How to Motivate Yourself to Change Addictive Behavior

[Music] hi everyone welcome to med circle i'm kyle kittelson and joined today by dr daniel hochman who is a psychiatrist and addiction recovery specialist i'm very excited to jump into our topic of conversation today if you are not a med circle member and would like to join med circle and be able to participate in these types of discussions live and ask questions live go to medcircle.com and join today if you're a health care worker a student a teacher military uh we have discounts for you so please email me kyle at medcircle.com for discounts on your med circle membership uh dr hochman while people are logging in here um they might be meeting for you meeting you for the first time so why don't you give a little introduction yeah i'm dr daniel hochman and i'm a psychiatrist i've got a private practice i also do consulting in the area and i've also built an online recovery program and so yeah i am a psychiatrist who's always very interested in looking at underlying issues understanding the real nature of people's suffering so i'm biologically oriented as a as a doctor and use medication but um my real mission is always to help people really understand themselves and demystify what's going on fantastic well dr hochman take it away good so um here we've got what i call the current of addiction and what this does is try and help people to understand that addiction is a pretty normal process and that's something that happens when we're experiencing some form of pain and and so the current begins there and so an emotional pain can be anything from you know major depression uh diagnosed anxiety panic disorders but can also be um more vague sorts of things that sit with people so boredom frustrated with life not where you want to be unhappy marriage uh really frustrated with work all sorts of things so any kind of emotional struggle there and the current sort of goes on from there and you'll see that the force sort of just keeps going and that's why i call it a current so when we don't feel well in our minds we generate a craving the craving is just simply the mind's way of saying i want out of this so i don't feel good i'm frustrated with the day or maybe just this long deeper depression i want out the out is the idea of how we're going to escape that it could be a drink it could be through exercise even so it can really range and so the craving is the idea the idea is the escape and when we follow through with the idea is when we move on in that current to actually the addiction so the the addiction phase as i consider it is actually just part of the more sort of uh larger current of addiction so addiction is when we carry assuming we all have these emotional pains uh that seems to be unavail unavoidable so why is it that some people would deal with their emotional pain in a healthy way while others uh turn to an unhealthy coping mechanism like addiction yeah exactly there's a difference between people who just say experience depression and people who are depressed and have addiction so the the biggest difference even people who have depression might have cravings as well meaning if you're sad you want a way out but it's the sort of how heavily you're looking for a way out of that feeling that decides whether it's addiction or it stays depression anxiety or hopeless or whatever it is so if you're preoccupied with getting out of that state and cannot tolerate that state you would have addiction people with depression who don't have addiction or anxiety or anything who don't have addiction are actually better at tolerating that state even though they might be miserable they might be very depressed they actually are better at tolerating that state and part of that has to do with where this whole current goes actually which is the false pleasure so the idea in addiction is that when you complete this current you're ending up in a state where you're either numbed or you feel euphoria you feel really good you're having a very good break from reality from the suffering and so people with addiction are training and always retraining this current and this process it gets continually reinforced and there's a development of a reliance on the system of escaping pain and going towards pleasure whereas just depression anxiety there's not that trained pattern they're better able to sit with the pain so yeah the false pleasure is where they wind up and when you do that well then the guilt and shame sets in and then you feel bad again and that's where sometimes you get this sort of triggering of events so you relapse or you drink more than you want you made a fool of yourself and then they go home and secretly now go on a binge and that binge you know it's because it's it's recycling around now there's that false pleasure made you feel so badly and it becomes actually now the source of suffering especially if you feel very guilty about a relapse so health to me is when you're just living outside of this current altogether you can address actually each part of this current and any one of these if you shut off or wind down the current dies down so health is not just through shutting those down when i treat people i'm trying to shut down each of these components so that if any one of them comes back you're still okay even if two come back you're still okay but even beyond that not even dealing with the current at some point and just actually being totally outside of it so if you were you know in this current metaphorically it'd be like just being on the river's edge watching it you're watching what goes on you still experience life you still have pains you still have cravings even and those come up but in more appropriate ways and contained and you're still mostly just removed from it you know this really resonates with me uh especially when i consider some of the literature i've read on mindfulness or meditation being able to take that step back um and and and watch things happen rather than you know feeling that full experience of course i don't want people to not feel anything but that's uh how it resonated with me when you said that yeah and mindfulness is absolutely a proven strategy and technique to help in this and it's probably the most relevant in the cravings and the false pleasure parts of this the cravings being able to tolerate these wants and desires that's a very buddhist philosophy actually to tolerate our wants the wanting mind and then the false pleasure too the idea that you know are we even as the goal of life even to be in this pleasurable state you know that's kind of hedonist right to be in this pleasurable state um and this starts to span into all sorts of things