ADDICTIVE THINKING

ABRAHAM J. TWERSKI

How to distinguish and correct your codependent behaviors.

 Foreword
Few fields of human endeavor research have produced as many experts as that of chemical
dependency. Alcoholism and drug dependence are filled with international and national experts,
each of whom claims to have special knowledge of those peculiar diseases that have caused so
much controversy, even though they continue to be poorly understood by so many people. There
are experts on the adverse effects of chemicals on the brain; experts who have studied the way in
which genes transcend the generation gap, carrying who knows what load of biological risk
factors; experts in family dysfunction; experts in AA, group therapy, nutrition, behavioral
approaches, self-esteem, stress, society and culture, spirituality, recurrence, dual diagnoses, and
more. And while each of these experts undoubtedly holds some of the truth about these
devastating diseases, no one seems to have as firm a grasp of the whole picture as Dr. Abraham
Twerski.

Dr. Twerski has a wonderful intuitive grasp of the disease of addiction and the ability to describe
true alcoholics in a few carefully chosen, insightful phrases. His deep knowledge of these
diseases makes it easier for others to understand them as well.

Long before academic psychologists began to emerge from the long darkness of mindless and
painstaking behaviorism to reaffirm the importance of things like reasoning, decision making,
concept formation, and so on, Dr. Twerski calmly pointed out the critical importance of the
cognitive processes of alcoholics and those addicted to other substances and the way in which
these processes are integrated into their behavior. He has shown that if we ever had to engage in
combat with the apparent illogic of addictive behavior, we must first come to terms with the
various “logics” of addictive thinking. Those of us who operate as change agents with addicted
people and their family members must learn to detect the resistance to change associated with
addictive thinking, demonstrate to our patients their peculiar logic and self-deception, and use
these tests to help people. to be abstemious and persevere in a stable recovery. This book will
help us achieve this.

This new edition of a classic work is a tour de force in addictive thinking and its ramifications on
all aspects of addictive diseases and how to recover from them. In this compact and concisely
written volume, Dr. Twerski focuses on the critical aspects of addictive thinking and, with
admirable economy of words and phrases, explains this type of thinking, clearly demonstrating it
through carefully chosen examples. From her clinical practice and general observations, she
examines its origins and explores the importance of such thinking in a multitude of situations
including conflict, guilt, shame, anger, feelings management, defenses, spirituality and
codependency.

In this age of information explosion, when we are easily overwhelmed by the amount of data that
exceeds what we could absorb in several lifetimes, we often feel like we are left groping in the
dark for some usable knowledge. And even if we manage to find some reliable information in all
the rubbish we call data, we often still need wisdom and analysis. Fortunately, Dr. Twerski, in
his warmly welcomed new edition of Addictive Thinking , manages to provide us with both.
After reading this book, most readers will come away better informed, with a greater knowledge
of alcoholics and other addicts, and a little wiser.

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 John Wallace

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Chapter 1

What is addictive thinking?

When interviewing Ray, a young man who had entered a drug rehabilitation
unit, I asked him: “What made you decide that it was time to do something
about the problem?”

“I've used cocaine for a few years,” Ray told me, “and I've occasionally
stopped using it for a few weeks at a time, but I've never decided to quit
completely before.”

“For the last year my wife has been pressuring me to leave her completely.
She also used cocaine, but she stopped several years ago. "I finally got to
the point that coke wasn't worth the fights we had, so I decided to quit
completely."

“Honestly, I wanted to stop it once and for all, but after two weeks I went
back to it and that showed me something. I'm not stupid. “Now I know that
perhaps it is absolutely impossible for me to leave her by myself.”

I repeated Ray's last sentence several times because I wanted him to hear
what I had just said. But he couldn't perceive what I was trying to point out
to him.

I said, “It's very logical to say: Maybe I can leave him alone. It is also very
logical to say: It is absolutely impossible for me to leave him alone. But to
say: Now I know that perhaps it is absolutely impossible for me to leave her
by myself; It is absurd because it is self-contradictory. Either it is absolutely
impossible or maybe , but it cannot be both.” However, Ray couldn't
understand my purpose.

I have repeated this conversation to many people and even experienced

therapists do not show any reaction at first, hoping to discover where the
joke is. Only after I point out the contradiction between “absolutely
impossible” and “maybe” do you perceive the absurdity of the phrase and
the distortion of thought that occurs in this man's mind.

The distortion of thought

The phenomenon of abnormal thinking in addiction was first recognized by

Alcoholics Anonymous, where the very descriptive term unpleasant thinking
was invented. AA veterans use this term to describe the “dry drunk,” that is,
the alcoholic who abstains from drinking but behaves much like an active

3
drinker.

However, thought distortions do not only occur in addictive disorders; Nor

are they necessarily related to the consumption of chemical substances.
Distorted thinking may be seen in people who may be facing other
adjustment problems. For example, a young woman was late in handing in
her exam for a subject.

“Why don't you finish?” asked.

“I'm done,” he told me.
“Then why haven't you given it to me?” asked. “Because I need to work on it
a little more,” he answered. “But I thought you were done,” I pointed out.
“That's right,” he told me.

Although his statement seems illogical to most people, it may make perfect
sense to someone who has an addictive thought process. Additionally,
although distorted thinking does not necessarily indicate addiction, the
intensity and regularity of this type of thinking is very common in addicts.

We all recognize that the statements “I ALREADY finished my exam” and “I

still need to work on it a little more” are contradictory. But Ray's phrase,
“Now I know that perhaps it is absolutely impossible for me to leave her on
my own,” may not seem absurd to us as long as we do not stop to analyze
it. In a normal conversation, we usually do not have time to stop and
analyze what we hear. Therefore, they can deceive us, and make us accept
as reasonable statements that do not make sense.

Sometimes these contradictions can be even more subtle. For example,

when asked if she had resolved all the conflicts associated with her divorce,
one woman responded, “I think so.” There is nothing visibly absurd in his
response, as long as we do not stop to analyze it. The question “Have you
resolved the conflicts?” means “Have you overcome the various uncertainties
and eliminated the emotional problems attendant to your divorce?” That's
what the word resolved means. The response “I think so” is therefore a
statement of “I'm still undecided if I'm sure” and is actually meaningless.

Thought processes in schizophrenia

To understand more thoroughly what we are talking about when we use the
term thought distortion , let's look at an extreme example, that is, the
thinking system used by schizophrenics. As absurd as it may seem, a
particular distorted thought to a healthy person makes perfect sense to a
schizophrenic.

Family therapists with paranoid schizophrenic patients who have delusions of

grandeur know how futile it can be to try to convince the patient that he is
not the Messiah or the victim of a global conspiracy. The therapist and the

4
patient operate on two completely different wavelengths, with two
completely different rules of thought. Normal thinking is as absurd for the
schizophrenic as schizophrenic thinking is for the healthy person. The
adjustment of a typical schizophrenic to life in a normal society can be
described in terms of a baseball manager ordering the team to kick the ball
or a football coach ordering a base to be stolen.

Schizophrenics do not realize that their thought processes are different from
those of most people. They do not understand why others refuse to
recognize them as the Messiah or the victim of a global conspiracy.
However, many people, even therapists, may argue with a schizophrenic and
become frustrated when the person cannot accept the validity of their
arguments. But that is equivalent to asking a color blind person to
distinguish colors.

However, the thinking of the schizophrenic is so obviously irrational that

most of us clearly recognize it as such. We may not be able to communicate
effectively with him, but at least we are not fooled by the delusions he
creates in his mind. More often we fall into the relative subtlety of the
distortions caused by addictive thinking.

How addictive diseases are similar to

schizophrenia

Sometimes people with addictive diseases are misdiagnosed as

schizophrenic. They may have some identical symptoms, such as:
• delusions
• hallucinations
• inappropriate moods
• very abnormal behavior
However, all of these symptoms can be manifestations of the toxic effects of
chemicals on the brain. These people have what is called a chemically
induced psychosis, which may resemble, but is not, schizophrenia. These
symptoms usually disappear when the chemical toxicity has been mitigated
and brain chemistry returns to normal.

However, it is possible for the schizophrenic to actively use alcohol or other

drugs, which presents a very difficult problem to treat. It may require long-
term maintenance with strong antipsychotic medications. Additionally,
someone with schizophrenia may not be able to tolerate the confrontation
techniques that are often effective with addicts in treatment. Therapists
teach them to give up escapism and use their skills to adapt effectively to
reality. You cannot ask this of a schizophrenic, who lacks the ability to adapt
to reality.

5
In a sense, both the addict and the schizophrenic seem like trains gone off
the rails. With some effort, the addict can get back on the rails. The most
that can be achieved is to put this person on other tracks that will take him
to his destination. These other rails are not “direct”. They have countless
connections and deviations and at any moment the schizophrenic can take a
direction that is not desired. Constant vigilance and guidance are needed to
avoid such misplacements, and medication may be required to slow the
speed of travel and keep it on the rails.

Confronting the thinking of an alcoholic, or someone with another addiction,

can be as frustrating as having to deal with a schizophrenic. Just as we are
not able to shake the schizophrenic from his conviction of being the Messiah,
we cannot get the alcoholic to accept that it is not true that he is a safe and
social drinker, or a safe user of tranquilizers, or a “recreational” user of
marijuana. and cocaine.

For example, the person who is close to and observes a late-stage alcoholic
(or any other drug addict) has before him a person whose life is continually
being destroyed; perhaps your physical health is deteriorating, your family
life is in ruins, and your job is in jeopardy. All these problems are obviously
due to the effects of alcohol or other drugs, but it seems that the addict is
unable to realize this. He may firmly believe that his chemical use has
nothing to do with any of those problems and seems impervious to logical
arguments to the contrary.

A clear difference between addictive and schizophrenic thinking is the

following:

• schizophrenic thinking is blatantly absurd

• Addictive thinking has a superficial logic that can very well be
seductive and deceptive.

The addict may not always be as intentionally tolerant as others think. It is

not necessary that you are consciously and deliberately deceiving others,
although sometimes it does happen. Addicts often fall into the game of their
own thinking, actually deceiving themselves.

Above all, in the early stages of addiction, the addict's perspective and
estimate of what is happening may seem superficially reasonable. As we
already said, many people fall into the game of addictive reasoning. Thus,
the family of an addict is likely to see things the “addictive way of thinking”
for a long time. The addict will appear convincing to his friends, priest, boss,
doctor or even psychotherapist. Each of his statements seems to make
sense; even his long accounts of events can be coherent.

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 Obsessions and compulsions in addiction and codependency

The falsehood of self-deceptive thinking can influence codependent family

members as well as people who are dependent on chemicals. Who is
codependent? There are various definitions and descriptions of
codependency, but the one that seems to be the broadest is that of Melody
Beattie: “The codependent person is one who allows the behavior of another
to affect them and who is obsessed with controlling that person's behavior.”

The important parts of this definition are the words obsessed and control .
Obsessive thoughts crowd out all other thoughts and drain mental energy.
Obsessive thoughts can take over at any time and, strangely enough, any
attempt to get rid of them only increases their intensity.

Trying to push away obsessive thoughts is like trying to uncoil a spring by

compressing it. The more pressure placed on the spring, the harder the coil
eventually becomes.

At the risk of oversimplification, we can say that the addicted person is

tormented by the compulsion to ingest chemicals. The codependent person
has an obsession with the addict's consumption and the need to control it.

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Obsessions and compulsions are closely related. For many years, the term
obsessive-compulsive neurosis has been used in psychiatry. Both obsession
and compulsion are characterized by the fact that the person is worried,
even overwhelmed, by something irrational. In an obsessional neurosis,
what torments the person is an irrational idea; In compulsive neurosis, it is
an irrational act. The reason that the two terms are combined in psychiatry
is that almost in all cases in which a person becomes obsessed with an idea,
there is some compulsive behavior. Obsessive thoughts occur in virtually all
cases of compulsive behavior. The following story illustrates how obsessive
thoughts operate.

• The chair on the desk

When I was teaching psychiatry to medical students, one of them expressed

interest in learning more about hypnosis. I felt that the most effective
method of teaching it to him was to hypnotize him and allow him to learn
firsthand what a hypnotic trance is and the various phenomena that can
occur under hypnosis.

This young man happened to be an excellent hypnotic subject and in several

sessions I was able to demonstrate the various applications of hypnosis. But
since I also wanted him to understand the phenomenon of post-suggestion
hypnotically, I told him: “A few minutes after emerging from this trance, I
will give you a signal: I will tap my pencil on the desk. At that time, you will
stand up, take the chair you are sitting on, and place it on my desk.
However, you will not remember that I gave you that order.” Then I
snapped him out of the trance, and we continued our discussion about
hypnosis.

After a long while, I nonchalantly picked up my pencil and tapped on my

desk while continuing to chat. A few seconds later, the student, clearly
uncomfortable, began to stir. “I have this crazy urge to get out of my chair
and put it on his desk,” he told me.
“Why do you want to do it?” asked.
"I don't know. “It’s a crazy idea, but I felt like I had to do it.”
He paused. “Did you order me something similar during the trance?” “Yes,
that's how it was.”
“Then why can't I remember?” he asked me.
“Because when I made that suggestion to you, I indicated that you wouldn't
remember it.” “So, I don't have to do it, do I?
“I don't think so,” I replied.

Shortly after, the student left. About twenty minutes later, the door opened.
The young man rushed into my office, raised his 8
chair and angrily placed it on my desk. "Curse!" He said, turned around and
stormed out.
This is the nature of an obsession or a compulsion, regardless of whether it
occurs because of a suggestion given during hypnosis or as a subconscious
impulse of some unknown origin. Just as there is no point in putting a chair
on a desk, the compulsive cato may be irrational, but the impulse to do so
will be virtually irresistible. Trying to resist the urge can cause so much
anxiety and discomfort that the individual will perform the act just to relieve
the intense pressure. For most obsessions and compulsions, this period of
relief is fairly brief; then the impulse returns, often with greater force than
before.

Codependent people often behave in this obsessive-compulsive manner

when trying to control the addict's behavior or chemical use. They may
become obsessed with trying to help or, later, if their efforts failed,
punishing the addict.

How addiction and codependency are similar

The similarities between the behavior of the addict and that of the
codependent are surprising. Addicts often look for new ways to continue
using chemicals while trying to avoid their destructive consequences. The
person can drink alcohol or consume cocaine “only on weekends” or only in
a certain amount that will give the desired “stimulus,” but not enough to
result in intoxication. When control efforts fail, addicts do not conclude: I
can't control myself. Rather, they say to themselves: That method didn't
work. I have to find another one that works.

Likewise, codependents will not conclude that since their efforts to stop the
addict have been futile there is no way to control them. Rather, they will
look for new ways to make it work for them.

Cause and effect

Can the addict's distorted thinking cause addiction, or is such thinking a

result of addiction? It is a complex question, and cause and effect cannot be
easily determined. By the time the addict enters treatment, several cycles of
cause and effect have generally already occurred, and anyone who tries to
say which is which may fall into a trap. In a sense, it does not matter
whether a person's thought processes contributed to their addiction or
whether their addictive thinking is a symptom of the addiction. In both
cases the treatment and recovery 9
They must be started at some point. Since active use of chemical
substances is an impediment to the success of treatment, abstinence must
occur first. After prolonged abstinence, when the brain returns to
functioning more normally, addicts can focus their attention on their
impaired thinking.

The goal of this book is to help the addict or codependent person identify
their thought processes and begin the process of overcoming them.

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Episode 2

Self-deception and addictive thinking

The importance of realizing that addicts are deceived by their own distorted
thinking and that they are its victims cannot be overemphasized. If we don't
understand this, we may feel frustrated or angry at having to deal with an
addict.

We often laugh when we hear old accounts of use or ingestion from

recovering addicts, because the absurdity of their thinking and behavior can
be laughable. However, the reaction is very similar to the one we have when
someone slips on a banana peel. When we have finished laughing, we
realize that whoever fell could be seriously hurt. Likewise, while we may
laugh at the addict's antics, we also have to realize that that person suffered
greatly during their active addiction and that many people are still suffering
in the same way.

Addictive thinking and intelligence

Alan, a recovering alcoholic, did not remember the effects of his alcoholism,
despite what people told him. Since he only drank beer, he was sure he did
not have an alcohol problem.

Eventually, he became physically ill and could no longer deny that

something was happening. He concluded that by drinking half a case of beer
per day, he was consuming too much fluid. So he switched to whiskey and
soda water. When his physical symptoms worsened, he blamed soda water
and drank whiskey with plain water.

Is this rational thinking? Of course not. Can it be classified as psychotic

thinking? Not according to the current definition of psychotic , which is a
general term defining any major mental disorder characterized by a
personality disorder and loss of contact with reality. But his thinking was
clearly different from normal.

Addictive thinking is not affected by intelligence. People who work at very

high intellectual levels are as vulnerable to these thought distortions as
anyone else. In fact, people with unusually high intellect often exhibit more
intense degrees of addictive thinking. Therefore, those who are very
intellectual are the most difficult patients to treat.

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 • The lawyer and the turkey
Christine, a brilliant and highly skilled lawyer, stubbornly refused to attend
AA meetings for fear that exposure of her alcoholism would jeopardize her
career and standing in the community. But a visit from a grateful customer
who delivered a dressed turkey for the upcoming Thanksgiving changed his
mind.

Christine remembered leaving her office that afternoon, walking in the

freezing rain, carrying her turkey wrapped in butcher paper. The next thing
she remembers was leaning against an office building in the center of the
city, with the turkey under her arm, now without the paper that the rain had
carried away. Anyone who saw her claimed, and rightly so, that she was
drunk. Although she gave that impression publicly, she was very
embarrassed to have anyone see her heading to a church for an AA
meeting.

Why didn't this woman's brilliant analytical mind prevent her from this
absurd reasoning? For the same reason that brilliant people are not immune
to psychosis, neurosis or depression. As soon as there is a psychological or
physical craving, it affects the person's thinking in much the same way that
a bribe or any other personal interest distorts judgment. The need for the
chemical is so powerful that it directs the person's thought process by
sanctioning or preserving drinking or consumption. That is the function of
addictive thinking: to allow the person to maintain the destructive habit. The
brighter you are, the more ingenious your reasons for drinking, for not
abstaining, for considering AA or other organizations useless for non-
addicts, will be.

