If you’re like our clients, you started this book under the assumption that you’ll be happy when . . . your loved one goes into rehab, gets out of rehab, stops using, has been abstinent for some time. . . . By now, however, having seen some improvements resulting from her efforts to change along with your efforts to encourage her, we hope you’re more receptive to the idea of thriving sooner rather than later, on your own terms. This chapter will help you synthesize skills from throughout this book in the service of building a better life for you.
The coping chapters aimed to help you develop awareness, acceptance, tolerance, and self-caring as well as some limits to prevent yourself from going over the edge. Now it’s time to aim higher, to go beyond acceptance and distress tolerance to doing things that make you happy, things you may have put on hold when worry for your loved one consumed you. We hope now you can build on the resilience you have gained through coping with distress and paying attention to your basic needs. It is time for you to set goals for your life, independent of your relationship that is affected by substance problems.
Though it may not feel like it now, you have all the skills you need to thrive. You know how to carry on despite lapses and relapses. You can remember that ups, downs, and setbacks are normal, though not inevitable. In fact, as you develop other sources of happiness besides your loved one’s sobriety, you’re less likely to be knocked over by her struggles. And when you know how to set doable goals and solve problems, you don’t have to fear so much what will happen next.
This chapter is structured like one big goal-setting and problem-solving exercise, framing subpar happiness levels as problems to be solved.
Take a minute to revisit the Happiness Scale in chapter 4 (pages 99–100). While it might not look like much, it’s both a thermometer for now and a guide for how to proceed in (re)building your life. Just as the Behavior Analysis was your map for helping your loved one, the Happiness Scale can be your map to helping yourself. These exercises will help you develop awareness of what’s missing in your own life that you would like to restore, with specific areas you would like to target.
This should be the fun part of helping (remember: helping yourself helps), except that family members often feel conflicted about having any fun themselves, as if it meant they were ditching their loved ones and responsibilities. Few people would argue that a balanced life is a bad idea, but when it comes to actually planning what you’re going to do to feel better, you may feel guilty about pursuing happiness independent of your loved one. We hope that after all you have read, you can see that your health and happiness are neither superficial nor irrelevant; they are necessary. If you are stronger and lighter at heart, more confident, more relaxed, less depressed, and less angry, you will be better equipped to help directly. If you’re not convinced that you deserve to be healthy and happy for your own sake, remember:
• Role models of good, healthy self-care might be in short supply elsewhere in your loved one’s life. Attention to your own self-care can act as an example.
• People struggling with substance abuse often carry tremendous guilt about negatively impacting the lives of people they love and may use substances to numb this awareness. Your happiness can help alleviate that burden and allow your loved one to get on with the business of making changes for himself.
• If you have been labeled “the problem” by your loved one—for being angry, anxious, controlling, or smothering—taking care of yourself can help you keep these emotions and behaviors in check and prevent your loved one from looking at your problems more than his own.
You don’t have to deny the problem at hand in order to take care of yourself and enjoy other parts of your life.
Once you have a score for each area of your Happiness Scale, take a moment to consider that it’s normal to not be perfectly happy with every area of your life. Next, note the areas about which you feel more happy than unhappy, that is, areas you scored 6 or higher. Take a moment now to appreciate this happiness. Count your blessings, but don’t just count them; see if you can really feel the happiness in your heart. Too often, people let unhappiness in one area cancel out happiness in another.
Then, try to see low scores not as failings, but potential. Let them prompt you to act. Consider friends, family, counselors, spiritual advisers, and other potential sources of support. Consider therapy, where a comforting ear and helpful suggestions could make a difference. Perhaps you could use a break from “the problem,” in the form of a vacation or personal day(s) off work. Some people need a more structural change in their relationship, like a temporary separation or sleeping in another room—painful actions to take, but sometimes warranted. Refer to the suggestions and exercises in chapter 6 to determine where your limits need to be and what you can do to protect them.
Pick an area of the scale that interests you. Perhaps it’s something you’ve been meaning to get to or something you’d forgotten all about. It should be an area that could use improvement, but ideally where your happiness score is not too dauntingly low. The idea is to set yourself up to succeed with doable goals.
You may feel inspired to work on more than one area, but in the name of simplicity and achievability, we suggest you start with one for now. Hold those other thoughts, and come back to them later.