right like consumerism and things that you know we're always clicking and wanting and buying and consuming right and that's based partly on this premise of you know a false pleasure you know escaping reality with these pleasures so yeah absolutely that's part of it and when i treat people mindfulness is absolutely a part of this picture excellent so we can go through here now are some of the common myths about addiction a lot of people think of it in ways that i find really get in their own way of moving forward and when we don't think of addiction in proper up-to-date ways we waste our efforts often so one of those myths is that 50 or more percent of addiction is caused by our genetic makeup and that you know so it's true scientists have identified these so-called addiction genes and and it sounds very scientific and so a lot of the consensus will say it's like half and half you know it's half nature half nurture and i i i think it's important to kind of dispel this myth not because you know genes don't exist or have anything to do with addiction but because genes only help determine our traits sometimes our temperament but they don't actually determine our actual behaviors or our choices so the genes determine a part of our traits but they don't determine what we actually do what we say how we behave what we choose and so that would be like saying you know because the genes make you tall that you're a basketball player that'd be ridiculous right i mean this most tall people aren't so great at basketball um same thing here right genes can make us risky uh so we might have a high risk tolerance so people with you know the heavier more risky addictions might have that temperament genetically but you can also be a risk taker in the investment world you can be an entrepreneur you could be a skydiver you could you know talk in front of people that you don't know there's a bunch of other ways to take risks so addiction is just one of those choices there's other things that come into that final determination of what we end up doing with our lives the other thing is that genes are always turning on and off so the idea that genes you know decide all these things or that they're static is wrong we now know genes are turning on and off from little and big things they're affected from birth they're affected from what we eat they're affected by hormones they're affected by the sun they're affected by all sorts of things minute to minute hour to hour month to month and if you don't believe this you know just think about this we have the same genes that make up our eye as make up our heart as make up our toes so it's the same genes making these things the body is quite good at learning where to turn different parts of our genes on and off and this is a regular part of genetic operation and we've got good studies to back all this up so primates we've looked at you know monkeys and see that the ones that have these so-called addiction genes turn off when they're given the proper nurturing so you could take no genetic predisposition to addiction and raise them in a harsh cold way and they have addiction and the opposite is true you take all the addiction genes in a monkey you raise them with nice warmth touch so the researchers will measure actually you know how much touch and warmth and stroking and all that that they're getting to feel secure and they don't have addiction so these things get turned on and off profoundly this happens early in pregnancy as well so there are certainly translations from that research to what we see in human life and the most esteemed people like lance dodis um you know comes through the literature and with a critical eye you know often there are many other people who would say that just no such thing as a gene for alcoholism and this goes for other addictions too okay also another common myth that circulates is that their brain abnormalities that cause addiction um you might have heard i certainly get a lot of patients and they say yeah i was just kind of born like this they just kind of come in and it's fixed i am just this way i'm i was born like this i'm always compulsive i'm always you know just you know impulsive and go you know for addictive things um and it is true that there's differences in brain activity of addict first non-addict but that's sort of a confusing picture because there's differences in brain activity between anything i mean we could we could look at the brain activity of any person pre and post anything or in different parts of the world different ways of studying you're always going to find these differences and so everything we do changes the way our brain grows changes the way it's made up and a really clear example of this it's a really nice study done followed cab drivers and we were able to track very very clearly and document that cab drivers were very good at growing spatial awareness and knowing where they were in their brain so you could measure them pre and post or measure cab driver versus non-cab driver and see a huge amount of differences not just in the spatial parts of brain but even takes over other parts of the brain so the brain's very adaptable and it learns these things and so the idea that addiction is like set from earlier and that the brain works differently is a misattribution it is true that there's a difference but it's not causal from some sort of set thing at birth it's actually because of a training when you train yourself to escape pain with pleasure you're training your brain and you're gonna have a certain dopamine pathway get reinforced over and over again so are you are you saying then are you saying then that you believe that there aren't people who are more predisposed to develop addiction i think that there is some slight predisposition like there are some genes that slightly slightly predispose you there are temperaments that slightly predispose you there might be and so there would be you could call it a brain abnormality i wouldn't call it an abnormality but you know that could be part of a temperament let's say to be you know more impulsive than someone else so those you could say are predispositions but first of all none of them are deterministic they're not going to mean that you have an addiction um and second they aren't things that are fixed so they'd all be adaptable so even if you were impulsive you can absolutely build skills that reduce that impulsivity like you're talking about earlier you know with certain meditative forms i mean we can grow cortical activity to insert into the impulsive regions of the brain and that can be trained there's nothing about this that's fixed i i have never once seen someone with addiction that