Addictive cycles

Addictive cycles

Over-medication and vulnerability

It is normal for people to try to reduce their pain and emotional pain is no exception. A person experiencing deep emotional wounding or anxiety is extremely vulnerable and will do whatever they can to block it. When the helpful protector characters in your inner village (inner selves) run out of ways to reduce the pain and can no longer provide protection, the next thing is to try substances or processes from outside the village. At first these often seem to work almost miraculously, so the process is repeated more and more often. But sooner or later the treatment starts to lose its effectiveness.

What is described as "an addiction" exists when someone finds themselves trapped in a cycle in which he or she keeps increasing the amount of their (external) emotional pain reducing medication because it is not working as well as it did at first, but expecting it will soon start performing miracles again. So, rather than the term ‘addiction’ it would be more accurate to describe the nature of the cycle that is happening inside their village.

In the same way, the person we typically call an addict could be more accurately described as someone who is ‘trapped in an addictive cycle’. The addictive nature of the cycle is made worse as he or she starts suffering side-effects caused by their emotional pain-reducing "medication", yet is unable to stop taking it.

The last thing needed at any point is for anyone to use a shaming and inaccurate term that labels the individual as for example an ‘addict’; "substance abuser" an ‘alcoholic’ or judges them as a ‘bad’ person who has selfishly adopted a ‘bad habit’ . Worse still is the shaming assertion that if the individual was a "good" person they would easily be able to get rid of their "bad habit".

It would be far more helpful, for instance, to recognise that they are a person who is trapped in the grip of an addictive cycle, and, at the same time, help them to become aware just how much they are suffering serious side-effects from over-using their emotional pain reducing medication.

The addictive cycle

A person who is likely to get into an addictive cycle goes through several distinct stages:

Stage 1 - Moderate medication - not yet an addictive cycle (trial period)

1. Increased emotional pain - Something happening in the person’s life triggers their emotional pain and their need for some way of reducing it. Examples include increased feelings of anxiety or vulnerability, resulting from the loss of a job or a failed relationship. The event may also lead to feelings of increased guilt, fear, loss, shame or a deeper sense of being to blame. Any experience that leads to loss of self-esteem or spirit, or a connection to polarised negative core beliefs will have the same effect.

2. Failure of previous ways of adapting - the individual’s usual protection by adapting or changing in functional ways is failing or is losing effectiveness. The inner protector characters, inner villagers or inner selves are no longer doing their usual jobs effectively enough.

3. Trying something outside me - discovery that when our inner characters (inner selves) seem to be losing their power that using a substance, an activity (or another person) instead seems to work better than trying to cope from within. This new external form of adaption or ‘medication’ usually does work better for a while.

The initial effect of all medications is to provide some alteration in mood or energy levels. This can include:

* Relaxation

* Stimulation

* Mood moderation (more relaxed, more joy, less shy, more confident)

For some fortunate people this is as far as the external medication process goes. They find an acceptable dose rate and follow it. Their medication might be a cup of coffee at morning tea time, a glass of wine in the evening, a sedative to help with occasional sleeping problems or a few drinks at a party.

Unless they progress to Stage 2 they will not become trapped in an addictive cycle. They may still have to face two problems associated with any medication - one, they need the help of something outside them to cope with something inside them; so if they run out of it they will have problems and two - using even moderate amounts of the medication may have unseen side-effects.

If however, using moderate amounts appears to produce "improvements" like those below, the person will connect these with their use of the medication. This in turn will encourage them to increase their use of that medication. (If two drinks make me feel less sad, six should make me really happy.)

Early changes during the Stage 1 or trial period that encourage heavier use include:

* Mood reversal (Example - low to high, nervous to super-confident, sad to super-happy, shy to over-confident))

* Feeling much higher self-esteem, great happiness and joy or just ‘so much better’

* Changed perception (my life/friends/work/relationships/driving etc. suddenly got so much better)

* Reduced emotional pain or anxiety

Stage 2 - Increasing use of medication

4. Increasing need to use their medication combined with build-up of tolerance - If a medication works well and people feel much better whenever they use it, it’s normal to develop an increased appetite for it. At the same time, as with any pain reducing medication, used repeatedly, a tolerance develops. The longer you use it, the more you need and the more often you need it, in order to get the same reduction in pain or anxiety.