Addictive thinking is different from logical thinking because it does not come
to a conclusion based on evidence or the facts of a situation, but exactly the
opposite! The dictum begins with the conclusion I need a drink (or a drug)
and then makes an argument that justifies that conclusion, regardless of
whether it is logical or not, or whether it is supported by facts.

1
 Why do children use drugs, why do parents drink?

Understanding addictive thinking may help explain why some efforts to

prevent alcoholism or other drug abuse fail. Despite the highly publicized
drug deaths of some celebrities and widespread media coverage of the
dangers of cocaine and heroin, many people are still enchanted by the
mystique. of drugs. The harmful consequences, which include the
helplessness of addiction, its enormous financial cost, the legal problems it
causes, and the high risk of death, are not always indicated.

With the campaign that urged young people to Say No to Drugs, an

important perception of the position of young people was achieved. When
asked what they thought of the idea, many teens responded, “Why? What
else is there?"

Some young people who feel excluded from the American dream may turn
to drugs as the only type of gratification they have access to. Others, who
do not have the opportunity for success, may lack the confidence in their
abilities to succeed. Still others will not understand why they should deprive
themselves of a pleasure.

When pleasure or relief from discomfort is the ultimate goal of life, many
people, especially young people, turn to chemicals to achieve those goals. It
is undeniable that substances that alter mental processes can produce a
desirable sensation, and to discourage the search for this stimulus we must
be able to convince our young people to sacrifice that pleasure. Since they
seem to consider themselves immune to the dangerous effects of drugs,
dire warnings are no deterrent. If we tell them to avoid chemicals in order
to grow into healthy, productive people, capable of enjoying life, we are
often faced with the verbalized or unspoken argument: “Why wait? "I'm
already enjoying life with the drink."

What makes life more complicated is that our culture thrives on technology
that eliminates waiting. We are consumers of microwave ovens, fax
machines, cell phones and instant foods. Even if “happiness” after life is
conceivable, the ethos of instant gratification makes the long wait
intolerable.

To effectively prevent youth chemical use, we would need to establish (1)

fundamental life goals other than sensory gratification and (2) tolerance for
waiting. It's 13
our culture is unlikely to accept those changes. Rather, you will opt for
addictive thinking.

People can present addictive thinking patterns, which block certain events,
even before falling into the consumption of chemical substances. For
example, young people contemplating cocaine use are often lulled with
promises of euphoria, unaware of its potentially terrible cost. Thus,
addictive thinking cannot be singled out as the sole culprit for the effects of
chemicals on the brain.

Ironically, another characteristic of addictive thinking is that while it distorts

your perception of yourself, it may not affect your attitudes toward others.
Thus, an active alcoholic parent may feel deeply frustrated if his or her son
or daughter is unable to understand the destructive effects of drugs. In the
same way, the son or daughter who uses cocaine will not be able to
understand that his father returns to drinking soon after a risk of death due
to the effects of alcohol.

Remember this, because it is important: The identification of the addictive

thought must come from a third person.

Self-deception in addictive thinking.

Everyone can be “deceived” by the addictive thought process, but the

person who is most affected is the one whose thinking is illusory, the addict
or the codependent. The following stories illustrate this argument.

• Entering treatment would not be honest

Martín, a fifty-five-year-old man, consulted me after an intervention for his

alcoholism problem. His ex-wife, his four children, his boss and two close
friends confronted them with how their excessive drinking was affecting
their lives. For example, Martin's boss threatened to fire him because of his
dishonest work habits.

The man claimed that this intervention “had opened his eyes.” Weeks
before, he had been in a drunk driving accident, but then he was still in
denial about the problem. When others became interested enough in him to
try to help him, he realized he had to stop drinking. In fact, since the
intervention, ten days ago, he had not had a single drink.

1
I told Martin that his determination was a good start toward recovery, but
that determination alone would not eliminate his alcoholism and that
treatment was absolutely necessary. I gave him the options of either in-
patient treatment at a rehabilitation center or intensive outpatient
treatment.

However, Martín refused to enter a treatment program. Although without a

doubt he did not want to lose the affection and closeness of his children, or
his job, with all his good faith he could not enter treatment. Because?
Because he was sure that he could now abstain from alcohol without outside
help. Therefore, entering treatment just to satisfy his family and his
business partner, when he knew that he did not require such treatment,
would be dishonest on his part and he was not willing to act that way.

My impulse to burst into laughter at the absurdity of his reasoning was

mitigated by my compassion for this man who was tragically deceiving
himself. During his many years as an alcoholic, he had frequently lied to his
family, his friends, his boss. During that period he had not been honest with
them. But entering treatment was unthinkable because doing so would have
been “dishonest.” In fact, he believed that what was stopping him from
accepting help was his commitment to honesty! This is the self-deception of
addictive thinking.

• Just a social drinker

Another example of addictive thinking comes from the story of a skilled

cardiologist who drank excessively for years. As time and his alcoholism
progressed, he began to experience hangover effects. Although he attended
his office and the hospital every day, he felt sick almost until the end of the
morning. However, he knew that “he was just a social drinker.” He knew
there was a problem with the way his stomach absorbed alcohol: there was
too much alcohol left in his stomach overnight.

The doctor recalled medical school, where as a student he participated in a

study about digestion. He was given measured amounts of food, and forty-
five minutes later a tube was inserted through his nose and into his
stomach. The contents found there were evacuated to be subjected to
laboratory analysis.

“I became adept at inserting a tube through my nose and into my stomach,”

the doctor recalled, “and it occurred to me that this technique could be the
answer to my morning suffering. Before going to bed at night, I would insert
a tube into my stomach and empty its contents. Like 15
I hoped, I woke up every morning feeling much better. I continued doing it
for six weeks. The only reason I stopped it was because the tube irritated
my throat so much that my larynx almost closed and I was afraid I would
require a tracheotomy to breathe.

“But not once,” said the doctor, “not once during those weeks did it occur to
me that a social drinker doesn't have to pump his stomach every night!”

Self-deception and attending Twelve Step groups

Participation in a Twelve Step program is extremely important for recovery,

although many people resist it because of the insistence on complete
abstinence. However, many alcoholics and addicts will deny this reason and
will convince themselves that they have other valid reasons for not joining
an AA group.

One alcoholic said, “I can't go to AA because the meetings are held just a
block from my ex's apartment.” Conveniently, he didn't want to admit that
every week there are meetings in over 140 different locations in his
community.

The same type of self-deception occurs in codependency, as the following

stories illustrate.

• I could never attend Al-Anon

The wife of a financial planner consulted me about her husband's alcoholism:

“His drinking has progressively increased. Now he comes home from work,
sits in front of the television with his supply of beers, and that's where he
wakes up the next day. Until now he has managed to get to his office every
morning, but it is inevitable that before long he will no longer appear at
work, or he will arrive at his office intoxicated and everything will be known.
You will lose your job immediately.”

The lady explained to me how, over the past few years, her home life had
deteriorated due to alcoholism. The father and son were no longer speaking
to each other. The couple no longer had a social life or sexual relations.

Until now, the financial planner's wife had endured all the consequences of
alcoholism, but since it seemed to be on the verge of ruining her career and
livelihood, she felt she had to do something.

She had tried to talk to him many times, but he rejected her suggestions for
help, considering that he did not have any alcoholism problem. He told her
that if she didn't agree she could leave.
1
Since neither she nor her son seemed to have any influence, there was no
point in confronting him. The wife believed that if they confronted him he
would continue to refuse help and would ask them to leave the house.

Since there did not seem to be any effective approach to the husband, I
suggested that the wife begin to meet her own needs and attend AA
meetings. I also arranged for her to meet with Robert, an accountant who
was now in a successful period of recovery and whose story was almost
identical to her husband's.

At that meeting, the accountant described to him how all of his wife's efforts
to get him to quit drinking had been futile and how he continued drinking
until his alcoholism became obvious at work. After they threatened to fire
him, he had to enter treatment. He went through a very difficult period until
he finally stabilized in sobriety.

“My wife attends AA today,” he said. “Maybe if I had done it sooner, I could
have come back to my senses sooner and my recovery would have been
smoother. I suggest you start attending AA meetings and my wife will be
very happy to accompany you to your first meeting, tonight if you want.”

The woman shook her head. "Oh no". “I can't go to AA.”

“Why not?” we asked.

“Because what would happen if someone recognized me and came to the

conclusion that my husband would lose all his clients. “Who would allow their
money to be managed by an alcoholic?”

His comment puzzled me. “There is something I don't understand,” I said.

“You told me that you had endured all the problems that alcoholism was
causing you. The only reason you consulted me is that you feel that
exposure is imminent, that any day I will walk into your office obviously
intoxicated, and that this will get you fired. Since this seems imminent, why
your reluctance to attend AA meetings? Based on what you told me, your
husband is going to go to the bottom of the abyss in a much more serious
way if he doesn't stop his alcoholism. “Robert’s opinion is that his wife’s
involvement in AA might actually have prevented that from happening to
him.”

No matter what we both said, the woman stood by her decision. I couldn't
go to AA because I felt it might expose the problem. He failed to realize that
AA was the only thing he could do to help him avoid the disastrous
consequences he feared.

• I have nothing in common with them

1
In another case, the husband of an executive who relapsed after detox
sought help. He told me that his wife refused to attend Alcoholics
Anonymous. After leaving the hospital she had attended several meetings,
but she considered that they were not for her, since she was different from
the other participants; He considered he had nothing in common with them.

I told the husband that the wife's reluctance to AA was not unusual. After
all, in AA I would have to learn not to drink again and that was what I didn't
want to hear.

“How are you doing with your AA program?” asked.

“I don't attend AA,” he told me. “I went to two meetings, but the program is
not made for me. “I have nothing in common with the people who gather
there.”

I pointed to the husband who was repeating the same words as his wife.
Although he criticized her for not participating in the recovery program and
for feeling that she was different from other alcoholics, he avoided his own
recovery program for the same reason.

Anxiety about change can be so intense that people, like those in our
examples, contradict themselves.

To make changes

Why is it that people can contradict themselves so flagrantly and not be able
to recognize it, even if it is pointed out to them? In a word, the answer is
denial. Much of the denial that occurs in the addict's distorted thinking is due
to intense resistance to change. While the person denies reality, they can
continue behaving the same as before. Acceptance of reality can commit it
to the very difficult process of change.

1
Often people do not have problems with changes as long as they occur in
others. When the alcoholic says, “I wouldn't owe as much as I do if my
partner were more considerate,” what he is really saying is, “I don't need to
change. Make my partner change. “Then I will be fine.”

For example, codependents may eagerly seek help, thinking that experts
will tell them what to do to stop someone from turning to chemicals. They
are disappointed to learn that they can do nothing to alter the addict's
behavior, that they are powerless over the problem. When the expert
suggests that they analyze their own behavior and start making changes in
themselves, they often retreat. Above all, they are likely to feel discouraged
when the people at Alcoholics Anonymous tell them, “We don't come here to
change our partner. We come to change ourselves.”

“Can I change?” they may answer. “Why should I change? I’m not the one
who drinks!”

Distorted perceptions

Many of the characteristics of addictive thinking can be observed in

codependents as well as in addicts because they come from a similar origin:
little self-love.

Most emotional problems that do not have a physical origin are related in
one way or another to low self-love. This refers to the negative feelings that
people have about themselves that are not justified by any facts. In other
words, while some people have a distorted perception of themselves that
includes delusions of grandeur, those with low self-esteem have concepts of
inferiority, incompetence, and unworthiness. What's strange is that these
feelings of inadequacy are often particularly intense in more gifted people.

If our perception of ourselves is incorrect, we will probably be prone to

maladjustment. We will only adapt to reality if we have an accurate
perception of it. We constitute an important component of our own reality,
and if we have an unrealistic vision of ourselves, we perceive a distorted
reality.

I have yet to meet someone dependent on chemicals who did not have
feelings of inferiority prior to their dependence. Sometimes they feel
inadequate or worthless in every facet of their lives, and other times they
feel very competent in their field 19
particular experience, but inadequate and unworthy as human beings,
partners, partners or parents.

Some people react to feelings of low self-love by fleeing from life's

challenges and suffering through chemicals, and some find a redeeming
feeling of worth and adequacy when they are the sober, controlling part or
when they suffer from a person dependent on chemicals.

The rule of the Three C's

Alcoholics Anonymous endorses the rule of the Three Cs: YOU DID NOT
CAUSE IT, YOU CANNOT CONTROL IT, AND YOU CANNOT CURE IT. But
many people feel responsible for another's addiction, try to control it and
believe they can cure it.

Sometimes it seems like the codependent person is thinking: I am so

powerful that I can cause an addiction, or control it, or cure it. This is not a
genuine feeling of superiority or arrogance. On the contrary, such feelings
are often a defensive reaction against feelings of inferiority.

The Three Cs are often related to an openly recognized inferiority. For

example, the codependent person thinks: I am the cause of my child's
addiction, because if I had been a better father (a better mother), I would
not have turned to drugs. If I had given him the love and support he
needed, he wouldn't have sought out the chemicals. His addiction is due to
my carelessness. If I were a better person, I would use it less or give it up .
These feelings are particularly common in the codependent when the other
person is in the initial stages of addiction.

The self-deceptive characteristics of addictive thinking and codependency

have much in common. In both, denial, rationalization and projection are
often observed. In both, contradictory ideas can coexist, and there is a fierce
resistance to changing oneself and the desire to change others. In both
there is a delusion of control and, invariably, little self-love. Thus, all the
characteristics of addictive thinking are present in both and the only
characteristic that distinguishes them may be the consumption of chemical
substances.

Chapter 3

2
 The Addictive Thinker's Concept of Time

“I can leave it whenever I want.”

If a contest were held for the phrase most used by addicts, this one would
win.

Anyone who has observed addicts knows that they “quit” countless times
and make countless resolutions. Abstinence can last for hours, days, or, in
some cases, weeks. But, in general, before long the active practice of
addiction resumes. This vicious cycle can persist for years.

Simply put, addicts are incapable of quitting whenever they want. For others
it is obvious, for them it is not. Family and friends may be confused,
wondering how can a person insist that they can quit whenever they want
when that is obviously not true?Even experienced therapists, accustomed to
this reasoning, will wonder: How is it possible for an intelligent person to be
so profoundly indifferent to reality? How is it possible that top intellectuals,
men and women in positions of great responsibility, who can analyze and
remember specific facts, cannot put two and two together when it comes to
their addictive use of chemicals?

The answer lies in understanding addictive thinking. Addicts may not seem
as illogical as we perceive them to be at first glance if we understand one
thing: the addictive thinker's concept of time. They may be very consistent
with themselves and others when they say, “I can quit whenever I want,”
but they have a different concept of time than someone who is not addicted.

For everyone, time is variable. In some circumstances a few minutes can

seem like an eternity, and in others weeks and months pass like water.

Addicts who claim they can quit at any time actually believe it. Because?
Because, by abstaining for one or two days, the addict has stopped “for a
while.” In fact, having often abstained for several days, addicts wonder why
others don't realize the obvious: that they can quit at “any time.”

You can tell the addict, “No, it's obvious that you can't quit whenever you
want.” His phrase and that of the addict, although seemingly contradictory,
are both true. The key is that everyone is using time , the word moment,
differently.

The future in minutes and seconds

For the addict, time can be measured in minutes and seconds. Of course, in
his search for the effect of a chemical substance, the addict thinks in terms

2
of minutes, and does not tolerate the delay of the desired effect. All the
substances they usually use produce their effects in a matter of seconds or
minutes.

I have promised myself to do the following experiment one day. I'm going to
take a large glass jar and fill it with multicolored capsules. Then I will spread
the word on the street that I received a shipment of “chochos” from South
America better than what has been proven up to that day. Because it causes
a “trip” much greater than the combination of heroin and cocaine!

"Wow!" addicts will say. “It must be very expensive.”

“No, that's the best. “Two dollars per dose.”
“You must be joking. Two dollars?"
“By God it's true, and it's the best.”
“Then give me one hundred dollars.”
"With pleasure. But first I have to tell you something. The trip is the best in
the world, but it only reaches you 48 or 72 hours later.”
“How long later?”
“It takes two to three days for the trip to happen, but then it will be the best
thing you have experienced so far.”

Customers will back off. “Who wants that crap. “Keep it!”

Addicts have told me that they would not buy a drug, regardless of its high
effect and low cost, if it took a long time to take effect. Part of addiction is
that the effect is immediate. Excessive lapses are not part of the addicts'
frame of reference.

The addict thinks about the future, but only in terms of moments, not years.
When they drink or take other drugs, they think about the consequences:
the feeling of warmth, the feeling of euphoria, relaxation, detachment from
the world, and perhaps sleep. These consequences occur within seconds or
minutes after ingesting alcohol or drugs, and these seconds and minutes are
what constitute “time” for the addict. Since cirrhosis, brain damage, job loss,
and other serious consequences are the result of a long process and are
unlikely to occur in a matter of minutes, they simply do not exist in the
minds of addicts.

How different is the alcoholic from the smoker, who runs the risk of facing
the consequences of serious circulatory problems, heart disease,
emphysema and cancer? The destructive effects of alcoholism and the use of
other drugs can be much more rapid than those of smoking, but neither the
drinker nor the smoker seems to care about the future. Likewise, those who
engage in risky sexual behavior may be playing with their health, but once
again the consequences are in the “future,” which is not part of their concept
of time.

2
 A culture with the concept of addict time

We are part of a culture that values providing services in seconds: express

mail, the Internet, fast food restaurants, all offer almost immediate
gratification. In some ways, we all operate on the concept of addict time.

We have polluted the air, rivers and oceans for short-term benefits, ignoring
the long-range effects. We have destroyed forests and other habitats of
endangered species in our interest in handing over this world to future
generations. Are we ignoring the future, much like the addict does?

Understand the way the addict thinks

People who participate in the Twelve Step program of Alcoholics Anonymous

showed me how prevalent the misconception of time is in addictive thinking.
These people like to use the slogans One Day at a Time and Give Time to
Time to combine the forces of addictive thinking.

People in recovery instinctively know that one of the ways they have to
change their unpleasant thinking is by managing their distorted concept of
time. Most are comfortable with the idea that a day is a convenient and
manageable unit of time. However, often, at the beginning of recovery, five-
minute periods should be considered and over time work up to longer
periods.

The idea that time must be given time is used to counteract the addictive
notion that change can come quickly, like the addict who prays, “Please,
Lord, give me patience, but give it to me right away!”

