Latest / Life Lived Better / Episode 149: Addiction - The Reality of Recovery

Transcript

Episode 149: Addiction - The Reality of Recovery · Life Lived Better

0:03
Hi, this is Paula. And I'm Joseph, and you're
0:06
listening to Life Lived Better. Welcome back to the Life Live
0:12
Better podcast, where we have real conversations about
0:14
important topics that impact our lives.
0:17
Over the course of the series on addiction, we've spent time
0:20
unpacking addiction from multiple angles.
0:23
What it is, what it isn't, how it develops, and why it is so
0:28
often misunderstood. But as we move through these
0:31
conversations, we kept circling back to something important, and
0:34
that was there are pieces of the addiction experience that don't
0:38
neatly fit into a single episode.
0:41
So today in our final conversation on on this series,
0:45
we want to explore some of the things that we haven't walked
0:47
through yet, some of the parts of addiction and recovery that
0:50
are of course deeply human, sometimes painful, but
0:54
frequently simplified if nothing else.
0:58
And we want to talk about like a return to use or what a lot of
1:01
people call relapse. And the question that sits
1:04
quietly underneath that if somebody in recovery returns to
1:08
use, is that a failure or is it a the symptom or is it just part
1:13
of the recovery process? People have all different
1:15
opinions. Then we have to take into
1:17
consideration cravings and triggers and those moments when
1:21
people wonder, you know, if they really wanted to stop, why
1:25
didn't they? We're also going to be diving
1:27
into the brain itself, why logic, promises, consequences,
1:31
and even love sometimes lose their power in the face of
1:35
addiction. We're exploring things like
1:37
shame, guilt, and identity because addiction is never just
1:40
about substances. It's also about how people come
1:43
to see themselves. And we have the touch on trauma
1:46
itself and the complicated truth that many people are not just
1:49
trying to stop using, but trying to survive their own internal
1:54
world. That's why they used to begin
1:56
with. You didn't.
1:58
We're covering a lot of ground, but we still need to revisit the
2:01
idea of the high functioning person with the addiction.
2:05
You know, when nothing appears to be obviously broken, yet
2:08
everything seems fragile beneath the surface and Co occurring
2:13
mental health challenges. You know, the entangled lives of
2:16
like having substance use and anxiety and depression and and
2:20
all the other mental health diagnosis.
2:22
But perhaps most importantly, what happens after a person
2:26
stops? So the discussion about
2:28
recovery, identity, reinvention, rebuilding a life rather than
2:33
just stopping the behavior of use, because recovery is not
2:37
just subtraction. It's really like a
2:39
reconstruction. I like that.
2:41
And of course, because we are the Life Live Better podcast, we
2:44
also need to touch on boundaries, the skill that may
2:48
be one of the most difficult, most misunderstood, and most
2:51
emotionally large aspect of loving someone with an addiction
2:56
or loving yourself through recovery.
2:58
We'll also confront some of the myths about recovery that,
3:01
despite sounding hopeful or motivational, often create harm,
3:05
pressure and unrealistic expectations.
3:09
So if this Syria has taught us anything, it is that addiction
3:13
is complex, recovery is not black and white, and people are
3:17
a nuanced. For sure, neat and tidy
3:21
narratives rarely capture the real human experience.
3:24
So think of this episode as kind of a closing conversation.
3:29
It's definitely not a summary, it's not a checklist, but it's
3:33
an honest walk through the realities that don't always make
3:36
it into simplified discussions about addiction.
3:40
We're we're really glad that you're here for it.
3:42
Relapse is one of those words that carries a lot of emotional
3:45
weight, and even hearing it can cause reactions like
3:48
disappointment, frustration, fear, and sometimes even anger.
3:53
And depending on who you ask, relapse gets framed in a very,
3:57
very different ways. For some people, relapse is seen
4:00
as a failure. For others, it's described as a
4:03
symptom. And in many recovery spaces,
4:06
you'll hear it called part of the process.
4:08
A lot of people believe that relapse is part of the recovery
4:11
process, so today we want to slow this down a bit because how
4:15
we think about relapse matters psychologically, emotionally,
4:19
and even clinically. What do you think when people in
4:22
treatment who work in treatment say relapse is part of the
4:25
process? I've kind of mixed feelings
4:27
about it. I think it's almost like you're
4:30
telling people it's OK to have a relapse.
