What Do I Do If I Use Substances During the COVID-19 Coronavirus?

What Do I Do If I Use Substances During the COVID-19 Coronavirus?

The COVID-19 coronavirus pandemic has affected everyone in some way – many of us are unable to work, unable to find access to child care or other important resources (one friend of mine has even been barred from doing laundry in his building). For some, like someone I know of who runs a milk delivery company, the pandemic is like an early Christmas present. Significantly and unfairly, the pandemic most adversely affects those who are most vulnerable: people living in or close to poverty who are out of work, people who are homeless, and those at highest risk to develop illnesses.

An important, but often overlooked group impacted by COVID-19 coronavirus are those who use substances. That includes those who rely on alcohol, cannabis or other drugs for medicinal or functional purposes (such as anxiety management), injecting drug users who rely on access to safe injection sites, and users of a variety of other substances for whom access has now dried up or become increasingly unreliable.

Imagine having to go device-free for a week, or longer – no phone, TV, computer, or other screen. For many of us this would involve literal symptoms of withdrawal, as we have become accustomed to using screens to cope with negative emotions, stress, anxiety, and to connect with others. I’m willing to bet you couldn’t, or wouldn’t, pull it off. A substance user’s drug of choice likely serves a similar function and is very likely quite painful to suddenly lose access to, without any sense of choice or control. My colleague very kindly reminded me of the difficulty some people will go through losing access to substances during a very uncertain and stressful time, and I feel sad to think of the number of us that will go through painful withdrawal symptoms (physical pain, uncontrollable anxiety or panic, and severe depression are just a few) and as a result will be forced to find other ways to cope.

People are incredibly resilient and will generally find ways to get through difficulties whatever the cost. I wanted to talk a little bit about the ways we can cope with difficulties, even in the face of withdrawal from something as mild as social isolation or as severe as substance addiction. Recovery from substance dependency involves building recovery capital, which is a blanket term referring to resources (both external and internal) that allow us to slowly build up capital – a wealth of other ways to cope. There are hundreds of examples, but some key themes are relationships with others, health (physical, mental, and emotional), strategies and tools, and a relationship with oneself.

Substances can be an effective tool in the short-term, but they have shortcomings: they don’t tend to last very long, they take a physical toll, and they can keep us away from some opportunities for the growth that comes from going through difficulty with the right support. Substances are considered part of passive coping, just like video games, junk food, and ignoring a problem. Passive coping is not bad, it is an important resource and we don’t want to overuse it. Active coping is also an important resource: exercise, diet, certain types of social support, therapy, learning, and other health behaviours fall into this category. Simply put, active coping is anything we do to directly cope with a difficulty, and passive coping tends to avoid the implications of a difficulty. The trick is striking a healthy balance between the two.

If you have recently lost access to substances or access to other important habits, I’m really sorry – you didn’t get to have a choice in the matter; an invisible and seemingly uncaring force made the decision for you. That really, really sucks, and now you’re stuck managing as best you can. Some that I have talked to will use tools such as exercise or meditation to achieve another type of “high,” and focus on emotional, spiritual, or intellectual pursuits when they have the energy to do so. When they don’t, they will use whatever means necessary to get through the really hard moments: sleeping a little more, indulging in TV or video games, venting to friends, or eating a little extra sugar.

You will find a sample list of different coping tools and a couple resource links at the bottom of this article. However, I’m not really here to give a bunch of advice, as everyone is different, and there aren’t any one-size-fits-all solutions. If you want help taking care of yourself right now and want to talk about creating a short-term plan, let me know and I can help with that. But you know yourself best, and you know what will get you through this better than anyone else does, and hopefully you know when you might need to seek support. Mostly, we just want to say that whatever your situation, we are thinking of you and rooting for you to get through it, because there is a lot of uncertainty and difficulty for a lot of us right now. Always feel free to reach out, and most of all, take care of yourself.

