The Discordant Echoes of the Past

The last six years of research has been dedicated to trying to understand a fundamental part of my illness of addiction, of me.  People often say there is more to you than addiction.

To which I normally answer yes, there is also recovery.

I don’t mean to be smart arsed by this but I view recovery not only as a healing in many ways, physiologically, physically, emotionally, cognitively and spiritually but also as a ongoing process of learning about me, the various strands that have contributed to my illness and the various aspects of my recovery which also give insight into what was wrong in the first instance.

If certain aspects improve in recovery there is a fair chance these were impaired in the addiction cycle. I believe there is a lot more to addiction that the end product of addiction, namely chronic pathological addictive behaviour.

Various aspects have contributed to the need to externally manage troublesome and painful internal feeling states.

Recovery according to my wife has made me a nicer person, more loving and considerate and easier to live with. Better company,  more mature in my emotional reactions and more responsible. I hasten to add that I have some way to go still in some respects. In simple speak, I have become less selfish, self centred and less me, me me!

These to me seem like the traits of addiction, this self obsession.

Other factors have fed into this manifest self obsession too however.

Recovery has been a continual process of learning how to do life in a more healthy, emotionally mature way, in simple terms. I have had to learn so many things, the things  more healthy people take for granted and learnt years ago.

Somehow I never learnt how to do some basics, was never properly taught these basics or always had inherently difficulties with certain basic, developmental skills.

For example my emotional life was a complete failure, continually running away from my feelings, avoiding them as if they were actually injurious to the self!

I have spent years trying to work out why I ran away from my feelings and from a very early age. I have that type of curious head.

In early recovery I was astounded that I could not feel what emotions I was having, could not generate a mental perspective on what emotions I was experiencing, could  not identify and label and thus use as a way to make effective decisions. My decisions were always based on the “distress” of not knowing exactly what I was feeling, actions were taken simply to escape this distress.

I had in effect an emotional disorder and that this emotional disorder seemed to precede, initiate and propel by addictions.

Addictions were the place I went to in fleeing me and my negative emotions. They were the tools I used to regulate my negative moods, emotions and negative sense of self.

Me overwhelmed Me – I appeared to need help regulating Me so I chose and used stuff outside of me which seemed to work originally in provide escape but increasingly contributed to this escalating problem of my inability to live with me.

Someone described the spiritual awakening which results from doing the the 12 steps of AA as fundamentally changing how we think and feel about the world and our place in it!

So what do I think and feel about the world and my place in it?

And has this changed in recovery?

Generally I would say I have had a revolution in how I relate to the world, it no longer scares me like it did, I am no longer to ashamed take my rightful place in it.

That does not mean I no longer struggle with fear and shame. In fact the longer I am in recovery I see these two factors as contributing most of the distress I can feel in recovery.

Fear I have always been aware of – we have a fear-based illness it is often shared in AA meetings but shame?

Six years of academic research has clearly shown me that this fear based illness is a distress based disorder. Neuropsychology has shown that the experiential wisdom and insight of 12 step groups has always been correct.

Fear/distress causes me problems via certain avenues such as catastrophic thinking, fear of an uncertain future, distorted /dishonest thinking.

Fear can lead to a wide range of other negative emotions. But honesty is often the first port of call for fear.  I find fear leads immediately to distorted dishonest thinking. Honesty comes from the ancient Greek “to be in (one with) God” so I guess dishonesty is not being in God which is the opposite to being in fear. Interestingly the Christian Bible refers to the Devil as the Father of All Lies!

I had not however realise that shame creates just as many emotional difficulties and emotional pain as fear!

Shame and fear certainly effect each other but both can take the lead.

Fear is referred to in the Big Book of AA “This short word somehow touches about every aspect of our lives. It is an evil and corroding thread; the fabric of our existence was shot through with it.” but shame is rarely mentioned!

This is not surprising as there was little research into the effects of shame of illness back then in the 1930s, in fact research into shame is relatively recent, in the last 25 years. Interest in shame came form an academic article which called shame the “master emotion!” which can effect and amplify all other negative emotions. Thus it has just a profound effect on emotional well being as fear!

I was delighted to come across this research recently as I have always been looking for answer to a vexing question, ever since early recovery in fact.

In early recovery, and since, I have always wondered when someone hurts my feelings, intentionally or otherwise,  I suddenly have this warm sensation, this spreading dendritic/branching type feeling in my heart which when activated captures my heart and pollutes my head with negative thoughts about me.

I suddenly feel hurt, upset, less than, smaller, weaker, hunched over, feeble, and then I get these other voices suggesting the person who upset me is right, I am worthless helpless, useless. Who the hell was I thinking I was, sure I was kidding myself?

I feel that I have been assailed, my head swoons, I lose my bearings. I am under some seemingly grievous emotional attack!

These feeling and thoughts multiply against the audio soundtrack of my tormenter’s voice which then blends into orchestra with my own and other voices of negative self perception.

I am suddenly strangely paralyzed by this emotional avalanche.