4:33
Yeah, almost like, you know, when you say it's part of the
4:37
process, to me it just feels like you're saying, you know,
4:39
just expect. It exactly.
4:41
And I don't think that it, you know, has to be part of the
4:44
process or is necessarily part of the process.
4:47
It's just something that happens sometimes.
4:50
That's what I wish they would add that caveat like, but it
4:53
doesn't have to be. But you know, I mean, we need to
4:57
talk about it because relapse or a return to use or a recurrence
5:00
of use, whatever you call it, it's not just an event, you
5:04
know, it's also like an interpretation. 2 People can
5:07
experience the exact same return to substance use, but the
5:12
meaning attached to the experience can shape what next
5:16
happens in really dramatically different ways.
5:19
You know, do they shame, spiral, or do they disengage from any
5:24
kind of treatment going on? Or do they learn something?
5:28
Do they recover quickly from it? You know, I mean, a lot of that
5:31
really is influenced by the story we tell ourselves about
5:35
relapse. Let's start with the most common
5:37
framing, which is relapse is failure.
5:40
A lot of people believe that. I don't think.
5:43
I don't think it's a failure, but it's definitely a way of a
5:48
way of thinking or a thought. This perspective often sounds
5:51
like I blew it. I'm back to square 1.
5:54
I ruined everything. This idea usually comes from a
5:57
very understandable place. Recovery often requires enormous
6:01
effort, emotional work, lifestyle changes, and
6:05
uncomfortable honesty. Also, daily discipline,
6:09
structure, routine. Just, you know, having that
6:12
daily discipline is really important, so when someone
6:15
returns to use, it can feel like all that work was just wasted.
6:20
I, I hate when people feel that way, honestly.
6:23
And I hate when clinicians kind of give that to someone to, to
6:27
believe, you know, because, because here's the problem with
6:31
the failure model is failure implies finality.
6:35
You know, it suggests A verdict rather than a set back.
6:38
And psychologically, failure tends to cause a lot of shame.
6:42
It doesn't cause accountability. It doesn't cause someone to
6:45
reflect. It causes shame.
6:47
And there's an internal voice that says I didn't just make a
6:51
mistake, I am the mistake. And that is a dangerous mental
6:55
space for anybody, but especially that someone who's
6:59
navigating addiction and recovery.
7:02
Exactly. And because shame rarely
7:04
improves behavior, shame often fuels avoidance, it often causes
7:08
secrecy, and it results in disengagement overall.
7:12
So if relapse equals failure, then the person may feel like
7:17
there's no point in returning to treatment, no point in Recon,
7:21
reconnecting with their support, or re engaging with the recovery
7:25
efforts at all. Failure thinking often turns a
7:28
single episode into a prolonged collapse.
7:32
Yeah. So now let's look at the site.
7:34
The second framing we mentioned it relapse as a symptom.
7:37
You know that this perspective is more common in clinical and
7:41
medical models of addiction. Here's where you know relapse is
7:45
not viewed as a moral collapse or a lack of willpower, but as a
7:49
manifestation of the underlying condition.
7:52
It's similar to how symptoms operate in any other chronic
7:54
illness. Right.
7:56
And you know, no one says depressive episodes means
7:59
someone failed at managing depression.
8:01
So, you know, why would that be the case with recovery?
8:05
So no one says elevated blood sugar means someone failed at
8:09
diabetes. But addiction often gets treated
8:12
differently. So the symptoms model shifts the
8:15
question from what's wrong with you to what actually happened.
8:20
And that is a profoundly different posture.
8:23
That is what I think we should do more of clinically because
8:27
relapse often has contacts, you know, the, the stress
8:31
accumulation, the emotional dysregulation, isolation and
8:36
address mental health issues. There are environmental
8:39
triggers, maybe an overconfidence or just fatigue.
8:43
You know, relapse rarely appears out of nowhere.
8:45
It's usually following in some kind of sequence and and settle
8:50
shifts that happen long before someone uses the substance.
8:54
And this framing really encourages curiosity rather than
8:58
condemnation. So instead of you messed up, it
9:01
becomes, let's understand the patterns.
9:04
So it's important to do like an autopsy, if you will, to find
9:08
out answers to questions like what changed, what
9:12
vulnerabilities emerged, what early warning signs were missed,
9:16
and what coping strategies failed.