Stage 2 is triggered by growing feelings of anxiety or vulnerability, more guilt, fear, shame, blame, greater loss of self-esteem or spirit. Pia Mellody describes the pain at this stage as becoming ‘intolerable’.

5. Rationalising - The person using the medication suggests reasons that (to them) appear to be completely logical and rational. Their "reasonable" arguments are often presented to support or justify their increasing use of their chosen medication. Example: "I just enjoy the taste of it" "It just helps me relax" "Everybody needs at least one little vice" "There is no evidence to show that it does any harm." "Other people might be addicted but I am not like them." To the outside observer these reasons may not be nearly as convincing as they are to the person who expresses them.

6. Early denial - This is really just a more extreme version of rationalising as described above. The reasons offered are often quite bizarre and to observers even less convincing. In extreme cases the individual may deny that the events that took place ever occurred or claim that they have been exaggerated out of all proportion by biased observers. Example: "So what? It didn’t do any harm and nobody got hurt." "No, that never happened." "Somebody is making up stories about me." "I am totally in control, I can take it or leave it." "I can give it up any time I want to." "It’s because you nag me about it so much. That only makes me need it more often!"

7. Withdrawal Issues - If a person can’t get their medication they are going to have to face their ‘intolerable pain’ again.

Withdrawal symptoms when the person is unable to get their medication are among the first observable signs of a developing addictive cycle.

8. Stashes and backup supplies

To avoid the pain of withdrawal they start to organise a secondary source they can rely on if their usual supply runs out. This stage in the cycle is another of the first noticeable signs as the individual starts organising ‘backups’ or ‘stashes’ (open or hidden) in case they cannot access their usual supply.

9. Side-effect problems - The more I use any medication the more serious the side-effects. Typical effects from overuse or extended use of emotional medication include:

ê reduction in everyday skills and abilities

ê reduction in moderation and ability to balance polarised inner protector characters, inner villagers (inner selves)

ê health problems directly due to overuse of the medication

ê losing touch with reality including increased denial about these side-effects

ê less awareness, inner protector characters (inner selves) more in control of life

If someone you know (or if you) reach this stage, (pointers 7 to 10 above) it is time to start describing the process as ‘addictive’ because from here on it becomes much harder to stop the cycle.

Stage 3 - Over medication

10. Problems from over-medication now make original problem worse - The side-effects listed above cause an upsurge in the original feelings of anxiety or vulnerability, guilt, fear, shame, blame, loss of self-esteem etc. that led to the use of the medication. The worse these feelings, the more medication is needed and the greater the damaging side-effects. The addictive cycle now tends to move faster and is much harder to stop.

Stage 4 - Major breakdown or recovery

If the person continues to increase their rate of medication the cycle goes one of two ways from here. Either they reach a point of total breakdown (often called hitting rock bottom) followed by recovery or they continue the cycle until it ends in an early death.

11. Increased overuse of medication results in major losses - Additional side-effects (listed above) all become worse. In particular reduction in everyday skills and abilities; loss of ability to balance polarised selves and health problems all become severe.

12. Deception, intentionally dishonest denial

The loss of touch with reality becomes more extreme. Shame about what is happening leads to a round of deception. Denial now becomes deception (intentional dishonesty).

Regardless of the substance or process involved these three pointers are almost always present and so help identify the stage the person has reached in their cycle.

Relationships with friends and family start to suffer severely. A person in the grip of their medication at this stage in the cycle is unable to have a functional relationship with any other human being. Their only significant "relationship" is with their medication. No one else really matters. This leads to massive problems including loss of jobs, loss of family and ultimately threatens their life.

Friendships are lost too, with the exception of fellow medicators who stay on, though there is no way at this point, that they can be classed as true friends.

Treating addictive cycles - do’s and don’ts

Do’s – only one

There s only one effective treatment for any addiction where the individual is medicating their deep emotional pain, shame, guilt, fear, loneliness or any strongly negative emotion. That is to increase the person’s ability to reduce, (and that means to reduce permanently) the pain, shame, guilt or whatever it is that is the driving their need for emotional pain reducing medication and their over-use of that medication.

