By Tom Horvath, PhD How well can I calm myself or energize myself using my own abilities? How much do I need to use a substance for help? Although at times a mild sedative (one drink) or mild stimulant (a cup of coffee) can be a helpful tool, the more we rely on such tools the more our internal abilities diminish (atrophy). Daily low doses of sedatives or stimulants can be helpful. As the doses get higher, problems can emerge. In cases of substantial addictive problems, it is common to see someone bouncing between “downers” and “uppers,” sometimes even multiple times per day. At that level of substance use we can lose all sense that self-regulation can be accomplished by ourselves. None of us may reach the ideal of regulating ourselves entirely from our own resources. However, ...

By Kenneth Anderson, MA The history of alcohol treatment since the 1960s has been a history of practitioners ignoring science and the scientific method and forming conclusions based on observations of clinical populations without testing hypotheses, then self-publishing these hypotheses or publishing them in the popular press rather than in peer-reviewed scientific journals. Some of the most notorious examples of this are Hazelden and the Johnson Institute, which will be discussed in later blog posts. Another notorious example is Lakeside Milam, founded by James Robert Milam (Mar 3, 1922 - May 6, 2016). This is a far cry from Shadel Sanitarium, which meticulously published its data in peer-reviewed journals in the 1940s and 50s. James Robert Milam Milam was born in the state of Was...

By Kenneth Anderson, MA The Wegscheider-Cruse Family Roles Theory is one example of how “chemical dependency” treatment does not have the firm scientific foundation that it is suggested to have. Despite this lack of foundation, to become a certified addiction counselor today one must study Wegscheider-Cruse's theory. Below I present the history of the development of this theory, and some of the specific problems with it. Sharon Wegscheider-Cruse Behind the Wegscheider-Cruse Family Roles Theory was Sharon Wegscheider-Cruse (Nov 16, 1938 - living), born Sharon Rae Roelandt in Jasper, Minnesota, the daughter of Emil Leonard Roelandt (Jan 19, 1915 - Dec 24, 1961) and Marjorie Annadell Roelandt nee Olson (Aug 7, 1919 - Aug 11, 1986). The Roelandts were Catholic, and Sharon attended Cath...

By Tom Horvath, PhD Although you can embark on a new habit at any time of year, the New Year remains a popular starting time! Here are some suggestions on how to maximize your project. Decide whether to start small or start “big.” Even though your end point may evolve over time, decide at the beginning what your endpoint is (and write it down). If you start small, build over time. What is the smallest step you are confident you can consistently take? Then wait until that pattern is well established and add another step. This approach may be more realistic and comfortable than starting big. If you start big you will definitely need to prepare in advance. Do you have the items you need (e.g., exercise clothes, a new shopping list, a well-practiced breathing technique that you ...

By Tom Horvath, PhD This month the Substance Abuse and Mental Health Services Administration (SAMHSA) of the federal government released a 15-page document entitled Advisory: Low Barrier Models of Care for Substance Use Disorders. The document summarizes the difficulties associated with reaching and providing care for individuals with substance use disorders. Less than 10% of individuals who might benefit from treatment participate in it. A “low barrier” approach to treatment attempts to reduce the difficulties that might reduce treatment attendance. Although not primarily intended as a list of the shortcomings of the current US addiction treatment system, the document can be understood that way. What’s wrong with US addiction treatment? Too many requirements for entry. The insu...

By Tom Horvath, PhD Boredom is the perception of being under-stimulated. We all have optimal levels of stimulation (some generally want more, some generally less). Whatever your level, when you are not getting enough, you are bored (and when over-stimulated, you may be stressed). Boredom is often considered an undesirable state. However, let’s start with its advantages. If not much is going on in your immediate world, you have time to consider the larger context of your life. It is easy to lose track of what is more important than day-to-day and moment-to-moment issues. If bored you have a moment to consider what is important, rather than just immediate or urgent. When feeling bored you might say, “I’m glad nothing is pressing on me at the moment; I can think about the bigger p...

by Kenneth Anderson, M.A. THIQ is an acronym which stands for tetrahydroisoquinoline, a chemical which is formed in the brain when a metabolite of alcohol combines with dopamine. The THIQ theory of "alcoholism" became very popular in the 1970s and 1980s, when it was erroneously believed that THIQs were formed in the brains of "alcoholics," but not in the brains of normal drinkers. The theory became so popular that it was regularly taught to clients at Hazelden, both in a document riddled with historical errors and in a videotape which I recall seeing in the 1990s. THIQ theory is discussed in more detail below. Although THIQ theory was debunked in the 1990s when it was found that THIQs were formed equally well in the brains of both normal drinkers and "alcoholics," recent research sug...

By Tom Horvath, PhD The Thanksgiving dinner table will provide many opportunities for conversation, and perhaps nearly as many opportunities for disagreements and fights. That level of tension can easily motivate us to overuse substances! Let’s look at some ways to prevent the tension from getting that high. Tips for Listening at Thanksgiving Is it essential that you provide your opinion? If you are talking with someone whose opinion (based on your experience with them) is unlikely to be open to examination, stating your different opinion will likely not lead to a meaningful conversation, and could lead to a fight. Instead, you could say “You have very strong feelings on this subject.” If someone holds forth at length (and perhaps in a way you have already listened to before...

By Tom Horvath, PhD A recent scientific paper analyzed the responses from nearly 10K individuals who identify themselves as “in recovery” from substance problems. In recent years the addiction recovery field has been considering how to define “recovery.” Five major organizations have offered definitions or attempts at definitions. However, there is not much data on this issue. Two previous studies have looked at how individuals in recovery define it. The present study is an advance because it identified 30 sub-groups, based on socio-demographics, substance use problems, and help-seeking history. Each sub-group was analyzed for which components of a recovery definition might be common for that sub-group. The second study had averaged all subjects together, thus losing some of the diff...

By Tom Horvath, PhD With Halloween parties starting this weekend, the holiday season begins. That season will continue through Thanksgiving, multiple holiday celebrations near the end of the year, New Years, and then on to the Super Bowl and Valentine’s Day. Including work, family, and other social events, you could be invited to a dozen or more events during the holiday season. If you are intending to stop or reduce your substance use, especially alcohol, for the next 3-4 months your work is cut out for you! I often feel especially sympathetic for someone who aims to start such a project at just this time. On the other hand, when next year arrives, you will have been through it already, and perhaps won’t dread the holiday season when it arrives. What might you keep in mind to ...