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Addiction: Can People Change

How Do People Change?

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Addiction – How Do People Change?   Introduction – From An Addiction Point of View From an addiction point of view, how do people change? Can an individual’s resistance to change hamper their recovery? Is resistance normal? You may be asking yourself some of these questions, either for yourself or a loved one struggling with addiction. Addiction can ruin lives and have a detrimental effect on all those involved. Through addiction, one may lose their job, their marriage, their family, their health, their assets and their dignity and self-respect, amongst other things. Even though the consequences of their addiction may be apparent to the addict, there may still be a pervasive unwillingness to reach out for help, go into therapy with a psychologist or even fully commit when they are in treatment. This is what we call resistance.   What is Resistance? In traditional psychotherapy, Sigmund Freud conceptualized resistance as an individual’s unconscious process, protecting them from unwanted and intolerable anxiety which can help prevent them from facing uncomfortable and unresolved feelings. Resistance can be seen as a completely normal part of the process. Part of resistance, is an individual’s motivation for change. Motivation can be understood not as something that one has but rather as something one does. It involves recognizing a problem, searching for a way to change, and then beginning and sticking with that change strategy (Miller, 1995). An individual’s level of motivation can be influenced by a number of factors, one of them being their loved ones and/or family members. Although, internal factors form the basis of change, loved ones’ support can be pivotal in an individual’s motivation for change. It is important to note that an individual’s motivation for change is fluid and can oscillate between levels, however, one does not need to have “hit rock bottom” or have destructive and damaging consequences, to realise that they need change. Resistance can take form in various ways and behaviours and is not limited to simply refusing treatment. Resistance can sometimes be seen through compliance. This is noticed when an addict who often complies with treatment, appears agreeable and passive, not allowing them to fully immerse into the recovery process, but rather “go with the motions”. This type of a resistance is difficult to work with as it is often overlooked, as the addict uses manipulation as a tactic to make others think that they are willing. Other forms of resistance include constantly focusing on other people during treatment, finding faults and grievances with the system, an unwillingness to open up about ones struggles and keeping secrets or hiding ones dysfunction.   Influences of Change There exists four aspects that influence an individual’s motivation for change. An addict’s distress levels regarding their addiction become an indicator for change. They may have experienced periods of stress, depression or anxiety that pervade their daily functioning. Secondly, important life events become another factor in motivating change, such as a death of a loved one, a birth of a child, a spiritual realisation or losing employment, just to name a few. Another factor to change can be a realisation of the negative consequences the addiction has on an individual’s life. Taking a holistic view of the impact the substances have had, financially, physically, psychologically and socially can lead to change. Lastly, as mentioned previously, external incentives such as support from friends, family and the broader community can stimulate an addict’s motivation to want to change. The process of change can be identified within five steps as conceptualized by Prochaska and DiClemente (1986): Pre-contemplation – This stage involves being unaware of any problem related to their addiction and the addict is often unconcerned about their addiction. They tend to ignore anyone else’s belief that they are doing something harmful. Contemplation – People at this stage are considering whether or not to change. They enjoy using drugs, they enjoy using substances, but they are sometimes worried about the increasing difficulties the use is causing. They are constantly debating with themselves whether or not they have a problem. Preparation – People at this stage are deciding how they are going to change. They may be ready to change. Action – People at this stage have begun the process of changing but require help identifying realistic steps, high risk situations, and new coping strategies. Maintenance – People in this stage have made a change and are working on maintaining the change.   Factors that Influence Resistance The concept of self-efficacy is also imperative when addressing resistance in recovery. Self-efficacy refers to an individual’s belief in oneself to achieve something or to reach a specific goal. This can be related to an individual’s self-esteem and whether they believe in their own abilities. The lack of this belief in oneself may result in resistance to becoming sober or clean. The addict may also be in a sense of denial within their addiction and believe that their dysfunctional behaviour is not as bad as it seems, often minimizing the extent of their addiction. This becomes a cycle, as the addict tends to disregard the effects of their behaviour and how their addiction is affecting various spheres of their lives. For instance, an individual may lose employment due to their addiction and in turn, use that an excuse to use their substances again due to an inability to cope with it. This denial often comes with blaming other people for their addiction and a refusal to take accountability for their actions. Through this, an apparent resistance to treatment is evident due to a denial of the severity of the addiction. It is also common for addicts to fear a life without their substances. They may have become so accustomed and dependent on their substance, that a life without it may seem bleak and terrifying. Addiction takes over all spheres of an individual’s life and essentially, forms part of an individual’s identity. With this being said, these substances may come with other “benefits”, or what is perceived as benefits.