is just stuck that way and can't get out good that's powerful that's really powerful and i hope people uh you know if you didn't get that and you're watching this on replay that's a stop and rewind moment right there uh please continue talking yeah um so that that is i think why you seeing why when i i don't like that certain myths that aren't don't even have legs in science persist when it gets in the way of what people can do in their treatment right if you believe you're just born this way genetics if you believe that you know i've got an abnormal brain you're going to give up or you're going to think you're in this uphill battle forever and you're not going to do the productive things in your treatment to get better so that's why these are so important these aren't just sort of facts to debunk for fun this is has everything to do with the course of treatment so let's see let's go to the next one and i think this will be the last myth that we'll discuss there are many but the last one here is that addiction is a choice and um the best representation of this was this is nancy reagan who i'll pick on a little bit although i uh every reason i think she was well intentioned and kind-hearted so don't pick on her character but but just that she was using flawed science that was given to her um the idea that addiction's a choice and so you just say no and so kyle if i came up to you and you know we're adolescents getting into trouble and i say hey man you want some drugs and and you all it is you just have to say no there's just a logical choice you know drugs are bad for you you see the egg on the frying pan thing or you know you know that it's it's gonna cost you friends it's gonna get you into trouble with the law you're not going to get into the career you want you know just don't do drugs that's never worked logic does not help treat addiction so um that's hard for me to hear as a very logical person and um you know i know if if my dad heard that and i was using drugs he wouldn't be able to understand that he'd be like what do you mean he knows it's bad and he does it anyway this doesn't make any sense so can you explain a little bit what you mean by the logic does not work here yeah i i would go more global than that i mean logic does not help our emotional state or our behaviors almost ever um if if it let's put it this way if it did we all know you go to bed on time you you know you wake up you eat you know you eat a healthy meal you exercise you keep good friends you're responsible you do your homework you show up a job you know you do all these nice things right right i don't know anyone including me that can do that on a consistently you're right you're right you're right we all everyone already knows the logic of life and what we're supposed to do and yet none of us can do it yeah that's not enough evidence experientially for why like logic is just not what drives how we actually operate as people then i don't know how to help you if that doesn't make enough sense and so yeah the chat right now is saying logic does not treat addiction and people are resonating with that statement thank you for that i'm really glad to hear that really because you can see when you talk about you know you can imagine your parents trying to say hey don't do that or i don't understand why you do that son it's a bad choice that's the myth right the the miss as a as a parent but also then the responsibility of a mental health provider it was not to respond with logic and everything in your intuition says well okay i just need to explain to this person why it's such a bad idea but that is not how we operate you've got to meet people in these other ways that deals with how their choices are actually coming to be and and so what i'd cue people into is that what really happens is we're acting in what's called implicit ways all the time by far by far by far our choices and our actions are made based on implicit or automatic sorts of activity and that's just purely because we cannot dedicate a huge amount of our brain function for all our little choices all the time uh but what i'm doing with my hands even i mean that's just automatically happening i'm not deciding i'm gonna put my my hand up and then move it here it's just these things happen so that happens with our choices with everything all the time is we're automatically being driven by a whole host of things that make up who we are and so i don't think of this as a choice or logic issue instead i call this a consciousness problem because we need to be able to tease and pull up the right components and be as specific and constructive as possible than growing consciousness around the most productive things we can do for ourselves this is awesome this is awesome i mean this is um if you're watching this and that resonated with you i would recommend that your next med circle viewing is a series we did with andrea arlington and dr dominic sportelli they talk about addiction and uh they go into more of these types of concepts as well that video is available in the med circle library watch dot med circle dot com uh thank you dr ahmed keep going yeah so we're kind of tearing down some of the myths hopefully building up new understandings okay well if it's not those things so what does cause addiction becomes the question that i think ought to be what's asked from there and the fact is i don't consider it like you know i'm healthy i don't have addiction that guy does have addiction i see him drinking a lot we all share and have the addiction pathway we we have that not just because it's like unhealthy or something we have it because we need it this is where semantics the words we use matters incredibly because if we think of addiction as this just separate disease process and that other people don't have it we miss what is even happening and this starts to get underneath this logic and stuff we have to have a mechanism to want things any species needs that right you need to want food you need to want shelter security you need to want to procreate as well any species at least not necessarily one individual but the species needs to be designed to procreate so we are built to want things and there has to be a biological mechanism for it it's not robotic right we're not born with instructions saying here's what you should do and here's what should be right instead it's just built into us these are things the things that protect us as an animal species those things are built in to be things that we want and so that's all addiction really is hijacking that's what it's using so it's using the circuit that is a reward pathway love feels good security feels good having a good job feels good good