By Tom Horvath, PhD, ABPP One of the simplest but most powerful ways to reduce stress is to focus on breathing. Although books have been written on this subject, the following ideas may be a sufficient guide for you. Because we breathe continuously, you will have lots of opportunity to practice! Less is More Perhaps the most important single step to reduce stress is to breathe less, while breathing regularly, through your nose. A deep breath or two can get you started on “breath work,” but after those initial breaths, focus on breathing regularly but more slowly, and with lower volume of air. You are not going to reduce your rate of breathing instantly. However, over the course of many breaths your rate will (probably not entirely smoothly) reduce. With practice you might breathe a...

by Tom Horvath, Ph.D. Would the term “preaddiction” be helpful? The National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) jointly issued a Request for Information on this term. The details of the Request are at the very bottom. Below is what I sent them (slightly edited): ** What would a better term be? Addiction (and thereby, preaddiction) is an undesirable term because it is used by many in an all-or-none fashion, or to denote a state of disease (leaving out those who view these disorders as primarily behavioral). Consequently, preaddiction is also undesirable. I believe that eliminating the terms addiction and preaddiction will greatly reduce stigma, because these terms are used to divide people into two groups (addicted, n...

A Closer Look at the Rat Park Experiment, Part 1 By Kenneth Anderson, MA Bruce K. Alexander's rat park experiment series have become a very popular topic among people interested in addiction in recent years. The rat park experiments, published in 1978, 1979, and 1981, showed that albino Wistar rats living in a naturalistic environment with other rats consumed a lot less morphine than rats in solitary confinement in individual cages. In this article, I will give some of the historical background which led up to the rat park studies (Part 1), review the rat park studies themselves (Part 2), and take a look at where we have gone since (Part 3). A huge number of studies have been conducted on the effect of environment on addiction in animal models since the days of the rat park experi...

by Tom Horvath, PhD It seems that almost everyone worries at times. We can think about a problem over and over and not make any progress. Ineffective strategies for worry include telling ourselves to “just stop,” and looking for guarantees or certainty when they are not available. Very little is guaranteed in life, and yet somehow we keep moving forward. Worry can be considered a problem-solving effort that is not working well because we are focused on the wrong parts of the problem. Most problems have aspects that 1) can be dealt with now or cannot be dealt with until later; 2) are under our control or not under our control; and 3) are more important or less important. If you focus your thinking on aspects of a problem that can only be dealt with later, are out of your control, o...

By Tom Horvath, PhD, ABPP Transforming the US Addiction Treatment Workforce, Part 1, argued that the US needs to follow other nations, which have substantially lowered overdose rates and rates of addictive problems by adopting harm reduction. To offer this approach we need providers who work with the client not against the client’s disease, accept that there are as many pathways for change as there are individuals, work with the client to discover their individual pathway (and not assume that the provider knows what it is), empathize with the value experienced from the addictive behavior, and not confront the client about the desirability of change. Part 2 reviews specific examples of how the US addiction treatment workforce (the providers and systems) would operate having made this ...

By Tom Horvath, PhD We regularly see criteria for evaluating our health, physical fitness, or financial well-being. If our relationships are the primary source of our emotional well-being (a statement apparently accurate for most people), then guidelines for evaluating our relationships would also be valuable. Having both one or a few intimates, and a wide range of other relationships, is conducive to well-being. We need to have one or a few people we know very well, and then many other relationships that could be meaningful in various ways. We can compare this situation to the specialist/generalist distinction. We need to be a specialist in one or a few areas (often to make a living), but we also need to have much general knowledge, to get along well in the world. The followin...

by Tom Horvath, PhD The Year of the Dog, a roughly 90-minute film, presents a fictional account of a mid-30s man and his early to middle change process out of alcohol problems. The story begins at the end of day 2. Matt has been released from jail, still experiencing withdrawal symptoms. Over the next several months he experiences various emotional setbacks, and several positive events he has worked to bring about. My interest in this film arose from the fact that the trailer showed Matt arguing forcefully with someone whom I suspected was his AA sponsor. Matt significantly ignores the sponsor’s advice. How open to alternative recovery approaches would this film be? This indie film, shot in Montana, impressively uses its resources to create a story I expect anyone dealing with alc...

By Tom Horvath, PhD, ABPP   “How do I love thee? Let me count the ways.” from How Do I Love Thee? (Sonnet 43) By Elizabeth Barrett Browning 1806-1861   [caption id="attachment_13904" align="alignright" width="281"] "I Love You" written in different languages.[/caption] This poem focuses on the writer’s experience of being in love. That experience could occur even if the love were not returned. We could have a “crush” on someone who does not know of our feelings. In this blog, I focus on the day-to-day experience of mutually expressing love and receiving it. The five “languages of love” have been popularized by Gary Chapman. Anyone not familiar with them would benefit from knowing them: kind and loving words, meaningful time together, physical affection, helpful...

By Tom Horvath, PhD, ABPP The rapid increase in US overdose deaths in recent years has resulted in increased attention to our drug policies and treatment system. In other developed countries drug policy has increasingly oriented toward harm reduction. Harm reduction approaches emphasize working with individuals who use drugs to increase safe use in the short term, and improved well-being and the resolution of addictive problems in the longer term. Transforming the US Addiction Treatment Workforce -  It's Needed This approach has been controversial in the US, on the assumption that any approach that does not insist on immediate abstinence encourages drug use and is therefore counterproductive. This controversy overlooks the reality that in the countries that have embraced a harm red...

By Tom Horvath, PhD In Part 1 I recommended that the term “addictive problems” replace several similar terms. In Part 2 I recommend that the term “recovery” be replaced with several better alternatives, depending on context. To summarize Part 1, there is a continuum of addictive problems (abstinence, moderation, misuse, mild substance use disorder, moderate substance use disorder, severe substance use disorder). Over time someone can move up or down that continuum. They are not stuck forever at one level. This possibility of movement is the most radical aspect of viewing addictive problems as lying on a continuum (vs. the view that you are an “alcoholic” or “addict” forever, or that you are not). The lower the level of problems, the less likely someone is to address them because t...