Stealing From Our Children?

  • May 27, 2013 8:05 am

It was recently reported that six employees of the San Francisco Unified School District have been arrested for stealing and that they face no less than 205 felony charges stemming from the alleged misuse of an estimated $15 million in grant funding.  The allegations include redirecting money into slush funds, bonuses and non-approved pay increases.  The San Francisco DA reports that approximately $250,000 went towards the SFUSD employees’ personal use.

One of the defendant’s attorney, stated that his client “felt she had the right to do it”.  Currently there are many unanswered questions in this troubling case but one very important question is can it be possible that people are so unclear about what stealing is or are able to justify it to themselves?  Is it so complex and confusing to understand what is and isn’t mine, either professionally or personally?  It may seem clear to some of us, and we can only imagine people in this scenario acting out of pure greed or selfishness. And that may be the case. But people with stealing disorders – as with other addictions or compulsions – often use justifications and twisted logic to rationalize their out of control behavior.

In our years of working with people who have stealing disorders we have discovered that there are many people who steal who otherwise spend most of their time contributing to society and their families in a positive way. These people are therefore very confused about their stealing behavior.  While they are almost always clear that  when they go into a store and steal a watch they are stealing, they are often unclear if it is stealing to taste fruit at a grocery store before purchasing it, take something out of the communal fridge at work without asking, skim a little money from their wealthy employer, or take home office supplies from work.  These scenarios (and even stealing a watch from a store) get rationalized and thinking becomes distorted in the face of emotional reactivity.

In our work with people with stealing disorders, therefore, it becomes a priority to help them keep their thinking simple.  In other words, we encourage them to ask questions such as: Does this thing or money belong to you?  Have you already purchased it for it’s full price?   If the answer is “no” and you take it, then you are stealing.  If the answer is “I don’t’ know” then you have to ask if you can have it for free.

People with stealing disorders are often unable to distinguish what is stealing and what isn’t.  Their impulsivity overrides their thinking and their emotional empathy which would allow for them to formulate the question of whether or not a certain thing or money belongs to them.  The impulsivity is often driven by several factors which include: internal and/or external stressors, at times co-occurring mental or medical health issues, co- addictions and the neurobiological dopamine reward cycle taking place in their brain each time they steal.  The urge to get something for nothing feels like a “high” or a “win” but most importantly it is feels really good (and even alters their brain chemistry) and therein lies their problem: people get addicted to it.  When people are addicted they formulate all kinds of defenses, cognitive distortions, rationalizations, conscious and unconscious that allows them to repeat the cycle in order to get the payoff of good feelings again and again.

It is disheartening when we see cases like this and of course can’t imagine how could someone who has spent their life serving the public good get caught up in something like stealing from the very institutions and people they serve.  It is easy in a case like this to be cynical and political in our commentary, and it is possible these people are stealing out of pure greed, lack of empathy, and criminality. However, stealing occurs every day all day, all over this city, country and world, and some of it is by people who can’t help themselves.  There is treatment and help for individuals who compulsively steal and it is our hope that everyone with this problem can get the help they need so we can all live in a safer world.  

Elizabeth Corsale, MA, MFT

Not Getting Clean: It’s A Killer

  • May 3, 2013 12:15 pm

In his recent book Clean, author David Sheff writes about addiction treatment and why it fails to help so many addicts. The idea for the book came out of his struggles helping his son with his addiction, which led to further research on the state of addiction treatment in the U.S. In a recent article on Time.com, he started his article by stating that:

“Every year in the U.S., 120,000 people die of addiction. That’s 350 a day.”

He goes on to write that “A growing body of evidence has proved that addiction isn’t a choice subject to willpower but a brain disease that’s chronic, progressive and often fatal.” He then writes that in spite of this, there are a shocking number of treatment programs which do not use techniques that are based on research on effectiveness. He writes that it is crucial that people need to find and utilize these programs which “use therapies that have proved effective in clinical trials, including cognitive-behavioral therapy designed to train addicts to recognize and interrupt the cues that trigger the relapse mechanism; motivational interviewing, a therapy approach widely used to treat many psychological disorders that helps addicts engage in treatment; contingency management, which essentially rewards addicts for clean time; and psychopharmacology.” These treatment programs can also include “alternative” therapies that have been proven effective, such as meditation, acupuncture, and animal-assisted therapy.