9:18
Overall, when we examine it this way, the relapse becomes data,
9:23
not destiny. That relapse autopsy is exactly
9:26
what I get clients to do. I think that's so important.
9:30
And then we have that third framing that relapse is part of
9:33
recovery like we mentioned. And now this one might be
9:36
helpful, but I think it's also misunderstood because part of
9:40
recovery does not, I mean, it's inevitable like we talked about
9:44
earlier, and it certainly does not mean that it's harmless.
9:49
So I hope that people in treatment are not hearing like
9:52
they've got one to give away or something.
9:55
Yeah, and that's important. So relapse might be common.
10:00
Relapse can certainly be understandable, and as you
10:03
pointed out, relapse can undoubtedly be informative.
10:06
We can learn from it. But relapse is not required.
10:10
It's not a required part of recovery, and we have to be
10:13
careful not to normalize it in a way that removes urgency or
10:17
accountability around it. Absolutely.
10:20
And, and what this framing is really pointing, pointing to is
10:24
something more nuanced that recovery is, is, is rarely
10:28
linear. You know, human change almost
10:31
never follows a straight upward trajectory.
10:35
Growth tends to involve all kinds of things, you know,
10:38
progress, setbacks, recalibration, learning,
10:41
refinement. It involves that for all of us.
10:43
So. So if it does occur, relapse can
10:46
sometimes function as a painful but powerful teacher.
10:50
Yeah, because relapse often exposes illusions, right?
10:54
So we might be able to discover some unrealistic beliefs a
10:57
person had prior to the relapse. Like I thought I could handle
11:01
that environment. I thought I was further along
11:04
emotionally. I didn't realize how strong that
11:06
trigger still was. Or I underestimated my stress,
11:10
how I manage my stress. So relapse can really reveal
11:14
gaps between intellectual confidence and lived
11:17
vulnerabilities. Yeah.
11:19
When I get people in treatment that come back after a relapse,
11:22
they'll often say like, you know, I just, I kind of knew in
11:26
the back of my head, you know, that even though y'all were
11:29
saying this, I was thinking I was going to do it a different
11:32
way and it was going to work out, you know, But they didn't
11:35
get honest about it. They're like leaving 1 little,
11:38
little possibility and not putting it on the table.
11:42
There's also a distinction that doesn't get enough attention, I
11:46
think. And that's that this is
11:48
something that I learned when I was fortunate enough to be a
11:50
student in an intensive week long training that was taught by
11:54
Terry Gorsky. He's kind of the relapse guru in
11:57
the field of addiction, and he taught and wrote about the
12:02
difference between lapse versus relapse.
12:04
And elapse is like a brief return to you.
12:07
So it's like an interruption of the recovery process, but
12:11
relapse is a sustained return to previous patterns.
12:15
That means it's it takes just total hold of you.
12:18
There's no recovery there. And the distinction matters
12:22
enormously because many people turn lapses into relapses
12:26
through catastrophic thinking messages.
12:29
Like, I already messed up, so what's the point?
12:31
I've ruined my recovery, which becomes permission for continued
12:35
use. Yeah.
12:36
That sounds like me whenever I go off of a diet one day.
12:40
Right. And, and, and, you know, a
12:43
different internal narrative might sound like that was a
12:47
lapse. Now what do I do to stabilize
12:50
right now? So same event, but very
12:53
different outcomes. Right.
12:55
We also have to acknowledge the brain here.
12:58
So addiction is not just behavioral, it's oftentimes
13:01
neurological. So repeated substance use
13:04
reshapes reward systems in our brain and our stress systems,
13:08
even our decision making circuits.
13:10
So cravings are not simply thoughts, they're
13:14
neurobiological events that happen under stress, fatigue,
13:19
emotional distress. The brain can revert to well
13:22
worn pathways, especially if substances were historically
13:25
used to relieve regulation or escape whatever it is that
13:29
you're experiencing. I think that's so valuable
13:33
information because, you know, our our neural pathways can be
13:37
rerouted and we can learn new behaviors and there's all kinds
13:41
of things that we can do to help kind of reroute those, you know,
13:44
negative kind of patterns and sequences.
13:48
That's why it's so important to kind of know what what caused
13:50
this, you know, you know, which direction to work.
13:54
And, and, and relapse often reflects like a vulnerability,
13:58
not a lack of intelligence. I mean, many people relapse
14:02
while fully aware of the consequences.
