[caption id="attachment_4919" align="alignleft" width="213"] Reinhold Niebuhr[/caption] Originally posted on March 8, 2013  on the Reunion San Diego blog For people opposed to “prayers”, AA meetings, traditional 12-step-based treatment and/or prayer in general, it’s too bad that the Serenity Prayer has been co-opted. What you probably don’t know, according to “The Secret History of the Serenity Prayer” by author Susan Cheever at TheFix.com, is that the prayer was originally conceived by theologian Reinhold Niebuhr – “not as an antidote to addiction, but as a response to the barbaric evil of Nazi Germany that threatened civilization itself during World War II.” Although some have challenged the prayer’s origins, Cheever cites Niebuhr’s original prayers as: “God give us the grace to...

So often, a return to drinking or drug use happens in a “screw-it” or “just-this- once” moment. Maybe it’s after a horrendous day or when everything seems to be going wrong at once. On the other hand, impulsive use can occur when celebrating something really great. The thinking commonly goes, “I’ll just have one or two drinks (or a few snorts), and that will be the end of it. But will it be just one or two? What about the next day? Have you been successful with short-term use in the past? That need for a quick fix, also known as immediate gratification, often drives use for someone with addiction, and the tendency can linger – sometimes for a long time. Part of overcoming the problem is recognizing and appreciating the value of enduring satisfactions versus momentary pleasures. On...

Discomfort is an unavoidable feeling. Anxiety, depression, anger, urges… these can be uncomfortable, even painful, experiences. While you may be tempted to avoid discomfort or to attempt to make it go away as quickly as possible, struggling against discomfort typically intensifies it. Alternatively, accepting that pain is just a part of life can actually make a painful experience easier to bear. In other words, the most effective way to deal with discomfort/pain is often to learn how to tolerate it. Your beliefs play a role in your ability to tolerate discomfort. If you tell yourself that discomfort is unbearable or that you shouldn’t have to feel any pain, then you will likely make the situation more challenging. Instead, try using coping statements such as “I can get through this” ...

By Tom Horvath, Ph.D., ABPP Wondering whether you should moderate or abstain? You're not the only one. Read on for some things to consider as you determine which approach is best for you. Practical Recovery's policy is not to give advice about whether to moderate or abstain. Unfortunately, this approach has sometimes been interpreted to mean that we “advocate” moderation. We neither advocate nor oppose any specific level of addictive activity, including cutting back (to something short of moderation) or focusing on safety without reducing quantity and/or frequency (e.g., “I won’t cut back my drinking, but I’ll stop drinking and driving”). Harm Reduction The term for this broad position, which follows the client’s lead on what changes to make, is harm reduction. Harm reduct...

By Dan Galant, PhD "The Abstinence Violation Approach" - This ominous sounding term from the relapse prevention literature is perhaps one of the most useful concepts to understand in addiction treatment. I often have clients tell me years after our last therapy session that this was the singular most helpful idea to keep them on track! So what’s it all about – and how can it help you? The Abstinence Violation Effect (AVE – think the abbreviation for avenue to help you remember it) is what happens when an individual deviates from his/her plan – and then continues to remain off that path due to frustration, shame, guilt, etc. Think of the problem drinker who has chosen to abstain from alcohol. When that person takes even one drink (”violating” their abstinence), the tendency is to t...

by Tom Horvath, Ph.D., ABPP Motivational Interviewing and Harm Reduction compared: In this article I compare these two important contemporary recovery concepts. From my perspective they are mostly similar, but have dramatically different rates of acceptance in the addiction treatment industry. You might also be interested in: Addiction Treatment: Motivational Enhancement Therapy Motivational Interviewing (MI) Motivational interviewing (MI) is a psychotherapeutic approach for promoting any healthy behavior change. MI was created for work with addiction, then extended to any behavior change about which someone is ambivalent. Ambivalence is a crucial aspect of MI. The person who is completely committed to change is actually changing, and not sitting in front of you discussing the pos...

by Tom Horvath, Ph.D., ABPP San Diego is coping with another major set of fires. Our hearts go out to everyone affected by these events. Any disaster brings additional risk for individuals in addiction recovery. We hope the following guidelines are helpful. 1. Focus on the physical first. Attend to injuries, even minor ones. Get to the safest place you can. Get warm (or cool). Stay fed and hydrated. Rest as needed. 2. Expect to be more emotional. It’s OK to be numb at first. However your emotions show up, and in whatever time, accept them. Express yourself to others. Be careful not to mistreat others. 3. Include self-care as a component of your efforts to restore your life. It is not just possessions that need restoration. In time, if needed, seek professional help. 4. Ma...

by Tom Horvath, Ph.D. “Everyone is entitled to his own opinion, but not his own facts.” Ironically, I have not been able to confirm (the fact of) who first expressed this idea. It is widely attributed to Daniel Patrick Moynihan, four-time US Senator from Massachusetts (1927-2003). What are the primary “facts” or findings about addiction and recovery, of which any theory of them, and any approach to treatment and recovery, would need to take into account? I will propose a few facts (and opinions too). Of course, even our selection of “facts” can be biased. However, only by making the effort to understand the foundations of one’s own opinions can these opinions be improved. 1) Prohibition will be of limited effectiveness in preventing addiction. Alcohol prohibition in the US (...

How could believing addiction is a disease be bad? There are now several studies suggesting that individuals who believe their behavioral problems (either addiction or mental health) are a disease may have more trouble recovering from them. The most recent study found that individuals who believe obesity is a disease are less focused on weight loss. If someone views himself or herself as having an addictive disease, there seems little benefit in trying to change that view (and possibly much to lose). However, if someone does not view addiction as a disease, is attempting to instill that view worthwhile? Given that viewing addiction as a disease may be a high-risk belief, promoting that belief is inconsistent with promoting recovery. Unfortunately, many US addiction treatment faci...

In addition to the facts arising from the science of addiction treatment, there is another compelling and relevant aspect of addiction: Natural recovery. Most who recover from addictive behavior do so without attending treatment or a support group. Recovery is thus a broader concept than treatment.  In daily life natural recovery is easily visible in how people quit smoking.  Although for most quitting smoking involves multiple attempts and a major expenditure of effort, very few individuals attend treatment or a support group to quit.  Nevertheless, in the US millions of individuals have quit smoking, especially since the widespread recognition in the mid-20th century that smoking was seriously harmful. Large scale population studies have confirmed that even for the substances of ab...