One of my patients wrote to me: “Four years ago they took me to your
office, totally beaten, wanting to die, but without the courage to commit
suicide… The first two years the only correct thing I did was not drink and
attend meetings… I want know that it took me four years to finally feel
different.”

When addicts recognize that part of their downfall was impatience and are
willing to wait for the rewards of sobriety, they are on the path to recovery.
If they want “instant” sobriety they are not going anywhere.

AA veterans consider their sobriety in terms of twenty-four-hour segments.

They celebrate the anniversaries of their sobriety, but with great care
because they know that it is risky to think in terms of years and not days.
That's one reason why many in recovery turn to meditation books that focus
on the one-day-at-a-time approach, such as Twenty-Four Hours a Day and
One Day at a Time in Al-Anon .

2
One day at a time is not only a smart motto, but absolutely necessary for
recovery from addiction, as the following two stories illustrate.

• Nine thousand eight hundred thirty-four days

I once asked a friend who was in recovery how long he had been sober. He
took a small diary out of his pocket and, after leafing through the pages,
looked up and said to me: “Nine thousand eight hundred and thirty-four
days.”

I asked him “what is that?” Twenty-five, thirty years?” With complete

sincerity, he answered: “You know, doctor, I really don't know. Maybe you
can allow yourself to think in terms of years, but I have to think in terms of
days.” This friend, John McHugh died at age 83, after 43 years of sobriety;
The night before his death he wrote the number 16,048 in his diary.

• Today you were sober longer than me

Once after an AA meeting, a woman said admiringly to John, “It must be

wonderful to be sober for so long.”

John smiled and replied, “You've been sober longer than I have, Elizabeth.”

“How can you say that?” Elizabeth told him. “I've only been sober for two
years, and you've been sober for almost forty.”

“What time did you get up today?” John asked him.

“Well, I have to be at work at seven; I get up at five thirty.”

“I didn't get up until eight today, so you've been sober longer than me
today,” John said.

When addicts and codependents fully understand the concept of one day at a
time, they have begun their recovery. However, they must proceed with
caution, because the recurrence of the time warp is a reason to suspect that
there is a possibility of a recurrence. The time dimension of thinking is then
an important consideration for both the recovering addict and the
professional in understanding and managing addictive diseases.

2
26
Chapter 4

Cause and effect confusion

I once heard a speaker in AA describe the way he thought during his

alcoholic days. The irrationality of his thinking was hilarious and everyone
burst out laughing. They laughed even more when the man suggested that
the alcoholic's thinking is as destructive as his alcoholism. To illustrate, the
man read the questions from a personal alcoholism test, replacing the word
drink with the word thought . Here is what he read:

Are you an addictive thinker?

1. Do you waste work time thinking?

2. Is thinking making your home life unhappy?
3. Have you ever felt remorse after thinking?
4. Have you had financial difficulties as a result of thinking?
5. Does thinking make you neglect the well-being of your family?
6. Has your ambition diminished since you thought?
7. Does thinking cause you difficulty sleeping?
8. Has your effectiveness decreased since you think?
9. Does thinking put your job or business in danger?
10. Do you think to avoid worries or problems?

The point is that, even in the absence of chemicals, addictive and distorted
thinking causes destruction. Many addictive thinkers reach their conclusions
because they tend to reverse causes and effects. Their judgment becomes
distorted and, as a result, their use of chemicals becomes entirely justified.
As one recovering alcoholic puts it: “I never had a drink in my life unless I
decided it was the right thing to do at the time.” Although addictive thinkers
twist logic, they are absolutely convinced that their reasoning is valid. Not
only do they resist the opponent's arguments, but they also do not
understand why others cannot see the “obvious.”

An addict's version of dyslexia

We can understand it better if we compare it with dyslexia. Some people

with this learning disorder “see” letters reversed in words. They are asked to
read cat and they will say TOGA or TAGO, but they are sure they read it
correctly. The problem concerns your perception of the organization of the
letters. That does not imply little intelligence; Dyslexia can occur in very
intelligent people.

2
Something similar happens when the addict mentally reverses cause and
effect. For example, Felicia claims that she drinks and takes pills because her
home life is intolerable. He recounts his perception of the truth. Her husband
isolated himself from her, is indifferent to her and makes scathing comments
to her. Her children are ashamed of her and disrespect her. She believes
that this emotional torture causes her alcoholism. He says: “When I finish
work and the excitement of the day is over, and there is nothing more to do,
I certainly want some drinks.”

We've all seen cartoons of a man complaining to a woman in a bar: “My wife
doesn't understand me.”

WOMEN: What do you not understand?

MAN: He doesn't understand why I drink.
WOMEN: Why do you drink?
MAN: Because my wife doesn't understand me.

The attitude of the family, the pressure of work, the insensitivity of the
authoritarian boss, the harshness of friends, anxiety attacks, irritating
headaches or backaches, financial difficulties, or any other problem,
whatever the reason that the addict gives for his consumption of chemical
substances, the formula is always the same. The fact is that they usually
cause the problems, but the addict believes that the problem is caused by
his use of the chemical.

Although Felicia does in fact have the problems she complains about, she
does not recognize her confusion of cause and effect. Her husband's
behavior, although unpleasant, is actually a response to his alcoholism and
pill use. I was unable to communicate fully with her due to her chemical use.
Her children are upset and embarrassed because they cannot invite friends
over for fear of their mother's unpredictable antics. They lost respect for him
because of his drug use.

Just as the dyslexic has difficulty reading until his or her perceptual problems
are managed, the addict's reading will remain distorted with or without
active use of alcohol or other drugs unless the thought process is corrected.
addictive.

Chapter 5

Origins of addictive thinking

How does addictive thinking develop? Why do some people have healthy
thought processes and others distorted ones? We do not have all the

2
answers, because chemical dependency is a complex disease that results
from an intricate mix of physical, psychological and social factors.
Understanding how addictive thinking develops can be helpful in preventing
addictive thinking, alcoholism, and other drug addictions. However, it has
limited value in the treatment and reverse management of addictive
thinking.

The inability to reason with oneself

The most compelling theory of how addictive thinking develops was

presented in a 1983 article by Dr. David Sedlak. describes addictive thinking
as a person's inability to make healthy decisions for themselves . He points
out that it is not a moral deficiency of the person's willpower, but rather a
disease of the will and the inability to use it. Sedlak emphasizes that this
unique thought disorder does not affect other types of reasoning. Thus, the
person who develops a thought disorder may be intelligent, intuitive,
persuasive, and capable of valid philosophical and scientific reasoning. The
peculiarity of addictive thinking, he says, is the impossibility of reasoning
with oneself . This can apply to a variety of emotional and behavioral
problems, but is invariably found in addiction: alcoholism, other drug
addictions, compulsive gambling, sexual addiction, eating disorders, nicotine
addiction, and codependency. 1

How does this inability to reason with oneself develop? To understand it we

must first recognize how the ability to reason with oneself presents itself.
According to Sedlak, it requires certain
factors. First, the person must have adequate elements about reality. He
who is unaware of the harm that alcohol or other drugs can cause cannot
reason correctly about their use.

Second, the person must have certain values and principles as a basis for
making choices. People acquire these values and principles in their culture
and in their home. For example, a young man who grows up with family or
cultural values that stipulate that a man demonstrates his masculinity when
he is able to withstand heavy alcohol consumption will drink excessively. Not
being able to live up to those expectations can lead to deep disappointment.

Third, the person must develop a healthy, undistorted self-concept.

Psychiatrist Silvano Arieti suggests that young children feel very insecure
and threatened in a huge and overwhelming world. One of the main sources
of security for children is their trust in adults, especially their parents. If
children think that their parents and other significant adults are irrational,
unfair, and arbitrary, the anxiety is intolerable. Therefore, you must
maintain, no matter the cost, the conviction that the world is usually
pleasant, fair, and rational.

2
It is true that the world is neither pleasant, nor fair, nor rational. However,
children can't see it that way. They conclude rather that, as the world must
be, their perception is defective, and they think I am not able to judge
things correctly. I am stupid.

Likewise, even if children are mistreated or unfairly punished, they may not
be able to think My parents are crazy. They punish me for no valid reason.
This would be too terrifying a concept for them to tolerate. To preserve the
notion that his parents are rational and predictable, his only option is to
conclude: I'm sure bad to have been punished this way.

Finally, we come into this world as helpless infants, unable to do many of the
things that adults do. With good parenting and a nurturing environment, we
largely overcome that feeling of helplessness as we grow up.

Sometimes parents demand things from their young children that they are
incapable of, and they may feel that they should be able to do them, and
this can cause them to feel inadequate. On the other hand, parents can do
too much for their children, without allowing them to exercise their own
muscles. Such children will not have the opportunity to develop self-
confidence. Successful parenting requires knowing what children can and
cannot do at various stages of their development, and parents must
encourage their children to use their abilities.

It is important that parents take an interest in their children's homework,

and even help them. However, when parents do homework, they reinforce
the child's conviction of incapacity. Incidentally, when they do much of what
the child can do on their own, they act codependently. The child who says “I
can't solve math problems” and is allowed not to try hard to do them
actually has his feeling of inadequacy confirmed.

As children grow, these misconceptions can continue to color their thinking

and behavior, making them feel like they are bad and undeserving of good
things. Or they will consider their judgment to be very flawed, allowing
others to easily influence them.

The person may feel bad or worthless, even though this is in total
contradiction to reality. Feeling insecure and inadequate makes an individual
more vulnerable to escapism, which is so often exerted through mood-
altering drugs. The person who feels different from the rest of the world, like
they don't belong anywhere. Alcohol and other drugs, or other objects of
addiction, anesthetize the pain and allow you to feel part of the “normal
world.” In fact, many alcoholics and other addicts claim that they are not
looking for a “trip,” but just to feel normal.

Many thought distortions are not necessarily related to chemical use. For

3
example, fear of rejection, anxiety, isolation, and despair are often the result
of low self-love. Many of the subterfuges of addictive thinking are
psychological defenses against these painful feelings, and the symptoms are
due to the persistence of a distorted self-image that began in childhood.

3
32
Chapter 6

Denial, rationalization and projection

The three most common elements of addictive thinking are (1) denial, (2)
rationalization, and (3) projection. Although those familiar with addiction
treatment are aware of the frequency of these traits in addicts, it is
warranted that we explore them in more detail. The progressive elimination
of these distortions is the key for recovering addicts to improve.

The term denial , as used here, can be misunderstood. In general, denying

something that actually happened is considered a lie. While addictive
behavior involves a lot of lying, denial in addictive thinking does not mean
lying, which is an intentional and conscious distortion of facts or
concealment of the truth. The liar knows he is lying. The addictive thinker's
denial is neither conscious nor intentional, as he or she may sincerely
believe that he or she is telling the truth.

Denial and, therefore, rationalization and projection are unconscious

mechanisms. Although they are often gross distortions of the truth, they are
a truth to the addict. The addict's behavior can be understood only in light of
the unconscious nature of these mechanisms. This is why it is ineffective to
confront denial, rationalization and projection with facts that contradict
them.

Some phobias are the result of faulty perception. For example, a young child
who is frightened by a dog may develop a fear of dogs and many years later
will have a panic reaction when approached by a harmless puppy. Although
physically what he sees is a tiny puppy, the psychological perception is that
of a ferocious dog about to attack him. In other words, while conscious
perception is that of a puppy, unconscious perception is that of a monster.
Emotional responses are often related to unconscious rather than conscious
perception.

The role of misperceptions

Addicts react according to their unconscious perceptions. If they were valid,

their behavior would be perfectly understandable. Unless we can show them
that their perception is wrong, we should not expect their reactions and
behavior to change.

Due to the importance of self-love in the addictive disease, the addict's

misperception of himself is his biggest problem. in reality, all other distorted
perceptions are secondary.

3
Virtually all of the addict's defense mechanisms are unconscious, and their
function is to protect them from an intolerable, unacceptable, and
catastrophic consciousness.

It should not be surprising that psychological defense mechanisms can

operate without conscious awareness. Of course, physical defenses function
without a cognitive perception of their function. For example, when we
experience an injury, even a tiny cut, our system adopts a defensive posture
to prevent the injury from becoming life-threatening. White cells from
remote regions of the body destroy bacteria that enter the body, and the
bone marrow soon begins to produce tens of thousands more white cells to
fight the infection. Platelets and other blood clotting substances transform a
clot to prevent blood loss. The immune system is alerted and begins to
produce antitoxins to fight disease-producing organisms. All this complex
activity occurs without us being aware of what is happening inside us. Even
if we know what is happening, we cannot stop it.

Psychological defense mechanisms are no different: they do not come into

action at our command. We are not aware of their operation and, unless
aware of them during recovery, the addict cannot stop them. Therefore, it is
useless and absurd to tell the alcoholic or those suffering from addictions to
“stop denying”, “stop rationalizing” or “stop projecting”, when they are not
aware of what they are doing. They must first be helped to discover what is
happening.

During my internship, a patient helped me understand the defensive nature

of unconscious denial.

• This couldn't happen to me

The patient, a woman in her fifties, was admitted to the hospital for
exploratory surgery due to the suspected presence of a tumor. He informed
the doctor that he was active in community affairs and had assumed many
important responsibilities. Although the tumor could mean cancer, it was
important for her to know the truth, as it would be dishonest to many people
and organizations if she continued to have responsibilities if her health
deteriorated. The doctor promised to be frank and reveal what was
discovered during the surgery.

Surgery revealed that he did indeed have a cancerous tumor. Obeying the
request for complete honesty, the doctor had a frank talk with the patient,
and told her that the malignant tumor had to be removed to stop the cancer.
Additionally, because the tumor showed some signs of having spread, the
patient would have to undergo chemotherapy.

Thanking the doctor for his honesty, she agreed to collaborate in any
3
treatment that was recommended. He spoke freely to nurses and staff about
his cancer.

After being discharged from the hospital, she returned to her chemotherapy
sessions every week. She often told hospital staff how lucky she was to be
living at a time when science offered a successful treatment for cancer. He
seemed to be adjusting well both physically and emotionally.

However, five or six months after his surgery he began to experience

several symptoms. The cancer had spread despite chemotherapy. Eventually
she developed gasping and severe joint pain and was hospitalized for
treatment. When I was doing his admission form, he told me: “I don't
understand what's wrong with you doctors. “I’ve been coming regularly and
they haven’t been able to figure out what’s wrong with me.”

The comment surprised me, since he had told me repeatedly that he had
cancer. After thinking about it I realized that as long as I considered cancer
as a kind of abstract concept that posed no immediate threat to his life, I
could accept the diagnosis. As soon as the condition began to cause pain
and gasping, concrete evidence that she was deteriorating, she felt so
threatened that her psychological system refused to accept the truth. He
wasn't intentionally lying or pretending; I didn't really believe I had cancer.

Denial as a defense

If we consider denial as a defense, the obvious question is a defense against

what? In the aforementioned case, the woman could not accept the
devastating idea of having a fatal illness and that her life would suddenly
end.

In the case of the addict, what is so terrifying that his psychological system
chooses to deny reality? The answer is that the awareness of being an
alcoholic or a drug addict goes beyond acceptance. Because?

• The person may feel the stigma of being labeled an alcoholic or addict.
• You may consider your addiction to indicate a weakness in your
personality or a moral degeneration.
• You may think that you are terrified of not being able to turn to alcohol
or other drugs again.
• You may not accept the concept of powerlessness and lack of control.

It may be a combination of these and other reasons, but for the addict to
accept the diagnosis of being an addict is just as devastating as for the
woman to accept the truth of her cancer. Until they overcome denial, addicts

3
are not lying when they say they are not dependent on chemicals. In truth
he is not aware of his dependence.

Rationalization and projection serve at least two important functions: (1)

they reinforce denial and (2) they maintain the status quo .

The rationalization

Rationalization means giving “good” reasons instead of the true reason. Like
denial, this defense is not unique to people who depend on chemicals,
although addicts can be very adept at it. Let us point out that rationalization
means giving good, that is, probable, reasons. This does not imply that all
rationalizations are good reasons. Some are really stupid, but they may
sound reasonable. Rationalizations divert attention from the real reasons,
and not only the attention of others but also that of the addict. As in the
case of denial, rationalization is an unconscious process, that is, the person
does not know that he is rationalizing.

A fairly reliable rule of thumb is that when people give more than one reason
for doing something, perhaps they are rationalizing. In general the true
reason for something is one.

Because they seem reasonable, rationalizations are very misleading and

anyone can fall for them.

A woman who graduated as an accountant was reluctant to apply for a

promising job because she feared being rejected. However, the reasons he
gave his family were different: (1) maybe they are looking for someone with
years of experiences; (2) the office is too far away to have to go there daily;
and (3) the starting salary is not satisfactory.

A recovering alcoholic stopped attending AA. Your reasons? “I work at a

rehab center and see alcoholics and addicts all the time.
day. “I really don’t need another hour with them at night.” Although his
reason may seem credible, the real reason he avoided AA was that he
wanted to drink again and attending AA would make it difficult for him.

Rationalization reinforces denial. The alcoholic may say: “I am not an

alcoholic. I drink because…” For the addict, a seemingly valid reason for
drinking means that they are not addicted.

Rationalization also protects the status quo , allowing the addict to feel that
not making necessary changes is acceptable. This feature of addictive
thinking can operate long after you have overcome denial and are
abstaining. Brian's story is an example of the way rationalization protects
the status quo .

3
 • The lost love

Brian, a 29-year-old man, came to me two years after completing treatment

for his chemical dependency. Although he successfully managed to remain
abstemious, he found himself at an impasse. He had abandoned his
university studies and could not keep his job. In general he worked very
well, but he left the job as soon as his performance led to a better position
or greater responsibilities.

Brian claimed to know exactly what his problem was. He was in love with
Linda and they were engaged. But Linda's parents opposed her marriage and
convinced her to end the relationship.

Although that had happened more than five years ago, Brian still loved Linda
and had not been able to get over the rejection. He was still grieving the
loss, he said, and what was keeping him from moving forward was his
continued attachment to Linda.

As painful as romantic rejections can be, people get over them in the long
run. Why was Brian different?

Over several sessions Brian and I attempted to analyze his relationship with
Linda and his relationship to rejection. I proposed a variety of theories, all of
which seemed logical, but both Brian and I felt that they didn't fit him.

