Oh, Grow Up
Addiction and stunted growth have been shown to be linked. Here are the methods I use in my practice to help patients overcome their self-defeating views of the world, and overcome their addictions.
Two of my clients recently shared the same feedback about why they they indulge in their drug of choice (alcohol, marijuana). Both said they “do not want to be told what they can or cannot do”…even by themselves.
In other words, the use of self-discipline and impulse control was not something they were interested in… until they each got into trouble because of their substance use.
Both are now in treatment and seem to be genuinely interested in figuring out just why they tend to act impulsively, and how they can change. They both admitted (sheepishly) that they realized that doing something inappropriate simply because you want to—without regard for consequences (or in spite of them)—is “pretty childish behavior” but they each said that they felt “almost powerless” to resist temptation.
As adults we have the opportunity to recognize and correct the erroneous, self-defeating beliefs that lie deep within us.
In many ways, addiction is akin to child-like behavior. Addicts have a lowered ability to delay gratification and control impulses, as well as a lowered ability to understand the impact of their actions on themselves or others, much like children. Leaning to stop, think, self-reflect and moderate emotional responses are skills that are supposed to emerge as we grow into adulthood. Many people “age-out” of childhood long before they acquire the emotional skills required to effectively deal with the challenges of adulthood. Addicts just fall farther out on the edges of the continuum.
I deal with people who have all kinds of different diagnoses, including addiction and the dual diagnosis of addiction plus mental illness. A common issue shared by almost all of my clients is essentially the need to “grow up”—to do the work of becoming emotionally mature as well as chronologically mature. Emotional immaturity cuts across all boundaries—race, religion, IQ, and of course, age. The two clients mentioned above exhibited very similar mindsets. One is a 17-year-old high school student, the other a 50-plus year-old mother of two grown children.
Why emotional maturity is so rare is an oft-debated question in the mental health field. Theories range from the biological and neurological (differences in brain functioning in the frontal lobe, the decision making and impulse control area) to poor parental attachment or bonding in early childhood. What is generally conceded, however, is that my 50-plus year-old client was likely to have been more impulsive than normal in childhood while the 17–year-old client will be more likely to remain rather impulsive and have more difficulty acquiring self-discipline later in life than his non-addicted peers.
This idea was first put forth in a study by B.J. Casey, Walter Mischel, et al., in the late 1960’s. The study authors, who originally conducted their research at Cornell University, recently did a follow up on the study, which looked at impulsiveness in pre-school children. The original study has come to be known as “the marshmallow test,” because the child test subjects were asked to attempt to delay eating one marshmallow in order to be rewarded with two marshmallows a few minutes later if they were successful. Forty years later, some of these same subjects were re-tested for impulsivity (using a different cue, not a marshmallow) and the results showed a significantly stable predictability. The subjects who tested as having low impulse control at age four, still tested about the same on this parameter as adults, and vice-versa for the high impulse control group. One of the key findings was that the perceived “allure” of a cue (marshmallow or addictive drug) was associated with the greatest impact. In other words, the greater the allure (or perceived positive value) of a cue, the more difficult it is to resist.
THE POWER OF IMAGINATION AND DISTRACTION
Yet, as troubling as these findings may be, the studies did identify two factors that helped subjects resist temptation. The first was distraction: the children who were able to resist the temptation of eating the marshmallow right away utilized various distraction techniques to keep their minds otherwise occupied. They looked the other way, played with toys or sang. In some cases, they were instructed to imagine the marshmallow as a cloud, or to imagine the taste of crunchy, salty pretzels. Those who used imagination held out about three times longer against the temptation than those who did not use it. The children who imagined an unrelated, but also pleasurable, sensation (the taste of pretzels) held off the longest. Therefore another potential tool for resisting temptation is to imagine an alternative pleasurable sensation.
In my work with addicts as well as people with other diagnoses, I use the power of imagination as well. In therapy, we call it visualization or guided imagery. I believe that we all are “programmed” with erroneous messages about ourselves from childhood, often because of faulty associations created by the childhood phenomena of magical thinking. Magical thinking has several components, including the common childhood tendency to allocate “real” attributes to items (favorite stuffed toy or doll) and to interact with imaginary friends. Another attribute, related to how we perceive ourselves (self-esteem) is the tendency for children to correlate the cause and effect of events (especially traumatic, potentially guilt-provoking events) to actions, thoughts or behaviors that they initiate.
As an example, for many years as a child, I believed that I was the cause of my grandmother’s death. When I was four, she went into the hospital and never returned. At the time, I was never told why, so my child brain came up with its own cause–I had left a skate on the sidewalk and she had tripped and fallen on it a few days prior to being hospitalized. So I figured the fall injury must have been the reason for her death. Sounds impossible, I know, but it seems that “illogical logic” is preferable to the brain than no logic at all. (By the way, years later I discovered that it was cancer that had taken her life.)
