Let It Hurt, Let It Heal

a large wave is breaking in the ocean.

On any given day in the US, nearly 700,000 prescriptions are dispensed for pain medications. If this number seems staggering to you, that’s because it is—especially when you consider that rates of opioid addiction and overdose in this country are at an all-time high. What can start as a pill here or there to manage pain can quickly unravel into a debilitating dependence. We don’t tend to (or want to) think about it this way, but many of the people who die from heroin overdoses started out in a doctor’s office. We’ve got a troubling epidemic on our hands in this country, and for the last several years of my career, I’ve been on its harrowing front lines.

I’ve worked with many people suffering from addiction to opioids and other substances; and while I treat each of my clients according to their unique circumstances, I often find that my conversations with them venture into familiar territory. One of the topics that comes up most often when I speak to these clients is a common one that also comes up when I speak to my other, non-addicted clients. That’s because it’s a topic that relates much more to the human experience in general than to the unique experience of becoming an addict.

The topic I’m referring to is pain. Not just physical pain, of course. I’m talking about the pain of everyday living. From momentary sadness to crippling regret; from a broken heart after a breakup to the devastating loss of a close companion. No matter who you are, no matter how fortunate you’ve been, pain is (or surely will be) part of your reality. And the truth is, your mental health and overall capacity to function in your life depend critically on your ability to effectively manage it. When I see the overwhelming numbers of people losing their lives and their loved ones to addiction every day in this country, I can’t help but think about how different things might be if we could all learn more adaptive ways to manage discomfort and cope with the tough stuff. People are suffering—and far too many of them are doing so in an effort to avoid feeling pain.

Though not everyone turns to substances, we all have ways of seeking to numb ourselves and avoid facing the parts of life that feel uncomfortable and unpleasant. We overeat, oversleep, overwork, or otherwise disconnect from our experience in the moment. And, in some ways, this makes sense. Pain avoidance is woven into the fabric of what makes us human, so it’s only natural that we look for ways to make ourselves feel better whenever pain arises. The problem is, instant gratification and immediate relief are terrible long-term strategies. They serve to lower our tolerance to pain so that we’re less equipped (and more afraid) to manage it the next time it comes up. It’s no wonder our society is more obese, addicted, and depressed than ever before. Our efforts to tune out and feel good in the moment only end up harming us in the long-run.

Life transforms dramatically when we learn to let ourselves feel pain. Trust me; I make a living helping people through this process. Many people spend their lives developing strategies—both consciously and unconsciously—to resist and avoid pain. But this is the worst thing we can do with painful emotions once they’ve arisen. The resistance only serves to strengthen the pain, making it harder for us to move through it. Think about how difficult it is to swim upstream. When you resist the current and try to move in the opposite direction of where it’s flowing, you make the journey to your destination much more difficult. You get stuck. You wear yourself out from the effort. When, however, you move in the direction of the current—going with what’s already flowing—you move much more swiftly. This is the way it works with our emotions, too. Though we’re naturally inclined to resist feeling painful emotions like anger, sadness, regret, or loneliness, we can move through them much more quickly and easily when we allow ourselves to feel them—going with the current, so to speak—than when we resist.

Our society compels us to believe that we should always turn that frown upside-down or find the silver lining on every dark cloud. But the truth is, life is as much about the difficulties as it is about the triumphs—as much about the happy feelings as the painful ones. Pain takes on a whole new meaning when we can learn to greet it and keep it company. Once we learn to let it hurt, we’ve taken the first step to letting it heal.

If something hurts for a while, or you experience difficult emotions every time you think about a particular part of your life, it doesn’t mean something’s wrong. Hurting is part of healing, and sometimes the healing process takes longer than we’d want or expect it to. If you find yourself stuck in this process and unsure how to manage it on your own, know that support is available to you. I sometimes think of myself as a tour guide or compassionate companion along the journey through pain; I’d be honored to keep you company. But whether or not you work with someone through this process or go it alone, trust that your efforts to make contact with your pain will lead you down the path toward healing. And not only will you heal, you’ll also strengthen your ability to face life courageously and open-heartedly, knowing you can handle whatever comes your way.

If we choose to see it this way, being in pain can serve as an opportunity for us to be with ourselves, slowing down and tuning in to our experience so we can move through it as gracefully as possible, learning what’s there for us to learn along the way. I invite you to begin the process of letting your painful emotions come and go; allow yourself to flow through them, supported by the knowledge that they will pass, so long as you let them.

2017: The Year of the Level-Up

a sparkler that is sitting on a table.

