Six Good Things That Happen Once You Quit Drinking
When people with an alcohol use disorder decide to quit drinking, there’s usually one big reason. Maybe they lost their job because of their drinking, their spouse threatened to leave and take the kids, or they ended up in a drug court with a choice between getting help or going to prison.
Even if you do have one big reason for quitting, there are many less important — but still pretty nice — benefits that come with it. Whether you have a serious problem with alcohol or you feel like you could just use a break from alcohol, the following are some of the good things that happen once you quit.
You sleep better.
A lot of people assume alcohol helps you sleep better, but really the opposite is true. Alcohol helps you fall asleep more easily, but it also prevents you from reaching deep, restorative sleep.
When you’ve been drinking, you spend more time in the shallow parts of the sleep cycle, especially REM sleep, which is why you tend to remember your dreams more. After the first few hours, your sleep becomes disrupted as the alcohol is metabolized and your body starts to experience the rebound effect, which typically results in increased anxiety.
Typically, people find they sleep better pretty quickly after they stop drinking. They feel more rested because they sleep more deeply and sleep all night instead of waking up frequently in the early morning hours. If you’re getting sober after a serious addiction, it may take weeks or months for your sleep patterns to return to normal, but it will happen eventually.
You feel better.
If you drink a lot, it might be that you only feel good or even normal for a short period when you’ve had a certain amount to drink. The rest of the time, you may be hungover, sleep deprived, or in the early stages of withdrawal.
If you’re a very heavy drinker, you may be feeling some health effects such as lack of energy from malnutrition, frequent illnesses, or even problems resulting from heart or liver disease.
When you quit drinking, you may temporarily feel worse while you’re going through withdrawal, but then you’ll start to feel much better in general. You won’t be hungover or starting withdrawal and you’ll have more energy because you’re digesting your food better and sleeping more deeply.
You think better.
Obviously, no one is mentally sharp while drunk but the cognitive effects of drinking tend to persist even when you’re not drinking. One reason is alcohol’s effect on sleep.
When you’re not sleeping deeply and running a chronic sleep deficit, your brain doesn’t work as well. Research shows that sleep deprivation and sleep deficit lead to cognitive impairments, including poorer working memory, poorer concentration, poorer long-term memory, and worse decision making.
Poor sleep also interferes with memory consolidation, so if you’re in school or trying to learn new skills, drinking will make it harder. When you quit drinking, you will probably notice your head feels clearer even if it takes a while for your sleep to get back to normal.
You lose weight.
Most people find they lose weight pretty quickly once they stop drinking. Alcohol has a lot of empty calories, which add up fast, even if you’re only having a few drinks a night.
For example, a can of beer has about 150 calories, so you could easily drink an extra 600 calories a night — about a quarter of the daily caloric needs for an average male — without even reaching the threshold for binge drinking. Not only that, but alcohol boosts estrogen production in both men and women, making it harder to metabolize fat.
As a result, many people are surprised to find that they lose weight when they stop drinking, even if they aren’t trying. It should be noted though, that some people actually gain weight. It’s not uncommon for people to start eating a lot of sweets when they quit drinking, which quickly leads to weight gain.
You look younger.
You’re probably aware that alcohol is a diuretic, meaning it extracts water from your body. That’s why you pee so much when you drink — you actually discharge more liquid than you consume. This has a number of effects, but the most apparent is its effect on your skin.
When your skin dries out, it becomes less elastic. As a result, you might look older and more wrinkled after just one night of heavy drinking.
If you drink often, the effect is compounded. However, once you quit drinking, you start looking younger pretty quickly. Your body wants to be adequately hydrated, so it will hold on to that water once you stop messing with your system.
You have more free time.
Most people are not aware of how much time drinking consumes until they quit. Heavy drinkers often block off time specifically to drink, which means they aren’t doing other things with that time.
Alcohol also distorts your perception of time, especially when you start missing chunks due to blacking out. What’s more, alcohol often makes people and activities seem more interesting than they really are. When people quit drinking, they suddenly find they have a lot of free time on their hands they can use to spend time with people they care about, engage in new hobbies, read, get things done, or whatever else they want to do.
A lot of good things happen when you quit drinking. The benefits described above are only the ones you might notice pretty quickly and don’t even include many of the health or relationship benefits that will become apparent with time. At The Foundry, we know that recovering from drug and alcohol addiction is about far more than just abstinence; it’s about becoming free to live the life you want to live. To learn more about our treatment programs, call us today at 1-844-955-1066 or explore our website.
How to Feel Better by Ending Rumination
You probably know the feeling: you’re a bit bored at work or home, or maybe you’ve just gotten into bed, when some thought pops into your head and you can’t let it go. Maybe it’s something embarrassing you did when you were a child or something you’re worried might happen at some undefined point in the future.