 

Tips for the “Green Zone” – when we have some energy or motivation:

 

  • Don’t overdo it – quality over quantity. Give yourself a realistic and short amount of quality time (say 15 minutes) to spend on something that your ideal version of yourself would do: go for a walk or a run, listen to some music, do yoga, spend some time reading, writing, singing, or drawing, complete a short work task, organize your cupboards – whatever. When you’re doing this, try to let all your focus rest on the activity at hand. Here’s a quick video tip from a children’s book I’m a fan of.
  • Try meditation. Focus for a few minutes on your breath, and spend some time being curious about yourself: how do I feel at this moment? What physical sensations do I notice? Do I feel anything towards myself or towards those sensations? Try to avoid positive or negative judgments during this time, and if they arise, just notice that they are there. The goal is just to be, to observe yourself internally at that moment.
  • Spend time cooking yourself a healthy meal from scratch, and eating it without any distractions, focusing on how good it tastes, and feeling good about yourself for putting the energy in to make it. If you can, even better to share it with someone.

 

Tips for the “Yellow Zone” – when our stress is present but manageable:

 

  • Notice what thoughts and feelings are coming up with as much compassion as possible. Imagine the things that are happening internally are happening to someone you really care about (real or imaginary). What would you tell them? How would you want to care for them? Try to identify a small way you could care for yourself in that moment. If all else fails, take some deep, slow, breaths.
  • Exercise. Get your blood pumping and get moving, this will give you an adrenaline spike to help you get through the next while. If you are tired later, you’ve earned a break! Take a nap.
  • Put on some music to match your mood, and paint, draw, or write along to it.
  • Call or chat with someone. Most of us have time on our hands – talk (or even vent) about what is stressing you, ask how they are doing and try really hard to listen well. When we share with others, or work hard to understand others, our relationships deepen and we feel closer and more comfortable. If you’re not up for a conversation, just play some online video games together. If you are struggling with something specific, try to find an online chat group that specializes in that type of thing. If substance use is your thing, there are tons of online chat groups full of people who have good advice and good support, all anonymous and for free.
  • If you have a therapist, an online session might be a good idea.

 

Tips for the “Red Zone” – When the bomb hits or is about to hit:

 

  • Breathe. Inhale for 3-5 seconds, hold for 2-3, and exhale slowly for 7-10, like you’re blowing on something to cool it.
  • Douse your head in cold water for a few seconds – this activates a survival “dive reflex” that calms the body. You can also try grabbing some ice cubes and squeezing them in your hands, focussing on that feeling and seeing how long you can go before having to let go. It’s pretty hard, and good at redirecting the brain.
  • Reach out to whoever feels safe to reach out to, in whatever way feels ok.
  • Feel free to use your favourite passive coping mechanism: watch a movie, eat something (preferably deliberately slowly), try to take a nap.
  • Imagine or daydream.
  • Write or draw – destroy some paper with whatever you’re feeling at the time.

 

There are countless other things you can do, and lots of online resources for meditation, emotional regulation, practical addiction support. Again, individuals vary wildly, so if you want help creating a specific plan for yourself, feel free to reach out to a mental health professional. We’re in this together, and we’re rooting for you here at Alongside You.

 

 

How Can I Deal With My Porn Use?

How Can I Deal With My Porn Use?

It probably doesn’t come as news that porn use is more widespread than ever, and is being introduced to increasingly younger consumers. This is partially due to increased accessibility and anonymity, a cultural shift towards more open attitudes about sex and pornography more generally, and increased technology use.

 

What Drives Porn Use

Another reason for this increased use may be that we have seen feelings of loneliness and disconnection rise to record levels. Pornography provides an effective, short-term solution for this that, at first glance, appears to have little risk: it gives us a free boost of the happy brain chemicals such as oxytocin, dopamine and opiates that we typically get in close relationships. Dopamine levels increase to an incredible 200 percent during orgasm. Oxytocin (the “connection” drug) plays a vital role in bonding, creating memories, empathy, trust, and relationship building. It spikes during sex, when we hug or kiss or snuggle, or even just have a good conversation. It also increases sensitivity to naturally occurring opiates in the brain, which makes it very effective for bonding and soothing physical and emotional pain.

