Bringing pleasure into recovery is the key to
turning over a new leaf
Newswise, November 16, 2015 — People in the midst of alcohol
or drug addiction tend to imagine life without those substances as one of
deprivation, which can make kicking the habit seem like a joyless and dreary
prospect.
But recovery from addiction has at least as much to do with
rewarding oneself as it does with depriving oneself, according to a new book by
a UCLA expert in addiction treatment.
“People with the most success in staying sober tend to get
involved in a range of pleasurable activities and do them frequently,” said
Suzette Glasner-Edwards, author of “The Addiction Recovery Skills Workbook,”
which is to be published Dec. 1 by New Harbinger Publications.
“These activities can replace the time and energy that they
had been spending on addictive behaviors, enabling them to experience pleasure
without the devastating consequences of alcohol or drug use.”
Glasner-Edwards is an adjunct associate professor at UCLA’s
Semel Institute for Neuroscience and Human Behavior and a licensed clinical
psychologist. Her research focuses on advancing treatments for addictions and
mental health problems at the UCLA Integrated Substance Abuse Programs.
Subtitled “Changing Addictive Behaviors using CBT, Mindfulness
and Motivational Interviewing Techniques,” the workbook details the science of
a wide range of treatment options for addicts and their loved ones, and it is
filled with worksheets, lists and questionnaires that allow readers to try them
out.
Among the newest approaches it describes is behavioral
activation therapy, which advocates rediscovering life’s healthy rewards.
Glasner-Edwards said the strategy is effective because it combats the allure of
drugs and alcohol at their source.
Both drugs and alcohol release dopamine, a chemical that the
brain associates with the pleasure of receiving rewards, but both cause the
brain to release dopamine at a far greater rate than life’s normal pleasures.
As a result, the book explains, activities that once brought pleasure pale by
comparison.
“While the feeling of disappointment at routine pleasure does
get better over time, it is one of the things that prevents people from really
getting a head start in recovery,” Glasner-Edwards writes.
“They keep relapsing in that early phase when nothing feels
enjoyable. Their brain is still really healing from all that depletion and
depression that the depletion can lead to.”
To combat these disappointments and blues, Glasner-Edwards
encourages people in sobriety to resume activities that they once enjoyed or
discover new ones: Cook something new. Plan a party. Exercise. Go to a museum.
Take up a sport. And, to increase the likelihood that readers will carry out
the activities, the book advocates scheduling them for specific times.
“Ideally you should have one pleasant activity worked into
each day,” Glasner-Edwards writes. What if embarking on the activity feels more
like a chore than a diversion?
“The workbook urges readers to rate how good — or miserable —
they expect the experience will be on a 10-point scale, and then, after the
activity, to rate how fun (or not) it actually proved to be.
“More often than not, an activity is more fun than you thought
it was going to be,” she said, adding that seeing the pattern play out
repeatedly can break down people’s resistance to enjoying future fun pursuits.
Readers are also urged to reward themselves again after the
activity: Get a massage or eat a piece of chocolate cake, for example. The
intent is to make them more inclined to pursue the activity again.
“Just like the rewarding feelings that follow the use of drugs
or alcohol in the early stages lead to forming a damaging habit, rewarding
healthy behaviors can establish positive habits,” Glasner-Edwards said.
In choosing which activities to pursue, the book notes, one
important consideration is whether the activity is likely to trigger a relapse.
Glasner-Edwards counsels against activities that a recovering addict would
associate with their substance abuse.
Someone trying to stop using marijuana, for instance, might
avoid attending concerts by musicians they used to listen to while high.
Another consideration is people the recovering addict spends
time with during their new activities. One person who Glasner-Edwards treated
for alcoholism began grilling dinners for his friends.
Although he relished his guests’ compliments about his
cooking, there was one problem: They often arrived with bottles of wine or
six-packs of beer.
“I finally had to say, ‘OK, you have this love of grilling,
but you have to be careful who you grill with,’” she said. “Because if they
bring booze, all of a sudden you’re feeling like, ‘Why not just one?’”
Although behavioral activation therapy has not yet been
extensively studied as a treatment for substance abuse, the new approach builds
on some of the oldest and most often validated findings in addiction therapy,
Glasner Edwards said.
Since the 1970s, repeated studies have shown that individuals
with all kinds of addictions are more likely to stay sober if researchers
routinely test them for substance abuse and then reward clean results,
especially when the value of the rewards climb with each negative test.
“It could even be a gift card — a whole range of prizes will
do,” Glasner-Edwards said. “It doesn’t even matter what the income level of the
addict is, so long as the value of the rewards escalates with consecutive good
outcomes. There’s something about the process of being rewarded that’s very
motivating.”
