Early Recovery: Overcoming Feelings of Emptiness and Loss

In previous articles about early recovery, I addressed problems with making major major adjustments to life to maintain sobriety (see my articles: Early Recovery: Focusing on the People Part of "People, Places and Things," Overcoming the Temptation to Use "Liquid Courage" to Cope With Social Situations and Early Recovery: You've Stopped Drinking. Now What?.  In this article, I'm addressing another common issue that people in early recovery experience, which is overcoming the feelings of emptiness and loss after you give up your addiction.

Early Recovery: Overcoming Feelings of Emptiness and Loss 

Many people in early recovery will say that one of the hardest things they had to do in order to get sober was give up the one thing they felt they could rely on--their addiction of choice.

For anyone who is unfamiliar with addiction and early recovery, these feelings of emptiness and loss for an addiction might seem confusing.

But as a psychotherapist in private practice in New York City, who has worked with people at all stages of addiction, I know that this sense of loss and emptiness is common and understandable.

After all, if the addiction, whether it's to alcohol, drugs, compulsive gambling, compulsive sexual behavior or any other addictive behavior, didn't serve a need, the person with the addiction wouldn't persist in it.

For many people, who are contemplating giving up an addiction, one of the most daunting aspects of attaining sobriety is the thought they won't have what feels to them as a "friend" who has served a need--whatever that need might be.

The need could be a way to relax, socialize, to temporarily forget problems, to elevate a mood, to feel empowered, and so on.  And if the addiction of choice didn't "work" in some sense, even temporarily, it would have been given up long before it became an addiction.

For someone who is unfamiliar with addiction, it would be hard to imagine just how scary and how courageous it is when someone who has an addiction gives it up.  Many people, who are not educated about addiction, think that the person with the addiction "should just stop."

But aside from the fact that there might be a physical danger to "just stopping" for many addictions where a detox is necessary, the person contemplating giving up the addiction is also taking a leap of faith that they will be able to survive physically and emotionally with the addiction.

This is why there's a high rate of relapse for people struggling to stay sober, especially if they try to do it without sober support and, eventually, working through the underlying emotional problems that led to the addiction in the first place.

What Will Take the Place of the Addiction for the Person in Early Recovery to Fill the Emotional Void?
Without the addiction, the person in early recovery will usually become aware of an emotional void and the sense of loss.

Early Recovery: Overcoming the Feelings of Emptiness and Loss

Since isolation and loneliness is often a part of addiction, many people in early recovery find support in 12 Step meetings like Alcoholics Anonymous or Gamblers Anonymous.

They discover that there are people in these self help meetings in all different stages of recovery--from early recovery to many years in recovery.

They also discover that they have much in common with the people in these self help rooms, including a continuing struggle to avoid relapse and to maintain the values and principles they learned in those rooms.

I usually recommend that people in early recovery give 12 Step meetings a chance by going to several beginners meetings to see if they find a particular meeting where they feel comfortable and where they can also find a sponsor to help them work the 12 Steps.

There is no one-size-fits-all approach to recovery, so I also understand that for some people in early recovery the 12 Step model doesn't resonate with them or they find the meetings too overwhelming after they've tried several meetings (see my article: The Early Stage of Recovery: What to Do If 12 Step Meetings Are Too Overwhelming For You?).

So, many people in early recovery prefer to go to structured treatment in either an inpatient or  outpatient substance abuse program, if they have health benefits that recovers this treatment, where they can also get group support from people with similar problems.

Other people seek out psychotherapists who have experience working with people in recovery, including early recovery.

For psychotherapy option to work well in early recovery, the psychotherapist needs not only to be familiar with addictions, she must also know how to assess the timing and what the client can tolerate in terms of working on the underlying issues.

It's essential that clients in early recovery have sufficient sober time, the coping skills and necessary internal resources to deal with the underlying emotional issues in therapy, so it's psychotherapists need to help clients to develop these internal resources before delving deeper (see my article: Developing Internal Resources and Coping Strategies).

All of these modalities--12 Step meetings, structured substance abuse programs, and psychotherapy--all have the potential to help clients to remain sober.

In addition, in many cases what's also needed is something deeper that will fill the void that's left from no longer engaging in the addiction.

Some people find meaning by discovering or rediscovering a sense of spirituality.

Spirituality doesn't necessarily mean religion, although it could (see my article: A Search For a Meaningful Life and Spirituality: Are You Contemplating Your Faith of Origin in a New Light?).

Spirituality can take on many different forms aside from formal religion.  For instance, many people feel a sense of spirituality when they volunteer to help others, including volunteering at 12 Step meetings or in schools or a local community program.  Others discover a sense of spirituality in nature and find a connection to nature a transcendent experience.

The important aspect of spirituality in whatever form it takes is that it is meaningful, fulfilling and transcendent.

I believe this applies to everyone--not just people in early recovery.  Whether you call it "spirituality" or something else, without a sense of meaning, purpose and transcendence, you're just living from day to day and it can feel empty.

Many people who don't struggling with addiction but who focus only on material things will often feel a sense of emptiness in midlife when money and possessions no longer serve elevate their moods.

Usually, midlife brings an awareness that money and material things, although necessary to a certain extent to meet basic needs and give some comfort, are never enough to fill up a sense of emptiness.

This is why many people in midlife, especially those who have more years behind them than ahead of them, recognize that they need to make changes (see my articles: Midlife Transitions: Part 1: Reassessing Your Life, Midlife Transitions - Part 2: Living the Life You Want to Live, Is That All There Is? When "Having It All" Leaves You Feeling Empty  and Redefining Happiness and Success For Yourself).

Conclusion
The early recovery stage presents certain challenges, including dealing with the sense of emptiness and loss that often occurs after giving up the addiction.

Early Recovery: Overcoming Feelings of Emptiness and Loss

Aside from the physical aspects of getting sober and maintain sobriety, people in early recovery need to find healthy and meaningful ways to fill the void.

