,rehearseasituationthatmayhappeninthefuture.

17.Role-play/rehearsal—SMARTmeetingsaresafeplaces

torole-play.Otherpeopleactthepartsofthepeopleyouanticipatewillchallengeyouinhigh-risksituations.Themeetingfacilitatorcanhelpsetuparole-play.Here’sasample:

Showyourrole-playpartnerhowyouthinkadifficultpersonwillbehave.Yourpartnerplaysthedifficultpersonwhileyouplayyourselfinthesituation.Onceyoufinishthescenario,swaproles,anddoitagain.Thepeoplewatchingtherole-playcanthenshowyouhowtheymighthandlethesamesituationdifferentlybyplayingyourpart.

Considerrole-playingchallengesassociatedwitheventslikeholidayparties,weddings,andotherspecialevents.

18.Refusetouseinsocialsituations—Therewillalwaysbeoccasionstouseoractout.Howdoyoudealwiththem?Herearesomeways:

Talkwithafellowrecoveringorrecoveredpersonaboutanupcomingeventthatyouthinkmaytrigger

anurge;aparty,forexample.Updatethemafterward.BringitupinaSMARTmeeting.Rehearseorrole-playtheeventwithaSMARTgroupandbyyourself.Role-playorvisualizethewholeevent.Prepareanswerstothequestionspeoplewillask.Visualizegettingasoftdrink.Doitinyourminduntilitbecomesnatural.Ifthehostisafriend,tellthembeforetheeventthatyouaren’tdrinking.Enlistthemasanally.Takeamoreexperiencednondrinkerorafriendwithyouwhoknowsyoursituation.Eatsomethingbeforetheevent,especiallyifyoudon’tknowwhen,orif,you’llbeabletoeatagain.Arrivelate;leaveearly.Prepareanduseanescapeplan.Ifnecessary,preparereasonsforleavingearly.Uponarrival,immediatelygetsomethingnonalcoholic.Youcanthensocializewithaglassinyourhandnotfeellikeyou’restandingout.Thisforestallsthe“CanIgetyousomething?”awkwardness.Rememberthatyourdrinkingornotdrinkingislessimportanttoothersthanyouthink.It’sunlikelyanyoneiswatchingyouorfocusingonyouforlong.

Ifsomeoneinsiststhatyouuse:

Makeeyecontact.Itshowsyou’reserious.Speakinafirm,unhesitatingvoice.Don’tfeelguilty.Youhavetherightnottouse.Afteryousayno,changethesubject.Youonlyhavetosaynoonce.

STRATEGY:DefeaturgeswithDEADSYoucanknockdownurgesDEADS!Thisisaneasywaytorememberstrategieswhenfacedwithanurge.Urgescanmuddyyourcognitiveabilities,makingithardtothinkclearly.DEADScanhelpyouthinkclearlyabouthowtodealwiththeurge,nomatterhowintense.D=Deny/Delay(Don’tgiveintotheurge)—Remindyourself,repeatedlyifnecessary,thisurgewillpass.Refusetogiveintoit—nomatterwhat!

E=Escapethetrigger—Ifyouknowwhatiscausingtheurge,leaveimmediately.

A=Avoidthetrigger—Youcankeeptrackofwhenyougeturgesusingtheurgelog(Figure4.4).Urgescanoccurroutinelyaspartofyourdailypattern.Ifyouknowyouwillbeinasituationthattriggersanurge,plantoavoidthesituation.Theearlierinyourrecoverythatyouidentifyhigh-riskstimulithattriggerurges,theearlieryoucanavoidthosesituationsorescapewhenunexpectedlyfacedwiththem.

A=Attacktheurge—Disputeirrationalbeliefs(DIBs)andobsessivethoughts,ordoanABC.Practicerelaxationormeditation.

A=Accepttheurge—Tellyourselftheurgewillpasssoonandthatifyoudon’tgiveintoit,thenexturgewillbelessintense,andtheywillbecomelessfrequent.Youmaywanttositquietlybyyourselftosurftheurge:feelitbuildthenfadewhileyouacknowledgeyourthoughtsandfeelingsabouttheurge,thepresent,andyourfuture.Remember,don’tturntheurgeintoabiggerissuebypretendingitdoesn’texist.

D=Distractyourselfwithanactivity—Dosomething:goforawalk,readabook,orwatchTV.Ifyou’reputtingyourmindonsomethingelse,thenitcan’tfocusontheurge.Simpleactivities,

suchascountingobjectsorsayingthealphabetbackwardalsocanfillupyourattention.Dosomething,evenifyoudon’twantto(cleanthefridge,walkthedog).Motivationmayfollowtheaction.

S=Substituteforaddictivethinking—Sendinhealthysubstitutethoughtstosqueezeouttheurge:

Replaceanirrationalbelief(Thisurgewillkillme)witharationalone(Thisurgeisbadbutitwon’tkillmeanditwillpass).SubstitutefeelingdownandalonebygoingtothegymorstoppingbytheSROLchatroom.

Figure4.7DEADSworksheetIdentifyyourstrategiesforsuccessfullycopingwithurges.D=Deny/Delay(Don’tgiveintotheurge)

Howlongdourgeslastifyoudon’tgivein?Howbaddotheygetbeforefading?Whatcanyouquicklydothatwillhelpyoudenythem?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________E=Escape

Whattriggerscanyougetawayfrom?Whatcanyoudotoescapeatrigger’sinfluence?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________A=Avoid,acceptorattack

Whatcanyoudotoavoidurges?Whattechniquesorstrategieshavehelpedyou“tobe”withtheurgeuntilitpasseswithoutgivingin?Howdotheymakeyoufeelandthinkthatisdifferentfromhowyouthinkandfeelwhenyou’renothavinganurge?Whattoolsorwordscanyouusetoattacktheurge?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________D=Distractyourselfwithanactivity

Whatactivitieshaveyouconsidered,writtendown,ordonetotakeyourmindofftheurge

andtofillthetimethatyouusedtospendonyouraddictiveactivity?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________S=Substituteforaddictivethinking

Whatthoughtscan/haveyoudevelopedtodisputetheillogicalthinkingthatcomeswithurges?Whathealthyactivitiescanyoudotoreplacedownthinkingandfeeling?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

ThinkingStrategies

TOOL:DISARM(DestructiveImagesandSelf-talkAwarenessandRefusalMethod)Inthesamewaythatyouraddictivebehaviorisonlyabehaviorandnot“you,”anurgeismerelyafeelingoranimpulseyouexperience,nottheessenceofyou.Somepeoplefindithelpstocopewiththeirurgesiftheygivethemaname,asiftheurgeswereanotherbeingorsomethingoutsidethemselves.Giveyoururgeanditsvoiceanamethatdescribeswhatitfeelslikewhentheurgecomeson.SMARTparticipantshaveusednameslike,“TheInnerBrat,”“TheLobbyist,”“TheWhiner,”andsimply,“TheEnemy.”Namingyoururgemayhelpyourecognizeitsooner.Whenyouhearthefirstwhispersofitsvoice,addressitbyname,andfirmlyrefuseit.Tellittogetlostorthatit’snolongerwelcome;laughatit.Thenvisualizeitgettingsmallerandweaker,anddisappearing.Personifyingyoururgehelpsintwoways:Itservesasareminderthatyouarenotyourbehavior;itdefinessomethingthat,untilnow,mayhavefeltamorphousandshadowy.Itputsyouinapowerpositionovertheurgeandyouraddictivebehavior.

DealingwithdiscomfortDiscomfortofanytype,emotionalorphysical,cangohand-in-glovewithurges.Asweexplainedatthebeginning,it’sourbeliefsaboutaneventandourresultingdiscomfortthatcaninfluenceouraddictivebehaviors.Yourbeliefscanbeamajorsourceofdiscomfort.Atsomelevel,youmaybelievethatyoucan’tsurvivediscomfortorshouldn’thavetotolerateit.Thinkingaboutitinthiswaymayactuallycauseittointensify.Abstinencewillbedifficultifyourefusetoacceptmildortemporarydiscomfortasanormalpartoflife.Ifyou’vespentyearsescapingfromdiscomfortthroughyouraddictivebehavior,you’vebuiltuppowerfulhabitualresponsestoit.Nowyouhavetheopportunitytoacceptanddealwithdiscomfortinhealthyways.Remember,beforeyouraddictivebehaviorbegan,youdealtwithdiscomfortwithoutthebehavior.Youcanlearnhowtodothisagain.Somesituationsarenotwhatyouwantthemtobe.Discomfortcanbeausefulfeelingthattellsussomethingisnotrightandmotivatesustochangethesituation,orourthinkingaboutit.Discomfortisnotalways“bad”;itissometimesjustpartofthehumancondition.

Whatisdiscomfort?Distressanddiscomfortmanifestthemselvesinthebodyindifferentways:

Physicalpain—It’snotjustthepainbutourdemandthatsuchpainmustnotexistthatleadstoadditional

discomfort.Withdrawalandrebound—Whenyoustopanaddictivebehavior,youmayexperiencewithdrawalorrebound.Forexample,ifyouraddictivebehaviorgaveyourelief,youmayexperiencedespairordepression.Thediscomfortmayfeelintenseforthefirstfewweeks;however,beconfidentthatitwilleventuallydecrease.Anxiety—Sometimespeopleexperienceanxietyafterwithdrawalandrebound.Thistypeofdiscomfortmaybewhatpropelledyouintoyouraddictivebehaviorinthefirstplace.Evolutiontellsusthatwemayhaveinheritedsomeanxietyoruneasinessfromourancestors.Itkeptthemvigilantagainstthedangersofawilderandmoreuncertainworld.Anxietyisstrongerinsomepeoplethaninothers,butit’snaturalinallofus.Weaddtoouranxietyanddiscomfortbybelievingthattheworldmustbesafeandthatwemustcontroleverything.Depression—Biologyandhereditycanbeamajorcontributortoclinicaldepressionthatrequiresmedicaltreatment;however,muchsadnessandsituationaldepressionisaresultofthedemandsweplaceonourselves,onothers,andontheworld.Ifyoubelievethatyoumustbelovedormustbesuccessfultobehappy,youwilllikelyfindyourselfunhappymuchofthetime.Othersmaybelievethattheydon’tdeservehappinessbecausetheyareunworthyofit.Youdon’thavetogetthethingsyoudemandtobehappy.Yoursenseofworthistoocomplextobejudgedbyothers.Frustrationandanger—Ifyouseeyourselfasdoingthingsbadly,doingthingsthataren’tinyourbestinterest,orseeothersastreatingyouunfairly,you’reprobablygoingtofeelsomediscomfort.Thepursuitofself-confidencemayleaveyoufeelinguncomfortablebecauseyoumaybelieveyoumustperformwellallthe

time.Dictatingthewayothersshouldactcaninevitablyleadtofrustrationwhentheychoosenottoactthewayyouwant.Youwillfeelallshadesoffrustration,anger,orevenragewhenthesedemandsarenotmetoryouthinktheywon’tbe.

