Friday, June 23, 2017

Can I really get off this stuff?

My friend is an experienced psychologist, counselor and professor.  He introduced me to the area of motivational interviewing.  The general problem of people wanting to do something but somehow failing to do it is a widespread one.  Motivational interviewing is a process where a counselor talks to a client with the goal of helping the client deepen personal motivation to work toward accomplishing the desired aim, whether it is less smoking, more exercise or something else.

I read Margaret Talbot's moving and helpful article in the New Yorker "The Addict Next Door" about the opioid epidemic as it shows up in Martinsburg, West Virginia and other places like parts of New Hampshire and Vermont.  I had been hearing about this opioid stuff but I didn't really pay attention until I saw that AARP article.  Whether it is alcoholism, domestic violence, screen time addiction or some other habit/behavior problem, motivation and self-knowledge are fundamental to making a change of the desired kind.

For whatever reason: basic curiosity, greater understanding of myself and others, I want to know more about motivational interviewing so I watched Dr. Bill Matulich on YouTube

From previous study and experience, I have learned that in many interpersonal situations, it works much better to listen reflectively and make I-statements.  Listening reflectively is the business of just listening with some rephrasing now and then that shows I have been listening and I am getting the message.  Making I-statements is making other comments about me and my state rather than telling the other person how he feels or what he should do.

A new understanding that I got from the short video above is ambivalence.  That is the situation where I want to change but I don't want to, either.  I know change would be good for me but I really like those cigarettes.  I have liked them.  I know they are hard to give up.  So, I am torn between yes and no.  That push-pull is itself unpleasant and internally embarrassing and irritating.  If I just have another smoke, I will have put aside my effort to quit and I will get a shot of nicotine.  If I feel like I am a weakling anyway and I doubt I am going to be able to quit, why not end the torture of deprivation and the added upset of wondering how well I am going to do in this quitting project.  

I hadn't really focused on the ambivalence alone but I can see that it is a force to be reckoned with.

In reading about the opioid problem, I also learned that continued use of heroin or its derivatives, including the lab medicine fentanyl, which is 50 to 80 times as powerful as morphine, increases the body's tolerance for the drug without making the body more able to handle it.  These drugs are central nervous system depressants, the heart and lungs.  While they deliver a dreamy state temporarily, the body needs more and more of the drug to get into that high so it is pretty easy to take enough to stop the heart and breathing, once the user is sufficiently experienced.

Without work on one's mind and thinking habits, it is possible to come close to stopping the heart and lungs, get an antidote drug and go back out and do it all again, this time using a bit more of the stuff. Famous quarterback Brett Favre had a similar problem but stuck to his treatment regimen and got out of it.

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