Of course, there’s a catch. You can’t really build a “healthy” relationship with pornography. It is a one-way street: dopamine-centred and novelty-seeking, and while a porn-induced orgasm will provide oxytocin and soothe pain, it won’t provide any of those healthy relationship building functions, or make us any less lonely. In fact, it may make us more lonely. This is one reason many people call pornography an addiction: it can create compulsive use that comes at a cost. As it provides effective temporary relief from implicit negative feelings, the brain will learn to direct us towards it compulsively.

 

How Does Pornography Impact Us

I could spend this post bashing pornography, and rattling off scary stats about how it breaks up marriages and has long term physical implications for the brain (it does, and it does), but I’m more interested in the human factors. Sex is great for bonding, and when used well, it builds intimacy, vulnerability and connection – the opposite of loneliness. Porn, on the other hand, based on vast amounts of research, actually tends to do the opposite: it builds shame and secrecy. It is typically a private experience and taps into some deep-seated urges that can feel very shameful. It’s possible that couples could use pornography in a healthy way, but research tells us that this is far more likely to be the rare exception than the rule.

This post is mostly aimed at men, mainly because I only work with men around these issues. Anyone can struggle with porn use, because it is so, so easy to come to rely on or use it, especially (though certainly not only) when we are feeling disconnected, shamed, or lonely. It’s a brilliant solution, really, but it tends not to solve the problem for future us. 

 

What Can I Do About My Porn Use

Alongside You is running a porn recovery group this fall, for men who would like to be able to talk openly about the role of porn in their life, past and present, and receive support. We aren’t there to judge ourselves but to recognize and talk about some of the things that affect all of us, and, hopefully, feel like we can begin to enter a period of recovery from those impacts. If you or someone you know might be interested in attending, it’s low pressure and low cost (as always, talk to us if money is an issue), and is a great way to feel some meaningful and healthy connection with great people.

If you have any questions, feel free to contact me directly here – I’m always happy to chat. If you would like support for yourself or a loved one, reach out to our reception, and they will help you find something that fits, whether it is at our offices or somewhere closer to home.

Why Do I Procrastinate?

Why Do I Procrastinate?

Writing these blog posts is one of the easiest parts of my job to put off until later. They require some unstructured thinking time (which is fertile ground for distraction), are unstructured themselves, and there always feels like there is something more important (read: easier and less personally exposing) I could be doing with that time.

Recently I read a fantastic article in the New York Times on exactly the process I’m describing. Most people call it procrastination. I really, really think you should read the article now because if you’re reading this one already, chances are you’re putting something else off.

 

If you don’t feel like doing that, the basic idea is that mainstream science has come to embrace an idea that makes intuitive sense to many of us: procrastination has much less to do with laziness, lack of self-control, and disorganization, and much more to do with emotions. For example, it is often the case that the task at hand will bring up a disquieting uncomfortable feeling that we often barely notice. Therefore, procrastination is about protection: we keep ourselves safe from feeling (for example) our own self-doubt or shame by doing something unrelated, whether it is productive or not. This has the effect of a short-term boost in good feelings (TV is fun!) but is often counterproductive in the long term. For example, these blog posts give me some anxiety, because I never know who is reading them and what I might be sending into the public eye that might not be good enough, or that I might even end up disagreeing with myself a year from now. So I often find something else to do.

 

Along these same lines, there is a much more complex system of underworkings at play in our decisions than we think. We in the mental health field love to talk about the brain (how its fear center causes us to react in response to stress, for example), but according to good recent research, there are mini “brains” around areas such as our heart and gut that make them function as powerfully as our heads at times. Daniel Siegel is a big proponent of this, and you can also read more about this at Heart Math here.