Other negative emotions are detonated such as self pity, the ever present sense of “poor me”.

Eventually other emotions may get activated too like fear and dishonest thinking.

I can work myself into quite a emotional state replaying the scene of my supposed insults via resentment and the re-sending of situations, feeling and thoughts from this and other previous episodes in my  life. Other negative mood congruent memory is activated and soon there are other similar memories of similar insults supporting this insult and my increasingly sense of low self esteem and self worth.

I found it impossible for years to stop this spreading emotional feeling and distorted thinking after it was first activated.  It simply continued  against my will. When activated it takes ages to reduce. In fact the intensity of the emotion always seems to get worse before any hope of it getting any better!

I usually need the help of a loved other to help me through it.

It feels as if there has been an emotion explosion in my heart?

One emotion explodes and it then detonates other emotions is the best way I can explain it.

These leads to increased negative thoughts about self and the reinforcing of a negative self schema ingrained in memory from childhood on.

It seems to confirm all the worse things about myself.

Chastises me for having thought any differently!

All because I took a slight at what someone may have said to me!

Often I have found out afterwards that I had misheard and misinterpreted the words and that no insult was intentionally given in the first instance!

My fear-based misinterpretation led to all these negative emotional reactions and cognitive distortions which all then ran away with themselves.

Now in recovery I feel that shame has just as profound an effect on my negative emotions as fear – in fact shame can lead to fear and vice versa. But to me now, it seems that shame is that negative emotion that detonates the other emotions that spread dendritically across my heart.

I have finally found out what has been at the heart of my emotion dysregulation –  shame.

Shame and fear also have similar parents – namely trauma /abuse, insecure attachment as a child to a primary caregiver.

Addiction doesn’t exactly help with shame either!

The trauma incidents I experienced in childhood have led to a fear based responding to the world and what I would call chronic or toxic shame.

A knawing feeling of being less than, not good enough.

An emotional achilles heel.

The above feeling of shame and the resultant negative emotions and thoughts that it detonates are the result of what is perceived  as insult and rejection. It is often said in recovery that the recovering person fears nothing more than rejection, as it brings that damning emotion of shame.

At least fear can activates action, shame always paralyses. Fear can embolden, shames weakens.

We sufferers of toxic shame thus very vulnerable to this type of “putting us down” or the feeling of being rejected or even “found out”.

We spend our lives constantly guarding against it, although we are often unconscious of this.

I sometimes wonder if the “hole in my soul” was shame-shaped?

This is why shame inspires the constant use of defense mechanisms, the myriad of self defence mechanisms that we use against shame, rejection and which I will discuss next time around.

As for the solution to the above perceived insult, pray for forgiveness or simply forgive the person who allegedly insulted you as it exonerates him/her of being a imperfect human being while doing the same thing for you at the same time.

Accept the gift of our communal and very human imperfection when you can.

 

 

 

Forgiving Others is the Number One Healer!?

“Resentment is the “number one” offender. It destroys more alcoholics than anything else… In dealing with resentments, we set them on paper. We listed people, institutions or principles with whom we were angry… The first thing apparent was that this world and its people were often quite wrong. To conclude that others were wrong was as far as most of us ever got. The usual outcome was that people continued to wrong us and we stayed sore. Sometimes it was remorse and then we were sore at ourselves. But the more we fought and tried to have our own way, the worse matters got…It is plain that a life which includes deep resentment leads only to futility and unhappiness…If we were to live, we had to be free of anger. The grouch and the brainstorm were not for us. They may be the dubious luxury of normal men, but for alcoholics these things are poison…We saw that these resentments must be mastered, but how?… (1)”

Later, p.77, it suggests  “a helpful and forgiving spirit.”

In the 12 Steps and 12  Traditions, p.78, in reference to step 8 it suggests “why shouldn’t we start out by forgiving them, one and all?

These truncated passages from the Big Book (1)  and the 12 and 12 (3) illustrates how resentments cause relapse and that they need to by treated with the antidote of forgiveness.

We suggest also that the myriad of resentments which swirl around our minds in early recovery are also negative emotions unprocessed and thus unregulated from the past. They continually haunt us because we have not put them “to bed” in long term memory.

We have not dealt with them, by clearly identifying, labelling, sharing via verbalising them with others and then by letting go of them via forgiveness. “Letting go” is another emotional regulatory strategy that healthy people use.

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Instead of constantly holding on to memories and incidents from the past, endlessly ruminating on them we maturely face up to them and consign them to the past.

We were thus interested in a study which was not using 12 step recovery but which came to the same conclusion but via another route (2).

“Anger and related emotions have been identified as triggers in substance use. Forgiveness therapy (FT) targets anger, anxiety, and depression as foci of treatment. Fourteen patients with substance dependence from a local residential treatment facility were randomly assigned to and completed either 12 approximately twice-weekly sessions of individual FT or 12 approximately twice-weekly sessions of an alternative individual treatment based. Participants who completed FT had significantly more improvement in total and trait anger, depression, total and trait anxiety, self-esteem, forgiveness, and vulnerability to drug use than did the alternative treatment group. Most benefits of FT remained significant at 4-month follow-up.