friends feel good all that stuff feels good the addiction pathway is what perpetuates the motivation to do that that the reward from a hug from a you know people liking our work that reward feels good that's the addiction pathway it's only when we do that with unhealthy things that are inserted into there that it would be what we colloquially call addiction so if you do that with heroin okay that's addiction if you do that with healthy work or with love we don't use the word addiction but it's using the same exact pathway and these brain images show that right sugar activates this pathway more than cocaine because we need food right and you can say okay well that's unhealthy though it's too much food same thing happens i can show you the same things with love love same exact pathway lights it up big time so the addiction pathway is something we all have you know that that's so interesting that you said that because i have been watching some uh quarantine reality tv shows of people falling in love and all these different you know remarkable ways and i made the comment the other day to my dad i said it's like they're addicted to this they're they're seeking out these feelings of love and when they get it i mean if they're just like oh they say it out loud they're like oh yeah ooh like like as if it were a drug and so now we have you a psychiatrist saying yes love is another way people cope or look for those uh reward uh you know feelings yeah we have the bench research for it we have our own experiences for it we and we see it happening it's it's confirmed in every way yep wow fantastic let's look now at then how does addiction develop and and when we say addiction here we're seeing more of the bad bad addiction so we all have this this circuit but why do some people then have more you know traditionally bad addictions there are three learned traits we've learned these in good very good longitudinal studies and we see that the three things that are very predictive for addiction is a lack of belonging you might by the way have people around you but that doesn't mean you feel like you belong in a secure warm way so uh it's not just living with you know people in your home it's not just having people at work it's actually feeling connected and secure um the number two is poor impulse control um so this is you know you're you're very impulsive person that just you know gets gets frustrated um poor impulse control around choices giving up quickly stuff like that and then emotional distress so there's always some emotional pain that triggers this remember the current there's always something that begins this current so the emotional distress and the lack of belonging are very much part of the first part of the current with emotional pain uh the poor impulse control comes in in that third stage where the craving turns into action and we kind of give up and we say f this you know i'm just what does it matter i don't care right now that's the impulse control that leads from the craving to follow through with the actual behavior we can go to the next one and then this here i like to go even further and say well how do you develop those traits then so so we named those three but how do you even get to that why would you have poor impulse control why would you feel a lack of belonging and these here are some of the commonest pathways and nothing i'm talking about here is always 100 for everybody but these are extremely common pathways addiction begins first of all long before your first drug so it is not the model that a lot of people learned you know a couple decades ago that you take a hit and then that drug somehow like takes over your brain and now you're addicted forever addiction this this trained pattern is is already in motion long before you use the first object of your addiction so you'll see here how that develops which is one is getting a very results oriented way of being so a very high sort of emphasis on your grades on what people have said of you could be your looks could be accolades and achievements so looking always at results and not like how hard you're trying or what you're doing the thought process to get there when it's results oriented it's very empty it's a very frustrating way to be and and there's never enough and you can't just enjoy yourself in the moment also being raised in a way where you're expected to please other people so this can happen with like narcissistic parents this can happen with just culture too that wants you and rewards you to be pleasing to satisfy other people at your own expense and that takes away your own sense of purpose you know life then becomes just this very boring slug it's like i just got to do this for other people i don't even get anything out of it for me and you start checking out so it's very empty kind of hollow existence and then criticism is anything from you know just always kind of being pestered and not being enough to outright abuse so of course being abused is a heavy form of criticism it's to say you know i disrespect you so much that i will use you sexually i will use you to hit you i will control you you're not enough so criticism can of course be in all kinds of varieties and that is part of the ways you develop a sense of not belonging and we talked last time about the core beliefs you know the core belief of i don't belong or i'm not good enough well if you if you're told that enough times and you're criticized for years and years of course you're going to feel like i don't belong even when later on in life people like you they think you're funny they enjoy your presence but if you've been criticized then you've been trained that you're not welcome you don't belong and people lash out against that you know if you're hopeless you'll do desperate things and you get a lot of you know unhealthy behaviors so the simple way to put all this is uh life just isn't fun and what does this do to the brain let's just tie this back into the the science that we see in the labs when you have this childhood of life isn't fun well then we do get brain changes so remember this isn't just genetics this isn't because you're born that way it's because you're being trained throughout childhood adolescence that life is bad life is stressful and if you're not getting healthy rewards you have an under active reward circuit under active dopamine system if it's under active and you're not getting enough of it when you reach out to lessons and when you get a little older and you can make your own sort of choices you're going to find things that give you that hit you're going to find ways to feel reward it's what we do we all want to feel good so if you're not getting it internally