Twelve Step programs such as Alcoholics Anonymous deserve to be recognised as one of the foremost successful treatments for all addictive cycles. Although their format remains incredibly simple and each group is conducted entirely by untrained volunteers, that group will include a number of people who do understand a great deal about teaching addicts how to reduce their emotional pain or wounding. And that is because they have had to do the same thing themselves and have managed to do it with some long term success.

The 12 Step program is effective because the group members are the best of all models and teachers for recovery - they are all people who have acknowledged their own problems with over-use and are successfully recovering from their own addictive cycles.

The groups are far from perfect but they have the reputation of getting more people out of addictive cycles than any other treatment.

There are now nearly two hundred different kinds of Twelve Step groups (each based on the particular substance or process involved - alcoholics anonymous, gamblers anonymous, co-dependents anonymous, over-eaters anonymous, debtors and spenders anonymous, rage-aholics anonymous, drama addicts anonymous, to name just a few) All of them enjoy a level of success seldom matched by treatment centres or expensive therapy.

A sample ‘Twelve Steps for Dependents Anonymous’ is included on a separate page.

Recovery programs such as those offered at the South Pacific Hospital in Sydney, the Currumbin Clinic on the Gold Coast and The Meadows in Arizona, all achieve very good results but need to be followed by regular work with a therapist and group meetings for several years, perhaps for the rest of that person’s life.

Recovery Don’ts

1. Do not shame, do not blame and do not make the person feel guilty. This one "don’t" stands out above all others. The person is over-using their medication because they found that despite the negative side-effects it at least gave them some temporary reduction in the their overwhelming shame, guilt or pain. Instead of reducing the over-use, increasing a person’s feelings of guilt and shame drives the addiction cycle further and faster. An addictive cycle cannot be reduced by shaming.

2. An addictive cycle is not a ‘habit’ and it cannot be broken by "will power". The only effective treatment is one that heals the deep emotional core pain and that may need to continue for the remainder of one’s life.

3. Never ask or expect an addicted person to ‘promise to give it up.’ The cycle they are in renders them incapable of the adult behaviour needed to honour such a pledge. I suspect the person asking for such a promise is also being less than adult if they believe it.

4. There is no ‘fast treatment’. People may ‘sober up’ overnight, using will power, but that just means that a more powerful one-above inner protector character (inner self ) has stepped and taken temporary control the medicating and enabling characters (inner selves). Any ‘rapid’ recovery, that involves the individual simply switching to a new medication, for example, from alcohol to chocolate or from gambling to increased smoking and drinking for example is not sobering up at all. In most cases it will only last for a few months. Or the new medication will simply take over from the old one on a long-term basis.

5. Any reduction in an addictive cycle based on punishment is only temporary. It’s much the same as if you had a really bad back injury and needed to take eight aspirin a day to block the pain.

Some concerned friends might consider this as evidence that you were addicted to aspirin and with the very best intentions might use some form of punishment to force you to stop taking aspirin. Your friends might then congratulate themselves that with their dedicated help you had beaten your aspirin addiction.

But you would still have the backache and you would still have to cope with pain. As long as the pain in your back is greater than the pain of the punishment, understandably, you will soon be back on the aspirin again.

FOOTNOTE: All addictive cycles are connected in some way to brain-altering chemical substances. In the case of process addictions like gambling the only difference is that the chemicals are produced within the body.

In both cases the end result is that adult awareness and the more functional moderate protector characters in your inner village are constantly being anaesthetised by the particular chemical and so that they have no chance of helping.

See also

Overview of Typical Addictive Substances and Activities

Inner selves and addictive Cycles

This could hurt a bit.....

The path and the holes - a story about recovery from addictions

Sex addiction

Example of the Twelve Steps (Dependants Anonymous)

Remember to H-A-L-T Hungry? Angry? Lonely? Tired?

Feedback - please e-mail me John Bligh Nutting - at nutting@growingaware.com.au

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