By Tom Horvath, PhD Mutual help groups for addictive problems have been in existence for centuries. No one knows exactly how they work. What follows is my best estimate of what happens in SMART Recovery meetings, and how they help. How SMART Recovery Works SMART offers an approach that will appeal to many (for either substance problems, activity problems, or both) because it is self-empowering, science based, progress-oriented, and holistic. Other mutual help approaches will appeal to other people. Some people may use multiple approaches. In 1994, when SMART Recovery began operating under that name, SMART elected to move beyond specific tools (which had been prominent in its pre-history) by identifying 4 common tasks for the process of addressing an addictive problem, the 4 Poin...

Neuronal Plasticity, Mindfulness Meditation, and Addiction Recovery by Nicholas A. Nelson, Ph.D. Part 1 of 2 It is not uncommon during active addiction or early in recovery for people to feel that their brain is working somehow differently than before, or to feel like it is going to be impossible to break out of harmful habits and thought patterns. It can feel like the mind is damaged, or operating out of our control. This lack of control, and feeling that something is broken, can lead to a sense of hopelessness. When we look at the brain there is some truth to this feeling - during engagement with problematic addictive behaviors and during early recovery, our brains are not wired in the same way as before these problems took root. Through months, years, or decades of repetiti...

by Lesley Wirth, MA I’m just going to say it: The self-help world needs to reconsider the phrase, “Take responsibility for your life.” Why? It rarely works. It is usually the wrong medicine, offered at the wrong time, to the wrong person. When someone has suffered from loss, injustice, or trauma, telling them to “Take personal responsibility for their reality,” is not helpful. It is damaging. Maybe you've been there: you lay your heart bare to a spiritual coach you believed you could trust, only to have them dismiss your experience by telling you to let go of your "victim consciousness." If you are really lucky, they will ask you what part of you attracted your situation so you could learn from it. I understand people mean well, but words like these can feel like...

by John de Miranda Early in my recovery from an alcohol use disorder I discovered that memoirs and first-person accounts of people struggling with addiction were a useful method to help me deal with the challenges of a life without alcohol. Many of these accounts were uplifting. Some were scary. I remember one in particular A Sensitive Passionate Man published in 1974 by Barbara Mahoney. Her account chronicles life with her husband Sean who died at the age of 45 from cirrhosis of the liver. Despite a life of material and personal success Sean rebutted all attempts from family and friends to intervene in his alcoholism and literally drank himself to death. In my pink cloud naivete I was taken by surprise that not all stories of addiction had a happy ending. I am an instructor in...

By Tom Horvath, PhD Although the following information is very basic, I hope it is a useful reminder for you. You are breathing all the time. With a few minor adjustments breathing can become a powerful tool to support yourself. Start by closing your mouth and breathing through your nose. Probably this step can happen immediately. You can also if you wish focus on the sensation of the air coming in and out of your nose. That focus can also be a helpful distraction technique. Begin to slow down your breathing. It may take many breaths to achieve a significantly slower pace. However, if you can get down to 6 breaths per minute (one every 10 seconds) you have a strong likelihood of lowering your stress level. If you are not sure how to accomplish slowing down, start counting you...

Update on Tobacco Use and Health Disparities in the US: A New Surgeon General’s Report By Tom Horvath, PhD On 11/19/24, the Surgeon General released Eliminating Tobacco-Related Disease and Death, Addressing Health Disparities. This report updates the report issued in 1998, Tobacco Use Among U.S. Racial Ethnic Minority Groups. Below are some key points of the current report (the 35th on smoking and health since the landmark 1964 report), and observations about them. Not included in the report is the fact that tobacco use has ironies that often get overlooked. Tobacco use is not a leading cause of individuals attending addiction treatment or mutual help groups, but it remains according to this report the leading cause of preventable death and disease (with over 480,000 premature ...

By Tom Horvath, PhD, ABPP Although many of us have warm memories about Thanksgiving spent with family and friends, there may be some painful memories as well. If you're looking for tips on coping with Thanksgiving, and the problems that might arise, consider the following goals: If avoiding squabbles is your goal, can you sit on your own opinions for one day? Say nothing, or say “I don’t agree with these ideas, but this isn’t the time or place to discuss them.” Repeat “this isn’t the time or place” as needed. If your goal is not drinking, or drinking less, you might need some preparation. Will a family member or two be “in the know” and support you? If you are likely to be asked questions (“why are you not drinking?”) do you have an honest but not necessarily revealing ans...

By Tom Horvath, PhD “If we have our own why, we shall get along with almost any how.” -Friedrich Nietzsche, Twilight of the Idols, Maxims and Arrows, #12, translated (1954) by Walter Kaufman, originally published 1889. Our Own Why There is a range of “whys” that explain how we behave. We have in-the-moment behaviors like eating (why? “I’m hungry”). As we mature, we also have much longer-term timeframes, such as multi-year educational plans (why? “I want to be an X”), and multi-decade parenting plans (why? “I want to give my children opportunities and an upbringing that I did not get to have”). You can probably recall many examples of how you tolerated discomfort or pain for the sake of a longer-term outcome. I suggest that it is helpful to make a list of these experiences in you...

By Tom Horvath, PhD I was recently contacted by a website putting together a list of 50 very brief accounts, including before and after pictures, about individuals resolving addictive problems. I was pleased that they included a few quotes from me, about the process of change. https://www.boredpanda.com/best-all-times-before-after-addicts-transformation/ Perhaps the most important fact to know about significant addictive problems is that most individuals fully or mostly resolve them. So often the stories we see are focused on problems, not success. The process of change often takes more effort and more time than we would like, but nevertheless it happens! The results of the change process are quite different from individual to individual. The lengthy time needed to change ca...

Progressive Muscle Relaxation: Using My Muscles to Relax My Mind By Tom Horvath, PhD Have you had moments when you believed “I cannot relax” or “I cannot relax unless I use?” Have you then used or drank because it was your best method to relax? Sometimes we do need to relax! The good news is that progressive muscle relaxation is one effective method that can work as well (with some practice) and does not have side effects. Progressive muscle relaxation (PMR) is over100 years old! There is strong scientific evidence of its effectiveness. It has been applied to anxiety, stress, insomnia, depression, sports performance, and other areas. Edmund Jacobson, a physician, developed the technique and wrote several books about it. You can easily find YouTube videos and other sources (such a...