I don’t know about you, but I’m thrilled to be at the start of a brand new year. Say what you will about 2016—and yes, I know there’s a lot to say about it—but there’s a great deal we can all take from it. Because no matter what kind of year you had personally or what kind of year it was in more general terms, there’s wisdom to be drawn from it. All of it—the good, the bad, and the downright horrific—can be a valuable teacher. It can offer great insight and clarity to support your journey in the year ahead of you, serving as the launching pad for new discoveries and breakthroughs. But in order to infuse your future endeavors with the wisdom of your past, you must be willing to take a brief but deliberate glance in the rearview mirror.

As the title of this post indicates, 2017 holds the promise of being a year to level up. It offers us all a chance to take our lives to the next level, using everything last year taught us as our springboard. So take this moment to reflect on your 2016 and see what stands out for you. What were the major events that most impacted you? What experiences challenged you most? What relationships were most significant for you, and how would you rate the quality of those relationships? What were your triumphs? What fears did you overcome? What held you back? What, if any, resolutions did you begin the year with, and how did you fare with accomplishing them?

With the information about your last year to support you, it’s time to set intentions for what’s to come. Here are a few things to keep in mind as you set your level-up in motion:

  • Put your intentions in writing. Whether you’re creating specific resolutions or want to start your year with a more general sense of the possibilities you’ll create, it’s a good idea to put it all in writing. When we put our thoughts down on paper, we solidify them and make them more meaningful and useful. So by writing down your intentions for the year, you’re giving yourself a tangible guide to serve your process and support your ability to turn your intentions into results. Take the time to write down what you envision for your 2017. What does your personal level-up look like? Write it down in whatever way will most inspire you. It might look like a statement of purpose, a bulleted list, a letter to yourself, or a summary of everything you’ll accomplish. However you choose to write it, just be sure to get clear, concrete, and specific. Then put what you’ve written in a place that you’ll be able to see it all year long. You’ll be amazed at how much power there is in putting your intentions on paper.
  • Focus on being as well as doing. Most of us tend to start the year with resolutions to do things more, less, better, or differently. And there’s a lot to be said for the value of doing that. But there’s a layer beneath the doing that we must address if we want to succeed: the layer of being. You see, the way you approach your intentions, resolutions, and commitments has everything to do with whether or not you’ll complete them. Let’s say, for example, that you set a resolution to “get in better shape” this year. The first step to having this happen will be to get a clear definition of what that means for you. The more concrete the goal, the more likely it is that you’ll accomplish it. So with that in mind, the original resolution becomes something like: “By June 1st, I’ll be able to wear my skinny jeans comfortably, with no love handles showing.” Now that you’ve got something specific to work toward, what’s left is putting forth the effort to have it happen. So here’s where the part about being comes in. If you’re going to make and sustain the efforts necessary to fit in those jeans, you’ll need to be a particular way. For example, you’ll likely need to be disciplined, focused, committed, energetic, consistent, creative, motivated, and self-aware. When you focus on the being underlying the doing, you ramp up your potential to successfully achieve everything you’ve committed to. And chances are, you’ll exceed your expectations and go beyond what you’ve thought possible. So when it comes time to plot your 2017 level-up, ask yourself, “How will I need to be in order to successfully do what I say I’ll do?” Then go have it happen!
  • Decide what will support you, and put it in place now. Using everything you learned last year as your guide, give some thought to what will help bolster your 2017 level-up. Who are the people you can count on to hold you accountable? What habits, routines, or resources set you up for success? Based on what worked and didn’t work last year, what do you think you can put in place now to make sure you have it all happen this year? Perhaps you’ll consider keeping a journal or using apps like Strides or LifeTick to track your progress and keep you organized. Therapy or coaching are also excellent means of keeping you on track. Whatever you decide, putting your supports in place now will help you win this year.
  • Start with the end in sight. One of the tricks to goalsetting is starting at the finish line. What this means is getting crystal clear about where you’re going in order to have a sense of how to get there. When you travel, you must first decide on a destination in order to know where to book your flight to, what to plan for, and what to pack. Similarly, you’ve got to know what the outcome of your goals will be so you know just what to do to make them happen. As you plan your 2017 level-up, take some time to envision what you want your life to look like on December 31st. Get as specific as possible, and don’t be afraid to dream big! Knowing what you want the end of this year to look like will help shape the journey from the start. You deserve to have it all, and you can! So let your vision be your guide, and plot the course for a stellar year.

Let this be the year you take your life to the next level. Let it be the year of saying yes to you and no to everything that doesn’t serve you. Take 2017 by storm, and show the world your best self. As always, I’m here to support you, guide you, and keep you company on your journey. Cheers to you, your best year, and your best life!

When the Unimaginable Happens: Coping With Tragedy

rows of lit candles in a dark room.