One night after a session with Brian, I dreamed I was in a rowboat. As a

child I really liked rowing; But since I didn't know how to swim, I wasn't
allowed to go out in a boat without the presence of an adult. Then, I would
go to the dock where the boats were anchored and, with the boat securely
tied to the dock, I would take flight rowing. There wasn't much danger
because the boat couldn't get away. As he rowed, he imagined that he was
reaching the other side of the lake and discovering a hitherto unknown land.
He would plant the American flag on that new frontier as the explorers had
done. It was a pretty normal fantasy for a 10 year old.

When I woke up, Brian's situation was crystal clear to me. In my case, my
adventures were not prevented by being tied to the dock. I needed the
bondage because it was my security.

Brian's situation was similar. For some reason it was terribly insecure. For
one thing, going to college or accepting a promotion at work could result in
failure, and he didn't want to accept that risk. On the other hand, he
couldn't face the fact that his stagnation was due to his apprehension,
because that would be equivalent to admitting that he wasn't aggressive or
brave enough.

3
What Brian was doing was similar to what I had done with the boat. Just as I
tied myself to the dock, Brian had tied himself to an event in his life that he
felt was holding him back. Since being rejected is painful and depressing,
and people often lose their motivation and initiative after a loving rejection,
the reason was perfectly reasonable to Brian and those around him. Poor
Brian. Isn't it a shame what happened to him? The poor boy cannot recover
from his unrequited love.

Attributing his problem to Linda's rejection was a rationalization. It was a

good explanation for why he couldn't succeed in life, but it wasn't the real
reason . Efforts to understand why his relationship prevented him from
resolving his grief were useless because they were based on a falsehood.
Like other rationalizations, “Linda's rejection” was a smokescreen.

The truth is, Brian didn't want to face his insecurities and anxieties. Only
after I refused to let him talk about Linda, and instead focused on his need
to face the challenge of moving forward with his life, did Brian begin to make
the changes he had been avoiding.

The pain

Surprisingly, physical pain can be a type of rationalization. It is not

uncommon to see people addicted to pain medications who say they cannot
stop taking them due to severe pain. They have often undergone one or
more surgeries and became addicted to the medications they took for
persistent pain after surgery. People with this type of drug use are not
considered addicts. “I have never gone out to buy a drug. I need the
medications because the pain is unbearable. “If I could get rid of the pain, I
wouldn’t consume them.”

In these cases, the examination by doctors usually does not reveal a

physical cause of the persistent pain, and these patients will be told: “You
are not in real pain. “It’s all in your mind.” They are often accused of faking
or simulating an illness.

What is not generally recognized is that the unconscious mind can produce
pain, real pain, which hurts as much as a broken leg. Although some addicts
fake pain to get the drugs they want, it is also possible for someone to suffer
from chronic pain that is not faked, but is a product of addiction.

In a sense people with this type of pain are rationalizing. Although they are
not making excuses, in essence their unconscious is doing it for them.
Because your body craves drugs, the unconscious mind produces pain. What
all of these people feel is pain, and they demand relief. Unfortunately, many
doctors feel compelled to respond to their demands and continue to
prescribe medications.

3
Addicts with chronic pain are challenging to treat, although many have been
treated successfully. A young woman who had a severe addiction to
narcotics due to persistent back pain has today given up the drugs. When
asked how he manages his pain now without drugs, he answers, “What
pain?”

The projection

Projection means blaming others for things that we ourselves are actually
guilty of. Like rationalization, projection fulfills two functions:

1. Reinforces denial.
• “I'm not an alcoholic. “She makes me drink.”
• “If you had my boss, you would also resort to drugs.”
2. Help protect the status quo.
* “Why do I have to change? I'm not the one to blame. When others make
the right changes I won't need to drink or take drugs.”

Accusing another seems to allow the addict to avoid the responsibility of

changing. “As long as you do this to me, you can't expect me to change.”
Since others are unlikely to change, the drinking or drug use will perpetuate.

Trying to convince addicts that their arguments are invalid is often

unsuccessful. Since the addictive projection serves primarily to maintain the
use of chemicals, it will disappear on its own when sobriety is achieved. The
best approach to take is to remind addicts: “You can't change anyone but
yourself. Let's work to make the healthy changes that you can make."

Addicts, like other people with psychological problems, may blame their
parents for their failures, something popular psychology has unintentionally
encouraged. Some addicts spend countless hours repeating the past and
tend to use that information to indulge in self-pity and to justify their use of
chemicals. I have found that it is helpful to say: Even if you are a product of
what your parents did to you, as you say, it is your fault. We cannot undo
the past. So, we are going to focus on making the necessary changes to
improve your functioning.”

These three important elements of addictive thinking, denial, rationalization

and projection, must be considered at every stage of recovery. They may be
present in layers, like the skins of onions. As one layer of denial,
rationalization, and projection is removed, another layer is revealed
beneath. The progressive elimination of these distortions of reality allows
improvement during recovery.

3
Chapter 7

Conflict management

It has been said that the difference between psychosis and neurosis is that
the psychotic says: “Two plus two equals five,” while the neurotic says:
“Two plus two equals four, and I can't tolerate it.”

The non-addict accepts that two plus two equals four and adjusts to it
without difficulty. The addict can also adjust well, sometimes. But at other
times the chemical makes him psychotic, and at other times neurotic. When
reality seems too unbearable, the addict neither adjusts to it nor discards it
in his imagination. Rather, he resorts to chemicals and ignores reality.

With abstinence, the addict must face reality without the escape that
chemicals provide. This may help us understand why sometimes families of
addicts, who have long requested that the addict stop using chemicals, are
disappointed when he finally stops using them. In fact, the teetotal addict
who has not received help to overcome the addictive thinking may be more
difficult to live with than the one who is still a user. Some families have gone
so far as to induce the addict to drink or take drugs again.

Contrary to common sense, addicts have no more problems in their lives

than anyone else, that is, before the use of chemicals complicates
everything. Once addiction is established, the confused mind can generate
an incredible amount of conflict. The cause of chemical dependency is not
overwhelming conflicts, but the addict's distorted perception, which makes
reality unacceptable.

A distorted image of yourself

The main distortion occurs in the addict's self-image. One way or another, it
feels very inadequate.

• A young drug addict will not go out with boys or look in the mirror
because she considers herself ugly.
• The chemically dependent man who is the author of a textbook on
medical pathology becomes very anxious when giving a talk to doctors
because he fears that someone will disagree with him, even if he is an
internationally recognized authority.
• An alcoholic and very experienced judge lives in fear of thinking that
what she is doing is not enough.

4
When the layers of lining peel away, the addict is found to have very little
self-esteem. If his distorted self-concept is not corrected, the addictive
thinker will find it difficult or impossible to continue his recovery and may
develop a psychosis, a neurosis, or a substitute addiction.

Addicts' misconceptions of themselves precede the development of chemical

dependency, sometimes by several years. The lack of self-love that comes
with chemical substance use is different: it is not related to a misconception
of reality.

Changing a negative self-image

Susan, a 37-year-old teacher, was admitted for treatment after a suicide

attempt. He had just lost his job due to his alcoholism. She had tried to hide
her alcoholic breath by drinking vanilla extract, but her dysfunction
progressed and led to her being fired.

Susan was very depressed and devalued herself a lot. When I asked her to
name some of her personality qualities, she couldn't find any redeeming
features about herself.

I then pointed out that he had graduated summa cum laude and had won
the Phi Beta Kappa award. “At least you could have told me,” I told him,
“that you are intellectually brilliant. After all, those awards are not given to
stupid people.”

Susan shook her head sadly. “When I was told I had won the Phi Beta Kappa
award, I knew they had made a mistake.”

Changing the negative self-image, the little self-love that precedes chemical
substance use, requires that the addict come to admit that he is an
adequate person. It is an important challenge for those whose life is in
ruins. And we must remember that not only the lack of self-esteem of this
“in ruins” person needs to be corrected, but also that of the “pre-in ruins”
individual. Many addicts seek escape through chemical substances because
they feel they cannot overcome their problems. They must learn that they
have healthy adaptive capacities. The following story shows how, deep
down, the ability to face conflict is already present.

• Be aware of what is already there.

Once, when I was preparing my monthly payments, I was very upset to

discover that I didn't have enough money in my checking account. I racked

4
my brain to figure out where my money had gone, but to no avail. I was left
with the following options: 1) apply for a loan or 2) allow myself not to pay
the bills that month. Neither option was pleasant, but I preferred the
second.

About ten days later my statement arrived and I was pleasantly surprised to
find that I had more money than I thought. I had simply forgotten to make
a deposit. There was no reason for him to have been so upset or to ask for a
loan.

My problem was that although I had the funds to pay my bills, I didn't know
it. My perception of reality was incorrect. I had to be aware of not needing a
loan.

Likewise, the addictive thinker needs to become aware of what he already

has. You will invariably have the ability to handle conflict, as soon as you
realize that you have the skills it requires.

How do we convince people with low self-esteem that they are valuable? We
must begin by having the conviction that they are. If we value them as
valuable human beings, we can safely assume that we will convey our
feelings to them. Empty compliments and simple praise are worthless, but
we must always be alert to identify the positive traits of their past and
present, and give them reasons to be proud of themselves. In general,
people are quite adept at pointing out the flaws in others. When dealing with
addicts, we must do just the opposite.

With addicts it is very difficult to overcome their erroneous conception of

reality. The one who is now, say, 42 years old may have doubted himself
since he was 3 years old. It will take a lot of time and effort to change that
misconception. Let us remember: for the addict this false conception is
reality.

The rule and/or

Addictive thinking is also often characterized by a rigidity of thinking, what

we can call the “and/or rule.” The addict may think only in extremes and
have a hard time understanding that flexibility is needed to solve problems.

For example, your recently recovered husband may not know whether he
should decide to divorce or stay with his wife. You could try a temporary
separation while you work on your sobriety and your wife receives
counseling, but this alternative will likely never occur to you.

This lack of flexibility or considering alternatives causes a lot of frustration,

4
because most people are not comfortable with extreme choices. It has not
been able to be defined because the addictive thinker cannot think of other
options or intermediate possibilities between the extremes.

All in all, the addict's logic does not appear to be flawed. If you only had two
choices, both inadequate, your frustration would be justified. It could fool us
if we were not aware of the addictive thinking and would share its
frustration when conflicts arise. Being alert to this should allow us to help
the addict find appropriate solutions.

4
Chapter 8

hypersensitivity

To better understand the attitudes and reactions of the addict, it is important

to know where the person comes from. We can understand a person's
extremely strange reactions to certain experiences only if we know the
conditions surrounding that experience.

If we were to see someone react with anger to what seems like barely
noticeable contact, say, someone rubbing in an elevator, perhaps we could
ask ourselves, What's wrong with this person ? Who we would think has a
tolerance very limited. But most likely we will consider your reaction to be
unjustified.

While a tan is apparent to all who can see, people's emotional sensitivities
are not. Therefore, we may not understand an intense reaction if we are
unaware of the person's unique sensitivities.

I have often wondered why some people turn to alcohol or other drugs to
feel better and others don't. Genetic and physiological differences between
people play an important role in the development of addictions. But they are
certainly not the whole answer.

A comfort for feelings of grief and discomfort

Although many people take alcohol and other drugs to get excited, many
others turn to chemicals just to feel normal. For these chemical dependents,
alcohol and other drugs are emotional anesthetics, as they seek solace for
their feelings of distress and discomfort.

Naturally, almost everyone's life is interrupted by a multitude of stressful

circumstances. But most people do not use alcohol or other drugs to cope
with their afflictions.

Some people seem to have greater sensitivity to stress, so they experience

emotional distress more acutely than others. Many addicts are emotionally
hypersensitive and perhaps have more intense emotions than non-addicts.
Those who depend on chemicals often appear almost inordinately sensitive,
with emotions of extreme intensity. When they love, they do it with
intensity, just like when they hate.

The emotional sensitivity of the addict may be similar to the hypersensitive

skin of a sunburn victim. The stimulus that may not cause emotional pain in
the non-addict will cause great distress in the addict.

4
Many addicts are lonely. They usually appear to be antisocial and enjoy their
solitude, but that is not necessarily true. Human beings by nature crave
company. The solitary does not really enjoy isolation, but it frightens him
less than company. Living with people exposes the addict to rejection, which
is devastating for him. He often anticipates rejection, when anyone else
wouldn't even think about it.

Ironically, the anticipation of rejection can be a torment of suspense, which

becomes so intolerable that the addict becomes offensive and provocative,
giving rise to rejection to get rid of the suspense. At other times, addicts try
to avoid rejection by clinging and being possessive. Thus, social isolation,
offensive behavior and fanatical jealousy are often observed in addicts.

I already mentioned that addictive and distorted logic is not always a

consequence of chemical use, but it often precedes it. The same applies to
emotional hypersensitivity.

• Didn't belong to all of you

After 19 years in recovery, one man said in an AA talk: “When I was about
nine years old I began to feel different from everyone else. I can't say why,
but that's how it was. If I walked into a room full of people, I felt like I didn't
belong with all those people, and I didn't feel good. It just wasn't my place.
Years later, when I had my first drink, I suddenly felt like the world
harmonized with me. I belonged.”

This example vividly illustrates the intense feelings of being different that
most addicts experience before using their first drug.

Sunburn can be very sensitive. Although someone else's touch causes acute
pain, there is usually no intention of harm in that touch. However,
hypersensitive addicts often ignore their excessive emotional sensitivity, so
they perceive hostile intent in innocent actions or comments and may react
accordingly.

When we observe a person's reactions based on addictive logic, let us

remember the example of someone who suffers from a sunburn. It can help
us understand better.

Chapter 9

morbid expectations

Often addictive thinkers, for no logical reason, feel apprehensive,

4
anticipating disasters. Good and bad things happen in this world. Most
people go through both. Addicts are not the only ones who worry and
anticipate negative events, but they tend to do so more frequently than
others.

Some people are optimistic. When they see a pile of manure, they look for a
horse. Others are pessimistic. When they see a beautiful cover of attractive
dishes, they worry that they are poisoned. It is not always easy to discover
why people develop such opposite attitudes.

Many addicts are unable to see the good in good things. Addictive thinkers
seem to carry a morbid feeling that they are out of luck. On the one hand,
they fear that everything that seems to work well will fail in the long run.
Some present the norm of reaching the threshold of success and then
sabotage themselves.

Feelings of impending doom

Tom, 32, had never managed to go more than three months abstaining.
However, during his last rehabilitation, he seemed to have crossed the
threshold. He was already approaching his first anniversary of sobriety, and
three days before that important date he was admitted for detox.

Tom cried as he said, “You have to believe me. I don't enjoy drinking. I
hadn't managed to not drink for more than three months since I was 12, and
now it was almost a year. I got promoted at my job, and for the first time in
years, my wife told me she loved me.

“I knew it was too good to last. I knew something terrible was about to
happen. Every time the phone rang, I thought it was to tell me that my little
daughter had been hit by a car. “I drank to get rid of that terrible feeling.”

It is important to understand the morbid expectations of addictive thinking.

Family and therapists may be excited by the recovering person's success in
employment and apparent happiness. There may be no danger signs that
indicate that beneath that superficial happiness the person in recovery is
thinking: I won't make it . Sometimes this insistent anticipation becomes so
intolerable that the addict comes to think Oh, screw it, I might as well
relapse , and then precipitates failure.

If the person in recovery resorted to normal logic, it would be reasonable to

reassure him or her that everything is fine and that there is no reason to
expect a sudden upheaval. But if you continue to operate based on addictive
logic (which doesn't go away immediately with abstinence), reasonable
arguments will have no effect. At the beginning of his recovery, the addict
may seem pleasant when these issues are analyzed from a logical point of
4
view, but another system of thought is operating inside.

When we analyze methods of helping the addicted person we will address

this problem. For now let's just be aware that addicts often feel like they are
walking under a black cloud of impending misfortune.

4
Chapter 10

Manipulation of others

Addictive thinking can occur before the consumption of alcohol and other
drugs. But there is one characteristic that seems to be caused by chemical
addiction: manipulation.

Nonaddicts are sometimes manipulative, and addicts may have manipulated

others before they began drinking or using other drugs. But with the
consumption of alcohol and drugs the problem increases. People are forced
to lie, cover up and manipulate. Addicts develop a mastery of manipulation
and, over time, it becomes a deeply ingrained character trait.

Manipulation may begin as a defensive maneuver to explain alcohol or drug

use, to cover up problems, or to create situations that will facilitate drinking
or drug addiction. But sooner or later he acquires an independent life. The
addict manipulates and lies for the sake of it, even if he gets nothing from it.
Manipulation and lies, instead of being a means, become ends in
themselves.

Avoid scam

During his drinking days Phil would often arrive home at dawn or disappear
for several days. After leaving rehab treatment, he frequently attended
AA/NA meetings. One night, after a meeting, he and several friends went to
an all-night coffee shop where they continued a mini-reunion until after
midnight.

Phil's wife was terrified when she didn't see him come home at 10:30 pm, as
expected, and imagined the worst. When he finally arrived, at the door she
asked him: “Why didn't you call me to tell me you would be arriving later?”
“I called,” Phil answered, “but no one answered.”

His wife knew the phone hadn't rung and doubted his story of a mini-
meeting at a coffee shop. She was only reassured when Phil's counselor
confirmed the story.
I discussed the incident with Phil, who said, “I don't know why I told you I
called. “I knew it was a lie, but it seemed natural to do it.”

I often warn people entering treatment that they have to be careful not to
shortchange themselves. You may gain a temporary advantage by blaming
others, but it is a useless triumph to deceive yourself. The winner is also the
defeated.

4
Early in recovery some addicts report having glimpses of insight. They are
suddenly struck by how blind they have been to their addiction, and how
selfish and inconsiderate they have been.

You may think: Surely I am not stupid enough to relapse into my destructive
behavior now that I am aware of it.

Having had this awareness of the truth, they may choose to stop treatment
because “they no longer need it.” Or, if they continue in it, they can become
“therapists” towards other patients, helping them achieve the same
awareness.

It's nonsense! Years of addictive thinking and behavior don't vanish

overnight. Despite protests of sincerity by addicts, they are manipulating.
The tragedy is that they fool themselves into believing that they achieved an
instant recovery.

The unsuspecting therapist can fall into the addict's game. How wonderful
not to have to laboriously break through the mountain of denials as with
other patients! What a relief to have someone who can soon start working
on the important issues in your recovery! Here is someone who is willing to
take a Fourth Step (taking a moral inventory) in the second week of
treatment, and a Fifth Step (sharing his or her life story with another
person) the next day!