 

To return to the article (here’s a link to it again!), it encourages self-compassion, which we counsellors also love. Having grace and compassion for our own mistakes is one of the best tools out there. The article offers three other, very simple tips for when you find yourself the victim of procrastination:

  • Be curious. Take a breath and allow physical sensations, emotions, and mental processes to come and go, observing them like you were watching a new TV show. Notice what happens to the sensations, feelings and thoughts as you observe them. What are the feelings that might be bringing up unpleasant feelings?
  • Hypothetically imagine the next step: “If I were the version of myself that wasn’t procrastinating right now, what would be the next thing I would do?” Just thinking about this might make you more likely to take action despite your feelings. Many pros agree that motivation often comes while doing something, and not before, so you might need to kickstart things a touch.
  • Make temptations more inconvenient. Hide the TV remote, put a screen time blocker on your phone, etc., etc. This also increases the timeframe for you to become aware of what’s going on, and makes your reward for procrastinating less immediate.

 

I would add a few of my own tips as well:

  • When you feel temptations arise, take a deep breath and allow yourself to be tempted, noticing the temptation to do something gratifying at the moment. This is called many names, but I learned the name urge surfing: you are riding the wave of your temptation and letting it run its course without trying to push it away or make it less intense. This fits really well with tip #1 from the article (Be curious!). Often, the urge will go away in 10-12 minutes, if not much less.
  • If you must, try to give yourself more productive ways to procrastinate. For me, I take a few minutes and stretch. This often makes me feel a little better about myself physically, mentally, and emotionally, and makes me feel better equipped to take on the original task. You might also choose to journal about your inner experiences at the moment, which will help you understand and articulate them (this removes some of the power those impulses have).
  • Building on #2, you could also call a trusted friend and chat about the fact that you’re putting something off. This will help in a number of ways. It will give you a sounding board for your thoughts and feelings, normalize your experiences, and make you feel generally supported (little motivates us as well as reminding ourselves of our supportive relationships).

 

Lastly (as I say with most of these articles), you can always feel free to talk to a professional helper, as they are often equipped with specific skill sets that can help you tackle something like the above, or help get you in position to tackle it. These include professional counsellors like us at Alongside You, but can also be something like a pastor, priest, social worker, or support group. Investing time in caring for yourself the right way has the best interest rate of any investment (by a huge margin). If you have questions about this process, please call our office, and you can even email me directly through my profile by clicking here – I will take the time to respond as best and as soon as I can.

 

Good luck, and now that I’ve written this, I’m off to do something fun.

Kids Anxiety: What Can Parents Learn From Them

Kids Anxiety: What Can Parents Learn From Them

An interesting piece about “The big myth about teenage anxiety” ran in the New York Times this week, authored by a fairly prominent psychiatrist – which you can find here.

 

The essence of Dr. Friedman’s editorial is that much of the research showing a rise in teen anxiety is not conclusive, which from a scientific perspective is unsurprising. Many of these studies rely on self-reports, which, though scientifically imperfect, offer an important window into human experience – something we as mental health professionals consider of paramount importance. A better understanding of what we deal with internally and externally on a daily basis (and the meaning we make of it) is essential to better understanding ourselves. Dr. Friedman also encourages readers to remember that phones are not necessarily to blame for anxiety, as much as it may seem that way. He points out that anxiety is normal, and that our brains are quite well-equipped to handle it.

 

The article is nuanced, and while I would hesitate to back up many of the things Dr. Friedman says, one important distinction he makes is between actual anxiety disorders and day-to-day anxiety and worry – something most teens are virtually guaranteed to experience. Social media and the internet have indeed made the social world more complex for teens to navigate – as many have noted, there is no “escape” from the reach of the internet anymore, and it is more than understandable that teens are often glued to their phones. Teens are under a lot of stress developmentally, socially and physically, and Dr. Friedman is careful to point out that there will and should be plenty of anxiety in teenage life.

 

The crux of the matter then is not eliminating or avoiding anxiety (avoidance, of course, will actually make the anxiety seem stronger than it is), but focusing on what we can learn to do in the face of anxiety. Teens can learn that anxiety is normal, learn to notice bodily sensations that arise, learn to stay grounded, and even learn to appreciate their anxiety for protecting them.