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Anger | Anger Management

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Anger Management | Marriage Counselling | Anger In this article, Sanam Naran, a Counselling Psychologist provides very important guidance on identifying anger and the best anger management methods you can use. These are very useful tools for relationship counselling and generally for one’s self. Anger Anger is a secondary emotion, reflecting some unmet expectation or need. Anger often arises from an underlying feeling of FEAR or PAIN. Here’s an example: “So my anger at being called a rude name may have its roots in my fear of being humiliated or from my pain over someone’s unkindness. Car suddenly pulls in front of me = initial fear that I might crash into the back of their car instead of anger over their bad driving.” I want you to ask yourself these questions: When was the last time you felt angry or had an angry outburst that was probably related to fear of losing face or looking weak? When was the last time you felt angry or had an angry outburst that was probably related to pain—being hurt by someone’s words or actions?   There are two versions of anger, namely: Anger in and Anger out. Anger In This is anger that is directed inward to oneself Fear of hurting/offending Fear of being disliked or rejected Fear of losing control Feeling its inappropriate to be angry Unable to cope with strong intense emotions Fear of damaging or losing a relationship   Anger Out This is anger or feelings directed toward other persons or things occurs when you want to: Appear powerful Hide other emotions Impulsive Passive aggressive   What Are Some of The Costs of Anger? You may develop high blood pressure. You may ruin relationships with others. You may lose a job or a mate. You spend less time in achieving happiness for yourself. You spend time thinking of the unpleasant acts of others. (This, of course, is the opposite of happiness.) You may commit violent acts while enraged. And Then What Are The Benefits of Anger? When you are depressed, your anger can feel better than your depression. You may feel good in your belief that you’re better than someone else, i.e., the person at whom you’re angry. It may work for you in the short run – like addictive behaviors. People may stop behaving in a way that bothers you. (But in the medium and long run they avoid you or, worse, they may wait to take their revenge when they get a chance.)   Is Anger Normal? Anger is part of being human. The ability to feel anger is something we are all born with—even babies get mad. All of us are entitled to our angry feelings. How we go about expressing our anger is another issue. We are not entitled to express our anger in ways that violate other people’s rights or safety. We may choose to do so—and we’re responsible for the consequences when we do. If our expressions of anger drive away the people we love, cut us off from support, make us feel guilty, or hurt us on the job, it’s time to consider some changes.   Journal Prompt: What do you like best about the way you deal with anger? What do you like least about the way you deal with anger? What would you like to do differently when you’re angry?   So, What Can I Do With My Anger? Once we are aware of feeling angry, the next thing to do is to express it in a healthy way, and then resolve it. It’s not healthy to “swallow” anger or let it go unresolved. When we swallow our anger we may begin to feel resentment or hostility. There’s even some evidence that holding back anger causes health problems such as stress or high blood pressure. When we express our anger, we have two choices about how we do it. We can respect the rights of others, or we can step on the rights of others. These two types of anger expression are very different. Strategies To Control Anger: The best way to deal with anger is of course to seek therapy or counselling by a registered psychologist. However, if you need something more practical, try these (Bare in mind that they will not address the core of the anger like therapy would): Keep your voice low Breath slowly, use relaxation techniques Count to ten Think before you react Ask yourself “Is my level of anger justified?” Hit a pillow or cushion Throw safe items into a container Go for a walk Write/draw your feelings, tear them up & throw them away. Tear up old newspapers Shout in a safe place Pretend to talk to the person who makes you angry Remember, it is healthy to let anger out in a safe way!  

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Anxiety?