Maybe you start replaying a conversation, thinking about all the things you should have said. The next thing you know, you’ve been rehashing these thoughts for 20 or 30 minutes, perhaps even longer. You haven’t gotten anything done, you haven’t slept, and now you feel more depressed and anxious than you did before.
This is rumination and it’s strongly associated with mental health issues such as depression, anxiety, and PTSD. When you’re recovering from a substance use disorder, ruminating definitely doesn’t help, but it’s also a hard habit to break. The following tips can help you quit ruminating and feel better.
Learn to recognize rumination.
Like other bad habits, you can start ruminating without even being aware of it. You quickly get swept up in your thoughts and are not aware of what your mind is even doing.
If you want to stop ruminating, then you have to learn to notice when you’re doing it. This is a skill called metacognitive awareness — being aware of what you’re thinking about. The first step is to label rumination whenever you catch yourself doing it.
It’s important that you do not scold yourself when you realize you’ve been ruminating. Instead, congratulate yourself for noticing: “Ah, there’s rumination again, good catch!”
Notice your rumination triggers.
Noticing rumination is only the first step. Your real goal is to better understand what’s causing it.
Rumination typically has triggers, just like any bad habit. That is, it doesn’t come out of the blue but rather is caused by something you hear or see — or even a particular train of thought.
When you catch yourself ruminating, notice what you’re ruminating about and notice what triggered it. For example, maybe you were reading an article that mentioned a topic you recently argued with someone about or that reminded you of a bad decision you made, perhaps years ago.
You will probably notice there are only a few topics you get stuck ruminating about and your triggers are likely things closely related to these topics. Once you are aware of your triggers, you can be more vigilant about falling into the rumination trap in the first place.
Our minds are very associative and once you fall into the rumination trap, it’s hard to get out just by trying to force yourself to think of something else. If you’re sitting or lying in the same position, in the same room, trying to do the same task, you’ll probably keep getting drawn back into the rumination.
Although rumination has negative outcomes, it is also more interesting to your mind than whatever you’re supposed to be doing because your mind thinks it’s solving a problem. If someone were running toward you and yelling, you would definitely pay attention to them even if you’d rather not have to deal with that situation.
Rumination is similar, except the threat you’re preoccupied with might be far in the past or a hazy possibility in the future.
To get out of that rut, you may have to change more than your focus. You might have to get up and walk around for a while, switch to a different task, go to a different room, or do something that demands more attention than whatever you’re ruminating about.
Maybe get some exercise or play a video game. The more you ruminate on a particular topic, the deeper that groove gets in your brain.
That means you fall into that rut more easily and have a harder time escaping. Distracting yourself will limit rumination and help keep that groove from getting much deeper.
Write down your thoughts.
Writing down your thoughts helps with rumination in several ways. First, it helps you recognize when you’re ruminating, identify your triggers, and distract yourself, as discussed above.
When you write about rumination, you’re automatically enlisting some of your metacognitive awareness. Second, when your mind ruminates, it believes it’s solving a problem, except that it never gets very far.
It just keeps rehearsing the initial steps. Typically, it’s gotten hold of some insight it doesn’t want to forget, so it gets stuck in a loop.
Writing down your thoughts commits them safely to paper so your brain can stop rehearsing it. Writing it down also helps you actually make progress thinking through the problem instead of repeating the first few thoughts.
This helps you process whatever it is you’re ruminating about. If it’s something you’re worried about happening in the future, it can even lead you to some concrete steps that might help you solve the problem and worry less about it.
Practice mindfulness meditation.
Mindfulness meditation is one of the best ways to expand metacognitive awareness, since it’s essentially a practice of spending 20 or 30 minutes a day just watching thoughts and emotions rise and fall in your mind.
With practice, you learn to avoid getting swept up in your thoughts. Mindfulness meditation also helps moderate activity in the brain’s default mode network, which is active during rumination.
Remember that it takes practice.
Finally, keep in mind that getting rumination under control will take practice and persistent effort. Rumination is a habit, probably one that you’ve been doing for years.
Breaking it for good will probably take months. The good news is that every time you catch yourself ruminating and take some definite action to stop it, you’re also sparing yourself a lot of pointless anxiety and self-criticism. After a while, you will notice rumination gradually diminish.
When you’re recovering from addiction, it’s crucial to look after your mental health. Anxiety, depression, PTSD, and other mental health issues are common among people recovering from substance use disorders and they are all conditions highly associated with rumination. Awareness is key, followed by action.
At The Foundry, we know that recovery begins in the mind. That’s why we use cognitive behavioral therapy, dialectical behavioral therapy, mindfulness meditation, and other treatment modalities to help our clients become emotionally resilient. To learn more about our treatment options, call us today at 1-844-955-1066 or explore our website.