 

Many parents are highly distressed when they learn their teen or child is struggling with anxiety, and I would encourage those parents to remember how normal that is. Your job is not to eliminate or protect from that anxiety, but rather to be with your child as far as they will let you, and creating as best you can a space of rest from it. There are many anxiety management techniques that can be learned to reduce day-to-day anxiety, but one of the best things to have is a secure relationship within which you do not need to be anxious. I can’t stress enough the impact of having someone with whom you feel safe to just be you, warts and all.

 

It’s no secret that I (along with many others here at Alongside You) am a big fan of attachment parenting, an idea propagated by Dr. Gordon Neufeld and brain researcher Daniel Siegel, among many others. I am also a big fan of parents taking care of themselves before they worry too much about taking care of their children, for several reasons. So I should mention that your anxiety about your kids’ anxiety is incredibly valuable: it tells you how important it is to you that your kids are safe and happy. This is wonderful, and you also should get to know that perfectly normal anxiety really well within your own safe relationships, because your kids will use you as a compass point to manage their own anxiety. If you have a good relationship with your anxieties, you will be very much ahead of the game in helping your child or teen with theirs. Normalizing our own experience of anxiety reduces it in our kids, and also shows them that they’re not alone.

 

Parenting is a tough job, and if you’re reading this, one that I imagine you take seriously. Best of luck, and as always, feel free to ask lots of questions and seek lots of support. If we can be a support to you, please don’t hesitate to contact us. We’re all in this together.

 

 

 

How Can I Forgive Someone Who Hurt Me?

How Can I Forgive Someone Who Hurt Me?

For a long time, a friend of mine (we’ll call her “Shirley”), genuinely hated a coworker of hers. Shirley wasn’t just bothered by this coworker, she genuinely couldn’t bring herself to think about them without being filled with a bitter anger, which ruined her evening on more than one occasion.

Notice that I don’t say Shirley didn’t have a “good” reason to hate this coworker – the person had deeply hurt her, and the organization that employed them both had failed to act appropriately in this situation, which made Shirley feel invisible, unsafe, and very, very angry. She had carried this anger for over a year, and it was taking a toll on her mentally, emotionally and physically.

For most of us, there has been a person in our life against whom we’ve carried a grudge of some kind. People hurt each other – it’s the price we pay for being able to have satisfying relationships; and, regrettably, these hurts are not always resolved. Shirley had been hurt, and like most of us, the very last thing she wanted to hear from a friend was that she needed to forgive and move on (this is not great advice, but is given more commonly than one might think).

For some people “forgiveness” is a bit of a dirty word; that is, how can we forgive someone who clearly doesn’t deserve it, especially if they don’t seem to understand the pain they’ve caused – or even seem to care? A better question to ask, perhaps, is, “What is forgiveness? And why should I forgive?”

Forgiving is not the same as forgetting (nor do these two things necessarily need to come as a pair). Forgetting is putting the hurt completely out of our minds, forever. Forgiveness is much more complex. Everett Worthington is a psychologist who has devoted much of his career to studying forgiveness, and he breaks the word into two main categories: ‘decisional,’ and ‘emotional’. Decisional forgiveness involves a cognitive decision to let go of the negative feelings we hold towards the person who has hurt us, whereas emotional forgiveness takes that a step further, replacing those negative feelings with positive ones like compassion and empathy. The person we are forgiving does not even need to be part of the process. We can forgive a deceased or estranged loved one that has no chance of ever receiving or reciprocating our gesture. We can also forgive someone as part of a relational gesture, regardless of whether or not the person chooses to, or is able to receive it.

It’s also possible that we might offer emotional forgiveness and have the person that hurt us accept it with genuine humility and remorse, which for everyone I’ve ever known, is a powerful experience. There is a famous scene in Les Misérables where a priest shows kindness to Jean Valjean, a man who hours before stole thousands of dollars worth of his property and knocked him unconscious after being shown kindness and trust. Valjean is completely and utterly undeserving. This scene brought tears to my eyes; there is something about undeserved forgiveness that can break down the most hardened exterior.