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Anxiety Identifying And Dealing With Anxiety Clip, clap…….kettle boiling! Please hurry up and get into bed…Toss…..turn…..hot…… duvet off …. …..right side…..left side…….what time is it?…….oh it’s 2am………I can’t sleep………oh no I can’t sleep……..but I must sleep……I must sleep in the next 15 mins……why did a car just speed down my road?…….I should re-set my alarm…..toss…..turn…… cold……duvet back on…… Sound familiar? This, unfortunately, is the reality for a lot of people. Read on along as Sanam Naran shares her expertise on the subject.  What is anxiety? Often identified with fear, anxiety is indeed a type of fear or strong feeling about a situation, it’s the thought of a threat or something which may go wrong in the future. Anxiety causes fright and uncertainty and lasts a short time or can be prolonged. Anxiety can affect our ability to eat, sleep, concentrate, travel, leave the house, go to school, or even work. Can interfere with our enjoyment and take over our lives.  Anxiety can be understood as the inability to accept uncertainty. Individuals avoid certain situations or tasks, in an attempt to avoid a negative outcome. They procrastinate, refuse to delegate, do excessive checking, avoid situations, constantly seek reassurance. Debunking anxiety: Anxiety is a normal reaction to stressful situations and can sometimes be useful, for example, before a competition or presentation or a job interview. It will increase your alertness and performance. Anxiety in situations of real danger enables individuals to act quickly to ward off/escape danger. Anxiety in the workplace may produce the following symptoms: Worrying Performance anxiety Imposter Syndrome Panic Obsessive thinking styles Why Do We Feel Anxious? Sense fear Extreme reaction to everyday events Loss of control Stress to a life situation Release of adrenaline in the body Preparation for an emergency “Fight or flight” primitive response Increase blood flow to muscles Dilated pupils, increased muscle activity etc. Possible Triggers of Anxiety: After something bad has happened Significant life events i.e. bereavement/illness/separation/bullying Fears: Dogs, spiders, snakes, flying, heights Genetic predisposition – how we are made up Temperamental disposition – how we behave Uncertainty– A fear of having to do something new or out of our comfort zone.   Physical Signs of Anxiety: Fast / irregular heart beat Increased breathing rate / shallow breathing Dry mouth or throat Weak/ tense /tingling/aching of muscles Feeling lightheaded /headaches/dizziness Stomach aches or bowel problems Sweating – hot and cold “Frozen” to the spot Blurred vision   It’s helpful to ask yourself these questions when feeling anxious: Is this really true? Am I exaggerating? Is this thought helping me? Am I making things out to be worse that they really are? What other explanations could there be?   What Can I Do? First port of call is always to seek therapy or counselling with a psychologist near you.   Mindfulness Be mindful of the things you say to yourself. List & acknowledge positive qualities about yourself- create a record to fill your personal bank account-PBA When anxiety threatens to take over ask yourself “am i making more withdrawals than deposits in my PBA?” Mindfulness is being present, being aware of what you are thinking and feeling in your body. Being aware of the here & now be aware of your breath and use it to remain present. Disengage from auto pilot mode. Self-care It is also important that you make time for yourself and your own relaxing activities. Make a list of the things you can do to feel good and relax. When you notice yourself feeling stressed or worried, engage in one of those activities. It could be something as simple as making a cup of tea, reading a magazine. Whatever works for you! Breathing You might notice that we you feel worried; your breathing quickens and becomes shallow. By taking slow, deep breaths, we can relax our body, our heart beats slower, and we feel less tense or worried. Try taking in a slow deep breath, starting from the bottom of your stomach, in through the nose. Breathe out as slowly as you can through the nose or mouth. Support system Social support is vital for our emotional wellbeing and can buffer against stressful situations in life. The ability to seek assistance from others is a skill that will help you cope throughout life Discuss all the different support people that are available e.g. Family, friends, teachers etc. Call upon a variety of members of their support team when they are faced with difficult situations.

