From Addiction to Resilience: Tools and Approaches to Support Recovery

In the first two articles in this series, I presented the first six of the nine pillars facilitating one’s shift from Addiction to Resilience. The first three focus on relationship and begin at the heart of resilience: one’s relationship with himself. The next two are one’s relationship with others, and then relationship with something greater. The second of the three groupings of resilience components had to do with organismic balance and mastery. These included physical balance and mastery, emotional and then cognitive or mental balance and mastery. In this third and last article I will turn my attention to the area of process, or the “how” of living.

I identify three broad components in this area of resilience: presence, flexibility and power. I define power as the ability to get things done. You can see that during our travels through the nine pillars of resilience, we have gone from the most internal — relationship with self — to the most externally focused pillar, the ability to get things done.

Unlike many other component models, there is considerable overlap among my pillars. I established the model based on its optimal functioning and usefulness. Thus far, respondents have found it accurate in its assessment of themselves and useful in identifying areas needing improvement, as well as owning their areas of strength.

In my previous article I discussed the importance of managing stress for the recovering addict. Of course, it’s important for anyone, however, it is even more crucial with addicts where the stakes are much higher. This is partly because the addict’s prime coping strategy is the use of drugs and drug-seeking behavior. But it is also because their nervous systems are much more fragile. In most cases, this fragility predates their addiction and results from a combination of factors including: poor communication between the limbic system (the emotional center of the brain) and the frontal cortex (executive functions); childhood trauma that results in a hypersensitivity of the part of the brain that centers around controlling autonomic activity; and impaired ability to recover from stressful events. These factors are further impaired as a result of the addiction. Thus, the cumulative impact of stress is much greater.

Related to the handling of stress is the perception of stress — the subjective determination of threat or danger. If one doesn’t have an inner sense of safety or the ability to experience a sense of secure personal boundaries — which is true for most addicts — more situations will be perceived as a threat, and thus trigger the stress response. Just as important is the difficulty addicts have of feeling safe enough to relax and recover. There is a rhythm in life that is reflective of a basic biological need for switching from the expenditure of energy to the recovery of energy, from external activity to healthy withdrawing into safety for the purpose of recuperation. It’s important to find the places where one feels safe and secure in order to be able to go “inside” and recover.

The recovering addict has difficulty achieving regular recovery from stress, a key to resilience. They might retreat and avoid, but are unable to achieve any sense of recuperation. They are, therefore, more vulnerable to their old drug-related behaviors — their old coping strategy. In these last three pillars of resilience, I discuss processes involved in one’s engagement with the outside world.

Presence

Presence describes one’s ability to be in the moment, as well as the quality of one’s energy and awareness in the moment. We might say a person has a strong presence, a powerful presence. When referring to ourselves, we might say, “I’m not very present”, which typically indicates being distracted or preoccupied. These comments refer to the different qualities of this concept, as well as how they might relate to the recovering addict.

There is a directional aspect to presence. The incoming aspect is about awareness and ability to notice and pay attention to your surroundings. This determines your ability to respond to events, as well as your awareness of internal cues, such as tension or fatigue, that need to be addressed. Presence is your ability to be in the moment, as opposed to being preoccupied or otherwise in your head.

There is also the aspect of presence that has to do with what one projects out into the world. It’s what we might label “personal energy”, sometimes referred to as charisma, or even magnetism. This determines whether others are attracted to or repelled by you; whether they feel comfortable or a bit nervous around you. All other things being equal between two applicants for a job, it may be presence that determines which one gets selected.

Another way of describing presence is how we relate to the contact boundary. This refers to the interface between an individual — the “I” — and either the outside world or their inside world. This, as we might say, is where the rubber meets the road: where our “I” connects with the world. One of the consequences of addiction, as well as the trauma and abuse that are common among addicts, is the constriction and even the elimination of one’s sense of personal “safe space”. This lack of a protective psychic boundary may also be the result of a history of impulsive behaviors or poor decision making, resulting in damaging consequences.

This impaired sense of personal safety results in a fear of being at the contact boundary. Drugs are one way of withdrawing from this boundary, but there are other less obvious mechanisms that are described by the various psychological defenses, such as withdrawal, projection, dissociation and splitting. Fear tends to move our sense of self inward, away from the contact boundary. This results in being less responsive and less able to engage with others and the world. This withdrawal from the contact boundary leaves a person less available for connection, and less able to respond appropriately to the demands of the environment.

Helping the recovering addict be more present

The therapeutic relationship is the most effective context for helping the recovering addict address both aspects of their presence: the quality of the energy they project, as well as their availability to be aware in the moment. Here are two approaches to impact both the incoming awareness, as well as the outgoing energetic presence of the client:

At some point in my sessions, I will have the client pause and take a moment to notice their surroundings. I will then ask them about the details of what they have just noticed and then have them notice again. I will shuttle back and forth, asking for more qualitative details, such as colors, shapes and what they liked. As an assignment, I might ask them to do this exercise within the context of their everyday activities. There are many variations on this theme, with the goal being the training and encouragement of greater awareness and being in greater contact with their environment. A second and related process I suggest is for the client to notice signals from their body. The instructions will be to notice without making any evaluative judgments about what they become aware of.

To address one’s energy and how they project this out into the world, I will work with the client in front of a mirror. I might have them notice their posture and particular aspects, such as slumped shoulders. By bringing their attention to how they hold themselves, I am able to help them connect this with how they feel about themselves. I might then have them exaggerate this posture and notice that this actually creates greater depression, lack of energy or negative self-assessment. As part of this evaluative process, I will also have them notice their facial expression and ask them what this expression says to the outside world.

