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A Controversial New Way To Think About Addiction | Carrie Wilkens

Sep 13, 2023 1h 4m 32 insights
<p><em>New episodes come out every Monday, Wednesday, and Friday for free, with 1-week early access for Wondery+ subscribers.</em></p> <p>---</p> <p>Wilkens talks about the stigma around substance abuse, potential alternatives to abstinence, and the role of meditation in recovery.  </p> <p><br /></p> <p>Carrie Wilkens, PhD, is the Co-founder, Co-president and CEO of the <a href="https://cmcffc.org/" rel="noopener noreferrer" target="_blank">Center for Motivation and Change: Foundation for Change</a>, a nonprofit organization with the mission of improving the dissemination of evidence-based ideas and strategies to professionals and loved ones of persons struggling with substance use through the <a href="https://cmcffc.org/approach/invitation-to-change" rel="noopener noreferrer" target="_blank">Invitation to Change approach</a>. She is co-author of the book, <a href="https://beyondaddictionworkbook.com/" rel="noopener noreferrer" target="_blank">The Beyond Addiction Workbook for Family and Friends: Evidence-Based Skills to Help a Loved One Make Positive Change</a> and <a href="https://www.amazon.com/Beyond-Addiction-Science-Kindness-People/dp/1476709475" rel="noopener noreferrer" target="_blank">Beyond Addiction: How Science and Kindness Help People Change</a>.</p> <p><br /></p> <p><strong>In this episode we talk about:</strong></p> <p><br /></p> <ul> <li>The stigma around substance abuse</li> <li>Defining terms: addiction vs. substance use disorder and why it matters</li> <li>How substance use disorder affects our brain</li> <li>How to diagnose a substance abuse disorder</li> <li>Whether there is an alternative to abstinence</li> <li>How we all need to be thoughtful about the relationship we want with substances</li> <li>How and why a substantial percentage of people naturally recover without going to treatment</li> <li> The strategies to use if you have someone in your life who you think is on a destructive path</li> <li> What positive communication is and how to practice it</li> <li>How we live in a quick fix society and recovery from substance abuse disorder is a slow process</li> <li>What actually makes people change</li> <li>The role of meditation in recovery—for the patient and the family</li> <li>And the importance of taking care of yourself so you can take care of others</li> </ul> <p><br /></p> <p><strong>Full Shownotes:</strong> <a href="https://www.tenpercent.com/tph/podcast-episode/carrie-wilkens" rel="noopener noreferrer" target="_blank">https://www.tenpercent.com/tph/podcast-episode/carrie-wilkens</a></p> <p><br /></p>
Actionable Insights

1. Honestly Assess Consequences & Values

Regularly and honestly evaluate the personal consequences of your substance use and determine if your actions align with your values and the person you want to be.

2. Be Curious About Substance Use

Pause and be curious about how substance use makes sense for you, understanding what draws you to it so you can explore alternative ways to meet those underlying needs.

3. Identify Benefits & Alternative Skills

List the perceived benefits you gain from substance use, then learn and develop different skills to achieve those same positive effects without relying on the substance.

4. Develop Emotional Regulation Skills

Learn and practice alternative ways to deal with your emotions and thoughts, rather than using substances as a primary coping mechanism.

5. Practice Mindfulness & Self-Compassion

Develop mindfulness strategies to stay in the present moment and practice self-compassion to manage emotions and thoughts, which can reduce the desire for substances and aid in learning.

6. Practice Self-Compassion During Setbacks

When experiencing a slip or setback in behavior change, respond with kindness and understanding towards yourself instead of self-criticism, which helps you stay on the path of learning and persistence.

7. Lean into Discomfort (ACT)

Utilize Acceptance and Commitment Therapy (ACT) principles to learn how to relate to pain and discomfort differently, understanding that leaning into these feelings is necessary to achieve your end goals.

8. Address Avoidance with Discomfort Tolerance

Recognize that substance use often serves as avoidance; when removing the substance, actively learn to lean into, cope with, tolerate, and move through the discomfort it previously masked.

9. Embrace Slow, Incremental Change

Understand that significant behavior change is an incredibly slow process that requires extensive new learning, patience, and tolerance for trial and error.