Importantly, he goes on to say that “most researchers agree that no single therapy is appropriate for every addict. Often they’re used in concert. An effective treatment regimen may include AA, but only for those patients who are open to it.”

One of the most important points that he makes is about how unregulated rehabilitation is, and how widely the programs vary.  He writes:

Currently there’s a chasm between these and other evidence-based treatments (EBTs) and rehab programs. Every day addicts fall into it, and many never make it out. Most people in need find themselves in the same frustrating position I was in when I was desperate and overwhelmed, shopping for programs and doing the best I could to navigate an unnavigable system that’s also largely unregulated. In many states, anyone can open a rehab program — no licenses or accreditation are required.

This is slowly changing. More people are being educated about the fact that addiction is a disease and therefore requires treatments based on the medical model. The more consumers are educated and demand EBT, the more the billion-dollar rehab industry will adapt and offer it. That is, the industry will adapt or it will die and be replaced. In the meantime, those who need treatment must do the best they can to find programs that offer EBT. The place to start is by receiving an assessment from a psychologist or psychiatrist who is trained in addiction medicine. … A competent doctor can determine the severity of addiction and the presence or lack of co-occurring psychological disorders and prescribe the next step. It may include a brief intervention, therapy, psychopharmacology, an inpatient or outpatient program that offers quality care or a combination of these things.

Sheff’s points are crucial and a matter of life or death for many. For some addiction programs, even “certifications” are simply designed by people who had theories rather than based on research and/or outcome studies. His plea for standard of care for addiction is critical – for the health and well-being, and even life or death, of so many.

Samantha Smithstein, PsyD

(Re)Defining Justice

  • April 13, 2013 10:48 am

Restorative Justice is a process to involve, to the extent possible, those who have a stake in a specific offense and to collectively identify and address harms, needs, and obligations, in order to heal and put things as right as possible.”

– Howard Zehr, 1990

Restorative (or Reparative) Justice is based on the Native American principle that criminal behaviors are offenses against human relationships and that after these behaviors are committed, there are both dangers and opportunities:

  • The danger is that everyone emerges further alienated, more damaged, disrespected, disempowered, feeling less safe and less cooperative.
  • The opportunity is that injustice is recognized, equality is restored and the future is clarified. So that participants are safer, more respectful, and more empowered and cooperative with each other and society.

Restorative justice is a process designed to try to “make things as right as possible” for everyone involved.  That includes: repairing what has been broken, making society safer, attending to needs related to the behavior, and making amends.

Traditional criminal justice seeks answers to three questions: What laws have been broken? Who did it? and What do the offender(s) deserve? Restorative justice instead asks: Who has been harmed? What are their needs? Whose obligations are these?

Restorative Justice can take place in a diversity of settings, including neighborhood courts, schools, therapy groups, and nations. The 12-step community has also attempted to address the need for restoration through steps 8 and 9: making a list of the persons harmed and making direct amends to such people whenever possible. Making amends is different from an apology – one is simply an acknowledgement and expression of regret, whereas the other attempts to create restoration. Sometimes people also talk about “living” amends, which has to do with choosing to live differently so as to not create more harm.

Restorative Justice, or making amends, doesn’t require forgiveness. Forgiveness is a step that the victim(s) may or may not be able or willing to choose. Instead, Restorative Justice seeks to restore and heal, so that everyone may move forward less broken, and more whole.

Samantha Smithstein, Psy.D.

This is your brain on dope(amine)

  • January 25, 2013 11:32 am

Dopamine is a neurotransmitter responsible for movement, pleasure, motivation, and cognitive processes, such as learning. For the purposes of understanding its role in addiction, let’s concentrate on pleasure and motivation.

Whenever we do something that propagates the advancement of our species, dopamine is released in order to motivate repetition of the action. When we sleep, eat, and have sex dopamine is released in our brain and the message is, “That was great, do it again!” We also release dopamine whenever we find something pleasurable. Be it 18th century poetry, heroin, or Radiohead, our brain will release dopamine to encode the stimulus as something that brings us pleasure.