TOOL:TheABCsforcopingwithurgesDr.AlbertEllisaddressedtheabovedistress-producingbeliefsinhisbookAGuideToRationalLiving.Hesuggestedthatpeoplefeelthewaytheythink.HeusedtheABCsofREBT(Figure4.8).Bylearningthistechnique,youcandevelopalifeskillthatwillhelpyouthinkandfeelbetter,andmoreconsistentlywithwhatyoudesireforyourselflong-term.AnABCwillhelpyouidentifyandworkthroughyourthoughtsandfeelingsaboutaspecificissueoreventthatcausesyoudiscomfort.DoinganABCtakeseffortandcanbedifficultatfirst.YoumaywanttodoyourfirstoneinaSMARTmeetingtogetthehangofit.

ABCsofRationalEmotiveBehaviorTherapyA–Activatingevent:Thestartingpointofyourdiscomfort,forexample,yourbossyelledatyou.Theresultisyoufeelanunhealthyemotion—“unhealthy”inthatittriggersyoutobehaveinaself-defeatingway.AcuesB.

B–Beliefsabouttheevent:Youholdirrationaldemandsanddemonstratelow-frustrationtolerance—Ican’tstandits—aboutfeelingthisdiscomfort:

Imust(getdrunk,gethigh,overeat,gamble,actout)tocopewithhowmadIamatmyboss.IfIdon’t,Iwon’tbeabletostandthesefeelings.

C–Consequencesofyourbeliefs:Becauseofyourbeliefsabouttheevent,youfeelevenmoreemotionaldiscomfort.Thisbuildsontheurgetoengageinaddictivebehaviorstofeelbetter.TheseemotionsandbehaviorsaretheconsequencesofB(I’llshowher.I’llleaveearlytogetdrunk.).

NOTE:YoumayfinditeasiertobegintheABCbyidentifyingtheunhealthyconsequencesfirst(Ilapsedandstarteddrinking),thenidentifytheactivatingevent(A)andtheirrationalbeliefs(B)youheldaboutAthatgotyoutoC.

TheB-Cconnection:Whathasmoreinfluenceoverhowyoufeelandwanttoactnow,theactivatingeventoryourirrationalbeliefsabouttheevent?IfyouchoseB,you’reright!ThisistheessenceofREBT.YoumaynotbeabletochangeA,butyoucancontrolyourbeliefsaboutit.IfyouchangehowyouthinkaboutA,you’llchangehowyoufeelaboutitandhowyoureact.

D–Disputeyourbeliefs:Identifyyourirrationaldemandandlow-frustrationtolerancebeliefsinBanddisputethembyaskingifthey’retrue:Eventhoughit’suncomfortablefeelinglikethis,doIhaveevidencethatImustgetdrunktocope?

E–Effectivenewbelief:Youcanreplaceirrationalbeliefswithrationalthoughts.Identifywhatyouwantthatyouhaveturnedintoarigiddemanddoesnotmakesense.Alsoidentifythatnotgettingwhatyouwantwillnotkillyousoit’snotunbearable:

IreallywanttousewhenIfeellikethisbutIdon’thavetoandIdon’tneedtofeelbetter.It’sunpleasantanduncomfortabletofeellikethisuntilthediscomfortandurgepass,butitwon’tkillme.Icanstanditanditisn’tunbearable.

Whenyouunderstandthatthesenewandeffectivebeliefsaretrue,yourdiscomfortsubsidesordecreases,reducingtheurge’sintensity.

Figure4.9ABCforcopingwithurges(example)

SummaryWepointedoutafewideasinthischapter.First,urgeswillbepartofrecoveryformostpeople.Inthepast,youmaynothavethoughtthatactingonanurgewasachoice.Now,you’velearnedthaturgesareopportunitiestomakechoices—engageinanunhealthybehaviortomakethediscomfortoftheurgegoaway,orchoosetodealwiththeurgeinwaysthatwillhelpyouachieveyourlong-termgoals.Wedispelledsomecommonmythsaroundurgesthatmayhavelockedyouintobadchoicesbecauseyoudidn’thaveanybetterinformation.Nowyoudo.Wealsoexploredsometoolsthatcanhelpyoudealwithurgeswhentheyariseandevenbuildupyourresistancebyexposingyourselftocontrolledurges—muchlikeavaccinebuildsyourabilitytofightdisease.Ifyoupracticeandrehearsethestrategiesthatworkforyou—athomeandatmeetings—youwilllikelysucceedatnotgivingintourges.Trythemallandusetheonesthatworkbestforyou.Makingthechoicetonotusewhenyouhaveanurgeisanimportantstepinlearninghowtomanageyourthoughts,feelings,andbehaviors.

Chapter5:Point3:ManagingThoughts,Feelings,andBehaviorsEarlier,weintroducedyoutothisbasicconceptofREBT:Manyofourbehaviorsareinfluencedbythewayweseetheworld.Likeouraddictivebehaviors,ourthinkingalsocanbecomeautomatic.Thesehabitualthoughtscanleadtofeelingemotionaldiscomfort,soweturntoouraddictivebehaviortofeelbetter.

ManagingthoughtsInthischapter,we’llguideyouthroughtechniquesthatcanhelpyouchangeyourautomaticthinkingpatterns.Asyoubegintothinkabouttheworlddifferently,youremotionsandbehaviorsalsowillchange.

ThephilosophyofunconditionalacceptanceAdoptingunconditionalacceptancecanbeakeytoovercomingemotionalproblemsassociatedwithaddictivebehaviors.Thisalsocanbealifeskillthatwillhelpyoulongafteryouraddictivebehaviorisbehindyou.Unconditionalacceptanceissomethingwealreadyknow,butforittobecomeapersonalphilosophy,youmayhavetolearntorecognizeyourunhelpfulbeliefsyouautomaticallyholdwhenunpleasantorunexpectedthingshappeninyourlife.Onceyouspottheseinyourthinking,youcanthenremindyourselfofmorehelpfulwaystothink.Thisstartswithremindingyourselfthatyouarehuman.Assuch,youknowthatyouaren’tperfectandthatyou’llmakemistakes,dosomethingsbadly,anddosomebadthings.Thisisallanormalpartofbeinghuman;makingmistakesandfailingishowwelearn.Ashumanbeings,it’snormaltoexaggerateeventsthatinvolveus.Whenyoufindyourselfautomaticallythinkingnegativethoughts,orexaggeratingandjudginghowbadyouare,remindyourselfofyourhumanityandofthosetraitsthatweallshare.Byidentifyingunhelpfulthoughtsandreplacingthemwithmoreaccurateandhelpfulthoughtsofacceptance,you’llfeelbetterandwanttoactinhealthierways.Afterpracticingthisforawhile,moreaccurate

thinkingwillbecomeautomaticforyou.Likemostthings,though,ittakespractice.

DowningbeliefsWecommonlyholdontodowningbeliefsinwhichweputourselves,others,andourlivesdown.Bydoingso,wemayendupfeelingguilty,ashamed,depressed(Imessedupagain—Iamatotalfailure),orangry(Hetreatedmebadly—he’satotaljerk).Theseinaccurateandexaggerateddowningbeliefscanleadtothepowerfullydistressingfeelingsthatcantrapyouinacycleofaddictivebehavior.Youcanchoosetoreplacedowningbeliefswiththeseacceptanceprinciples:

Unconditionalself-acceptance(USA)Unconditionalself-acceptanceistheideathatyouhaveworth,justasyouare.Thisexplainswhatseparates“you”—yourcharacter,traits,personality,strengths,andweaknesses—fromyourbehaviors.ThisiswhySMARTdoesn’tuselabels.Youmayhaveaddictivebehaviorsbutyouarenotanaddict.Whilethismightseemlikeagameofwords,it’simportanttorecognizehowpowerfulwordsandlabelsare.Thesamelabelsthatyoumaycarryinternally—“failure,”“disappointment,”or“loser”—ledtoyourunhealthybehaviors.Attachingnewlabelswon’thelp.Ifyoucan’tacceptyourself,canyoureallyexpectothersto?Eveniftheydo,wouldyoubelievethem?

Acceptingyourselfmaybedifficult.Youmayhavecausedothersandyourselfextremeharmandpain.Youmayhaveruinedthelivesofothers,plungedyourfamilyintodebt,broughtdiseasesintotrustingrelationships,orsquanderedyourlifesavings.Whocanforgivethat?Noteveryonecan,butyoucanforgiveyourselfandacceptthatyouareaworthwhilepersoninspiteofyourpastbehaviors.Bepatientwithandkindtoyourself.Behonestaboutwhatyou’vedone.Acceptthatyoucan’tchangethepast,butyoucancreateyourfuture.Youmaybetemptedtocompareyourselftoothersorholdyourselfuptosomearbitrarystandard.Thereisnostandardoruniversalmeasureofyourvalue.Youstandaloneinyourself-worth.Comparingyourselftoothersisasmeaninglessasjudgingonecoloragainstanother:Isredgoodorbad?Isbluemorevaluablethangreen?

Unconditionalother-acceptance(UOA)Youmayjudgeotherpeopleinaccuratelyandinanexaggerated

way,justasyoujudgeyourself.Onceyouacceptthatotherpeoplearecapableofmakingmistakes,thenyoucanacceptthattheymayfailatthings,too.Judginganotherastotallybad—nomatterhowbadlytheytreatyou—isasexaggeratedandasdamagingasmakingthesamejudgmentaboutyourself.

Unconditionallife-acceptance(ULA)Youcanjudgelifeinthesameway,asbeingcompletelyunfairortotallyterrible.Whenyoufindyourselfthinking,“Lifesucks!Itcouldn’tbemoreawful!”Remindyourselfofthegoodthingsthathavehappenedinyourlife.Ifyoucanacceptthattherearemanythingsyoucan’tcontrol,itmayhelpyoutobetteracceptwhatlifethrowsatyou,evenifyoudon’tlikeit.

RationalandirrationalbeliefsBeliefspeoplehaveaboutthemselvesandabouttheworldcomeintwocategories:

1. Rational–They’retrue,makesense,orarehelpful.2. Irrational–Theseareuntrue,don’tmakesense,orare

harmful.

Thelistbelowissomeofthecommontypesofirrationalbeliefsassociatedwithnegativefeelingsthatfueladdictivebehaviors.Doyourecognizeany?

Demands:Must,haveto,andshouldbeliefsareabsolutesthatputunrealisticdemandsonyou,others,

andlife.Haveyoueversaid,“Ihavetosucceedatthis,”“Theyshouldnothavedonethattome,”or“Mylifemustbebetterthanthis”?Alloftheserigiddemandswillleadtoemotionaldistresswhenthey’renotmetorwebelievetheywon’tbe.Over-generalizations:Only,always,andneverbeliefsalsoareabsolutes—allornothing—withnoroomforoptions.Doyoueversay,“Youalwaysscrewup,”“MyaddictivebehavioristheonlywayIcancope,”or“ThingsnevergothewayIwantthemto”?Believingabsoluteseliminatesanyroomforvariation,andlifeisfilledwithgrayareasandunknowns,evenifyou’dratheritwasn’t.Frustrationintolerance:Ican’tstand,Ican’thandle,andIcan’tdealwithbeliefsaregenerallyfalse.Haveyoueversaid,“Icannotstandthisaggravation,”“Icannothandlethepressureofmynewjob,”or“Icannotdealwithyournagging”?Thetruthis,youdostand,handle,anddealwith,althoughnotalwaysinhealthyways.Awfulizations:Worstthingever,horrible,awful,andadjectivesendingin-est(meanest,laziest,cruelest,nastiest,etc.)beliefsexaggeratehowbadthingsare.Forexample:“Thisistheworstthingthat’severhappenedtome,”“She’sthecruelestbossonearth,”or“Thatdriverisabsolutelyhorrible.”Iswhathappenedtoyoureallytheworstthat’severhappened?Howmanytimeshaveyouappliedthatverybelieftounpleasantsituationsinyourlife?Awfulizingmayhavebeenoneofyourexcusestouse.

