If only we could all afford psychotherapy all the time, we would all be better off. Luckily, if you have a recognised condition and live in a first world country with a universal healthcare system, you can likely get a full compliment of treatment focused sessions bulk billed.
Removing self blame, being prepared for the whole undertaking to be difficult, and managing the biology side, are certainly the core things. Knowing about salience neuroscience. Knowing about things seeming worse, as your brain distorts inputs (as it was trained to do by you). All in order to seek drug input. And, on occasion, there is a kind of “culture shock” as you begin to see life and “choices” more clearly. Just being aware that this occurs for everyone is important.
But supportive therapy is another worthwhile option. If you are not familiar with behavioural techniques like relaxation, avoiding cues and mindfulness; these are worth learning. As are cognitive techniques for self work in observation; changing language use to alter brain firing patterns; identifying independently wired cognitive distortions outside of addiction; and disputing techniques. Invaluable. And you can’t throw a stone (no matter how hard) without hitting a CBT therapist. And a compact therapy treatment course is covered by Medicare.
There are, however, too many amazing explorative techniques and experiences out there that find themselves (unfairly) eclipsed by CBT (important though it is). These may also be of benefit. But these will likely cost more. But probably not much, it depends on what and how serious you are. Try them all if you can, why not.
There are a range of supportive motivational techniques, where there is simply a place outside of your regular life you can go to talk about anything. Or not talk, just go. Most importantly, this breaks patterns. This is why any therapy will help. Never give up on anything too soon either, it is all retraining pathways. But finding a form of self work that “clicks” with you is important.
There is benefit in having the journey be for you alone first. Alcohol, in particular, is difficult because of the enormous and unyielding social components centred around it; no matter where you go. This must be planned for.
And you must somehow locate 3 activities outside of the house that bring some reward. This is a midterm strategic plan that becomes important for the overall picture. In the immediate, complete each task one thing at a time. Including planning these 3 activities, and getting to them. Get up. Clean your teeth. Dress. Be in transit. It is all another task accomplished, and each is actually another reward firing to assist in rewiring. These are the tactical concerns explored in the previous piece, and are some of what will be honed with your therapist.
The tactical is the moment to moment, but the strategic consideration includes things like getting or keeping a job or beginning or continuing and completing study. But it all hinges on the three activities. You must leave the house. You must break patterns.
You may (very likely) find you must force your self to do these, like a robot. And, as usual, do not expect them to be miracles in and of themselves either. However, your system will be seeking input. It almost doesn’t matter what they are; if you can complete these elements, the input will assist of its own accord. It is another one of those biological things. We are socially wired.
There are data describing these underpinning bio-social elements in primates going back to nearly the earliest records of biological research. It is an important part of self mastery that I think many people miss in their operational therapy plan, one that may account for relapse in some cases.
Speaking in operational terms is always the hardest, because “quitting” is never really the aim; taking an alternate path which allows greater opportunity for higher level hedonic dividends is the actual aim. Always.
We do not ever really know what that operational path “is” in its entirety from the “bird’s eye view”; not while on it. It forms beneath ones feet while walking. Thus, it is important not to be discouraged if you can not picture what that future looks like from where you currently are. This is normal. Indeed, at least in part, almost a necessity. Your predictive faculties have not been honestly and clearly directed to draw such a picture in a very long time.
This is also why the 3 moderate term strategic “experiences” out of your normal routine can be almost anything: it is in large part exploration. Socio-biological input and strategic exploration to colour in the picture of what the ultimate operational landscape will be. A new arsenal of what is requisite for such a world will also be collected along this journey. You will have what you need when you get there.
But do not worry about that, concentrate on now. Let your focus fall on now. Your goals know themselves. The future takes care of itself. Time does that.
It is in the tactical application of daily self-work to counter, whatever it is you consider to be, maladaptive behaviours and cognitions; as well as strategically responding to “surprise” life stressors and boredom; and in the effortless paving of the new operational ground work for the next chapter in your life, through seeking input outside of your former life path pattern: that will be where the challenges and answers are found.
And both will be yours alone. But the challenges do not have to be faced alone. Not entirely.
This is why the first step is always recruiting. A GP to address the biological. A therapist to assist in the psychological. And courage, with commitment, to alter daily patterns that have, across time, been given your permission to become “automatic’ and have for too long been allowed to operate unchecked.
The journey only seems far standing on this side of it. But, to borrow from the hippies again; “the journey of a thousand miles begins with a single step”. It was Jesus who said that. Probably. Or Ghandi, maybe Buddha, look, it doesn’t matter alright; the point is it is inherently true.
If you keep going that way, you know where you will end up. If you want to change direction, you have to actually physically put effort in to point a foot in a different direction. It is physics. Well, I mean, most things are. And then you have to actually take a step.
And that first step is always to begin to map, with honest foresight, your strategically focused and tactically rich, path forward; following a recruitment phase (ie see a generalist (GP)).
And never be afraid of doctors. If you don’t like what they have to say, you can keep door knocking until you find someone who does have ideas which appeal to you.
Medicine is not a science, after all.
But do remember, this is a daily and integral part of your life you are replacing with something else; it is no small task. This is why the techniques are many, and you benefit most in taking advantage of them all. If you do things in halves, you may not ever reach “escape velocity”.
And a final truism – if you do nothing at all: you will go nowhere.
DocJA (R), hc. (2013). Escape Velocity II. J Chron Lett Sc, Ed5. (19).
**Image: “Escape Velocity with Supernova” by Juggernaught9900