Dealing with Addiction

11 03 2015

Recently I saw a couple of encouraging articles in the news which inspired me to write a brief post about dealing with addiction. I will link to the two articles at the end of this post.

Addiction is an issue that comes up all the time in therapy. Sometimes it appears in very overt and obvious forms – such as substance misuse, gambling, or sex addiction – but often in more covert and subtle ways as well, such as compulsive exercise, workaholism, or obsessive thoughts and habits. In many ways all humans are addicts, as we are creatures of habit; we thrive on things that are familiar and comforting, and carve out repetitive patterns for ourselves. This is no bad thing, as it means that we can create healthy routines, or stick to a structured approach when making changes or adjustments; but it can also be dangerous and become an unhealthy, destructive force where a reliance on a certain way of thinking or behaving can start to interfere with the rest our lives.

addictionhelp

So, why is it that some people can keep their habits under control and choose healthy routines for themselves, whereas others find themselves losing control to harmful urges? What decides whether we will find a healthy or an unhealthy outlet for our need for comfort? This is a complex issue, with numerous answers (see Gabor Mate’s talk on The Power Of Addiction for some great points), but I think these three are the most important:

1. Psychobiology. Some people inherit genetic traits or learned behaviours from their ancestors, where they may be predisposed to certain ways of thinking or doing things, or have a particular physiological ‘weakness’ for a certain substance.
2. Environment. We are hugely influenced by our surroundings, and by our social networks (see Nicholas Christakis’ wonderful talk on The Hidden Influence Of Social Networks for more information). The people around us shape our ideas of accepted norms and influence the behaviours that we establish; we often look to see how others are coping with their lives, and then we copy them.
3. Early attachment experiences. Our early experiences shape our identities and also, crucially, our emotion regulation strategies. If we have positive attachment experiences then we learn that we can rely on others, and turn to them during times of need; and this also teaches us that we are ‘worthy’ of other people’s care and attention. However, if we have negative attachment experiences then we learn that we cannot rely on others, and instead have to develop our own methods of self-soothing; and this also teaches that we are ‘unworthy’ of other people’s care and attention. It’s this latter group of people who often seek external sources of affirmation and validation, which can slip into addictive cycles: if it doesn’t feel emotionally safe to turn to other people for reassurance, then they will seek that comfort from the escapism and rush of sex, drugs, or gambling instead.

Amazingly, many addiction treatment programs continue to focus on only the first of those three issues. They see addiction simply as a psychobiological disease, and they dissect the cognitive, behavioural, and physiological components of this disease, and then set out to replace previous bad habits with healthy new ones. However, they often overlook the crucial factors of social networks and attachment experiences; factors which will be massively influential on a person’s chances of maintaining their recovery over time. I believe a crucial element in treating addiction is to process and repair negative attachment experiences from the past, and then to create new, healing attachment experiences in therapy; so that a client can feel a sense of attunement, and learn that it’s safe to turn to others for soothing and reassurance, rather than having to self-soothe or seek out alternative sources of validation. This process also empowers the client to develop a new sense of worthiness, overcoming internalished shame from past rejection, and recognising that they are indeed deserving of the attention, care, and love of others.

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I spent several years as the Clinical Lead of a substance misuse treatment agency within the NHS in North London, and always made sure that we were taking a holistic approach to our clients’ recovery; addressing all three of the factors I list above. I continue to use this approach in therapy with my clients.

Now, here are the two articles I referred to earlier:

1. A Huffington Post article, titled “The Likely Cause Of Addiction Has Been Discovered, And It Is Not What You Think”.
2. An NPR article, titled “What Heroin Addiction Tells Us About Changing Bad Habits”.

Hopefully you will find them as informative as I did. And if you are seeking information or therapy for issues related to addiction, then please do feel free to contact me.

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Guardian Interview about sex for the over 60s

25 08 2014

A while ago I did a short interview with The Guardian, to discuss sexual health and relationships for the over 60s. It was recently published on their website, and you can read it here.

older couple

Unexpectedly, the story seems to have been picked up by a number of other international sites as well, including this American news site and some blog posts. It’s nice to see the story spreading around, and hopefully this will encourage further healthy discussion around the topic.

I think sometimes there’s a stigma that you “can’t teach your grandmother to suck eggs”; that after a certain age we just get stuck in our ways and refuse to change. So the misconception follows that therapy is reserved for younger people; from teenagers facing problems in puberty, up to married couples in their 50s facing divorce.

But the truth is that it’s always good to talk; no matter what age you are. I see many elderly couples who find it transformative to discuss their relationships and sex lives in therapy, and it’s always rewarding to see the progress they make together. It’s never too late to make a change!





Spent: Sex, Evolution, and Consumer Behaviour

14 06 2011

Here’s another recent book review. “Spent: Sex, Evolution, and Consumer Behaviour” by Geoffrey Miller.