Dopamine not only serves to categorize the good things we encounter in life, it also programs our pre-frontal cortex (the part of the brain involved in judgement and decision making) to alert us when the pleasurable stimulus is available. If your brain cells could talk, it might sound something like, “OMG! There’s a flyer on that lamppost for a Radiohead concert. Go look at it!” In other words, we become hyperaware of opportunities for engaging in behaviors that bring us pleasure. In fact, a study on people with alcoholism found they were more likely to spot alcoholic beverages in a busy photograph than people who don’t have problems with alcohol.

When we consume substances, it makes us feel good because our brains release dopamine, but drugs elicit a higher amount of dopamine release than is necessary. This is part of what causes experiences of euphoria and feeling high. Sometimes the amount of dopamine released is so great, the chemicals in our brain become unbalanced and we may experience hangover or withdrawal. In time, our brain regains chemical equilibrium. However, if one abuses substances, the brain may develop a tolerance (meaning the person needs to use greater amounts to get high) or dependence on the substance as a source of dopamine. If one becomes dependent on a drug, it may take some time for the brain to regain equilibrium and the person may experience extreme physical discomfort and emotional distress when they aren’t using. The period of re-calibration depends on the amount, type, and frequency of the drug used. For this reason, it’s always a good idea to be under medical supervision and receive support from friends, family, and a mental health professional if you’re dependent on a drug and want to stop or decrease your use.

The mechanism of tolerance is also evident in impulse control disorders, such as sex addiction, kleptomania, and compulsive gambling. Although it doesn’t appear that persons with an impulse control disorder undergo the same intensity of withdrawal that persons addicted to substances experience, there can certainly be a period of re-calibration of dopamine receptors during which a person feels irritable and agitated after stopping a behavior.

Based on the information presented here, we can conclude that we are all hard-wired to potentially become addicts and you may be asking yourself, “If this is true, why do some people become addicted and others don’t?” This is a really good question and the answer is “We don’t really know.” We can predict the likelihood of someone becoming an addict based on factors such as first age of substance use and family history of addiction, and we know that a lack of social support and coping strategies (especially when coupled with mental illness) can also lead to addiction, but there is no conclusive answer to date.

The best ways to prevent addiction are to educate yourself about the substances you use (or to abstain from substance use altogether) and to be mindful about the choices you make. If you have a mental illness, ensuring that you are getting appropriate treatment and maintaining social support are good preventative measures.

Jennifer Fernandez, PhD

We Admitted We Were Powerless

  • December 3, 2012 4:13 pm

The very first step of every 12-Step program begins with these words – an admission of powerlessness. For many people, that very first step makes participation in a 12-Step program very difficult and with good reason: powerlessness is an uncomfortable feeling and not one that most people seek out or admit to.

In fact, most of us spend a great deal of energy, time, and effort attempting to try to control things and other people in our lives. We work hard to try to create a life of happiness, as we should. However, these efforts often involve trying to gain control over something we don’t have control of, like an addiction. Other times, the efforts involve trying to change or control other people who are in our lives. And understandably, because the people in our lives – their choices and behaviors – affect us; sometimes profoundly.

But when we stop and look at how effective our efforts are to bend others’ actions to our will – when we really examine how well our efforts to control things go – we find that, in fact, we cannot figure out a way to make others be or do what we want. We discover that using all of our efforts to control someone so they don’t cause us pain doesn’t, in fact, protect us. As the program of Alanon says: we don’t cause the behavior of others, we can’t control it, and we can’t “fix” it. Trying to do so simply makes our life feel unmanageable and increases our unhappiness.

Acknowledging that we are powerless is not about acknowledging that we are weak. Instead it acknowledges what is true, and allows us to focus on the things that we can control and the person who we can help: ourselves. Acknowledging the ways we are powerless also allows us to be more accepting of others, and to find a more peaceful way of being in the world and in relationships.

Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing. Helen Keller

Enjoy Your Life

  • September 1, 2012 8:51 am
Sometimes change is simple, even if it’s not easy

Enjoy your life and be happy. Being happy is of the utmost importance. Success in anything is through happiness. More support of nature comes from being happy. Under all circumstances be happy, even if you have to force it a bit to change some long standing habits.

Just think of any negativity that comes at you as a raindrop falling into the ocean of your bliss. You may not always have an ocean of bliss, but think that way anyway and it will help it come. Doubting is not blissful and does not create happiness. Be happy, healthy and let all that love flow through your heart.

— Maharishi Mahesh Yogi

 

To many, this quote by Maharishi Mahesh Yogi may seem trite, or overly simplistic. And indeed, there are times when we need more than this to create happiness—we may to make changes in our lives or our behaviors, we may need insight and/or healing. We may need transformation through meditation, psychotherapy, or relationship before we can apply new ways of thinking effectively.

However, there is a basic truth to the above quote, as evidenced by Cognitive Behavioral Therapy (CBT); a psychotherapeutic approach that addresses dysfunctional emotions, behaviors, and cognitions through a goal-oriented, systemic process. It is also evidenced through programs such as the 12-Step programs, which helps its members transform, in part, through addressing habits of thought. Programs such as this address a basic truth in the same way Maharishi does: habits of thought create an experience in life, and sometimes we have to consciously change those habits in order to create a different experience, one of happiness.

Addiction or Excuse?

  • September 1, 2012 8:47 am
Public shaming is counterproductive and simply wrong.

Whether it’s food, alcohol, or sex, there are a number of people who react strongly to hearing that someone has engaged in self-destructive behaviors because they are an addict by saying, “Don’t use addiction as an excuse for your behavior! Take responsibility!”

This concept of an “addiction excuse” is relatively new, and while it captures the imagination of those who are hurt, angry, or frustrated by the behavior of an addict, or by someone who lacks basic understanding of addiction, it simply doesn’t hold water for people who are addicts or those who work with people who struggle with addiction. People who speak about addiction as a “convenient excuse for bad behavior” or a “way to not take responsibility,” don’t comprehend what addiction is, and what the experience is like for the person who struggles with it.

Addiction is a psychological and physiological disorder. Even for “process addictions” such as those related to eating, sugar, sex, gambling, and stealing, there is strong scientific evidence that the neurological pathways related to dopamine are activated similarly to an addiction to cocaine. So addiction is not something made up by people to explain something away, it is a real condition, with both biological and psychological underpinnings.

For the vast majority of people who suffer from an addiction or impulse control disorder, acknowledging an addiction is one of the most difficult steps they will ever take. Most are in denial for years, believing in the “free will” that addiction naysayers speak about; addicts want to believe they are in control, and can stop any time they want. Many struggle for years to gain that control and feel deep shame when they fail, again and again.

Acknowledging an addiction, therefore, is an incredibly important first step. No problem can be solved if the problem is not acknowledged. Until someone admits, “I have lost control of this situation and can’t stop myself,” they cannot possibly be open to learning and working on the steps it takes to change their behavior. To the addict, acknowledging an addiction may be the most difficult, shameful, and scary step they take … but is also a crucial first step in saving his or her life. In fact, rather than being about shirking responsibility, acknowledging an addiction is the first step to taking responsibility.

As a society, we must stop shaming them further by telling them that acknowledging their addiction is an “excuse” and that they should “take responsibility for acting badly” and just feel ashamed. Instead, addicts must be supported in their first step and invited to take the many steps— psychological, physiological, spiritual, and emotional—that must take place for them to become well.

It may be that part of what people are reacting to is the overwhelming list of addictions that we hear about these days. People have begun to feel as if it is an overused term, and that there simply can’t be so many people in our society addicted to so many different things. Sadly, this is also not something that is made up. It doesn’t take much work to look around and see the sheer numbers of people who are addicted to food, shopping, electronics, alcohol, drugs, gambling, sex, and the myriad of ways available to us to avoid the profoundly beautiful but sometimes acutely painful process of being human.

Samantha Smithstein, Psy.D.

Stealing or Stealing Madness? And Is There A Difference?