Irrationalandunrealisticbeliefstendtocomeeasytous.Taketimetoexaminewhatyou’rethinking,andaskyourself,“Isthisbelief

reallytrue?Whatistheevidencethatsupportsit?Whatisamorebalancedbeliefformetoholdaboutthissituation?”

EXERCISE:DisputingIrrationalBeliefs(DIBs)Youcanusethistooltoexamineanybeliefthatmaybeharmfulifyouactonit.Anirrationalbelief(IB)is:

Nottrue—It’sunrealisticandthereisnoevidencetosupportit,oritDoesn’tmakesense—It’snotlogical,orit’sHarmful—Itwon’thelpyougetwhatyouwantforyourselfinthelongrunifyouactonit.

Arationalbelief(RB)is:

True–It’srealisticandthereisevidencetosupportit,oritMakessense–It’slogical,orit’sHelpful–Ithelpsyougetwhatyouwantinthelongrunifyouactonit.

DisputingirrationalbeliefsYoucandisputeanIBbyturningitintoaquestionandthenansweringit.YouranswerwillprobablybeaRB.

ExampleIB:Iwilljusthaveonedrinkandthenquit.QuestiontheIB:WillIjusthaveone?Answer:Imay,butprobablynot.Ineverjusthaveone.I’lljustgetdrunkagain,getinafight,getarrested,andmywifewilllikelyleaveme(RB).

ExampleIB:ThisurgeisunbearableandIcan’tstandit!Question:Isthisurgeunbearable?Answer:No.It’sreallyunpleasantbutitwon’tkillme.Icanstandit,therefore,it’snotunbearable(RB).

UsingthefollowingtableinFigure5.1,identifysomeofyourIBsthatleadtoemotionaldistressandwantingtouseoractout.

Figure5.1DisputingIrrationalBeliefs(example)

Whataresomeofyourbeliefsthatcommonlycomeupwhenfeelingdistressedorwhenyouhaveanurgetouse?Writethemdownthenturnthemintoquestions.Thenanswerthequestionstodevelopmorehelpfulbeliefs.

Disputingmyirrationalbeliefs

STRATEGY:Changeyourvocabulary,changeyourfeelingsBecauseyourfeelingsareinfluencedbyyourthoughts,youcanchangeyourfeelingsandbehaviorsbychangingyourthoughts.Andyoucanchangeyourthoughtsbychangingthewordsyouuseinyourthinking.Thedifferencethatchangingjustonewordmakesmightsurpriseyou.Themoreyoudothis,themorenaturalitbecomes.Figures5.2–5.4showsomeexamplesandincludespacetowriteyourown.

Figure5.2Wordexchange

Figure5.3Statementexchange

Figure5.4Emotionvocabularyexchange

ManagingfeelingsStrongemotionsareaninevitablepartofthehumancondition.Youcanlearntoreduceunhealthynegativeemotions(unhealthybecausethesemakeuswanttobehaveinself-defeatingways)andevenchangethemtohealthynegativeemotions(healthybecausetheycanhelpusgetwhatwewantforourselvesinthelongrun).Let’suseangerasanexample.Somelow-levelannoyanceoraggravation—healthyanger—canleadtopositiveandassertiveaction:standingupforyourselforothersinthefaceofinjustice.Rage—unhealthyanger—canbedangerousanddestructive,leadingtonegativeandaggressivebehavior.Whileannoyanceisbalancedbylogic,extremeanger—aswithanyintenseemotion—reducesyourlogicalbrain’sabilitytocontrolyourbehavior.Youmaystartthinkingthatextremeangerandaggressionarejustified,andendupgettingintoserioustrouble.Learningtoreduceorchangeexcessiveemotionswillmakeiteasiertochangehowyouact.

TOOL:TheABCforemotionalupsetsTheABChelpsreduceorchangeanunhealthyemotionaboutaneventbychangingyourbeliefsabouttheevent(Figure5.5).Asyoumayremember,doinganABCtakeseffortbutwhensuccessful,you’llbebetterabletodealwithproblems,andyou’llhaveanotherlifeskillthatwillbewithyoulongafteryouhaveputyouraddictivebehaviorbehindyou.

Figure5.5ABCfordealingwithemotionalupset(example)

WorkingthroughanABCStartwithyourmostdistressingemotionaboutaneventortheoneassociatedwithanurge.It’simportanttodealwithjustoneemotionandoneemotionalgoalatatime.

1.FindtheCandA

Initially,you’llfindtheemotionalandbehavioralconsequencesatC.

Howdoyoufeelorhowwereyoufeeling?Whatdidyouwanttodoorwhatdidyoudo?

Emotionsdonotjusthappen.Thereisalwaysasituationthataccompaniesanemotionalproblem.Wecallthisthe“activatingevent.”Itcanbeasituation,person,place,thing,orthought.Withintheactivatingevent,thereisusuallyonethingthatisthemostdistressingabouttheevent.Oftenthisisanegativeandinaccurateevaluationofwhatwefindtobetheevent’smostdistressingaspect.Tofindtheactivatingevent(theA),askyourself:

Whathappenedtomakemefeelthisway?Whatwasthesinglemostdistressingthingaboutit?

2.IdentifytheemotionalgoalatEWhatisthehealthyemotionIwillworktoward?

AnnoyanceinsteadofrageAcceptanceinsteadof“should”Concerninsteadofjealousy,etc.

3.FindtheirrationalbeliefatBTheAandCcangetyoutoyourbeliefBifyouask:

WhatamItellingmyselfabouttheAthatmakesmefeelandwanttoactthisway?WhatdemandamImakingofmyself,others,orlife?Ifthisdemandisnotmet,isittrulyawful,oramIputting

myself,others,orlifedown?

4.DisputeyourirrationalbeliefandfindhelpfulbeliefatDDisputeyourIBusingDIBsbyturningyourIBintoaquestion.Youranswerwillbeyournewrationalbelief:

It’shisfaultIfeelthisway!Aremyfeelingshisresponsibility?Ijustknowshe’scheatingonme!DoIhaveevidencethatsheis?

IfyoufindanirrationaldemandatB,showyourselfthatthedemandisunrealistic:

IacceptImaynot(rationalbelief)insteadofImustsucceed(irrationaldemand).IknowIcan’tcontrolherbehavior(rationalbelief)insteadofshemustbenicertome(irrationaldemand).

Youalsocanaddanyanti-awfulizing,frustrationtolerance,andacceptancebeliefsifyoufindanyattachedtothedemand.Forexample:

Anti-awfulizing—Goodthingsdohappentome(rationalbelief)insteadofnothinggoodeverhappenstome(irrationalbelief).Frustrationtolerance—Idon’tlikethosedogsinmyflowergardensoI’lltalktotheirownersaboutit(rationalbelief)insteadofifthosedogsdon’tstayoutofmyflowers,Iwillkillthem(irrationalbelief).

Acceptance—Hecanbeverylovingsojudginghimastotallybadisunfair(rationalbelief)insteadofheisacompletejerkbecausehegetsmadatthelittlestthings(irrationalbelief).

5.Adoptnewbeliefs–E–tofeelthehealthyemotionThiswilltakepracticeandyoumayhavetoworkatitalotuntilyoufeelthebeliefstobetrue.OnceyoucompletetheABC,runthroughitinyourmindmanytimestoconsciouslyfeeldifferentlyabouttheevent.

Figure5.6Replacingexcessiveemotions

STRATEGY:CopingstatementsduringacrisisWhenyou’reinacrisis,anABCprobablywon’tbeveryhelpfulbecauseittakestimeandrationalthought.Simpleandeasycopingstatementswillhelpyougetthroughacrisis.TheyaresimplystatementsyousaytoyourselftogetthroughthemomentuntilyouhavetimetodoanABC.WorkthroughanABCwhenyou’reemotionallydetached,notintheheatofthemoment.It’smosthelpfulifyoudevelopandrehearseseveralcopingstatementssothatthey’rereadywhenyouneedthem.Forexample,“Thisisfrustrating,butIcanlivethroughit,”“I’mhurting,butusingwillmakemefeelworse.”Makeyourcopingstatementsrealisticwithoutputtingdemandsonyourselforothers.YoucanuseacopyoftheworksheetprovidedfortheDisputingIrrationalBeliefsexercise(page47)tocomeupwithandkeepalistofyourownrationalcopingstatementshandy.Belowaresomeofexamplesofcopingstatements.Toimprovefrustrationtolerance:

I’mfrustrated.Idon’tlikethis,butitwon’tkillme.IcanhandlewhatIdon’tlikewithoutshootingoffmymouthandsayingsomethingI’llregret.Thisisupsetting,butIcanstandwhatIdon’tlike.

Tocalmanangryrage:

I’mreallyannoyed.It’sOKtofeelthiswayandIdon’t

havetoactonmyfeelings.Idon’thavetoloseitwhensomeoneactsbadlytowardme.It’sOKtofeelannoyed.

Tocurbanxietyanddepressionlinkedtoself-judgment:

Ican’tchangewhathappenedsoI’mnotgoingtoletitgettome.Imadeamistake.I’mhuman.IforgivemyselfsoIcanmoveon.

YoucanfindmorecopingstatementsinBillBorcherdt’sbook,“ThinkStraight,FeelGreat!:21GuidestoEmotionalSelf-Control”.ThereisalsoalistofcopingstatementsonSMART’swebsite.Eachtimeyoureplaceirrationalharmfulthinkingwithrationalhelpfulthinking,youfeelbetterandwanttoactinwaysthatreflectyourfeelings.

Solvinglife’sproblemsWhenyoutakeanaddictivebehavioroutofyourlife,youwillstillhaveyourshareofdifficulties,butwithouttheextraproblemsandcomplicationstheaddictivebehavioradds.Onelifeskillwecanalluseisproblemsolving—breakingdownparalyzingproblemsintosmaller,manageablesteps.Managingproblemsbecomeseasieronceyouacceptthat:

Therewillbepeoplewhowillneveracceptthatyouhavechanged.Thereareandalwayswillbesomesituationsthatarebeyondyourcontrol.

Youmayhaveactedoutbecauseproblemsoverwhelmedyouandyousawnosolutionexceptescapethroughyouraddictivebehavior.Abigpartofmanagingthoughts,feelings,andbehaviorsisfindingawaythroughlife’sproblemsratherthanaroundthem.Havingamorepositiveoutlookandacceptingthingsforwhattheyarecansaveyoualotoftroubleandworry.Bystubbornlyrefusingtoletyouremotionstakeover,problemsolvinggetseasier.RememberthethreePs:Practice,Patience,Persistence.

EXERCISE:FivestepsofproblemsolvingConsiderusingthismodelforsolvingproblems:

1.Definetheproblem.Youcan’tsolveaproblemthatyouhaven’tdefined.It’sacommonhumantraittoassumeweknowwhattheproblemis,thenjumptoconclusionsandsolutions.Someproblemsaresolargetheycan’tbesolveduntilyoubreakthemdown.Youcan’tsolveworldhunger,butyoucanfeedahomelessfamily.Definingaprobleminvolvestwosteps:1.Understandingitsspecificnature,and2.Identifyingworkablesolutions.Ifyourproblemisfindinganewplacetolivebecauseyou’vebeenevicted,thesolutionisstraightforward.Ifyourproblemisateenagedaughterwhokeepsrunningaway,itmaytaketimetodefinetherootproblem,andevenlongertosolveit.