because those were taken from you and you're trained that you don't deserve them you shouldn't get them or you'll never get them then you find it from the outside in the form of drugs alcohol or bad behaviors and that is rewarding to use you know drugs it increases that dopamine release you get that hit it feels good and the double whammy is that when you do that your own body says okay if i'm getting enough of it externally we're gonna shut off our own production and not make dopamine on our own anymore if you keep getting these hits three times a day then why am i making it and so your body actually becomes even weaker and that's the reliance on addiction these are all trained patterns now so is i see on the graph here cocaine that alcohol heroin obviously huge really destructive drugs but what about things like food television social media our relationships if they're if those things exercise if those things can be good for us and also give us those dopamine hits does that also make our body weaker then because our body's like ah we're getting dopamine because you're watching the office so we'll stop production on that yep yep that's exactly what happens you oh yeah so drugs would be the most severe form of this but you know you saw there sugar you know actually hits this more than cocaine um you know stimulants tend to do this the most strongly but yeah you know you've got this whole host of different substances that that do these in different profiles but yeah behaviors food so so it's you know it could be the food and the sugar but it's also the behaviors so porn addiction is extremely common um sex addictions you know workaholics exercise-a-holics so yeah those are safer kinds of things to be addicted to but it is the same same process just healthier or less risky in an outcome but the same process is how i've got it yeah understood excellent and so the last couple things we're going to go over here is then trying to frame this in a way that's very productive so you know we're kind of deconstructing un helpful ways of thinking about it with those myths trying to lay out the science here okay how does it really work how is addiction developing so from there well if we know how it develops and we have good studies that show that now then how do we need to think of it what do we how do we think of actually moving forward and so the current we've already gone over now this is a a way of thinking about this so that everything we've talked about falls in here somewhere if you address these parts of what i call the current you will never leave out a component of addiction so if you shut off the pain the emotional pain the distress you shut it off you don't have addiction if you shut off that want for it or you tolerate the want you don't have addiction if you fix the addictive part which would be more superficial things in that phase like you know making sure you hang out with the right people clearing the liquor cabinets someone's watching your bank account those accountability measures that would do it and that's where actually most treatments i see for addiction stay focused it's on just these kind of rules and accountability and you can see that's just a sliver of what's happening for someone who is addicted so if you still have pain and you don't um see through the cravings then you might be able to hold yourself together with enough accountability and really take care of that addiction component of the current but for how long right if you're a grown adult and you have a lot of distress and you can't tolerate your cravings that's when you relapse right you're going to only last so long you're motivated for a while you've got the right friends your partner is behind you and they're with you all the time but for how long right if you're a grown person you're going to find your way to something if you're failing on those first two um and then same thing false pleasure you're gonna shut this down all together so um beyond that living on that bank of the river being able to watch this see it unfold understand yourself fully enough that there's other ways to feel reward there's other ways to think of living addicts often they they're like at a loss for like well if i'm you know not addicted i'm you know i want to find some other way to find rewards so they'll all usually flock to like the gym when they're getting healthy you know they're not addicted anymore and you see them you know flock to uh to do other things and that's good i encourage people to to do that and i still help my patients you know to get to the gym instead but that's not going to take you the distance forever that's still using the current and manipulating the current much better to not even need the reward not even need to like escape this pain and there's profound ways of dealing with that um so see how this makes sure that you won't miss anything that that is incredibly comprehensive and the metaphor of the current really resonated with me we're still going to ask us or have our members who are watching live ask you some questions dr hochman but for uh you watching or listening to this tomorrow we have another med circle live event with dr hochman it's on addiction treatment debunked discovering the approach with a 90 success rate dr hochman is a board certified psychiatrist and addiction expert he is in austin texas and treats addiction issues and his private practice while he's also worked with the various addiction treatments and addiction centers so he knows what he's talking about and has the history to back it up let's go uh with this question from an anonymous attendee on the current why is this thing called false pleasure and how is it different from real pleasure what is the difference in the way you experience it yeah so i call it false pleasure because i'm certainly not being secretive about you know it's not a good pleasure at the end so there there could be a euphoria and a high you know that's what we would call the high and you feel good for a while so it we could just leave it at calling it pleasure but i differentiate that it's a false pleasure because it's a it's an empty one and it's short-lived and it's not healthy and i would call you know to differentiate with a healthy pleasure would be the opposite of all that you know be healthy because it's something that helps you in life and it's something generally that lasts so those are some clues to figuring out what's healthy and what's not as a pleasure clearly the high of a drug you know is not as healthy as you know the high of a really good hug or a relationship um and so we know that common sense wise but we could say well how do we really know that is there is there a