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 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...

By Tom Horvath, PhD, ABPP When we experience anguish (despair, heartache, melancholy, sorrow) after a significant loss, the depth of the anguish reminds us of the depth of the loss. Usually, the anguish does not surprise us, but we may be surprised at how powerful it is. Even our bodies can hurt. We feel anxious and confused. We ruminate about the past and imagine “if only” over and over. We neglect ourselves, and possibly others. We fear for the future. We think we need to talk about how we feel, but we don’t know where to start. Most often we think of grief as arising from the loss of a person or a relationship, but grief can arise from any significant loss. Like other aspects of human life, grief is an experience we will likely have several or more times. We will somehow get th...

By Tom Horvath, PhD, ABPP   Am I an “alcoholic” or “addict?” Do I “need help?” If so, what kind? If you are asking one or more of these questions, this blog is for you!   A somewhat out-of-date but nevertheless helpful federal publication considers these questions. Although this NIAAA (National Institute Alcohol Abuse and Alcoholism) document is focused on alcohol problems, many of its ideas can also be applied to other addictive problems. In this blog I will attempt to improve upon and expand their ideas. In my opinion NIAAA 1) focuses too much on treatment and not enough on the individual choosing or considering change, 2) does not alert the reader about the serious problems that can arise in treatment, and 3) is not up-to-date on the finding that AA specifica...

Addicted in Film: Movies We Love About the Habits We Hate, by Ted Perkins A review by Tom Horvath, PhD www.addictedinfilm.com I have already provided advance praise for this book, and I am pleased to repeat it: [Addicted in Film: Movies We Love About the Habits We Hate] is a must-have if you or anyone you know has been touched by addictive problems. It's filled with enlightening stories about powerful films that could become a turning point for people. You might also be interested in: 14 Addiction and Recovery Movies to Add to Your Queue Perkins** reviews over two dozen addiction-related films (culled from over 100 that he considered including). The reviews are thorough and cover the main components of each film. He selected films that might help someone change. He exc...

by A. Tom Horvath, Ph.D., ABPP Might you be looking for an up-to-date and thoroughly scientific “textbook” on alcohol, alcohol problems, and how to deal with them? In May, 2022, the US National Institute on Alcohol Abuse and Alcoholism (NIAAA), one of the 27 National Institutes of Health, published one online. Although this resource is written for healthcare professionals who address alcohol problems, motivated non-professionals will find answers to many of their questions, as well as links to resources for investigating further. NIAAA's Core resource provides 14 articles, which address: How much alcohol is too much? Risk factors for developing alcohol problems The neuroscience of alcohol Understanding and coping with stigma about alcohol problems Medical complic...

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...