10. Recognize New Learning Requirements

Understand that giving up substances necessitates learning new skills, such as how to socialize or deal with feelings, which takes considerable time, practice, and acceptance of setbacks.

11. Modify Your Environment

Actively identify and change aspects of your environment that contribute to old behaviors, such as temporarily distancing yourself from certain friends or situations that trigger substance use.

12. Cultivate Sober Relationships

Invest in and experience relationships and social interactions without relying on substances, recognizing that camaraderie and connection can be achieved without them.

13. Run Personal Substance Experiments

Experiment with substances to understand their effects on you personally, helping you determine if they are truly beneficial or if they are not working well for you.

14. Utilize CRAFT Strategies

Learn and apply Community Reinforcement and Family Training (CRAFT) strategies, an evidence-based approach designed to help family members positively influence loved ones who are resistant to treatment.

15. Prioritize Self-Care as a Helper

Engage in self-care to manage the immense stress of caring for someone with a substance use problem, ensuring you remain emotionally regulated and effective in your support.

16. Allow Natural Consequences to Play Out

Let the direct, natural consequences of a loved one’s substance use choices occur, as experiencing these can activate their motivation for change.

17. Maintain Connection with CRAFT

Use CRAFT strategies to stay connected with a loved one struggling with substance use, as positive relationships compete with substance use, while doing so effectively without inadvertently supporting the use.

18. Approach with Compassion & Curiosity

Engage in conversations about substance use with compassion, understanding, and curiosity, rather than judgment, to foster open dialogue and exploration.

19. Practice Motivational Interviewing

Create a safe and comfortable environment for open conversation by approaching without a personal agenda, allowing the other person to express their thoughts and feelings freely.

20. Ask Open-Ended Questions

Engage in conversations using ‘how,’ ‘what,’ and ‘why’ questions to encourage deeper sharing and understanding, rather than yes/no or agenda-driven questions.

21. Frame Requests Positively

Phrase requests in terms of what you do want (e.g., ‘I’d love it if you came home sober’) rather than what you don’t want, to shift the conversation’s tenor and improve relationships.

22. Use Permission-Based Requests

When making requests, first ask permission to share your idea, respect a ’no,’ and follow up with reflection and validation to ensure understanding and maintain connection.

23. Validate & Reinforce Positive Changes

Actively validate emotions and notice and reinforce any positive changes or efforts made by the individual, no matter how small, to encourage further growth.

24. Reinforce Alternative Behaviors

Provide practical support (e.g., gym membership, app access, childcare, treatment payment) to reinforce and facilitate engagement in alternative, healthier behaviors.

25. Set Limits on Undesired Behaviors

Strategically set limits and withhold support for behaviors you want to discourage (e.g., not providing cash that could be used for substances), while still offering support for other positive areas.

26. Time Difficult Conversations Strategically

Express anger or concerns when you are regulated and the loved one is not high or crashing, choosing a time when you can handle the conversation effectively and minimize negative outcomes.

27. Reject “Hit Rock Bottom” Myth

Discard the belief that a loved one must ‘hit rock bottom’ to change, as this notion is cruel, untrue, and can have fatal consequences, especially with opioids.

28. Eliminate Stigmatizing Labels

Avoid using labels like ‘junkie,’ ‘addict,’ or ‘alcoholic’ unless the individual self-identifies with them, as these terms can be judgmental and push people away from help.

29. Understand Behavior Makes Sense

Recognize that a loved one’s substance use behavior, even if problematic, makes sense to them in some way (e.g., self-medicating underlying issues), and be curious about these reasons.

30. Investigate Underlying Mental Health Issues

Be curious and seek to understand any underlying mental health issues that might be contributing to a loved one’s substance use, as these are often worth exploring.

31. Talk Openly for Support

Overcome the shame and judgment around discussing a loved one’s substance use by talking openly with trusted individuals to gain support and brainstorm solutions for yourself.

32. Interfere with Dangerous Consequences

Actively intervene to prevent dangerous natural consequences, such as a loved one drinking and driving, as some risks are too high to allow to play out.