The venue was our Sunday morning “Open Circle” gathering. Each week we have a speaker on a different topic, typically someone local with specialized expertise in a certain area. They let me speak anyway, and, in fact, they let me come back on April 22nd to talk about Rational Emotive Behavior Therapy, which I’ll be posting here in a week or so.

Enjoy the video! When you reach the end of the first segment, click on the little white box to start the second segment. Rinse, repeat.

I’m going to teach you a simple form of meditation, designed to help you train your mind to “stay there,” wherever you are. Why is this section here? We are beginning a journey of discovery, and what better place to start than learning how to focus our attention upon what’s going on in our own minds. To recognize the feelings and beliefs that keep us chained, it helps if we are present, and aware of our reactions. Is it necessary to practice mindfulness perfectly in order to recover? Of course not! Recovery is a process, not an event, and we only need be aware that there is such a thing as mindfulness, so we can tell when we are “in the moment” and when we are not.

There is another reason I am introducing mindfulness meditation here. Along with learning to stay in the moment, it’s also important that we learn to treat ourselves with compassion. We don’t practice compassion very much when we are using, not with those around us, and certainly not with ourselves. If we can learn to treat ourselves gently, with loving kindness, we can learn to treat others in the same manner.

Find a quiet spot where you won’t be disturbed or distracted for at least ten minutes or so. Make yourself comfortable. Sitting in a chair with your feet flat on the floor is ideal, but almost any reasonable position will do. There is no need to screw your body up like a pretzel, and turn the session into an endurance contest. This isn’t that kind of meditation, and I’m not trying to turn you into a Buddhist.

Let your body slowly relax. Move your head slowly from side-to-side, relaxing the muscles in your neck and shoulders. Feel your rib cage slowly rise and fall with your breath. Relax your hips, your knees, and your feet inside your shoes. Place your hands in your lap, or on the arms of the chair, whichever feels better. Be aware of your breath slowing down as you begin to relax.

Notice your chest rise and fall as you breathe normally in and out. Begin to count each inhalation and exhalation. When you reach ten, start counting over again with one. Thoughts will come and go. Just acknowledge them and continue to follow your breath. When you notice that your mind has drifted off the breath and followed a thought, acknowledge the thought, let it go, and gently bring yourself back to the breath, beginning the count again at one. Do not berate yourself for letting your mind drift, it is completely normal. The important thing is that you noticed, and brought yourself back. Sensations will come and go, don’t react to them, just gently acknowledge them and continue following your breath.

The counting is a feedback to help you know when your mind has drifted off. Each time you return to the breath you are empowering yourself with the ability to put your mind where you want it, when you want it there, for as long as you want it there. That simple fact is extremely important. When you’ve been practicing this process for a while, your awareness will sharpen. You’ll begin to notice things that were always there but escaped your attention. Because of the preoccupation with the internal dialogue, you were too full to be able to see what was happening around you.

When you’re able to stay with the counting and repeatedly get to ten without any effort and without thoughts interfering, it’s time to begin counting every cycle of the breath. Inhalation and exhalation will count as one, the next inhalation and exhalation as two. This provides less feedback, but with time you will need less feedback.

In the process of working with the breath, the thoughts that come up, for the most part, will be just noise, just random thoughts. Sometimes, however, when you’re in a crisis or involved in something important in your life, you’ll find that the thought, when you let it go, will recur. You let it go again but it comes back, you let it go and it still comes back. Sometimes that needs to happen. Don’t treat that as a failure; treat it as another way of practicing. This is the time to let the thought happen, engage it, let it run its full course. But watch it, be aware of it. Allow it to do what it’s got to do, let it exhaust itself. Then release it, let it go. Come back again to the breath. Start at one and continue the process.

Scattered mental activity and energy keeps us separated from each other, from our environment, and from ourselves. In the process of meditating, the surface activity of our minds begins to slow down. The mind is like the surface of a pond – when the wind is blowing, the surface is disturbed and there are ripples. Nothing can be seen clearly because of the ripples; the reflected image of the sun or the moon is broken up into many fragments.

When you first begin a meditation practice, five minutes is a good time to shoot for. As you gain experience, you can increase the time to thirty minutes, or even longer. You should feel refreshed when you stop, awake, alert, and ready to go on with your day.

Up to now, we have been discussing neuroplasticity as though our brain is a one-way street, but that’s definitely not the case. Our brain is totally fluid, what we can learn we can unlearn just as quickly. In the first part of this chapter, I mentioned that our neural circuits are pruned to the tune of 20 billion synapses a day, or so, during adolescence, and this practice continues, although at a slower rate, for our entire lives.

Pathways we don’t use simply shrivel-up and die. We forget people, places, and things; we lose skills, some acquired with a great deal of effort; we change habits, likes, dislikes, political parties; we adapt new ways of doing things, discarding the old; in other words, if we are the sum of our experiences, we become different people over time, and this is all a result of neuroplasticity.

Baseball players have batting practice every day, during the season, and many continue all winter; actors rehearse again, and again, and again; in fact, every learned skill must be practiced to maintain the neural circuits we have created, or we lose it, over time. Jascha Heifetz, the renowned violinist is rumored to have said: “If I don’t practice one day, I know it; two days, the critics know it; three days, the public knows it.”

Neglect and atrophy is not the only way our circuits can change. When we change our minds about something, we really change our minds. When we receive new information that changes how we think or feel about someone or something, we literally alter synaptic connections all over our brains. Neurons that used to be connected to one place are now connected somewhere else, firing with different neural circuits. We don’t have to worry about the mechanics of it, we just make a decision and it’s done for us through the process of neuroplasticity.