Sober support from 12 Step meetings, substance abuse programs and psychotherapy offer various options for staying sober and, in the case of psychotherapy, working through the underlying emotional problems that led to the addiction in the first place.

Beyond these options, people in early recovery need to find a sense of meaning and purpose in their lives.  I refer to it as "spirituality," but it doesn't have to involve a formal religion or even a belief in a higher power.

Without a sense of meaning and transcendence, people in early recovery often struggle with the sense of loss and emptiness that usually follows after they become sober.

Getting Help in Therapy
Many people choose to attend psychotherapy to address underlying emotional issues at the core of their addiction (see my article: The Benefits of Psychotherapy).

As previously mentioned, it's important to find a psychotherapist who has an expertise in addiction and who can work with you in a way that feels emotionally manageable for you (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

I have helped many clients in all stages of recovery to maintain their sobriety and work through the underlying emotional problems that were at the root of their addiction.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Overcoming a Need to Rescue Your Loved Ones as Part of a Codependent Pattern

Many people attempt to rescue the people in their lives, especially family members and romantic partners (see my articles:  How to Stop Being the Rescuer in Your Family, Overcoming Codependency: Taking Care of Yourself First, and Overcoming the Need to Be Everyone's Rescuer).

Overcoming the Need to Rescue and Fix Your Loved Ones as Part of a Codependent Pattern

I believe most people who try to rescue others have a genuine concern for their loved ones and want the best for them.  Their intention comes from a good place within them.

At the same time, there are problems involved with rescuing.  One problem is that there are usually underlying emotional issues involved for the rescuers which causes them to feel compelled to fix others. They avoid dealing with their problems by focusing on others instead of themselves.

Another problem is that this dynamic often causes problems in relationships because the person, who is the "rescuee," often doesn't want to be rescued or fixed.  This is bound to cause friction.

Even if they do want to be rescued, the problem is that this dynamic keeps both people from facing their problems and growing and developing as mature, responsible adults.

Usually people who try to rescue others have developed this pattern first with their families and then it carries over into other relationships.

Let's take a look at a fictional vignette which illustrates this dynamic:

Fictional Vignette: Trying to Rescue and Fix Your Loved Ones:

Nina
As the oldest in her family, Nina's parents and siblings relied on her to resolve family problems from the time she was a young child.

From the time Nina was seven or eight years old, Nina's mother, who was a single parent, often confided to Nina about her problems.  She treated Nina as if she were a close friend rather than a child (see my article: Why Your Child Can't Be Your Best Friend).

Even after they were grown, Nina's siblings relied on Nina to bail them out when they got into trouble or needed money.

Helping her mother and siblings often meant that Nina would put herself in a financial bind, but she found it impossible to say no to them.

When she started dating Ed, Nina recognized that he drank too much, but she liked him a lot and she thought, "I can change him" (see my articles: Relationships: "I'll Change Him After We Get Married.")

Little did she know that Ed didn't want to stop drinking, and he resented her suggestions that she could help him.  After a few months, Ed's resentment led to his breaking up with Nina, which upset her.

A few months later, she became friendly with Tom, who worked in the same restaurant where Nina worked.  At first, they were friends.  But, as time went on, their friendship turned into a romance.

Shortly after Nina began dating Tom, she discovered that he had serious financial problems even though he did well as the bartender at the restaurant.

When Nina offered to lend him money and make a budget for him, Tom felt ashamed and told her that he didn't need her help.  But Nina persisted, which resulted in Tom ending their relationship.

Soon after they broke up, Tom left the restaurant and took a job somewhere else because it was too uncomfortable for both of them to work in the same place after they broke up.  This saddened Nina because she felt she lost a lover and a friend.

Right after Tom ended their relationship, Nina began getting headaches and backaches, which she never had before.  Her doctor ruled out any medical problems and suggested that it might be related to emotional problems.  He suggested that she seek out help from a psychotherapist.

As Nina described her family history and her romantic relationships, she and her psychotherapist discussed her need to try to fix others--even when these people didn't want it.

Nina said that she felt she could see others' problems much clearer than them could, and she wanted to help.  She took pride in being the "go to" person to be relied upon, "I'm the one everyone comes to for help in my family."

When her psychotherapist asked Nina who she went to when she had a problem, Nina acknowledged that she usually didn't go to anyone--not even her close friends--because it made her feel too uncomfortable.

Over time, as Nina and her therapist continued to discuss these issues in their psychotherapy sessions,  Nina realized how much she was neglecting herself by trying so hard to help others.

Since she gave her adult siblings so much money, she had little for herself.  She had not even bought herself a new coat in several years because her youngest brother had a gambling problem and she was constantly giving him money to bail him out.  She thought it would be "cruel" to allow him to face the consequences of his actions.

She also paid her mother's bills, even though her mother had a good job and could afford to pay her own bills, "Ever since I began working, I've just always paid my mother's bills."

When her therapist asked Nina to think about her situation as if it were someone else's story, Nina thought about her it for the first time, "It's just what I've always done, and I've never thought about it before."

But as she considered the personal sacrifices that she was making, she realized that she couldn't continue to do this.  She knew it would be hard for her to stop and for her family, "How will my family get along without my help?  They're not used to taking care of themselves."

What really convinced Nina that she needed to change was when she realized that she was focusing so much on other people so that she wouldn't focus on herself.

Nina's psychotherapist provided Nina with information about codependency so Nina could understand this is a dynamic and the ways to overcome it (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation).

Nina's psychotherapist also told her about how Al-Anon  meetings can help to overcome codependency.  Nina tried a few meetings, but she felt too overwhelmed by what others shared, so she decided not to continue and read the literature instead (see my article: The Early Stage of Recovery: What to Do If 12 Step Meetings Are Too Overwhelming For You?).