Some changes are easier to make than others, often depending on how immediate or delayed the rewards. Thriving eventually generates its own momentum—when something makes you happy, you want to keep it going. But it’s not all tiptoeing through the tulips, especially in the early stages of making a change. Exercise is a classic example; it may not feel so good at first if you’re out of shape. Even the more immediately rewarding activities, like coffee with a friend, or an afternoon catnap, may not come easily if you’re not in the habit of doing them. You might sincerely wish to catch up with an old friend, but for that you would need to make time in your already strained schedule. And how are you supposed to nap if all you can do is worry?
So, when the goal is your own change, keep in mind that pessimism, distraction, and inertia will always be obstacles to some degree. You can treat each goal as a problem to be solved, according to the problem-solving steps you know from chapter 8:
1. Define your goal—just one, and make it doable.
2. Brainstorm possible solutions, the more the better.
3. Eliminate unwanted ideas, anything that on second thought you can’t imagine yourself actually doing.
4. Select one potential solution that you can imagine yourself doing in the foreseeable future.
5. Anticipate possible obstacles.
6. Address each obstacle. (If you can’t solve each obstacle, pick a new solution and go through the steps again.)
7. Give yourself the assignment. Decide exactly when and how you’ll execute your solution. Then do it!
8. Evaluate the outcome. If you ran into unanticipated obstacles, address them and commit to trying again.
The only person you know better than your loved one is yourself, and awareness will help you see how you get in your own way of change. Many of our clients come to realize that their own thoughts can be one of the obstacles; thoughts like: “I’m too busy,” “This is ridiculous,” “I don’t deserve this,” or, “If I have any free time, I should do something ‘productive.’ ” If any of this sounds familiar, try thinking of a really good comeback—to yourself.
Cognitive-behavioral strategies are not just for substance problems; they are among the most effective for dealing with anxiety and depression and for improving self-care. The cognitive parts of these strategies help people change their own judgmental or helpless thinking by working with thoughts as habits like other behavior patterns, to be replaced with healthier, less negative, and more constructive thoughts.
Notice a few of the thoughts that typically get in the way of doing something for yourself. How do you talk yourself out of it? Common ones we hear from clients include “I’ll do it later” and “I probably won’t like it.” After you identify yours, consider alternative thoughts, or what comeback might feel most convincing to you. You might counter “I should do something ‘productive’ ” with “I’ll actually be more productive later if I take time for this now,” or “I’ve allotted plenty of time for productivity—this is my time for rest,” or “Productive schmucktive, this is important too!”—whatever would be most compelling to you in the moment when you encounter the obstacle thought.
As you problem-solve, try for a balance of shorter- and longer-term gratification in your range of solutions. Immediately enjoyable goals can even serve as rewards for the work you do toward a longer-term change. Going out to your favorite restaurant with your partner could be a relationship goal, for example, and it could double as a reward for finishing an assignment for a class you’re taking. As with your reinforcement strategies for your loved one, your rewards for yourself should cover a range of time commitments and expense. What can you do at a moment’s notice and what will take more planning and time to realize? What are some activities that are free or inexpensive? What would you like to do that costs more but would be worth it to your happiness? If you’ve been in caretaker mode, you may be rusty when it comes to fun for you. But, hopefully, brainstorming rewards for your loved one gave you some ideas. Now is the time to pay all that hard work forward, to yourself.
Take some time now to remember, or imagine, what it is that you like to do. What are activities you used to enjoy that you haven’t done lately? Or it could be time to try something new. Asking yourself the following questions may stir up some possibilities.
When was the last time you . . .
read for pleasure?
spent time outdoors?
laughed?
rode a bike?
went for a swim?
exercised some other way?
got a haircut?
shared a pleasant meal with family or friends?
ate at your favorite restaurant?
played an instrument?
reminisced with an old friend?
felt grateful?
felt pampered?
played a game?
played a sport?
took a road trip?
went camping?
enjoyed nature in some way?
traveled to another country?
had a vacation?
listened to music?
danced?
snuggled?
treated yourself?
had time to yourself?
cooked?
baked?
finished a project around the house?
smelled fresh-cut grass?
rewatched a favorite movie?
got in a boat?
meditated?
got dressed up?
made something from scratch?
learned something new?
helped something grow?
worked for a cause (other than your loved one!) that you believe in?
The point is not to whip yourself into frenzied distraction with too many activities, but to start to develop meaningful, pleasurable pursuits. You might have noticed that this list did not include “sat motionless while watching another rerun on TV.” At certain times, this could be a much-needed escape, but take care not to confuse inactivity with relaxation or pleasure. If you’re literally running around all day, being still may truly be the rest you need; but if you are running around in your thoughts and feelings, vegging out doesn’t necessarily rejuvenate. Also not on the list is “took time to worry.” Worrying is not problem solving, so worrying more will not better your chances of coming up with a creative solution. In fact, it may take you further away. If you worry when you try to take time out, find a way to distract or soothe yourself.