I had to take a few weeks off from writing, and I was really looking forward to getting back to it. But this post is not at all what I had in mind. It’s been an incredibly trying few days for countless people who are finding themselves dumfounded and devastated in the wake of the mass shooting at Pulse nightclub in Orlando, Florida. Forty-nine innocent queer individuals and allies lost their lives, and the world is still reeling. I’m not yet able to fully articulate my thoughts and emotions about this horrific event, but I would be remiss if I didn’t take an opportunity to address what happened in some fashion. If you have been affected—as most of us have—by what happened in Orlando, I offer these suggestions:

  • Give yourself permission to feel what you feel. Events like this one can stoke a number of unpleasant emotions. Feelings of anger, sadness, despair, fear, and defeat are common; and though it never feels good to keep company with those emotions, it’s important that you allow yourself to do it. Failing to attend to the natural emotions that arise when tragedy strikes can lead to what we in the mental health field call complicated grief. It can prolong the bereavement process and lead to the development of other, more chronic emotional and psychological challenges. Remember that all feelings are okay. Whatever emotions arise for you are completely valid—and like all emotions, they will eventually pass.
  • Set limits on your media consumption. If you tune in to any form of media in the wake of a tragedy, you’re guaranteed to be inundated with images, videos, commentary, and debates that are, to some extent, informative but can become completely overwhelming if not limited. When a traumatic event occurs, it’s natural to want to seek information in an effort to make sense of what happened. But how much is too much? Social science researchers tell us that repeated exposure to tragic events through the media can result in vicarious trauma, a secondhand form of trauma that is incited and perpetuated by the flooding of imagery and information about a tragic event. It’s okay to inform yourself, but do it mindfully and in moderation.
  • Seek the comfort of community. Connect with the people around you, and seek solace in the relationships you have with them. Find strength in togetherness, and lean in to the supportive structure that community provides. There’s something very soothing about recognizing that we’re all in this together. Do everything possible to remind yourself of that.
  • Get involved. One of the most difficult things about coping with a tragedy is the feeling of helplessness it provokes. Knowing that people are suffering as a result of what happened can be troubling, especially if it feels like there’s nothing you can do about it. But in most cases, there are plenty of ways that you can make a difference in the lives of the people most affected by the tragic event. One of the greatest things about social media is that when disaster strikes, we can quickly and easily connect with people, organizations, and resources that will help us get involved and give in whatever ways we can. Volunteering your time or contributing in other ways—like giving blood, making financial contributions, donating necessary items, or building houses—is a helpful way to cope with the tragedy and regain a sense of hope.
  • Talk to a professional. It isn’t always easy to recover from the shock and trauma of a tragic event. Everyone processes things differently, and how long it takes to feel okay again is completely unique to each individual. But while it’s normal to be affected, you should seek the help of a therapist or other professional if your functioning is impaired. Having someone to talk to about what you’re experiencing is incredibly important during times like these; through the support of a professional experienced in treating trauma, you can learn ways to cope effectively and manage to stay well.

 Dealing with the emotional impact of a largescale tragedy is never easy. But it’s important that you find ways to adaptively cope and take care of yourself. Try to keep your hope alive, and remember that you are not alone. Give yourself permission to grieve, and then gather your strength and continue living. The world needs you. Be well, today and always.

Fundamental Factors of Successful Recovery from Addiction

a tree with red leaves and the sun behind it.

If you or someone you love has struggled with addiction, you know how difficult it is to get and stay clean. The road to recovery doesn’t go in only one direction, and as hard as it may be to accept, setbacks and relapses are part of the process. Although we all wish it were different, professionals in the field of addiction treatment don’t have a cure to offer. We do, however, have important information about the factors that improve the likelihood of long-term recovery. There’s no such thing as a one-size-fits-all recovery model, but the available research—and my own clinical experience—suggests that some factors are essential. Regardless of what form of treatment you receive or what kind of program you work, here are the fundamentals:

1) Readiness to Change – If you know anything about recovery, you know this one’s a no-brainer. No matter how bad things have gotten, no matter how much other people want you to change, if you’re not ready, it’s not happening. The truth is, it’s hard to take the first step. Sometimes even misery can seem safer than change, so taking action to do things differently is a courageous and commendable act.

2) Belief In the Ability to Overcome Challenges and Create Change – In psychology we call this self-efficacy. It’s basically a fancy term that refers to a person’s belief that he or she can make things happen. When it comes to recovery, this is crucial. Once you’ve decided to get clean, you have to have conviction that you can actually do it. This, of course, can be challenging, as past experiences may make it hard to see that change is possible. But every day clean and sober is an occasion to feel a little stronger, a little more capable. The beautiful thing about self-efficacy is that it builds on itself; the more positive changes you create, the more capable you feel, and the more capable you feel, the more energy you have to keep the positive changes going.