As difficult as it was for Nina, she and her therapist came up with a plan to deal with her codependency:  Over the next several months, she would gradually stop contributing as much financially to her family so they had time to work on becoming more independent and she had time to learn how to stop rescuing them.  Nina realized that, although she thought she was helping them, she was really fostering an unhealthy dependency and they would never learn to take care of themselves.

She was aware that her mother and siblings would protest because this would be a big change for them, and they wouldn't like it.

At the same time, Nina and her therapist began to explore the underlying reasons why Nina felt compelled to take care of others.  She discovered that she felt a need to have control over her siblings and her boyfriends because things were so chaotic when she was growing up.  Taking care of others and feeling in control helped her to have a sense of stability.

She began to understand that her intention for wanting stability in her family was a good one, but the codependent dynamic was hurting her and her family and her former boyfriends.

As part of Nina's plan, she told her family about the plan.  Initially, Nina's mother and siblings were angry with her and they refused to talk to her. They felt like she was being cruel, even though the plan would take place over several months.

But things gradually turned around.  During that time, Nina's mother became more conscious of how she spent money and took over her own bills.  After a several months, she told Nina that she felt a sense of pride that she could manage on her own because she never thought she would be capable of doing it.

Her brother, who gambled, got help from a psychotherapist who specialized in working with people with compulsive gambling problems.  He also began attending Gamblers Anonymous and got a sponsor.  He had a few "slips" along the way, but he took responsibility for them and felt better about himself.

Nina's other siblings got more serious about finding work and, after a few months, they were each employed and taking more responsibility for themselves.

Even though Nina developed insight into her codependent patterns, she had to remain aware of her problem at first or she knew she could easily fall back into her old ways.

Nina and her therapist worked on the underlying issues related to her childhood trauma, including how overwhelmed she felt as a child by the chaos in the household, using EMDR therapy (see my article: What is EMDR Therapy?).

As Nina dealt with her own underlying issues, her headaches and backaches went away.  As her doctor suggested, what appeared to be solely medical problems were related to her emotional problems.

Overcoming the Need to Rescue Your Loved Ones as Part of a Codependent Pattern

Working through her early trauma helped Nina to make healthier choices in her relationships (see my article: Choosing Healthier Romantic Relationships).

Conclusion
Trying to rescue and fix others is damaging to the rescuer as well as the people the rescuer wants to help.

A pattern of rescuing behavior usually involves codependency, which keeps the rescuers from focusing on their own problems because they're so busy trying to rescue others.

This pattern is often a blind spot for people who are codependent, but it can be worked through in therapy (see my article: Overcoming Your Blind Spots).

Changing patterns isn't easy or quick, but when people begin to see how beneficial these changes are for themselves and others, they realize that it's worthwhile.

Getting Help in Therapy
If this article resonates with you, you could benefit from getting help from a licensed mental health professional who specializes in helping people overcome codependency (see my article: The Benefits of Psychotherapy).

Dealing with the underlying issues at the root of the problem and freeing yourself from a traumatic history allows you and your loved ones to grow and flourish.

Rather than suffering on your own, you could get the help you need from a skilled psychotherapist (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article:  The Therapeutic Benefits of Integrative Psychotherapy).

I have helped many clients to overcome their codependent patterns as they work through the traumatic roots of their problems.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me. 

Recovery: Understanding Cross Addiction - Substituting One Addiction For Another

Many people who are recovering from addiction don't understand the concept cross addiction, which is substituting one addiction for another (see my other articles about substance abuse:  Recovery: Maintaining a Balanced Life,  "Liquid Courage:" Overcoming the Temptation to Abuse Alcohol to Cope With Social Situations, The Myth About Having to "Hit Bottom" to Change, and Coping With Addiction: Boredom as a Relapse Trigger).

Recovery: Understanding Cross Addiction - Substituting One Addiction For Another

The reason it's so important to understand cross addiction is that people who have a history of addiction often switch from one addiction to another, especially when they're under stress.

So, for instance, if someone who has been sober from alcohol for a few years suddenly finds himself under a lot of stress at work, instead of picking up a drink, he might start to abuse prescription drugs or gamble compulsively or engage in some other form of addiction.

Recovery: Understanding Cross Addiction - Substituting One Addiction For Another

It's easy to fool yourself into thinking that you can dabble with another addiction because it's not your primary addiction.

But when you're under a lot of stress and you haven't developed adequate skills, if you have a history of addiction, you're more likely to either relapse with your primary addiction or engage in cross addiction.

Let's take a look at a fictional vignette to see how this plays out:

Fictional Vignette: Recovery: Understanding Cross Addiction: Substituting One Addiction For Another:

Connie:
Connie was sober from alcohol for two years.  During that time, she struggled to maintain her sobriety, but with the help of her psychotherapist and her sponsor, she celebrated her second year as a sober person.

Soon after she celebrated her second anniversary of sobriety, she left Alcoholics Anonymous and told her psychotherapist that she wanted a break from therapy.

A few months later, her mother fell, broke her hip and had to go to an inpatient physical rehabilitation center.  When her mother got home, she needed Connie's help because she wasn't able to take care other daily needs.

Although Connie and her mother had a conflictual relationship, Connie agreed to move in with her mother temporarily to help her.  She knew that other siblings, who also had conflicts with their mother, wouldn't be willing to do it and her mother really needed help.

The stress of taking care of her mother and working a full time job took a toll on Connie after a few weeks (see my article: Are You Experiencing Chronic Stress and Unaware of It?).

There were times when she wanted to tell her mother to fend for herself, but she knew her mother couldn't be alone, so she tolerated her mother's emotional abuse.

Connie was often tempted to have a drink, but she knew that if she had one, she wouldn't be able to stop, so she refrained from drinking.  But she started using food to soothe her stress, and she gained 20 pounds within a few months.

Recovery: Understanding Cross Addiction - Substituting One Addiction For Another

When she went to the doctor for her annual checkup, her doctor couldn't believe that Connie had put on so much weight since the last time he saw her.