Of course, we all know we have a built-in “forgetter,” and we see evidence of it every day, but is neglect and inattention the only way our neural circuits can change? Fortunately for us, the answer to that is no. Just as new information that we deem important can change our thinking and our beliefs, we can also change habit or working memory using the same tools. Let’s say we have always done something a certain way, perhaps because a parent or teacher showed us early in life, and years later we find a new way to do the same thing that’s much more efficient, and produces a better result. It might be a woodworking technique, a golf swing, or a sewing method, what it is doesn’t matter. The fact is, we can change habitual behavior as easily as we can change our minds. All it requires is that we pay attention, and practice the new method until it becomes our new habit. Connections in the brain that used to exist will disappear, replaced by the new connections we create simply by changing the way we think, and subsequently, our actions.

Oftentimes, change isn’t easy, and I don’t mean to leave you with the impression that it is. If it was, this book wouldn’t have nine chapters, and I could stop right here, and perhaps leave you with just a few simple instructions. All I’m trying to do here is impress upon you that your brain is constantly changing, and you have ultimate control over it – for good or ill. The rest of this chapter will address how we learn addiction, and the factors that influence us along the way. I just want you to remember, as you read, that just because your brain has formed certain connections, and you have learned to respond to certain cues and triggers, doesn’t mean you can’t go back, make new connections, and form new habits that countermand and supersede the old.

After all, the people in the surveys and studies in Chapter three are just like you and I. They found a way out, and so can you!

(Excerpted from Chapter 2 of the forthcoming book: “Powerless No  Longer” Copyright^© 2011, Pete Soderman)

We forge long-term memories, and learn nearly everything we retain by strengthening neural connections through repetition, and sometimes trauma or reward. Certain events can imprint permanent memories, simply by their magnitude, and their effects upon our lives and our emotions. Events such as Pearl Harbor, the assassination of President Kennedy, and the horror of 9/11 evoke strong associations, and any of us who lived through them remember where we were and what we were doing when we first heard about them. Few of us, however, could recall what we did on the preceding day. We are all familiar with that kind of memory imprinting and recall, but what about the normal, everyday kinds of things we try to remember – and sometimes fail. How does this neuroplasticity really work, and, most importantly, do we have any control over it?

The first step in memory formation is called “encoding,” which is a biological process, rooted in the senses, that begins with perception. As an example, think of meeting your first “crush.” When you met him or her, your visual system registered things like their physical appearance, the color of their eyes, the tilt of their head, and their smile. Your auditory system may have recorded the sound of their laughter. You may have experienced the smell of their after-shave or perfume. You may have even felt the touch of their hand upon your arm. These separate sensations traveled along neural pathways from different regions to a portion of your brain stem called the hippocampus, where they were integrated, as they occurred, and became one single experience – your experience of that specific person.

Imaging studies indicate that the hippocampus, along with another part of our brain, called the frontal cortex is responsible for analyzing these various sensory inputs and deciding if they’re worth remembering or not. If they are, they become part of our long-term memory. If not, they stay in short-term memory for a brief time, and are then forgotten. Do we have any control over what information is retained in long-term memory? Yes, we absolutely do, there are a couple of tools we can use to train our minds to commit information to long-term memory, one is repetition, and the other is mindfulness.

If we perform a task or recall some information that causes groups of connected neurons to fire in concert, it strengthens the connections between those cells, and they become what we call declarative memory, or memory we use in conscious decision-making. Eventually, if we strengthen them enough, these frequently-used pathways turn into what we call working or habit memory, and we can recall information, or perform certain tasks without the intervention or collaboration of our conscious mind! Practice makes permanent. The more times the network is stimulated, the stronger and more efficient it becomes.

To use another baseball analogy, there is nothing harder in all of sports than to hit a good major-league pitcher, but a great hitter never thinks about all the muscles that have to move in perfect coordination to hit the ball. He makes a decision in a few milliseconds, based upon his opinion of what the pitch is going to be, and well-developed neural pathways do the rest. A concert pianist does not consciously control his fingers while playing a piece he has practiced his whole life, any more than we think about the answer to 7 X 7, or our own social security number. These are things that have been committed to what we call “working or habit” memory. We don’t “think” about riding a bike, or turning on the tap when we’re thirsty, we just do it.

Many recent studies have concluded that “mindfulness” can play a major role in the retention of information, and thus the remolding of the brain. By mindfulness in this context, I am referring to simply “paying attention,” or being in the moment, and present to our lives. How many times have you been reading a book, and discovered you have “read” several pages and don’t remember a single one of them, because your mind drifted off to something else? Or you’re having a conversation with a friend, and suddenly discover that you can’t recall a single word they’ve said for the last minute or two? That’s what I mean, that’s how our mind works. We can focus for a time, but without some sort of mindfulness training, it’s difficult for us to keep ourselves from wandering off on some adventure or other. Simply paying attention is one of the best ways to improve our chances of not only retaining information, but also making major changes in the way we think, and how we perceive the world about us.

So, to briefly review: In response to a new experience or novel information, neuroplasticity allows either an alteration to the structure of already existing connections between neurons, or forms brand new connections between neurons, depending upon the experience or information. Either way, the brain is remolded to take in this new data, and if useful, retain it. When we are first exposed to something new, that information is entered into our short-term memory. If we decide that the information or experience is particularly important, it is repeated a number of times, or we are paying attention, it may become part of our long-term memory. If you want to increase your chances of remembering where you left your car keys last night, be sure you’re “present” when you set them down.

The reward-driven learning process

Above, we discussed stimulus-driven learning, in which the emotional content, novelty, significance, or perhaps the mindfulness we applied were the primary determinants in whether or not new experiences or information would be incorporated into our long-term memories, creating or strengthening neural pathways. We also mentioned feedback-driven learning, or the use of repetition to strengthen previously-existing neural pathways. There is another learning process, much stronger, and more primitive than any we have discussed thus far. Headquartered in a part of our brain that evolved hundreds of millions of years ago, is the system that incentivizes us to eat, reproduce, defend ourselves, protect our young, and other important functions that are key to our survival, and the survival of our species. It’s called the Reward Pathway, or Limbic system, and it’s one of the most powerful and complex systems we have.

