Four Essentials of Recovery

Counseling Model for Successfully Overcoming Addiction

Recovery Perspective

– Treat the Addictions• Consider the symptoms of addictions – substance &

behavioral• Could an addiction be symptomatic?

– Treat the Underlying Causal Factors• Understand the unseen factors that created the addiction• These are often based in trauma or chronic distress

• Encourage health & strength development

Factors of Psychological Health

– Those who are generally healthy have:1. Positive Self-beliefs2. An Internal Sense of:

• Emotional self-regulation• Nurturing self-care

3. Effective Interpersonal Relationships4. Perspective of Purpose and Meaning

Four Essentials of Recovery

– Those in long-term recovery exhibit:1. Positive Self-beliefs Believe2. An Internal Sense of:

Understand• Emotional self-regulation• Nurturing self-care

3. Effective Interpersonal Relationships Connect4. Perspective of Purpose and Meaning Imaginer

Synopsis

• Believe – Understand – Connect – Imagineer

• The Four Essentials of Recovery serve as a model to

integrate clients’ positive experiences which they

had before their addiction with

• current constructive recovery experiences.

• This model correlates with Twelve Step principles.

• Believe• Our Self-Beliefs Govern Life Choices &

Outcomes•

BELIEVE

“I am unworthy to be loved”• Virtually everyone in initial recovery does not accept

that they are worthy of being loved . • In many cases, this is the underlying reason for their

dependence.

• Substance or Behavioral Dependence

• Shame Self-Beliefs

More than persistent personality traits

How the person experiences self - for example;

You alone see through your eyes and only you interpret what you perceiveNo one will ever experience what you have – your unique combination of experiencesYou daily construct your own unique worldThis always links to what you believe about your self

Our self-beliefs essentially shape who we are

Individuals fall into one of two groups

Those individuals who deeply believe:

• “I am unworthy to be loved” ‘I am not enough and never will be.’ ‘I am ashamed of myself’ ‘I cannot stand who I am so I numb myself with food, addictions, ‘right’

thinking, meds, anger, etc.

• How does this correlate with those who suffer from substance addiction?

Other Shame Self-Beliefs

• I don’t deserve love• I am a bad• I am worthless• I deserve bad things• I am damaged, broken• I am ugly• I am stupid, not smart enough• I don’t matter• I don’t belong, I am different• I am irresponsible• I cannot be trusted, trust myself• I cannot trust others• I am weak, not in control• I am a failure• I am imperfect, flawed, I must please

• Shame self-beliefs distort and disfigure how individuals perceive

themselves.

• Evidence is accumulated that the shame beliefs are true

• The psychic pain of shame dominates consciously and

subconsciously e.g. destructively disparaging self-talk

• Shame is the Petri dish in which the bacteria of addiction thrive

Shame Self-Belief Qualities

Distinguishing between guilt and shame

Guilt:

“I did something wrong or bad,” “I did something dumb,” “I acted carelessly,” etc.

Guilt motivates us to change

Shame:

“There is something wrong with me – I am bad,” “I am dumb,” “I am careless,” etc.

Shame beliefs lead us to accept the lie that we cannot change

Counselors must be skilled in shame resolution

Origins of Shame Self-Belief

Shame self-belief arises from emotionally charged events (trauma) as well as other disturbing experiences (small t trauma, chronic distress, developmental trauma)

The individual lives with distress such as a loss of attachment, fear for the safety of self or others, chronic low-grade anxieties, cultural conflicts, feelings of inadequacy, etc.

There is often a sense of terrible helplessnessIn order to blunt the high level of fear & shame, individuals use

coping mechanisms that provide instant, temporary relief – most commonly substance or behavioral addictions

Shame Self-Belief Results

Shame self-belief induces negative coping mechanisms

In addition to drugs and alcohol, individuals may turn to sex, gambling, working, religion, blaming, exercise, politics, eating disorders, or any other addiction patterned behaviors

Shame Self-Beliefs most often lie in the subconscious

Self-beliefs trump everything else mentally & emotionally – they color are decision making

We must go beyond cognitive-behavioral therapy

’Counselors can create the pre-conditions for transforming Shame Self-Beliefs into Positive Self-Beliefs

Positive Self Beliefs

The second of the two groups :

Those individuals who predominantly believe:

“I am worthy to be loved”

How many individuals with addictions have this self-belief?

What can we learn from this?

