addicted to negative emotions?!

Question:

I remember reading something according to which negative emotions, as a whole, can be addictive, probably on a chemical level.  Apparently many therapists are agreeing and it seems to be the general consensus.  All the new age woo woo stuff aside, is that true? 

Answer:

Thanks for tickling my brain!

Human beings generate all kinds of theories based on correlations instead of explanations!  The "addictive to negative emotions" theory may be one of those theories. 

I think that we can get addicted because of negative emotions but not TO them.  Think about it: how addictive would getting an electrical shock be? Smelling shit?  Getting screamed at?  Or ignored?  We may get addicted to what happens right after the negative emotion, like relief, a rush of warmth, silence, connection, etc...  Endorphins?  This might also explain why some people like to jog :)  As one runner friend of mine put it once: I am addicted to jogging because stopping feels so bloody good!

Negative emotions might get paired with positive ones, but that is another thing.  This might be the case in masochism.  Or it might be the case that someone needs to hurt in order to feel anything at all :( 

Whose problem is it anyway?

There is a tendency to want to blame someone else for how we feel about them.  We’ll say, for example, that You’re annoying me rather than say, more truthfully, that I am annoyed by your behaviour, a semantic and cognitive tweak that shifts the onus for my feelings onto someone else in a moment of confusion about the source of my experience.  

 

According to infant psychiatrists, this is what babies do.  Before they are able to differentiate between themselves and the external world, before they acquire the sense of an “I”, infants confuse their bodily experience (inside) with what is going on peripherally (outside), in a symbiotic relationship with the world and those around them.

Once I acquire a sense of self, however, I can know myself as the source of how I feel such that, when others’ behaviour triggers bad feelings in me, I know that is not their “fault”, let alone their problem.  To hold them responsible for how I feel is a regressive delusion, not to mention counter-productive, particularly if others don’t have a problem with their behaviour, or don’t want to change just because I want them to.

What’s more, in blaming others for how we feel, we declare war against them, escalating an already problematic situation.  The origin of the word war is the German verwirren "to confuse, perplex" and, indeed, when the boundaries between your experience and mine become blurred or confused in this way, violence is a real possibility.

So, unless someone has misused a position of power with me or broken an implicit or explicit agreement, he or she is not responsible for my feelings and I cannot blame him or her for my feeling hurt or upset  by his or her behaviour.  My feelings are my own reaction, not universal signposts by which do judge others.  If we are involved in a dance that doesn’t work for me, like it or not, that makes it my problem.  

The only person I can change is myself and, if I’m not happy with how someone behaves, I’m the only one who can do anything about it.

Big disclaimer: This is not to be used as a way to push responsibility for an act of aggression back onto the victim.  Acts of aggression are not projections.  They also blur and transgress boundaries.

addiction and biology

Question:

What do you think, from a professional standpoint, of the suggestion that alcoholism is not a biological proclivity (as it is popularly portrayed) but rather a character flaw? If it were a biological matter, how would anyone be able to stop?

Answer:

What a timely question.  I have quite a few clients struggling with addiction right now (not that we aren't all struggling addicts to some degree).  They have different proclivities (food, gambling, alcohol, work) but they what they all have in common is that they are in search of a fix for hard-to-deal-with feelings and get hooked on what works for them. 

You need two things, as far as I can tell, for an addiction to develop: a problem and a short-term solution that fixes it.  We are all prone to the former (some more prone than others, depending on biology, psychology, up-bringing and, of course, stress).  The solution depends on all of the above, but there is certainly a strong link to biology.  Chemistry regulates our emotions, and vice versa.  Some chemicals even regulate our choice of addiction.  Did you know that people who take L-DOPA, i.e. for Parkinson's, tend to develop gambling addictions?

How is anyone able to stop?  Some stop and it’s no big deal.  Some have to struggle like hell against their “proclivity”. 

I think this too is largely determined by biology.  Some people are born addicted to their mother’s habits.  That is no “character flaw”.  It seems to me that the only way to quit an addiction is to go against the grain of what you want to do on a more impulsive level, for whatever reason you’re doing it, and stop and do something else instead, even if this initially means, as I think it does for many people, doing nothing at all, feeling the urge and letting it pass.

The key, for many, is to have a goal, something that motivates you to look beyond the immediate and short-term fix, sometimes it's a matter of one biological urge dominating another.

Is a successful quit the result of strength of character, timing, luck or biology, divine intervention or allowing the Divine to intervene on our behalf, or a chicken-egg thing?  I would have to say "yes" to all of the above :)

Don't advise and explain

The other day I witnessed a painful dialogue between a husband and wife.  

The woman was telling her husband about how she “loses” it with her nine year-old son, John.  He pushes all her buttons at the worst times, she explained, like in the morning when she is pressed to get out the door and he refuses to get dressed or turn off the TV, whines and is altogether oppositional.  She tries and tries to reason with him but, at one point, she begins to feel like he is making zero effort, feels taunted and flustered and then-finally- “loses it” on him.  She begins to scream and threaten him with consequences.  Once she even hit him.  

At this point, the woman began to sob.  She told her husband how ashamed she was of being unable to control her emotional reactions and how guilty she felt for hurting their son.  She knew it was both useless and wrong to yell at him in these situations but she felt helpless to do otherwise.

Her husband, who until then had been listening empathically to his wife, cleared his throat and started to speak:

“Dear, you really just need to learn how to control your temper.  Step out of the situation, relax and tell yourself to calm down so you can deal with John more rationally.  I know you can do it.  You really just need to learn anger management.  Here, dry up those tears.”

He handed her a kleenex and then went on to explain to her a step-by-step plan for how she should deal with their son.  His wife looked over at me, her face hardened and her lips pursed angrily.  