It is a person who takes a high-speed elevator instead of proceeding through

the Twelve Steps. It is necessary for the therapist to be prepared. It is mere
manipulation. It is very likely that, on the way home, the person will stop at
the nearest bar.

Often the shortcut is the quickest way to get to a place you weren't going to.
Why would anyone take that shortcut? Because unlike normal thinking, in
which people take shortcuts to reach a goal faster, in addictive thinking the
shortcut is the goal. It doesn't take you anywhere in particular.

As with other aspects of addictive thinking, the addict's shortcuts and

manipulations do not seem obviously absurd, and it is easy to fall into their
game. Furthermore, these manipulations do not disappear immediately with
abstinence from chemicals. It takes a long time and a lot of work before the
recovering addict can overcome his or her manipulative behavior.

Chapter 11

Guilt and shame

It is often thought that addicts are burdened with guilt. Of course, when we

4
hear the addict express remorse, we sense how deeply guilty he feels.

Addicts may feel genuine remorse, but they often feel not guilt but shame.
The difference between the two is enormous.

The difference between guilt and shame

The main distinction between guilt and shame is this:

• The guilty person says, “I feel guilty about something I did.”

• The person full of shame says: “I am ashamed of what I am.”

Why is the distinction so important? Because people can apologize, make

amends, make amends, and ask for forgiveness for what they did , but they
will do pathetically little about who they are . In the Middle Ages, alchemists
spent their working lives trying in vain to turn lead into gold. The person
who feels shame does not even try, since he thinks: I cannot change my
essence. If I am made of inferior material; There is no reason for me to try
to change. It would be an ineffective act .

Fault can lead to corrective action. Shame leads to resignation and

hopelessness.

Deep analysis of addicted people often reveals very little self-love and deep-
seated feelings of inferiority.

How shame develops

It is not always possible to discover where feelings of shame come from,

since it can be the result of many things: the book Letting go of shame by
Ronald and Patricia Potter-Efron points out the genetic and biochemical
constitution, culture, family, relationships. shameful thoughts and behaviors
that involve shame of oneself as sources of shame . 1 But another important
factor may be the way in which human beings come into the world: they are
helpless and will be dependent much longer than other living beings. Animal
cubs begin to run around a few days after they are born, and weeks later
many are already looking for their own food. Humans would die without
adult care during the first years of their lives. And although they are
physically self-sufficient, some children remain economically dependent on
their parents until the third decade of their lives. Depending on others does
not promote self-esteem. Helplessness and dependence can generate
feelings of inferiority.

A parental effort based on knowledge is required to help children develop

their self-esteem. Those who are too protective or do too much for their

5
children will not allow them to develop a sense of mastery. Those who
demand things from their children that they are not yet capable of fulfilling
can cause them to feel inadequate. Ideal parental and environmental
circumstances are rare; For this reason, many people grow up with
uncertain self-esteem.

Why addicts feel shame

The feeling of little self-love or shame in addicts is usually more serious. The
circumstances that usually cause feelings of guilt in emotionally healthy
people cause feelings of guilt in addicts like a kind of short circuit. Suppose
you turn on the air conditioner and the lights come on, or you turn on the
dishwasher and the garbage disposal comes on. It is obvious that the wires
are crossed. This is what happens with addicts. What should produce guilt
causes shame.

Because addictive behavior often results in inappropriate, irresponsible, and

even immoral acts, there are many reasons why the addict should feel guilt,
but what he or she will actually experience is deep shame.

Shame is not only fruitless but also counterproductive. Suppose you have a
car that runs well, but a part becomes defective. You will replace it and your
car will run well again. However, if you discovered that your car was a
clunker and every time you fixed something, something else broke down,
you might throw your hands up in exasperation. You will conclude,
justifiably, that there is no point in fixing the car.

The same thing happens with addictive thinking. The deep shame that the
addict feels results in him thinking that it is useless to change his way of
being. The guilt may have been overcome, but the amendment cannot
change the defective material that addicts feel they are made of.

Remorse in the addict is as common as daisies in spring. The addict's tears

can be heartbreaking. Anyone who listens to it and does not know the
addictive thought will swear that that person will never drink a drop of
alcohol or use a drug again.

Ed, a 44-year-old electrician, came to the rehab center from out of town
because he feared his alcoholism would come to light if he sought treatment
locally.

When he was admitted, Ed expressed great remorse. “How can I have

caused so much misfortune to those I love most? How could I have done this
to my family? I love them and I have treated them badly. "I'd rather kill
myself than drink again."

5
Later that night, the nurse called me to tell me that Ed was acting strange.
At my suggestion he checked his room and found an almost empty bottle of
vodka.

Ed's remorse was not hypocritical, but it represented shame rather than
guilt. He felt that no matter what he did, he would always be an inadequate
husband and father, and that being sober wouldn't make him any better.
The pain and damage he had inflicted on his family required comfort, and
since he felt that nothing would change whether he drank or not, he
returned to the vodka he had smuggled into the facility where he planned to
stay sober. That is addictive thinking.

Psychologist and addiction specialist Rokelle Lerner says the Twelve Step
program swaps shame for guilt. The program helps addicts understand that
they suffer from a disease. Although they are told that they are completely
responsible for their behavior, they are not to blame for having that illness.
However, they are expected to follow the treatment program, remain
completely abstinent, and make important changes in their character traits.

As addicts find acceptance among other people in recovery and discover that
those who have gone through the program and made substantial changes in
their character are respected and loved, they begin to realize that they too
are basically good people. . What is needed is abstinence and a general
personality review. This is how shame is changed to guilt. When a personal
inventory is made, when it is shared with someone else and amendments
begin to be made, the guilt is reduced. Addicts who work with these steps
become constructive people and begin to receive the love and respect of
their family and community.

5
54
Chapter 12

Omnipotence and impotence

A feature of addictive thinking is the illusion that you are in control. To

some degree, a delusion of omnipotence (the feeling of having unlimited
power) is present in every addict and codependent. Most alcohol or drug
addicts eventually lose control of the chemical, even though they continue
to insist that they can control their use. Although their life has become very
unmanageable, they resolutely claim that they control it. This inability to
admit the loss of control despite reality is characteristic of addictive
thinking. It is a delusion of omnipotence and must be overcome before the
recovering person can admit and accept their helplessness, a necessary
first step to recovery.

Illusions of control

Alcoholics may have many excuses for why Alcoholics Anonymous is not for
them. They object: “I have attended AA meetings. They talk about God all
the time and I'm an atheist. I do not believe in God; “AA doesn’t work for
me.”

However, the problem is not that the addict does not believe in God. The
majority deep down believe that it exists. The problem is that they think
they are God.

There are many things over which a person has no control or is powerless.
This in no way constitutes a weakness of character. Hay fever sufferers
cannot control their sneezing. They are relieved by proper medical
treatment, but without it, they are powerless against their sneezing.
However, not even the worst bout of sneezing makes sufferers feel like
second-class citizens. Insisting that they control their sneezing, when in
fact they can't, would amount to delusion.

People who think that addiction is a moral deficiency rather than a disease
see the inability to control drinking or drug use as a weakness of character.
When people defensively deny their powerlessness over chemicals and
insist that they are still in control, they are actually delusional. Any addict
who says “I can't be powerless” is manifesting a delusion of omnipotence.

AA simply says that because addicts have no control over their chemical
use, they should look elsewhere for curbs. At 55
That “other part” that constitutes the Higher Power does not believe in a
religious Higher Power can find other external sources of control. For
example, many consider their AA group to be a Higher Power.

To accept a Higher Power, whether religious or otherwise, addicts must

realize that they are not in control of some aspects of their life. In fact,
that's what hay fever sufferers do when they take medication.

Delusions of grandeur

In addition to the delusion of omnipotence, addicts have an attitude or

fantasy of grandiosity, another characteristic of addictive thinking.
Grandiosity in addictive thinking exists in absolute defiance of reality, as the
following story illustrates.

• THE CEO without keys

Mel, once a successful business executive, suffered the all-too-common loss

of family, business and home. Sitting at the bar, he cried into his beer,
fantasizing that at any moment someone would walk in and offer him the
position of chief executive officer of a major corporation.

Ultimately, this man entered rehabilitation and, throughout his stay,

manifested excesses of grandiosity. Sure that he was better than anyone
else, he looked everyone up and down. He was against the recommendation
that he go to an intermediate facility after treatment, even though he had
nowhere else to go. Reluctantly and with an air of superiority he went to the
intermediate center. Despite the reality, he still believed he was still a
successful executive.

The moment of truth came six weeks after his arrival at the intermediate
center. Mel remembers it this way: “I was standing outside, hands in my
pockets. When I shook the contents of my right pocket, I discovered that I
had twelve pennies and a trouser button. Then I looked in my left pocket,
and suddenly realized I didn't have any keys. I didn't own anything I needed
a carry for! No apartment, no office, no car.” It wasn't until this moment
that he accepted reality.

Grandiosity and the delusion of omnipotence often occur at the same time.
Both can be desperate efforts not to become aware of helplessness.

After all, human beings are powerless in various ways. Many things in life
(the weather, other people, the price of milk) are beyond our control. Many
parts of us, both physical and psychological too.

5
People who feel good about themselves do not usually perceive a threat in
becoming aware of their helplessness. But when they lack self-esteem,
when they feel inadequate, incompetent, or worthless, they must protect
themselves against what they see as another humiliation: their inability to
control chemicals. Building self-esteem can help recovering addicts
overcome this subtle but strong threat.

5
58
Chapter 13

Admit mistakes

Many people who depend on chemicals have great difficulty admitting that
they are wrong. They may disagree with this information, claiming that they
would have no difficulty accepting that they are wrong if it were to happen.

One of the characteristics of addictive thinking is the person's perception of

always being right. Many of the other common features of addictive thinking
(denial, projection, rationalization, omnipotence) come into play to reinforce
the insistence that the person has always been right.

Being a human being means making mistakes

The way addicts explain and defend their behavior may seem perfectly
logical. At first each explanation will sound reasonable. However, as we take
into account the entire litany of incidents and explanations, we must ask
ourselves: “If the addict truly had no errors, why did things end up being
such a horrible mess?” After re-examining the addict's story, the addictive
thinking becomes evident. Often their seemingly logical explanations are
just clever rationalizations and projections.

The person in recovery must learn not only that it is okay to be human, but
also that the greatest achievement is to be a good human being. But you
have to be human first, which means mistakes will be made at some point.

One of the most effective ways to accept the phrase “Making a mistake is
not the end of the world” is to see that other people, especially those the
addict respects, also make mistakes. Anyone can serve as a model. I will
give you an example from my own life.

• A fatal meeting

I once had a young psychiatric patient who was hospitalized for a long
period. As he recovered he was given passes to leave the hospital for
several hours.

One Friday the patient told me that he wanted to attend a class meeting the
next day and join his classmates before they left for the four corners of the
world. I saw no reason to deny permission. Before leaving him, the patient
told me: “Please remember to write the pass on the board, otherwise the

5
nurses will not let me leave.” I immediately went to the nurses' station and
signed the permit.

When I met with the patient the following Monday, he greeted me with an
outburst of crying and anger. “Why did you lie to me? Why did you tell me I
could go and then not let me go? “Some of my classmates are leaving town
and I will never see them again!”

I told the patient that I didn't know what I was talking about, because I had
left the leave as promised.

“So your nurses lied to me,” he shouted. “They told me that the permit was
not on the table.”

I then examined the patient's chart and, to my great surprise, the order was
not there. What happened to the permit I remembered writing?

The mystery was solved when I discovered the permission on another

patient's chart . I did write the permission that I promised, but the nurses
were right to tell him that there was no authorization on his chart, because
in fact there was none. It was in someone else's.

I grabbed both charts and took them to the patient's room to show him
what happened. I apologized for my mistake that had deprived him of
seeing his classmates and told him that nothing could correct that mistake.
The only thing I could do was apologize.

Something strange happened: after that incident there was a significant and
progressive improvement in the patient's condition. I later discovered that
one of the patient's main obsessions was perfectionism. Making a mistake
was taboo.

But lo and behold, his doctor made a mistake. And it wasn't just any
mistake. A pass written on the wrong chart could have resulted in a patient
at high risk of suicide being allowed to leave the hospital. A doctor's mistake
can be fatal, and the doctor accepted it. Furthermore, he continued to work
as a doctor, the nurses still respected him, and his orders were still obeyed,
even if he had made a mistake! Therefore, mistakes do not demolish a
person. Perhaps in him, the patient did not have to be eternally on guard to
avoid mistakes.

Quick recognition of errors

When I first became familiar with the Twelve Step program, I loved step
Ten: “And when you make a mistake, admit it quickly.” Like many other

6
people, I used to defend my mistakes. My ego wouldn't allow me to accept
that I was wrong.

Some people will create a violent battle to prove that they were right, and
only when their arguments are refuted do they reluctantly accept that they
were wrong. This attitude can have disastrous consequences. A much
simpler and more effective method of conserving our energy is to simply
admit that we were wrong and do so quickly without futile attempts to
defend a mistake.

What a relief it has been to free myself from that burden! I'm not immune to
making mistakes, and when I admit my humanity, people always
understand. Only when I insist on being right do I provoke his wrath.

When you discard the delusion of omnipotence, which is part of addictive

thinking, you are able to admit your own mistakes.

6
62
Chapter 14

The wrath

Anger is a powerful and important emotion. Its management may well be

the most difficult psychological problem of our time. While the addiction
literature consists of some good books on anger, we still need to understand
more about its true essence.

The three phases of anger

Anger can be subdivided into three phases. The first is the feeling of anger
when provoked. If someone offends me or hurts me, I get angry. It is
essentially an instinctive or reflex emotion, over which we have little control.

Phase 2 is the reaction to anger. When I am offended, I can bite my lip and
say nothing, make a comment, curse, push, or hit hard. Although I may not
have control over the feeling of anger, I have a lot of control over my
reaction.

Phase 3 is anger retention . Granted that I have no control over the initial
feeling when it is provoked, but how long do I retain that feeling? Minutes?
One month? Fifteen years?

For convenience, let's refer to phase 1 as “anger,” phase 2 as “rage,” and

phase 3 as “resentment.”

Very often anger quickly provokes rage. Addicts seem to have particular
difficulty reacting to anger, even when they are not under the influence of a
chemical substance. Of course, when these substances have weakened self-
control, the rage reaction can be very serious. Is there a way to decrease
the intensity of phase 1 anger?

All emotions have a function. Although devout fanatics and free thinkers
disagree on many points, they agree that everything in nature has a
function. For example, the wide range of colors in the animal world, from
multicolored birds to the splendor of aquatic life, all serve a purpose. Colors
allow creatures to harmonize with their environment, it serves as
camouflage that protects them. Or, bright colors will attract a partner.

We can ask, “What is the function of anger in nature?” It does not seem
necessary for survival. If I were attacked, I might defend myself adequately
without getting angry. Fear can exist without anger and initiate the flight or
confrontation reaction necessary for survival. Even without anger I can

6
remember who attacked me and be alert for future attacks.

Anger is not the same as hate. We can be very angry with someone we love,
and we can hate someone without being angry with them. So what is the
purpose of anger?

I believe that the natural purpose of anger is to preserve social order. Our
feelings of outrage when someone is assaulted, beaten, or harmed lead us
to act to prevent such events. Without anger we can defend ourselves
adequately, but we will not make the effort to protect another. Anger is an
emotion evoked by injustice towards ourselves and others.

But what is unfair? It depends on the person's thoughts, values and beliefs.
People differ greatly about what is fair or unfair in this world. Therefore,
some get angry much faster than others.

Addicts and intense anger

Many addicts seem to think that the world is unfair to them. They feel
cheated by everyone and are angry at everyone, even God. Because I? Why
are you doing this to me?

The addict's sensitivity to any perceived injustice is much like that of a

person with a migraine who feels excruciating pain when faced with bright
colors or loud noises. Addicts often feel offended, belittled, and humiliated
by everyone else. Their family doesn't love them enough, their friends don't
value their company enough, they don't get the recognition they deserve
from their bosses for their hard work, and so on. How much is enough? Due
to the hypersensitivity and insatiable needs of some people, not even infinity
is enough.

So, the problem for addictive weighers is not only in their angry reaction,
but also in the distortion of their perceptions. For example, a man comes
home from work and announces “Hello, everyone, I'm here!” The wife and
children, absorbed in an exciting television program, answer him distractedly
and do not jump to welcome him. To this man, their lack of response
indicates how little they value him. What do you think? I break my back all
day to

maintain them properly and here's how they appreciate me . For him this
lack of appreciation is a great injustice and he feels intense anger. Or, when
your wife pays attention to her friends, you may feel that she doesn't value
you enough and get angry at her for “humiliating” you.

Thus, we can understand, although not excuse, the reactions of the addict

6
who feels like a victim of “injustice.” All cultures accept that perpetrators of
injustice must be punished. This is what the addict does when he expresses
his anger, punishes the other for an “injustice.” Although anger
management techniques are important, overcoming the distorted thinking
that generates anger would obviously be more helpful.

How recovery helps

In recovery the addict's perceptions may undergo a gradual change. With

the help of counseling and working the Twelve Step program, addicts
become less selfish and less exquisitely sensitive. As sobriety progresses,
self-love improves and they no longer interpret everything as personal,
belittling. They begin to accept responsibility for their actions and stop
blaming others. The things that used to provoke their anger and rage no
longer affect them.

This is very different from repressing anger. This occurs when there has
been a real injustice, and when the person who has a legitimate reason to
feel anger does not become angry at all. This is as abnormal as not feeling
pain when stung by a sharp object. Some people have learned, in one way
or another, not to feel anger. This repression is not a control technique by
which the person recognizes anger and decides to handle it in a certain way,
such as slowly counting to ten. Repression is a mechanism slowly up to ten.
Repression is an unconscious psychological mechanism that prevents a
person from becoming aware of an unacceptable emotion or idea. At an
unconscious level, anger can be felt, but it does not manifest in the person's
consciousness.

• Feeling anger would be sinful

A good example of repressed anger is a patient I treated during chronic
depression. Because she was a nun with strict religious training, she had
developed the idea that feeling anger was sinful.

Getting to my office took him an hour and a half, taking two buses. He didn't
want to be late for his appointment, but the bus schedule was such that he
arrived an hour early. I always tried to hurry, and she always waited
patiently.