Addressing Your Own Fears and Anxiety While Your Family Member is in Treatment
Family members address and navigate through seemingly endless stormy waters once their family member enters treatment. Having a family member in treatment is demanding of our time and resources and most of all, it’s emotionally exhausting.
Our worry and anxiety fluctuate throughout the process and we often find ourselves in a constant state of “fight or flight.” This helps to keep us prepared to take action when dealing with a crisis or a threat. It is a constant state that keeps us striving to take “control” of the fear or worry. The challenge of taking “control” of a situation this way is that it really only works if we are in physical danger. When dealing with anxiety, perceived or real, our version of taking “control” becomes more of a problem…an emotionally exhausting problem.
There is no doubt that our fear is real, especially when our family member’s needs must be met through more intensive interventions. However, our tendency to allow our thoughts to create and exacerbate anxiety keeps us in this state of automatic response, constantly reacting to our perceived fears using ineffective tools to take “control.”
Below are 10 useful ways to manage your anxiety more effectively as you engage in this journey with your family:
10 Ways to have Long-Term Success with Managing your Anxiety:
- Find control within ourselves to decrease the need to control “the situation”
- Change negative beliefs
- Cultivate new approaches to thinking
- Increase awareness of thoughts and storylines that we follow, especially those that always increase anxiety
- Learn how to stop replaying the past and rehearsing a dissatisfying future
- Decrease self–judgment and blame
- Distinguish between urgency and importance when it comes to situations that need addressed
- Increase self-awareness and identify patterns that are impacting our success as a parent
- Change language to change behavior to increase self-awareness
- Learn how to decrease expectations and truly allow for acceptance
- While it can seem challenging to change how we think and cope with difficult situations, we must also remember that a loved one is trying to learn an entirely new life without addiction. In our Family Program we can work with you and your loved one to create a new path together.
Jen Murphy, M.Ed., LPC is the Family Director at The Foundry, a rehab and substance abuse treatment center in Colorado, providing services specifically for Foundry family members to provide support and guidance throughout their family member’s treatment process. In our work with families we continually honor the family’s therapeutic process and creatively support the unique needs of each individual family. Jen Murphy can be contacted at firstname.lastname@example.org
Have You Suffered Emotional Abuse?
Abuse is a major risk factor for developing mental health issues such as major depression and anxiety and for developing substance use issues. This can happen to both children and adults and while childhood abuse and neglect have a greater effect on people over the lifespan, abuse is a major concern for adults too.
When we think of abuse, physical and sexual abuse are typically the first things to come to mind. However, emotional abuse can be just as damaging and more insidious. While people are typically aware they are being physically or sexually abused, emotional abuse is often more subtle. Part of the power of emotional abuse is its deniability and emotional abusers are often adept at making you doubt your own judgment.
As with physical abuse, the goal of emotional abuse is to control you. However, while physical abuse mainly works through intimidation, emotional abuse gets inside your head and undermines your confidence and judgment. People who are emotionally abused often feel like they are incapable or unworthy of leaving an abusive situation. Although they may know they are unhappy, they may not be aware that what they’re experiencing is emotional abuse. The following are some common signs of emotional abuse and what to do about it.
What It’s Not
First, it’s important to clarify that someone is not being emotionally abusive just because they do something we don’t like or something that makes us feel bad. Arguing, for example, is common in almost every close relationship because it’s normal for people to sometimes have conflicting needs and desires. Even yelling is typically not a sign of emotional abuse. Breaking up with someone or otherwise protecting your own boundaries is not emotional abuse, nor is honest communication. Emotional abuse is done with the intent to make someone feel bad, inadequate, stupid, guilty, or weak and usually for the purposes of control.
Perhaps the most obvious sign of emotional abuse is disparaging behavior. This is an overt assault on your sense of self-worth. Disparaging behavior may include name-calling, such as outright calling you stupid, weak, ugly, hysterical, fat, and so on. A slightly subtler way is to use “pet” names that are played off as playful or affectionate but are really belittling. If you’re the object of such a pet name, you can easily spot it by how it makes you feel. Other ways of disparaging include making sarcastic remarks, making jokes at your expense, or making light of your interests or accomplishments. This is all intended to make you feel worse about yourself so you feel like you need the abuser’s approval and so you don’t think you could do better elsewhere.
Isolating or Controlling Behavior
As noted above, emotional abuse is primarily a means of control and therefore any controlling behavior – overt or covert – is also a form of emotional abuse. Controlling behavior can take many forms. One way that has become disturbingly common is checking your partner’s phone for incriminating texts. This implies your partner is untrustworthy and it makes unfair demands on their privacy. If you believe your partner is cheating on you, you should ask. If you feel like you can’t trust your partner, then break up.
