• Radical Acceptance

    Posted on June 4, 2021
    by Tom Horvath, PhD, ABPP Dialectical Behavior Therapy (DBT) places a primary focus on improving distress tolerance. One of several tools DBT offers for tolerating distress is radical acceptance. The context of using any of the distress tolerance tools is the recognition that life will have distress, and that we need to learn how to bear up under it. Life is worth living even if it can be painful. DBT distress tolerance skills are designed to help us get through a crisis, but these tools benefit from practice in advance. These skills can help us accept the discomfort or pain that occur in a crisis, while preventing that discomfort or pain from rising to the level of suffering. Radical = “going to the root,” like a radish. Radical acceptance does not mean we approve of reality. ...
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  • Dialectical Dilemmas

    Posted on May 7, 2021
    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...
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  • Managing Interpersonal Boundaries, pt. I

    Posted on April 9, 2021
    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...
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  • Alcohol and Sexual Performance: Too Much May Mean Not Enough

    Posted on October 16, 2020
    by Tom Horvath, PhD., ABPP Macbeth, Act II, Scene 3: [Alcohol] provokes the desire, but it takes away the performance It was not until 1976 that scientific evidence supporting this line from Shakespeare was published. In a study of 16 male volunteers, ages 18-24 (mean age 20), the diameter of erections was approximately 10% larger than normal after about 1 drink, about 5% smaller after 2-3 drinks, and about 20% smaller after 4 drinks. With even higher doses of alcohol we can only guess the impact, but clearly the trend is not in the desired direction. The phrase “whiskey dick” is less than Shakespearian but expresses a similar idea when it comes to alcohol and sexual performance. Search the web and you can find numerous articles about this term. A related finding is that lo...
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  • Staying Sober in a “Let’s Grab Drinks” Culture

    Posted on January 25, 2019
    By the team at Practical Recovery Separating libations from social situations in American culture is about as easy as separating hassle from air travel.  A 2017 study published in the Journal of the American Medical Association found that alcohol consumption is on the rise in the United States, especially among women, older adults, ethnic minorities, and the socioeconomically disadvantaged.  Going out for drinks is such a staple of US culture that establishing a natural, rich, and fulfilling social life is a legitimate challenge for those who pass on the party scene.  For those who resist liquid luncheons, thirsty Thursdays, not-so-happy hours, and whiskey sours, it is important to have some ways of staying sober in a “let’s grab drinks” culture. People don’t drink for a variety o...
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  • Preventing Relapse: The Role of Lifestyle Balance

    Posted on April 22, 2016
    In addiction recovery, if your life is filled with non-pleasurable activities, you are more likely to relapse. The relapse will provide an intense, but only temporary, satisfaction. Perhaps the greatest risk for imbalance comes when we are too focused on what we “should” do and not enough on what we want to do. Of course, we need to do what we should do, but with balance! Lifestyle balance can be considered from a number of perspectives. Below is a list (taken from Dr. Horvath's book, Sex, Drugs, Gambling & Chocolate, page 191) that you might use to consider how balanced you are: Work and relaxation Activity and contemplation (self-assessment) Duties and fun Long-term projects and momentary pleasure Alone time and social time Routine household chores and new proj...
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  • On being a SEN Master, Part 1

    Posted on January 22, 2016
    by Tom Horvath, Ph.D., ABPP What did the Zen Master say to the hot dog vendor?  “Make me one with everything.” This article is NOT about gaining enlightenment.  Rather, I focus on gaining greater lifestyle balance and greater overall physical and emotional health.  The term SEN Master, which I coined a few years ago, emphasizes the benefits of good Sleep, Exercise and Nutrition.  Of course, there are other valuable health habits (not abusing substances, washing your hands regularly–so as not to spread germs, taking care of your teeth, limiting sun exposure), and other habits that indirectly promote health (having a good social life, having meaningful activities).  The term SEN Master, however, suggests that good sleep, exercise and nutrition are the core health habits. Physicia...
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  • Defend Your Recovery and Mental Health During Seasonal Changes

    Posted on October 9, 2015
    With the end of summer comes shorter days, less sunlight, less time spent outdoors and, for some of us, a bit of a negative shift in our mood. Known as the winter blues or even Seasonal Affective Disorder (in more severe cases), this shift ranges from feeling a little down, sluggish, withdrawn, or even depressed, as the colder, darker days begin to replace the rejuvenating days of spring and summer. We all know that taking care of our mental health is a key component of our recovery, that’s why it’s critical we address any negative feelings which start to creep in – including those brought on by a change in the weather. While you can’t control the seasons, you can stave off some of those ill feelings. If your mood is beginning to fall with the leaves outside, try these tips for a ...
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  • 8 Tips for Better Sleep

    Posted on October 2, 2015
    Sleep is a crucial element of healthy recovery from addiction. “Without sleep, we all become tall 2 year olds.” -JoJo Jensen According to a study by Harvard Health, lack of sleep affects many aspects of our overall well-being, including memory, metabolism, mood, cardiovascular health and disease. In early recovery, sleep is especially important, giving you energy and willpower to cope with cravings and make rational decisions. There are lots of ways to set yourself up for a restorative night of sleep. Here are some reminders: Set a regular time for sleeping and waking up. Stick to this schedule! (Even on the weekends) Avoid consuming caffeine late in the day if you’re sensitive, after mid- to late afternoon. (According to information from the National Sleep Foundation, once in...
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  • Building Trust in Recovery

    Posted on March 24, 2015
    By Devon Berkheiser You can build trust again! Often, building trust with loved ones is a significant part of the recovery process. It’s not uncommon for people in the midst of an addiction to engage in lying, sneaking, and other behaviors that create a loss of trust in relationships. While it can be daunting to think about repairing your important relationships, here are 5 ways to help you manage the process: 1. Be patient First and foremost, recognize that rebuilding trust takes time. Addictive behaviors may have occurred over a span of many years, so it’s not realistic to think that you’ll be able to regain trust immediately. Your friends and family members have their own feelings to work through, so give them time and space for that. It’s normal to want to make things better...
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