Sometimes referred to as our “reptile brain,” because of it’s early evolution, this system organizes the behaviors that are life-sustaining, provides some tools necessary to take the desired actions, and then rewards us with pleasure when we do. Research shows that almost any normal activity we find pleasurable, from eating a chocolate chip cookie, to hearing great music, or seeing a beautiful face, can activate the reward system. When this happens, not only are we stimulated, but these circuits enable our brains to encode the circumstances that led to the pleasure, so that we can repeat the behavior, and the reward in the future.

A critical component of the system is a chemical, called dopamine, which is released from neurons in the reward system circuits and functions as a neurotransmitter, heightening our awareness and focusing our attention. I know, I promised I wouldn’t talk about chemicals, but understanding the effects of the release of this important component of the reward system is the key to understanding the system itself. As a matter-of-fact, the reward system is sometimes referred to as the “dopamine” system. Many other areas of the brain are wired-into this system as well, including decision-making areas, such as the frontal cortex. I’m not going to discuss other areas that are involved, because they’re not important for our purposes, and they vary from drug-to-drug anyhow.

One thing that I want you to understand, though, is that we are talking about our most basic survival mechanism here, and the established neural pathways that are used by this system are some of the most-used, and therefore strongest pathways in our entire brain. There is no other system, no other stimulus that will drive the formation of new connections, or the strengthening of existing ones’ faster then the reward, or limbic system. The limbic system connects the higher and lower functions of our brains, and serves as its’ emotional center. If we, as Humans, had to consider one part of our brains to be the core of our personal consciousness, it would be the limbic system and, especially, the interaction between it and the cortex. Physical disruption of the limbic system causes major behavioral changes, and, as we shall see in a later section of this chapter, it is this system that is hijacked by addiction.

The memory formation process is virtually the same for reward-driven memories as it is for stimulus-driven. The key difference between the two is that following the initial encoding or acquisition phase, the stronger emotions and already well-established neural pathways involved with the reward system can, and often does lead to much more rapid formation of declarative and working or habit memory. Again, declarative memory is that long-term memory which we use for concious decision-making, while habit memory is that which is called into play without our concious mind being involved.

When a person experiences a positive, pleasurable outcome from an action or event, the release of dopamine alters the brain circuitry, providing tools and encouragement to repeat the event. The memory circuitry stores cues, or triggers, to the rewarding stimulus, so previously neutral cues (a perfume, a particular location) become important. Our brains map the environment in which we experience the rewarding activity by recording the place, the people, the smells – in fact the entire experience. Triggers alone are not enough; actions are necessary to get a reward. The brain’s reward system is organized to engage the areas of the brain that control our ability to take action.

When we experience a rewarding event, the “thinking” portions of our brain are engaged. It remembers the actions used to achieve the reward and creates the capacity to repeat the experience. So, not only does a pleasurable experience result in pleasant memories, but also the executive center of the brain provides motivation, rationalization, and the activation of other brain areas necessary to repeat the experience. Each time the experience is repeated, all of these brain changes and reorganizations become stronger and more ingrained.

(Excerpted from Chapter 2 of the forthcoming book: “Powerless No  Longer” Copyright^© 2011, Pete Soderman)

Nearly every recovery self-help book explains the mechanism of addiction, if they address it at all, by discussing the chemical changes that take place in the brain during the various phases of the addiction process, some of which are irreversible. Explaining addiction in that manner merely feeds into the disease and powerlessness model, when we are not powerless over our addictions at all. I’m not denying that some of these chemical changes are, in fact, irreversible, but they do not effect our ability to overcome our addictions by changing our thoughts, beliefs, and actions. Fortunately there is an entirely different way to look at both the process, and the effects of addiction that is not only equally valid, but also does a much better job of explaining not only how we become dependent upon substances, but also how most of us manage to recover, on our own, from this “irreversible” condition.

Our brains have the ability to rewire themselves, changing structurally and functionally, in response to changes in our environment and our experiences. For most of the twentieth century, the general consensus among neuroscientists was that the brain was relatively fixed and immutable after a certain critical period during early childhood. This belief has been challenged by new findings and evidence, especially detailed brain imaging that has conclusively proven that our brains retain a significant ability to change, which is called “plasticity,” into adulthood, and even old-age. Neurological research indicates that experience can actually change both the brain’s physical structure and functional organization from top to bottom. It was also once believed that our brains can never grow new neurons, but this has also been proven to be false, for at least two areas of the brain having to do with learning can indeed grow new neurons. In fact, it’s happening to you right now as you read this page! This characteristic of the brain, called “Neuroplasticity,” not only is responsible for our ability to learn and unlearn, but also for the ability of some people to recover from serious injuries, strokes, and diseases that disable or disrupt some of their brain functions.

Why am I talking about this when most other books on addiction discuss the chemistry that drives the process? I do it for two important reasons:

1. Understanding that we learn to become addicted is an important key to overcoming it, and the underlying chemistry, fascinating though it may be, that drives the addiction learning process, doesn’t really matter. In fact, the chemistry varies from drug-to-drug, while the learning process remains the same.
2. We don’t recover from addiction chemically; we recover by changing our thoughts, feelings, beliefs, and therefore our actions. This is an unlearning and a learning process, and in the context of neuroplasticity happens in the same way as addiction itself, making the whole process much easier to explain.

To draw a sports analogy, if you were teaching your son or daughter to hit a baseball, would you talk about contracting this muscle or that, at what time, and to what degree, for a hundred different muscles? Of course not! You would just tell them to keep their eye on the ball, their shoulders level, take a good swing, and follow-through. As we go through this discussion, I think you will understand why I chose to go this way – at least I hope you do!

At birth, our brains contained approximately 100,000,000,000, that’s one hundred billion nerve cells, called neurons. Each and every neuron has the ability to connect to anywhere from a few thousand to as many as 100,000 other neurons.

The neurons connect to one another through what is called a synapse. The synapse is nothing but a gap, one-millionth of a centimeter wide. Through these tiny gaps flow all of our thoughts, emotions, and sensory perceptions. The scientific consensus is that at the peak, around age three, the average neuron makes about 15,000 connections with other neurons, before some of them begin to die off in a process called pruning. In the adult brain, we can estimate the number of connections, or synapses to be somewhere between 100 and 1,000 trillion!