Another common and subtle way to control is withholding affection unless the other person does what you want. This tactic can be used by romantic partners or by parents and it can be especially harmful to children. However, it’s not the same as not being affectionate because you’re arguing or angry about something specific.
Isolating is another common control tactic. The idea is to keep the person dependent. The abuser might try to keep you from interacting with friends and family, for example. They don’t want you to have options they don’t approve of and they don’t want other people filling your head with ideas they don’t like.
Gaslighting is a way of undermining your sense of reality. This is typically done by contradicting things they know to be true. For example, they might spring plans on you at the last minute and when you say you didn’t know anything about it, they might insist you talked about it last week. Over time, you start to doubt your own memory and start to rely on your partner, who seems to remember everything. Often, a gaslighter will lie about things that aren’t important at all just to undermine your confidence.
Having Unrealistic Expectations
Other tactic emotional abusers use to undermine your confidence is to have unreasonably high expectations. These might pertain to them specifically, such as expecting you to spend all your time with them or make unreasonable sacrifices on their behalf. It might also be more general, such as never being satisfied with anything you do, never complimenting you, always finding fault, and generally making you feel like you always fall short. If you set the bar high enough for someone you can always be sure they will fail, or at least feel like they’ve failed. This is especially damaging because it develops a sense of learned helplessness – nothing you do is good enough, so why try? It also keeps you seeking the abuser’s approval.
What to Do
Emotional abuse is hard to escape because much of the time, you’re not even sure it’s happening. Awareness is the first step. Pay attention to the patterns. Your parents, teachers, boss, spouse, or romantic partners aren’t supposed to make you feel bad about yourself. If you’re always walking on eggshells around them, something is wrong. Look out for the behaviors described above.
Next, know it’s not your fault. Emotional abusers often make a good show of being kind and supportive and it’s easy to fall for. If you experienced emotional abuse as a child, you probably just thought that it was normal. The sooner you realize it’s not, the better.
Get away from the abusive situation as soon as possible. If you can’t for some reason, work on setting boundaries. This can be incredibly hard and you may need the help of a therapist and possibly a support structure, which an emotional abuser certainly won’t like. What’s more, don’t fall into the trap of thinking you can fix an emotional abuser. They’re good at making apologies and promises, but they also have their own problems and they aren’t likely to change their behavior for good.
If you’ve been the victim of emotional abuse, it has probably caused you some problems, which might include depression, anxiety, or substance use issues. Of the 10 adverse childhood experiences, or ACEs, linked to increased addiction risk, emotional abuse accounts for two, each of which at least doubles your risk of addiction. Awareness is the first step.
At Foundry Treatment Center, we share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at 1-844-955-1066.
Caring for Your Mental Health During Quarantine
At the moment, Americans and people around the world are currently advised to stay home to help prevent the spread of Covid-19, or the coronavirus. While this is a sensible precaution to protect public health, it may seriously test many people’s mental health, especially anyone with a history of anxiety or depression. No one knows how long the quarantine might last but the current estimate is at least eight weeks. On top of that, people aren’t sure how this virus might affect their jobs or the economy overall. Then, of course, there is the possibility that you or someone you care about might get sick. Compounding all this uncertainty, we are denied major sources of comfort such as spending time with family and friends, religious and spiritual gatherings, and 12-Step meetings. If the quarantine has got you on edge, here are some suggestions for managing your mental health.
Don’t Obsess Over the News
It’s tempting to spend your day refreshing Twitter or watching cable news, trying to keep up on new developments with the virus. That’s especially true since this is--we hope--a once-in-a-lifetime event. We want to know if we should be doing anything, if there have been new cases or cures, how many cases there are in our area, what the government is doing, and when this whole thing might be over. However, obsessing over the news, now more than ever, is only going to make you feel worse. While a lot of the media coverage has been uncharacteristically measured, it can still give you the feeling that we’re all living in a disaster movie. Try to limit your news consumption to once a day. Check the CDC website for information and updates, and otherwise keep calm and carry on.
Stay In Touch With Your Therapist
If you’ve had issues with anxiety, depression, or substance use, you may have a regular therapist. You may or may not be able to keep your regular appointments, depending on where you live. Be sure to contact your therapist and make some kind of backup plan. A lot of therapists are now offering HIPAA-compliant video sessions, so that may be an option. Other people have been doing phone sessions or Skype sessions. If you don’t have a regular therapist or if you can’t get in touch with your therapist and you or someone you care about is feeling overwhelmed, sad, depressed, anxious, or possibly a danger to yourself or others, call 911 or call SAMHSA’s Disaster Distress Helpline at 1-800-985-5990.
