Originally published by Democracy Now! Febuary 15, 2010

The Vancouver-based Dr. Gabor Maté argues that too many doctors seem to have forgotten what was once a commonplace assumption—that emotions are deeply implicated in both the development of illness and in the restoration of health. Based on medical studies and his own experience with chronically ill patients at the Palliative Care Unit at Vancouver Hospital, where he was the medical coordinator for seven years, Dr. Gabor Maté makes the case that there are important links between the mind and the immune system. He found that stress and individual emotional makeup play critical roles in an array of diseases. (Transcript)

About Dr. Maté: Vancouver, Canada-based physician and author. He is staff physician at the Portland Hotel Society, which runs a residence and harm reduction facility as well as Insite, North America’s only supervised safe-injection site. His four books, all bestsellers in Canada: Scattered: How Attention Deficit Disorder Originates What You Can Do About It, Hold on to Your Kids: Why Parents Need to Matter More Than Peers, When the Body Says No, and his latest, In the Realm of Hungry Ghosts: Close Encounters with Addiction.

Unemployed? Need help with succeeding in your job search? Join us for a 6 week free online job search support program.

Being out of work can trigger a cascade of stressors that correlates with anxiety, down moods, and painful conflicts, thus making sticking to your recovery goals more challenging.  With the holidays approaching, SMART Recovery will provide a six-session on-line voice program on handling job-loss stress and on effectively using standard and innovative techniques to get reemployed. The program is open to anyone who wants to get reemployed including people with or without substance abuse challenges, so if you have a loved one in need of a job, please invite him/her to participate.  Each session will briefly start with a different theme, such as how to sustain realistic optimism in tough times. Thereafter, each session is open to all topics you want to bring.

Dr. Bill Knaus is our program leader. Bill is a licensed clinical psychologist, former psychology professor, and jobs expert. Bill was one of the original Directors of Training at Albert Ellis’ REBT institute. He has authored 20 books on diverse topics, such as illusions, anxiety, depression, blame, and overcoming procrastination, where he is the top authority. He wrote the original “SMART Recovery Quick Start Primer” that helped launch SMART.   Bill’s newest book is “Fearless Job Hunting”. Bill will bring in other top experts in REBT and job searches. He will post a free crash course on job hunting, and other material on getting a job.

The sessions will take place for 6 consecutive Mondays, beginning December 6th and concluding on January 10th.  The meetings will be hosted in one of the SMART Recovery voice meeting rooms – The SMART Room – at noon eastern time, and each will last 30-45 minutes.

To access the SMART Room, you will need to register for SMART Recovery Online (if you haven’t already done so).  This can be accomplished via www.smartrecovery.org.  Click on the online activities drop down and select “register SMART Online”.  Once registered, you will access the message board and select the “SMART Recovery Chat and Meeting Rooms”. The SMART Room will be on the list of available meeting rooms, and will be opened at 11:45 a.m. Eastern Time each Monday for the 6 weeks.

We are grateful to Dr. Knaus for volunteering to do this helpful and critical service to our community and beyond!

S.

Shari Allwood

Executive Director
SMART Recovery
7304 Mentor Ave., Suite FMentor, OH 44060
PH: 440/951-5357    Fax: 440/951-5358    Toll Free: 866/951-5357
Email: sallwood@smartrecovery.org Website:  www.smartrecovery.org

That voice we all hear in our head telling us to engage in destructive behaviors can be very convincing: it will try to rationalization, make up excuses, and lie relentlessly to get its way. So how do we fight giving in? Most people understand how to win an argument with a two-year old: don’t argue. Similarly, the way to fight an urge is to not argue with it. Put your foot down, and say NO to the urge. Instead of arguing with every well rehearsed reason the urge will throw at you, engage in a different conversation with yourself.

DISARM

Destructive Self-talk Awareness and Refusal Method (DISARM) is a tool which exposes the self-talk and images which tell us to use. It challenges those urge-producing thoughts at every opportunity, shooting them down and eventually reducing them to the point of absurdity. All humans, not just humans with substance abuse problems, have thoughts, urges, or other impulses, which, if followed, would harm their long-term interests. Realizing the power to control what we think and believe, especially about our strong urges to use, and understanding how to change the distorted thinking is crucial to success.

“It is a man’s own mind, not his enemy or foe, that lures him to evil ways.” ~Siddhārtha Gautama

We are wise to learn how to make ourselves aware of our destructive self-talk: the thinking that is contrary to our values and long-term interests. Once we recognize it, we can then adamantly refuse to go along with it.

When a strong urge is recognized, ask and answer the following questions:

1. Question: Do I have to give in to the urge because it is intense and hard to resist?
   Answer: No, I don’t have to give in. Because the urge is strong, it would be easy to give in, but I don’t HAVE TO. I have had urges that I did not give in to, therefore it must be possible to resist.
2. Question: Will it be awful to deny myself by not giving into the urge?
   Answer: No, it won’t be awful. It may be quite unpleasant, but unpleasant is not awful, it’s just unpleasant. If I don’t give in to the urge, it will get weaker and come less frequently. If I do give in, the urge will stay strong, be harder to resist next time and show up more frequently.
3. Question: Is it really unbearable not to give into this urge?
   Answer: I don’t like the way it feels to deny my urge, but since it doesn’t kill me not to give in, I can keep on resisting. (Remember, individuals drinking large amounts of alcohol may need to go to a detox center when they first stop because the sudden end of alcohol really could be injurious.)
4. Question: Am I somehow entitled to be able to give up using without strong urges to go back to using?
   Answer: No! I don’t have a note from God, my mother, or anyone else which entitles me not to have strong urges to use. It may be unpleasant to resist some of my urges, but no one gave me a ‘get out of unpleasantness free’ card.