way that we can test or know that and the test that i put it through to know if it's a healthy or unhealthy pleasure is if we were to do more and more and more of it would that be okay would that be better or worse for me so um that helps to kind of quickly throw it in one bucket or another are there some great areas of course but you know we we all pretty well know that you know that the ones are just empty shallow short-lived um and and wouldn't be good if we even did twice in a day or once in our whole life um that are unhealthy yeah the unhealthy pleasure test perfect uh anonymous attendee asked i'm 56 and recently diagnosed with did dissociative identity disorder from complex trauma from birth i drink 20 to 30 ounces of wine and smoke pot every day will i be able to heal the traumas if i continue to drink wine and smoke weed does one need to break the addictions first or else you can't heal yeah that's a good question because i as a as a psychiatrist i see people not knowing how to enter treatment or what to do first and our mental health field is guilty of confusing people sometimes um you if you if you knock on one door they say i can't treat your depression or your trauma in your case until you stop drinking or until you're not high anymore um and colleagues i have that i like say that and do that um they won't take you until you're you're clean and sober um i was even you know taught that by some of my supervisors in residency um and then you've got people on the other end right who who say well you know treat you know this is all your your pain and your emotional distress is only a result of your addiction and that the truth is it's always both you you need to be able to do these together i don't like if someone has an addiction and trauma or mood issues to treat it with only one or the other you really have to bring those those treatments together or at least combine the right treatments together to get that comprehensive look and um and so a lot of it has to do with what someone's ready to do at the moment i will never turn someone away in my practice when if they're drinking a lot they're getting high a lot i'm not going to deprive them of the chance to work through their psychological and emotional issues uh why would i do that it'd be a you know foolish to me and this is my own you know philosophy but it if the addiction if we looked at that current right if it's coming from pain and you who's asking the question you've got trauma that current is is going to be way too uphill if if you just treat the addiction part you've got too much of the current coming at it you know to be expected to go you know to stop that current by the time it gets the addictive phase which is when you're drinking or when you're getting high um so we've we've got to allow you to get help right to treat that trauma um but yeah is it harder to treat the trauma when every day you're either high or kind of subtly withdrawing and probably got a lot more depression or anxiety going than necessary because of that no we wouldn't we wouldn't wait right you'd want to do everything at the same time so yeah you know whoever's asking i think you can absolutely get better wherever you're ready to begin is is fine you know if it's more exciting and you're more ready to get sober and you see you know what happens from there and then you go get treatment for trauma that's fine the other way will work fine as well and the key is to finding a therapist psychiatrist you know counselor who gets that picture and isn't going to shame you because you know you're doing it in the wrong order or the you know in the wrong way you want someone um who who accepts the state that you're in and can work with you as you are if they can't work with you as you are you're you're not working with the right person well as a reminder med circle is not a treatment service and does not aim to replace or replicate treatment in any way med circle and med circle live sessions are for educational purposes only we'll go to another member question this member asks wondering why you can't be raised or why you can be raised in the same home and some people raise the same way end up in addiction and some do not yeah well devil's in the details so um you know we need to know what was going on there and and so i'm going to throw some things out that could be you know totally off the mark or maybe hit the mark for this person since i don't all know their experience but um yeah you know you might go through your own set of relationship issues or failures you might go through a different you know birth order has a lot to do with things too you know a little harder on the first kid more expectations on the first kid there of course can be other things going on outside the home besides the relationships and romantic failures but also just um how athletic we are might help us get accepted more quickly all that stuff so um the you know there are always differences there um that like i said it's always in those details but um yeah the the home is certainly where we're getting a lot of experience and you could think of it as a pretty controlled setting but it's it's really not it's it's not a it's not as controlled the setting as um as a lot of people think it's very very different different sets of friends different teachers different relationships um you know different activities all that stuff red circle member wb asks i keep hearing that marijuana is not addictive however if someone smokes daily and is in a constant stupor to where work family etc doesn't matter anymore is that the pleasure pain current only or can it also be to a point of addiction yeah marijuana is certainly classified as an addictive substance and i think appropriately um is it as addictive as other substances no no i mean we have lab research we can kind of actually measure and and compare these things um and do i see people struggle as much trying to get off of it as other ones yeah in different ways so the you know people who are trying to stop smoking weed are are generally fighting more of sort of this internal battle than they are like with the withdrawal so you try and stop alcohol you're going to withdraw big time and you're going to have a lot of physical dependence and and sort of classic addiction barriers that that make it hard to get off of marijuana is much more internal so people that are addicted to marijuana are typically still using it very much to emotionally regulate get through often anxiety and often using it as a sort of sleep aid as well and and so until you kind of fix those reliances um it can still be hard to get off of less of the physiologic reasons and more of the psychological ones