Many of the connections we are born with are indeed dictated by our genes, but as the human genome has something on the order of 35,000 different operative genes, and only half or so of those are involved in the brain, it seems clear that most of the connections that are active in our brains right now are the result of our environment and experiences, not heredity. Synapses that are not used are pruned-away. By one estimate, we lose about 20 billion a day between childhood and early adolescence. Connections we don’t use wither and die, while at the same time we are continually forming new connections as we learn about the world around us and interact with others.

As Jeffrey M. Schwartz puts it in his book, “The Mind and the Brain:”

“Here is where the power of genes falls off rapidly: genes may lead neurons to make their initial, tentative connections and control the order in which different regions of the brain (and thus physical and mental capacities) come on line, but it’s the environmental inputs acting on the plasticity of the young nervous system that truly determine the circuits that will power the brain. Thus, from the earliest stages of development, laying down brain circuits is an active rather than a passive process, directed by the interaction between experience and the environment. The basic principle is this: genetic signals play a large role in the initial structuring of the brain. The ultimate shape of the brain, however, is the outcome of an ongoing active process that occurs where lived experience meets both the inner and the outer environment.”

One additional concept is necessary in order to understand neuroplasticity, and that is the issue of synaptic strength. In 1949 it was proposed, and later confirmed by studies, that when two connected neurons are simultaneously active a good deal of the time, the synapse itself changes in such a way that makes the activation of one cell more likely to cause the other cell to fire. This has become known by the maxim “cells that fire together, wire together.” Picture the concept as being similar to a well-used dirt road in the country, with deep ruts worn by generations of traffic, making it easy to stay on the path, or like a school child learning the multiplication tables, repeating them over and over, until constant use allows us to remember that seven-times-seven is forty-nine without having to do any conscious computation. That’s the concept of synaptic strength.

In order to communicate with each other, neurons synthesize chemicals called neurotransmitters. These are released from one side of the synaptic gap and attach to receptors on the other side. They have the dual function of transmitting a signal and modulating signals that are already present. Communication between neurons takes place through this exchange of neurotransmitters. Information flows from one end of a neuron to the other because of a difference in electrical potential between the two ends of the neuron. This difference in potential produces an electrical current, and when it reaches a sufficient magnitude, it forces a release of neurotransmitters from one neuron to the other.

So, we have these billions of neurons with trillions of connections, all talking with one-another. How do they work together in the process of learning? Why do we remember some things, forget others, learn new things, and most of all, form what we come to know as “habitual behavior patterns?”

My next post will answer these questions, as it explains the learning (and unlearning) process in terms of neuroplasticity.

(Excerpted from Chapter 2 of the forthcoming book: “Powerless No  Longer” Copyright^© 2011, Pete Soderman)

The famous Astrophysicist and science popularizer, Carl Sagan quite correctly wrote: “Extraordinary claims require extraordinary evidence.” I will present extraordinary evidence that you already possess within yourself all the power you need if you have a genuine desire to effect self-change in any area of your life, including your addiction.

Every one of you reading this knows someone who has quit smoking  and you might have even done so yourself, without using nicotine-replacement therapy, or any other program. Nicotine is an extremely addictive substance, and especially hard to quit because it wends its way into every facet of our lives. In spite of this, millions can and do quit smoking every year, and, according to the American Cancer Society, nearly 90% of them do it completely on their own.

This book is written primarily for those of you who are currently in the process of questioning their own drug or alcohol use, or who have tried 12-step programs and not succeeded there for some reason. Perhaps you have been told you are “powerless” over your addiction, but believe me, you are not any more powerless over drugs or alcohol than the people who quit without help were powerless over nicotine. I will describe in detail the methodology for self-change that worked for the 75% of addicts who successfully recovered on their own, and show you how to apply these principles in your own recovery. My aim is to suggest methods that science and actual experience indicate can be successful for the majority of people who choose to employ them.

What makes this book truly unique is the viewpoint and experience I bring to it as a recovered addict, and that I have combined in one volume:

• A detailed explanation of the bio/psycho/social aspects of addiction
• The appropriate research and studies into how most people recover
• A broad review of the current recovery methods, and
• suggestions you can use to take what’s currently available and construct a recovery program that fits your own needs and life situations

I will make some suggestions based upon the available science, I won’t try to convince you to accept an inflexible system of rigid dogma, and mold yourself to fit into it. There is no one system that will work for everyone, there are only methods and principles that will work for most, and these have been discovered in scientific surveys and studies, not by some variation of divine revelation.

This effort grew out of curiosity that began over twenty years ago, when I was attending Alcoholics Anonymous (AA) meetings, but didn’t buy the “higher power” concept or believe that I was powerless. I never worked a step, used a sponsor, prayed, or followed most of the other “suggestions,” except for one: I didn’t drink. Why was I successful when studies indicate that only 5 out of every 100 people stay sober in AA for a year? I drifted away after a few years, began a Zen mindfulness practice, and started a secular recovery meeting with a few friends.

It wasn’t until Mike Werner, one of the founders of SMART Recovery^® introduced me to their scientifically-based program a few years ago that I learned most addicts recover on their own with minimal informal help. Mike and I started a SMART meeting as co-facilitators that’s still going strong in Wilmington, NC. As I continued to learn more about the ways in which people really recover from addiction, I became more curious about how addiction works, why I behaved as I did, and why I continued to drink even when I received little benefit from the drug. I did the research necessary to learn the answers to these questions, and many more, which clearly showed that the current conventional recovery establishment is based upon principles that have little or no relevance to how addiction works, or how addicts actually recover.