14:04
Where logic is present, the memory of relapse is present.
14:08
But competing brain systems are active, and also are active
14:12
things that we need to think about, like relief systems,
14:15
habit systems, stress systems, reward anticipation.
14:19
That's why relapse can't just be reduced to the idea of the bad
14:24
choice. And perhaps the most productive
14:26
way to think about relapse as part of the learning model.
14:31
So this way is not romanticized, it's not minimized.
14:34
And you might ask yourself, in a relapse, what did this
14:37
experience teach us about risk? What did it teach us about
14:40
triggers, about our emotional tolerance, about our
14:44
environment, or even about our coping capacity?
14:48
Because recovery is a developed skill, it involves learning to
14:52
have and to practice stress tolerance, emotional regulation,
14:56
trigger navigation, boundary setting, self-awareness,
15:00
lifestyle restructuring. I mean, relapse can highlight
15:04
which of these skills are fragile.
15:06
Needing to learn that to be in recovery kind of is a big
15:10
demonstration of why just going to treatment for a couple of
15:14
weeks does not. It doesn't change everything
15:17
that needs to change. It's a long process.
15:21
And ironically, the greatest danger, relapse is often not the
15:24
substance use itself, it's what follows, which is
15:27
psychologically. So a relapse is often followed
15:31
by things like shame, secrecy, isolation, feelings of
15:36
hopelessness, and that all or nothing thinking that we talked
15:39
about. Right.
15:41
So a single return to use doesn't define recovery's
15:44
trajectory. But when you totally disengage
15:48
after a relapse, that can define your recovery.
15:52
Relapse becomes far more destructive when it leads
15:55
someone to withdraw from their support and from treatment and
15:58
self reflection when they just go fully back into the use and
16:03
and don't consider going back to a recovery lifestyle.
16:07
So the questions become So is relapse failure?
16:11
Not necessarily. Is it a symptom?
16:14
Often, yes, it is. Is it part of recovery?
16:17
Sometimes, but it's not required.
16:20
There if we could just do away with saying that all together.
16:22
But if people insist on saying it, if they could add that
16:25
little but not required to it, right?
16:28
So maybe the healthiest framing is relapse is a risk, but it's
16:32
not a verdict, you know, it's a signal.
16:35
It's a moment that requires some attention, some analysis,
16:39
recalibration and compassion paired with accountability.
16:43
Big accountability. Absolutely.
16:45
And it's important to remember that recovery is not about
16:48
perfection, it's really more about persistence.
16:51
And perhaps most importantly, relapse does not erase our
16:54
progress. That's so important to keep in
16:58
mind. Your skills that are learned
17:00
remain learned, insights gain remain gained, and growth
17:04
remains experience. So those things are not just
17:07
undone. Although the path may bend, it
17:10
does not automatically reset. That's why I don't like people
17:14
saying they have to go back to square 1.
17:16
I mean like no, the time you had in recovery is very valuable.
17:20
So if someones navigating recovery and they've experienced
17:24
relapse, I think the most useful question may not be why did I
17:29
fail, but rather what can this teach me about protecting my
17:33
future stability? And if somebody that you're
17:36
supporting, you know, if you're supporting a loved one who's
17:39
recently relapsed, remember that the relapse is not proof that
17:42
nothing worked. It's often proof that there's
17:45
something that needs to be strengthened.
17:48
I like that, and it's important to remember that recovery is
17:51
rarely linear. It is rarely simple, but it is
17:54
still possible even after setbacks.
17:57
Sometimes, especially after setbacks, it is impossible.
18:01
Remember that. Absolutely, because resilience
18:04
isn't measured by never falling. It's the returning, you know,
18:08
again and again to the work of rebuilding your life.
18:13
It's so it's so easy to forget our progress when we have, you
18:17
know, when we have a set back and it's important to remember
18:21
that again, it does not erase all of that.
18:24
Absolutely. So now let's move the
18:26
conversation to inside a craving.
18:29
What people don't understand about urges.
18:32
Cravings are one of the most misunderstood parts of
18:34
addiction. And from the outside, they often
18:37
look deceptively simple, like a thought, a temptation, a moment
18:41
of weakness. But someone might think they can
18:44
just tell a person with a craving, if you really didn't
18:47
want it, you wouldn't do it. You know that That way of
18:51
thinking, it's so hard to get my head around, But you know,
18:56
cravings are rarely straightforward.