Knowing that Connie had a history of alcohol abuse, her doctor asked her if she was overeating.  When Connie told him that she was "stress eating" at her mother's home, he talked to her about cross addiction and recommended that she get back into therapy.

Connie had never heard of cross addiction.  Before she saw her doctor, she thought that as long as she didn't touch alcohol, she was doing well.  But when her doctor explained cross addiction to her, it made sense to Connie, and she knew she needed to take care of herself (see my article: Self Care For Caregivers).

The next day, Connie called a family meeting with her siblings and explained to them that they needed to pitch in.  She could no longer take on the sole responsibility of being her mother's caregiver.

At first, her siblings balked, but Connie insisted that either they help her out or she would hire a home attendant for their mother.

None of Connie's siblings wanted a home attendant in their mother's home, so they agreed to work out a schedule so they could take turns taking care of their mother.  Since there were seven of them, they each took a day, and sharing the responsibility made it less stressful.

Once her siblings were involved, Connie went back to her former psychotherapist to deal with her stress eating and unresolved issues about her mother (see my article: Returning to Therapy).

She also resumed attending Alcoholics Anonymous meetings, and she contacted her old sponsor on a daily basis.

With emotional support and reduced stress, Connie was able to get back on track so she could eat in a healthy way again and lose the weight she gained.

She also had a new appreciation for how stress could put her at risk for cross addiction.

Conclusion
The term "cross addiction" refers to substituting one addiction for another.

The fictional vignette above highlights how important it is to recognize your particular vulnerability to cross addiction and also the importance of self care, self help meetings, and getting help in therapy.

Getting Help in Therapy
Setbacks are part of recovery and part of psychotherapy (see my article: Setbacks Are a Normal Part of Psychotherapy on the Road to Healing).

If you've had a setback in your recovery, it's important to get help before the problem progresses (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist, who is knowledgeable about addictions, can help you to get back on track again (see my article: How to Choose a Psychotherapist).

Rather than struggling on your own, contact a licensed mental health professional who has an expertise in addictions so you can remain healthy.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

I have helped many clients to establish and maintain their recovery.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Understanding the Difference Between "I Can't" and "I Won't"

Understanding the difference between "I can't" and "I won't" is often the key to successfully making lasting changes in your life.  While "I can't" means you're not capable of doing it, "I won't" implies a choice--in other words, you're not willing to do it (see my article: Fear of Making Changes, Making Changes: Are You Creating Obstacles For Yourself Without Even Realizing It? and Making Changes: Overcoming Ambivalence).

Understanding the Difference Between "I Can't" and "I Won't"

Often, when people really mean "I won't," they say, "I can't."

For instance, when someone, who he wants to give up smoking, says, "I can't," he's saying that he thinks it will be too hard for him to do it so he chooses not to do.  Although he might not see it that way, if his psychotherapist explored the meaning of "I can't," it usually comes down to choosing not to do it (see my article: Becoming a Successful Nonsmoker).

While it's understandable that change can be scary, when you say, "I can't" it tends to foreclose any discussion about the obstacles that are getting in the way.  Whereas if you say, "I won't do it because I'm afraid that I'll fail" or "I won't do it because I'm too ashamed to admit that it's a problem," that leaves an opening for an exploration of the internal obstacles getting in the way.

The Clinical Implications of "I Can't" and "I Won't" in Psychotherapy

People often come to therapy because they want to make a change in their life.  Usually, they've tried on their own to make changes, but they run into obstacles.

Even though many people begin psychotherapy because they want to make changes, once there is a possibility for change, they often experience ambivalence because there are core issues that need to be addressed that are getting in the way.

If fear and shame are involved, and they often are, an inner conflict develops between the desire to change and the desire to remain the same and not work through the necessary obstacles to be able to change.  

The other possibility, when faced with fear and shame, is that the status quo begins to look good to the client for a while ("Maybe things aren't so bad in my life after all") until the client realizes, once again, that he really needs to change.

At that point, the client's psychotherapist can help the client, if the client is willing, to face the internal obstacles to making the change.  If the client isn't willing to explore his ambivalence, he might leave therapy prematurely (see my article: When Clients Leave Therapy Prematurely).

Let's take a look at a fictional vignette which illustrates these dynamics in therapy:

Ed

After Ed's father died, he became a compulsive gambler as a way to distract himself from his grief (see my article: Overcoming Grief Gambling).

His gambling began with March Madness and quickly progressed to other sports (see my article: Compulsive Gamblers: Beware of March Madness).

At first, when basketball season ended and he began betting on baseball games, he told himself that he would stop gambling at the end of the baseball season.  Then baseball season came and went and he was gambling on football games, and he continued to bargain with himself about stopping.

When the bookmaker refused to take any more bets from Ed because Ed owed him money, Ed got panicky.

Without the highs and lows of gambling as a distraction from his grief, he felt overwhelmed with anxiety and sadness, and this was a "wake up call" for Ed.  He knew he needed help, so he contacted a therapist who specialized in addiction.

Understanding the Difference Between "I Can't" and "I Won't"

During the initial consultation, Ed told his psychotherapist that he knew he needed to stop gambling because he was in debt for thousands of dollars and he didn't want to get any further in debt.

At that point, Ed didn't make the connection between his gambling and his fear of facing his grief over his father's death.  He only knew that he couldn't go on gambling and getting more and more in debt.

When Ed and his psychotherapist talked about when the gambling started, Ed told her that he gambled a little when he was in high school, but nothing compared to his current level of gambling.

As they traced back the origin of his compulsive gambling, Ed was able to see that it began soon after his father died.  Reluctantly, he began to put the pieces together, and he understood that he used gambling as a way to distract himself from his grief.

His therapist recommended that, in addition to coming to therapy, he also attend Gamblers Anonymous groups (G.A.), but Ed didn't think this was necessary.  He told his therapist that he would "just stop."  He believed, "I can stop whenever I want to."

