See, Do, Teach

If you think that going to therapy means you can go to a shrink’s office, unload all your problems, and walk away a new man, you’ll be disappointed. You might feel better for a minute, but if you go home and do the same things you’ve always done, you’ll get what you’ve always got.

Therapy involves learning new skills. The couple who’s coming in for marriage counseling needs to learn to listen and respond differently. The anxious person must learn to relax; the depressed one, how to keep going; and the addicted one, why and how to stop using their substance. Every person must be able to observe themselves accurately and compassionately. The greater part of all this learning occurs outside the therapy hour, far from your shrink’s office.

A surgeon once told me they have a saying in medicine: see one, do one, teach one. Only when you complete all three can you say you know the procedure well enough to do it on your own. See one means you watch someone perform a surgical procedure. When you try your hand at it under supervision, you are doing one. Teach one requires you to explain it to someone else, so they can do it, too.

There’s a lot of wisdom in this method, which can be applied with variations to almost any kind of learning. It’s not enough for me to tell you how you can calm yourself down in sixteen seconds by square breathing, you must do it. Then, it’s not enough for you to do it, you must explain to someone else how to do it. I have often found that I think I know something when I start writing about it, only to be confronted by all the ins and outs of the topic before I’ve reached the end of the page. Teaching someone is how you work out the kinks in a skill and develop real mastery. Then, if you really want to learn something, learn it well enough to explain it to your grandmother.

Learning a new skill in therapy is harder than learning a surgical procedure because you really need to use the skills when you are under extreme duress. You need to learn to listen when your spouse is yelling at you, how to calm yourself when you think you’re going to die, how to go on when you wish you would die, and why and how to stop using a substance when it seems like nothing but the substance could solve your problem. You need to be able to observe yourself accurately and compassionately when you are the most ashamed. That’s hard. It’s as hard as a surgeon learning a new procedure, not on a patient, but on himself, blindfolded, without anesthesia. To be able to learn to do that is going to take more than watching one, doing one, and teaching one. You’re going to have to do ten thousand.

This is where drilling comes in, otherwise known as repeated conscious practice. No one likes to drill, but a musician who hasn’t done his scales will not know how to play. An actor who hasn’t rehearsed does not know her lines. A basketball player who hasn’t shot from the foul line countless times will not score a point when the game is at stake. The idea of drilling is to repeat something often enough so you can do it in your sleep. If you’re ever going to be able to listen when your spouse is yelling at you, listening must be automatic.

If change is ever going to occur as a result of therapy, then most of the work, and the drilling, must occur between sessions. The anxious person must take up meditation; the depressed one, action; and the addicted one must repeatedly choose not to use his substance. Everyone must practice observing themselves accurately and compassionately if they’re ever going to have a chance of doing it when it’s hard.


So, you’re anxious. It happens. There are basically two things to do with anxiety. You can face it or avoid it. Avoiding it is often the sensible thing to do if it’s a thing you are not likely to encounter very often; like snakes, for instance. I’m afraid of snakes. If I got a job as a snake charmer, I would have to do something about it; otherwise, I just avoid them.

Now, if I did become a snake charmer, I would have to face my anxiety. I wouldn’t just go and grab the first snake I found and say, go ahead bite me, I dare you. No, that freaks me out just to write about it. A better method would be face my fear systematically, little by little, in circumstances in which I was likely to be successful. And, and this is most important, I would keep myself grounded.

When you are grounded, you are most alert, yet calm and in control. You can get grounded before you step into a difficult situation and it will help you keep your wits about you. If you’re already in a difficult situation, you can ground then, too. If you just left the hard situation and your nerves are still jangled, ground and you will begin to settle down. You can ground anytime, anyplace, anywhere, and no one has to know. Grounding puts healthy distance between you and negative feelings.

No, grounding is not the same as relaxing, being cool, or mellowing out. It’s not a form of meditation. It’s getting a grip on the obvious, that’s all. The general idea is to get out of your head, at least the part of your head that’s like a broken record. It’s a little like breaking a spell.

If you know how to ground, you don’t need that stiff drink, or that pill, or that cigarette, reefer, or that bag of dope. If you know how to ground, you can go anywhere, do anything, and deal with anyone, within reason.

