VideoJug Transcripts

How do I know when I'm ready for help with my behavioral addiction?
The first way to know if you are ready to be helped with your behavioral addiction is to acknowledge if you have tried to make course corrections yourself. Nobody on a 12-step program hasn't tried to do it on their own first. Everybody tries. The question is at what point to do you reach out for some professional help? Hopefully, people seek out treatment for their behavioral addiction before they hit the classic phrase "rock-bottom". It can be done. It is a little harder when you haven't hit rock-bottom because you have nothing to push off of. Nothing has scared you enough to make your behavioral addiction serious. If you continue to try to make changes, look at relapse or failure at recovery as a positive not a negative. Every time you fail, pick yourself up and say - "What didn't I do to protect myself from falling back into the system?"
VideoJug: How do I know when I'm ready for help with my behavioral addiction?

What does it mean to "hit bottom" in behavioral addiction?
The way one "hits bottom," or what "bottom" looks like for person A versus person B, might be very, very different. "Bottom" is nothing more than a place, an activity, a time, where someone comes to the realization that "this is as much pain and suffering as I want to go through, and I want to change. I'm willing to do whatever it takes." For some people, it means getting in a car accident or a DUI, or being diagnosed with liver failure. For others, it's substantially less. I'm a big believer that, yes, there is a bottom for everyone. I wish that it wasn't so. Sometimes the bottoms are really low bottoms. "Low bottoms" are: you lose your wife or family, you lose your career, and you find yourself out on the street. Or worse, your health has deteriorated to the point where there's no recoverability. Now hopefully no one waits to that point, but often, many people do. There's also "high bottom" people, and those are the people that I really want to nurture to get the ball rolling. Where things haven't come to the black-and-white "If I don't get help now I'm going to die," but rather, see the bottom coming, see the motion in that direction, and sort of start reaching out for help or start looking inside themselves, to start course corrections, way before they get to that bottom phase.
VideoJug: What does it mean to "hit bottom" in behavioral addiction?

Why is it so difficult to give up a behavioral addiction?
During the course of involvement in an addiction and we start to give up friendships and ballgames and other ways of feeling good. We go through a process I call "unlearning." We unlearn ways of coping with life. I work with many people that knew how to ask a girl to dance and by the age of thirty they are afraid to. They have unlearned through the course of the addiction working efficiently, effectively, predictably, how to do that. They have unlearned how to go and enjoy a ball team, how to cope with life, how to do hundreds and hundreds and hundreds of things they knew at the age of fifteen, but by the age of thirty, they no longer know how to do because they didn't work as efficiently and effectively as their drug of choice. So, they are now in a stage of unlearning. They feel completely handcuffed, not only by the reinforcement of knowing how to feel good, but by the resources that they once had, or the resources that they would have used or learned at 18, 19, 20, never were developed.
VideoJug: Why is it so difficult to give up a behavioral addiction?

How does cognitive-behavioral therapy work for behavioral addicts?
Cognitive-behavioral therapy is not a single body of techniques. It is grown from a very small number to quite a different sort of pool of interventions. Yes, it maybe one-on-one talk therapy, but unlike dynamic therapy it's not about what happened in childhood. It's all here and now. It's what you can do tomorrow. You talk about triggers; you talk about feelings and thinking that leads to involvement in destructive behavior. Cognitive-behavior therapy goes beyond all that talking. Educational homework; assignments will be given with the expectations that you would practice certain strategies about how relax yourself or how just to be with your feelings. A big tool today in cognitive behavioral therapy is to just be with your feelings. Lots of people with addiction hate being with their feelings and they use these behaviors to escape uncomfortable feelings. So, cognitive behavior will sort of focus on groups, meditation for example, and bio feedback to help one regulate and to stay with just uncomfortable feelings and be able to manage without escaping them.
VideoJug: How does cognitive-behavioral therapy work for behavioral addicts?

What are the "stages of change" and how do they apply to behavioral addiction treatment?
Stages of Change' was developed by Prochaska & DiClemente. It basically was a basis of research about cigarette smoking literature, and it helps cognitive behavior therapists, in particular, understand the motivation of an individual who's coming in for treatment. The first stage in the 'Stages of Change' is called precontemplation, meaning the client just says, "Well, I don't really think I have a problem." In the twelve steps of the disease model, we call that denial. "I don't really have a problem. You think I have a problem, then that's your problem." The next stage is contemplation. Contemplation is, "Yeah, I've got a problem, but I don't know if I want to do anything about it." That's often the case. Lots of people come in and say, or they say to their spouse, "I know I have a problem, but I don't know if I really want to go through all the misery, or all that stuff to stop." Some people stay in the contemplation phase for years. Sometimes they even go to the grave in the contemplation; they never even evolve out of it. Then the next stage, if there that balance beam of the contemplation phase eventually tips it up, is that they'll then go into the preparation. In other words, they'll pick up a self-help book, or they'll maybe go to a therapist and start to learn about the resources that are available to discontinue this behavior. If that's successful, they'll move on to what's called the action phase, with action being doing something. They stop gambling. They stop Internet surfing. They stop something. That's generally a short phase. From that we can either go to a maintenance phase, where they sustain the change in the behavior, or there's a relapse. If there's a relapse in the 'Stages of Change Model', we try to bring them back around to not going back to the precontemplation phase, but actively into the preparation phase, and start the cycle all over again. The idea is that we bring to bear certain strategies at certain stages. Most treatment centers assume that the individual is ready for the action phase when they walk in the door, and that's not the case. Rarely does a client, whatever the addiction is, walk in and say "I'm ready to stop." They have to hit bottom; they have to do a variety of different things to get to that place. That's why so many treatments go awry, because there's a false assumption about the motivation of the individual with the addiction.
VideoJug: What are the "stages of change" and how do they apply to behavioral addiction treatment?

How can behavioral addicts become motivated to change?
Propelling yourself, motivating yourself, is not an easy thing to do. Let's start talking about motivating ourselves to change by acknowledging something called ambivalence. Okay, you have an addiction, or you've decided you think you have an addiction, and you know it's not good for you, you know you're spending too much money or spending too much time with pornography, even though you know all that. I've never met anyone with a behavioral addiction who is truly behind changing. I mean, the truth is we're all ambivalent. We like it in some respects, and we don't like it in some other respects. So part of the difficulty with getting motivated is accepting that ambivalence we have about the activity. It's fun to look at pornography or it's fun to gamble, and you're going to deprive yourself of those fun things? You're going to take that lollipop and purposely give it away? So motivation is very hard to generate within yourself. But the place I would encourage people to start is accepting their ambivalence. Ideally they would make a chart with a four by four square, and put the pros of stopping their addiction, the cons of stopping the addiction, the pros of not stopping the addiction, the cons of not stopping the addiction, and get some sort of reading on all the language you use to stay on the fence about this sort of topic. Beyond that, motivating yourself is leveraging yourself where it's not comfortable. You've got to be somewhat off the edge, you've got to be willing to do something, but let's say you went and told a lot of people about your behavioral addiction and asked, maybe not for their help, but let them know that you're struggling with it. Well, you're locking yourself in there. You're closing the back door on your behavior, at least with these people. That's a way you can motivate yourself. Other ways of motivating yourself include stopping for a while and seeing if there are any benefits, such as increased energy or optimism, self-esteem rises, things like that, and trying to capitalize on the outcome of that.
VideoJug: How can behavioral addicts become motivated to change?

Contemporary Addiction Recovery Guidance and Treatment