There is honest debate in the scientific community over whether or not addiction should be considered a “disease.” Presently, the American Psychiatric Association does not consider it so. Instead, they refer to both substance abuse and dependence as “disorders.” Even if that should change someday, it doesn’t matter, for purposes of recovery, as it’s purely a technical issue. AA has unfortunately coupled the “disease concept” with the principle of “powerlessness” in the mind of the public, and thus created a “disease model” that actually makes recovery more difficult for most, and increases the incidence of relapse. In his book, “7 Tools to Beat Addiction,”  the noted addiction researcher, Dr. Stanton Peele pointed out in Chapter one:

“Psychologist William Miller and his colleagues at the University of New Mexico conducted an important study in which they tracked subjects who reported for outpatient treatment for an alcohol problem. The investigators’ purpose was to forecast which subjects were more likely to relapse following treatment. They found two primary factors predicted relapse—“lack of coping skills and belief in the disease model of alcoholism.”

Think of it—treatment in the United States is geared primarily toward teaching people to believe something that makes it more likely that they will relapse! Instead, psychological theory and research indicate that it is more empowering and successful for you to believe in—and to value—your own strength. In this view, the critical element in cure is to develop your sense of self-efficacy. Yet if you express this view, or that you are uncomfortable with the value of powerlessness taught in the twelve-step approach, you will be told that you are in denial and that you cannot succeed at quitting addiction. “

It is impossible to separate the disease concept or the principle of powerlessness from the 12-step institutions themselves, as they are all built around them, so to argue against the disease model is to argue against the institutions. I’m afraid I’ll have to do some of that in a later chapter, because to succeed in changing your perceptions and outlook on the world, you first must believe that you and you alone, have the power necessary to do so.

(Excerpted from Chapter 1 of the forthcoming book: “Powerless No  Longer” Copyright^© 2011, Pete Soderman)

The one element that’s common to all successful recoveries achieved by any method is that we must somehow find the resolve or motivation necessary to overcome our addictions. This is true no matter what the addiction, or the relative severity. If we are properly motivated, almost anything will work, but in the absence of motivation, nothing will! The motivation for change may come from many different sources, in fact the most common, according to the majority of studies, is a single consultation with a trusted medical professional, such as a family doctor. Other sources of motivation that rank highly in studies are family or financial pressures, a major life event, such as an illness or the death of a using significant other, or simply a “moment of clarity” that reveals to us our true situation.

The motivation to make a change can also be generated by an outside source, such as a program that emphasizes motivational enhancement. Such programs are useful for someone who is merely questioning their substance use. There are many techniques that when properly employed can bring us to the realization that change is not only advisable, but absolutely essential in order for us to regain control of our lives. Such programs should include most, if not all of the following elements:

1. An assessment of our drug or alcohol use, our risk factors, and/or drug-related problems, along with our level of dependence.
2. Objective, non-judgmental feedback from the assessment that doesn’t slap a label on us or try to push us in any particular direction.
3. Motivational enhancement that helps us consider the positives and negatives (pros and cons) of our drug use, both short and long term, designed to assist us in overcoming our ambivalence about attempting a change.

Whether the needed motivation is generated internally by ourselves, or as the result of a program, the outcome must be a conscious decision on our part that the benefits of using no longer outweigh the costs (physical, emotional, financial, etc.) of using, otherwise, as the statistics show, we will not be successful regardless of what path we choose.

After motivation, the next common thread among those of us who were successful is that we began to make some substantial changes in our lives, including such things as replacing associations with using friends, finding substitute activities, (we have to do something with all that extra time), and finding some way to cope with the urges and cravings that coerce many of us back into drug or alcohol use. Studies show that the majority of us who were successful relied heavily upon friends and family members, and also Community Reinforcement techniques, along with self-help books, such as this one.

The Community Reinforcement Approach (CRA) is a structured program that was designed primarily for alcoholics, and usually administrated by a treatment professional. It includes some of the analytical elements we have already covered regarding motivation, and many additional tools, most of which are shared with other programs, and discussed at length elsewhere in this book. CRA also includes the use of the drug disulfiram (Antabuse^®), which has the effect of making the drinking of alcohol intolerable, thereby, in theory, helping alcoholics through the first few months of abstinence. Most of the available studies compare CRA with other treatment modalities, such as Alcoholics Anonymous (AA), and various forms of Cognitive Behavioral Therapy (CBT). Results show that CRA does very well against AA, and demonstrates very little difference in statistical outcomes when compared to CBT, which is to be expected as CRA and CBT share many of the same techniques.

Thanks to the modern self-publishing industry, there is no shortage of recovery-oriented self-help books on the market, and studies show that a large percentage of us who stop on their own do so by using some of the techniques found in such books. Most of them seem to concentrate on 12-step programs themselves, or variations on 12-step themes, and others spend a lot of time bashing 12-step programs, and little time either explaining addiction, or presenting scientifically-proven alternatives to the 12-step method. An increasingly larger share of the self-help literature is devoted to programs that foster moderation as opposed to abstinence, which is appropriate, for many of us have been able to moderate our drug or alcohol use, as the studies presented in chapter three will show.

Many techniques exist for dealing with the cravings, urges, and “gotta have its” that occur in early sobriety, and there is a lot of commonality between some of the different programs and methods for dealing with them. According to the studies, most of us who quit on our own do so without any sort of chemical help, relying instead on the techniques that such programs as CRA, SMART Recovery^®, and Moderation Management recommend. Chapter five explains some of the various programs, how they differ, and methods they share in common, while chapter seven covers all of the effective urge-control methods in great detail.

After learning to deal with urges, the next thing we have to address is how to get along on a day-to-day basis without resorting to the drugs we were using to kill pain and alter reality, while, at the same time, facing the same problems that everyone else does. Most of us see the world differently than our non-using friends. For reasons I will explain in the chapter two, we are more susceptible to stress than most, and our belief systems have to undergo a major change in order for us to obtain long-term sobriety (or moderation). In order to change our belief systems, we have to change the way we think about ourselves, and our relationship with the world. This requires a good deal of properly-directed effort; it does not happen by itself. As it turns-out, studies show that the same programs I mentioned in the last paragraph contain the elements that offer the best statistical chance of achieving this goal.