Since the quarantine feels like something between a sick day and a holiday, you might feel tempted to splurge on junk food. However, it’s important to keep two things in mind. First, this might go on for a while and you don’t want your cheat day eating to become a habit. Second, what you eat has a pretty direct effect on your mental health. This effect appears to be especially strong for depression. Try to eat meals that are mainly composed of whole foods, especially fruits, vegetables, whole grains, nuts, beans, legumes, and lean meats, especially fish. As much as possible, avoid processed foods, especially processed meats, which are highly inflammatory, sugar, and fried food. If you’re recovering from addiction, it should go without saying that you should avoid alcohol as well.
Try to Get Some Exercise
Exercise is one of the best ways to boost your mood and lower stress. It releases mood-boosting endorphins and serotonin as well as BDNF, which grows neurons in the hippocampus, a part of the brain that helps consolidate memories. Exercise also increases blood flow to the brain, especially the prefrontal cortex, which is responsible for executive functions such as planning, emotional regulation, foresight, and self-control--all of which are great to have in a crisis. At the moment, it’s still considered safe to walk, run, or bike outside, since the risk of transmission is low in outdoor environments. There are also plenty of workouts and yoga routines you can do in a small space at home. Check out YouTube for some options that appeal to you.
Reframe How You Think About the Quarantine
The funny thing about the quarantine is that up until a few weeks ago, there seemed to be no end of complaints about how Americans never properly socialize anymore. We all just stay home and play video games and watch Netflix. When we do go out, we spend all our time looking at our phones. Now that we have to stay home, it seems like a huge burden. Instead of feeling constrained, choose to focus on all the stuff you can do at home. Catch up on reading, cleaning, TV shows, or other projects that you seem to always put off.
Stick to Your Regular Routine as Much as Possible
Part of the stress of being quarantined is that it feels like the whole world has suddenly changed. Change is always a bit stressful, especially changes you can’t control. Part of the solution in this case is to take control of the things you can control and stick to your normal routine as much as you can while still complying with public health recommendations. Keep getting up at your regular time and taking a shower, even if you don’t have to be anywhere. Eat your regular meals, do the things you normally do, and go to bed at your regular time. If you are recovering from addiction or a mental health issue, there are probably things you normally do at home as part of your recovery plan and there’s no reason why you can’t keep up with those.
Stay in Communication With Friends and Family
We have more ways to communicate than any people in history. Don’t get so much into your reading or binge watching that you don’t keep in touch with friends and family.
Remember, We’re All in the Same Boat
If you’re sitting home alone during the quarantine, it’s easy to feel like you are alone in the world. However, there are millions, perhaps hundreds of millions who are having very similar experiences at the moment. So first, consider that whatever discomfort you’re feeling as a result of the quarantine is a small sacrifice that you’re making willingly to help protect the most vulnerable people in our society. Second, consider the welfare of other people under quarantine. Approaching the situation with compassion helps you feel less alone and you may think of some small way to help your neighbors too.
You never know what kinds of challenges you may face when recovering from a mental health issue or a substance use disorder. While we typically prepare ourselves to cope with more mundane sorts of stress, the same principles basically apply for outlier events like a pandemic. At The Foundry, we know that recovery from addiction is really about giving you the skills to lead a happier, more fulfilling life. To learn more about our treatment programs, explore our website or call us today at 1-844-955-1066.
What’s the Difference Between CBT and DBT?
Cognitive behavioral therapy, or CBT, and dialectical behavioral therapy, or DBT, are both forms of psychotherapy frequently used as part of a comprehensive addiction treatment program. Both have been proven effective for treating substance use disorders as well as many commonly co-occurring mental health issues. As the names suggest, CBT and DBT have much in common. In fact, you could say that DBT is a specialized form of CBT. Which is best for you depends on your particular situation. The following is a look at the important differences between CBT and DBT.
CBT Came First
As noted above, DBT is a specialized form of CBT. CBT was developed in the 1960s by psychologist Aaron Beck, based in part on the rational-emotive behavioral therapy, or REBT, of Albert Ellis. Beck was trained as a psychoanalyst but wanted some way of giving his clients more tangible results in less time. The core insight of CBT is that the things that happen to us don’t directly cause our emotions. Our emotions are a result of our thinking about what happens to us. What’s more, many of our thoughts, beliefs, and assumptions are distorted in such a way that we suffer more than is necessary when things don’t go how we would like. Much of CBT is about identifying and challenging these faulty beliefs and thereby changing our emotional reactions.