Understanding the Difference Between "I Can't" and "I Won't"

His therapist decided, at that point, not to challenge Ed or insist on G.A.  She told him that they could see how he did with coming to therapy and not attending G.A.

Ed managed not to gamble for the first week, but he felt overwhelmed by anxiety and sadness, so since his bookmaker refused to take his bets until Ed paid off his debt, he told himself that he would "just place one more bet" on an Internet poker site using his credit card.

After placing the first bet, Ed felt he still had his gambling compulsion "under control," so he placed another bet and another--until he was gambling online nearly every day.

Although he felt ashamed about it, he knew that if he wasn't honest with his therapist, he would be wasting his time in therapy, so he admitted that he was now gambling online nearly everyday.

His therapist explained the brain chemistry involved with gambling and other forms of addiction and why continuing to gamble would make it that much harder to stop.

His therapist recommended that they work on coping skills so that Ed could manage his urges.  She also recommended that he identify the triggers that made him want to gamble.

Ed knew that he had a problem tolerating his anxiety and sadness related to his father's death.  Until now, he didn't realize the magnitude of his gambling problem and what it would take to overcome his problem.

He agreed to practice mindfulness meditation at least once a day, but he didn't follow through with his commitment.  Instead, he gave into his urge to gamble, telling himself each time, "This will be the last time."

When he returned to see his psychotherapist, Ed acknowledged that he didn't listen to any of the mindfulness recordings that he downloaded on his phone.

He also admitted that he was still gambling, and he was beginning to feel hopeless about overcoming his gambling addiction.   He asked his therapist, "Isn't there any easier way?" (see my articles: Beyond the Band Aid Approach in Therapy).

His therapist recommended that Ed come twice a week to therapy, attend G.A. meetings and get a sponsor in G.A.  She also explained to Ed that, when he was ready, they could work on the underlying trigger, the grief that he was avoiding.

In addition, she discussed how, if he followed her recommendations, he would probably be able to build up his tolerance for his uncomfortable feelings so they would no longer feel intolerable to him (see my article:  Expanding Your Window of Tolerance in Therapy to Overcome Emotional Problems).

At that point, Ed threw up his hands and told his therapist, "I can't.  I can't do this."

When his therapist explained the difference between "I can't" and "I won't," at first, Ed continued to maintain that he couldn't do what needed to be done to overcome his gambling addiction.

But as they continued to explore whether he was really incapable of overcoming his gambling addition or he was unwilling to give it up, Ed reluctantly admitted that he was unwilling.

At that point, his therapist and Ed had a basis to discuss his unwillingness to give up gambling and unwillingness to deal with his grief.

Over time, the more Ed talked to his therapist about his emotional struggles, the more he was able to see that he was creating obstacles for himself.  So, he followed his therapist's recommendations to practice mindfulness meditation every day, he began attending G.A. meetings, and he obtained a sponsor.

After attending a G.A. meeting, Ed told his therapist that he was surprised to discover how many people were in a similar predicament specifically related to grief gambling.  When he heard other people in G.A. speak about their guilt, shame and overwhelming sadness, he understood what they were talking about.

Gradually, Ed began to talk to his therapist about his grief.  At first, he was afraid that he would be overwhelmed, but he was surprised to discover that he actually felt better after he talked about it.

Understanding the Difference Between "I Can't" and "I Won't"

As Ed dealt with his unresolved mourning in therapy, he felt no desire to gamble.  He paid off his debts and even began to save money.

Over time, Ed was also able to see that he used the idea of "I can't" as a way to avoid dealing with his uncomfortable feelings.  Now he could see the difference between "I can't" and "I won't" and it was an important lesson in other areas of his life.

Conclusion
Even when people really want to change and they come to therapy to get help with making a change, ambivalence often sets in as the process begins (see my article: Starting Psychotherapy: It's Not Unusual to Feel Anxious or Ambivalent).

At that point, they're likely to say, "I can't" when they really mean "I won't."

Although making a change can be scary, it's a conscious choice and, by the same token, so is not making a change.

Fear and shame are usually the underlying obstacles as to why people are unwilling to take the necessary steps to change.

This is especially common for people who grew up in a family where they didn't have the emotional support they needed when faced with difficulties as a child.

On an unconscious level, they fear that they will be as overwhelmed by emotion as they were as children, but this is rarely the case.  For one thing, as an adult, there is a greater capacity to tolerate emotions (as compared to when they were children).  And, for another thing, as an adult, they have the wherewithal to ask for help.

Making a change that's challenging is often a gradual process:  One step forward and two steps back.     Along the way, there are usually setbacks before you succeed (see my article: Setbacks Are a Normal Part of Psychotherapy on the Road to Healing).

Getting  Help in Therapy
It takes courage to make a major change (see my article: Developing the Courage to Change).

There are some changes that feel so daunting that you might need help from a licensed mental health professional (see my article: The Benefits of Psychotherapy).

If you've been struggling on your own to make a change in your life, you could benefit from seeing a licensed psychotherapist who has experience helping people to overcome obstacles to change (see my article: How to Choose a Psychotherapist)

Everyone needs help at some point in his or her life, and getting help from a skilled psychotherapist could make all the difference between making a successful change or not.

The choice is yours.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

I have helped many clients to overcome the obstacles that were getting in the way of making a major change in their life.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Relationships: Thinking of "Starting Over"? Ask Yourself, "What's Changed?"

Before you consider "starting over" in a troubled relationship, it's a good idea to ask yourself, "What changed?," especially if, as a couple, you haven't reflected on what needs to change and how the two of you are going to bring about that change (see my article: Love: Is It Really Better the Second Time Around?)

Relationships: Thinking of "Starting Over"?  Ask Yourself: "What's Changed?"

Many couples, who have having problems in their relationship, decide that telling themselves they're "starting over" means they've changed their problems.