Spent: Sex, Evolution, and Consumer Behaviour

In his new book Spent, leading evolutionary psychologist Geoffrey Miller takes us on a journey through modern consumerism; explaining how and why we choose to buy the things we do, and what these choices say about us, both as individuals and as a society. Approaching the issue from a systemic perspective, Miller looks at the ways in which marketing concepts have permeated mainstream culture, suggesting that we now live in an Age of Marketing which marks a “decisive power shift from institutions to individuals”. Miller explores the numerous ways in which this power shift has impacted human behavior, from the hidden instincts behind our shopping and spending, to the traits we value most in our romantic partners.

“Marketing is not just one of the most important ideas in business. It has become the most dominant force in human culture.”

As a Marriage and Family Therapist, I have to admit I was initially a little reluctant when faced with reviewing this book, which ostensibly seemed to be a study of market forces and economics; but I needn’t have worried. Spent is a fascinating study of human behavior, using consumerism as the starting point from which to explore the evolution of human psychology and the ways in which we have all become consumers, even in our private lives. Miller’s book is written in a style that will appeal to anyone who is interested in these topics, and it doesn’t require any kind of previous knowledge or expertise:

“You don’t need to know much about psychology, beyond what you already know about people. You don’t need to know much about consumerist capitalism, beyond what you already know about shopping. In fact, the less you’ve been taught about traditional marketing and economics, the fewer misconceptions you’ll have to overcome.”

As well as being accessible and easy to understand, Miller’s writing style is engaging and humorous, and he frequently peppers his prose with amusing personal anecdotes and pop culture references. I quickly found myself deeply entranced in the book, eager to keep reading, and fascinated by all of the facts he revealed in each chapter.

In fact, the more I read Spent, the more Miller’s insights into human behavior reminded me of the work therapists do with their clients; trying to identify the driving forces that lead us towards the choices and decisions we make for ourselves, throughout our lives.

“Marketing’s empiricism works like Rogerian psychotherapy, in which the therapist restates and reflects the patient’s concerns. Marketing holds up a mirror to our selves, reflecting our beliefs and desires so we can recognize, remember, evaluate and transform them… It allows us to accept or reject potential ways of displaying our traits through our product choices.”

Miller suggests that there are six main personality traits (known as the “Central Six”) which all of us display as a means of “taste-signaling”, and which we also all assess when evaluating potential partners, as a means of “social screening”. These are: intelligence, openness, conscientiousness, agreeableness, stability, and extraversion. He goes on to analyze each of these traits in detail, explaining how we “market ourselves” to others, primarily as consumers; by supplementing each of these traits with a specific choice of product, brand, or lifestyle choice, according to our own individual tastes. Marketing enables us to establish our preferred identities by aligning ourselves with certain choices, and we make these choices in order to impress others; as a means of establishing our status and attracting potential mates. These choices are known as fitness indicators:

“Fitness indicators are signals of one’s individual traits and qualities that are perceivable by other individuals.”

The irony of this, says Miller, is that we already have these indicators within us, as inherent traits, regardless of consumerist capitalism:

“The most desirable traits are not wealth, status, and taste – these are just vague pseudo-traits… Rather, the most desirable traits are universal, stable, heritable traits closely related to biological fitness – traits like physical attractiveness, physical health, mental health, intelligence, and personality… Consumerism’s dirty little secret is that we do a rather good job of assessing such traits through ordinary human conversation, such that the trait-displaying goods and services we work so hard to buy are largely redundant, and sometimes counterproductive.”

This is the central message of Spent; a timely reminder that the obsessive capitalist demands to which we constantly subject ourselves are not only unnecessary, but also often unhealthy.

“We humans have already spent millions of years evolving awesomely effective ways to display our mental and moral traits to one another through natural social behaviors such as language, art, music, generosity, creativity, and ideology. We can all do so without credentials, careers, credit ratings, or crateloads of product… Runaway consumerism leaves us feeling superficial and empty, because we project ourselves outward to observers too promiscuously and desperately.”

So, having identified this painful cultural phenomenon, how do we eschew these unnecessary values which capitalism has taught us; how do we rid them from our private lives? Far from suggesting that we go back to living like our Cro-Magnon ancestors, Miller concludes his book with several chapters on this topic, with numerous ideas on how we can improve our quality of life, not just as individuals, but on a wider societal level, too. Miller’s suggestions range from simple changes to our consumer habits (such as buying locally or second-hand, or even making things ourselves), to having our personality traits tattooed onto our bodies as clearer fitness indicators for potential partners. He also supports the concept of a consumption tax – whereby every product or service is priced according to its ecological footprint and impact on the environment – and the idea of restructuring the ways in which we build our communities, so that likeminded people can choose to live together, based on shared common interests and ideas, rather than for economic reasons alone.

Sure, some of these ideas may seem a little far-fetched or idealistic, but we have to start somewhere, and Miller’s crusade is a noble one. He concludes by asserting that the best method of implementing any change within society is by changing our informal social norms, one at a time; the unspoken rules which we all take for granted, at a local level. We could all do a lot worse than to live by Miller’s suggestions, and for those who may want to take things even further, Miller provides some exercises for the reader, and a booklist for further reading.