The point is that all of us have within us examples of this kind of illogical logic that dampens down our self-esteem (so called cognitive errors). Guilt-producing error messages are “hardwired” deep in our subconscious minds and we generally are unaware that these negative beliefs may be prodding us to do things that we’d be better off not doing (drinking, taking drugs, for instance). To truly gain recovery, addicts must acknowledge the truth that can set them free—that such feelings, and other negative beliefs about themselves, are really doubts, fears and worries, programmed into the subconscious, and not a true expression of reality. By connecting with such beliefs at a deep, feeling level (via the subconscious), they can be “updated” and “re-programmed” with the truth. To do this, I like to use guided imagery because it allows the client to have direct communication between the conscious and subconscious parts of their mind.
As I see it, the job of adulthood is to bring awareness to these deeply held and habituated negative self-beliefs. They often make up the “foundational layer” of our belief systems because they were programmed so early on. I have observed about 6-8 “life theme issues” that are common among my clients, beliefs such as “I’m fatally flawed,” "I’m incompetent,” "I can’t trust the world (or those closest to me) to support me,” "I’ll be abandoned,” and “I must ‘buy’ the affection of others by doing things for them.” These are childhood beliefs created to deal with, as best as a child can, the fact that they have little control over their lives and are dependent on others for survival. Is it any wonder that many of us grow up to be “pleasers?”
CHALLENGING THOSE CORE, SELF-DEFEATING BELIEFS
Unfortunately, most people never address the negative, self-esteem dampening self-beliefs that are untrue and programmed into the foundation level of their minds. These thoughts surface automatically when a person encounters a circumstance or event that reminds them of the original feeling. (The mind, which works via pattern and association, is essentially saying, “I know how you feel about this…here is your default belief.”) Unfortunately, each time such an automatic thought surfaces and is not challenged, the person is inadvertently giving the signal to their inner mind that they are in agreement with the belief. When an automatic thought surfaces, it offers an opportunity to set the record straight and re-program the default setting with the truth. But when this opportunity is not taken, not only does the negative belief remain, it is actually strengthened. We “feed and water” such beliefs each time we allow them to return to memory unchanged.
When working with clients to counter erroneously programmed negative beliefs, I use a dual approach. I first give them an assessment to determine which “life theme issues” they subscribe to, and then I teach them to “have their radar out” in order to notice repetitive patterns where these beliefs surface. I instruct them that instead of running away from these feelings, they should instead, “celebrate” them when they occur, because they represent an opportunity to release a portion of the doubts, fears and worries (that they are afraid may be true, but aren’t) still hardwired into their subconscious minds. I describe the time that a client is feeling the painful feeling as both an opportunity and a moment of power. Emotions are energy, and energy cannot be destroyed, but it can be transformed…and the greatest potential for transforming emotional energy comes when an emotion is being felt or experienced. Therefore, I instruct clients to allow the painful feeling to be felt, but at the same time, mentally dispute it as an inadvertent childhood error in thinking. This exercise is the first part of the clients' training to take charge of their emotions and “grow up.” The second part we do together, using guided imagery. In this process, I have the client communicate directly between his/her subconscious mind and conscious mind to clear up erroneous beliefs and to make a pact between their “adult self” and “child self,” to allow their adult part to take over the role of supportive inner parent.
Along with re-programming erroneous self-defeating beliefs, I use guided imagery with clients to substitute and practice positive behavior changes. As mentioned, distraction and substitution of an imagined alternative pleasurable cue are ways to resist temptation. In a recent case, I used guided imagery to have a client imagine changes in a daily routine where her most risky time for drinking was between 5pm and 8pm. We brainstormed alternatives prior to the imagery and then during the imagery she fully immersed herself into imagining the changed behaviors. She put all the pleasurable emotions and sensations she could muster into the imagery, fully feeling the imagined alternative behaviors. Then she also fully imagined the pleasurable sensations of positive self-esteem, empowerment and pride that she felt after having been successful in using her alternative behaviors instead of drinking. Finally, we reinforced that these alternative behaviors were her choice, made by her, to move her forward toward a goal that she desired and that would bring more joy, more contentment and peace, and more positive life-enhancing experiences into her life.
The reality is that we all have issues. I often tell my clients, “If you are breathing, you have issues.” A person is not flawed, unlovable or inadequate because they have issues. If they have not “grown up” yet, they may simply not have yet been made aware of how to accomplish this. Once they access the right combination of support, inner commitment and self-acceptance needed to face their innermost doubts, fears and worries, they can find the truth that will set them free.
As adults we have the opportunity to recognize and correct the erroneous, self-defeating beliefs that lie deep within us. We will never be able to completely stop them from surfacing, but we can recognize them for what they are and refuse to believe in them. As children, we don’t understand that beliefs are choices, but as adults we can come to understand this and choose to do the work of re-parenting ourselves emotionally, so that we can finally grow up.