The Transformational Approach

“Client shame self-beliefs relate to attachment, abandonment, and trauma”

Shame Self-beliefs can be transformed into Positive Self-beliefs

Outcome research shows that addressing underlying shame is a critical aspect dependence recovery.

Transformational Self-Beliefs

Shame self-belief example:

‘I am evil’ replaced with: I Am Accepted

What are the chances for his recovery?

Transformational Approach

Show clients how to transform ‘Shame Self-Beliefs’

1. Develop Client Emotional Regulation

2. Treat Trauma

3. Promote Positive Self-Beliefs

4. Support Forgiveness, No Use of Labels, Self-Change, Addiction Recovery

Which comes first?

Therapeutic considerations

Seek out shame beliefs: “What are you ashamed of?” “What traumatic or chronic distress experiences have you

had?” (e.g. abuse, accidents, injuries, combat, learning difficulties, bullying, alcoholic caregiver, etc.)

“What negative beliefs do you have about yourself starting with the words; ‘I am. . .’? (e.g. “I am unsafe,” “I’m stupid,” “I am out of control,” I’m a terrible parent,” etc.)

Distinguish for the client the difference between guilt and shame

Outcomes of Positive Belief Alleviation of root source of substance

dependence

Enhanced emotional resilience

Better physical well-being

Improved relationships

Increased appreciation, enjoyment, & meaning

Lasting recovery outcomes

•Understand• Emotional self-regulation• Nurturing self-care

•

Emotional Self-Regulation

Virtually all people afflicted with dependence have used substances and behaviors to numb out painful emotions

• Withdrawal usually brings an immense increased of often overwhelming emotions and feelings

• Most do not have a vocabulary to describe what they are experiencing

• They feel flooded with unwanted emotional pain

“They are swimming in a sea of their own emotions”

Therapeutic considerations

• Teach an easy-to-understand emotional vocabulary

• Distinguish between secondary emotions (e.g. “I am mad”)

from primary feelings (e.g. I feel Accused, Guilty, Rejected,

Unlovable, and/or Powerless) so that the client can identify and

discuss their emotions and feelings

• Focus on their emotional experience (e.g. What emotions are

you experiencing now. What are your feelings?)

Develop Emotional Regulation• Fear/Shame Love/Empathy

• Help clients understand their emotions and feelings:

• I am Mad – Sad – Anxious I am Glad

• I feel: I feel:• Accused Worthy• Guilty Acceptable• Rejected Capable• Unlovable• Powerless

Nurturing Self-Care

• Clients rarely know how to perceive the balance that is

needed for recovery?

• They seldom recognize how the 12 Steps integrate the

key elements of successful living.

• Help them daily review their well-being.

Therapeutic Considerations

• A new approach to a greeting

• Instead of; “Hi, how are you?”

• How goes your H E A R T?How is your Health?How are your Emotions?How is your Awareness?How are your Relationships?How is your Transcendent spirituality

Health

How is your Health? Sleep 7 to 8 hours Eat well Drink enough water Exercise regularly * Take care of health needs Nurture your well-being Stop smoking * Take a supplement if needed Limit caffeine, sodas, & sugar

– Which of these lower the risk for relapse?– Which of these are you modeling for your clients?

Emotions

How are your Emotions?

• Recognize emotions & feelings

• Regulate & soothe yourself

• Appreciate positive feelings

• Practice appreciating

• Understand yourself

• Use empathy to understand others

– –We cannot control emotions but we can regulate them & soothe ourselves

Awareness

How is your Awareness?

• Know what you are focusing on

• Use your mind to resolve shame

• Work through guilt

• Value the worth of others & self

• Realize that you are becoming more Worthy, Acceptable, and Capable

– Cognitive awareness is central to reason, logic, and effective action

– The ability to focus our thought changes our brain

Relationships

How are your Relationships? • Clean up your side of the street (& only your side)

• Work through resentments

• Practice forgiveness • Support the “Five Positives to One Negative Interactions”

• Sit as an adult not as a parent or child

• Know your family constellations

– Almost every person with an addiction as been the ‘victim’ of others

–Continuing to blame is almost a sure sign of relapse – How come?

Transcendent Spirituality

• How is your Transcendent Spirituality?

• Develop your own sense of the spiritual

• Tap into the energy of your higher power

• Find the joy in enjoyment and the heart of courage in encouragement

• Become open to ‘Coincidences’

– How many of your clients have ‘religion problems’– Many have not understood their spiritual experiences

– (e.g. nature, caring, connection, wonder, etc.)