Behavior is another important element of CBT. Imagine thoughts, emotions, and behaviors as sides of a triangle. Any change in one has some effect on the others. So, for example, you can change your emotions by changing your thoughts or by changing your behaviors. Therefore, CBT also emphasizes strategies for behavioral change that don’t necessarily require you to feel like doing something. More than anything, CBT represents a fairly large toolkit--skills that therapists can teach their clients to help them better control their emotions and behavior.
DBT Was Developed to Help With Borderline Personality Disorder
DBT was developed in the 1980s by psychologist Marsha Linehan to treat clients with borderline personality disorder, or BPD. BPD is a condition characterized by volatile and intense emotional reactions and frequent relationship problems. For example, someone with BPD might adore a particular friend one day, then feel like that friend has betrayed them--often based on little or no evidence--and switch to hating that person the next day. The friend, understandably, would be confused by this behavior and consequently, close relationships are fraught for someone with BPD.
Linehan found that her BPD patients were often resistant to typical CBT. The main issue was that CBT emphasizes changing challenging emotions by changing faulty thinking. Patients often felt this approach failed to validate their feelings. As a result, Linehan developed an approach to therapy that attempted to balance change and acceptance, and this is where “dialectical” became part of the method. Treatment becomes more of a discussion about which feelings are more valid and which might be constructively altered.
While DBT was originally developed for people with BPD, it has since been adapted for treating other conditions. It has been proven effective for substance use disorders, as well as commonly co-occurring conditions like eating disorders, self-harm, PTSD, and suicidal depression.
DBT Emphasizes Distress Tolerance and Social Skills
In addition to more emphasis on acceptance, DBT also focuses on distress tolerance and social skills. These are particular areas where people with BPD typically struggle the most. CBT focuses on managing challenging emotions by managing thoughts. The volatility and intensity of emotions common in BPD can make this challenging and the patient’s desire for validation may make them less likely to employ cognitive strategies. Therefore, DBT adds an element of distress tolerance. These are skills include mindfulness and acceptance skills, as well as short-term survival skills like distraction and self-soothing. The idea is that the patient will inevitably feel unpleasant and strong emotions but they can develop the skills to keep them from causing problems in life.
Social skills are another important aspect of DBT. These are typically incidental in CBT. For example, you may have social anxiety resulting from an unfounded belief that others are judging you harshly. Since relationship problems are such a central feature of BPD, it makes sense to give special attention to developing social skills--called interpersonal effectiveness. These include skills like expressing your needs, saying no, and resolving conflict.
DBT Is More Structured
In a way, DBT is more intensive than CBT and it is also more structured--both in terms of time and content. In terms of time, people in DBT typically meet individually with a therapist once a week to work on specific issues and skills. They also have a group session each week, which typically lasts two-and-a-half hours. In between sessions, patients will typically check in with the therapist over the phone.
There are also four specific modules in DBT. Distress tolerance and interpersonal effectiveness are two of them and have been discussed above. The other two include mindfulness and emotional regulation. Mindfulness is especially helpful in distress tolerance. It emphasizes observing emotions and events nonjudgmentally. Emotional regulation includes skills like recognizing and labeling emotions, increasing positive emotions, and applying distress-tolerance techniques.
DBT Has a Group Component
As noted above, DBT typically includes both individual and group therapy. CBT can be used with either or both but doesn’t specifically incorporate both. The purpose of including group sessions in DBT is to give patients an opportunity to practice their new interpersonal and emotional regulation skills in a safe, supervised environment.
Neither CBT nor DBT is necessarily better than the other. It really depends on your specific needs. If you do struggle with borderline personality disorder, major depression, an eating disorder, or PTSD, it’s likely you will need DBT. Each of these conditions carries a very high risk of a co-occurring substance use disorder and if you have both, you need treatment for both. Substance use and mental health issues each make the other worse so it’s crucial to treat them in an integrated way.
At The Foundry, we know that everyone seeking help for a substance use disorder has different needs. We offer many options for individualized treatment, including CBT and DBT. To learn more about our treatment options, call us today at 1-844-955-1066.
6 Common Thinking Errors that Worsen Anxiety
Anxiety is a common problem for anyone struggling with or recovering from addiction. The National Epidemiological Survey on Alcohol and Related Conditions surveyed more than 43,000 people and found that among people who had experienced an anxiety disorder in the past year, about 15 percent had at least one substance use disorder--about twice the rate of addiction as in the general population. And that didn’t include post-traumatic stress disorder, or PTSD, which is an even greater risk factor for substance use than generalized anxiety disorder or social anxiety disorder.
At the moment, most of us in the US and elsewhere are under lockdown to help slow the spread of the coronavirus, or COVID-19. If you are already struggling with anxiety, this only adds to the challenge, compounding uncertainty with boredom and isolation. Unfortunately, our own thinking is typically the biggest source of anxiety. The following errors in thinking may be making you more anxious than you need to be.