Spent is an entertaining and fascinating read, and I would highly recommend it to anyone with an interest in human behavior or evolutionary psychology. Miller’s explorations of consumer behavior caused me to completely reassess even the most mundane choices I make every day, and the things these all say about me; including my music playlists, the video games I play, my personal fitness, my Facebook page, my choice of friends and partners, and even the bumper stickers I put on my car. Whatever your background, I guarantee that Spent will make you re-evaluate some of the assumptions you had previously taken for granted about your own lifestyle and behavior traits. And you’ll never play The Sims in quite the same way again.

5 out of 5 stars.

Not only did I thoroughly enjoy the book (as you can tell by my review) but I think Miller raises some important issues relating to culture and wellbeing, as well. Many of my clients often come to me saying they feel dissatisfied with their lives – tired of working too many hours, worrying about finances, feeling cut off from family or friends, and like something important is lacking – but not knowing how to escape the cycle. Miller’s book shows us how the cycle is very much one of consumerism and spending, and our culture’s tendency to binge and purge, as a way of making ourselves feel better, or of rewarding ourselves for ‘being good’. I always see products advertised as ‘Treats’ or telling us that we ‘Deserve it’ and I think about the underlying message that this sends: that we cannot be intrinsically Good unless we consume. No wonder so many of us feel lost or worthless! Fortunately, it doesn’t have to be this way. True happiness lies within, and no amount of material goods or wealth can ever change that.

If you or someone you know is struggling with anxiety, depression, or financial worries, and you want to find that inner happiness for yourself, I can help. Don’t wait for that change – make it happen now!





The internet, relationships, and the benefits of having a tech-savvy therapist.

15 04 2011

Although researchers continue to constantly explore the myriad of ways in which modern technology impacts our mental health, many mental health professionals still seem uncertain as to how to broach this subject or incorporate it into their clinical practice with clients. Increasingly, it is vital that counsellors stay up to date with the latest technological developments and gadgetry, so that they can be aware of the effects these may have on their clients and their relationships.

As a modern, systemic psychotherapist, I like to think of myself as pretty ‘tech-savvy’ too. I am consistently aware of the possible role technology might play in the lives of my clients. Be it smartphones, Android devices or iPads, technology has significantly changed the ways in which we interact with one another, and also shifted the boundaries of sexuality and intimacy. Explicit sexual materials are easily accessible online, and ‘digital infidelity’ and porn addiction are now problems in many marriages.  ‘Emotional infidelity’ is also becoming more and more common, as people explore intimate secrets which might have, in the past, been reserved for face-to-face time with their partner – or remained undiscovered altogether – through sexts, forums, chatrooms and webcams, with relative strangers. This article in the Huffington Post even goes so far as to suggest that modern couples should change their wedding vows to “until Facebook do us part”.

Similarly, this viral YouTube video suggests that Facebook may contribute to rising levels of depression, as it encourages us to constantly compare ourselves to others, or become competitive with people we barely even know (it’s somewhat ironic that the video spread so well across Facebook itself, though).

Furthermore, this recent story on USA Today suggests that social media websites can be bad for our children, too; exposing them to cyberbullying, depression, and inappropriate content (although Facebook has recently added a ‘suicide-alert’ utility to help identify those who may be at risk).

So, if this is the case, we don’t we all just shut off our computers for good?

Well, the answer is simple: the internet has a lot of advantages, too. It can be an incredibly unifying place for many people, not only as a great networking tool for businesses, but also a hub of infinite connections across the world. More and more of us meet our partners online; either through shared interests, online communities, role-playing games, or the plethora of dating sites which promise to help us find our perfect match if we just answer a few simple questions. Forums, chatrooms, memes and viral videos can help to create a sense of community, particularly for those of us who may not be able to find it elsewhere. If we’re seeking advice, information, or like-minded people, the internet offers us a unique opportunity to feel connected to others, no matter how far away they might be geographically. Social networking ensures that we all feel more connected than ever, to our colleagues, our acquaintances, and even our favourite celebrity Tweeters. And text messages, emails, Facebook and Skype all ensure that we need never lose touch with our friends and loved ones.

A lot of this is often overlooked, as it is easy to just point the finger and blame technology for modern woes, and remember the mythical ‘good old days’ when everything seemed so much simpler.

I believe that we should all keep our computers running,  and that the internet holds a lot of benefits for us all, both as individuals, couples, and families, as long as we remember to invest plenty of time and effort in our real lives and face-to-face relationships, too. Ultimately it is those that are the most rewarding and the most important. I believe that ‘everything in moderation’ is a healthy motto, and that the internet can be a great source of fun, facts, and friendship, as long we don’t let it turn into an addiction or an obsession.

In addition, I’ve had many clients roll their eyes wearily when I suggested they keep a paper journal or write something down, only to see them light up with excitement when I recommend using an online journal or creative writing website instead. It’s just a fact that the keyboard is sometimes easier to fit into our daily lives that the old fashioned pad of paper.

So, if you’re a client looking to see a therapist, don’t overlook the benefits of having a tech-savvy counsellor. I’m not saying it’s a necessity by any means – in fact, it shouldn’t really matter, if your therapist is good at what they do – but it can be nice to have a counsellor who knows the ins and outs of your situation and can really relate to what you’re talking about; particularly if the issue you want to discuss is directly connected with technology or the internet.