by Tom Horvath, PhD In September 2021, Netflix released a seven-episode miniseries that mentions Rational Recovery (RR) as an alternative to Alcoholics Anonymous (AA) in episode II (starting in minute 46). Ironically, the mention of RR occurs in a very small (two-person) AA meeting. The pro-RR speaker is required to attend AA as part of parole, but he objects to AA’s powerlessness and God-centered approach. He prefers RR’s addictive voice recognition technique and the idea that he could take charge of his own behavior. In that AA meeting, he takes an extended moment to explain RR concepts and what he likes about them. Miniseries Mentions Rational Recovery - The Significance The significance of RR’s presence in Midnight Mass is that self-empowering approaches to resolving addictive ...

Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction, by Maia Szalavitz Review by A. Tom Horvath, PhD The harm reduction approach to addressing addictive problems has until recently been highly controversial, at least in the US. Treatment and other change efforts in the US have been primarily guided by the views that addiction is a disease and that the 12 steps are the primary (or only) method for change. Harm reduction accepts and encourages small steps toward change. The US approach has typically required an immediate and large change, often involving a completely new perspective: “I’m an addict, I have a disease, I will abstain from everything forever.” The small steps approach of harm reduction, even though it describes how most human change occurs, has ...

By Tom Horvath, PhD Addiction professionals say they're working toward ending stigma surrounding addiction, but they also tend to promote addiction as a disease. These activities are contradictory. By promoting addiction as a disease they play into the general tendency to perceive in-groups (“normies”) and out-groups (those with the disease). Instead of emphasizing that “addiction is a chronic brain disease” or “treatment works,” the following ideas, depending on the context, would make much more helpful and less stigmatizing messages: You might also be interested in: The Stigma of Addiction and the Inadvertent Contribution of the Recovery Community 1. Addictive problems range from very mild to very severe. 2. Most addictive problems are not in the severe or very severe range. ...

by Tom Horvath, PhD Practical Recovery and SMART Recovery both use the self-empowering approach for resolving addictive problems. This approach contrasts with the powerlessness-based approach of AA and other 12-step groups, at least on the surface. Both approaches begin with the person considering change, and then deciding to change (at least to some degree). Both approaches can be effective, but one may work better for specific individuals. The powerlessness-based approach is described in AA’s 12 steps. In the first step you admit you are “powerless over alcohol.” In the third step there is “a decision to turn our will and our lives over to the care of God as we understood Him.” This approach can be described as serenity (as used in the Serenity Prayer, and also as “letting go” o...

A Scientific Life on the Edge: My Lonely Quest to Change How We See Addiction, by Stanton Peele, reviewed by Tom Horvath, PhD Peele’s latest book (#14) is a personal autobiography, an intellectual autobiography, and a detailed comparison of his work with that of many other authors and scientists, including Maia Szalavitz, Carl Hart, Marc Lewis, and Johann Hari. For those unfamiliar with Peele’s work, this book would be an excellent introduction. If you already appreciate him, the historical and comprehensive nature of this book (379 pages, plus 52 pages of online references) will likely be appealing. The references online are helpful, and save the reader from flipping pages back and forth. Peele revolutionized our understanding of addiction. Love and Addiction, published in 1975 (...

by Tom Horvath, PhD If guilt is the bad feeling I get after doing “something wrong,” then shame is the bad feeling I get about being myself. Shame might arise along with guilt (“I’m not good enough, and a bad person, for doing something that terrible”). However, shame might arise by itself. In the extreme I might think “I do not even have the right to exist. I’m so bad and foul and awful that I don’t deserve to belong to the human race. I should not be allowed to have the air I breathe, the food I eat, and the time and attention I get from others.” Understanding Shame vs. Guilt Simply stated, guilt is about what I did. Shame is about who I am. When I behave wrongly or badly, and feel guilt or regret, there are often ways I can resolve these feelings: Make it up to someone, apologiz...

by Tom Horvath, PhD When we talk about having boundaries, we can talk about managing external boundaries and we can talk about managing internal boundaries. This blog will discuss the management of external boundaries. To better understand external boundaries, it helps to understand the concept of interpersonal boundaries. Interpersonal boundaries are the rules we establish for ourselves about how we interact with other people. We can compare interpersonal boundaries to having a house. The house, with roof and walls, protects us from the outside, and keeps our possessions together. But there are also doors, windows, window coverings, pipes, wires, vents, and so forth, which allow us to be flexible about what comes in and what goes out. In this blog we focus on protecting ourselves fr...

by Tom Horvath, PhD A well-lived life needs to have significant and possibly considerable amounts of discomfort in it. For instance, do you want to exercise well, maintain a certain weight, get up early, work hard at something, or hold your tongue in an intense discussion? You are likely to feel uncomfortable! The key, then, is to learn skills for managing discomfort that will inevitably come. You might also be interested in: Coping with Stress in Addiction Recovery In particular, if you want to stop an addictive problem, you are likely to have a transition period as you change how you live. Cravings might die off almost entirely after 90 days (although there is no guarantee they will completely), but other challenges might last much longer. Maybe you should just give up now? Fortu...

How well am I asserting myself? It is an increasingly competitive world. We need to assert our wants and desires in order to thrive. It is also an increasingly (socially) distant world, and not just because of a pandemic. It is easy to get distracted by the limited connections provided by social media, and not have the richer experience of direct interaction with others. To connect with others we need to be comfortable revealing ourselves. Considerations when answering the question, "Am I asserting myself?" Assertiveness is the direct expression of my experience and reactions, including my thoughts, beliefs, opinions, emotions, and the like, while recognizing that others may have (and have a right to) different experiences and reactions. Assertiveness is a mean between aggressiveness...

by Thaddeus Camlin, PsyD As cannabis crawls toward federal legalization, the 11th hour panic push is in on.  Last week saw the introduction of the Cannabis Administration and Opportunity Act, which seeks to federally legalize cannabis in the U.S.  For those opposed to legalizing cannabis, ‘cannabis-induced psychosis’ and ‘ultra-high potency THC products’ are the buzz words working most effectively to enliven the embers of cultural pot fears.  Cannabis-induced psychosis is something to take seriously, as are ultra-high potency THC products, but neither is a reason to keep pot illegal. You might also be interested in: Drugs Don't Cause Addiction Cannabis-induced psychosis (CIP) refers to an individual experiencing delusions, hallucinations, disorganized speech, or grossly abnorma...