needing to find you know better sleep hygiene sleep habits also being able to kind of wind down and let things go not be so wound up or anxious about things what was the other part of that i want to make sure i address everything because about um well i had already closed out the question when you started about pain and i wasn't sure if they were meaning i i got it [Music] so yeah she says is is that the pleasure pain current only or can it be to a point of addiction so i think you've covered both yeah yeah i'd say it's both yeah okay um the this anonymous attendee asked what are some healthy ways to get over or deal with boredom and emptiness yeah and that gets into the health part of the current which is just to be outside of that because most of us are kind of led to believe we should be in this state where we're always stimulated and motivated and and you know finding these rewards and the reality is again look at just the animal kingdom you know animals do find reward when they hunt an animal and kill it or get food or procreate but a lot of the time they are just sitting around laying on their side you know and they're not looking for like stimulation and activity all the time so part of the journey is actually reorienting your whole reward pathway so that you don't feel like you're trying to find a reward so if you're bored and feeling empty the goal is not always to just keep finding all these stimulating activities and so on the weekend i'm gonna i'm gonna hike and then i'm gonna watch this then i get together with these people and do all these things and volunteer that still comes from this idea of like i'm i'm like always supposed to be stimulated and active and rewarded and that's that's not really how we're built fundamentally um we're supposed to find reward in things as a product of life but it's not supposed to be sort of the i you know what we wake up to do right so have you heard of these dopamine fasts yeah yeah what do you think of them yeah i i think it's it's cool i mean the idea of like you know is sort of what you do on like a retreat right you you would you would deprive yourself of this you know of rewards and and um perhaps sort of sensitized to when they do come in these more natural ways um i think that can be used to kind of wake ourselves up just like a good diet can do you know yeah it's like like a exactly and for if people go well it's a dopamine fast my understanding is that it's a period of time typically 24 hours where you just intentionally deprive yourself of anything that could bring you joy and this is the nitty-gritty so no music no television no social media no internet nothing like you just spend 24 hours with yourself and then the idea is that the next day you know you open your email and you're like wow i'm so stimulated by these emails and you go outside and you're like well look at all the wind you know and so um i don't know i've never done it but it's on my to-do list yeah so there's a couple things about that one is yeah it can work to because i sensitize two rewards that next day or would you know pretend forever you know you're more sensitized and enjoy them more i i like to push my patients hard though and they know that i would say go beyond that though it's not about trying to sensitize yourself to more subtle stimulate stimulants it is to not even feel like that's owed to you or deserved or that that's like the object so you want those things to come when they come naturally when they arise but you you don't want to wake up thinking i'm going to try and find more reward so the idea of sensitizing more to it still to me we can one up and do even better right which is wake up and just exist and be things might happen in the day that feel good and when they do feel them entirely and but the goal should never be to just become more and more sensitized to to right yeah excellent that that really reframed my outlook on that thank you uh sa asked do you see social media as an addiction within the current yeah yeah and i know people listen you know some people are strict about the definition especially people who are you know have been addicted for decades sometimes even take offense to calling other things addictions and then other people are looser in their definition i'm on the looser definition side i think it doesn't mean that someone with a heroin or alcohol addiction you know isn't suffering more or you know more at the precipice of death even um but i do think we need to be honest about what's happening the process is the same so yeah i mean from my philosophy yes we need to still be able to understand that when someone's incredibly compulsive preoccupied with social media looking for them to be liked and you know worried about their picture they're posting and looking for those rewards or just through observation you know looking at other people's feeds and finding you know all those little hits um social media is designed to do this it's not even nefarious and bad i mean it's just of course any business is going to want you to be more on their platform consume more of their things that's that's fine and hello i want you to consume med circle videos so come on and do it you know right yeah i mean that that's fine right i think we still are ultimately responsible for ourselves and when we need to you know not just blame facebook we need to say okay i want to proactively use it from five to six in the evening and catch up with people or whatever but you know it's it's up to us to be proactive about how we engage in anything and no one can take that right from us so you'll be okay if you do that uh is it possible to overcome addiction without the help of a professional oh yeah the and and that we have studies and evidence to show that's the overwhelming majority get through this without professional help now i don't i i wouldn't necessarily go around you know screaming that from the mountaintops because you know i don't want more people than necessary to to try for longer and longer on their own without professional help um and and struggle for longer so there's a lot of good professionals out there that understand how to help and can help you sooner faster longer lasting um but yeah it'd be you know not too far off from really anything right if you want to learn a subject you can learn a subject i love learning on my own there's other things i know i need some guidance and sort of more formal instruction on and same would go for training exercising whatever you'll usually if you have a good guide and if you have a bad one well then that's crap but if you have a good guide you should be learning and growing you know at a faster rate it should be a little more