Social life—a special category of thriving represented in the Happiness Scale by “friendship,” “family,” “significant other,” and “community,”—is particularly vulnerable to the stresses of substance or compulsive behavior problems, which can isolate the person using substances and those close to him. Typically people experience a shrinking social support network as the problem takes over. They may keep it a secret from other friends and family members for some time. Socializing with your loved one, who is perhaps often not in control, may feel embarrassing. Talking about the problem in social situations may not feel appropriate, but not talking about it and pretending everything’s fine can be stressful too. For these and other reasons, you may have given up on your social life.
This inclination to withdraw, while understandable, is happening right when you need contact the most. You need people to talk to about your problems, and you need people to spend time with to get away from your problems—to distract you and make you laugh, recharge you, and remind you that nobody’s life is perfect. We cannot overstate the importance of social support and enjoyment independent of the status of the substance problem you’re dealing with. If you are low on happiness in any of the social areas in the scale, consider this a priority.
New activities in any area (or ones revived from the past) may organically lead to new sources of social support. You may find yourself making new friends as you volunteer, or start going to church again, or take a spinning class at your gym. Indeed, such activities could potentially be solutions to the problem of limited social support. But if you target one of the social areas for improvement and feel blocked by shyness or awkwardness, don’t panic. Social anxieties are more common than people tend to acknowledge. It might help to set your goal around an existing friend or acquaintance rather than trying to make a brand new friend. You can also use positive communication to plan how you will reach out to someone, and practice in advance.
Don’t be afraid to come right out and ask for help. The evidence from many areas of behavioral change (including substance use, exercise, and diet) shows that asking for help from others is associated with success in making and maintaining change. Yet some people feel ashamed or embarrassed to admit wanting attention and support. Others don’t know what to ask for, or whom to ask. If you feel awkward, afraid, or reluctant for any reason to ask for help, remember this is a skill you can learn. The exercise at the end of this chapter will help you identify different kinds of help you may need and whom you could ask.
Mindful awareness, or mindfulness, is not only helpful in times of crisis or intense distress; it also helps people thrive. At CMC, mindfulness is woven into everything we do. We teach mindfulness because it helps people achieve all three of our ACT goals (awareness, coping, and tolerating). It increases awareness. It is a coping skill. And it helps people improve their ability to tolerate the trials of change. We teach it to our clients and practice it ourselves. The more you practice mindfulness in everyday life, the better your mind can serve you in times of distress and point you toward happiness, because with mindfulness you can choose what you will attend to in any given moment.
Mindfulness can make the difference between actually enjoying the enjoyable activities you pursue and hardly registering any pleasure because you can’t stop thinking about a problem. If you invest the effort in making changes to improve your life, we hope you will notice change when it comes and allow yourself to feel joy when it happens.
As scientific evidence has accumulated for the effectiveness of mindful awareness to improve outcomes for depression, pain, substance use problems and other afflictions, so have the resources and training options to help you develop this skill. We include some favorites on our website.
What if, after some period of time and some amount of effort, you feel things have not changed enough? What if you have worked hard to develop your empathy, patience, and understanding—and your loved one’s behavior still pushes you over your limits? What if you are taking better care of yourself and still find you’re falling apart? What if you have worked in earnest to change the way you communicate, reinforce the behavior you want, and not reinforce the behavior you don’t want, to little avail? What if your loved one seems oblivious to every natural consequence you can stand to allow, as he careens toward ones you would never wish for him to experience?
First, we want to acknowledge how hard you’ve been trying. Then we want to encourage you to go back to chapter 6 and reassess your limits. You may need to consider more radical lines in the sand between you and your loved one, maybe for the time being, maybe for a very long time.
Though we are optimistic and cherish our work every day because people do get better, we also know that substance problems sometimes end marriages, break apart families, and cause monumental losses of financial, emotional, and physical well-being; for the person with the problem and everyone who cares about him or her. This is the heartbreaking reality: some people just don’t change enough, or don’t change fast enough, or don’t change, period. Sometimes, all the evidence-based treatments and loving support systems in the world don’t seem to touch them. Sometimes, for whatever painful internal, historical, genetic, lifestyle, or other reasons, a loved, cherished family member cannot or will not let himself be helped. Our hearts break for him, and for you if you happen to love someone like this.