2.Brainstorm.Comeupwithasmanysolutionstotheproblemasyoucan.Youcandothisalone,withafriendortherapist,orinaSMARTmeeting.Thesecretistoletideasflowwithoutjudgingordiscussingthem.Bewild;pushtheenvelope.Beopentoallideasanddothisuntilyourunoutofideas.Themainruleisdon’tanalyzeorjudgetheideas.Don’tletanyonesay,“Thatwon’twork,”or,“Itriedthatonceand....”duringbrainstorming.Ideas,evenbizarreones,maystimulateyourthinking,andleadyoutoideasthatcanwork.Letthembuildoneachother.You’llassesstheminthenextstep.

3.Evaluate:Useascalefromzeroto10torateeachidea:

Howrealisticisit?Howlikelyisittowork?Doesthesolutionhaverewards?Whataretheconsequences?CanIaffordit?

Ifanideascoreszero,throwitout,butbecarefulnottojudgetooquickly.Anideathatseemsunworkableortoo“outthere”atfirstmaylookmorereasonablethelongeryouthinkaboutit.Ifyouhaveassumptionsaboutanyoftheideas,youmayneedtogathermoreinformationbeforeyourateittodetermineifyourassumptionsaretrueorfalse.

4.Select:You’veevaluatedandratedyourideas.Nowselectoneandtryit.What’smostimportantisthatyouhavethoughtthroughyourchoices,somethingyoumaynothavealotofexperiencedoing.

5.Createawrittenplan:You’llmostlikelygetbetterresultsifyouwritedownyourplaninsteadofjustcarryingitaroundinyourhead.Writedownthesolutionyouchoose,andhowyouwillimplementit.Writethestartdateandlocation,andeverythingyou’llneedtomakethesolutionsuccessful.YoucanusetheChange-Planworksheetforthis.Thenputyourplanintoaction!

Recordyourresultseverydayifappropriate.Isyourplanworking?Didyoumodifyit?Compareyourresultswithyourexpectations.It’s

likelythatyourresultsaredifferentfromwhatyouwantedorexpected.Canyouadjustyourplan?Shouldyoutryadifferentsolution?Askothersfortheirideas,ordiscussitataSMARTmeeting.Gettingquickfeedbackonyourplanwillhelpyoustayfocusedonsolvingyouroriginalproblem.Likemostthingsinrecovery,thistakespractice.Likeallskillbuilding,ithelpstofindpeoplewhowillgiveyouhonestfeedbackwhilesupportingyou.You’llmakemistakes;you’llgetdiscouraged.Don’tgiveup,anddon’tlabelyourselfafailure.Withtimeandeffort,healthyproblemsolvingwillbecomesecondnaturetoyou.

STRATEGY:RelapsepreventionYou’llrecallthatalapseisashortslipintooldbehaviors.Relapseisaprolongedreturntoyouroldwayoflife.Asingledrunkennightversusamonth-longreturntousingalcohol,forexample.Ifyouconsideryourselfrecovered,watchoutforcomplacency.Rememberwhereyouhavebeenandwhatyouhaveachieved—forever.Youwillneedtothinkcarefullyandhonestlyabouthowvulnerableyoumaystillbe,andbeappropriatelyvigilant.Aperiodofabstinencealsomayleadyoutothinkyouhave“regainedcontrol”andcannowre-engageinmoderateuse.Bewareofthisthinking;it’sanexcusetouse.DoinganABCon“I’veregainedcontrol”thinkingmayhelpyoumaintainyourmotivationandpreventlapsesorrelapses.Bodysystemshavememory,soevenifyou’reabstinentforalongtimethenlapseorrelapse,youmayengageinyouraddictivebehaviorwithmoreintensity.Thisiscalledtheabstinenceviolationeffect.SMARTconsiderslapsesandrelapsesastemporarysetbacksinrecovery.Ifyouhavealapseorrelapse,youcanlearnfromit.Useittodevelopmorestrategiestoavoidanotherone.

DangersituationsAlapseorrelapsecanhappenwithouthavinganurge.Therearesixdangersituationsthatmaysetyouupforthis.Recognizethemsoyoucanbeprepared.Youmayprepareforthembygoingoveryourcorevalues,goals,anddevelopingaplanforthesesituations.Thedangersituationsare:

1. Association—Exposuretosomethingthatwasatriggerinthepastorbeinginsituationsinwhichyouusedinthepast.

2. Boredom—Thediscomfortofboredommaybringupoldthinkingpatterns.

3. Emotions—Strongemotionsmaycatapultyouintooldcopingmethods.

4. Fantasy—Romanticizingthefunpartsofyouraddictivebehaviors.

5. Frustration—Likeotherstrongemotions,frustrationmayhurlyoubackwardtooldwaysofcoping.

6. Opportunity—Atimewhenthereisseeminglynodownsidetoactingout,andnoonewillknowbutyou.Opportunityisapowerfulenticement.

Remember,thebestwaytohandlealapseorrelapseistopreventit;activeinterventionmeasurescanbesuccessful.Ifthethoughtthatyouwanttoengageintheoldbehaviorhitsyoubutisnotanoverwhelmingurge,youcansimplyaskyourselfifactingonyourthoughtisagoodlong-termchoice.AnyofthetechniquesmentionedinPoint2:CopingwithUrges,willhelpyouthinkaboutsuchcravingsmorerealistically.Justusethetechniquesthathaveworkedforyoubefore.Althoughlapsesandrelapsesarecommon,theydon’thavetobecommonforyou.Herearesomeothertipstohelpyouavoidfallingbackintounhealthybehaviors:

1. Getmedicalandpsychologicalhelpforemotionalor

mentalillness,andtakemedicationsasprescribed.2. LivewithawarenessofthePIGandofconsequences

forlapsesandrelapses.Carry,review,andupdateyourCBAoralistofreasonsforstickingtoyourchangeplan.

3. Stimuluscontrol.Avoid,escape,orchangetheactivatingevents,cues,ortriggersforusingthatyoucanavoid,escape,orchange.

4. ABCs.Continuetoworkonchangingirrationalbeliefsthatmaybringonarelapse.

5. Rewardyourselfforcontinuedabstinenceandcompliancewithtreatment.

6. Substituteactivitiesforyouroldbehaviors.Developabalancedlifewithoccasionalhealthyindulgencesthatcansubstitutefortheunhealthybehaviors.Discoverandcreateotherinterests.

7. Distractions.Relaxation,meditation,exercise,art,reading,talkingwithpeoplewhosupportyou,etc.

8. Irrelevantdecisions.Bemindfulofseeminglyirrelevantdecisionsyoumaymakethatputyouinhigh-risksituations.Recoveryrequireslivingwithgreaterawareness.

9. Abstinenceviolationeffect.Don’tusealapseasanexcusetorelapse.

10. Lapsesandrelapsescanbeopportunitiesforgrowth.Theydon’tproveyou’reafailureorthatyou’relockedintoyourdestructivebehaviorsforever.Regardthemasanormalbutundesirablepossibility.Takeitseriously,figureoutwhyithappened,andfindnewstrategiestoavoidrepeatingtheerror.

SummaryBylearningtomanageyourthoughts,youfeelbetter.Whenyoufeelbetter,youbehaveinwaysthatreflectyourfeelings.Developingmorerationalthinkingthroughpracticeanduseofthetoolsandstrategiesinthischapterwillhelpyoutemperorchangethestrongemotionsthat,inthepast,ledyoutoactout.Inthepast,thinkingirrationally,experiencingexcessiveemotions,andactinginwaysthatreflectedthosefeelingswereautomatic,sothinking,feeling,andbehavinginnew,morerationalwayscanbecomeautomatic,too.

Chapter6:Point4:LivingaBalancedLifeRegainingyourhealthandcreatingalifestylethatbringsyoulong-andshort-termsatisfactionisanimportantpartofrecovery.Avoidinglapsesandrelapses,andachievinglong-termbehaviorchangeissupportedbylivingabalancedlife.Balancecomesfromfindingandpursuingintereststhatyoufindabsorbing,andachievingyourshort-andlong-termgoals.Ameaningfullifeisonethatisinbalance;younowhavethetimeanddesiretopursuetheactivitiesthatexpressthevaluesyouidentifiedintheHierarchyofValues.Manypeopledonotlivetheirlivesinbalanceorinamannerthatconsistentlysustainstheirvalues.It’simportanttonotethatachievingabalancedlifestyleisjustliketheotherpointsinour4-PointProgram—ittakeswork.YoucanusemanyoftheSMARTtoolsinyourquesttoachieveandliveabalancedlife.Thetoolsaren’tjustrecoverytools;theyaretoolsforlife.Therearetwomainactionsthatleadtoabalancedlife:

1. Understandandrespecteachoftheareasofyourlife.2. Changeyourperspectiveintheareasinwhichyouare

stuck.

EXERCISE:CreatingbalanceEatingright,gettingenoughsleep,relaxing,andmeditatingwillhelpyourestorebalancetoyourlife.Let’slookattheotherareasofyourlife.Inthisexerciseyou’ll:

1. Takeaninventory.WhencompletingtheLifestyleBalancePieinFigure6.1,you’lldetermineandevaluatetheareastofocusyourtimeandenergyon.

2. Behonest.Thisexercisewillshowyoutheareasinyourlifethatmayneedmoreorlessofyourattention.Whenyou’redonefillingoutthepie,behonestwithyourselfaboutyourreactiontothepictureitshows.Whatareyourthoughtsandfeelings?Arethereareasinwhichyouwanttospendmoretime?Arefearsordiscomfortskeepingyoufromdoingsomething?Howwouldyoustartfillingouttheneglectedareas?Whenwouldyoubegin?

3. Gowithyourgut.Whenlookingatyourpie,youmayfindseveralareasthatyoufeelcouldusemoreattention,andyouprobablydon’thavetimetoworkonallofthematonce.Whichoneiswavingitshandwildlyandsaying,“Mefirst!Pickme!”Followyourinstinct.It’seasier—andmorefun—toworkontheareayou’redrawntofirst.

4. Planandprepare.Topaymoreattentiontotheneglectedareas,you’llneedtomaketimeforthem,otherwisetheywon’tgetdone.Focusingontheseless-tendedareaswilltakesomegettingusedto.Createaplanthatyoucanstickto.

5. Getsupport.Makingchangesisn’teasy.Ratherthanstrugglingandriskingfailure,getalltheoutsidehelp

andsupportyoucan.Youmightasklovedones,friends,colleagues,orseekprofessionalhelp.

6. Balance.Yourpiemayshowthatyouspendalotofyourtimeinoneareaattheexpenseofothers.Howmuchtimedoyouspendonthethingsthataregoingwellforyou?Again,behonest.Isitthatspecificareathatyouspendthemosttimeon?Alloftheareasinyourlifeshouldbedonewithmoderationandbalanceinmind.Otherwise,yourlifebecomesunbalancedandone-sided.