enjoyable it should be you know take you farther than on your own so that's one way not just to think about should i enter into professional help but is the professional help i'm getting good i mean it should be more than you would be able to do on your own um or else yeah and again i can't recommend enough our other series on addiction especially uh we have a few with andrea arlington watch.metcircle.com let's get in as many more questions as we can we'll go a little past 11 since we started a few minutes late but not too much anonymous attendee asks i smoke pot daily and would like to smoke less and not out of habit or addiction i'm coming out as transgender and i'm working on healing my complex trauma and gender dysphoria but haven't been able to find an effective replacement behavior for smoking can you give any more tips on redirecting my behavior yeah and this gets to some of what we talked about earlier could you know could you transfer to healthier things and we talked about like exercise as one of those um could you find you know pleasure in just watching you know netflix or other things you know those are those are the logical steps to help slowly we call harm reduction you know you're still in the current but you're replacing and trying to find things that are not going to get you into as much trouble or not you know probably for smoking a lot might make work harder it might make things feel a little bit harder to get initiated and those would be sort of the commonest downfalls um so yeah replacing it with any of those and you know probably whoever's asking that question is capable of coming up with other things besides you know netflix or hikes or exercise so you can certainly find your own things to replace that with but again the goal would be not to feel like you're in this never-ending scramble to replace or find healthier objects of stimulation instead you know i'd still say you eventually want to be outside of that current on that riverbank watching it in this you know what that means is watching your own mind watching how desperately you're trying to belong perhaps right if you're transgender if you've had trauma um odds are you're trying to find your place and find a sense of belonging um does that mean you find other people of your sexual orientation does it mean that you find anybody who accepts you as you are what you know what does that mean for you might mean that you're connecting in ways that have nothing to do with your sexuality just because that's your story right now and on your mind you might want to connect more with people that like philosophy and read books and have a book club like there there's other ways to to feel that and that's where that belonging comes in as well with you know one of those traits of addiction so um so it would be you know to to try and figure out other ways of existing outside of looking for just a replacement mm-hmm uh dr rockman do you have a patient right now or do you have three more minutes uh i have three more minutes so we're good okay we'll do uh one more question then uh sk asked why are people who deal with addiction and denial about their problem and why does relapse happen i i think there's a lot of denial because of the way that we talk about it there's there's a problem with and that's what i try to debunk and thanks for doing this i mean this is what this is about it's when we think of i'm healthy i don't have addiction and that person over there does that's the stigma the the stigma is that you're different there's something wrong with you and you either disgust me or scare me right that's that's the stigma there isn't stigma unless we're we're making it this different wrong thing instead we need to be able to accept and normalize people's experiences and how they deal with life and that's different than saying go on and keep drinking and that that's fine and good it's just saying okay you're a pretty normal person right we all have the addiction pathway and you know yours has been hijacked and there's something going on for you then and there should be curiosity around trying to help that person and what they're suffering with and um there wouldn't be stigma if we could talk about it as matter-of-factly as that but but we don't instead it's this scary or disgusting thing and um and so that that's where the stigma comes up and so yeah you know if you know there's stigma there why would you admit to it why would you let everyone know what your struggle is um often when people start you know peer groups or trying to you know be sort of honest about their addiction they feel like they're supposed to sort of tell everyone and be honest with everyone and that's a lot to ask someone when there is stigma you will be judged you know it could be judged at work you could have friends that are scared that you're going to drive drunk with them or not be like you know dependable or just be dangerous to be around or you know that it's it's it's a turn-off for a lot of people so why would you feel comfortable telling everyone um so it's something that um is appropriately something to to be you know to to come out with the right people at the right time and and be sort of intentional i think it's great to be honest but you know it's it's another thing to just overly you know expose yourself and um and so you know i think that that's a normal part of this process you know to have this stigma but deny it yeah yeah uh dr hochman thank you for your insight today with the presentation and also answering our questions we're going to have more from dr hochman in our next med circle live event uh the next one is all about addiction treatment and uh dr hochman's uh method i guess i can call it that's having 90 success rates that'll be tomorrow you can register using the links below or you can register at medcircle.com slash live you will need to be a med circle member to join that event you can always start with a free trial dr hochman thanks for being here and remember whatever you're going through you've got [Music] this you

Channel: MedCircle

Views: 70,082

Rating: 4.8929491 out of 5

Keywords: behavior, basics in behavior, human behavior, brain, decision making, social science, self improvement, personal growth, sugar cravings, how to stop cravings, craving, cravings, constant craving, addiction, depression, anxiety, recovery, how to overcome addiction, addiction recovery, overcoming addiction, Lifestyle, Social Science, tedx talks, Psychology, tedx talk, English, United States, quitting, neuroscience, ted, medcircle, kyle kittleson, video, mental health, mental illness, youtube

Id: 4SNuafesofs

Length: 59min 20sec (3560 seconds)

Published: Sat Sep 19 2020