18:58
And they're not just ideas. They're based on like actual
19:01
experiences that you're having, and if we don't understand what
19:05
a craving actually feels like from the inside, it becomes very
19:08
easy to judge the behaviors that follow.
19:11
This is where the family please hear this, you know, because a
19:15
craving is not merely wanting something.
19:18
It's not comparable to casually wanting coffee or a dessert.
19:23
A true craving can feel urgent. I mean, it can feel intrusive,
19:27
physical, emotional, sometimes overwhelming.
19:30
People often imagine cravings as psychological.
19:33
Many, many people describe them almost like physiological
19:38
though. So let's start with something
19:42
important. Cravings are not simply thoughts
19:45
you can reason with. They involve brain systems tied
19:48
to things like survival, reward, memory, stress regulation, and
19:54
habit information. Which means that when a craving
19:57
hits, the experience is often layered.
19:59
You know, it's not just simple, it's complicated.
20:03
Absolutely. There may be thoughts, but also
20:06
sensations, things like restlessness, tension,
20:09
irritability, or just an overall sense of pressure and it's
20:13
almost like you're being pulled towards relief.
20:16
We all want relief when we're having those, kind of.
20:19
Things I always say, yeah, I always say our brain operates on
20:22
pain or pleasure. And if you're feeling pain, how
20:24
do you feel pleasure? And how do you feel that
20:25
pleasure quickly? Absolutely, absolutely.
20:28
And our brain knows, especially when we have a substances in in
20:32
its past, right? That's where the
20:34
misunderstanding begins. You know, observers tend to hear
20:39
the internal dialogue of the person who's struggling.
20:42
They might hear a person say, I want to use, you know, but the
20:45
internal experience that the person struggling is actually
20:49
having is often closer to, I feel uncomfortable, I feel
20:53
unsettled. I feel like something's missing,
20:55
and I need to change this feeling.
20:58
So the substance becomes associated with relief, not with
21:01
pleasure. And cravings also distort how
21:05
choice feels. So technically a person still
21:08
has agency, but subjectively it may not feel like a balanced
21:12
decision. Cravings really narrow person's
21:16
attention, and they amplify the perceived benefits of use while
21:21
muting the memories of the consequences.
21:24
So that romanticizing kind of thing.
21:27
And it's not that consequences disappear from awareness, it's
21:30
that urgency gets much louder than our logic.
21:34
I can understand that in lots of different places in my life.
21:39
Yeah, that's important to point out, you know, because people,
21:42
people often confuse this with lack of caring.
21:45
They might think, well, I guess they didn't care enough about
21:48
their recovery or they didn't care enough about me.
21:50
But cravings often override emotional priorities in the
21:53
moment. You know, while the person is
21:56
struggling, their goals are still there.
21:58
They still have a desire to remain in recovery, and the
22:01
consequences are still understood.
22:04
But those competing systems are still active and the urge to
22:08
stay in recovery is competing with relief, seeking the habit,
22:12
memory, reward, anticipate, anticipation and and the learned
22:17
stress response. One of the biggest
22:19
misconceptions is that cravings are always about the substance
22:23
itself, and they're often about changing an internal state, if
22:27
you will. They're about changing the
22:29
overwhelming feelings that we may experience.
22:32
Feelings like stress, anxiety, loneliness, boredom, fatigue,
22:36
shame, even emotional discomfort.
22:39
And the substance becomes like the Learn solution.
22:42
It becomes our default way of coping.
22:45
And because substances frequently function as
22:47
regulators, we we can't deny that they alter mood, they
22:52
dampen distress, they create stimulation, they numb the pain,
22:56
they so much numb the pain, and they interrupt thoughts.
23:00
So over time, the brain builds up those associations.
23:03
So when someone has an uncomfortable feeling, they use
23:06
the substance, they feel relief, and eventually the craving may
23:09
attach more strongly to relief than to the drug.
23:13
Makes sense? Absolutely.
23:16
And people tend to imagine triggers as like obvious things,
23:19
like seeing a bottle passing a bar or being offered the drug
23:24
itself. But triggers are often subtle,
23:27
and they're often deeply personal.
23:30
They could be something you can't see or understand, like
23:33
fatigue after a long day, a familiar emotional tone, a
23:38
conflict, a memory. Even positive emotions can lead
23:42
to, you know, a trigger. Honestly, as hard as it is to
23:46
believe, celebrations can trigger cravings.