7. Havefun.Iftheworkyouputintobalancingyourlifestartstofeelburdensome,backoffabit.Youaredoingthisworktobecomehealthyandwhole,nottoaddmorechorestoyourlife.Seekoutthefuninallyourefforts;haveagoodtimewiththenewexperienceswhileexploringtheotherareasofyourlife.Whenyourlifebecomesmorebalancedandwell-rounded,thehealthierandhappieryou’llbe.

LifestyleBalancePieUsetheLifestyleBalancePieinFigure6.1torepresentthedifferentareasinyourlife.

1. Labeleachslicewithanareaofyourlifethatisimportanttoyou.Forexample,family,friends,spirituality,romance,health,work,recreation,personalgrowth,money,physicalsurroundings,etc.(RefertoyourHierarchyofValuesworksheetforinsight.)

2. Thinkofthepie’souteredgeasbeingcompletelysatisfied(10)andthecenterasbeingverydissatisfied(0).

3. Rateyourlevelofsatisfactionineachoftheareasyou’velistedbyplacingadotonthemiddlelineofeachpieslicetoindicatethelevelofsatisfactionyouhaveinthatarea.

4. Afteryourateeachslice,connectthedotstocreatetheoutsideperimeterofyourpie.Whatdoesitlooklike?Isitroundandfullordoesitlooklikesomeareasarenotasfilledoutasothers?

5. Nowaskyourself:

Aremytruevaluesandprioritiesreflectedhere?BasedonwhatIsee,amIlivingabalancedlife?AmIinvolvedintoomanyactivities?Istheretoomuchonmyplate?Howmuchofmytimeisspentcaringforothers?Formyself?Whatarea(s)needsmoreattention?Whatneedslessattention?IsthereadreamordesirethatI’dliketofocuson?

WhatchangesdoIwanttomake?WhatcanIdoto“roundout”mylife?

Tomoveyourselftowardamorebalancedlife,allowyourselfmoretimefortheareasthatshowgaps—thoseplaceswherepiecesofyourpiearemissing(becausetheyare).Whendoingso,besuretofocusonthewholepictureofyourlife,notjustspecificareas.

Figure6.1LifestyleBalancePie(example)

MyLifestyleBalancePie

TOOL:Vitalabsorbingcreativeinterest(VACI)Beforeyourlifewasovertakenbyaddictivebehavior,therewereprobablyhobbiesandactivitiesyouenjoyedandothersyouwantedtotry.Nowyoucanbringthembackintoyourlife,andexplorethenewones.Hobbiesandinterestshelpbalanceyourlife.Avitalabsorbingcreativeinterestcanhelpbringthesimplepleasureoflivingbackintoyourlife.Whenwegetoverlyinvolvedinanyoneactivity,beithelpfulornotsohelpful,wecutalotoutofourlivesthatweusedtoenjoy.Findingabalancecanrestorethefunandenjoymentthatlifehastooffer.So,howcanwegetbacktothosesimplepleasuresoflife?First,lookatthebenefitslistonyourCBA.Whatweresomeofthebenefitsyouweregettingfromyouraddictivebehaviorbeforethecostsbecametoohigh?Didyouenjoythebuzz?Didyoulikebeingabletojustcheckoutforabit?Wasitthetasteorthesocialaspect?Believeitornot,eachofthesebenefitsisakeytofindingaVACI.Ifyouenjoyedthebuzz,thenlookatthingsyoucoulddotogetarealbuzzoutoflife.Therewardwillbegreaterandyouwillrememberitinthemorningandforyearstocome.Maybeyoudecidetoridearollercoasteryouhaveneverriddenbefore.Maybeit’stakinguprunningorracewalking.Perhapsyouhavealwayswantedtoskydiveorrideamotorcycle.Figureoutwhatwouldgiveyouabuzzandtakeiton.Ifusingoractingoutallowedyouto“checkout”forabit,maybelookingatsomewaysofbeingawayfromtheworldforawhilemightgiveyouthechancetorestoreyourenergy.Takeawalkbyyourself.Gototheoceanandwatchthewaves.Goonadaytrip

andbealonewithyourselfinyourcar.Abikerideisagreatwaytobealonewithnature.Whataboutgardening,crafts,andartisticendeavors?BecarefultodoyourVACIinmoderationsothatyoudon’treplaceoneaddictivebehaviorwithanother.Ifyouleanedonalcoholordrugstohelpyoufeelcomfortableinsocialsituations,youmightchallengeyourselftogotoasocialeventandactasfunandasfriendlyasyouwerewhenyouwereusing.Whatdidyouliketodoasakid?Whathobbiesdidyouhave?Whatdreamswereneverrealized?Nowisthetimetotakeyourlifebackandmakesomeofthosethingshappen.Varietyisthespiceoflife.FindmanyVACIsandkeeplookingformore.Lifeisfullofamazingandnewthingstolearnanddo.

VACIlistUsethetableinFigure6.2tomakealistoftheVACIsthatinterestyou.Writeitdownthenrateit,1-10,onhowmuchitinterestsyou.Afteryoutryit,comebacktothelistandrateitagaintoseehowcloselyyour“beforeandafter”ratingsare.

Figure6.2VACI“beforeandafter”list

SettinggoalsSofarinthischapter,we’vehelpedyouidentifywhatpartsofyourlifeareprobablyinneedofyourattention:regainingyourphysical,mental,andemotionalhealth;andrediscoveringlostpassionsandinterests,andcreatingnewones.Youalsoidentified,intheLifestyleBalancePie,theareasthatareimportanttoyouandwhichonesmightneedalittlemorework.Puttingthisalltogetherrequiresplanning,flexibility,creativity,andenergy.Butwheretostart?Bysettinggoals.Goalshelpyoumaintainyourfocusonachievingbalanceanddirectyourenergytowardyournewlifeandawayfromyouroldone.Likemanywhosufferfromaddictivebehaviors,goalsettingmaybeunfamiliartoyou.Nowthatyouhavefreedupthetimeyouusedtospendengaginginaddictivebehavior,youhavetimetofocusonyourvaluesandinterests.Thegoalsyousetwillbemoremeaningfulifyouconnectthemtoyourvalues.YoumaywanttoreviewyourHierarchyofValuesfromPoint1.Usingyourvaluesasyourguidewillhelpyousetprioritiesandpointyournewlifeinthedirectionyouwantittogo.

EXERCISE:Values,goals,andplanningEstablishingvaluesandgoals,andcreatingplansandstrategiestoachievethosegoalsareessentialtoallaspectsofrecovery,especiallywhencreatingabalancedlife.Ourvaluesguideourlives,fromthelong-termgoalswesettotheday-to-daychoiceswemake.Consciouslydefiningandlivingyourcorevaluesareempoweringbecauseyourvaluesaretheessenceofwhoyouare.Yourvaluesmayincludehonesty,fidelity,reducingyourenvironmentalfootprint,noteatingmeat,honoringyourelders,parentingbasedonloveinsteadoffear,etc.Ifhonestyisoneofyourvalues,thenoneofyourgoalsmightbe,“IfIhavealapse,IwilltellsomeoneasquicklyasIcan”;or“Iwillbehonestwithmychildrenaboutmypast.”Planningwillhelpyouachieveyourgoals.Whilemostofusprobablyhaven’tdonealotofplanning(weweretoofocusedonimmediategratification),it’sacrucialskilltolearn.Ifyou’recommittedtotellingthetruthaboutalapse,writedownhowyouwoulddothatandwhomyouwouldtell.“IfIlapse,Iwilltellmybestfriend”;“Ifmychildasksaboutmypastdruguse,IwilltellthemwhatIbelieveisappropriatewithoutglorifyingmybehavior.”You’llhearpeopleinSMARTtalkaboutthethreePs:patience,practice,andpersistence.Wecouldaddafourthone:planning.It’sthatimportant.Settingafewshort-termgoalsisgreatstartingplace.Youcansetlong-termgoalsafteryousetsomethatwillbenefityounow.Makesureyourgoalsarerealisticwithoutbeingtoohard,anddon’tsettoomany.BasedonyourHOV,whataretheareasofyourlifeyouwanttoimprove?Herearesomeideastogetyoustarted:

Finances—Savemoremoney?Payoffbills?Donate

tocharity(SMARTperhaps)?Thismightbeoneofyourfirstgoalsifyourfinancialsituationiswhatmotivatedyoutogethelp.Friendsandfamily—Improverelationships?Makenewfriendswhoaresober?Spendmoretimewithyourchildren?Manyinrecoverymakethistheirfirstgoal.Career—Findanewjob?Improveacurrentskilloron-the-jobtrainingtoadvance?Physicalhealth—Rebuildmuscletone?Walkaroundtheblockwithoutwheezing?Govegetarian?Getmoresleep?Tendingtoyourphysicalhealthimprovesyourmentalhealth,too.Funandleisure—Bowling?Modeltrains?Sharkfishing?Cooking?Astronomy?Ontheroadtorecovery,boredomcanbeadangeroussinkhole.Rediscoveringoldhobbiesandinterestsorlearningnewonescanhelpyouavoidfallingintoit.Artisticactivities—Singing?Embroidery?Glassblowing?Sculpting?Self-expressionthroughtheartsboostsself-confidence.Education—Finishyourdegree?Takeclassesforfun?Makeyourselfmoremarketable?Asyouknow,youcanalwayslearnnewthings.Takingcoursesatacommunitycenter,communitycollege,oruniversitywillhelpkeepyouengagedinlifeandlearning.Volunteer—SMART?Hospital?Child’sschool?Charities?Animalshelter?Electioncampaign?Youmayfeeladesiretogivebackaspartofyournewlife.Volunteersareinshortsupplyeverywhere.Findinganorganizationthatisinlinewithyourvaluesisuplifting,rewarding,andagreatplacetomakenewfriends.Socialactivities—Ballroomdancing?Bookclub?MeetUpgroups?Church?Manyofyourpastsocialactivitiesprobablyrevolvedaroundyouraddictive

behavior,solearningtosocializeinnewwaysmaytakedetermination.

SettingrealisticgoalsGoalsshouldbe:Specific—“RunBostonMarathon”vs.“Improvemycardiohealth”Measurable—“Gotobedat10p.m.”vs.“Getmoresleep”Agreeable—“I’minvestedinthisgoal”vs.“Ishoulddothisbecause...”Realistic—“Trainfornextyear’sBostonmarathon”vs.“Runmarathonnextmonth”Time-bound—“Volunteerfivehoursaweek”vs.“Donatetocharity”Herearethreepracticegoalstohelpyouseetheprocess.

Figure6.3GoalsettingExamplegoal#1

Examplegoal#2

Examplegoal#3

Nowit’syourturn…

Mygoalsetting

Othergoal-settingtips

Choosethecategoriesinwhichyouwanttosetgoals.Don’tsetsomanythatyougetoverwhelmed.Writedowneachgoal,andincludewhatyouneedtodotomeeteachgoal.Tostayontrack,createweekly“ToDo”listswithallofthetasksthatyouneedtodoeachdaytomeetyourgoals.Reviewyourlistattheendoftheweek.

Checkoffthetasksyoufinished.Moveunfinishedtaskstothenextweek’slist.

Repeatedlyunfinishedtasksmayindicatethatyou’renotasinvestedinthegoalasyouthought,orthegoalsimplyneedsfine-tuning.