Most of us who started using at a rather young age never “grew-up” in the sense that we didn’t learn the value of working for the achievement of long-term goals. We were much more into short-term gratification, and our lives were spent, for the most part, in the pursuit of the pleasures of the moment. Our lives became centered around using, as our addictions progressed, and we never gave much thought to the future. In my case, as I drank more-and-more, my world began to shrink, as alcohol took away most of what I formally thought was important. Woodworking was first, as I was afraid to work with sharp things after I had a “pop or two.” Reading was next, followed by sports, clubs, and finally, most of my contact with my children and the outside world. I accepted this as being “normal,” I just figured that’s how my life was now, and I didn’t see a problem. When I quit drinking, I had to rediscover that there really is a life out there, and I could be part of it without drinking! There is life after alcohol, who knew?

Every recovering person has to go through this same process. Somehow, we must learn to restore some balance in our lives, learn to manage short and long-term goals, for instance, and learn to interact with other people on an equal footing. We must also learn to accept personal responsibility for our actions, which as users, we seldom did, at least outwardly. These are learned skills, and whether we get them from a program, from friends and family, or from a professional, we must acquire them in order to have long-term success in our new lives. I devote the last chapter of this book to this topic, not only because the studies say it’s an important one, but also because it’s fun to write about.

Underlying all of the points above is a technique that is just beginning to be scientifically studied in the context of alcohol and drug abuse recovery, although it has been known and utilized for centuries, commonly called mindfulness. We act as we feel, and we feel as we think, therefore our thoughts drive our actions. The suggestions for change favored by available research mentioned above all share the common goal of changing our thinking, our beliefs about ourselves and the world around us, and subsequently, our actions. As our expressed goal is to modify our thoughts and feelings, it would seem entirely appropriate that we adapt some reliable method of monitoring them on an ongoing basis, and that is the object of Mindfulness Meditation.

The following is quoted from Page 2 of a 2009 National Institutes of Health (NIH) publication titled: “Mindfulness Meditation for Substance Use Disorders, A Systematic Review:”

“The theoretical framework for mindfulness meditation suggests that it may be a promising approach to treating addictive disorders. Mindfulness has been defined as the intentional, accepting, and non-judgmental focus of one’s attention on the emotions, thoughts, and sensations occurring in the present moment. Such a purposeful control of attention can be learned through training in techniques such as meditation. The ‘observe and accept’ approach, characteristic of meditation refers to being fully present and attentive to current experience but not being pre-occupied by it. Thus, meditation can become a mental position for being able to separate a given experience from an associated emotion, and can facilitate a skillful or mindful response to a given situation. Meditation is often contrasted with everyday, habitual mental functioning or being on ‘auto-pilot.’ As such, meditation may be a valuable technique for [Substance Use Disorder] SUD-affected persons, whose condition is often associated with unwanted thoughts, emotions and sensations (e.g. craving), the tendency to be on ‘auto-pilot,’ and pre-occupation with the ‘next fix,’ rather then ‘being in the present moment.’ Meditation may also be a component of maintaining lifestyle balance, with meditation-acquired skills complementing and enhancing CBT effects for SUDs.”

The review goes on to say that mindfulness meditation and Cognitive Behavioral Therapy (CBT) techniques compliment one-another well, as they address different aspects of substance abuse:

“The integration of meditation and traditional CBT strategies may improve overall treatment efficacy e.g. by increasing awareness of sensations, such as craving, emotional states, and physiological arousal.”

The bulk of the available research tells us that statistically, our best chance of overcoming our substance abuse problems lies in learning techniques that alter our thought processes on a permanent basis. Learning to focus our attention upon our thoughts and emotions, as well as our actions is the key to doing this successfully; therefore, mindfulness should play a major role in whatever path we choose.

Before leaving this section, I would like to say a few words about a popular, indeed ubiquitous program that was not mentioned here. I devote part of chapter five to Alcoholics Anonymous (AA), simply because it is such a well-known program, and, according to a 1997 study, 93% of American drug and alcohol treatment programs follow the 12-step method. This section, however, is about what works, not about what’s popular, and according to most major studies that have been done, AA has been shown to be no better than no treatment at all. In other words, the 12-step method is no better than chance alone in aiding in recovery from drug and alcohol abuse. In fact, there is much evidence that AA might even be harmful to many substance abusers.

Psychiatrist George Vaillant, an advocate of the standard hospital and AA treatment program, and a long-time member of the Alcoholics Anonymous Board of Directors, reviewed his own studies of his own program in his book “The Natural History of Alcoholism:”

“It seemed perfectly clear that….by inexorably moving patients from dependence upon the general hospital into the treatment system of AA, I was working for the most exciting alcohol program in the world. But then came the rub. Fueled by our enthusiasm, I and the director…tried to prove our efficacy. Our clinic followed up our first 100 detoxification patients.. [and found] compelling evidence that the results of our treatment were no better than the natural history of the disease.”

I will talk further about the 12-step method in chapter five, because there are some aspects of it that you might consider including in your recovery plan, as there is some evidence that they work. By the way, if you happen to be in AA, and it’s working for you, by all means stick with it! You’re in the minority, even according to AA’s own surveys, but, as they say, if it ain’t broke, don’t fix it!

So to wrap-up this section, multiple studies and surveys show that successful recoveries share a few common elements, and that among them are:

• We had to make a conscious decision that the benefits of not using outweighed the costs (physical, emotional, financial, etc.) of using, thereby gaining the motivation to quit.
• We had to deal with the urges associated with stopping any drug, the “gotta have its’.”
• We had to learn, perhaps for the first time, how to get along on a day-to-day basis without resorting to drugs they were using to deal with stress, kill pain, and alter reality, while facing the same problems we all face.
• We had to learn to balance short and long-term goals, achieve a happy lifestyle, get along with others, in short, learn how to live.
• There is growing evidence that the practice of mindfulness can be a tremendous help in augmenting any program of recovery.

In chapter five, we will explore in detail some of the programs that contain these elements, along with some others that may be helpful.