Forgiveness is pretty much always hard, no matter your situation. It doesn’t always go the way we hope it might. But one thing is certain: the resentment you are carrying is most likely hurting you a lot more than it is hurting the other person.

Resentment takes a toll on us; it takes energy to harbour a grudge (like carrying around a weighted pack). We are not required to forgive, but it is healthy for us in almost every conceivable way. Research shows that it improves heart health, immune system function, your gastrointestinal system, brain functioning and perhaps biggest of all, it reduces stress. Much research suggests that it also reduces rumination, which has been reliably linked to depression, anxiety, anger-related disorders, obsessive-compulsive disorders, post-traumatic stress disorder, and psychologically related physical disorders.

For this reason, we can choose to view forgiveness as something we are doing for ourselves, rather than the offender. We can decide to try to let go of a grudge without actually feeling any different – and that is OK.

Try this: hold your arms out in front of you, with your hands clasped tightly together, as though you were clasping your resentment between them. Hold this for a minute (Not exhausted? Try two minutes), and then let your arms drop and relax. What did you notice? This is what happens internally when we let go of a grudge – we are releasing tension. Try it while actually picturing a minor grudge you are holding, and see if it makes you feel any different towards that grudge.

Lastly, I want to acknowledge that things are not that easy. In many ways, we cannot just decide to forgive, and all hurts are definitely not created equal. However, if you recognize that you might be carrying a grudge (big or small) that is actually hurting you more than it’s helping, and you feel you can’t get over it, there are lots of options to help yourself with it:

  • Try cognitively deciding you want to commit to forgiving, even if you don’t feel like it, as a gift to yourself. If you want to take this a step further, try Everett Worthington’s evidence-based REACH forgiveness worksheets (available here for free). Many people have found these exercises very helpful.
  • Talk through what you are experiencing with a trained therapist. Even just putting words to your experience and having them heard and understood can be very relieving, and therapists are trained to help you recognize and navigate challenging circumstances.
  • Read stories of people who have forgiven under seemingly impossible circumstances, and try to be curious about your reactions to these stories. Do you agree with them? Do they make you angry? Humbled? Chances are, reading others’ experiences with hurt and forgiveness will help you feel less alone, and even just the experience hearing those stories can shift some of the weight. If you are part of a faith community or come from a faith background, try talking to a spiritual leader about what your faith says about forgiveness, and question what you find.

Most of all, remember to give yourself some grace as you wade through this process; forgiveness is both one of the most difficult and most rewarding things a person can go through. If you have any question regards on forgiving and forgiveness, feel free to contact us.

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Resources

Akhtar & Barlow have a few good articles out. This 2018 meta-analysis provides evidence for reduced depression, stress, anger, and hostility, as well as increased positive affect, related to forgiveness:

Akhtar, S., & Barlow, J. (2018). Forgiveness therapy for the promotion of mental well-being: A systematic review and meta-analysis. Trauma, Violence, & Abuse, 19(1), 107-122. doi:10.1177/1524838016637079

Akhtar, S., Dolan, A., & Barlow, J. (2017). Understanding the relationship between state forgiveness and psychological wellbeing: A qualitative study. Journal of Religion and Health, 56(2), 450-463. doi.org:10.1007/s10943-016-0188-9

Baldry, A. C., Cinquegrana, V., Regalia, C. & Crapolicchio, E. (2017). The complex link between forgiveness, PTSD symptoms and well-being in female victims of intimate partner stalking. Journal of Aggression, Conflict and Peace Research, 9, 230-242. doi:10.1108/JACPR-08-2016-0247

Orcutt, H. K., Pickett, S. M., & Pope, E. B. (2005). Experiential avoidance and forgiveness as mediators in the relation between traumatic interpersonal events and posttraumatic stress disorder symptoms. Journal of Social and Clinical Psychology, 24(7), 1003-1029. doi:10.1521/jscp.2005.24.7.1003