by Tom Horvath, PhD, ABPP Dialectical is a word with a long history (back to the Greeks), but for now let’s define it as “focusing or acting on the interaction of opposing forces or ideas.” Dialectical Behavior Therapy (DBT) identifies and addresses three common dialectical dilemmas, in order to improve emotional self-regulation, one of the primary goals of DBT. DBT can be helpful for individuals in whom large and rapid emotional swings (e.g., from love to hate) are common, painful, and harmful. The first of the dialectical dilemmas involves being emotionally vulnerable (either at present, or over a lifetime as a result of being emotionally more sensitive than average), but then downplaying the intensity of emotions. Typical self-statements are “this won’t be that hard” or “I shou...

by Tom Horvath, PhD, ABPP Interpersonal boundaries are part of the rules we establish about how we interact with other people. In this blog we focus on protecting ourselves from the outside. In a parallel blog we focused on keeping inside what needs to stay there. In both cases we can compare interpersonal boundaries to a house, which protects us from the outside, and keeps inside what needs to be there. We prevent violations to ourselves by establishing and managing boundaries. For instance, who can touch us and how, who can enter our living space and how far, whom we respond to online and whom we do not, whom we will accept advice from and whom we won’t, and so forth. The challenge often is that these boundaries need to be communicated and enforced, and communication and enforce...

by Tom Horvath, PhD, ABPP Interpersonal boundaries are part of the rules we establish about how to interact with other people. We can compare interpersonal boundaries to being in a house. The house protects us from the outside, and on the inside we protect our warm or cool air, our possessions, and our privacy. Houses have walls, roofs, doors, windows, window coverings, pipes, wires, and vents, which allow us to be highly flexible about what comes in and what goes out. In this blog we focus on keeping inside what needs to stay in. In a parallel blog we focus on keeping outside what needs to stay out. In either case, I am the one ultimately responsible for managing the boundary. I need to be prepared for others who may not know or respect the boundary I have established. I need to kno...

by Thaddeus Camlin, PsyD Saying drugs cause addiction is like saying clouds cause tornadoes.  Tornadoes are caused by a complex combination of factors including warm, moist air, changes in wind direction and speed, and an unstable atmosphere decreasing in temperature rapidly with height.  Similarly, addiction is caused by a complex combination of factors, not drugs themselves.  Let us not forget, drugs are not even a necessary component of addiction, as addictive behaviors manifest in the absence of drugs with process addictions like gambling, video games, sex, food, social media, work, etc.   Just like tornadoes require an unstable atmosphere, addictions invariably grow from unstable, often traumatic environmental conditions.  Clouds don’t cause tornadoes, drugs don’t cause addictio...

by Thaddeus Camlin, PsyD [caption id="attachment_12950" align="alignright" width="500"] HBO's Euphoria misses the mark when it comes to addiction, again[/caption] The latest installment of HBO’s Euphoria is chock-full of harmful addiction myths and contradicting information.  The show’s main character, Rue, is a young and intelligent woman with a history of severe trauma.  Her father died young from cancer, she was drugged and nearly raped, and she was cheated on and heartbroken by her first true love.  Like many who experience horrible trauma, Rue found solace in substances like MDMA and opiates.  Like many who find solace from trauma in substances, Rue got a bit carried away.  Like many who get a bit carried away with substances, Rue experienced some negative consequences becaus...

by Thaddeus Camlin, PsyD The ‘us & them,’ ‘normies and addicts’ mentality continues to lose its stronghold in addiction theory.  The more addictive behaviors are recognized as a manifestation of normal human learning rather than diseased character defects and spiritual maladies, the better.  New Year’s resolutions, and their reputation for failure that often precedes them, offer yet another opportunity to highlight the universality of addictive behaviors.  New Year’s resolutions often fail because of a phenomenon of all-or-nothing thinking frequently referred to in the world of addiction as the ‘abstinence violation effect,’ where a single breach of a vow to change is viewed as failure and justifies absconding from the entire change attempt. Old habits die hard, new habits for...

By Thaddeus Camlin, PsyD Holidays are ripe with tales of family gatherings gone sour.  Many families anticipate disruptive antics from at least one family member, maybe more.  As the beloved Lion King character, Zazu, memorably proclaimed about rabble-rousing kin, there’s one in every family, two in mine actually!  Whether there are one, two, or 10 family rascals to navigate this holiday season, SMART Recovery offers effective tips for family communication to help maximize enjoyable interactions with loved ones. The SMART acronym PIUS outlines four core communication skills.  The ‘P’ stands for positive communication.  Before anyone jumps to ‘captain obvious’ critiques about how much of a no-brainer it is to try to communicate positively, let’s take more than a passing, dismis...

by Thaddeus Camlin, PsyD Gratitude tends to be hard-earned.  When life’s complexities converge and we endure a series of painful complications, gratitude may seem like a fool’s errand at precisely the time when it is most needed.  Thanksgiving reminds us, no matter our circumstances, to pause and appreciate.  Nestled amidst a global pandemic, this iteration of our annual holiday of thanks may be a strange and creative version of our usual traditions.  The felt experience of true gratitude may be elusive amidst uniquely trying times.  What follows are some considerations for how to cultivate gratitude for Thanksgiving 2020 (spoiler alert: it's a not a matter of '5 easy ways to be grateful,' there are no shortcuts or drive-thru paths to true gratitude). Gratitude is not the most nat...

by Anonymous A psychedelic treatment renaissance is underway, driven by a proliferating body of empirical support.  The schedule I status of psychedelic compounds all but suffocated scientific research for decades and continues to stifle the pace of progress.  While the weight of excessive bureaucracy continues be a drag on scientific investigation of psychedelics and their implementation in various treatments, those who may benefit significantly from such treatments are forced to either go without or get creative.  What follows is an account (lightly edited and reprinted here with permission) from someone who chose to get creative.  The stirring account illustrates the intensity, power, and healing that can occur in psychedelic-assisted psychotherapy.  The psychotherapist referred t...

by Thaddeus Camlin, PsyD The aphorism ‘blood is thicker than water’ reminds us to prioritize family.  When it appears that people choose drugs and alcohol over family doubt reverberates through the deepest truths of human bonds.  We become so focused on how someone could choose drugs and alcohol over family that we miss the bigger question:  Why is someone in a position to choose drugs and alcohol over family in the first place?  Often, people are issued an ultimatum something to the effect of: “It’s us, or the booze.”  Rather than reflecting a corrosive character defect in the so-called “addict,” the answer to why people choose drugs and alcohol over family may instead lie, at least in part, at the hands of those who issued the ultimatum in the first place. Anyone who ever is...