23:49
You know that makes sense. What do you do when you
23:51
celebrate? You pop a bottle.
23:54
Even success can trigger cravings.
23:57
Celebration and, oddly, relaxation can also trigger
24:01
cravings. Yeah, yeah.
24:03
Because the brain is pattern based, you know, So if
24:06
substances were historically linked to comfort, reward,
24:10
escape, connection, confidence, relief, then many emotional
24:14
states, not just distress, can activate urges.
24:18
That's when when families like everything was going well.
24:21
What happened? Right.
24:23
And the families always feel, I think they always feel like a
24:27
sense of responsibility somehow, somehow what, you know, what did
24:31
they do? Where do they go wrong?
24:33
How do they, you know, not support you, whatever that is
24:35
so. They need to family.
24:37
Any family listening needs to know.
24:40
Like give yourself a break. You cannot control this.
24:44
Sometimes the person can't control it.
24:46
Well, and a critical piece is that cravings, they often feel
24:49
like truth, you know, not preferences or suggestion, but
24:54
truth. And a person struggling with
24:57
fears hears and actually believes that this will help,
25:02
this will make this easier or they they need it.
25:05
So cravings carry convictions. Yeah, they're very loud, very
25:10
loud. And which makes them mean
25:12
resisting them psychologically exhausting.
25:15
People often assume that resisting a craving is just like
25:18
a single act of willpower. But for many individuals it's a
25:23
sustained internal friction. You know, minute by minute.
25:27
It's a negotiation, A rationalization, urge escalation
25:31
and and discomfort tolerance. I mean, it can feel like it can
25:36
feel less like decision making and more like an enduring
25:40
pressure. Once you know, the program talks
25:43
about one day at a time, and sometimes it's one minute at a
25:46
time. Absolutely.
25:47
Whatever. So early recovery frequently
25:51
involves what people call that good old white knuckling.
25:55
So holding on through cravings with just sheer determination
25:59
and willpower, which is understandable, but it's also
26:02
draining because cravings by nature rise and fall.
26:06
There are waves, not, you know, permanent states of emotion or
26:11
change. It just kind of hips and flows.
26:14
And, and this is something many people don't realize that
26:16
cravings really are time limited.
26:19
They peak, they Crest, they eventually do subside.
26:23
But when you're inside one, it can feel endless, like you know.
26:27
So the person in recovery, learning to ride the wave, to
26:31
observe the craving without immediately reacting, becomes
26:35
such a crucial recovery skill. Like that, and most importantly,
26:40
the psychological shift that can happen.
26:42
That a craving is not a command, right?
26:46
It's more of an event. It's an internal experience that
26:49
can be noticed, tolerated and survived.
26:53
But the distinction is often hard earned because cravings
26:58
feel like a directive and they sometimes will push and push and
27:03
push. And so, you know, understanding
27:06
that it is just a moment in time, it is something that's
27:09
going to pass off until clients like give, you know, go distract
27:14
yourself for an hour. Do something, get out of your
27:16
space, get out of, you know, physically remove yourself from
27:19
wherever you are and just give yourself some time because
27:22
oftentimes that will change the direction.
27:26
And many people even interpret cravings as a failure.
27:29
They think to themselves, I shouldn't still feel this.
27:32
Or I thought this was in the past.
27:34
And and even more devastating, they might think, what's wrong
27:37
with me that I keep having these cravings.
27:39
But cravings aren't evidence of weakness.
27:42
They're they're just evidence of conditioning.
27:44
I mean, the brain remembers what once proved relief.
27:48
Yeah, we always remember the pleasurable things.
27:52
Absolutely. We like, yeah, like you say, the
27:55
pleasure versus versus pain faith.
28:00
So it's important to remember that cravings don't always
28:02
disappear in predictable like timelines.
28:06
They may reappear during major life transitions.
28:09
Things like stress, emotional upheaval, environmental shifts,
28:13
and just unexpected reminders. Things that you know, you
28:17
encounter throughout the day, they can come back sometimes
28:20
after long periods of stability, which can be, you know, really
28:24
discouraging and hard to understand.
28:27
You know, when things are all going well, you know it's all
28:29
looking up and you got that new job and you're the weekend
28:33
before that new job. You know what a what an awful
28:37
thing to happen and to try to understand because people often
28:43
expect recovery to eliminate urges entirely.
