Wednesday, February 9, 2011

Break the Trance of Craving

(Also check out our most recent post on this topic: Don't Fight Your Urges, Cure Your Cravings.)

Charlie had just relapsed the day before our session, so we had fresh craving material to work with.

"I was so discouraged after I gave in. I'd been doing well for two weeks."

I had Charlie close his eyes and imagine that he was looking down some stairs at a door to an underground room. "Walk down the steps 1-2-3-4-5-6-7-8-9-10. Now you're on the landing. Open the door, walk in, and you find a table there with chairs around it. There is a window and a door in the wall to your right and a window and door in the wall to your left. Walk over to your right and look in that window.

In that room is you from yesterday, right after you messed up. Tell me what you notice about the guy in there, that former you. How does he feel? What's going through his mind?

Tears were squeezing through Charlie's closed eyes. He is 61 years old and he's been struggling with this addiction since he was a teenager.

"He's depressed and discouraged. He feels worthless. At times in the past he has even felt suicidal. He wonders if Louise is finally going to give up on him."

"Walk into that room and take him by the arm," I instructed Charlie. "Walk back into the main room with that downhearted you and take him over to the window of the other room, the room on the left. You both look in and see another you, the one from just an hour earlier yesterday, the you that was craving pornography, ready to go find some. As you watch him, can you tell what's going on inside him?"

"He's lonely. Confused. He's discouraged about mixed signals from Louise."

"What mixed signals."

"The night before, she initiated snuggling. We were lying close to each other and our legs were entwined. But when I tried to initiate sex, she pulled away. Then I remembered that she had pushed me away the last time I tried to be affectionate with her."

I asked Charlie to go into the room and bring that craving self into the main room and sit both the craving self and the downhearted self down at the table.

"Now ask them both, 'Isn't there a way to keep working toward connection with Louise--without feeling down on yourself because of the way things go or behaving in a self-destructive way?"

The discouraged, post-relapse part of him had an idea: "I could talk to Louise about wanting to be closer and tell her that the relationship is too important to me to keep destroying it by pulling away or acting out."

The tempted, pre-relapse part of him wasn't sure that would work. "It seemed useless to talk to her yesterday. It felt hopeless. It seemed like the relationship had no meaning to her, so why try? I lost perspective, got depressed, and then the good stuff in my life loses importance."

Charlie thought for a minute as I took notes on what he'd just said. "Plus, if I tell her that feelings about our relationship were a part of what led to my relapse, I'm afraid she'll feel like I'm blaming her for my problems."

What the heck, I thought. Let's bring an imaginary Louise into the room and let her speak for herself. We had both the pre-relapse Charlie and the post-relapse Charlie tell Louise what a central role she plays in his life. They admitted that they sometimes overreact to the way she responds. The bottom line for all three Charlies was this: he wants to be close to her. He wants to make love more often but he didn't want her to take on feelings of responsibility for keeping him sober.

He wants to be able to open up about what he was going through instead of keeping it bottled inside. I asked him how the imaginary Louise felt about that. The tears flowed again. "She can handle it. She welcomes it. She's always wanted it and keeps asking for it. It's me that struggles with openness."

Seemed like a productive session. A few more bricks out of the wall that keeps Charlie from reaching out instead of acting out when he's in need.

I think that future craving states will be a little less impervious to other options and other ways of viewing life. Hopefully, Charlie's maladaptive lines of thinking will be a little less convincing in the heat of future moments of temptation.

(A brief note about this technique: it is based on the work of George Leowenstein and others in the field of behavioral economics. They study the phenomenon of temporal flux in our preferences. At different points in time we experience very different states of mind with different preferences and inclinations. When I crave porn I can't relate to the way I will think and feel after relapsing. Leowenstein calls this "the intrapersonal hot-cold empathy gap." The me that I am right before I relapse doesn't empathize with the me I will become immediately after relapse. Fortunately, just as it's possible to develop empathy for others, we can also develop greater empathy between our own various temporally shifting states. That is the purpose of this technique. To delve further into the fascinating field behavioral economics, check out Dan Gilbert's book Stumbling on Happiness. To see how it can be applied in a practical way to overcome addictions... keep coming back to this blog and watch for my next book.)

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