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Beginning to Resolve Ambivalence About Changing an Addiction

 
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A. Tom Horvath, Ph.D.

To accomplish almost anything in life two basic elements are required: 1) we need to want to accomplish the task, and 2) we need to know how to accomplish it. In changing an addiction, knowing how to change is typically less important than wanting to change. The mechanics of changing addiction are not minor, but they are typically less important than maintaining a continuing commitment to change.

It is easy to start out with a burst of enthusiasm (“I just quit smoking!” or “I am cutting back to no more than two drinks per day!”). As the days go by, we can see that we can change (we are doing it!), but we may want to change less and less as time goes by. Many times we go back to our former behaviors. The burst of enthusiasm does not last, and wanting to change turns into wanting to use.

The fundamental issue for most of us is that we are really "of two minds" about change: we love the pleasure of the addictive behavior and what it does for us, but we also hate the trouble the addictive behavior causes us. In short, we are ambivalent about changing.

To the extent we have “addictions” that are mostly pleasure and little or no pain, we don’t even consider them addictions. If, for instance, you are a very light drinker and alcohol causes no problems beyond the minor expense of purchasing it, you are not likely to call this behavior an addiction. On the other hand, if the “addiction” only caused trouble, it would be easy to change. For instance, some people smoke pot once or twice and feel highly anxious and paranoid. They have no interest in using pot anymore! What we often mean by an addiction is a behavior that causes both satisfaction and pain.

What we really want is an addictive behavior that is all pleasure and no negative consequences. We want to keep the satisfaction but eliminate the pain. If too much of a good thing is causing problems, then maybe by cutting back, or doing something else differently, we could keep the satisfaction but eliminate (or at least greatly reduce) the pain. The traditional wisdom is that cutting back or moderating is impossible once you have become an "addict" or "alcoholic." However, these terms have been overused. Even individuals who later decide to call themselves addicts and alcoholics attempt to moderate at first. If they are successful at moderating we don’t usually hear much from them anymore!

If you are still in the ambivalence stage, the important question is whether the pain is great enough to do something, regardless of whether that is to stop altogether or cut back. As with a conflict between two individuals or two groups, the place to start is to get your two minds (the one that likes the addiction, and the one that hates the consequences of the addiction) communicating with each other. From that discussion a sensible action plan can arise. If one does not, consulting a professional might be a good next step.

Fortunately, we have already resolved other ambivalences in life. Resolving this ambivalence is similar. You have resolved ambivalence before, you can do it again!

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Adapted with permission from an article originally published in the SMART Recovery newsletter. A. Tom Horvath, Ph.D., ABPP, is a board certified clinical psychologist and president of Practical Recovery (addiction treatment), an addiction treatment facility in La Jolla (San Diego), CA, focusing on collaborative care and self-empowerment.

Article Tags: behavior [See Dictionary], change [See Dictionary], pain [See Dictionary]
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Article published on February 18, 2009 at Isnare.com
 
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