Craving (16 page)

Ask for Help/Be Teachable

In my experience, women certainly do struggle with asking for help, but men often have the hardest time. “Male answer syndrome,” while not an official diagnosis, does have some behavioral correlation among several animal species, and while it may have conveyed some selective advantage in the past, it really can interfere with successful recovery. When you think you have the answers, it’s hard to hear alternatives. We reviewed this important concept, called confirmation bias, in
chapter 3
. This is when we focus only on evidence that supports our theory and ignore evidence to the contrary. For both men and women, the bias can prevent learning and being teachable. The most important suggestion, the one that is most likely to help you, may not get the attention it deserves because of the way your brain works to block it out. Talk to others who have successfully addressed your type of craving, asking, “How did you do it?” “What worked and what didn’t?” and “Will you help me with this?” Keep asking until you stop your target behavior; then keep asking to further enhance your recovery.

See Things Differently

In Brooke Musterman’s wonderful book recounting her experiences working with and for caffeine addicts, she notes the following:

The key to overcoming reptilian behavior, although very obvious, seemingly simplistic and often the hardest thing is to get out of brainstem mode and start thinking with the higher parts of the brain. There are any number of ways that people can do this…. [s]elf talk and what psychologists like to call “reframing” the situation (stepping back, taking an objective look at what is really happening and not what I have blown up in my head are the primary methods I use….
⁹⁴

Brooke is not a psychologist or counselor. She’s a barista (and a great writer). She simply documented her experiences serving coffee drinks to thousands of caffeine addicts, learned a bit about the reptilian brain (which we explained in detail in
chapter 2
), and found that a shift in perspective often made the difference between an automatic, reptilian response and a thoughtful, mature, healthy choice. Of course, you can’t always see things differently; you can’t always step outside of yourself and develop the sense of clarity you need to make healthy, positive decisions. That’s why this won’t work by itself, in a vacuum. But very often, the difference between giving in to a craving and passing through it unscathed is as simple as reframing the situation, taking a different perspective, taking a deep breath, and simply seeing it differently.

Be Helpful and Practice a Genuine Love for Others

“You will learn the full meaning of ‘Love thy neighbor as thyself’”

— ALCOHOLICS ANONYMOUS, P. 153

This is a suggestion that might not seem to make much sense as a strategy for diminishing cravings. You might be thinking, “Sure, being helpful is a great suggestion. Who could be opposed to being helpful? But what does that have to do with cravings?” Well, when it comes to cravings, helpfulness can make an enormous impact. It may be the most important suggestion in this book and deserves close attention and an expanded look.

It turns out that the healing power of love and helpfulness is very real. Furthermore, most so-called self-help groups, as well as most mutual-aid groups (such as AA, NA, or even SOS), emphasize the importance of love and service.

There is significant research to suggest that helping others has numerous health benefits, including increasing the probability of recovery.
⁹⁵
In my experience, it’s a serious mistake to discount the importance of helping others when addressing cravings. In the early history of Alcoholics Anonymous, cofounder Bill Wilson, who was actively trying to help other alcoholics, was able to stay sober while cofounder Dr. Bob Smith had originally been unable to get sober through participation in the Oxford Group. Dr. Bob later attributed his ability to finally get sober to the act of serving others. Self-centeredness, ego, selfishness, and other forms of “obsession” with self are considered by AA members to represent the core spiritual pathology of alcoholism, and working the Twelve Steps and participating in the fellowship are essentially designed to reduce this pathology. A comprehensive review of AA is well beyond the scope of this book, but clearly its successful members have developed an effective strategy for addressing their cravings, and a big part of their success can be directly attributed to the principle of helping others.

Research has also shown significant benefits associated with being helpful even outside the self-help and mutual-help group settings. Stephen Post, Ph.D., a bioethics researcher at Case Western Reserve University, reviewed the evidence in an excellent paper titled “Altruism, Happiness, and Health: It’s Good to Be Good.”
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Post, in reviewing the evidence, argues that there may be powerful evolutionary, physiological, and psychological forces at play that result in the benefits of altruism. Post notes that over fifty studies have demonstrated the health, happiness, and even longevity benefits associated with being helpful to others. He reviewed studies spanning various areas including endocrinology, immunology, alcoholism, death and dying, depression, and even the “helper’s high” that is experienced with volunteerism. I reviewed these studies as well, and I agree with his conclusion that “when we help others, we help ourselves, with the caveat that we need balance in our lives and should not be overwhelmed.”
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Post recently wrote a fantastic book on this topic (and I strongly recommend you read it) called
The Hidden Gifts of Helping.
⁹⁸

A study of older adults showed that volunteerism has been associated with reduced depression, anxiety, and physical symptoms.
⁹⁹
Others have connected altruism with an increased will to live, improved self-esteem, greater happiness, and better morale. All of these improvements will be particularly helpful to those who suffer from cravings. Some studies have even shown that givers of help fare even better on these measures than receivers do, confirming the adage that “’tis better to give than receive”! Some of the research on altruism and volunteerism emphasizes that the majority of volunteers do so in a religious context, but further analysis has demonstrated that nonreligious volunteerism produces similar benefits.