  • June 8, 2012 2:37 pm

When most people think about theft they think about criminals who steal possessions of other people in order to resell them and make money. Or the identity theft who is able to steal money out of the bank account of others. The “criminal” who profits from stealing from others rather than working for his or her money. But there is a different kind of stealing – stealing that people do when they don’t “need” to. People who compulsively steal and experience intense urges, obsessive thoughts and elaborate rituals and planning.

Recently a high tech executive was arrested for forging bar codes on Lego toys, purchasing the Lego’s way below value and reselling them on EBay and making thousands of dollars.  When this hit the news he was being called “a man with an obsession” because he couldn’t possibly need the money and could well afford to pay full price.  Maybe it was because he was a highly educated individual and it’s harder to think about those with status and privilege really having a stealing problem, but on the surface he appears to be suffering from kleptomania, or compulsive stealing.

What about the rest of us who are not “criminals” or suffering from compulsive stealing?  Are people such as this executive so different from us? Consider for a moment, you are going on a trip and in order to make reservations and  you need to submit a copy of your passport.  You take your passport into work, make two copies, and mail it in with your application, which you print out while you are there.

Is this stealing?  It depends on what the policy is at the office, but most likely it is, since office equipment and paper was not likely purchased for employee personal use.  Is it something you are likely to get fired for?  Probably not, but it may depend on just how many copies you are making and how strict the workplace is.

The above example represents the myriad of ways that people steal every day, without even thinking about it.  Whether we make copies at work, walk off with a pen we borrowed, use someone’s unsecured wifi, or don’t report the income from a garage sale on our taxes, most of us steal in some form or another during the course of our lifetime and even on a regular basis.  If we do think about the fact that we are stealing, we typically rationalize it, telling ourselves that “a few pieces of paper and a little ink is a drop in the bucket at work” or “I’m only making a few dollars at the garage sale – the government doesn’t need this money as much as I do.”

Why is this important to think about? When most people think about stealing, we think of it as something “I would never do” and hold ourselves as separate from “people who steal” – we assume the person caught stealing is simply greedy and only in it for themselves.   But whether we don’t tell the server they forgot to include a drink in the bill, pocket a pack of gum at the grocery store, or rob a bank, the common thread is the rationalization in our mind that makes it possible.  This distancing may be part of why we are so blind to how commonplace the problem is in our society, or why the field of psychology is not thinking enough about stealing and what the thoughts and behaviors are telling us about the person committing the acts.

Larry came into treatment in order to deal with his stealing issues.  Larry was diagnosed with kleptomania and bulimia (he threw up and over-exercised after over-eating).  He was a well-educated having attended and graduated from a prestigious college prep boarding school and an Ivy League University.  He was under employed, frequently complained of boredom and struggled with personal and professional relationships.  It was difficult for Larry to open up and be honest in therapy. Overtime he began to trust his therapist and group members.  He shared that he felt incredibly out-of-control and ashamed of his obsession with stealing.  He shared that his problem wasn’t only the everyday simple shoplifting it went much deeper.  Over several years he had been going to music stores and large big box store that sold DVDs.  He would purchase the DVDs and then with painstaking care using exacto blades, hot glue guns he would slowly and carefully unpackaged the DVD’s, take them out and upload them to his computer and then repackage them and return them to the store for a full refund.  It took hours upon hours and he expressed that it gave him and incredible high and a tremendous sense of accomplishment and he felt less guilt having returned the merchandise. 

In the example above, as well as the recent case of the executive who stole Lego kits, or an individual who purchases an outfit, wears it to an event, and then returns it, these actions take more planning to execute than simply walking off with a pen.  However, oftentimes these individuals don’t need the money from these transactions, in the same way that you can afford the pen you walk off with (or afford to pay the taxes on the earnings from the garage sale), and so the motive for the stealing, and the subsequent rationalizations, are often complex. But these rationalizations, similar to the distancing, keep us from acknowledging the ways we steal and how commonplace it is in our society – and keep us from being able to effectively help those who steal compulsively and need it.

Samantha Smithstein, Psy.D.