But without introspection by each individual, an understanding of what went wrong in the past, and a plan to make changes, in most cases, the same problems continue--no matter how many times these couples vow to "start over."

Some couples might say that they've talked about their problems and they've decided not to repeat the same mistakes.  But with complex relationship problems, if you don't understand the underlying issues at the root of these problems, a simple declaration to not repeat your mistakes won't resolve the problems.

Let's look at a fictionalized scenario that illustrates these issues:

Jane and Bob
Bob and Jane were dating for two years when they moved in together.  Both of them were divorced and had not dated in a long time before they met each other.

Relationships: Thinking of "Starting Over"?  Ask Yourself: "What's Changed?"

Initially, things were going well and they were enjoying their time together, but several months later, Jane discovered that Bob secretly engaged in online gambling.

One night, she woke up in the early hours of the morning to find Bob at their computer in the living room playing poker online.

When he heard Jane come into the room, Bob tried to hide what he was doing by switching to another website, but Jane had already seen what he was doing and she confronted him (see my article: Are Toxic Secrets Ruining Your Relationship?)

They stayed up all the night to talk about Bob's gambling.  At first, he told Jane that this was the first time that he had ever gone onto this gambling site.  But when Jane looked at the browser history, she saw that he was regularly on various gambling sites.

At that point, Bob had to admit that he would frequently gamble online, and he had been gambling online for several years, but he didn't want Jane to know about it because he felt ashamed about it.

Although Jane felt compassion for Bob, she was also shocked and angry that Bob hid his problem from her.

Over the next few days, as Jane and Bob continued to discuss his gambling, Jane found out that Bob had withdrew a considerable amount of money from their joint checking account.

When Jane confronted Bob about this, he told her that he had planned to replace the money before Jane found out about it, but he was having a "bad streak of luck."  He admitted that he was also gambling on sports and he had lost a lot of money.

By now, Jane was very upset.  She was beginning to realize that Bob's gambling problem was a lot worse than she had originally suspected.

After thinking it over for a few days, Jane told Bob that she couldn't live with a gambler, especially since her father gambled away her family's savings.  Then, she asked Bob to move out.

Relationships: Thinking of "Starting Over?" Ask Yourself: "What's Changed?"

Bob pleaded with Jane to give him a chance to overcome his gambling problem.  He knew he would be miserable without Jane and he felt deep remorse for putting their relationship in jeopardy.

Jane wasn't sure what to do at that point, so she asked Bob to move out for a few weeks so she could think about what she wanted to do.

During the weeks that Bob and Jane were apart, they agreed to no contact.  They each missed each other a lot, and Jane wondered if she had made a mistake by asking Bob to move out.

After their separation period was over, they agreed to talk.  Bob told Jane that he wanted more than anything for them to get back together.  He asked her if she would consider "starting over" and he promised he would never gamble again.

Jane told Bob that their weeks apart had been very hard for her, and she missed him a lot.  She made Bob promise that he would never gamble again and, when he did, she agreed that they should "start over."

They both agreed that they wouldn't discuss his gambling or this painful period in their lives again, and they would resume their relationship "as if nothing had ever happened."  They both wanted to "put it behind" them (see my article: Overcoming Your Emotional Blind Spots)

Relationships: Thinking of "Starting Over"?  Ask Yourself, "What's Changed?"

Initially, they were so glad to be back together again that they went on a romantic vacation together to rekindle their relationship.  They had a wonderful time, and when they got back, they were more resolved than ever to be together.

But a month or so later, Jane couldn't help wondering if Bob was secretly gambling again.  She wanted to trust him, but she began to have doubts.

Whenever she began to have doubts, Jane tried to put these doubts out of her mind, but they kept coming back.

Then, one day, when Bob was out, Jane decided on a whim to look at the browser history, which had been cleared of the previous history, and she saw that Bob had resumed gambling again.  She felt completely betrayed.

When Bob got home, he discovered that Jane had packed his things and put everything by the door.  He realized immediately that Jane had discovered that he started gambling again.

He pleaded with Jane to give him another chance, but she was adamant that he needed to move out.  She didn't want to live her mother's life with a gambler.

A few weeks later, Bob began therapy with a therapist who specialized in addictions.

Over time, he learned about the emotional triggers that triggered his compulsive gambling.  His therapist told him that, in addition to attending therapy, he needed to attend a 12 Step program for gamblers, Gamblers Anonymous and also get a sponsor in that program.

Bob attempted to bargain with his therapist, telling the therapist that he thought he could cut back on his gambling so that it would be less of a problem--rather than abstaining completely from gambling (see my article: Starting Therapy: It's Not Unusual to Feel Anxious and Ambivalent).

But his therapist told Bob that he had a serious problem and explained that if Bob gave into his compulsion to gambling, even if it was less frequently than before, he would be reinforcing this habit and wouldn't stop.  He also explained the brain chemistry involved with gambling and other addictions.

Bob decided to leave therapy (see my article: When Clients Leave Therapy Prematurely).

He felt he could handle his problems on his own, so he made a promise to himself that he would only gamble once a week and he would set a limit on how much money he would allow himself to lose

For the first month, this appeared to work for Bob and he was proud of himself.  He kept to his promise to himself to only gamble once a week and to stay within certain monetary limits.

Bob felt so good about what he saw as progress that he told himself that he was able to control himself and he could gamble twice a week and increase the limit of what he allowed himself to lose.

As time went on, Bob felt bored and he kept bargaining with himself and this resulted in his gambling more often and losing much more money than he had ever lost before (see my article: Overcoming Addiction: Boredom as a Relapse Trigger).

Before he realized it, Bob had gambled away much of his savings and he was tempted to borrow money from his parents.  But at that point, Bob stopped himself.  He knew that he had sunk to a new low and his denial about his problem was only making it worse.

Bob went back to therapy and made a commitment to remain.  He also began attending Gamblers Anonymous (G.A.) and he got a sponsor that he called several times a week, especially when he felt a urge to gamble.