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Hindu And Muslim Perspective on Addiction

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Muslim And Hindu Perspectives on Addiction Sanam Naran, a seasoned Psychologist provides insight on the subject of addiction from a Hindu and Muslim perspective   Hindu and Muslim Perspectives on Addiction The concept of addiction has been largely studied and conceptualized from a physiological and psychological (mental health) standpoint. However, there is little knowledge around religious understandings of addiction. As we know, addiction does not discriminate and affects individuals from all religions, races, cultures and ethnicities. Today we delve into the understandings of addiction from a Hindu and Muslim perspective. Hinduism is known to be one of the oldest religions in the world, dating back over 4000 years and consisting of approximately 900 million followers. The primary aim of a Hindu’s life is “Moksha”, which represents the union with a higher power and the ending of the cycle of birth and death, as reincarnation is an important aspects of Hinduism. In order to achieve this, one must lead a pure life, free of any negative “Karma”. This means that they must strive to live a life of purity and avoid any unacceptable actions towards themselves and others, as one of the basic premises of Hinduism is non-violence and no harm to others. “Meat eating is not wrong, nor alcohol, nor sex. These are natural actions of living being: but abstinence from such actions is highly rewarded” (M 5:56). Another important feature of Hinduism is to achieve complete mental control over compulsions and impulses. Being able to achieve this control and disregard any activities that create immediate pleasure is seen as the ultimate goal or “Moksha”. Therefore, there is no place for substances within the Hindu religion, as these substances are seen to contradict the strive for mental control and induces negative karmic energy. It is known that most substances result in a decrease of inhibitions and may cause an individual to behave in a way that is seen as “unacceptable” which is believed to increase bad karma, which in turn, can result in “bad” rebirth. “He who has perfect 3 fold control: that is over speech, thought and actions”. Contrary to this, some evidence dating back many years, suggests that “Sadhu’s” or otherwise known as, a holy person in Hinduism, would utilize medicinal plants including Cannabis and Hashish to invoke trance-like states. The use of these substances would also extend to Ayurvedic medicine for pain relief. Although, most followers of Hinduism are entirely against this. Ultimately, the concept of addiction is rejected or seen as obstructive in an individuals life, however, the use of substances are not prohibited. The question of knowing ones limit is important in Hinduism, which seems to be at odds with the disease model of addiction. Islam, on the other hand, is the second largest religion in the world, with over 1.8 billion followers. The basic premise of Islam is submission to the will of God. That may sound familiar to some as it is the principle of Step 3 in The 12 Steps of Alcoholics Anonymous. Firstly, in Islam, the act of intoxication by substances “Khamr” is viewed as a sin, specifically alcohol. The use of perfumes or toiletries that contain Ethanol is equally prohibited. The holy book in Islam, known as the “Qur’an” clearly states that the use of substances can be punishable and is forbidden “Haraam”. Muhammad stipulated forty lashes for one caught under the influence of intoxicants (al-Zarkashi, Zahr al-Arish, cited in [18]). The reason for this is that substances are seen to diminish ones remembrance to God and breed a sense of hatred. Secondly, addiction is viewed as a spiritual disease, suggesting that the use of substances is the “handiwork of Satan”. It is said that the individual who becomes addicted to substances, has given in to satanic impulses, thus deviating from God. “It diminishes the powers of the soul, destruction of the mind (fikr), forgetfulness (nisyan al-dhikr), vulgarization of secrets, commission of evil actions, the loss of modesty (haya’), great stubbornness, the lack of manly virtue, the suppression of jealously, wastefulness, keeping company with the devil, the omission of prayer, and the falling into unlawful activities” ([18], pp. 86, 89, 178). As much as the above suggest that addiction results in the severance in the relationship with God, it is also said that a weak relationship with God can be seen as an aggravating factor in one becoming prone to the utilization of substances. Although, there is still a minority of Muslims that abuse substances, despite it being prohibited, one may begin to question the amount of stigma that is attached to being an addict and the shame that is experienced around this, which can deter one from seeking help. Religion may occasionally prove to be a contentious and controversial topic, specifically in addiction. However, it is important to understand the different beliefs around substance use and how that may influence cultural understandings of addiction. In most religions, the use of substances are not accepted, some may prohibit it more than others, however, what they do have in common, is that substances diminish ones relationship with God and progression to self-actualization. Furthermore, religious beliefs on addiction breed a sense of shame, whilst possessing secure faith is seen as a protective factor in becoming addicted. References Ali, Mansur. (2014). Perspectives on Drug Addiction in Islamic History and Theology. Religions. 5. 912-928. 10.3390/rel5030912.