The information in this section was referenced from dozens of reviews, studies, and surveys which appeared in several professional publications. Many of the points were reinforced and corroborated by several studies, so to avoid confusion, I elected not to reference individual points. All of my sources are listed in the chapter notes.

(Excerpted from Chapter 1 of the forthcoming book: “Powerless No  Longer” Copyright^© 2011, Pete Soderman)

Firstly, consider that those false beliefs stem mainly from a book that was published in 1939, called “Alcoholics Anonymous,” which became the foundation of the drug and alcohol treatment industry, and the source of most of the public’s knowledge about addiction. Not a single word or phrase in the operative portion of this book has been modified or updated in the slightest since its initial publication, seventy-plus-years-ago, in spite of all we have learned about addiction, especially in the last half-century. For its part, the addiction research community has hardly gone out-of-its-way to change public opinion either, partially because of a reluctance to challenge the established treatment industry, and partially, I suspect, due to their lack of access to the public-at-large. That last is truly unfortunate, because the truth of the nature of addiction, revealed by the available studies and research paint an entirely different picture than the one the public, and even most addicts, currently believe.

Addiction is an extremely complicated Biological, Psychological, Neurological, and social disorder, with no single cause. We are not addicts because we are weak, immoral, or fated to be so. We are addicts mostly because we learned to be, not because of any spiritual shortcoming. We became addicted because of a combination of genetics, experience, personality, opportunity, and outlook.

Family, twin, and adoption studies have demonstrated that genes contribute to the development of alcoholism and drug abuse with heritability estimates ranging between 50 and 60 percent. That’s a pretty good percentage, but it’s not exactly destiny either. Specifically, the genes most associated with alcohol dependence are those that encode the enzymes that metabolize alcohol, and certain drugs. Other suspects include genes that alter some of the functions of chemicals called “Neurotransmitters,” such as dopamine, which mediate and influence transmission of signals in the brain. This could lead, for instance, to an individual being more susceptible to stress, or other environmental stimulants than other individuals. There is no particular gene that has been firmly linked to any particular drug or alcohol addiction, but although there have been some strong correlations discovered between some genetic configurations, and certain manifestations of drug and alcohol abuse, as we will see in the next chapter, genetics are only one piece of the puzzle.

Addiction is not driven by the drug itself, or the effect it has on a person’s brain chemistry, it’s driven by the emotional and psychological needs it fulfills for the user. These needs are determined, not from genetics, but from the persons environment, their perceptions of the world, and most importantly, their beliefs about themselves. If a person has a poor self-image, for whatever reason, and believes they’re a “screw-up” who will “never amount to anything,” and is subsequently exposed to a drug that reverses all that, makes them feel ten-feet-tall, bulletproof, and “one of the gang” for the first time in their life, who wouldn’t want to repeat the experience? Who wouldn’t want their social anxieties to disappear?

Because of this combination of factors, using did things for us that drugs don’t necessarily do for others. The effects they initially had on us provided the positive reinforcement that encouraged further use. This further use resulted in the eventual development of physical tolerance, where ever larger doses of the drug were required to achieve the effects we sought. At some point, if we continued to use, positive reinforcement turned to negative reinforcement – we still sought the effect of the drug, but our using was driven more by nearly irresistible cravings and avoidance of the effects of withdrawal than by the positive effects of using.

This was our learning process. Regardless of the particular drug, the process – and the end result – was the same. We will find in the next chapter, that as we were learning to use, we were strengthening certain neural pathways in our brains, while we were growing new ones, thereby reinforcing and changing our thinking, beliefs, and perceptions of the world around us. As we continued down the path, our craving for the drug became wired into the most primitive parts of our brain, until it reached the point where the “thinking” portion of our brains  couldn’t distinguish between the drug-related “gotta have it’s,” and our primal drives for reproduction, food, and survival itself. When we reached this point, using was no longer a choice, something we had conscious control over, but an almost “hard-wired” response to how we learned to perceive the world outside, and our beliefs about it.

I don’t mean to present this as though we were, in any way, helpless “victims” of genetics, personality, upbringing, or anything else, because we were not! At any point along the path we could have chosen, as the vast majority do, to quit using, or at least abusing, drugs or alcohol. The fact that some of us do not doesn’t indicate weakness or immorality, it simply means that for whatever reason, we saw our using not as a problem, but as a solution – the best one we had available – to help us cope with the world as we saw it! Fortunately for us, that was the problem – and it also contains the seeds of our solution.

That greeting won’t earn you many points at an AA or NA meeting, but it will give you a pretty good idea of what this book is all about. We addicts are no different from anyone else; we have simply learned to see the world from a somewhat different perspective than most other people. That’s right, I said learned! We have learned to be addicts. We were not born with our addictions, although genetics do play a role; nor did we acquire them due to some moral flaw or shortcoming, although almost everyone in society and the treatment industry believe that we did. The good news is that 75% of us overcome our addictions on our own without the use of treatment centers, formal programs, pills, or patches. Not only are we capable of unlearning what we learned to become addicts, we can, as millions have, learn new skills that allow us to cope with the normal, and abnormal stresses in life that drove many of us to dependency in the first place.

We became addicts by using certain substances in sufficient quantities, and for sufficient periods of time to bring about changes in our brains, affecting both our physiology and our perceptions of reality. By “using,” I mean the ingestion of any addictive drug, from nicotine to heroin, and everything in between. Although there are differences between the affects different drugs have upon our brain chemistry, they are unimportant from the standpoint of how we learn to be addicts.

At first, we use because we receive positive feedback from the use of the substance – it makes us feel good! It makes us feel like “one of the crowd,” some of us for the first time. It makes us feel better about ourselves, improves our self-image, and makes that “not-quite-good-enough” feeling disappear – at least for a little while. As “social” drug users, we feel as though we finally have a handle on life, and what’s going on around us. Using helps us deal with the stresses we occasionally face, especially when dealing with others. For some of us, it makes us feel ten-feet-tall and bulletproof; for others, it seems to add that “layer of insulation” that was somehow left-off when we were going through the assembly-line. In other words, for some of us, it does too much!