3) Maintenance of Psychological and Emotional Wellness – There’s a strong link that binds addiction, anxiety, and depression. Research shows that mental and emotional wellness are essential to a solid recovery program. Addressing the addiction without attending to any other dimensions of mental health is ineffective. People in recovery who suffer from untreated anxiety or depression tend not to stay clean for very long. When their symptoms become overwhelming, they seek relief; and since their brains are primed to seek a particular type of relief—in the form of their drug(s) of choice—it’s often only a matter of time before the untreated mental health issues result in relapse.

4) Support – This one cannot be understated. Study after study has shown that interpersonal support is essential to recovery. It isn’t easy to get and stay sober. Being in recovery—especially at first—can be terrifying and isolating. That’s why it’s so important to be surrounded by people who understand you; know what you’re going through; and are willing to stay by your side, cheering you on and keeping you focused when the going gets tough. Check out this 2015 Ted talk from Johann Hari, which offers a thought-provoking perspective on why support and connection are so vital to recovery.

5) Structure – Life in active addiction is often uncertain, unbalanced, unstructured, and unpredictable. That’s why a structured environment and routine are cornerstones of a successful recovery program. The research evidence and my experiences with clients make a strong case for the importance of setting up a clear structure and sticking to it. This means having a consistent routine and adhering to it every day. It means establishing a sense of organization and order with regard to daily tasks and responsibilities. It means attending to the basic activities of daily life, keeping a simple daily schedule that you can stick to, maintaining a balanced lifestyle, and making sure sobriety remains a priority. It might sound like a lot, but with a little help from the right supports, it’s completely possible—and it makes all the difference in the world.

6) Productivity – The last, but certainly not least, quality of a successful recovery program is productivity. Everyone who’s ever attempted sobriety can attest to the fact that boredom is a major trigger with enormous relapse potential. That’s why it’s so important to stay busy. The research suggests that people who engage in productive and meaningful activities tend to stay sober for longer. Whether it’s working at a job, engaging in a hobby, doing physical exercise, playing in an intramural sports league, fellowshipping at meetings, or volunteering in the community, staying productive is key to staying sober.

While this list contains proven factors that contribute to a solid recovery program, it is by no means exhaustive. If you’re new to recovery, it’s important to engage the support of a sponsor or mental health professional with experience in addiction. You are not alone, and yes, you can do this! Change is possible, and you are worth it.

Loving an Addicted Person: The Help/Harm Paradox

a road with a mountain in the background.

As a family therapist with years of experience in addiction treatment, I know how painful it is to love someone with a substance use problem. It means staying up all night worrying about what might happen. It means fearing the worst every time the phone rings. And for many people, it means tirelessly trying to figure out how to help.

It can feel helpless to witness a loved one struggle with substance abuse, and it’s natural to want to do everything possible to keep him or her safe. The problem is that when it comes to addiction, helping can sometimes be harmful. Many people try to support their loved ones in active addiction without realizing that they’re doing more harm than good. Despite their best intentions, their efforts to help ultimately allow their loved ones to keep damaging their lives.

Although loving a person who suffers from addiction can feel hopeless, you need to know that there is, in fact, hope. Here are a few ways you can manage the difficult help/harm paradox, supporting your loved one while keeping yourself well.

1) Learn about addiction. As it is with most illnesses, the more informed you are about addiction, the better positioned you’ll be to effectively support your loved one. There are some excellent resources out there (like this one) that clearly explain the nature of addiction. Learn as much as you can, and develop a relationship with a therapist or professional who can answer your questions.

2) Aim to strike a balance. As difficult as it can be, it is possible to help your loved one without causing harm. This means being compassionate but keeping necessary boundaries in place. It means remaining in connection with your loved one while holding him or her accountable. You’ll need to be clear about what you are and aren’t willing to tolerate. Only by determining and being firm with your limits can you effectively support your loved one while keeping your mental and emotional health in tact.

3) Understand that recovery is a process. People can and do change, but they pass through several stages on their way to making it happen. These stages are not linear, so some stalls, stops, and reverses in progress are to be expected. Understand that although there are likely to be setbacks, your loved one is still capable of creating and sustaining a sober lifestyle.

4) Take care of yourself. When you fear for a loved one’s health and safety, it can be easy to lose yourself. But if you’re not well, you’re in no position to help anyone else get well. It’s essential that you attend to your personal needs, prioritizing your health and wellbeing. As you work on trying to get your loved one professional support, make sure you’re being supported as well.

6) Know that you are not alone. You’re tired, you’re angry, you’re afraid. But you’re not alone. Addiction doesn’t discriminate, and it’s more common than you might think.  Al-Anon Family Groups are held every day in countless locations throughout the country, offering family members of people with substance abuse problems a place to vent their struggles in an atmosphere of mutual support.

Whether your loved one is in active addiction, in treatment, or in recovery, it’s possible for you to be an important ally and champion for change in his or her life. Educate yourself and take care of yourself, being sure to be good to yourself while you do good for your loved one.