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Boundaries - Setting Boundaries

Relationships | Boundaries | Setting Boundaries

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Boundaries And Relationship Sanam Naran, a Counselling Psychologist, gives profound guidance on boundaries and relationships, how to identifying boundaries and properly applying them in relationships and day to day life.   What Is A Boundary? A boundary is what belongs to you and what you are responsible for. It is the line around the stuff inside you that makes you uniquely you (such as personal feelings and emotions, hopes and dreams, opinions and preferences, personal time, your physical body, values, morals) and marks it off as private property. Boundary lines help us to not cross into another person’s business uninvited, and to recognize when someone is inappropriately crossing into ours. But Why Me? Because of low self-esteem! The reason for this inability is that with low self-esteem comes a variety of irrational thoughts, emotions and actions that leads people to lose themselves in relationships with others. People with low self-esteem have a weakened “internal locus of control” and become dependent on a “strong external locus of control”. They become victims to being controlled by how others think, feel about and act towards them. People with low self-esteem are dependent on others’ approval and recognition and are therefore fearful of rejection by and conflict with others. Boundaries & Relationships In unhealthy boundaries, there is a fear of saying ‘no’ because it would result in loss of relationship—the love goes away. You can only say ‘yes’ if you want to stay connected. If you say ‘no’ the connection is threatened or taken away. Boundaries are the “skin” of how you relate. Skin allows us to go out into the world or into the open air and be active there because the vital organs are protected by the skin, because of the skin, toxic contaminates are not allowed in to access your internal organs. Boundaries do the same job relationally. This is how we manage to stay in relationships and work on them. What’s The Purpose? Boundaries serve the purpose of protecting love and caring in relationships, freeing the person to express love, to serve someone, to give to someone without being taken advantage of or abused. Boundaries structure the relationship, setting up healthy and appropriate ‘rules’ (the guidelines and limits that keep balance in the relationship). Boundaries provide protection for the individual through safety in the relationship. What Are The Risks? Why do we avoid healthy boundaries? It is usually because we have learned that others will punish us if we try to have healthy boundaries. This creates fears: (1) Fear of loss of relationship. Being abandoned when the other person withdraws, pulls away, disengages. (2) Fear of being controlled by an angry person. Being exposed to someone else’s out-of-control anger or rage. (3) Fear of guilt. Feeling responsible for someone else’s feelings to the point of being controlled by or “held hostage” by them emotionally. Characteristics Of A Healthy Relationship Calm, centered and focused. Safe, supportive, respectful, non-punitive and peaceful. Taken care of, wanted, unconditionally accepted You feel part of something & not alone. Forgiving and being forgiven with little revenge. Free to be who you are Free from “paralysis of analysis”. A sense of directedness with plan and order. Supports individuality. Lack of Individual Identity Maybe you are hooked by the irrational belief that: “I am a nobody without a somebody in my life.” If you are, you maintain no boundaries with your relationship partners because you are very dependent in getting your identity from being with your partners. You are willing to do whatever it takes to make the relationships happen, even if you have to give your health, money, security, identity, intelligence, spiritual beliefs, family, etc. Scarcity Principle Rather the devil you know = Settling for 2nd best “because the current status of our relationship is better than anything we have ever had before”. This is a common problem for people recovering from low self-esteem who have faced trials and challenges in relationships in the past. The problem is that the current status of your relationships might be better than what you have experienced in the past, but they might not really be as healthy and intimate as the intimate relationship described earlier. Guilt Control issues – reflection on you. Maybe you are hooked by irrational guilt that you must think, feel and act in certain ways to ensure that your relationships are preserved, secured and nurtured no matter what personal expense it takes out of you. You have a problem of feeling over responsible for the welfare of your partners and cannot allow your partners to accept personal responsibility, to make choices and live with the consequences of their choices. This irrational guilt is a driving motivation to keep you tearing down your boundaries so that you will always be available to your relationship partners at any time, in any place, for whatever reason your partners “need” you. Inability to Differentiate Love from Sympathy Maybe you are hooked by the inability to differentiate between love and sympathy or compassion for your relationship partner. You find yourself feeling sorry for your relationship partners and the warm feelings, which this generates makes you think that you are in love with them. The bigger the problems your relationship partners have, the bigger the “love” seems to you. Because the problems can get bigger and more complex, they succeed in hooking you to lower your boundaries so that you begin to give more and more of yourself to your “pitiable” partner out of the “love” you feel Helplessness and Neediness of Relationship Partners Maybe you get hooked by the neediness and helplessness of your partner. You find yourself hooked when your partner gets into self-pity, “poor me” and “how tough life has been”. You find yourself weak when your relationship partners demonstrate an inability to solve personal problems. You find yourself wanting to teach and instruct, when your partner demonstrates or admits ignorance of how to solve problems. These sad, weak, distraught, lost, confused and befuddled waifs are so needy