A year later, Bob celebrated his one year anniversary of abstaining from gambling.  He knew his triggers, and he knew he needed to talk about his habit in his individual psychotherapy sessions and in G.A. groups and with his sponsor.  He also knew that he needed to be aware of not becoming complacent.

Throughout this time, Bob continued to miss Jane.  He had thought about calling her many times, but he was afraid that she would hang up on him.

After celebrating his one year anniversary, Bob called Jane and hoped for the best.  He had already discussed this with his therapist and his sponsor, so he was prepared if she rejected him.  But, to his surprise, she sounded glad to hear from him, and they decided to meet for coffee.

Relationships: Thinking of "Starting Over"? Ask Yourself: "What's Changed?"

Coffee led to dinner.  Jane was happy to hear that Bob hadn't gambled in a year.  She sensed his sincerity and commitment to his recovery. He also offered to have her come to a therapy session with his therapist.

After that, they decided to go to couples counseling (see my article: Starting Couples Counseling).

They both knew that simply saying that they would "start over" wasn't the answer, and they needed help from a licensed mental health professional if they were going to get back together again.

Conclusion
A couple's decision to "start over" is usually well intentioned.  But if the couple doesn't address the issues in a meaningful way and with professional help, especially if they have serious problems, it's usually a misguided strategy.

Without realizing it, many couples tell themselves that they will "start over" as a form of denial--a way to avoid dealing with their problems on a deeper level.

In most cases where there are serous problems, it's magical thinking to think that their problems will automatically vanish because they've decided to "put it behind" them.

Many relationships that could be salvaged with professional help end permanently after many efforts to "start over" don't work.

Getting Help in Therapy
While it might be tempting to put aside problems by vowing to "start over," this is usually a doomed strategy.

Acknowledging and understanding the problems on a superficial level is only the first step.

Rooting out the underlying, unconscious issues requires the skill of a licensed mental health professional.

If you and your significant other have been struggling with relationship problems and "starting over" hasn't worked for you, you could benefit by seeking help from a licensed psychotherapist.

It could make the difference between salvaging your relationship or ending it.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

The Myth About Having to "Hit Bottom" to Change

The myth that people who have addiction problems have to "hit bottom" before they decide to change is both extremely dangerous and completely wrong.  This is an outdated concept that is still around in some recovery circles, and it has been detrimental to many people.

Recovery: The Myth About Having to "Hit Bottom" to Change

Even though many people in recovery now realize that "hitting bottom" is detrimental, there are still some people in recovery who still believe it.

If you're struggling with addiction, whether it's drinking, drugging, compulsive gambling, sexual addiction or some other form of addiction, or you love someone who has an addiction problem, it's important that you understand why the "hitting bottom" myth is dangerous.

Let's take a look at a fictionalized scenario and see how believing in the "hitting bottom" concept can be dangerous and what to do if you or a loved one is stuck in this type of distorted thinking.

Ed
Ed began gambling in college.  Initially, his gambling involved sports, like gambling on the Super Bowl.  Over time, it grew to include other forms of gambling.

While in high school, Ed was able to hide his gambling from his parents.  But by the time he was a senior in college, he gambled away his tuition money, so he was forced to reveal his gambling problem to his parents.

Ed promised his parent that he would never gamble again, so they lent him the tuition with the agreement that he would pay them back when he graduated college and began working.

When he graduated college, Ed got a high-paying job in finance and he began to pay his parents back.  Little did his parents know that Ed never stopped gambling, and his secret gambling problem had progressed to include going to the casinos, playing high stakes poker with friends, and online gambling.

Recovery: The Myth About Having to "Hit Bottom" to Change

After a few months, despite his high salary, Ed was making excuses to his parents as to why he was unable to make his monthly payments to them.  He was also asking to borrow more money from them.

By then, Ed's parents realized that he had not been honest with them and he was still gambling, so they confronted him about it.  At first, he denied it.  Then, he admitted that it was true.  But he felt that he could "control it" if he wanted to and rejected their suggestion to get help in therapy or to attend Gamblers Anonymous.

Recovery:  The Myth About Having to "Hit Bottom" to Change

Not sure what to do, Ed's parents spoke to a close friend, Tom, who once had a gambling problem, but who overcame it by attending Gamblers Anonymous (G.A.).  Tom had been in recovery for many years, and he rejected their idea to have a family intervention to confront Ed about his gambling problem.

Instead, Tom told Ed's parents that Ed would only be willing to change after he had "hit bottom." He told them that it would be useless for them to try to persuade Ed before that, and they should let Ed find his own way to his "bottom."

Ed's parents weren't sure what to do.  They were worried that Ed's gambling would continue to get progressively worse if they didn't urge Ed to get help.  But they decided that Tom had a lot of experience in G.A. and he must know what he was talking about.  So, with much difficulty, they stood by while Ed continued to gamble, hoping that he would "hit bottom" soon before he had ruined his life.

A year later, Ed's parents were shocked and dismayed to discover that Ed was arrested for attempted fraud as part of an internal investigation in his company.  He was taken out of the company in a pair of handcuffs.

Recovery: The Myth About Having to "Hit Bottom" to Change

Fortunately, since it was his first offense, the judge mandated Ed to get into treatment, a combination of psychotherapy and Gamblers Anonymous in lieu of going to jail.

His parents attended some of his therapy sessions in order for them to understand what happened and for Ed to repair his relationship with his parents, who were hurt and angry.

During one of those sessions, Ed told his parents that, before he was arrested, he was sure that he could stop gambling at any time if he really wanted to do it.  But, after a while, he was deeply in debt to loan sharks and he was so desperate that he did what he never would have thought he would do--he tried to embezzle money from his company.

Ed took full responsibility for his actions.  But his parents realized that following Tom's advice to allow Ed to "hit bottom," rather than doing a family intervention earlier on, was ill advised.