“Is there something you want to say with that look?” I asked her, “Something you are asking me to say?”

“I know he means well,” she said, “But I am really hating him right now.”

I nodded.

When someone is expressing their feelings to us, one of the first things we all need to learn is how not to do anything and just listen, or mirror back.  All too often we feel the urge to respond, explain, justify, advise or apologize, i.e. offer the person something that hasn’t been asked for.  This has a tendency to frustrate the person who may feel like they have not been heard, or that they are being goaded into doing something they are not ready to do.  It is more often met with resistance or anger rather than gratitude.

The motivation to do something about a problem is an organic process; it usually arises naturally when just given space.

So give it space.

No (Red) Bull!

I just finished meeting with a young woman, Katie, whom I have known for about seven years, and whom I first met at the child/adolescent out-patient clinic of the Charles Le Moyne Hospital.  She had been evaluated by Dr. Jean-Pierre Bienvenu and diagnosed with Juvenile Bipolar Disorder as well as the highly unusual Intermittent Explosive Disorder related to alcohol consumption.

In the seven years that I have known her, Katie has suffered tremendous anxiety and tortuously obsessive thoughts for which various medications have been prescribed to help get these debilitating symptoms under control.  The medications, usually some variation on the standard prescription of long-acting anti-depressants in combination with short-acting ant-anxiety pills, provided little relief.

Until recently.

A few months ago, Katie ended up at the hospital one evening after having had a few too many drinks in combination with a joint.  She was on the verge of hysterics and her boyfriend, seeing his girlfriend so completely transformed, insisted they go to the emergency room.

Katie was evaluated by a nurse who took stock of everything Katie had consumed on top of her prescriptions over the past years, then told Katie, “You might have died”.

It turns out Katie had been consuming the energy drink Red Bull on a daily basis for eight years, since before her initial consultation with the psychiatrist at Charles Le Moyne.  Over the past few years, on top of her prescription drugs, she'd added a daily joint or two because of incessant jitters.  Now and then, she would also have a few drinks on top of that combination.  Every time she did so, she would have an “episode” where her heart would beat excessively fast and she would become “another person”, doing things that were reported to her later that she was never able to recall.  She would experience profound distress after these humiliating episodes, and her anxiety would be full-blown and debilitating for several days.  

While the doctor who initially evaluated Katie hadn't taken a complete history, misdiagnosed the source of her episodes and prescribed something that made her anxiety worse, the nurse took the time to find out everything Katie was putting into her system and told Katie that Red Bull was like taking speed and that she probably started using marijuana regularly to help counteract the effects.  Katie's psychiatric diagnoses may not have been accurate and her prescription drugs may not have even been necessary.  Certainly the drug and alcohol combinations were very dangerous for her heart, the nurse told her, and Katie's hormone and serotonin levels were probably seriously out of whack.  She said that Katie had to stop mixing Red Bull and drugs immediately or she may die.  So she did.

Katie quit Red Bull and marijuana that day but continued to drink alcohol occasionally.  She has not had an “episode” since, and she is calmer, more serene, and happier than I have ever seen her.

There are obviously psychoactive ingredients in these over-the-counter energy drinks that not only accelerate the heart and trigger anxiety but, in combination with other drugs (prescription or street drugs) and alcohol, are apparently very very harmful.

Consumer beware!  Consult a health professional who takes the time to do a full medical examination and history before prescribing anything to you.

after the affair

[Note to readers: all published exchanges are edited to remove any identifying information about the querent.]

Question: 
My wife and I separated because I had an affair.  Although I ended the affair as soon as she found out, my wife started seeing someone else as soon as we separated.

Now we both want to get back together.  I’m really happy about that, but my wife says she needs time to end her relationship with this new guy.  I want to give her the time she needs but the thing is: I can’t stop looking up her activities on Facebook, and I’m jealous, especially when I see her online at the same time he is, after she’s just told me she’s going to bed.  She isn’t.  She’s chatting with him!  We were making progress there for a while but now it seems to me like she has no real intention of stopping the relationship she has with this person.

I'm finding it really hard to deal with this situation and I wanted to get your opinion on how I can effectively set boundaries without it coming off as being inconsiderate or mean from my end.  

I feel as if I should just ask her what their status is and whether she has told him that she is strongly or seriously working things out between us.  Or maybe I should give her time to do it on her own without my mentioning it and seeming jealous. What do you think? 

Answer:
I can understand your distress!

The first thing I would advise you is: tell her how you feel.  By this I mean, not your observations or judgments of her, but your loving feelings for her, i.e. "I really care about you, I am not interested in any other woman and I want to be with you again".  Do not "confront" her about her stuff in a way that is harsh or judgmental.  She is probably scared about putting all her eggs in one basket with you again.

The second thing I would do is tell her that you cannot work on your relationship with her if she is seeing someone else, and that, if she is with you on going forward as a couple, you need to be exclusive and absolutely transparent with each other.  You will both have a lot of work to do to regain each other’s trust, and to do this you need to close the "exits” that you have used to escape intimacy.

Finally, and this may be the hardest thing for you to grasp (as it is for all of us when we find ourselves in situations beyond our control): setting boundaries is something you do on your own turf, not on hers.  The only person you can control is yourself.  You cannot tell her what to do or change her behavior, but you CAN change yours.  So, if it bothers you that she is on FB after having told you she is going to bed, then you should tell her that you cannot have a relationship based on deception and that you are withdrawing from the relationship until she ends it with the other guy.  You don’t need her to do anything, but you do need to act on your own sense of violated boundaries.  She will then have to decide if her relationship to you is important enough to change herself.

Hope that helps!