Trying to Eliminate Anxiety
The first thing to realize is that anxiety is a normal and useful emotion. You can’t eliminate it entirely, nor would you want to. Anxiety alerts us to danger and spurs us to prepare for upcoming challenges. People who never felt anxious left the gene pool a long time ago, which is why everyone feels anxious occasionally and as many as 30 percent of American adults experience an anxiety disorder at some point in their lives.
Trying to eliminate or avoid anxiety, ironically, just ends up making you more anxious. What does make sense is to think about anxiety--and things that make you anxious--rationally. When you do feel anxious, recognize that it’s just the ancient parts of your brain trying to protect you. Accept your anxiety for what it is--a feeling, a sort of warning signal. Then, try to figure out if the thing you are anxious about is really a threat or if you’re making it worse with faulty thinking.
Jumping to Conclusions or Predicting the Future
Worrying about the future is always an issue for people with anxiety issues because the core thinking of anxiety is always something along the lines of “Something awful is going to happen and I won’t be able to do anything about it.” At the moment, that kind of worry is both more concrete and widespread than normal. Right now, a lot of people have the same few worries--will they be able to keep working? How long can they go without income? How long will we be quarantined? Will I or someone I care about catch the virus? And so on.
It’s likely that most of us will face a challenge on one or more of these fronts but attempting to predict the future only makes you worry unnecessarily. No one knows what’s going to happen but when you think about it, the same has been true every day of your life. When you have trouble with anxiety, you tend to imagine the worst possible outcome and assume that it is inevitable. In reality, the future is fundamentally unpredictable. All we can do is make sensible preparations right now and trust that we will find ways to meet challenges in the future.
Should thoughts come from a belief that you, other people, or the world should be different somehow and that it’s awful that they aren’t. When you apply should thoughts to yourself, the result is often depression, whereas applying should thoughts to other people and the world tends to increase stress, anger, and anxiety. So, at the moment, a lot of people are thinking this quarantine is unfair, that they should be able to go to work, go out with friends, play sports, and so on. However, should is just a wall for you to beat your head against. It would be lovely if the world and other people conformed to our wishes but most of the time they don’t. Insisting they should, in the face of overwhelming evidence to the contrary, only makes you more miserable.
Black-and-white thinking, sometimes called all-or-nothing thinking, is the idea that if an outcome isn’t exactly what you want, you shouldn’t bother. This is also sometimes called letting the perfect be the enemy of the good. There are many ways black-and-white thinking can lead to anxiety. In our current situation, if you’re trying to figure out how to cope with being under quarantine, you may not bother with measures that can make you feel better if they aren’t perfect solutions. For example, many people have started doing therapy sessions and 12-Step meetings over Zoom and other online platforms. These are clearly not as good as in-person meetings, but they are considerably better than nothing.
Mental filtering is the habit of only seeing the bad things that happen. It’s a special case of the larger phenomenon of confirmation bias, which is when you only look for evidence that supports your current beliefs. When you do mental filtering, you’re only seeing evidence that supports your belief that something bad is going to happen or is already happening.
In times of crisis, it’s far too easy to focus on the negative, especially now, since all we see on the news is the rising death toll and the shortage of medical supplies to treat new patients. However, if you look for them, there are positive things too. As Mr. Rogers said, look for the helpers. In addition to medical workers and people supplying critical goods and services, there are a lot of communities coming together to help each other and find ways to adapt. If you’re stuck at home, it might be a great opportunity to read, make art, or learn new skills.
Emotional reasoning is the belief that something is true because it feels true. It’s easy to fall into this trap when thinking about the future because ultimately, we don’t have much evidence to rely on. The central belief of anxiety--“Something bad is going to happen and I can’t do anything about it”--relies entirely on emotional reasoning. In reality, no one knows what’s going to happen; everything is a guess. However, you may be able to refute the second part to some extent. Most of us have survived trying experiences. One thing you can do is to look back on those times and think, “If I made it through that, I can make it through this other thing I’m worried about--if it even happens.”
Anxiety is a common challenge for people recovering from addiction and right now is an especially trying time. Anxiety is normal and healthy, but our thinking often makes anxiety far worse than it needs to be. Learning to identify and change this faulty thinking is one of the main priorities of cognitive behavioral therapy, or CBT, and dialectical behavioral therapy, or DBT. It can be very hard to recognize your distorted thinking on your own and a good therapist will speed up the process. At The Foundry, we use CBT, DBT, and several other evidence-based methods to help our clients recover from substance use and co-occurring mental health issues. To learn more, call us at 1-844-955-1066.
When Should You Consider Changing Therapists?
Therapy is an integral part of addiction treatment and most people will continue therapy, at least intermittently, throughout recovery. In an ideal situation, your therapist is your partner in mental health.