Self-Care

The Self-care Imperative for Recovery

• Recovery is not a simplistic formula

• However, there are factors that greatly decrease risk factors

• Most clients do not understand these concepts on first hearing– Seeking a balance in

– health, emotions, awareness, relationships, and spirituality – is an ongoing, life-long journey

• Connect• Isolation is the common thread in substance or

behavioral addictions

Problematic Relationships They have poor relational conceptualizations Expectations are high & acceptance is low There is little ‘friendship’ in their relationships

The power of Friendship

• When individuals rediscover how to be friends:

Relationships start to heal & then flourish

The pieces fit

• How does this happen?

There are five qualities of interactions

which summarize the closeness & the

effectiveness of the relationship

between any two people. They are:

G R E A T FriendshipsAsk: Am I really . . .

• Genuine? Do I demonstrate that I am genuine by being honest, sincere, open, truth full, &

transparent so that others can be at ease with me?

• Respectful? Do I respect the ability of every adult to make their own choices even when I

disagree? Do I allow them to be responsible for the results of their decisions?

• Empathetic? Do I express through empathy that I care enough to listen, understand, and want

the best for the other person? Do I understand what others are saying, their feelings, their fears

& their caring love?

• Accepting? Do I fully accept the other person as they are. Even when I disagree with them,

can I express my thoughts without ‘constructive criticism’ or imposing my values and

expectations on them?

• Trustful? Do I believe in the basic good-hearted nature of the other person by acknowledging

the best about them? Am I trustful of their intentions?

Creating ‘g r e a t’

Focus on ‘what works’ and ‘what doesn’t work’

Ask yourself to do more of ‘what works’ Do G R E A T experiments Observe how you feel, think, & act Observe the results Report how it works

As we model a G R E A T friendships we grow in our abilities

G R E A T Friends

• Empathetic

Respectful

Genuine Trustful

AcceptingYOU Respectful

Empathetic

Genuine Trustful

Accepting

YOUR FRIEND

The Power of ForgivenessResolving the imbedded resentment of trauma & chronic distress

Forgiving is not: Forgetting Excusing Trusting Continuing relationship

Forgiving lets go of the need for another to suffer for my sake

Resolved resentment alleviates triggers & frees the forgiver

Build Great Connections

Overcoming addiction’s isolation Work through passed relationships concerns

Family conflictsPrior injurious relationshipsThe impact of the addiction on loved ones

Build functional, fun relationships – 12 steps, friends, etc.

Learn how to trust & rely on others Develop a “Cone of Support” – Self, Reliable

Others, H P

The Power of Connection

We all want to be heard, understood, and accepted

When we practice hearing, understanding, & accepting others – we become more

Worthy

Acceptable

Capable

• Imagineer• Helping those recovering to visualize and

create meaningful, enjoyable lives

The crucial question• “What are you going to do with the rest of your life?” In addiction, creativity is focused on obtaining, using, &

hiding the use of substances There is little or no effort concentrating on obtaining

enjoyment, meaning, or fulfillment Those caught up in dependence fear the responsibility &

opportunity to create their own life In recovery, sobriety is never enough – it is fundamental but

each person has to envision their life as satisfying & worthwhile

Therapeutic Considerations

–Engage the client in identifying their values: Many do not know their values Many are conflicted between their held values

& behaviors Listing values by each person in a group is

value provoking Individuals can track their own reliability Self-trust is dependent upon consistency

What R U 4?

–Identify aspirations (We are what we desire to be) Show how unproductive it is to focus on what

they do not want Help them focus on the desires they want in

their life Teach them to use the power of visualization Demonstrate how to daily engineer the creation of

their desires

Create a wheel of good fortune

• Bringing it Home

THE FOUR ESSENTIALS OF RECOVERY:

1.Integrate with Twelve Steps programs

2.Address the underlying distress sources of addictions

3. Help clients build their life’s path & their own program of recovery

4. Are based on holistic health principles utilizing individual skill development

5. Positive reinforcement is a natural effect of using these skills

6. Clients learn how to put into practice these skills & achieve better outcomes

7. It is imperative that we also attend to taking care of ourselves by practicing these skills with our clients, those whom we work with, as well as our family and friends

Four Essentials of Recovery

– Those in long-term recovery meet the following

criteria:1. Believe They exhibit positive self-beliefs

2. Understand They show an internal sense of Emotional self-regulation/Nurturing self-care

3. Connect They achieve effective interpersonal relationships

4. Imagineer They realize their own purpose and meaning

• Questions?