How the Benefits of Recovery Expand

by Julie Myers, PsyD, MSCP

Licensed Clinical Psychologist in San Diego;  http://www.DrJulieMyers.com

When you begin to contemplate changing your addictive behavior, you may think about all the problems that your behavior has caused.   There may be a single negative event (such as a DUI) or an accumulation of events and problems.  These problems may be enough to motivate you to change, but for sustained motivation, you may want to consider the positive change that may happen.

Try this simple exercise.  A cost-benefit-analysis¹  is a simple way to start thinking about the benefits of changing.   First, draw a line down the middle of a sheet of paper.  On the left side, list all of the benefits of your addictive behavior, for e.g., “It’s fun”, “It helps me sleep”, “It makes me more social”.   Now, on the right side, list all the negatives (costs) of using, for example “Hangovers”, or “My spouse is mad at me”, or “Legal issues”.   If your costs outweigh the benefits, you may be ready to change your addictive behavior.

Now, try expanding this simple exercise by adding two more columns on another page:  “Costs of Quitting” and “Benefits of Quitting”.   For example, costs may include losing friends or being bored.  The benefits may be something simple, such as “I’ll have more money”.

Something interesting happens the further you move forward in recovery:  The costs of quitting diminish.  Things that once seemed so important to you may lose their significance or you find new ways to satisfy your need.  For example, you may believe that you won’t have any way to calm yourself down, relax, or relieve your depression if you don’t use.  But as you learn to identify your thoughts, emotions, and behaviors, you will find new and more enduring ways to relax and deal with emotions.  Another commonly held belief is that you won’t have any fun, you will be bored.  But as the brain becomes accustomed to less intense rushes of dopamine (which most drugs of abuse and some maladaptive behaviors supply in overabundance), you will learn new ways to find enjoyment.

Even more interesting is how the benefits of stopping expand in unexpected ways.   The simple benefits of  “feeling better” or “having more time” lead to even more benefits.  For example, feeling better may mean that you feel good enough to enjoy the sunrise or climb a mountain.  You might not have predicted that you could find the time to go back to school, play basketball with your kids, or even read a book.  But the benefits of quitting are real, and in the end, more deeply satisfying than your maladaptive behavior.   As you move forward in your recovery, make note of all the things you discover that you can now do and enjoy, which you couldn’t do before.

¹For a great examples of this exercise, go to http://www.SMARTRecovery.org/resources/toolchest.htm

© (2011)  Julie Myers, PsyD

Hyperventilation Symptoms: How they may lead to panic, anxiety, or substance use

 Hyperventilation Symptoms: 

How they may lead to panic, anxiety, or substance use

by Julie Myers, PsyD, MSCP

Licensed Clinical Psychologist in San Diego;  http://www.DrJulieMyers.com

Many people with panic/anxiety symptoms are hypervigilant to internal body sensations, such as the subtle changes brought about by an increase in breathing rate.  Mild anxiety or fear may trigger faster breathing in order to prepare the body for fight-or-flight via the sympathetic nervous system.

Faster breathing increases the amount of oxygen in the blood stream.  Unless the body steps-up activity to use this oxygen, the oxygen level can build up while the carbon dioxide (CO₂) level decreases.   A decrease in CO₂ causes the blood to become more alkaline, which causes the hemoglobin in the blood (which carries the oxygen to the body) to bind more tightly to the oxygen, refusing to disperse the oxygen to the tissues and organs.   This overbreathing is called hyperventilation.

Decreased oxygen availability in the tissues and brain may cause feelings of dizziness, light headedness, confusion, breathlessness, blurred vision, and feelings of unreality.  It also decreases blood in the extremities (which causing them to become cold and/or tingling), and causes sweating, muscles tension, and an increase in heart rate.

Individual react to these symptoms in different ways.  For some, these subtle changes may lead to a full-blown panic attack, which is a period of intense fear and arousal, where the person may feel like they are dying or going crazy.  Panic attacks may decrease a person’s willingness to engage in important activities, such as driving, because of the fear of having another attack.

Other individuals may attempt to reduce these symptoms by using alcohol or drugs.   Alcohol and many drugs (particularly those considered “downers”) can bring immediate relief of anxiety/panic symptoms.  The alcohol/drugs may slow down breathing, reduce sympathetic nervous system arousal, and bring fast relief.  However, relief is only temporary and usually results in an increase in anxiety once the drugs/alcohol wear off.

Different therapies are available to treat symptoms of panic/anxiety resulting from hyperventilation:

1. Breath retraining techniques can help to decrease symptoms.  Retraining involves teaching the person to breathe more slowly, smoothly, and with a relaxed diaphragm.  Such breathing reduces the sympathetic nervous symptom response, hence reducing anxiety.  Training can be accomplished by psychophysiological techniques and/or with biofeedback.
2. Interoceptive exposure, which teaches a person to recognize and tolerate normal bodily sensations such as overbreathing.
3. Cognitive Behavioral Therapy (CBT) can help individuals recognize the thoughts, emotions, and behaviors involved in anxious reactions.
4. Exposure to feared situations, either gradually or by “flooding”.
5. Medications, such as SSRIs.
6. Reduction of or abstinence from alcohol and other drugs.