6
On one occasion I had to go out of town unexpectedly, and I forgot to tell
my secretary to call the sister and cancel the appointment. I later found out
that after waiting much longer than her appointment time, the sister asked
the cause of the delay and was informed that I was not in the office that
day.

When I returned, I called his sister, apologized and gave her another
appointment. When he arrived at the office, I once again expressed my
regret that he had not been notified of the cancellation of his appointment in
advance.

“I'm sure when he found out I was gone, he was very angry,” I told him.

The sister smiled. "No. Why should I get angry?”

“Because she made the trip for an hour and a half and then waited two more
hours, she lost a lot of time because I forgot to call her. "There's no way he
wasn't angry."

The sister continued smiling sweetly. “I understand that those things can
happen. You are a very busy man. There is no reason to be angry.”

“I apologize,” I replied. “I appreciate your thoughtfulness and willingness to

overlook my mistake, but don't tell me you weren't offended.”

With the same smiling and sweet expression, the sister said, “No, why
should I have been offended?”

I'm sure the sister was telling the truth when she said she wasn't offended
or angry. The feeling is a sensation and his sensory system did not register
anger. That's how they trained him.

I consider that to be wrong. It's like discovering numerous burn marks on

your hands and not remembering being burned. If your nervous system is
intact, the burn should cause pain. If not, then something is wrong.

Voluntarily controlling reactions to anger is not wrong; It is certainly not

necessary to throw things, hit the wall, or shout obscenities. In fact, those
who say that a person should vent his anger by yelling or even hitting his
punching bag have little clinical basis for making that recommendation. It is
perfectly healthy to decide not to express anger. But not feeling anger is
very different: it indicates unconscious denial and repression, and can cause
problems. It is not surprising that 66
The sister was chronically depressed and suffered from high blood pressure
and ulcers. Anger that is denied and repressed can result in depression and
various physical illnesses.

Men can and should cry

When they have been hurt, many men become angry rather than offended.
It seems like they should be crying, but instead they explode with anger.
Maybe it's because they can't allow themselves the normal reaction of
crying. Because? Because they believe that “men don't cry.” Many cultures
equate masculinity with stoicism. For example, newspapers will report that
in one tragic incident, a man cried “without any shame.” Why should a man
be ashamed of crying when he is hurt?

When deprived of the outlet of crying, the male psyche may seek another
outlet that often results in rage. In fact, being deprived of the ability to cry
when we are hurt is unfair, and perhaps that injustice turns pain into anger
and rage.

When they enter recovery, some men cry for the first time since childhood.
They learn that it is right to feel; and, thus, an important source of anger is
eliminated.

Get rid of resentments

Phase 3, resentment, is handled particularly well in the Twelve Step

program. People in recovery are told, “If you hold on to resentments, you
will drink again.” People in meetings unload the grudges they have been
harboring. In the process they often become aware that they were
misinterpreting the other's actions and that there was really no reason for
animosity. Sometimes we may realize that what we thought was harmful to
us was actually a blessing in disguise, or we may then discover the common
sense of the idea that nursing a resentment is allowing someone we dislike
to live in our head rent-free. When we share perceptions and feelings with
others and take an objective perspective, resentments diminish and can be
eliminated completely. The recovery program recognizes the destructive
nature of anger and resentments.

People are not able to consider that being an addict is very desirable. But if
we realize that the gains of recovery in a Twelve Step program are not
easily achieved any other way, being an addict may not be the curse we
thought it was.

6
Chapter 15

The seclusion wall

Because of their emotional sensitivity, poor self-image, and addicts' morbid

expectations, it is understandable that they may try to protect themselves
from anticipated discomfort. They always think that they are going to be
despised, criticized or rejected. To defend their psyche from the pain it
causes, many addicts build a protective wall between themselves and the
rest of the world.

Many describe themselves as loners. In fact, the only way they can interact
with others without discomfort is when they have anesthetized themselves
with chemicals. When not under that influence they may passively isolate
themselves or keep others at arm's length by being self-righteous,
hypercritical, or obnoxious.

The degree of porcupine

Although isolation spares addicts the anticipated discomfort inherent in

socializing with others, it also deprives them of the company they crave. We
can say that the addict is in a dilemma due to a high “porcupine degree”,
since he is just like him, who wants to be in contact with other porcupines,
but fears that their spines will sting him. Getting too close can be painful,
but staying too far away is loneliness. The porcupine must therefore
carefully calculate how close to get some company while avoiding being
hurt.

Although the defensive walls addicts build protect them from the “barbs” of
the outside world, they also seclude them, frustrating the intense human
need for friendship. The wall erected as protection then becomes a prison.

Much of the addict's behavior reinforces his isolation. Their lying,

disappointing, manipulative, resentful, and judgmental behavior causes
everyone to shun them. Anger, selfishness, lack of consideration and
irresponsibility make their company undesirable. Although they act in a way
that causes them to be avoided, they resent the isolation in which they find
themselves. Loneliness makes matters worse, as it is another reinforcer of
their poor self-image, and addicts try to avoid it by increasing their
consumption of anesthetic chemicals, perpetuating the vicious cycle.

6
 Casting out family and friends

The isolation of addicts from outside social contacts is bad enough, but the
problem is compounded when they create a defensive wall at home. They
often find that their physical isolation is not easily achieved and then
behavioral tactics become their only available defense. This often results in
violent behavior toward those they love most: spouse, children, parents,
and siblings.

At first, the addict's expectations of rejection are based on a bad perception

and become a self-fulfilling prophecy. Because they think so poorly of
themselves, they believe that others will reject them. As defensive
maneuvers increase, anticipated rejection ceases to be a fantasy; people
actually avoid them, which in turn reinforces their poor self-image.

If family and friends try to reach their loved one by pushing through or
around the defensive wall, the addict may be overcome with terror and
reinforce the wall. For example, a woman sought treatment for her drug
addiction because she had already damaged all the veins in her body. Her
appearance when she was admitted to the rehabilitation center was horrible.
When she seemed to be much healthier, three weeks later, I pointed out to
her: “Celia, you are starting to look good.” My comment was met with a
hateful imprecation.

The next day Celia came to my office to apologize for her offensive
comment. “You don't understand,” he told me. “You told me something
positive. "I don't know how to handle it." The initial treatment had at least
made her aware of her provocative behavior, but it took months before she
could accept a positive statement without discomfort. Without the treatment
he would have continued rejecting everyone who approached him.

The value of support groups

We can now understand both the need and effectiveness of anonymous

communities. Associating with others who share a problem is much less
threatening than having to deal with society as a whole. In support groups,
addicts do not have to fear rejection. They discover that not only are there
many respectable people who were at one time active addicts like them, but
also that many share their emotions and some of their characteristic traits.
They begin to better understand the defensive nature of addictive behaviors
when they observe them in others and learn to identify them in themselves.
in the safe confines of 70 meetings
Comrades, addicts can begin to dismantle their defensive wall. At first, they
tear down the part of the wall that kept their family and friends at a
distance. Gradually they begin to accept society as a whole.

The characteristics of addictive thinking are the tools that the addict uses
both to raise the defensive wall and to maintain it. With adequate
treatment, the vicious circle is broken and, as bad perceptions are corrected
during recovery, the entire wall will be eliminated.

7
72
Chapter 16

Managing feelings

Addicts can have big problems with their feelings: negative ones, such as
anger, envy, guilt, and hatred, are not the only ones that are difficult to deal
with. Although some positive feelings (for example, love, admiration, and
pride) may be disconcerting to the addict, they will sometimes be even more
disconcerting when he or she has stopped using chemicals.

Emotions are motivating forces; It is what drives us, just like the engine of a
car.

Let's think about a situation in which the driver is afraid of driving a car.
Maybe you're behind the wheel of a race car that generates so much power
and high speed that you can't maintain control; You either think the brakes
are failing or the steering mechanism is malfunctioning. Whatever the
reason, you will be very reluctant to get behind the wheel, for fear of losing
control and having an accident.

When people fear their emotions, two things may be happening:

1. They are so intense that they feel uncontrollable, or

2. You feel that you are unable to handle emotions with normal intensity.
He doubts the reliability of his “brakes” and his “steering mechanism.”

While some chemically dependent people use alcohol or other drugs for
stimulation, others turn to chemicals to feel normal. Mood-altering drugs are
essentially emotional anesthetics: they numb feelings. When people stop
using chemicals, previously dulled emotions will be felt acutely.

The Depression

Depression is one of the most painful feelings that the addict may have
numbed with alcohol or other drugs. It is not surprising that the newly
abstained person may feel depressed. Abstinence unmasks previous feelings
of depression. And the clarity of mind subsequent to abstinence allows the
person to perceive the damage that alcohol and other drugs did to their
family, their work, their economic condition and their physical health.

• The “joy” of a cigarette burn

Emily, a 23-year-old woman, was admitted to the treatment center after
eight years of using alcohol, pain pills, sedatives and amphetamines. The
day after his admission he found me walking down the hallway and asked to

7
spend a moment alone with me. Then he leaned on my shoulder and began
to cry bitterly, “I can't stand it, Doc! I can not stand! It hurts so much. I
have never felt so much pain before. Please help me, doc! Give me
something. “I can’t stand the way I feel!”

When she calmed down I told her about a woman who, in a car accident,
damaged the nerves that transmit sensations from her right arm to the
brain and surgeons tried to repair her nerves. During the weeks of
convalescence, his right arm hung limp, without sensation, lifeless like a bag
of cement. Depressed and discouraged, she thought she would never regain
the use of her right arm.

One day someone dropped a lit cigarette on his right hand and he felt the
pain of the burn. She jumped and shouted excitedly: “I can feel! I can feel!
It hurts me! I can feel!" For anyone else the pain would have been
unpleasant. For that woman, the pain was a joy because it told her that her
abilities were returning.

I told Emily that since I was 15 I had been living like a zombie, anesthetized
with alcohol or other drugs, and unable to feel emotions. True, he hadn't felt
much pain, but he mustn't have experienced many pleasant sensations
either. Now that he was off drugs, he could feel the pain and joy of life
again.

Addicts who are beginning to recover may experience anxiety and panic
when confronted with new feelings they never learned to deal with. They
may believe that to be angry is to feel homicidal, that to love is to absorb
someone, that to hate is to alienate the entire world, and so on. Confronting
those feelings is a formidable challenge.

At the beginning of recovery, some people fear that they will not be able to
control a specific feeling. Not knowing how to isolate or manage said feeling,
they simply close their entire apparatus of sensations.

The emergence of emotions

A newly abstinent addict is now subject to many feelings that were numbed
by the chemicals. The initial reaction can be a kind of “daze”, similar to
turning off the master valve, a feeling of not feeling anything. In those
cases, family members will worry that their loved one has been transformed
into a “zombie.” Other addicts will begin to express themselves in a way that
their family and friends have never seen before, and that may scare them.
Learning to manage emotions takes time, and if family members are
uncomfortable with the behavior of the person entering recovery, they will
consider that it was easier to live with the addict before he or she got sober.
Sometimes this sends subtle signals to the addict that result in relapse.

7
Therefore, it is extremely important for both the addict and family members
to understand that in addiction, feelings were the primary target of the
chemicals and that withdrawal may initially result in chaos or emotional
paralysis. Learning to evaluate and manage feelings is an important goal.
This will take time, it will require a lot of trial and error. The person in
recovery must have patience and those around them will need even more.

7
76
Chapter 17

The flavors and colors of reality

Often, even if he accurately perceives reality, the addict will feel that it is not
good enough. The normal gratifications and pleasures of life are not enough.
Something is missing, and you feel cheated of true pleasures. Other people,
who seem content, must be experiencing the “true,” but somehow the
addictive thinker feels deprived of it. There must be more to life , the addict
thinks.

From gray to pink

Clancy, a popular AA speaker, says it best: “My world was dull and gray. My
family, my job, my home life, my car... everything was gray. I can't stand
anything that's gray. I need color! And alcohol gave color to life.” For the
alcoholic and other addicts, life is like stewed food without seasoning:
tasteless.

A sensory experience is personal and subjective. It is almost impossible to

communicate a sensory experience to another person or quantify it
objectively. If two people try the same dish, hear the same melody, or see
the same sunset, there is no way that one can know exactly what the other
is feeling.

Likewise, when non-addicts try to understand the addict's chemical use, they
may not know how. What the hell is wrong with this person who has a good
home, a good marriage, healthy children and a well-paying job? They
wonder. Why your dissatisfaction? Why do you drink so much? The answers
may not be easy to accept.

• Why does this person drink so much? Alcoholics drink because they
suffer from the disease of alcoholism. They lost control over their
alcohol consumption due to the illness.
• Why the dissatisfaction? The addictive thinker's view of reality is
distorted. Because you are chronically dissatisfied, you don't feel like
you are experiencing what you should be experiencing. Life is not
giving you enough gratification, and alcohol and other chemicals seem
to color it. The grays change to dazzling colors. Now feel what others
must be experiencing. It feels normal.

When a chemical is withdrawn, the addict faces withdrawal symptoms. Once

these pass, the depressions

7
they establish The world looks gray again, devoid of color, interest,
excitement and pleasure. Addicts entering recovery must realize that
abstinence from chemicals will not be enough to turn everything rosy.

How clinical depression and addictive depression differ

If the addict consulted a psychiatrist, his symptoms would seem similar to

those of a depressed person suffering from a major affective (emotional)
disorder:

• Loss of interest in life

• Inability to concentrate
• Feeling of worthlessness
• Low sex drive and
• The feeling that life is not worth living

Not surprisingly, psychiatrists often diagnose the condition as a major mood

disorder or clinical depression, and prescribe antidepressant medications.
For addicts entering recovery and not suffering from clinical depression,
these medications are notoriously ineffective and can threaten sobriety.

Although the symptoms of a recovering addict and a person suffering from

clinical depression may be similar, there are important differences.

A major affective disorder is essentially a biochemical disease. In other

words, something went wrong with neurohormones, the chemicals that
transmit messages between brain cells. Biochemical changes can result from
severe stress on the system or be due to genetic factors. The symptoms of
clinical depression have a fairly well-defined onset. The person enjoyed life,
was active and had interests until a particular moment when things began to
change. Sometimes the change can be related to a physical event, such as
childbirth, menopause, surgery, or a serious virus. At other times it may be
linked to an emotional incident: for example, a financial setback, the death
of a loved one, or, strangely enough, a promotion at work. The important
point is that the change in the person's feelings and attitudes can be traced
back to a starting point, perhaps several weeks or months earlier.

With addiction the “depressive” symptoms do not even appear to have an

approximate onset. In many cases, the person always felt this way, even as
a teenager. Addicts are likely to say they never believed 78
receive fair treatment and that everyone else always had more or better
things. They may have been considered thrill seekers. Very often they will
say that they have felt dissatisfied with life for as long as they can
remember.

This type of depression is not relieved by antidepressant medications. The

only thing they can produce is annoying side effects. Although tricyclic
antidepressants and monoamine oxidase inhibitors (MAOIs) do not work for
characterological depressions like the ones I described, these
antidepressants are not addictive. The danger arises when drugs such as
benzodiazepines (for example, Xanax, Tranxene, Ativan, and Valium) are
used for depression. Often prescribed tranquilizers may actually temporarily
relieve the addict's symptoms of depression, just as alcohol and other
chemicals did, but they carry a high risk of addiction. Inadvertently the
doctor may have substituted one addiction for another.

The addictive thinker may experience chronic dissatisfaction. This may be

due to unrealistic expectations rather than actual deprivation. This person
may require the help of a therapist to clarify reality. The most effective
therapy may be a group experience in which, under the guidance of an
experienced therapist, the addict can begin to identify with others in the
group and observe their distortions. You will become aware that you are also
distorting reality. Observing other people with unrealistic expectations will
help you realize your own unrealistic hopes. Maybe the real world is not all
dazzling colors, but it is not dull and gray either.

Often the addict has blocked an entire system of sensitivity to avoid some
unpleasant feelings. As he is helped to realize this, he begins to understand
that much of his perception of dullness and grayness was due to a sensory
block. As you become more comfortable with feelings and dismantle this
massive defense system, you begin to appreciate some of the color and
excitement that exists in the world.

Nothing prevents the addict from presenting clinical depression. However,

diagnosing clinical depression in a person early in recovery can be very
difficult and will have to be done based on the doctor's evaluation.
Therefore, it is important for the physician to be familiar with both addictive
diseases and clinical depression for appropriate evaluation and judgment.

When both appear

People who only suffer from clinical depression and are not addicted can be

7
treated effectively with antidepressants and psychotherapy. Those who are
addicted and do not have clinical depression can be helped with a recovery
program and counseling. If the person suffers from both addiction and
clinical depression, both treatments will be necessary. Antidepressants are
not a substitute for the recovery program, any more than it is a substitute
for antidepressant medications. Proper use of both can result in overall
recovery.

If an addict is diagnosed with clinical depression and the doctor prescribes

an antidepressant, there should be no hesitation in taking the medication.
Some people in recovery may say that taking a mind-altering drug is a
violation of sobriety. While this may be true of addictive tranquilizers (with
rare exceptions), it is not true of antidepressants or mood stabilizers, such
as lithium, which can be safely taken by the recovering addict.

Some people may have taken antidepressant medications during their active
addiction and found that they did not help them. It may have been due to
interference from alcohol or other drugs. Once abstinence is achieved, the
antidepressant can be effective.

8
Chapter 18

Should we get to the bottom of it?

True addiction recovery means more than just abstinence. It means giving
up the pathological thinking system and adopting a healthy one. Since
addiction involves a distortion of perception, only a few major events can
cause the addict to question the validity of his or her perception. The event
or events that cause this discovery are sometimes called hitting rock
bottom.

The meaning of the background

The term background has been traditionally used and is still widely used in
the field of addiction, so we will retain it. However, it must be clarified.
“Bottom” does not necessarily mean total desocialization, loss of family or
employment; It doesn't imply a complete disaster. It means that something
happened in the addict's life that had enough of an impact for them to want
to change at least part of their lifestyle.

In recent years many businesses have implemented an employee assistance

program (EAP). When an employee appears to have a problem that is
affecting their work performance, they are asked to see a counselor. If the
problem is a chemical dependency, then the employee is taken for further
evaluation and treatment. It may be implicit or explicit that an employee
who refuses to ask for help and continues to perform poorly will be fired. For
many men and women, this has provided a foundation and, as a result, they
entered a treatment program ten or twenty years earlier than they would
have otherwise. Without this background that makes them feel their jobs are
at risk, they could have reached more extreme consequences.