This would be followed by having them adjust their posture, straighten up and hold themselves high. While holding this posture, I’ll have them walk around the room and notice what feelings or other sense of self that they notice. I will bring their attention to their breathing and also adjust their breathing into a more supportive breathing pattern. I will also have them consciously adjust their facial expression to one that they think appears more positive.

By placing these exercises within the context of the client’s “presence” and how this helps them in their lives, I am giving them valuable tools for self adjustment and more effective responsiveness to both their outside and inside worlds.

Flexibility

Addictions “lock-in” the addict into very specific, stereotypic behaviors. We say they are in a rut and that the drugs are so powerful that they hijack the reward mechanisms of the brain, becoming much more powerful than the most basic of needs (for someone vulnerable to addiction). It takes very few trials for conditioned aspects of addiction to take hold and run their lives. In chaos theory, we would refer to this as an attractor state that is very quickly developed in the brain.

Flexibility is at the heart of vitality and health. If you think of the evolutionary process and the survival of a species, the greater the variability of the genetic material, the genetic pool and of the traits of that organism, the greater its survival success. This is because variability results in greater options and the ability to adapt.

This is also true for our behaviors. Flexibility is at the heart of one’s ability to adjust to circumstances. It facilitates one’s ability to react to change. The ability to adjust also results in it being easier to become satisfied when interacting with the environment.

Improving the recovering addict’s ability to be flexible

My first step in helping clients become more flexible is to educate them about brain plasticity. I explain to them new information about the ability of the brain for neurogenesis. We have discovered that a half-hour experience, if impactful, can actually trigger gene expression and the birth of new nerve cells. This is something that for hundreds of years was thought to be impossible. I make an effort to help my clients actually become fascinated by this idea: they can literally trigger the birth of new nerve cells. Even though they have spent many years harming their bodies, they carry with them the potential for regeneration, new birth within their brains.

I will then help them visualize new brain and nerve growth. I will take out pictures of the brain and of nerve cells with their dendrites, axons and synapses. I will coach their visualization of their nerve cells sprouting new dendrites and synapses. I will explain that the key to this process is novelty and self-challenge. Doing something new; doing something different, will coax the brain to grow new nerve cells. This is at the heart of learning and at the heart of developing flexibility. This is also encouraging them that change is possible.

Their homework would be to do some of their daily routines differently, such as using their other hand to brush their hair and their teeth. Part two of their homework would be to give them a challenge.

Power

As noted previously, I have defined power as the ability to get things done; to accomplish; to achieve. This is the ability of the recovering addict to engage with the world to set goals and find a way of reaching them. It involves being persistent, holding the tension of uncertainty in their body without running or otherwise avoiding the constructive process. Success in this area then contributes to their sense of confidence. Most importantly, it contributes to their trust in themselves; rather than a sense of dependence on others. If we think of an engine, then achievement refers to increasing the engine’s size or capacity. For a car, the greater capacity makes it easier to handle hills with less strain. For the client, greater capacity reduces the impact of life stresses.

Addicts have to be resourceful in order to maintain their addictions. However, these skills get used for drug-related and other destructive behaviors and, thus, never get owned or integrated as positive traits. It is important to begin the process of reinterpreting and positively accepting their cunning and resourcefulness and even their ability to manipulate; holding out the carrot that these abilities, if used for positive and constructive objectives, can lead to success in life.

Helping the addict become more powerful

There are a number of factors that contribute to the facilitation of this resilience component. I begin with tools to help the recovering addict cope with a sense of overwhelm, of so many things that they feel bombarded with. The next issue is helping them begin to value aspects of themselves. And finally, I address initial ways for them to be focused.

One technique I use is to have them stand at one end of the room, with the goal of getting to the other side of the room. I give them the task of getting to the other side of the room but they are not allowed to step anywhere within 10 feet of where they are standing. When they finally give up, saying it’s impossible, and that they must first take an initial step that’s about two feet from where they are, I relate this to where they are in life. Baby steps, first steps, small steps, manageable steps are the only way to reach their goals. When they can accept this, — that they can’t solve all their issues at the same time — it goes a long way to short-circuiting their sense of overwhelm.

Accepting their positive skills and abilities is like emotional nourishment. It is the fuel that helps them be able to take these first steps. This becomes the next exercise for these clients: beginning to recognize their sharpness, their cunning as well as the scattered successes in their lives. I make this into an exercise in which the client makes a list of the skills that they have demonstrated in their “goal-oriented” behaviors. I use this term as being more neutral than “drug acquiring”.

Success in life, the ability to get things done, requires being focused. I use our sessions as a training ground for clients acquiring this skill. My process flows from the idea of one day at a time, asking the client to choose a goal for each day. Write down the goal at the start of the day on a three by five card, along with each behavior that needs to be done to achieve that goal. The goal becomes the focus for the day and should be simple enough that it can be accomplished in one day. I create a schedule of times during the day in which they “focus” on their goal and each of the behavioral steps. Importantly, I let them know that this process is actually training their brain and creating new nerve connections and circuits supporting their success and recovery. Thus, every time they focus on their daily goal, they are “rewiring” their brain.

Conclusion

The notion of going from addiction to resilience can be conceived as the coming out of the client. It is teaching the many skills that help them handle stress and maintain recovery. It is an ongoing process that can be thought of as a spiral. After going through the nine pillars, they return to the first, but now at a more advanced level.

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