Elizabeth Corsale, MFT

When Is Therapy Done?

  • March 27, 2012 3:27 pm

Everyone who has been in psychotherapy has had the question arise: When am I done here?

This question is a good one, as there is no obvious ending point for psychotherapy – it isn’t like a course of antibiotics, or a broken bone, when the ending of treatment can be prescribed.  With psychotherapy, the ending has to do with 1. the goals of the therapy (which can grow and change), 2. the ability of the therapist to adequately address those goals and 3. the ability and/or willingness of the patient to do the work necessary to complete the goals.

Let’s address each of those questions individually.

1.    Have I achieved the goal(s)?

This question is an interesting one.  Often, people come into therapy with acute problems which tend to improve after a while, sometimes within several months.  If the goal was to address these acute problems, there can be a perception on the part of the patient that therapy has done its work and they are therefore done.  That is certainly one way of looking at it but is it a good enough reason to end therapy?

Often the improvement someone experiences is because they have been able to identify the problem, learn new communication skills, and experience being heard through nonjudgmental inquiry and feedback from the therapist.  They learned their part in their problem and/or the psychological impact of the problem and have been able to begin to talk freely about the problem.

However, several months, or even a year, is usually not long enough to address the underlying vulnerabilities that led to the acute problems in the first place.  This makes the person highly vulnerable to repeating the acute problems in the future.  It is also not typically long enough to create a lasting change, so that the person may find that they are coping better but they have not made the deeper changes that address their orientation to life, work, or relationships.  If the goal is to have fewer symptoms and feel generally better, that goal might have been met, but if the goal is to have a broader understanding of themselves and a shift of perception enough to implement lasting change, they may not be.

Take, for example, the case of Marty: Marty came to therapy to try to figure out why she was so burnt out in her chosen field as a creative director in an advertising agency.  Her goal for therapy was to get back her passion and excitement about her work.  Through therapy she discovered that it wasn’t really her work that was the problem.  She and her husband were parenting three teenagers and had very little time for themselves and each other.  Her therapist came to feel that an underlying issue was Marty’s lack of self-care, and began to work with Marty on it. Marty discovered it wasn’t that easy.  It was easy to support her husband to go swimming and get back to his passion for woodshop.  But for some reason she couldn’t seem to sign up for yoga, painting and ask her kids to pitch in more.  Slowly her therapist suggested that perhaps they needed to look a little more closely at her childhood growing up with an alcoholic mother and father.  Marty was willing to consider adding this to her goals and realized that she was never very good at taking care of herself, she was good at surviving in an out of control alcoholic family.  After a few months she was able to sign up for yoga and a few months after that she signed up for weekend painting class.

As in the example above, deeper work often means a revision of the goals.  Sometimes it means that the therapist and patient do not have shared goals – the therapist may see the potential for greater change and the patient may not be interested (see #3).  But often as the patient and therapist work together they come to see that there are goals that were not initially apparent.

2.    Is my therapist capable of helping me achieve my goals?

This is also a very important question and one that can be difficult to assess.  Sometimes people encounter frustration with their therapist and feel they must leave – that they are not done with therapy but done with that therapist. This very well may be an accurate assessment on the part of the patient: even if people seek specialists for their particular problem, or they get a recommendation from someone who they know, not every therapist can work well with every person – there needs to be a “fit” for the therapy to work.  Additionally, some therapists are more skilled than others.

However, often people underestimate their therapist and leave instead of working with their therapist to see if the frustration can be resolved.

Take, for example, the case of Sue and Dave: Sue and her husband Dave brought their child to a therapist because they had reports from school that he wasn’t doing well academically and were concerned that their son had an emotional issue that was causing him to lose concentration.  Sue and Dave luckily saw an adult & child psychologist, Dr. Lee, who not only specialized in mood disorders but also in learning disorders.  After an initial evaluation the psychologist told them that he felt their son didn’t have mood based learning problems, rather he suspected the neurological based learning disorder dyslexia.  Initially Sue and Dave were upset by this thought, and felt Dr. Lee was the wrong therapist for their son. However, after discussing it further with Dr. Lee they agreed to testing and discovered Dr. Lee had been correct.  Dr. Lee was able to work with the family to help them accept the diagnosis, including the depressed feelings Dave initially experienced as a result. Dr. Lee was able to support Dave to work on all his feelings and now both Sue and Dave are involved parents and advocates for their son, and their son was able to receive the help that he needed.