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Covid19 & Psychology

Wearing Masks: How Has it Changed The Way We Relate to Others?

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Coronavirus And Psychology In this article, Sanam Naran speaks on a global touch point, coronavirus and how it has affected the way we relate with one another as masks become mandatory.   Coronavirus – What Has Changed In The Way We Relate To Other Since Wearing Masks What do we miss, or risk missing, in our interactions with other people when everyone’s wearing masks? I believe facial expressions are an important mode of communication and play a pivotal role within interaction. We tend to miss meta communication via facial expressions due to wearing masks. For example, we are unable to see when someone is smiling or communicating something more serious, thus, we are unable to see people’s authentic selves. What key facial expressions are no longer ones we can rely on? Are there other ways those emotions can show up? People would now need to use their tone of voice and body language to express emotions that would usually be picked up through facial expressions, specifically in the mouth area. But is there a way to to read the eyes since they are usually the only visible part of the face? I believe most facial expressions are portrayed around the eye area, therefore, we are still able to rely on facial expressions with masks on, to some extent. I would not say that there is a way to read eyes, however, I do believe we are able to pick up quite a bit of meta communication through the eyes. The way people authentically feel, may be communicated through the eyes. What sorts of other body language signs can be important to pay attention to? Body language as a whole, is important in communication. The way a person in standing or sitting is often quite telling. For example, if an individual is sitting with their arms or legs crossed, this can communicate a resistance to being open to what is being said in the conversation. Or if individual A is sitting in an opposing direction to individual B, yet they are in conversation, this can communicate that individual A is uninterested or uncomfortable. If a person utilizes their hands excessively through conversation, they may be experiencing feelings of anxiety. What about conveying your own emotions to others—is it important to learn to do that in other ways? Verbally? Say more, when in doubt? It is imperative to convey the way we truly feel to people, verbally. Mental health issues such as: Depression, anxiety and substance use disorder, amongst others, may stem from many factors, although, one of them may be an inability to express our feelings and emotions, thus, bottling them up within ourselves. This can be detrimental. However, many individuals struggle with this. Can you share a personal experience you’ve had with either a misunderstanding with a friend or stranger due to masks, or a need to clarify, and how you remedied the situation? One of my clients had an argument with a work colleague, recently. Her colleague smiled at her as a greeting and she understandably, did not reciprocate as she was unable to see this through the mask. They have had prior conflict which would explain the sensitivity to not being greeted back. They did not remedy the situation, until I suggested that she has a conversation about this and clarify this with her. Conversation is going to be an important method of reparation, during these times. Anything else you’ve noticed about how our relating with one another has changed or needs to change now that we’re all masked? As I have mentioned above, we need to rely on conversation a lot more which would prove beneficial in the long-run as many people struggle with conflict resolution and expressing their feelings through conversation. In addition to this, we need to be more aware of our body language and what this communicates to others.   More on Coronavirus and Resources

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