LivingwithemotionsStrongemotionsareaninevitablepartofthehumancondition.Asdiscussedin“Point3:ManagingThoughts,Feelings,andEmotions,”learningtoleveloutyouremotionsishelpfulinmanagingbehaviorandalsocanbepartoflivingabalancedlife.Emotionsresideonaspectrum.Oneendisgeneralwell-beingandemotionalbalance.Here,logicandemotioncomplementeachother.ThinkofYinandYang.Theoppositeendofthespectrumisextreme,intensefeelings:burstinghappiness,debilitatingdepression,homicidalrage,etc.Thecloseryougettotheextremeend,thelesslikelyyouwillbethinkingrationallyandtheharderitwillbetobalanceanyofyouremotionsandbehaviors.Learningtobalancefeelingsandrationalthoughtisimportanttoachievingamorebalancedlife.

AwarenesstechniquesManypeoplerecoveringfromaddictivebehaviorsfindthemselvespreoccupiedwiththoughts,pronetoruminating,oreasilycaughtupwithstrongfeelingssuchascravings.Learningtopayattentiontothepresentmomentandbecomingmore“mindful”canimprovewell-beingandlifestylebalance.Mindfulnessistheoppositeofmindlessness.Itdescribesastateofactive,nonjudgmentalattentiontothepresent.OriginallyaformofBuddhistmeditation,therehasbeenalotofresearchintomindfulnesstechniques.Theyareshowntoreducedepression,obsessivethinking,stress,anger,andevenpost-traumaticstress.Emergingevidencesuggestsithelpspeopleinovercomingaddictivedisorders.ThereisashortexerciseinFigure

6.6;muchhasbeenwrittenaboutmindfulnesssotherearealotofresourcesavailable.

RelaxationWhileyouwereengagedinyouraddictivebehavior,it’slikelyyouavoidedordidn’tmaketimejustforyou.Learningtorelaxmayseemlikealuxuryoranunneededself-indulgence,butitisbeneficialtorestoringbalancetoyourlife.Althoughtherearesimilaritiesbetweenmeditationandrelaxation,theyaren’tthesame.Findingwaystorelaxcanbeimportanttoyourrecoveryjourney.Relaxationisanindividualexperiencesofindwhatworksforyou.Followingareafewrelaxationtechniquestotry:

ProgressiveMuscleRelaxationProgressiveMuscleRelaxation(PMR)helpsyoubecomeawareofwhatyourmusclesfeellikewhenthey’retense,andwhenthey’rerelaxed.(Figure6.4)Inthisexercise,you’lltenseandrelaxallofyourmajormusclessowhenyou’redone,allofyourmuscleswillbecompletelyrelaxed.ManypeoplereportfeelingimmediatelyrefreshedandcalmedafterdoingPMR.Youmayfeelthis,oryoumayfeelnothing,especiallyinthebeginning.YoucandoPMRlyingdownorinachair.Tenseeachmusclegroup,holdforfiveseconds,thenrelax.Thishelpsyoufeeleachmusclegroupinatensestateandtheninarelaxedone.Hereisanexampleofhowtotenseandrelaxeachmajormusclegroup:

Figure6.4PMRexercises

VisualizationOurimaginationismorepowerfulthanwerealize.Inadditiontousingvisualizationasawaytorelax,youcanuseittoprepareforjobinterviews,difficultconversations,andevenforgoalsyouwanttoachieve.Athletesusevisualizationtoenhanceperformance.Figureskatersspendfocusedtimevisualizingtheirentireroutines.Publicspeakersoftenvisualizegoingthroughtheirpresentationsbeforegivingthem.Forthisrelaxationexercise,allowyourselfabout15minutes.Makesureyoudon’tfeelrushedandthatdistractionsareataminimum.Sitorliedowninacomfortable,quietplace.

Figure6.5Visualizationexercise

Closeyoureyesandseeyourselfenteringintoaquiet,safe,andrelaxingplacealone.Fillyourplacewithdetailsofwhatyouhearandsmell,whatyouaresittingorlyingon.Createinyourmindthenoisesandsmellsthatyoufindrelaxing.Fillthisplacewithasmuchdetailasyoucanaboutthingsthatrelaxyou.Letyourbodyrelaxandyourshouldersandheadfallgently.Breatheslowly.

MeditationMeditationandmindfulnessarenotusuallypartofaSMARTmeeting;however,somepeoplesetasidesometimeeachdayformindfulnessmeditation.

Figure6.6MeditationguideThisexercisehelpsyoulearntobe“inthemoment”andletemotionalupsetsubsidewithoutreactinginanunhelpfulway:

Sitinacomfortableuprightposture,withastraightbutnotrigidback.Trynottoslouchasthisaffectsyourbreathing,andbreathingisanimportantpartofmeditation.Breatheslowlythroughyournose.Fillyourlungs.Noticehowyourdiaphragmexpandsandyourtummysticksoutwhenyoubreathein.Putyourhandsonyour

stomachjustbelowthebellybuttontofeelthissensation.Closeyoureyes.Takethreedeep,longbreaths,noticinghowitfeels.Now,letyourbreathsettletoanormalrhythm.Ontheout-breath,silentlycount“one.”Onthenextout-breath,count“two,”andsoonupto10.Whenyougetto10,gobacktoone.Ifyoulosecount,juststartagainatone.Feelthephysicalsensationofyourbreathing.Thoughtswillenteryourmind.Don’ttrytopushthemawayorpretendtheydon’texist.Simplyrecognizetheirpresencebutdon’tengagethem.Ifyoufindyourmindwandering,gentlyturnyourattentionbacktoyourbreathingandcounting.Don’tjudgeyourselforyourmeditation“abilities.”

Dothisforthetimeyoudecidedinadvanceandtrynottogiveupearly.Setatimersoyoudon’thavetocheckaclock.Meditationtakespractice.Atfirst,youmayonlybeabletomeditateforafewminutes,butthemoreyoudoit,thelongeryou’llbeabletodoit.You’llmeditatebettersomedaysthanothers.That’snormal.Ithelpsifyoudoitthesametimeandsameplaceeveryday.SomepeoplesitonpillowsintheBuddhistlotuspositionwiththeirhandsrestingontheirknees,palmsupward.Otherssitinacomfortablechair.Youmaywanttoburnacandleorincense.Meditativemusicmayhelp,too.Experimenttofindwhatworksbestforyou.Youalsocanpracticebeingmindfulwhereveryouare,noticingwhatyoufeelandthink,thetasteofyourfood,thepresenceofother;justbeingawareoftheworldaroundandwithinyou.Pay

attentiontothepresentandthoseexcessiveemotions,andruminatingandtroublesomethoughtsmaybegintotroubleyouless.

Regainingyourhealth

NutritionAfteryoustopanaddictivebehavior,youmayfindthatyourappetitereturns.Healthyeatingandmaintainingabalanceddietareessentialtogoodliving.Goingoutforanoccasionalmealwithfriendsorfamilycanbefun.Makingashoppinglist,goingtothegrocerystore,preparingthefood,cookingyourmeals,andcleaningupcanbeincludedinyourplanfortheday.Thiscanhelpkeepyouoccupiedorfillinanysparetimeyoumayhave.Eventhoughapersonwithanaddictivebehaviormaythinktheyareeatingnormallyandregularly,thisisgenerallynotthecase.Vitamindeficienciesarecommon,especiallywithheavyalcoholabusebecausewater-solublevitamins—Bvitamins,suchasthiamineandfolicacid,andvitaminC—arewashedawayfrequentlybecauseyourbodydoesn’tstorethesenutrients.It’sagoodideatoeatmealsatregulartimestohelprestoreyourhealth.YoumayconsideraddingvitaminBandCsupplementstoyourdiet.Yourdoctormayrecommendspecificvitaminsupplements.

ExerciseAnyformofphysicalexerciseisbeneficial.Ifyoucan’tjoinagymordon’thavethestaminatoliftweightsordobriskaerobics,thentakewalksorrideabike.Exercisedoesn’thavetobestrenuoustobebeneficial.A30-minutewalkfivedaysaweekcanbeenjoyableandisknowntoreversetheeffectsofdepression.Buildupgraduallyif

youhavenotexercisedforawhile.Physicalactivitycanhelprelievetensionandrefreshyou.You’llgetthemostbenefitifyoucanexerciseforatleast30minutesthreedaysaweek.Makesureitisnottoostrenuousifyouhavenotexercisedforawhile.Periodicbreakssuchasabriskwalkorgoingforaswimcanrejuvenatethebodyandmakeyoufeelmorepositiveandproductive.Youmaywanttocheckwithyourdoctorbeforestartinganexerciseroutinetomakesureyou’rehealthyenoughforevenmildexercise.

SleepSleeppatternscanchangewhenapersonstopsdrinkingorusingdrugs.Thisisnormal;yourbodyneedstimetoadjust.Ifyouhavedifficultysleeping,cuttingdownoncaffeinewillhelp.Takingashortwalkintheeveningorreadingabookinbedalsomayhelp.Itmaytakeweekstorecoverfromsleepdeficitandtostartsleepingnormally.Vivid,sometimesdisturbingdreamsarecommonearlyinrecovery.Sleeppatternsusuallyimprove.

MedicationSMARTRecoverysupportsthescientificallyinformeduseofpsychologicaltreatmentandlegallyprescribedpsychiatricandaddictionmedication.Ifyouhavedepression,anxiety,orothernon-addictivedisordersfeelfreetopursuetreatmentandmedications.SMARTwillsupportyouifyouchoosetousemedicationsdesignedtohelpwithsubstancedependenceandsmokingcessation.

ProcrastinationWeallprocrastinatetosomedegree;however,problematicprocrastinationcanresembleaddictivebehaviorandbecomeadetrimentalhabit.Youcanapplywhatyouhavelearnedaboutovercomingaddictivebehaviortoovercomingprocrastination.Procrastinationistoocomplextoaddresshere,buthereareafewpointstokeepinmind:

Procrastinationisauniversal—andsometimesevenuseful—humanbehavior.Itcanbeaformofself-sabotage.Likeanything,ifit’sextreme,it’spotentiallyharmful.Itcanbeassociatedwithtryingtoavoidstrongemotionssuchasanxiety.Itmaybeasignalthatyouhavelingeringambivalenceaboutrecovery.Procrastinationcanweakenyourabilitytoachieveyourgoals.ItcanbeaddressedwithaCBA.

SummaryLivingabalancedlifeisscary,exhilarating,andauthentic.Experimentwithdifferentaspectsofyourlifetodeterminewhataddsvalueandbalance.Thisisyourlifeandyougettochoosehowtoliveit.Settinggoals,planningtasks,anddevelopingaVACIareimportantbuildingblockstoyournewlife.SMARTwillcontinuetohelpyoumaintainyourchangeandyourself-empowerment.Continueusingthetoolsthathelpyouandattendmeetingswheneveryouwant.Theskillsthatyouacquiredalongyourrecoveryjourneywillproveinvaluabletoyouwhenfacingfuturesituations.Alwaysrememberthatyouhavethepowertocreateyourlife.