Often, the therapist and patient can work through the impasse together and the process itself can be a very effective part of the therapy.

3.    Am I willing and/or able to do the work necessary?

This final question is crucial.  The process of therapy is intense and powerful. Often when people find their symptoms are (temporarily) alleviated, they feel incredible relief, and this feeling of relief allows them to feel the possibility of wellness.  Typically, as they continue in therapy, they then begin to feel uncomfortable. The therapy process begins to take a deeper look into the person and his or her life. Unpleasant feelings can emerge, such as feelings of dependency, or a deeper unhappiness.  More subtle thought distortions, relationship patterns, or acting out can begin to be revealed, and all of this can be frightening or make the patient feel worse.  This is a common time when people have the urge to leave.

Take, for example, the case of Tony: Tony came to therapy after his partner discovered Tony’s compulsive sexual behavior involving internet pornography, multiple affairs and frequent encounters with prostitutes.  His partner had told Tony if he didn’t get help to stop his behaviors, she would leave and take their three kids with her.  Tony was motivated to change, got into an intensive outpatient treatment program, joined a twelve step program and his wife joined a support group. Tony was hugely relieved that things started to calm down at home and he and his wife were finally able to communicate without painful arguments.  Six months into the therapy, Tony had a very deep session with his therapist acknowledging he thought he’d been depressed since his mom died when he was eleven years old.  A week later Tony came to therapy stating he was confident he was over his problems and decided after six months of no longer acting-out in his sexual compulsivity he was done.  His therapist asked him if he thought he’d touched on something very painful when he had brought up his mother and that he had more work to do to grieve her loss and look at the corresponding depression he’d had since that time.   Tony disagreed and in a couple of days sent her an email stating he would not return.  His therapist called him back and told him that her door was always open to him and encouraged him to consider a final session for closure.  Two months later he returned to therapy and said his wife had caught him again on an internet pornography site. His twelve step sponsor said he was still in his addiction and he needed to get additional help of therapy to get and stay sober.  He acknowledged he wasn’t done and indeed was really just getting started.  Tony later learned that when he had been in so much pain remembering his mother, it wasn’t his sober adult mind doing the thinking and acting, it was the addict defensive part of his mind that was telling him to run and hide from therapy. That was a part of his mind that had developed to help him survive a traumatic event when he was young but it was no longer helpful – it was self-destructive.

People spend a large portion of their lives acting without knowing really why or where the action is coming from.  Part of the goal of therapy is to develop a mind that can think “real thoughts” versus automatic responses, awareness of feelings and ability to tolerate them, so that conscious decisions can be made and intimacy can be created.  The discomfort – experienced as frustration, irritability, restlessness, sadness, pain, anger, unhappiness, etc – can be an indication that the real work can begin – the work of discovery and healing.  The deeper problems are now within reach and are available to be explored and resolved.

Samantha Smithstein, Psy.D. & Elizabeth Corsale, MFT

Our Thirst for Wholeness

  • February 3, 2012 11:49 am

The majority of people’s problems are caused by the fact that they are disconnected with the rest of creation. (C.S. Lewis)

 We came to believe that a Power greater than ourselves could restore us to sanity. We made a decision to turn out will and our lives over to the care of God as we understood Him. (Steps 2 and 3 of the 12 Steps of AA)

In his correspondence with Bill Wilson, co-founder of Alcoholics Anonymous, the psychologist Carl Jung stated his opinion that craving for alcohol was really “the spiritual thirst of our being for wholeness.” In their book on Maharishi Ayur-Veda, Transcendental Meditation, and treatment of addiction, authors David O’Connell and Charles Alexander state that in addition to genetics and physiology, “addiction arises from the ‘mistake of the intellect,’ known as pragyaparadha, in which one perceives one’s self not in terms of the wholeness of pure consciousness (the Self), but rather as a highly limited individual personality burdened with conflicting impulses and feelings, cut off from the wholeness of pure consciousness.”