Because of the growing awareness of chemical dependency in adolescents,

most young people who enter treatment have suffered few of the
consequences of advanced addiction. For them, the bottom line is the desire
to stay at home and maintain a relationship with their parents.

As we will see, the variability of what constitutes bottoming can be explained

by the law of human gravity.

The law of human gravity

A law of human behavior that seems as unbreakable as the law of physical

gravity may well be called the “law of human gravity”: the person will
gravitate from a condition that appears to be one of great suffering to a
condition that appears to be one of great suffering. less suffering, and never

8
in the opposite direction. According to this law, it is impossible for a person
to choose to suffer more. Any attempt to reverse the direction of the
election will be as futile as trying to make water flow up a hill.

greater suffering

less suffering

Alcohol and other mind-altering substances offer some degree of relief from
discomfort, regardless of whether it is relief from anxiety, depression,
loneliness, shyness, or just a compulsive urge. Withdrawal, at least initially,
causes suffering, sometimes psychological unrest, and often severe physical
discomfort.

If we try to get addicts to stop using alcohol or other drugs, we are

essentially asking them to choose greater suffering, which is beyond human
capacity. From this analysis, it would seem that we should surprise all
treatment efforts! The treatment can't work! But we know that it works and
that people achieve sobriety. How does it happen?

Achieving sobriety through perception changes

Although the law of human gravity is inviolable, and the direction never
changes, it is possible for people to change their perceptions . They can
learn to see that their chemical use causes greater suffering and that
abstinence implies less suffering.

8
Active addiction Recovery less suffering: chemical
increased substance use
suffering:

abstinence
less suffering: consumption of chemical substances How does this change in
less suffering:
perception occur? All mind-
abstinence
altering chemicals sooner or
later cause some form of uneasiness:

• loss of respect from family

• falls and bruises
• convulsive attacks
• the concern of bad memory
• the threat of imprisonment
• the terror of delusions

When any of these, alone or in combination, reach the critical point, where
the suffering is equal to or greater than any relief the chemical offers, then
the person's perception of what is more or less concern changes.

So this is what happens when you hit rock bottom. The bottom line is
nothing more than a change in perception, in which abstinence is perceived
as less of a concern than chemical substance use . If at any time after
achieving abstinence, even several years later, it becomes a source of
greater concern again, a relapse will occur.

The natural course of addiction is such that you hit rock bottom if no one
interferes. But the people around the addict, with all good intentions, can
eliminate some of the anxieties caused by chemicals. For example, a
collaborator will cover for a colleague who has a hangover. This prevents a
change in perception of greater and lesser concern from occurring and
allows the active addiction to continue. This is why people who prevent the
painful consequences of drug use are called facilitators.

Let us remember that allowing unpleasant natural consequences to occur is

not the same as punishing the consumer. To punish is to inflict pain from the
outside. If, for example, a drinker views marriage as a source of unease, he
or she will separate rather than stop drinking. Only when the alcoholic
discovers that his consumption is what causes his suffering will sobriety
become a solution.

Addicts' perceptions are also modified when they perceive the rewards of
abstinence. When these begin to outweigh those of mind-altering
substances, addicts can change their perceptions of which is the source of

8
greater or lesser concern.

Meeting sober people and seeing that they are happy and productive
demonstrates the rewards of abstinence. Getting a positive response to
sobriety from family, friends, and colleagues is rewarding. Recovering self-
esteem is a reward, and so is keeping a job.

The active addict may recognize that they are all like gratifications and still
feel that they are out of reach. This is where appropriate therapy, with a
realistic and adequate elaboration of self-esteem, can make a difference.
With appropriate help the addict will begin to realize that he or she can
achieve these rewards and perceive that abstinence is a source of less
concern.

People vary greatly in their perceptions of rewards and suffering. The

therapist must discover what each person considers a reward and a
suffering in order to help him or her perceive addiction and withdrawal from
an appropriate perspective. Combining background experiences with realistic
anticipation of the benefits of abstinence will make abstinence possible.

8
Chapter 19

Addictive thinkers and confidence

Treatment professionals and others can use many techniques to gain the
addict's trust; Regardless of the method, the success of the treatment
depends on that trust.

Let's become aware of what we are expecting from the addict. May this
person completely and permanently abstain from the consumption of
chemicals that allowed them to live life, perhaps the only thing that made it
tolerable. It's a lot to ask of someone.

A brilliant sales rep in recovery said to me on my tenth year of sobriety:

“Doctor, when I was in detox and you showed me my physical exam and lab
tests, and explained to me that if I didn't stop drinking I would soon die, It
didn't faze me. I would have chosen to drink and die. "I couldn't conceive of
living without alcohol when I needed it."

Abstinence is often a formidable challenge. But even abstinence is not

recovery, only a requirement for it. This requires a change in attitude and
behavior, which means a change in the way the addict thinks and has
thought for most of his or her life. It means overcoming addictive thinking.
The formula can be displayed as follows:

RECOVERY = ABSTINENCE + CHANGE

The difficulty of reasoning with addicts

Consider, for a moment, what would happen if someone you trusted told you
to take something valuable, say, a fine crystal vase or an expensive
porcelain sculpture, and drop it from a fourth-story window. You would say
“Are you crazy? It's a family heirloom. For me it is invaluable. Why would I
be stupid enough to break it?”

Imagine your friend answering: “Aha! You're wrong about that. You see, you
have been operating under the illusion that there is a law of gravity and that
when you let go something falls. But you have been the victim of deception.
There is no law of gravity. Trust me, friend. You will see that if you take the
vase or sculpture out of the window and let it go, it will not fall to the
ground. It will remain suspended in the air and you can take it again
whenever you want.”

8
Without a doubt, you will conclude that your trusted friend has gone crazy.
The poor thing is crazy! you will say to yourself. I have always known that
when I let go things fall, and that there is a law of gravity. This poor lunatic
friend is trying to convince me of a huge nonsense. How crazy can a person
get?

When we try to convince addicts of the fallacy of their thinking, it is like

telling someone that they are delusional because they believe in the law of
gravity. The height of futility is to expect the addictive thinker to abandon
his concept of reality and accept ours instead.

Two essential factors in recovery

So how can recovery happen? There are two essential factors for this.

1. Addicts must lose faith in their current reasoning powers . They must
learn that their concept of reality and their thought processes are
distorted. Unfortunately, there is little others can do to cause the
addict to doubt the way of thinking they have had their entire life. The
only thing that will cause doubt is hitting rock bottom, any event that
might cause the addict to reconsider his or her behavior and attitude.
At that moment the therapist or professional may intervene and say:
“Look, you are becoming aware that your perception of reality is
incorrect and that your way of thinking has been distorted. I will help
you discover a valid system of thought.”
2. Addicts accept the possibility of another version of reality from
someone they trust . I try to help patients in treatment understand this
“reality check” by giving them the example of an excellent cook who
always cooks by tasting, and never following a recipe: he does not pay
attention to measuring ingredients. After putting them in, the cook
tests the cooking and adds salt, sugar, lemon and spices, tasting the
mixture from time to time, always adding what is missing until it has a
good flavor.

But what happens if you catch a bad cold and your sinuses are blocked and
you are unable to perceive flavors? Since the cook doesn't trust
measurements, the best thing to do is call someone and ask, “Can you
please try this for me and tell me what you think is missing?” "I have a bad
cold and I can't distinguish the flavors."

For addicts, treatment center staff can fill this role. Addicts' “taste buds” for
evaluating reality do not work well. Professional treatment can help them
evaluate reality and develop a correct thinking system.

8
 Building trust during treatment

Isn't it too much to ask that the addict trust a person he or she has never
met before?

Most addicts lack the ability to trust. If I had grown up in a home with an
alcoholic father, I would have had few opportunities to learn trust. The home
could have been riddled with lies and deception: the alcoholic lied to the
sober person, and the sober person deceived the alcoholic. Most children of
alcoholics learn not to trust anyone.

Even children from healthy, functional homes have trouble trusting others.
Parents are not always frank with them, for many reasons: they often think
that children cannot understand some things. So instead of telling them the
truth, they plan something that they think they will be able to understand.

The addict who encounters a treatment professional has little reason to trust
him or her. Having hit rock bottom may have taken away your foothold, and
you feel suspended as if in mid-air. A person in the treatment group shakes
his hand and says, “We will try to help you.” Brilliant!

If addicts have so little trust, how do they accept treatment from doctors
and nurses? Or do they agree to undergo surgery? The answer is that
professional helpers are not saying things that contradict what the addict
already believes. The dentist will tell you that your wisdom tooth is broken
and needs to be removed; The addict has never believed that a broken
wisdom tooth should not be extracted.

Treatment for chemical addiction is different. The addict will have to start
thinking differently during recovery, and that requires deep trust.

Addicts in treatment must have reason to believe that they will not be
deceived, that their well-being is the primary goal of treatment, and that
nothing will divert the staff from that goal. Treatment staff should seek to
establish alliances with the addict's family, boss, and judicial system, but
only on the condition that the addict knows.

8
People in chemical dependency treatment test those who treat them, as
they should. Doctors tell them that much, if not everything they believed
until now is false, that their thinking was distorted and incorrect and that
they should trust someone else's thinking.

In the past, residential treatment programs typically lasted four weeks.

Many years of addictive thinking can be corrected in 28 days, but at least
the addict got a head start in a chemical-free environment. Today, when
outpatient treatment essentially replaces in-home treatment, most addicts
do not have the benefit of this protected period.

The restriction of residential treatment has presented a challenge for

therapists who, like their patients, are forced to manage a new reality.
Outpatient programs have given rise to the challenge. With alcohol and
narcotic addiction, the enforcement of abstinence has increased through
broader use of disulfiram and naltrexone. Contracts have been established
with patients, and therapists have developed additional skills to help them
survive the post-acute phase of withdrawal.

Although the traditional 28-day residential treatment program has been

replaced, intensive outpatient treatment is typically longer in duration. This
allows the therapist a little more time to help the addict transition from an
addictive thought to a normal one.

Not addressing addictive thinking

Let's say a newly sober addict leaves the treatment program after a period
of imposed withdrawal in which he overcame the physical symptoms of
withdrawal. If you immediately relapse into your alcohol or other drug use,
that means you haven't started to change your addictive thinking. No one
who thinks clearly would want to quickly return to an active addiction. The
only possible conclusion is that that person kept his or her addictive
thinking .

In turn, this almost always means that the therapist was unable to gain the
patient's trust. It is not necessarily a reflection of the doctor's skills and
dedication; The person may have entered treatment with a deep feeling of
distrust and is still unable to believe in anyone. Or, despite everything
that's happened, you still haven't hit the bottom that will begin to fragment
your addictive thinking. It is usually a matter of time before the addict
realizes that 88
therapist was right and that his thinking was wrong. Then he usually returns
to treatment; this time with more trust in the doctor.

What we said about trust applies to everyone who wants to interact

constructively with an addict. This includes not only the therapist but also
family members, boss, priest or pastor, counselor, and friends of the
recovery program. Everyone can earn trust, respect it, and maintain it
carefully.

8
90
Chapter 20

Spirituality and spiritual emptiness

Although almost all human diseases can be found in animals, there is little
evidence that, in their normal habitat, they develop addictive conditions.
Some animals whose brains have been treated with certain chemicals may
eat or drink excessively, but this is not the case in those in their normal
environment. Indulgence in excess seems to be a uniquely human
phenomenon. Because?

Unlike animals, which only have physical impulses and desires, human
beings also crave spiritual satisfaction. When this need is not met, they feel
a confusing restlessness. While hunger, thirst, and sexual urge are easily
identified, spiritual craving is more difficult to recognize and satisfy. People
may feel like something is missing, but they don't know what it is.

It should not be surprising that spirituality is also a subject of addictive

distortion . 1

Fill the spiritual void

Most people learn from experience that certain substances produce a feeling
of gratification. Consequently, addictive thinking can lead to trying to
alleviate this confusing spiritual anxiety through food, drugs, sex or money.
These may provide some gratification, but they will not at all solve the basic
problem: unmet spiritual needs. The feeling of satisfaction soon disappears,
replaced by longing.

Let's consider it this way. Humans require certain amounts of vitamin A, B

complex, C, D, E and K to function normally. A lack of any of these vitamins
will result in specific deficiency syndromes, such as scurvy due to a vitamin
C deficiency or beriberi due to vitamin B-1 deficiency. If the person lacks
vitamin B-1 and is given massive doses of vitamin C, the deficiency will not
change. Nothing can change until the necessary vitamin is supplied. You
cannot compensate for a deficiency of one vitamin with an excess of
another.

This is similar to the mistake addicts make. The addictive thinker reasons
that since food or sex or money or alcohol or other drugs have satisfied
some of their cravings, they will also satisfy others.

This also helps us understand the phenomenon of addiction change; for

example, changing an eating disorder for compulsive gambling, or a sexual

9
addiction for a work fanaticism.

Many people in recovery have said: “During the periods of withdrawal I felt a
certain emptiness inside me. I had no idea what it was about. Now I know
that it was the empty space where God belonged.”

The meaning of spirituality

Why is it that we can easily identify that food satisfies hunger and water
satisfies thirst, but it is difficult for us to know what satisfies spiritual
longings?

There is an answer, which theologians consider to be the core of what

humanity is about: a human being is not just an animal that differs from the
rest only in its degree of intelligence. Human beings, as morally free beings,
can choose to recognize their spirituality and their unique relationship with
God.

But what if a person is not religiously oriented, and “God as we understand

Him” is the support group? Does the lack of formal religious belief impede
spirituality?

Not at all. Humans are different from other animals. In addition to their
greater intelligence, they also possess several characteristics that animals
do not have. For example, we have the ability to learn from history and
obviously animals do not. We can contemplate the purpose of existence. We
can think of ways to improve and we implement them. We can delay
gratification and think about the long-term consequences of our actions.
Finally, we have the ability to make moral decisions, which can result in
denying ourselves behaviors that our bodies crave.

It can be said that all these capacities, which are unique to the human
being, constitute the spirit . Therefore, this is the part that
distinguishes it from other forms of life. A devout fanatic will say that the
spirit was infused into humanity at the moment of creation. An atheist may
say that it developed over millions of years of evolution. But few will deny
that human beings have these capacities, and therefore that they possess a
spirit.

When we exercise those unique human capacities we are being spiritual .

However, it is possible to be spiritual without being religious, because
nowhere in these unique human abilities is it said that this is a requirement.

We can also understand the importance of spirituality in addiction recovery.

9
Active addicts obviously have not learned from the history of their past
behavior, because they repeat the actions that proved destructive to them.
Their purpose in life is to stimulate themselves, and they have no other goal.
They can barely consider self-improvement when their behavior is frankly
self-destructive. Active addicts cannot delay gratification and do not consider
the consequences of their actions. Finally, they lack freedom, because they
are cruelly dominated by the impulse of addiction. Therefore, addiction is the
antithesis of spirituality.

Addictive thinking is not spiritual , since its goal is the other pole of
spirituality. This is why addiction recovery requires a shift from addictive
thinking to spirituality, although not necessarily religion. Naturally religion
encompasses spirituality, and can be an additional source of strength in
recovery, but it is not absolutely necessary for it.

9
94
Chapter 21

Addictive thinking and relapse

Often the recurrence of addictive thinking precedes relapse into drinking or

other chemical substance use. Distorted thinking can also follow relapse
when the person attempts to return to the Twelve Step program.

Growth in recovery

Because recovery is a process of growth, relapse is an interruption of that

growth. But it doesn't mean going back to box number one. However,
almost without exception, it may be what the relapser thinks. After two to
twelve years of recovery, the person who relapses may feel like he or she
has returned to rock bottom. However, this conclusion is erroneous and can
negatively affect recovery from a relapse. Many people who relapse think,
What's the point? I tried it and it didn't work. It doesn't matter if I abandon
the fight.

The problem is that they are starting with a conclusion instead of

considering the facts of their situation: the progress they made, the skills
they learned, the rewards of recovery. Rather, the person who relapsed
wants to continue his or her chemical use. Ideas of worthlessness and
despair are nothing more than typical addictive thinking, the purpose of
which is to promote continued use of drugs. The correct conclusion, as the
following story illustrates, is that relapse does not undo everything addicts
gained up to that point.

Slippery stains

One winter day I had to send a package in the mail. My car battery was
dead, and I had to walk eight blocks to the post office. I tried to avoid the
slippery spots on the sidewalk, but despite my caution, I slipped and fell.
Although fortunately I didn't break any bones, I felt severe pain.

I may have muttered a few curses at the person who should have cleaned
the sidewalk more carefully, but I also knew that whether I fell because of
the deceptive appearance of the sidewalk or because of my negligence, I
wasn't going to get to the mail unless I fell. for me to get up and walk, with
everything and the pain. As I limped along, I paid even more attention to
possible slippery spots that could cause me another fall.

Despite my painful fall, I was two blocks closer to my destination than when
I left. The fall did not erase the journey he had already traveled.

9
This is how I consider a relapse. No matter your pain, it is not a regression
to box number one. The progress made to the point where it is given cannot
be denied. The addict who relapses must start over from that point, like
when I slipped on the ice, and be even more alert to anything that could
cause a recurrence.

Recurrence of thought

An astute observer, therapist or counselor, can detect the recurrence of

addictive thinking that may result in relapse. If it is corrected, relapse can
be prevented. For example, the person in recovery who begins to show signs
of impatience may have reverted to the addict's concept of time. He who
claims not to need so many meetings because he is now in control may be
returning to omnipotence. He who wallows in regret may be returning to
shame. One who resorts to rationalization or blame projection, or who
becomes unusually sensitive to the behavior of others, may be experiencing
the hypersensitivity or self-righteousness of the addict. Becoming surly or
pessimistic can signal depression or the morbid expectations characteristic
of addictive thinking. Any recurrence of what we have come to recognize as
addictive thinking can be a prelude to a relapse. Prompt detection of relapse
to addictive thinking and restoration of healthy thinking can help the addict
avoid chemical relapse.

Return to the Twelve Step Program

Many people become frustrated when returning to AA, NA, or another

Twelve Step program after a relapse. They remember the wonderful feeling,
glow and affection they experienced when entering the program for the first
time and are disappointed that they do not feel the same when they return
to it.