Chapter7:SMARTScienceInourpursuittoprovidethebestpossiblescienceandrecoverytechniques,weadjustandupdatetheSMARTprogramasnewinsightsandlearningemergefromresearch.Millionsofdollarsarespenteveryyeartounderstandthenatureofaddictionandhowtorecoverfromit.Therearegapsinwhatisknownbutvastlymoreisunderstoodtodaythanacoupleofdecadesago.Weworkasapartnerwithpeopleinrecoveryandwithprofessionals,includingpsychologistsandresearchersinterestedinaddiction.Thispartnershipbenefitsallinvolvedbytrackingdevelopmentsinthescience—whatresearchsuggestswillwork.Plus,ourlargeteamoftrainedfacilitatorsprovidefeedbackonwhatseemstobepracticalandeffectiveinourmeetings.WealsohaveanInternationalAdvisoryCouncilwithsomeofthemostwell-respectedresearchersinaddictionandmentalhealth,fromwhomwecanseekadvice.Aswithanymutual-helpprogram,thereislittleresearchontheeffectivenessofSMARTRecoveryasawhole;however,theindividualtoolsandmethodsaresupportedbyenoughevidencetoconcludethattheyareeffective.Therealsoissolidresearchsupportingthevitalrolethatmutual-helpgroupsplayinaperson’srecovery.

HowweusescienceOneoftheaspectsofaddictionisthatthereisnosinglemodelthatprovidesa“universaltheory”aboutthephenomenonofaddiction.Instead,scienceoffersabroadsetofoverlapping,competing,andevolvingsetoftheoriesandmodels.Theseincludebiochemicalexplanationsofhowaddictionworksinthebrain,psychologicalexplanationsofhowaddictionisstructuredintothewaywethink,andhowaddictionandrecoveryneedtobeunderstoodinthecontextofsocialrelationships.Thescientificconsensusisthatthesethreeaspectseachplayapartinaddiction.It’scalledthe“bio-psycho-social”model.Inpractice,thetoolsandmethodsofSMARTaretakenmostlyfrompsychologicalunderstandingsofaddictionandbehaviorchange.It’shelpfultohaveabasicunderstandingofthebrainchemistryofaddiction.Ourtoolsandmethodsareconsistentwithcurrentneuroscienceresearch.SMARTRecoverysupportsthescientificallyinformeduseoflegallyprescribedpsychiatricandaddictionmedication,aswellaspsychologicaltreatments.Recoveryisacomplexandindividualprocess.Whathelpsonepersonmaynothelpanother.Whathelpsduringtheearlydaysofrecoverymaynotbewhatisimportantseveralyearslater.SMARToffersaroundedprogramofrecovery.Wetrytohelpparticipantsatallstages,fromtheirfirstmeetingwhentheymightnothavebegunaseriousattemptatchange,tothosewhohavebeenabstainingforyears.Thisbreadthofinterestleadsustodrawfrommanytheoreticalmodels,methods,andideas.NotalloftheideasortoolswithintheseapproachesarerelevanttoSMARTRecovery.Welookfortoolsthatarepracticalwithinourmutual-helpmodel:

CognitiveBehaviorTherapyRationalEmotiveBehaviorTherapyMotivationalInterviewingTranstheoreticalModelofBehaviorChangeRecoveryCommunitiesandMutualAidRecoveryCapitalTherapeuticLifestyleChangeThird-waveCBTincludingDialecticalBehaviorTherapy(DBT)andAcceptanceandCommitmentTherapy(ACT)

Noapproachtorecoverywillworkforeveryone;weknowwedon’thavealltheanswers.SomeparticipantsuseonlySMARTRecoverymeetings(perhapssupplementedbyonlineactivitiesandourpublications).OtherscombineSMARTmeetingswithattendanceatothermeetings,suchas12-stepgroups,orworkwithamentalhealthprofessional.Formoreaboutthescienceofaddictionrecovery,visit:

www.drugabuse.gov/publications,PrinciplesofDrugAddictionTreatmentbyNIDAwww.behaviortherapy.com/whatworks,whatworksinalcoholtreatment,aslistedintheHandbookofAlcoholismTreatmentnrepp.samhsa.gov,TheNationalRegistryofEvidence-basedProgramsandPractices

DSM-VThefourtheditionoftheAmericanPsychiatricAssociation’s(APA)DiagnosticandStatisticalManualofMentalDisorders(DSMIV-TR)usedbymedicalprofessionalstodiagnoseclinicalmentalhealthconditionswasupdatedinMay2013.TheDSM-Vaddedanewandseparatesectionof“behavioraladdictions”containingthesingledisorderthatcoverscompulsivegambling.ThisallowsothertypesofbehavioralcompulsionsnotcoveredelsewhereintheDSM-Vtoberecognizedasaddictivebehaviorsifmeetingthesamediagnosticcriteriaasgambling.TheDSM-Vdefinesdifferenttypesofaddictiveorcompulsivebehaviorcomprehensivelyandrecognizesthatthesetermsmayapplytoothertypesofbehavioraldisordersbeyondthosethatinvolvealcoholordruguse.

Chapter8:SMARTToolsandStrategiesMatrixWe’vepreviouslypresentedseveraltoolsthatcanhelpyouthroughrecovery.BelowisamatrixthatmapstheSMARTtoolstotheStagesofChangetohelpyouidentifywhattoolsaremosthelpfulateachstage.

Table8.1Matrix:StagesofChange,strategies,tools

Chapter9:Family&FriendsWhilemostoftheHandbookisforpeoplewhosufferfromaddictivebehaviors,thischapterisfortheirfamilyandfriends,alsoknownasconcernedsignificantothers(CSO).Weusethosetermsinterchangeably.Apersonwithanaddictivebehaviorisn’ttheonlyoneaffectedbyit.TheirCSOsareaffected,too…deeply.Ifyou’reinarelationshipwithsomeonewhosuffersfromaddictivebehavior,it’sadifficultjourney;SMARTRecoverycanhelpyou,too.

CRAFTSMARTusesascience-basedprogramcalledCommunityReinforcementApproachandFamilyTraining(CRAFT)thatrecommendsnewwaystointeractwithyourlovedonethatenhanceyourabilitytoinfluencepositivechange.CRAFT’sapproachprovedtwiceaslikelyastheJohnsoninterventionandsixtimesaslikelyasAl-Anontogetalovedoneintotreatment.CRAFTisbasedonprovenbehavioralprinciplesandCBTtechniques.Itteachespositive,non-confrontationalstrategiessuchasrewardingpositivebehaviorsinsteadofengaginginemotionallychargedconfrontationsthatmayactuallypushalovedonetouseoractout.CRAFThasthreemajorgoals:

1. Improvethequalityofyourlife,regardlessofyourlovedone’schoices.

2. Influenceyourlovedonetoreducetheirusing.3. Influenceyourlovedonetopursuerecovery.

Italsocanhelpyoulearnhowtodealwithyourlovedonecompassionatelyratherthanwithhostility,frustration,oravoidance.AnexcellentbookcalledGetYourLovedOneSober:AlternativestoNagging,Pleading,andThreateningbyRobertJ.Meyers,Ph.D.,andBrendaL.Wolfe,Ph.D.,explainsCRAFTandisthemainstayofSMART’sFamily&Friendsprogram.ThebookprovidestoolsandscenariostohelpyoulearnhowtouseCRAFT.Usingplainlanguageandrealexamples,thebookteachesyouhowto:

Stopfixingyourlovedone’smesses.Takecontrolofyourlifeandyourrelationship.Mapnewbehavioralpatterns.Recognizewhenasituationbecomesdangerous.Createarapidexitplan.Encourageyourlovedoneintoprofessionaltreatment.Identifyyourlovedone’striggersforusingoractingout.Supportyourlovedone’srecovery.Usenewtechniquestosolveoldproblems.

OnlinemeetingandforumSMARToffersaFamily&Friendsmeetingonlineandtherearesomeface-to-facemeetings,too.Checkourwebsiteregularlyfornewsaboutnewface-to-facemeetings.Meetingtopicsrangefromself-caretoproblemsolving,andmayfocusonanissue,suchasestablishingboundaries,communicatinginnon-confrontationalways,orsettinggoals.TherealsoisanonlineMessageBoardforumforF&FonSMARTRecoveryOnline(SROL).Inthisforum,youcanshareyourthoughts,ideas,questions,andconcerns.F&Fparticipantsoffersupportandshareexperienceswitheachotherinasafeandsupportiveenvironment.OthersintheSMARTcommunityfrequentlyjointhediscussionsandsharetheirperspectivesaswell.

PublicationsTheSMARTRecoveryFamily&FriendsHandbookisaterrificresourceforpeopleaffectedbytheaddictivebehaviorofalovedone.And,trainedSMARTfacilitatorsinterestedinstartingaFamily&FriendsmeetingintheircommunitywillbenefitfromtheFamily&FriendsFacilitator’sManual,whichisaguidetoconductingFamily&Friendsmeetings.

Chapter10:AboutSMART

Purpose,Mission,andVision

Purpose:Tohelpindividualsgainindependencefromaddictivebehaviorandleadmeaningfulandsatisfyinglives.Tosupporttheavailabilityofchoicesinrecovery.Mission:Toofferno-fee,self-empowering,science-based,face-to-face,andonlinesupportgroupsforabstainingfromanysubstanceoractivityaddictivebehavior.Vision:ThinkSMARTWorldwide.

Fromthesestatements,it’seasytoseewhatSMARTisaboutandwhereitwantstogo.SMARTisanetworkofvolunteerswithonlyasmalladministrativestaff.Weareaglobalorganizationofferingexperience,knowledge,andsupporttopeoplesufferingfromanytypeofaddictivebehavior.

HistorySMARTRecoverybeganastheRationalRecoverySelf-HelpNetwork.In1994weendedouraffiliationwithRRandchangedournametoSMARTRecovery.Sincethenhavefocusedonbuildinganetworkofvolunteersaroundtheworldandincreatingawebsitetoofferonlineservicestothosewhocan’t,ordon’twantto,attendface-to-facemeetings.Today,hundredsofface-to-facemeetingsareheldallovertheworld,andmoreareaddedeveryyear.

SMARTvolunteersandsupportWerelyprimarilyonvolunteerstomovetheorganizationforward;theyaresupportedbyasmallstaff.OurVolunteersinclude:

BoardofDirectorsInternationalAdvisoryCouncilRegionalCoordinatorsCommitteeMembersAdvisorsFacilitators

Onlinemessageboard,meeting,andchatroomvolunteers.Manyofourvolunteershavegonethroughrecoveryandfindthatreachingouttoothershelpsthemmaintaintheircommitmenttoahealthierlife.Ifyou’rejustbeginningyourrecovery,youhavehardworkaheadofyou.Intheearlystages,that’senoughtofocuson.Eventually,youmaywanttovolunteerwithSMARTtohelpothers.WeareagrowingorganizationandcanusehelpinpromotingSMARTasarecoveryoption.Evenifyoudon’thavethetimeorinteresttovolunteer,youcanstillsupportusinotherways:

MentionSMARTinconversationsasafreeaddictivebehaviorrecoveryprogram.HandoutSMARTbrochuresinyourcommunityandtothosewhomightneedhelp.Letlocalhealthprofessionals,clergy,lawenforcement,andlegalprofessionalsknowaboutSMART.

DonateSMARTbooksandmaterialstolocallibraries.SubscribetothefreequarterlyNews&Viewsnewsletter,availableonline.Shareyourstorybysubmittingarticlesforthenewsletter.Telllocalmedia,humanservicesdepartments,charities,intervention,andtreatmentcentersaboutSMART.Beanadvocate—tellothersaboutSMARTifyouthinkthey,orsomeonetheyknow,couldbenefitfromourapproachandsupport.