In an article titled “The 12 Steps: Building the Evidence Base” that appeared in the May 2009 issue of Addiction Professional magazine, Valerie Slaymaker, Ph.D., reviewed a series of studies examining the role of spirituality in addiction treatment. In the introduction to her article, she acknowledges the difficulty of defining spirituality.

“Spirituality is a difficult concept to study scientifically,” she states. “Ask 10 people how they define spirituality and you will receive 10 different answers. To some, spirituality implies a connection with the metaphysical, whether that is a traditional concept of God or a nontraditional concept of a higher power. To others, spirituality is intertwined with religion and formal, organized practices such as church attendance and group prayer.”  That said, spirituality has become an integral part of many forms of treatment for addiction. “Despite differences in conceptualization, and challenges with measurement,” Slaymaker state, “scientists have begun to examine spirituality’s role in recovery from alcohol and drug dependence.”

Slaymaker found that studies suggest that people with a spiritual belief system are less depressed, less anxious, and less suicidal than non-spiritual people, and that they are better able to cope with stressful and traumatic events. Those who incorporate spirituality into their daily lives through meditation, prayer, and other spiritual practices report having a more positive outlook and an overall sense of satisfaction with life.

Dr. Slaymaker also pointed to research that compared individuals in treatment for alcohol use who relapsed with individuals who maintained abstinence. Although all participants demonstrated significant initial increases in spirituality scores (measured by spiritual experiences, gratitude, tolerance, humility, and other factors), those who relapsed showed significant declines in spirituality scores in a three-month follow-up. Still other research highlighted by Dr. Slaymaker has shown that higher spirituality levels directly relate to improved treatment outcomes and life satisfaction.

Many people have a negative experience of religion.  Throughout the course of human history, people and cultures have committed horrible deeds in the name of religion, and individuals have preached messages in the name of religion which have turned many away from the concept of God or spirituality. Still others have never been exposed to a healthy spiritual community or tradition, and are bereft of regular practice that gives them the spiritual experience they need.  In addition to contributing to depression, anxiety, and other mental health issues, this lack of experience can contribute to a spiral into addiction, just as gaining regular spiritual experiences can help lead the way out.

So how does one cultivate a more spiritual life? There are many paths to expanding spiritual connection, some formal and others not. Twelve Step programs, organized religion, some forms of therapeutic treatment, meditation, and yoga are all more formalized paths. Going for a hike in the woods is not. In his letter to Bill Wilson, Carl Jung address it by stating his opinion that “The only right and legitimate way to such an experience is that it happens to you in reality, and it can only happen to you when you walk on a path which leads you to a higher understanding. You might be led to that goal by an act of grace or through a personal and honest contact with friends, or through a higher education of the mind beyond the confines of mere rationalism.”

In addition to psychologists, other scientists have articulated the importance of spirituality. Francis S. Collins, MD, head of NIH, has written about his views on God and how spirituality fits with his experience as a doctor and scientist. “Science is not threatened by God,” he writes, “it is enhanced.” Albert Einstein wrote about how living without an expanded consciousness is like living in a prison. “A human being is part of the whole called by us universe, a part limited in time and space,” he wrote. “We experience ourselves, our thoughts and feelings as something separate from the rest. A kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from the prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty. The true value of a human being is determined by the measure and the sense in which they have obtained liberation from the self. We shall require a substantially new manner of thinking if humanity is to survive.”

However one cultivates it, the cultivation of a spiritual life must be conscious, purposeful, and regular to be effective.  While the rigorous separation of church and state in the US gives everyone a right to pursue their own path of connection to something more expansive then our own self, this leaves the task of finding that path up to us.  And find it we must.

Like the air, God’s grace is available to us. It is permeating every fiber of Being and the Being of the entire universe. When we take our attention to that Being, finer than the finest, then we establish ourselves on the level of God’s grace. Immediately we just enjoy. Life is Bliss! (Maharishi Mahesh Yogi)

Samantha Smithstein, Psy.D.

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