28:46
And the reality is, recovery often involves changing the
28:50
relationship they have with urges and and that they'll
28:54
benefit from learning how to panic less, having fewer
28:58
automatic reactions and having more awareness, more tolerance,
29:02
and even learning to have increased choice over how you
29:06
respond. And managing cravings.
29:09
It's not about like suppressing desire, it's about building
29:14
alternative responses. So it's about learning emotional
29:18
regulation, learning stress management, distress tolerance,
29:22
self soothing techniques and even environmental design and
29:27
overall increasing our support systems.
29:30
Those are all things that are going to help you, you know,
29:33
hopefully avoid a reoccurrence I.
29:35
Think that's why it's important to get a bunch of people that
29:38
are supportive and safe and not keep turning back to the people
29:42
from the past, right? Because craves cravings thrive
29:46
in certain conditions. You know, they thrive when a
29:49
person is overly fatigued and they're in isolation, when they
29:53
have a lot of unstructured time, when they're emotionally
29:56
overloaded and having chronic stress.
29:59
You know, recovery becomes a process of stabilizing the
30:03
internal and external environment, not just removing
30:07
the substances. That part is pretty easy.
30:10
And it's a it's a simple change. But now let's turn our attention
30:15
to why logic loses when it comes to the addicted brain.
30:19
Right. And one of the most frustrating
30:21
and confusing aspects of addiction, and both for the
30:24
individual and also the people who love them, is that question,
30:28
if they understand the consequences, why do they keep
30:31
doing it? So, you know, on the surface it
30:35
doesn't make sense to anybody. But a person continues, a person
30:40
who continues to use experiences, things like high
30:44
risks, relationship damage, career loss, legal problems, and
30:49
so much more. And the logic seems obvious to
30:53
them. And yet logic so often loses in
30:57
this scenario. Yeah, the person on the outside
31:00
watching it is like you understand all the, you
31:04
understand what it looks like when you're using.
31:06
Why do you do this? And and this is where it becomes
31:10
essential to talk about the brain like we promised, because
31:13
addiction is not simply a problem of decision making, it's
31:17
a problem of competing brain systems.
31:19
When people imagine choice, they tend to picture like a calm,
31:23
rational weighing of the options, a pro versus cons list.
31:28
But addiction rarely operates in that mental environment.
31:32
And a starting point is to remember that the brain is not a
31:34
single unified decision maker. So it's a collection of systems
31:39
with different priorities. Some systems are reflective,
31:43
analytical, or future oriented. Other systems are emotional
31:47
reactive and survival driven. Yeah, the brains complicated.
31:52
Very amazing. Isn't it amazing?
31:55
And it's amazing that it also can correct itself, you know?
31:59
But those systems don't always agree.
32:02
That's part of the problem, the part of the brain associated
32:05
with reasoning, planning and long term thinking.
32:08
Often simplified as the thinking brain can absolutely understand
32:13
the consequences. But other systems are asking
32:16
really different questions like will this bring relief?
32:19
Will this reduce my discomfort? Will this give me the reward I'm
32:23
looking for? Will this restore the balance
32:26
that I'm looking for? The brain is constantly looking
32:29
for balance. Yeah, an addictive substances
32:32
interact directly with our brains reward system and the
32:36
reward system, it's not trivial. It's deeply tied to survival and
32:42
learning. We associate rewards with, you
32:45
know, responses, food safety, social connection, These all
32:49
activate reward systems because they historically increased
32:52
chances of survival. So substances artificially
32:56
stimulate those same pathways in a pretty powerful way.
33:00
And that means that the brain doesn't categorize some
33:02
substances as a bad idea. It categorizes them as a high
33:07
value experience, not intellectually, you know, but
33:11
neurologically. So over time, the brain learns
33:15
that substances equal relief, they equal reward, regulation
33:19
and escape. And those associations become
33:22
deeply encoded in the brain. And that's where the logic
33:27
struggles. So consequences are future based
33:30
but reward and relieve our immediate situation, right?
33:35
And the brain tends to prioritize immediacy, especially
33:39
under stress, fatigue, and emotional distress.
33:42
Things that are uncomfortable. How do I immediately feel
33:46
better? And your brain knows that before
33:48
I think sometimes we can cognitively think.