You work together to figure out what’s not working in your life and what to do about it. However, as with any relationship, your relationship with your therapist might not be very good or it may start out good and later fall apart. Here are some times you should consider finding a new therapist.
Obviously, if you’re moving, you may have to find a new therapist. Consistency is important in therapy and if you have to drive an hour or more to appointments, it will probably wear you down eventually.
However, geography is becoming less of a barrier to treatment these days. Many therapists were already expanding to remote sessions and that number has probably increased dramatically, since, at the moment, we’re all under quarantine to slow the spread of the coronavirus.
So if you like your therapist and you’re moving, see if remote therapy is an option. Otherwise, consider asking your therapist for a recommendation for someone who can see you remotely or who works in the area you’re moving to.
Unprofessional conduct is definitely a sign you should consider switching therapists. It depends to some extent on how bad the conduct is.
For example, breaching confidentiality or making sexual advances should make you dump your therapist right away.
These behaviors are pretty rare, given that the vast majority of therapists genuinely want to help people and they depend greatly on their professional reputation.
Other forms of unprofessional conduct might include missing appointments, showing up late, or canceling appointments last minute. Sometimes these things are unavoidable, so it shouldn’t be considered unprofessional unless it becomes a pattern.
Behaviors, like looking at their phone during your session, eating, or otherwise not paying attention, are also not encouraging. If you generally like your therapist but you’re bothered by these behaviors, it might be worth a discussion before moving on to someone else.
You Feel Like You’re Not Making Progress
You may get to the point in therapy where you feel like you’re not making any progress. Ideally, you will have set out some goals for therapy and some benchmarks so you can tell how you’re progressing, so it should be fairly obvious when you’re stuck.
Another way you can tell you're stuck is if you feel like every session is the same. You come in and complain about the same things for 50 minutes, then leave and nothing seems to change. Therapy can start to feel like a chore if you’re not getting anything out of it.
If this happens, discuss it with your therapist. Perhaps you can change strategies or re-examine your goals.
Your Needs Change
Sometimes people find that they make a lot of progress in therapy at first and then somehow they get stuck. This is often because your needs change as you go.
For example, maybe when you first started in therapy, your biggest challenge was coping with drug and alcohol cravings but as you got those under control, you found the biggest problem in your life was your relationships.
Yet your therapist keeps focusing on managing cravings and so you feel bored and stuck.
Typically, your therapist will check in from time to time and make sure your needs are being met, but they are not mind readers. If your goals have shifted, you need to let them know.
Usually, you will be able to refocus and work on your new priorities. However, therapists, like everyone else, are better at some things than others.
It’s possible your therapist was great at helping you deal with cravings but not so good at helping you improve your relationships. If that turns out to be the case, it may be time to look for a therapist whose strengths better match your needs.
You Feel Like You Can’t Speak Freely
If there’s one thing that’s essential in a therapist-client relationship, it’s that you should be able to speak freely. This is why confidentiality is so critical.
You can’t be worried about whether your therapist is going to testify against you in court or blab all your secrets to their barber if you’re going to share what’s really bothering you.
However, confidentiality isn’t the whole issue. If you feel like your therapist is judgmental or critical, it can be just as hard to speak openly, as if doubting their discretion.
One skill every therapist should have is non-judgmental listening. As a client, you should feel heard and validated.
That doesn’t mean your therapist has to approve of everything you say or do, just that you shouldn’t be made to feel like a bad person. However, we all have our prejudices and sore spots.
It’s not always possible for your therapist to refrain from judgment. If you raise the issue and it doesn’t improve, it might indicate that your therapist isn’t the best person to help you with your particular issues.
Your Therapist Has Boundary Issues
Healthy boundaries means you protect what’s important to you and you respect what’s important to others. A good therapist might give you suggestions but they shouldn’t try to control you, tell you what to do, or otherwise violate your autonomy.
Nor should they be too familiar. While you should feel like you can be open with your therapist, your therapist is not your friend.
If they share too much about their personal life or try to have a relationship outside of therapy, it signals a lack of boundaries and you may want to find someone else.
It’s important to keep in mind that it can take a little while for a therapeutic relationship to develop. It may take several months for you to feel comfortable opening up and it may take that long for your therapist to get a clear picture of your background and needs. For those reasons, it’s always better to talk it over first if you are not happy with the way therapy is going. It’s usually better to fix a problem if it can be fixed rather than start over with someone new.
However, some problems just can’t be fixed, at which point, you should just move on. At The Foundry, we know that mental health is a key aspect of a strong recovery and we use evidence-based methods to treat substance use disorders and co-occurring mental health issues. To learn more, call us today at 1-844-955-1066.