As we learn to like the way the drug makes us feel, we might notice that after a while, it takes more and more of the substance to reach the level where we’re comfortable with the world around us. At this point, we may be using more, but we are still able to choose whether to have a glass of wine or help a child with their homework, or to stop after the proverbial “one or two,” because we have an important meeting at work the next day, or have to drive our family somewhere for an outing. We may be occasionally “binging,” but although our drug-seeking habits are becoming more ingrained, we are still making socially-appropriate conscious choices.

If we continue on this path long enough, we ultimately lose the ability to make conscious choices about our using behavior. Even after a period of abstinence, various environmental cues or stressors trigger drug use almost automatically, hijacking our basic survival instincts, triggering a response we seem to have little or no control over. Social concerns have little meaning any longer at this stage, no matter how pressing they might seem. We have learned that we must have the drug, no matter what the cost, even to those we hold most dear, because our basic survival is at stake. Neither family, jobs, possessions, or even personal safety are important now, the drug is all that matters!

Sounds pretty hopeless, doesn’t it? Well, if it were truly hopeless, then the 75% of addicts we will learn about in Chapter three wouldn’t have been able to overcome their problem, and believe me, I wouldn’t have survived to write this book. If you’re reading this and you place yourself in one of the last two categories I just described, something has driven you to the point where you at least suspect you might “have a problem,” and perhaps you are wondering what to do about it. Helping you decide “what to do about it” is the purpose of this effort, and the reason for writing “Powerless No Longer.” I was once in the very same, or at least a similar position to that in which you find yourself, and I would like to begin this journey with you by relating how my own personal journey out of the darkness began. Further on, this chapter will discuss why we are not powerless over addiction, and go into more detail about how we learn to become addicts, and give some recommendations as to how you might use this book.

I had a twenty-six-year drinking career that began on my eighteenth birthday, and ended in August of 1990. The last year or two were undeniably the worst. I was failing at work, my personal life was a mess, and I kept getting into one scrape after another. Not legal scrapes, but I was doing the kinds of things that hurt other people, destroy your reputation, and cause a great deal of personal pain. Of course there was one thing that would kill the pain, but unfortunately it was also the thing that caused more pain. And so on, and so on…, until you reach the point where alcohol no longer kills the pain, but you continue to drink anyway because at least it brings the relief of oblivion!

I convinced myself that the pain I was in, and all of my problems were due to my wife, my family, my job, and in fact, just about everything in my life, except, of course, myself. I made plans to escape to another part of the country, where I could “get myself together,” free from all these people and things that, in my mind, were causing these problems I was having.

One night, about a week before I was due to leave, on my one-way trip to self-destruction, I was sitting in the living room of our garrison colonial, continuing a normal evening of drinking scotch, after the mosquitoes finally drove me off of the deck in back of the house. I was making-up stories in my head about my upcoming adventure, and wondering what my new life would be like, when I was interrupted by the unexpected presence of my fifteen-year-old daughter, seemingly appearing out of nowhere, standing about ten feet in front of where I was sitting, nervously holding a piece of paper with some writing on it in her hand.

“Dad,” she said with a slight tremor in her voice, “what did you think of the poem I read for you before, on the porch? You said you wanted to think about it for a while.”

Before I could stop them, the words came out: “What poem?” I couldn’t remember even seeing her earlier, let alone her reading any poem.

She held out the paper in her hand, “This poem, I’ve been working on it for days.”

I shifted my gaze down towards the floor, pretending to remember, and muttered something that I hoped was appropriate; frankly, I can’t remember what I said. When I met her eyes again, even through the alcoholic haze, I could tell she was hurt, and then I began to see something else, I saw myself, and what I had become reflected in her eyes. As her expression changed from hurt to anger and from anger to disgust, we both realized, at the same instant, that I was a complete and absolute fraud!

She crumpled the paper into a ball, and disdainfully tossed it onto the rug between us, like Gary Cooper flipping his badge into the dust in “High Noon.” I can still remember how her long hair swung as she wordlessly spun on her heel, ran from the room, and up the stairs, the first of her wracking sobs cutting through me like a knife.

I had seen myself through her young eyes, and I was devastated by the vision of deceitful hollowness and self-loathing I saw reflected there. I looked around the room, and realized that this was all coming to an end, and soon! We were living off sales I had made two and three years ago, selling into the defense establishment was like that, the procurement cycle took forever. There was nothing in the pipeline, as I hadn’t made a major sale in almost two years. I saw things that night that I had never admitted, or faced before. Not only was I a liar, a cheat, and a phony, I realized that I was one of the few people I knew who didn’t already know it!

I wanted the world to just stop! If it would do that, for just a little while, I could get myself together, I thought, and begin to make all these things right. I wanted not to continue drinking scotch that night, I really tried hard not to drink, but somehow the glass continued to fill itself, seemingly without any conscious effort on my part. I drank until the pendulum clock on the wall bonged one o’clock, then I stumbled up the stairs, undressed in the dark and fell into bed. As the room began to spin, my last conscious thoughts were filled with indescribable fear – I couldn’t even comprehend facing life without alcohol to kill the pain, and yet I knew, I mean I was totally certain that I would die if I continued to drink. I was absolutely terrified of whatever I might decide to do when morning came.

Obviously, I didn’t put a gun to my head, nor did I continue to drink beyond the next day. I found another solution, and discovered that there was, indeed, a life out there that didn’t require constant alteration of my perceptions of reality. This book is about how anyone can discover that life, and actually how most addicts discover it either completely on their own, or with minimal help.

We learn to become addicted, and we can learn to make the changes necessary to our thoughts, feelings, and beliefs that will relieve us of the burden of our addictions for a lifetime, not just a day-at-a-time. The objective of “Powerless No Longer,” is to teach you how to take advantage of your brains’ natural ability to rewire itself, its neuroplasticity, to overcome your addictive behavior, and reach your full potential.