33:51
We're actually realizing that we're thinking that.
33:54
So when someone says that they knew this would cause problems,
33:57
that's often true. But knowledge and behavioral
34:00
control aren't governed governed by identical systems.
34:05
So understanding risks is cognitive, while resisting urges
34:09
is regulatory. And those are really different
34:12
neural functions. And stress plays a massive role
34:15
here. So under stress, the brain
34:17
shifts our priorities. It becomes less interested in
34:21
abstract future outcomes and more focus on that immediate
34:24
state of change and how immediate relief and comfort and
34:28
stability is the goal. And that's not weakness, it's
34:33
biology. Stress amplifies emotional and
34:37
habit based systems while dampening the reflective and
34:40
analytical processing. So in other words, the exact
34:44
conditions that increase cravings are the same conditions
34:47
that reduce cognitive flexibility.
34:50
And and repeated substance use becomes increasingly automated,
34:55
so becomes less like a decision and more like a pattern, and the
35:00
brain builds efficiency. And that's why many people
35:04
describe substance use as feeling almost reflexive.
35:08
You know, not because there's a choice, but because the pathway
35:12
is well rehearsed and the brain loves efficiency.
35:15
And fortunately, it doesn't automatically distinguish
35:19
between healthy and destructive habits.
35:21
And that would be nice. I don't know, I just stayed out
35:24
of some relationships in my life.
35:27
Same well and from the outside addiction can look like you know
35:31
just repeated bad choices. It just looks like the person
35:34
just can continues those negative patterns.
35:37
But internally something more complex is happening.
35:40
Internally there are competing drives.
35:43
Immediate relief versus long term well-being is happening.
35:47
And that's why people frequently use while fully aware of the
35:52
consequences. So that's not ignorance, it's a
35:54
conflict between those systems. You know, this is a terrible
35:58
idea. I'm going to regret this.
35:59
I don't want to keep living like this.
36:02
But that coexists with I can't tolerate this feeling.
36:05
I have to have some relief. I just need to stop.
36:09
Yeah, I just need this to stop. And you know, This is why
36:13
willpower alone is such an unstable strategy.
36:16
Willpower is a limited resource. So stress, fatigue, and
36:20
emotional distress all deplete our willpower.
36:23
And man, I've had so many clients that I don't have a
36:27
problem, not an issue that are on probation.
36:31
I can do it with willpower, but then they fail a drug screen and
36:35
it's like, you know what's happening with your willpower.
36:39
If that's your solution, you know, And how serious is this
36:42
problem? If you know your freedoms on the
36:45
line and you continue to use, right?
36:47
Common sense says you don't do that.
36:50
I need an artistic person to draw a a a poster of stress,
36:55
fatigue, emotional distress. Like running rapid over
36:59
willpower. There you go.
37:01
You know, recovery is rarely about becoming mentally tougher.
37:04
It's about changing the conditions under which your
37:07
decisions occur. So reducing triggers and
37:11
increasing regulation skills, stabilizing routines,
37:15
strengthening support and also developing distress tolerance.
37:21
And neural pathways built over years, they do not disappear
37:25
through just inside alone. The the brain changes through
37:29
repetition and you know, not resolution and rewiring.
37:34
It just takes time. Time and consistency.
37:37
And how many times have you said something like, I know, I know
37:41
logically that this is not a good idea, but here I am again,
37:45
doing something that you know, I know I don't need to do.
37:49
I'd say that I'd say that a lot. I've said it a lot.
37:53
And there are many more points to address here before we would
37:58
fully complete with a topic of addiction.
38:01
But we should probably leave a few of those for future episodes
38:05
because we could talk about this for chapters.
38:08
We will still need to just to discuss in the future.
38:11
Like trauma and addiction and Co occurring disorders and a number
38:15
of other topics that are related to recovery.
38:18
Definitely, and we've addressed a lot in the series and we
38:22
appreciate the feedback we've received so far.
38:25
We love hearing what our listeners have to say and what
38:29
they would love to hear more of. So please send us that
38:32
information. Send us your topic ideas.
38:34
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Next time we will be back with new topics and episodes.
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38:58
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39:05
Live Better with Paula and Joseph.
39:10
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You can also find us on most social media platforms and our
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39:24
Paula Garland, edited by Joseph Massey, and recorded on Spotify.
39:27
Information used in this episode and other content data can be
39:30
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