Here’s a few general tips on grounding: Continue reading

Some Things You May Not Know About Substance Abuse, Part 11: Often Drugs Work Too Well

Often Drugs Work Too Well

You’ve told your doctor you are anxious or in pain. You got a prescription for Atavan, Klonopin, Valium, or Xanax, if it was anxiety; if it was pain, you might’ve gotten a script for a narcotic like Percoset, Vicodin, Oxicotin, or Morphine. These will certainly take away your anxiety or pain; fast. If you use them sparingly, or intensively for a limited period of time, they can be wonderful. If you use them too long, they can cause more problems than they solve.

There are drugs that work right away to make you feel better and others that take time to raise blood levels. The type that slowly raises blood levels never results in addiction. Anti depressants are like that, you get the side effects first and the desired effects don’t come for two to three weeks, if they come at all. That kind of drug may make you feel better, but not right away, and you can safely take them for an extended period of time.

The drugs that make you feel better right away by removing anxiety or pain can cause real problems if you rely on them too much and for too long. The first sign of trouble is increased tolerance, needing a larger dose of the drug to achieve the same effect. The body, in its wisdom, is building up defenses against the drug.

Why would your body do such a thing? Why won’t it just let you be free of anxiety and pain? Why does your body have to torture you like that?

It’s necessary to have some anxiety and pain for the body to function properly. They are signals that there is danger or something is wrong. Without anxiety, you wouldn’t look both ways when crossing the street. Without pain, you would walk on a broken ankle and injure it more. Anxiety and pain are too valuable to do without.

This is why the body will develop tolerance for the drugs that immediately take away anxiety and pain. If you fail to listen to the body and go on taking more anyway, then you begin to show the second sign of addiction, withdrawal. In withdrawal, as we have seen, (go here if you don’t remember seeing this) whatever anxiety and pain you took away with the drug, comes back, doubled, making up for lost time. This makes you use the drug even more, to avoid withdrawal.

The third way that these drugs get you is by working too well. They do such a good job of taking away anxiety and pain, short term, that you don’t develop ways to cope with them yourself. We can learn to cope with anxiety and pain without drugs; there are skills, if you learn to use them. If you don’t need to use them, you never learn.

If your doctor has prescribed drugs for anxiety or pain, it’s definitely OK to take them for a few weeks if needed, if you have no history of addiction. If you have a history of addiction, then you should tell your doctor so that the risks and benefits of taking them can be accurately considered.

How long is too long for these drugs? When you begin to show tolerance, when the initial dose is no longer enough, it’s already been too long. You should be making plans to stop them before bigger problems develop. Problems such as withdrawal, and not learning how to cope without the drug.

You, have a remarkable ability to learn to cope without drugs. If you tried it without drugs, you would know it.

Click here to see other posts I’ve written about addiction

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When Madness Takes Cover

So, you’ve stopped drinking, or drugging, or gambling, or sleeping around. Your depression seems to have lifted. You haven’t been violent. Your anxiety no longer makes all the decisions. You’re up in the morning and dressed when you need to be. The madness seems to have gone away.

Has it, really?

Madness takes cover sometimes when it feels threatened. It’ll hide in the bushes and come roaring out when you least suspect it. Make no mistake, madness is cunning, baffling, and very, very patient. While you’ve been collecting key rings at your NA meeting, the madness has been doing pushups in the dark.

Madness prefers the dark. It likes to perform its dirty deeds in secret. The night belongs to Michelob. However, madness is rarely ever a real secret. It’s kidding you when you believe it leaves no trace. You can tell when madness is still afoot if you are willing to read the signs.

These are the signs:

You haven’t done the things promised for your recovery

If the problem behavior is gone, but you still haven’t been to see a therapist, attended meetings, written that letter of apology, changed associates, or done any of the things you promised, then the madness is just hoping you won’t notice.

The behavioral changes have been minor

The more serious the madness has been, the more excited you’ll be when there’s been a slight improvement.

You were drinking every day, now you’re thrilled that you cut down to once a week. You used to gamble away all of your paycheck, now you only buy a few scratch-offs. You used to beat your wife, now you only puts holes in the wall. The underlying attitudes towards drinking, gambling, or violence have not changed; the only thing changed is the frequency and severity.