The levels of anger and violence observed among alcohol and other substance abusers are far higher than the levels found in the general population.

Alcohol and other substance abusers administered the State-Trait Anger Expression Inventory typically have been shown to have higher state and trait anger, to be more likely to express anger to others, and to have less control of their anger.

Reducing levels of anger and its related emotions is now seen as an important feature of recovery programs. For example, according to the Project Match 12-step facilitation therapy manual, “Anger and resentment are pivotal emotions for most recovering alcoholics. Anger that evokes anxiety drives the alcoholic to drink in order to anesthetize it. Resentment, which comes from unexpressed (denied) anger, represents a constant threat to sobriety for the same reason” (Nowinski, Baker, & Carroll, 1999, p. 83).

Marlatt (1985) emphasized the importance of anger and frustration as triggers for relapse in both the intrapersonal and interpersonal domains. He noted that 29% of relapses are related to intrapersonal frustration and anger and that 16% are related to interpersonal conflict and associated anger and frustration.

Litt, Cooney, and Morse (2000) reported that those alcoholics who had urges to use after treatment had higher degrees of alcohol dependence, anxiety, and trait anger than those without such urges.

Forgiveness is an important way to resolve anger and restore hope (Enright & Fitzgibbons, 2000). In helping clients move toward forgiveness, it is essential to differentiate forgiving from condoning, pardoning, reconciling, or forgetting.

Forgiveness is a personal decision to give up resentment and to respond with beneficence toward the person responsible for a severe injustice that caused deep, lasting hurt. FT helps the wronged person examine the injustice, consider forgiveness as an option, make a decision to forgive or not, and learn the skills to forgive.

Findings – Our clients came to the program with trait anxiety and trait anger scores substantially above the published norms for adults; after treatment, however, FT participants exhibited scores comparable to the average.  In other words, the treatment did not lead simply to a change in anxiety and anger (particularly the reportedly more stable trait anxiety) but to a change toward normal profiles. In contrast, patients in the alternative treatment condition had anxiety scores well above average, especially in terms of trait anxiety, which showed little change at post test and only minimal improvement at follow-up.

FT did not focus on drug vulnerabilities, whereas the alternative treatment did. Urges to use substances are not necessary for relapse, they are important indicators.

FT  treatment is centered more on clients’ thoughts, feelings, and behaviors about someone other than themselves: an offender who hurt them deeply and unfairly. In FT, a potential reason for substance use is examined, that of avoiding painful memories of betrayal, violence, or abuse. When patients are allowed to heal, their motivation to abuse substances may be substantially reduced…(it) is worth considering as a way to address core issues of emotional pain.

resentment

 

This can lead to a reduction in negative emotions and increases in self-esteem and forgiveness… it moves to the heart of the matter for some clients. Deep hurts borne out of unfair treatment seem to play a part in substance use and abuse. Even when clients have many people to forgive…we find that they seem to know which person is most crucial to forgive first before moving to other offenders. Substance use, from this perspective, is a symptom of underlying resentments and related emotional disruptions.

If we fail to realize this, we may end up treating only symptoms rather than underlying causes. ”

 

This process seems practically the same as the inventory of Step 4 and the forgiveness implicit to steps 8 and 9. This study also highlights that we through forgiveness we actually tackle the underlying condition of emotional dysregulation. It is this emotion dysregulation (or spiritual disease) which appears to drive addiction so needs to be fundamentally addressed. By addressing these issues via the steps especially step 4 we begin to see how it works!

It was interesting that forgiveness led to higher self esteem, as if being tied to the past was akin to being tied to a former negative self schema, that people from our pained past did actually have the power to control us! Especially how we feel about ourselves. We change how we feel about ourselves and our past by simply forgiving, it is such a powerful tool in recovery.

Importantly by viewing studies like this (2)  we get beyond negative views of 12 step recovery to show that the recovery program’s effectiveness is clearly highlighted by the success of other psychological treatments getting the same positive results by using exactly the same strategies.

12 step groups provide a battery of the most profoundly effective psychological therapies for addiction ever contained within one treatment philosophy.

Don’t we all need to re-appraise how we see 12 step recovery?

Can’t we all benefit from stepping to one side and looking via a different angle to see why 12 step recovery is effective?

 

Reference

1. Alcoholics Anonymous. (2001). Alcoholics Anonymous, 4th Edition. New York: A.A. World Services.

2. Lin, W. F., Mack, D., Enright, R. D., Krahn, D., & Baskin, T. W. (2004). Effects of forgiveness therapy on anger, mood, and vulnerability to substance use among inpatient substance-dependent clients. Journal of consulting and clinical psychology, 72(6), 1114.

3.   Twelve steps and twelve traditions. (1989). New York, NY: Alcoholics Anonymous World Services