Which brings us back to acceptance, a hard, sad valley to walk through in such cases. But this valley of acceptance is still the place—the only place—for letting go and starting on a new path. It may not be the path you hoped to walk, the one you bought this book for, and not the one we would wish for you, but we do want to support you in taking the path of reality. If you have reached your limits and need a break, short-term or long-term, in your relationship, we encourage you to focus on your own self-care and problem solving and to build a better life for yourself even if you decide that your life cannot include your loved one. If you’ve done your best, and can’t do any more, we hope that you can go on treating yourself kindly and go forward with the care and support in your life that you deserve.
We wanted to write a book you can keep on your shelf in case you need to refer to it again, because on the one hand change takes time, and on the other hand, even if you separate, divorce, stop financial support, stop talking, or otherwise detach from your loved one, most likely your love will continue. In your life or in your heart or both, as long as you love her, she will be a part of your life and we hope this book will be helpful to you for as long as you need help.
Substance problems can end. Books must end. Change, however, goes on, especially when you know how to keep it going—as now you do—and the skills and understanding in this book are for life. Which is a good thing, because nobody, not even the experts, knows how long it will take.
If you started this book with problems that you just wanted to be over and at this point all your problems aren’t quite gone, we hope at least to leave you with more reasons to keep going. We hope that if you can’t close the book and say that’s the end of that, you nonetheless have a better idea of what you can do than when you started: knowledge to hold onto, skills to keep practicing, and strategies that will keep helping you and your loved one in any and every stage of change. We hope you found sources of calm to keep tapping into, and optimism to keep on keeping on.
We started the book with ten principles. We hope the rest of the book helped you apply the principles to your unique situation, and your reasons for optimism deepened in the process. Consider how much you may have changed since you first read these principles and what they mean to you now: You can help. Helping yourself helps. Your loved one isn’t crazy. The world isn’t black-and-white. Labels do more harm than good. Different people need different options. Treatment isn’t the be-all and end-all. Ambivalence is normal. People can be helped at any time. Life is a series of experiments.
Remember, your optimism helps change happen; sure-footed, grounded optimism. We’ve shown you the ground. You have our optimism. We hope that your optimism will grow in you from here and more change in your life will follow.
This exercise will help you identify the kinds of help you need and whom you can get it from. Keep in mind that certain people may be helpful in some ways and not others. Be specific!
Ways of Helping |
Who Can Help |
Distracting you during tough periods |
_________________________________ |
Tolerating you when you are irritable or down |
_________________________________ |
Openly appreciating you |
_________________________________ |
Spending time with you during difficult moments or hard days |
_________________________________ |
Letting you complain |
_________________________________ |
Respecting your needs |
_________________________________ |
Doing activities with you |
_________________________________ |
Giving you perspective |
_________________________________ |
Cheering you up |
_________________________________ |
Other: |
_________________________________ |
Pick one person to ask for help using the positive communication guidelines. If you are still reluctant to ask after you have planned what you will say, why do you think that is? Sometimes it’s enough just to be aware of your uneasiness and give yourself permission to go ahead anyway. Or you may be able to take steps to minimize your anxiety, such as calling instead of asking in person. If you identify an obstacle to asking that you don’t know how to address, you might consider asking someone else.
You can practice mindfulness anytime. The literature overflows with specific exercises and examples, but the basic instruction is to pay nonjudgmental attention to what you’re doing when you’re doing it. Your mind will wander, or sprint, to other thoughts; it’s what human minds evolved to do. It may cover great (or more often not-so-great) distances before you notice that your mind is gone and you’re lost in thought, but as soon as you do notice, gently but firmly—as nonjudgmentally as possible—bring your attention back to what you are doing. You don’t have to “meditate” to practice being mindful—just try to do One Thing: to practice mindfulness of eating breakfast, close your laptop, don’t try to have a conversation, just eat. To be mindful of walking, take the earphones out of your ears and just walk. If you want to be mindful of music, don’t relegate it to the background of something else . . . just listen.
In chapter 4, we asked, “How are you?” and offered some tools for building awareness.
How are you now?
It’s important to keep asking. We leave you with this question, and this exercise to help you assess how you’re doing in all the areas we’ve covered in this book.