When gardeners trim bushes back a little, they call it pruning; it doesn’t destroy the bush, it makes it grow more. The same thing happens when only minor changes are accomplished. You wouldn’t be satisfied with your surgeon if you had a mastectomy and he left some cancer behind, so don’t fool yourself by minor behavioral changes.

Other problems have arisen

Sometimes the illness plays whack-a-mole by extinguishing one problem behavior, only to transfer it to another. We see this frequently with addicts who will use one drug until the heat is on, and then switch to a different drug. Instead of scoring heroin on the street and using dirty needles, they get their narcotics from a doctor. You’ll think that’s an improvement, until you start to abuse those pills, too. The underlying issue remains.

Thinking has not changed

If the rationalizations that have justified the madness are still in evidence, then the madness has not gone away. You used to say you needed to drink, so you drank. Now, you don’t drink, but you still say you need to. Guess what? You’ll drink again. If the madness was truly gone, you’d no longer believe you needed it.

No fence has been built

It is not enough just to change the problem behavior to eradicate an illness. You also have to know the route that it takes before it arrives. You need to put up a gate and shut out behavior that, in itself, is not problematic, but leads up to the problem.

Madness comes masquerading as something harmless so that you will not see it coming. Pedophiles start off by making friends with a child. There’s nothing wrong with making friends with a child, right? But, then they gradually groom the child to accept more and more sexual behavior. We protect children from pedophiles by not permitting them to live near schools. This is not because it is bad to live near a school, but it is bad for pedophiles to live near schools.

Authentic recovery means that you see through all the disguises.

History is minimized

If the story you tell about the illness differs significantly from your partner’s, then the madness is still lurking about. If you talk about your depression only in terms of your suffering and leave out how it affected others, then you’ve not incorporated other points of view into your own. Your limited perspective is still all you have. You have an incomplete appreciation of the costs of your choices. You should be able to tell your partner’s side of the story as well as your own.

You’re withdrawn

If your partner complains that you’re virtually unreachable, emotionally inaccessible, or sexually uninterested, then the madness may be in hiding. It doesn’t want people to ask too many questions, know too much, or get too close.

You’re always angry with your partner

You may be blaming other people for calling out the madness and challenging it. you may be using anger as a way to keep others away, off balance, and uninformed. You may still be taking sides with the madness, against your partner.

Your partner is working harder at recovery than you are

Your partner has been on you like white on rice. Ever since you had that affair, she’s been monitoring your phone, checking your whereabouts, scanning your emails, opening your letters. She met every single female acquaintance you have and gave them all the stink eye. She scrutinizes your expression when every waitress approaches. She tried every new position you wanted in an attempt to reawaken your sex life. She found a therapist for you, set up the appointment, went to every session, paid, and did the homework assignments. Your partner is working harder than you are.

If you have not taken responsibility for change, then you will not make the right choices the moment your partner’s back is turned.

You say everything is changed

You’re not the one to judge whether anything has changed. When your madness fools people, it fools you first.

You want to move on and not get stuck in the past

That’s the madness talking, trying to convince you to not learn from the past. Truly recovering people remind themselves of the past regularly, so that they’ll not repeat it.

You want credit for improvements

An adult straightens the house every day. He scrubs the toilets when they need it and mops the floor when it’s dirty. He doesn’t expect a medal for it. He just does it because it needs doing.

A toddler tickles the furniture with a feather duster once in a while and everyone will fall all over him, saying he was very helpful. That’s what they do for a child. Are you a child?

When madness takes over: the less you do, the more credit you think you deserve.

In a healthy world: you don’t earn special points for doing what you should have been doing all along.

It’s still all about you

Not only have you stopped the problematic behavior, but you’ve been going to therapy, attending AA, writing in your journal, and getting in touch with your feelings. These are all good things, but you’re still as self-involved as ever.

Real change means taking action towards becoming more loving, generous, caring, and empathetic towards others.

There are no signs

You looked over this list and you did not find a single thing that indicates madness may be lurking. There seem to be no signs. Well, that’s your sign. If you aren’t seeing signs, then you’re fooling yourself. There are always signs.

The road to recovery is the same road as the road to ruin; you’re just traveling in a different direction. You pass by the same markers as when you were heading to ruin. You should be seeing them now and recognizing them for what they are. You should also be seeing some signs that indicate you are heading in the right direction. You should be seeing meaningful change.