But there is only one first kiss. The experience will never be duplicated.
When addicts first enter the Twelve Step program, they find others like
them. They come to feel welcome and comfortable as they integrate into the
recovery population. The person who returns to the program and seeks this
feeling will become frustrated and disappointed. It won't feel so fresh and
new.

Cocaine addicts say that throughout their addiction they tried in vain to
recapture the stimulus of their first use, but were never able to do so. Trying
to re-experience the first feeling of recovery is quite similar.

Remember this, because it's important: Be realistic about relapse . The

growth in sobriety that preceded the relapse has not been lost and the

9
person cannot expect the original experience of recovery the second time
through. These are two facts that addictive thinking often distorts.

9
98
Chapter 22

The frustrations of growth

Frustration is not the cause of alcoholism or other drug addictions. Many

people have learned to tolerate frustration and somehow manage it without
escaping into chemical anesthesia. It is possible that those who use drugs to
deal with frustration have not learned to tolerate it, or perhaps they control
some, but in their addictive thinking they have great difficulty with others.

We become frustrated when we feel that things could and should be

different than they are. When we know that things happen as expected we
don't get frustrated, even if we don't particularly like what is happening.

A series of challenges

What addictive thinkers often don't realize is that life is a series of constant
challenges. We may invest a great deal of effort in overcoming one difficulty,
but we have barely begun to relax when we find ourselves faced with
another, and so on ad infinitum.

Addictive thinkers consider this unusual. If they find that they are unable to
go for a long period without their peace being disturbed, they feel separated
and unfairly tormented. If they drink or consume other chemicals, they will
point out an intolerable set of problems that they must try to deal with. It's
one thing after another , they tell themselves. I never have a moment of
peace .

Although it is a legitimate complaint, this is the reality for many people and
yet the addict is unable to become aware of it. According to him, no one else
could be subject to such terrible tensions and problems.

Those around the addict must know enough not to believe that the person
has a legitimate excuse for using alcohol and other drugs. But they can be
inadvertently led to unhealthy empathy. The various problems the addict
describes may seem like too much for anyone to deal with; But, upon closer
analysis, their problems are not so different from those of the non-addict.
But what the addictive thinker perceives is that they are radically different:
other people get a break from time to time, but I don't. Never.

Recovering addicts can express their unrealistic expectations while sober.

They will believe that other people also in recovery had it easier. My
problems are worse , they think. My spouse complained when I drank, and
now he complains about me coming to meetings every night. The supervisor

9
watches me like a hawk. My former friends don't even call me anymore...
However, as recovering addicts come into contact with others in the same
situation, they begin to realize that things are not easier for others and, in
fact, that there are others that look very similar to them.

Every aspect of recovery is subject to growth. Accepting life in its own

circumstances, accepting helplessness, submitting to a Higher Being, making
and sharing a moral inventory, making amends: all of this happens
gradually. The person who has been in recovery for several years can look
back at the beginning of this stage and see how much they have learned,
how far they have come.

The difficulties of the beginning

A recovering alcoholic complained to me about the constant frustrations and

crises she had to face. When we examined them, we discovered that each
crisis consisted of new demands placed on it. These additional demands
arose because he was making a good effort at his current level: each crisis
was a starting point towards greater growth.

“But it's so painful,” he complained.

“Of course,” I replied. “Have you never heard of the difficulties of starting?”

“Well, how long will I have to keep growing?”

“We must all continue growing until we die,” I told him.

Another woman in recovery put it succinctly: “They told me that if I stopped

drinking things would get better. Well, they were wrong. Things didn't get
better. I got better",

Some of the problems associated with chemical use may actually go away
with sobriety, but many real problems will remain. For most people,
economic survival is a struggle. Things can happen in our economy that are
beyond our control and that will threaten our

subsistence. Likewise, we are all subject to diseases. Our children can have
problems at school, with friends and, of course, with drugs. There is no
shortage of problems in the reality we all face, and there is no reason for
addicts to expect problems to go away just because they are sober. What
happens, however, is that recovering addicts begin to recognize their
strengths in dealing with these various challenges. Additionally, if they need
any help managing them, they have learned how to find it and how to accept
it.

1
 Just the beginning

Many people naively believe that they have completed their course of
recovery when they “graduate” from a treatment program. At that point it is
difficult for them to understand that they have not even begun their
recovery. The recovery program is just an introduction; recovery still has to
happen.

One of the worst things that can happen to a person leaving a treatment
program is for things to go quiet for several weeks. This reinforces the
fantasy that life can be without challenges. The person begins to think how
easy the recovery is because all the irritating problems no longer occur.
When inevitable problems occur, the person is taken by surprise.

I tell the residents of our rehab center that if they experience difficulties
during the first few weeks after discharge, they can blame me. I pray that
things don't go too well for them during the first few weeks because I want
recovering addicts to face real life and immediately experience the pressures
of reality. I hope that you will soon use the tools you received during
treatment:

• Call your supervisor

• Attend to the reunions
• Share with others, and
• Follow the recommendations of others

Addictive thinkers may think they deserve a break after their grueling
treatment efforts, but this type of thinking can lead them to relapse.
Difficulties along the way are inevitable and it is realistic to expect them
during recovery.

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Chapter 23

Ridiculous explanations, sensible solutions

When we see addicts behaving irrationally, we are often so shocked that we

don't know how to react. We are a lot like the farmer who sees a giraffe for
the first time in his life at the zoo and exclaims, “I see it, but I don't believe
it.” It's obvious that what addicts are doing is destructive to themselves and
others, we think , so why aren't they able to relate their behavior to alcohol
and other chemicals?

The fact that a psychotic behaves insane does not cause us to become
stunned. But we are surprised that a person who is otherwise perfectly sane
and rational would do crazy things. We begin to doubt our senses,
wondering, Is what I see really happening? This shower itself is so intense
that we become vulnerable to accepting the wisdom of the most ridiculous
explanations.

The addict's thought processes may be so affected by the effect of chemicals

on the brain that inherent contradictions and the strangest behavioral
inconsistencies are understandable. However, when the addict recovers and
turns back to his former irrational behavior, he is often surprised by the way
he thought and acted. What is less understandable is how and why other
important people around them, whose minds are not altered by chemicals,
fall prey to so many distorted thoughts and behaviors.

The answer is that all of us have unique needs, some healthy, some not so
healthy, and the emotional pressure to gratify those needs can greatly affect
the way we think and feel. Sometimes these emotional pressures can distort
our thinking almost as much as the drug taken by the addict.

This is why it is so important to understand the concept of addictive

thinking, which exists and operates in every active person and, to a greater
or lesser extent, in those around them and who are important to them.

Testing reality

In everyday life, no one stops to ask themselves: Is it possible that I am

hallucinating? We cannot function well in reality if we doubt everything.
When the bus arrives at the stop, we get on it and don't think: Maybe this
bus doesn't really exist. Maybe I'm just hallucinating a bus. This thought
paralyzes us.

1
When things happen that are beyond our expectations, we may pinch
ourselves to make sure we're not dreaming. This can occur when something
out of the ordinary happens, whether good or bad. We pinch ourselves to
test reality.

It may be asking too much of active addicts to try to discover whether their
perceptions are real or distorted. But it would be worthwhile for people
whose brains are not distorted by chemicals and who are related to a drug
addict to check their own thinking and consider the addict's behavior from a
proper perspective. This is legitimate whether you are a husband, wife,
parent, child, therapist, supervisor, friend, priest or pastor, or anyone
involved with an active addict. The more we understand the way addicts
think and function, the less likely we will be to be paralyzed by the impact of
their behavior and fooled by their clever schemes and manipulations.
Furthermore, if we can understand our powerful internal forces that produce
many of the same distortions that result from chemicals, we will put up less
resistance when our role as codependents is pointed out to us.

• Two plus two equals five

The mother of a young man who was destroying himself with alcohol and
other drugs could not understand how he did not realize the disastrous
effects of chemicals on his life. He asked for help to handle it. “But don't tell
me that I have to throw him out of the house or that I shouldn't pay bail to
get him out of jail,” he said. “I don't want to hear that.”

I replied, “Please tell me how much two plus two is, but don't say four.”

He had been unable to realize that his own thinking was no less distorted
than his son's. Why had his thinking become distorted? Because when she
paid bail to get him out of jail and didn't throw him out of the house, she
allowed him to continue using drugs without realizing the magnitude of the
problem. It kept him from hitting rock bottom, and that would have made
recovery possible.

The concept is not new

If you read publications about addiction, addictive thinking will be mentioned

on every page.

Is deep pain normal? No. Is it normal for a person with a broken leg to
suffer severe pain? Yeah.

Is fever normal? No. Is it normal for a person with an infection to have a

1
high fever? Yeah.

Is addictive thinking normal? No. Is it normal for people who are dependent
on chemicals and codependents to have addictive thinking? Yeah.

Since you read this book, in one way or another you are interested in
addiction. As such, it may be vulnerable to thinking
addictive. Check with someone who can analyze further.
objective his own life. With the help of another you will be better able to
clarify your
own reality.

1
1 David Sedlak, MD, “Childhood: Setting the Stage for Addiction in Childhood and Adolescence,” in
Adolescent Substance Abuse : A Guide to Prevention and Treatmente , ed. Richard Isralowitz and Mark
Singer (New York: Haworth Press, 1983).
1 Ronald and Patricia Potter-Efron, Letting Go of Shame: Understanding How Shame Affects Your Life
(Center City, Minn.: Hazeldenn Educational Materials, 1989), 2.
1 The ideas we discuss in this chapter are from Animals and Angels: Spirituality and Recovery by
Abraham J. Twerski (Center City, Minn: Hazelden Educational Materials, 1990)

1
 INDEX

ADDICTIVE THINKING..........................................................................................................................1
ABRAHAM J. TWERSKI......................................................................................................................1
Foreword..............................................................................................................................................1
What is addictive thinking?.............................................................................................................3
The distortion of thought.................................................................................................................3
Thought processes in schizophrenia................................................................................................4
How addictive diseases are similar to schizophrenia......................................................................5
Obsessions and compulsions in addiction and codependency.........................................................7
How addiction and codependency are similar...............................................................................11
Cause and effect.............................................................................................................................11
Self-deception and addictive thinking...........................................................................................11
Addictive thinking and intelligence...............................................................................................11
Why do children use drugs, why do parents drink?.......................................................................15
Self-deception in addictive thinking..............................................................................................14
Self-deception and attending Twelve Step groups.........................................................................16
To make changes............................................................................................................................18
Distorted perceptions.....................................................................................................................21
The rule of the Three C's................................................................................................................20
The Addictive Thinker's Concept of Time.....................................................................................21
The future in minutes and seconds.................................................................................................22
A culture with the concept of addict time......................................................................................23
Understand the way the addict thinks............................................................................................23
Cause and effect confusion............................................................................................................27
Are you an addictive thinker?........................................................................................................27
An addict's version of dyslexia......................................................................................................27
Origins of addictive thinking.........................................................................................................29
The inability to reason with oneself...............................................................................................29
Denial, rationalization and projection............................................................................................33
The role of misperceptions.............................................................................................................33
Denial as a defense.........................................................................................................................35
The rationalization.........................................................................................................................36
The pain.........................................................................................................................................38
The projection................................................................................................................................39

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Conflict management.....................................................................................................................41
A distorted image of yourself........................................................................................................41
Changing a negative self-image.....................................................................................................42
The rule and/or...............................................................................................................................43
hypersensitivity..............................................................................................................................45
A comfort for feelings of grief and discomfort..............................................................................45
morbid expectations.......................................................................................................................47
Feelings of impending doom.........................................................................................................47
Manipulation of others...................................................................................................................49
Avoid scam....................................................................................................................................49
Guilt and shame.............................................................................................................................51
The difference between guilt and shame.......................................................................................51
How shame develops.....................................................................................................................51
Why addicts feel shame.................................................................................................................52
Omnipotence and impotence..........................................................................................................57
Illusions of control.........................................................................................................................57
Delusions of grandeur....................................................................................................................56
Admit mistakes..............................................................................................................................59
Being a human being means making mistakes..............................................................................59
Quick recognition of errors............................................................................................................61
The wrath.......................................................................................................................................63
The three phases of anger..............................................................................................................63
Addicts and intense anger..............................................................................................................64
How recovery helps.......................................................................................................................65
Men can and should cry.................................................................................................................67
Get rid of resentments....................................................................................................................67
The seclusion wall..........................................................................................................................68
The degree of porcupine................................................................................................................68
Casting out family and friends.......................................................................................................72
The value of support groups..........................................................................................................72
Managing feelings..........................................................................................................................73
The Depression..............................................................................................................................73
The emergence of emotions...........................................................................................................74
The flavors and colors of reality....................................................................................................77
From gray to pink...........................................................................................................................77
How clinical depression and addictive depression differ..............................................................80
When both appear..........................................................................................................................80
Should we get to the bottom of it?.................................................................................................81

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 The meaning of the background....................................................................................................81
The law of human gravity..............................................................................................................81
greater suffering.............................................................................................................................82
less suffering..................................................................................................................................82
Achieving sobriety through perception changes............................................................................82
Addictive thinkers and confidence.................................................................................................85
The difficulty of reasoning with addicts........................................................................................85
Two essential factors in recovery..................................................................................................86
Building trust during treatment......................................................................................................87
Not addressing addictive thinking.................................................................................................90
Spirituality and spiritual emptiness................................................................................................91
Fill the spiritual void......................................................................................................................91
The meaning of spirituality............................................................................................................92
Addictive thinking and relapse......................................................................................................95
Growth in recovery........................................................................................................................95
Slippery stains................................................................................................................................95
Recurrence of thought....................................................................................................................96
Return to the Twelve Step Program...............................................................................................96
The frustrations of growth.............................................................................................................99
A series of challenges....................................................................................................................99
The difficulties of the beginning..................................................................................................100
Just the beginning........................................................................................................................101
Ridiculous explanations, sensible solutions.................................................................................103
Testing reality..............................................................................................................................103
The concept is not new................................................................................................................105

Chapter 11
ADDICTIVE THINKING..........................................................................................................................1
ABRAHAM J. TWERSKI......................................................................................................................1
Foreword..............................................................................................................................................1
What is addictive thinking?.............................................................................................................3
The distortion of thought.................................................................................................................3
Thought processes in schizophrenia................................................................................................4
How addictive diseases are similar to schizophrenia......................................................................5
Obsessions and compulsions in addiction and codependency.........................................................7
How addiction and codependency are similar...............................................................................11
Cause and effect.............................................................................................................................11

1
Self-deception and addictive thinking...........................................................................................11
Addictive thinking and intelligence...............................................................................................11
Why do children use drugs, why do parents drink?.......................................................................15
Self-deception in addictive thinking..............................................................................................14
Self-deception and attending Twelve Step groups.........................................................................16
To make changes............................................................................................................................18
Distorted perceptions.....................................................................................................................21
The rule of the Three C's................................................................................................................20
The Addictive Thinker's Concept of Time.....................................................................................21
The future in minutes and seconds.................................................................................................22
A culture with the concept of addict time......................................................................................23
Understand the way the addict thinks............................................................................................23
Cause and effect confusion............................................................................................................27
Are you an addictive thinker?........................................................................................................27
An addict's version of dyslexia......................................................................................................27
Origins of addictive thinking.........................................................................................................29
The inability to reason with oneself...............................................................................................29
Denial, rationalization and projection............................................................................................33
The role of misperceptions.............................................................................................................33
Denial as a defense.........................................................................................................................35
The rationalization.........................................................................................................................36
The pain.........................................................................................................................................38
The projection................................................................................................................................39
Conflict management.....................................................................................................................41
A distorted image of yourself........................................................................................................41
Changing a negative self-image.....................................................................................................42
The rule and/or...............................................................................................................................43
hypersensitivity..............................................................................................................................45
A comfort for feelings of grief and discomfort..............................................................................45
morbid expectations.......................................................................................................................47
Feelings of impending doom.........................................................................................................47
Manipulation of others...................................................................................................................49
Avoid scam....................................................................................................................................49
Guilt and shame.............................................................................................................................51
The difference between guilt and shame.......................................................................................51
How shame develops.....................................................................................................................51
Why addicts feel shame.................................................................................................................52
Omnipotence and impotence..........................................................................................................57

1
Illusions of control.........................................................................................................................57
Delusions of grandeur....................................................................................................................56
Admit mistakes..............................................................................................................................59
Being a human being means making mistakes..............................................................................59
Quick recognition of errors............................................................................................................61
The wrath.......................................................................................................................................63
The three phases of anger..............................................................................................................63
Addicts and intense anger..............................................................................................................64
How recovery helps.......................................................................................................................65
Men can and should cry.................................................................................................................67
Get rid of resentments....................................................................................................................67
The seclusion wall..........................................................................................................................68
The degree of porcupine................................................................................................................68
Casting out family and friends.......................................................................................................72
The value of support groups..........................................................................................................72
Managing feelings..........................................................................................................................73
The Depression..............................................................................................................................73
The emergence of emotions...........................................................................................................74
The flavors and colors of reality....................................................................................................77
From gray to pink...........................................................................................................................77
How clinical depression and addictive depression differ..............................................................80
When both appear..........................................................................................................................80
Should we get to the bottom of it?.................................................................................................81
The meaning of the background....................................................................................................81
The law of human gravity..............................................................................................................81
greater suffering.............................................................................................................................82
less suffering..................................................................................................................................82
Achieving sobriety through perception changes............................................................................82
Addictive thinkers and confidence.................................................................................................85
The difficulty of reasoning with addicts........................................................................................85
Two essential factors in recovery..................................................................................................86
Building trust during treatment......................................................................................................87
Not addressing addictive thinking.................................................................................................90
Spirituality and spiritual emptiness................................................................................................91
Fill the spiritual void......................................................................................................................91
The meaning of spirituality............................................................................................................92
Addictive thinking and relapse......................................................................................................95
Growth in recovery........................................................................................................................95

1
 Slippery stains................................................................................................................................95
Recurrence of thought....................................................................................................................96
Return to the Twelve Step Program...............................................................................................96
The frustrations of growth.............................................................................................................99
A series of challenges....................................................................................................................99
The difficulties of the beginning..................................................................................................100
Just the beginning........................................................................................................................101
Ridiculous explanations, sensible solutions.................................................................................103
Testing reality..............................................................................................................................103
The concept is not new................................................................................................................105

Chapter 22
The frustrations of growth __________________99-101
Chapter 23
Ridiculous explanations, sensible solutions_103-105

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