Motivation/Energy Level
1. How motivated are you feeling about doing the work (learning strategies, increasing your understanding, etc.) needed to help your loved one and change your situation?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not motivated |
|
|
|
Very motivated |
||||
2. How much emotional/mental energy do you have available?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Little energy available |
|
|
|
A lot of energy available |
||||
3. How much physical energy do you have available?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Little energy available |
|
|
|
A lot of energy available |
||||
Optimism
4. How optimistic do you feel about your loved one making positive changes?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Very pessimistic |
|
|
|
Very optimistic |
||||
5. How optimistic do you feel about your relationship improving with your loved one?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Very pessimistic |
|
|
|
Very optimistic |
||||
6. How optimistic do you feel about your life starting to feel better day-by-day?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Very pessimistic |
|
|
|
Very optimistic |
||||
Self-Care
7. How are you sleeping?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Poorly |
|
|
|
Well |
||||
8. How are you eating?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Poorly |
|
|
|
Well |
||||
9. How frequently are you engaging in exercise?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not often |
|
|
|
Very often |
||||
10. How involved are you with your interests and/or hobbies?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not involved |
|
|
|
Very involved |
||||
11. How involved with/supported by outside friendships/relationships are you?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not involved |
|
|
|
Very involved |
||||
12. When you consider your life as a whole (relationships, work, responsibilities, emotional life, etc.), how well balanced do these areas feel?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Very imbalanced |
|
|
|
Very well balanced |
||||
13. How much do you feel your actions and behaviors match your values?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not at all |
|
|
|
Completely |
||||
Emotional State
14. What is the level of anger you feel in relation to your loved one?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Very angry |
|
|
|
Not angry |
||||
15. What is the level of worry/fearfulness you feel in relation to your loved one?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Very worried |
|
|
|
Not worried |
||||
16. When you have negative feelings (anger, fear, hostility, resentment), how constructively are you managing these feelings?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Very destructively |
|
|
|
Very constructively |
||||
17. How emotionally “resilient” (able to roll with difficulties rather than getting “stuck” in negative emotional states) do you feel?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not resilient |
|
|
|
Very resilient |
||||
Use of CRAFT Skills
18. Do you have clear goals for improving your own physical/emotional well-being?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not at all clear |
|
|
|
Very clear |
||||
19. Do you have clear goals for positive behaviors you want to see more of in your loved one?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
No goals/very vague |
|
|
|
Clear goals |
||||
20. Do you have clear responses/ideas for positively reinforcing your loved one’s positive behaviors?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not at all clear |
|
|
|
Very clear |
||||
21. Are you aware of some natural consequences that could result from your loved one’s behavior?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not aware |
|
|
|
Very aware of several |
||||
22. How able do you feel to allow those natural consequences?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not able at all |
|
|
|
Quite able to allow |
||||
24. How positive is your communication with your loved one?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not positive/mostly negative |
|
|
|
Quite positive |
||||
25. Do you understand (e.g., from the Behavior Analysis) the reasons your loved one uses substances?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not at all |
|
|
|
A good deal |
||||
26. How much do you feel like you’ve been practicing the new strategies of CRAFT?
1 |
- |
2 |
- |
3 |
- |
4 |
- |
5 |
Not at all |
|
|
|
A lot |
||||
Key
First, know that just taking the time to ask yourself these questions will increase your awareness and insight! Then, examine your scores for each section, as well as overall. Lower scores indicate more of a struggle for you, while higher scores indicate you are actively engaged in change, both for your loved one and yourself (possible totals range from 26 to 130).
Motivation/Energy Level: The lower your score in this section, the less energy you feel, indicating less interest in or capacity for learning, planning, practicing, and problem solving. In this case, it is wise to attend to caring for yourself and improving the moment. What could you do to lower your stress and up your energy reserves? Start with the basics: sleep, nutrition, affection, exercise.
Optimism: This is one of the most useful areas to track, since a consistently pessimistic view (lower scores) over time suggests something significant needs to change; whereas overall increasing optimism (higher scores), while it may include blips of pessimism, indicates that you are on a path of improvement.
Self-Care: This section provides a snapshot of how well your needs are being cared for. The specific items can direct you to areas in need of attention as well as areas you can take a moment to appreciate because your needs are being fulfilled.
Emotional State: This section spotlights prominent negative emotions (anger, worry, anxiety) that may feature in your day-to-day life. Low scores suggest you’re running low on emotional resilience, and you might want to pay more attention to self-care or positive communication.
Use of CRAFT Skills: This section focuses on your attention to some of the basic skills of CRAFT, including self-care, communication, and positive reinforcement. Higher scores indicate you have either been working hard to integrate the CRAFT skills into your life or they come naturally to you already!