DonationsSMARTRecoveryreliesonthegenerosityofindividualstohelpsustainourprogramsandservices.Inadditiontopersonaldonations,moneycomesinfrompublicationsales,meetinggroupsthatsharetheircollectionswiththeCentralOffice,andtrainingfeesandwebsitesupporters.Alldonationsarewelcomeandaretax-deductibleintheU.S.Youmayvisitourwebsiteandclickonthedonatebutton,orsendacheck,moneyorderorcreditcardinformationto:

SMARTRecoveryCentralOffice

7304MentorAve.,SuiteFMentor,OH44060

SMARTPoliciesWhilewewanttokeepSMARTassimpleaspossible,givingeachpersonthelatitudetoworktheirownrecovery,wehavedevelopedsomepoliciesandpositionsoncertaintopics.

MedicationSMARTRecoverysupportsthescientificallyinformeduseofpsychologicaltreatmentandlegallyprescribedpsychiatricandaddictionmedication.

DiseasemodelSMARTRecoverytoolscanhelpyouregardlessofwhetherornotyoubelieveaddictionisadisease.

ConfidentialityRecoveryisapersonaljourney.Inface-to-facemeetingsandonSROL,peopleopenlydiscusstheirlives.Wewanteveryonetofeelsafeinthesemeetings,knowingthattheirprivacywillbeprotected.Donottellanyoneoutsideofameetinganyinformationordetailsthatcouldidentifyanindividual.Ifyouseesomeoneoutsideofameeting,donotidentifythemasmeetingattendees.Ifyouviolateconfidentiality,youmaybebarredfromSMARTmeetings.

Personalresponsibility

Drinkingalcohol,takingdrugs,orengaginginpotentiallyharmfulactivitiesaremattersofpersonalchoice.You’rewelcomeatmeetingswhetherornotyouarecurrentlyusing.Ifyourbehaviordisruptsthemeeting,youmaybeaskedtoleave.However,ourpolicyisnottoshameyouorpressureyouintostoppingyouraddictivebehavior.

RespectShowrespectforothersatalltimes.Don’tlabelanyone,oruseoffensiveordenigratinglanguageorbehaviorinmeetingsoronSROL.Threats,intimidation,violence,andothernon-respectfulbehaviorsisnottoleratedinmeetingsoronline.

SpiritualityWebelievethatthepowertochangeaddictivebehaviorsresideswithineachindividualanddoesnotdependuponadherencetoanyspiritualviewpoint.Theuseofreligiousorspiritualbeliefsandpracticesinrecoveryisapersonalchoiceandnotapartofourprogram.

APPENDIXA:DefinitionsofTerms

APPENDIXB:WorksheetsFigure3.1.HierarchyofValues(frompage14)Figure3.3.Change-Planworksheet(frompage18)Figure3.4.Cost-BenefitAnalysis(frompage22)Figure4.4.UrgeLog(frompage30)Figure4.6.WeeklyPlanner(frompage33)Figure4.9&5.5ABC(frompages41and52)Figure5.1.DisputingIrrationalBeliefs(frompage48)Figure6.1.LifestyleBalancePie(frompage61)Figure6.3.GoalSetting(frompage66)

APPENDIXC:RecommendedReadingandResourcesSMART’spublications(AvailableatSMART’sonlinebookstore)

SMARTRecoveryHandbook—Acompilationofpracticalinformationdesignedtoassistthereaderinattainingtheultimategoalofrecovery.SMARTRecoveryFamily&FriendsHandbook—Designedforpeopleaffectedbytheaddictivebehaviorofalovedone,this138pageHandbookcontains14sectionswithawiderangeoftopicsincluding:ChangeandMotivation,PositiveCommunication,HealthyBoundaries,SafetyandSupport,CopingwithLapses,DisabletheEnabling,TrustandForgiveness–andmuchmore.ItcanbeusedinconjunctionwithattendanceatSMARTFamily&Friends(F&F)onlineorcommunitymeetings,oronitsown.SMARTRecoveryTeenHandbook—DevelopedwithagrantfromTheCommunityCoalitionforTeensinGreenfield,Massachusetts.SMARTRecoveryFacilitator’sManual—Thishow-tomanualprovidesanexcellentoverviewofhowtostartaSMARTRecoverygroupmeeting,andalsoservesasasuperbrefresherforindividualswhohavebeenleadinggroupsforsometime.SMARTRecoveryFamily&FriendsFacilitator’sManual—Thishow-toManualprovidesinformationforconductingaSMARTRecoveryFamily&FriendsMeetingusingacombinationofSMART’stoolsand

CRAFT(CommunityReinforcementandFamilyTraining)concepts.Itexplores:ChangeandMotivation,PositiveCommunication,HealthyBoundaries,SafetyandSupport,CopingwithLapses,DisabletheEnabling,TrustandForgiveness–andmuchmore.TheManualisusedinconjunctionwithSMART’sFASTDistanceTraining.AddictionandCo-OccurringDisordersfromaSMARTRecoveryPerspective:AManualforGroupTherapists—byDawnAdamson,RN,CPMHN(c),CARN,andA.G.Ahmed,MD,FRCP,Thismanualaimstoengagetheindividualintherecoveryprocess,increaseindividualinsight,motivateandsustainchangethrougheducationandskilldevelopment.Theprogramhasbeenadaptedanddeliveredinacommunitysettingtoindividualswithco-occurringmentaldisorders.SMARTRecoveryMotivationalGuideandWorkbookforRecoveringHealthcareProfessionals—byMariaElsaRodriguez,DNP,ACNS-BC,Chaptertopicsinclude:Motivation;ThePrevalenceofAddictioninHealthcareProviders(physicians,nurses,psychologists,pharmacistsanddentists);InformationAboutSMARTRecovery;TheBrain,Drugs,&Motivation;AnOverviewofCognitive-BehavioralTherapy;TheTranstheoreticalModelofChange;Self-Efficacy;Self-EsteemandSelf-Worth;LocusofControl;Resilience;CopingSkillsforEmotions&Behaviors;andanAppendixreviewingTheBackgroundandHistoryofNarcotic&AlcoholUseintheUnitedStates.Anumberofinteractiveactivitiesareincludedthroughouttheworkbook.

AddictiveBehavior

ForSMARTparticipantsorfamilyandfriends:

Alcohol:HowtoGiveitUpandBeGladYouDid,ASensibleApproach—PhilipTate,Ph.D.(SeeSharpPress1997)Sex,Drugs,Gambling,&Chocolate:AWorkbookforOvercomingAddictions—ThomasHorvath,Ph.D.(ImpactPublishers,Inc.-1998)TheSmallBook—JackTrimpey,LCSW(DelacortePress,NewYork,NY-1992)WhenAADoesn’tWorkforYou:RationalStepstoQuittingAlcohol-AlbertEllis,Ph.D.andEmmettVelten,Ph.D.(BarricadeBooks,Inc.,FortLee,NJ-1992)RecoveryOptions:TheCompleteGuide—Volpicelli&Szalavitz(JohnWiley&Sons,Inc.2000-2002)Resisting12-StepCoercion—StantonPeele,CharlesBufe,andArchieBrodsky(SeeSharpPress-2000)SoberforGood:NewSolutionsforDrinkingProblems:AdvicefromthosewhohaveSucceeded–AnneFletcher(HoughtonMifflinCo.2001)TheTruthAboutAddictionandRecovery—StantonPeele,Ph.D.andArchyBrodskywithMaryArnold(Simon&Schuster-1989)GetYourLovedOneSober:AlternativestoNagging,Pleading,andThreatening—RobertJ.Meyers,Ph.D.,andBrendaL.Wolfe,Ph.D.(HazeldenPublishingandEducationalServices2004)

TheAuthoritativeGuidetoSelfHelpBooks—Santrock,Minnett,andCampbell(GuilfordPress-1994)ChangingforGood—JamesProchaska,Ph.D.,JohnNorcross,Ph.D.andCarloDiClemente,Ph.D.(Wm.Morrow&Company,NewYork,NY-1994)

ForFacilitatorsandVolunteerAdvisors:

TheHandbookofAlcoholismTreatmentApproaches:EffectiveAlternatives(3rdedition)—HesterandMilller,eds.(Allyn&Bacon2003)ManagingAddictions:Cognitive,EmotiveandBehavioralTechniques—F.M.Bishop,Ph.D.(AlbertEllisInstitute2001)MotivationalInterviewing(2nded.)—MillerandRollnick(GuilfordPublications,Inc.April2002)PrinciplesofDrugAddictionTreatment:AResearchBasedGuide—NationalInstituteonDrugAbuse,www.drugabuse.gov

Websites

www.smartrecovery.orgwww.health.org

ForFacilitatorsandVolunteerAdvisors:

www.abct.orgwww.mindtools.com

Generalbehaviorchange

Manualstoguidechange

CopingBetter…Anytime,Anywhere—MaxieMaultsby(RationalSelf-HelpAids1990)FeelingGood—DavidBurns(Signet,1980)HowtoStubbornlyRefusetoMakeYourselfMiserableAboutAnything,YesAnything!—AlbertEllis,Ph.D.(LyleStuart,Inc.,Secaucus,NJ-1988)ThreeMinuteTherapy,ChangeYourThinking,ChangeyourLife—MichaelEdelstein,Ph.D.(GlenbridgePublishing,Ltd.-1998)WhenISayNoIFeelGuilty—ManuelSmith(Bantam/NonfictionRe-issueEditionFeb.1,1975)

Otherresources

DVDs(ForanupdatedlistofSMARTRecoveryDVDs,visitouronlinebookstore)

FacilitatingaBasicSMARTRecoveryMeeting—Toattractandtrainnewfacilitators.AnimportanttoolforanyonewhowantstobecomeatrainedSMARTfacilitator.FacilitatinganAdvancedSMARTRecoveryMeeting—FeaturesJonathanvonBretonandEmmettVelten’strainingprogramthatreviewsourprogramtools.ThisvideopresentationhelpsmeetingfacilitatorsaddresssomeofthemoresignificantissuesthatmayariseduringSMARTmeetings.TheSMART4-PointProgram®—FeaturesDr.JosephGersteinandDr.MichlerBishop.Theyrevieweachpoint,theirunderlyingprinciples,andthetoolsandtechniquesassociatedwiththepoints.SMARTRecovery:WhoWeAre—AnoverviewofSMART;agreattooltoacquaintpeoplewithprogramconcepts.SMARTRecoveryAddictionRecoveryinthe21stCentury—JosephGerstein,M.D.,presentingSMARTRecoverytoaddictionprofessionalsattheMaineMedicalCenter,inwhichhemakescleartheimportanceofchoiceoftreatmentandchoiceofmutual-helpgroupsisneeded.Heexplainswhysomearemoresuccessfulinovercomingsubstanceabuseiftheyareofferedtheoptionofarational,cognitiveapproach.

Podcasts

Ourlistofpodcastsisevergrowing,andrepresentsawidearrayofguestspeakersontopicsofinteresttoourparticipantsandvolunteers,includingprocrastination,TheArtofLivingseries,

CombatingDepression,PreventingandCopingwithRelapse…andmanymore.Pleasevisitwww.smartrecovery.libsyn.comforthefulllibrary.