The therapist, who had an addictions background, also advised them that "hitting bottom" was a dangerous myth.

Conclusion
The motivation to change can come in many different ways.

Sometimes, people get a wake up call that they're heading down a slippery slope and they need to make changes in order to avoid a disastrous end.

Other times, people make a few false starts before they make a commitment to change.

The idea of "hitting bottom" would certainly be seen as ridiculous with just about any other type of problem.  Imagine telling someone who had a progressive medical problem that s/he had to wait until the problem got much worse before s/he got help.

The idea of "hitting bottom" is just as ridiculous and dangerous when it comes to addiction.

Getting Help
If you have a loved one who is caught in the grip of an addiction, rather than waiting for the problem to get worse, express your concern.  If that doesn't work, try doing a family intervention in a loving and tactful way to let your loved one know that the family cares and is concerned.

If you're the one who is struggling with addiction, get help sooner rather than later, before there are serious consequences to you and your loved ones.

Living a healthy and fulfilling life is its own reward.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me. 

Overcoming Grief Gambling

News stories about former San Diego mayor, Maureen O'Connor, have brought to light the importance of getting help for grief gambling.  According to news reports, Ms. O'Connor gambled more than a billion dollars of her own money as well as money she embezzled from her foundation due to a combination of grief gambling, which is a syndrome that is more common than most people realize, and a medical condition that she was contending with at the time.  According to news reports, Ms. O'Connor started grief gambling after her husband and other people close to her died.

Overcoming Grief Gambling

What is Grief Gambling?
Grief gambling is a compulsive and addictive form of gambling.  It usually occurs among people, especially the elderly, who have had a lot of losses and who haven't learned healthy ways of dealing with their grief.

Rather than dealing with their feelings about their losses, people who engage in grief gambling use it as an escape to avoid emotions that are uncomfortable for them.  Generally speaking, they don't go through the usual mourning process because they avoid feelings that are uncomfortable for them.  Grief gambling can occur at any age, but it often occurs among the elderly because they've sustained the losses of so many people in their lives.

Overcoming Grief Gambling

Unlike excessive drinking or drug abuse, where there are usually signs of impairment, grief gambling is easier to hide.  People who engage in grief gambling can sit in front of their computers and gamble away thousands of dollars or, as in the case of Ms. O'Connor, more than a billion dollars, in less time than most people would imagine.  They can maintain their secret life of gambling for a while--until, inevitably, they must face the consequences of their losses because these games are always stacked in favor of "the house" and the odds are against the person gambling.

Compassion Instead of Criticism For People Who Have Problems With Addictive Behavior
While it's true that people who engage in irresponsible or illegal activities must face the consequences of their behavior, I believe that, rather than judging people who are caught in the grip of addictive behavior, we need to have compassion for them.  While it might be hard to understand how someone could get him or herself into a predicament where s/he gamble away a child's college fund or the family's life savings, it's important to not to be judgmental.

What Are the Consequences of Grief Gambling?

People who engage in grief gambling to escape feeling their grief have been known to file for bankruptcy.  Marriages are ruined, and jobs are lost due to this form of gambling.  Most people who engage in grief gambling don't engage in sociopathic activities to continue gambling.  But there have been other cases where individuals, caught in the grip of this addictive behavior, have engaged in "white collar" crime and other illegal activities to feed their gambling habit.

Grief Gambling and Denial

You might ask how a sane person could allow themselves to get caught up in such addictive behavior.  This is a complex subject, but one important factor is the psychological defense mechanism of denial.  Most people who are caught up in grief gambling know that it's only a matter of time before they have to face the consequences of their behavior, but denial keeps them from fully coming to grips with this.  Whether they tell themselves, "I'll just do it one more time, and then I'll stop" or "I'll stop after the next big win," denial keeps them going. 

The Psychological "Rewards" of Grief Gambling

The online games are designed to be compelling with psychologically-rewarding intermittent rewards for online gamblers.  Playing these games also stimulates the dopamine receptors in the brain, which also helps to make it addictive.  For grief gamblers who go to the casinos, the casinos reward "high rollers" with free hotel rooms, expensive meals, and just about whatever they want to keep them gambling.  They're made to feel very special.

Getting Help:  Psychotherapy to Deal with Grief
As I've mentioned in other blog posts, we're hard wired for attachment, not loss.  Needless to say, losing someone you love or, worse still, multiple losses of loved ones, is very difficult.  It's understandable that no one would want to go through the mourning process if he or she had a choice. But, unfortunately, loss is part of life, whether we like it or not or whether we feel we're ready to deal with it or not.

Aside from being at risk for addictive behavior, unresolved bereavement  can put you at risk for other psychological problems, like depression or an anxiety disorder.  Unresolved bereavement can also compromise your immune system, putting you at risk for medical problems.

When you work with a skilled psychotherapist, who has experience helping clients through their grief, you learn to mourn the loss of your loved one so that you can begin the healing process and you no longer feel overwhelmed by your grief.   You'll learn to develop healthy coping skills, rather than turning to grief gambling or other unhealthy activities.

Mourning is a process, and the process is different for each person.   In a society that tends not to discourage dealing with uncomfortable feelings, well-meaning people will often tell you to "just get over it."  But no one can tell you how long it should take you to mourn your loss.  With the help of a skilled therapist with whom you feel a rapport, you can get through this difficult time with the emotional support and new coping skills you'll learn in therapy.

Getting Help:  Gamblers Anonymous http://gamblersanonymous.org
For people with gambling problems, I often recommend that they attend the 12 Step program, Gamblers Anonymous.  At Gamblers Anonymous, people usually find supportive group members, many of them who have been successful at abstaining from gambling for many years.  Other group members are at various stages in their recovery.  The link to the G.A. website provides a list of meetings all over the U.S.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

I work with individual adults and couples.  I have helped many clients to heal from bereavement issues.  I also have an expertise in working with addictions.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (917) 742-2624 during business hours or email me.