We cannot simply will ourselves to not have certain thoughts and feelings. However, we can learn how to recognize the thoughts driving urges and how to refuse to go along with them: we can learn to DISARM them. We can then walk away from the situation, or get our mind involved with something else, rather than dwelling on the urge to use. DISARM allows the individual experiencing the craving and to carefully and rationally answer a few key questions. The results of using DISARM will help an individual to understand that urges can truly be overcome. As success is experienced, the urges will eventually become less strong and will occur less frequently.

DISARMING the ‘ENEMY’

Some people find it helpful to use a technique to dissociate themselves from the voice inside each of us which says, ‘It’s a good idea to do something self- destructive.’ It is a game you can play with yourself, which might help you to:

1. Identify the specific thoughts which, if followed, would lead to using when you have already decided that, in the long term, this choice is not for you, and
2. Steadfastly refuse to go along with this thinking no matter how attractive it might seem.

Instead of talking yourself into lapsing you can develop powerful countering and coping statements. To do this, it may help to invent and personify an ‘enemy’ who lives in your mind, and whose only purpose is to get you to use. The Enemy (your alter ego) knows you well, and can change form to take advantage of your weakest moments. Name your enemy (i.e., salesman, gangster, diplomat, bad cop). When urges come, ask yourself, ‘What is she/he telling me now? How is she/he trying to trick me?

When thoughts are identified:

1. Without debate, ATTACK the enemy with powerful counter statements: ‘Nice try, jerk. You can’t fool me!’ You can be as aggressive or profane as your nature allows with the Enemy – after all, it’s trying to screw up your life.
2. Then quickly FOCUS on some other thoughts, images, or activities which are consistent with what you want in the long run and inconsistent with what the Enemy is saying. The Enemy then looses its perceived power and fades away.

Once the urge has passed, you can submit the Enemy’s tricks to an ABC analysis in order to rationally dispute them. You usually discover irrational themes and patterns to the thoughts and arguments the Enemy throws at you. While the coping statements used in DISARM alone will often work, it is important not to omit disputing. If your coping statements aren’t working, it is because you don’t believe them as strongly as you believe the Enemy. Through disputing we can develop powerful coping statements you fully believe for use in the future. Through actually resisting the Enemy’s suggestions, you become increasingly more skilled at doing it.

Why do we harm our selves by choosing destructive habits? Is it because things like alcohol and drugs have some mysterious power to control us? No. We choose our actions based on our experiences, our habits, and the way we think. If we want to change our destructive behavior we must change; we must learn to choose different solutions to our problems.

“Our liquor was but a symptom. So we had to get down to causes and conditions.” ~William G. Wilson, The Big Book, page 64.

We can simply choose to avoid the substances and experiences that are destructive. I have heard the term “white knuckling it” to describe this solution: it is uncomfortable, difficult, and usually leads back to our destructive behavior as a way to relieve the pain. We must understand that we choose those behaviors because on some level, they work. When we simply stop the behavior without finding a more beneficial alternative, we suffer. Avoidance does not eliminate the underlying thoughts, beliefs, and lack of knowing of alternatives behaviors that drew us to the destructive behavior in the first place.

In this video Sogyal Rinpoche discusses how the mind works to perceive the world around us. As he explains, we must look inward to get to the root of suffering rather than focusing on the external symptoms. We can change to address the causes of our condition, and we can address the real problem we were trying to fix with our destructive behavior.

“All men’s miseries derive from not being able to sit in a quiet room alone.” ~Blaise Pascal

To explain some of the terms used in this video for the non-Buddhists: “Samsara” refers to a general state of overt or subtle sufferings that occur in day to day life. “Nirvana” is the state of being free from that suffering.

Thank you to Darren Littlejohn, The 12-Step Buddhist, for acquainting me with Sogyal Rinpoche’s videos.

Rational thinking presents a vivid contrast to its illogical opposite: It is based on reality – it emphasizes seeing things as they really are, keeping negative events in perspective, tolerating frustration and discomfort, preferring rather than demanding, and self-acceptance. This way of thinking helps you achieve your goals and purposes; It creates emotions you can handle; and It helps you behave in ways which promote your aims and survival.

I’m not talking about so-called “positive thinking”. Rational thinking is realistic thinking. It is concerned with facts – the real world – rather than subjective opinion or wishful thinking.

Realistic thinking leads to realistic emotions. Negative feelings aren’t always bad for you. Neither are all positive feelings beneficial. Feeling happy when someone you love has died, for example, may hinder you from grieving properly. Or to be unconcerned in the face of real danger could put your survival at risk. Realistic thinking avoids exaggeration of both kinds – negative and positive.

In Buddhism, the fist step on the Eight Fold Path is “Right View.” This simply means to see and to understand things as they really are. When our view of the world is clouded by irrational though, we impose our interpretation on the world instead of accepting the reality of how it actually exists: this can cause suffering. Right View is the cognitive aspect of wisdom. Right View is not necessarily an intellectual capacity, just as wisdom is not just a matter of intelligence. Instead, Right View is attained, sustained, and enhanced through all capacities of mind. Since our view of the world forms our thoughts and our actions, Right View yields right thoughts and right actions. This is a skill that with practice, we can mastered. By recognizing our irrational beliefs, and  choosing to changing them, we can start to see and accept the world as it exists.

In Rational Emotive Behavioral Therapy (REBT) certain core self-defeating and irrational beliefs, which have been clinically observed, are understood as the root of most disturbances in our life.

Below are twelve examples of common irrational beliefs, and contrasting rational thoughts.