Do volunteers actually live longer? Several studies have asked this question, and the results are mixed but generally favor that mortality is reduced by volunteerism or altruism. One study conducted in 1999 by Doug Oman of the University of California at Berkeley looked at several thousand older adults and found that those who volunteered for two or more organizations had a more than 60 percent reduction in all causes of mortality. Oman discovered another result that was particularly surprising: religious attendees had over a 60 percent reduction in mortality as long as they engaged in some (even minimal) level of volunteering! Oman looked at potentially contributing variables as well and found that the lower mortality rates for volunteers could not be fully explained by health habits, physical functioning, or even levels of social support.

A few years later, Oman studied nearly 7,000 California residents, their religious service attendance, and their causes of death over a thirty-year period (from 1965 to 1996). He found that although there was no reduction in external causes of death (such as accidents), mortality from cardiovascular disease, cancer, or digestive and respiratory ailments were significantly lower in people who attended religious services at least once a week.

How exactly does helpfulness help the helper? If it’s clear that altruism has a significant benefit on mental and physical health, on longevity, and yes, on cravings, it’s not yet completely clear why, although there are several hypotheses. It may, for example, be true that altruism conferred significant evolutionary advantage. If you consider that groups with altruistic members would be more likely to survive harsh environmental pressures than groups without such members, it’s easy to see how altruism might have been “selected” for.

Another way that altruism might be biologically adaptive is in focusing the fight-or-flight response. This response, which is very helpful and adaptive under periods of acute stress (by heightening awareness, attention, and the sympathetic nervous system), becomes maladaptive, or harmful, under periods of chronic stress. In short, what helps in the short term can interfere with your ability to deal with longer-term stress. Altruism may reduce the anxiety and stress hormones associated with chronic stress, thus conferring additional advantage in the face of prolonged threat.

Altruism may also exert its protective and beneficial effects by reducing or eliminating the negative, harmful emotions that have been shown to impair health (and drive cravings). Quite a bit of research connects negative emotions such as depressed mood, anxiety, and anger to impaired health outcomes. Worry and stress alone are linked to a variety of adverse health outcomes, including cravings. In Robert Sapolsky’s groundbreaking book
Why Zebras Don’t Get Ulcers,
he reviews the adverse health effects of stress on addiction, sleep, and illnesses such as cancer and coronary artery disease. Worrying literally makes us sick. Sapolsky argues, as I do here, that spirituality plays a key role in protecting against the negative effects of these destructive emotions.

In addition to the value of being helpful, several studies have examined the relationship between another spiritual dimension, forgiveness, and addictive behaviors. Jon Webb from East Tennessee State University studied 721 college-age problem drinkers in Appalachia and found a favorable relationship between forgiveness, especially self-forgiveness, and drinking and health.
¹⁰⁰
In an earlier study, he and his team found a relationship between forgiveness
of others
and mental health among people entering alcohol treatment.
¹⁰¹

On the other hand, the science is also clear, as Dr. Stephen Post notes in his research, that when caregivers and helpers are consumed or overwhelmed by their helpfulness, it can produce negative results. It’s worth mentioning that in my clinical experience, I have seen some people use helping others as a strategy to avoid dealing with their own feelings. For these people, their efforts to help others impair their own satisfaction and the quality of their relationships. Often, they discount their own needs in an avoidant fashion and focus obsessively on others and their needs. One way of understanding these people is that they use other people’s dependence to meet their own pseudo-narcissistic need to be helpful. In this view, despite appearing to be helpful, they are actually placing their own needs first. For these people, helpfulness to others can actually be harmful, until they have addressed their core issues of shame and inadequacy that drive their behavior. Some authors have referred to these behaviors as
codependent.
If you think this may be an issue for you, focus on the other suggestions in this book rather than helping others as a cravings strategy until you’ve made more progress.

The late Viktor Frankl, an Austrian psychiatrist and Holocaust survivor, once wrote, “The facts of our lives are not as important as our attitudes toward them.” Most reasonable people would agree that a Holocaust survivor is in a relatively unique position to make such an assertion. Altruism changes our attitude and our perspective. It reduces our stress and counteracts negative emotions such as anger, fear, and sadness. (It’s hard to experience anger when expressing unconditional love toward another human being.) Helpfulness is in our genes as well as our hearts. Altruism forms the basis of Twelve Step approaches to recovery and, in my experience, has helped countless sufferers reduce or eliminate their cravings. It represents the very foundation of spiritual approaches to managing cravings.

***

Although there is no clear agreement on a definition of spirituality, and various programs have been established to address addiction and cravings, most of the successful methods share some core similarities. To the extent that you can take advantage of the core features I have outlined in this chapter, you should. They have worked for countless people and they can help you too.

…

7

You Can’t Do It Alone

Why Groups Can Reduce Urges and Improve Behaviors That Individuals Can’t

“We allow our ignorance to prevail upon us and make us think we can survive alone, alone in patches, alone in groups, alone in races, even alone in genders.”

— MAYA ANGELOU

So far in this book you have learned about the way your brain influences your decisions and how memories, thoughts, and even the clarity of your judgments can become distorted when you experience cravings. You’ve learned about the role of cognitive bias in fueling cravings and in preventing you from always making healthy, rational choices about your behavior. And you’ve learned about the role of spirituality and spiritual approaches in reducing your cravings. However, we’ve only touched on one of the most powerful influences on reducing or eliminating cravings: the group.