Beyond Addiction
1,018 Words • Books • 08/08/2024
currently on: ch. 4 - pg. 89
key takeaways:
- understand how change works
- allows you to create better behavioral intervention
- understanding change as non-linear allows for lapses and failed attempts
- understand your loved one’s usage and why and create targeted behavioral interventions for change
- reduce defensiveness in interactions
- yelling bad
- confrontation bad
- ultimatums bad
- insulting bad
- talking down bad
- increase agency though choice
- Someone might resist a choice thrust upon them but compare that to giving them choices that they have to make
- abstinence and treatment is not the only option, everyone is different
- encourage and praise, lead with positivity patience and optimism
notes:
- states of change model
- it’s okay to approach someone rather than hitting rock bottom it’s just about awareness of wanting to make a change
- withdrawing from your loved one has the opportunity cost of missed time with the person
- With positive reinforcement you can be happy versus negative reinforcement where you have to be stern
- behavior analysis to help understand and develop more targeted behavioral interventions
- exposure therapy is practicing in context is learning is unlearning is changing
- find ways to minimize abstinence violation effect aka the double edged sword of the seinfeld method—accumulation is a strong motivator but a crippling loss
- creating these specific skills and behavioral interventions are probably what happen in rehab and you can do them yourself in a way
- you know your loved one the best
- you don’t have the experience or knowledge of what might be best or what others have tried but you can at least come up with first steps to try and then seek help if you can’t crack it on your own
further reading:
- Brain disease or biopsychosocial model in addictions?
- Addiction and Present-Biased Preferences
- A Revealed Preference Analysis of the Rational Addiction Model
- Control and Effort Costs Influence the Motivational Consequences of Choice
- An opportunity cost model of subjective effort and task performance
- Situating cost perceptions: how general cost and motivational regulation predict specific momentary cost dimensions
answered questions:
- is there a particular kind of person who becomes an addicted to drugs?
- evidence shows that there is no type of person who becomes an “addict”
- people with self control issues? who like taking the easy way out? people who are exposed at a bad time?
- baseline pleasure and drug metabolism
- how can you best communicate to someone who is going through substance abuse problems?
- the dynamics of talking to an addict how to avoid thick language and patronizing phrasing
- does worrying for them and communicating that help? can it be off putting?
- how can we lower defensiveness?
- how can we be less all or nothing in our treatment efforts?
- studies show that a commitment of lifelong abstention as a requirement to change led to a higher rate of relapses
- harm reduction because there are types of usage and there are certainly some types of relapses but can’t some people use responsibly?
- moderation has been shown to work for some people
- having people commit to abstention up front takes their ability to come to that conclusion by themselves
open questions:
- how can we prevent shame spiraling and secretive behavior?
- how can you make someone want to change?
- can you make someone want to change? or only plant the seeds
- people can change you just have to make them want to and that can be done without hitting rock bottom—how can you motivate someone to change in positive way without shame or threat of consequences
- how can you step back to allow someone to experience consequences and realize and learn from them?
- how can you maintain their agency and respect their decisions?
- how can you discourage bad behaviors and encourage good ones?
- do you need to worry about discouraging? or only about encouraging more positive alternatives?
- is there a clear point when someone is addicted versus not? is this a useful discussion or distinction?
- what use does a label have? are there effects of identifying with being an addict? do you start doing X or stop doing Y because you are an addict?
- how can we give people options for their own treatment/addiction?
- either the illusion of choice or actual creation of agency seems like it would help emotional investment
- people usually know their situation best and having prescribed action kills motivation and can build resentment
- can we frame it not as an ultimatum?
- how can the friend or family member of a person going through substance abuse problems best take care of themselves?
- what is a healthy boundary?
- what are the best forms of self care?
- what are important things to keep in mind about worrying and letting go?
- what allows some people who abuse drugs to self-correct while others can’t?
- some are intervened beyond their control
- some things spiral out of control or nothing changes if nothing changes
- some people have low self efficacy
- how can we responsibly raise the costs and lower the benefits of substance use? both societally and interpersonally?
- how can you shine a mirror on behavior?
- people change when they see their behavior as inconsistent with their self image
- how can DARE be set up without fear tactics and instead demonstrate the costs of drug use as outweighing any benefits?
- why does AA and dare and fear and shame motivate some people while potentially encourage others?
- do some people just do better with external motivation?
- is family behavior sometimes to make themselves feel better and like they’re doing something?
- confrontational feels more direct and therefore more meaningful?
- yelling blows off steam and speaks your mind but otherwise just makes the other person more defensive and is ineffective
- is drug rehab carceral?