GORSKI ADDICTION MODEL

April 26, 2016

 The Gorski Comprehensive Addiction Model is a a science-based system that incorporates both chemical and behavioral addictions in a comprehensive biopsychosocial perspective.

THE HUMAN CONDITION: The Gorski Model builds upon a recognition that all addiction is based within the human condition. The human condition is organized and directed by the CORE HUMAN PROCESSES OF PERSONALITY

DEVELOPMENT. The human process begins with an intangible but self-evident primal life force which motivates human beings to survive and thrive in the physical world. The frustration resulting from the collision of the infinite potential of the human spirit with the finite limitation of the physical world results in ANGST, the normal pain of life and living. ANGST is managed by people in one of three ways: DENIAL, it doesn’t exist – everything is beautiful;

DEMORALIZATION, since life hurts I will just give up and stop trying; or MOTIVATION, in spite of the psi of living there is a counterbalancing joy in living that makes it worth while. Motivated people to STRIVE to find safety, security, excitement, and accomplishment in an often difficult and hostile world. They maintain their motivation because of the capacity human beings have for with PASSION. With maturity passion becomes focused into psychological and spiritual practices that help people find peace, serenity, and security without the constant need to strive, perform, and produce.

Many people find that a state of euphoria induced by the addictive use of alcohol and other drugs can give them short term relief from the angst of life. Unfortunately, people who experience this addictive brain response are at high risk of developing addiction. The addictive release leads to obsession I have intrusive thoughts about how good the euphoric response felt. I feel a COMPULSION to repeat the experience.

As the compulsion becomes stronger it turns into CRAVING which turns wanting the addictive release into the need for the addictive release. This creates a self reinforcing pattern of addictive use which is called ADDICTION, which is marked a compulsive pattern of DRUG SEEKING BEHAVIOR.

Over time, the cycle can be described as a EUPHORIC RESPONSE to addictive use, a DYSPHORIC RESPONSE to abstinence, a CRAVING or perceived need to use, DEPENDENCE or being unable to function normally without addictive use, and TOLERANCE the need to use more in order to get the same level of euphoria.

Once the ADDICTION CYCLE BEGINS, addictive THOUGHTS, FEELINGS, URGES, and ACTIONS become engrained in automatic and unconscious habits. These habits attract people who support the addictive way of life or are willing to become committed to enabling it.

These Social and Cultural Reactions to addiction create a permissive environment for early stage addiction when addictive use makes people feel good and be more productive and stigma reaction when people lose control and begin stepping outside of social, cultural and legal limits.

This is all part of the addiction, which is a health crd problem that is best dealt with using a Public health Addiction Policy:

(1) TOXIC SUBSTANCE: Identifying the toxic substances causing the illness;

(2) VULNERABLE HOST: Identifying the people who are predisposed to addiction); and

(3) PERMISSIVE ENVIRONMENT: Changing the societal and cultural norms that make ready access to and heavy regular use of the toxic substances and behaviors socially, culturally, and personally unacceptable.

Gorski Books: http://www.relapse.org

Gorski Training: http://www.cenaps.com

Gorski On Facebook: http://www.facebook.com/gorskirecovery

LIVE SOBER – BE RESPONSIBLE – LIVE FREE

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Addiction: Frequently Asked Questions

August 4, 2015

 The source of these question and answers is: http://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
Treatment and Recovery

Frequently Asked Questions

1. Can addiction be treated successfully?

Yes. Addiction is a treatable disease. Research in the science of addiction and the treatment of substance use disorders has led to the development of evidence-based interventions that help people stop abusing drugs and resume productive lives.

2. Can addiction be cured?

Not always—but like other chronic diseases, addiction can be managed successfully. Treatment enables people to counteract addiction’s powerful disruptive effects on their brain and behavior and regain control of their lives.

3. Does relapse to drug abuse mean treatment has failed?

No. The chronic nature of the disease means that relapsing to drug abuse at some point is not only possible, but likely. Relapse rates (i.e., how often symptoms recur) for people with addiction and other substance use disorders are similar to relapse rates for other well-understood chronic medical illnesses such as diabetes, hypertension, and asthma, which also have both physiological and behavioral components. Treatment of chronic diseases involves changing deeply imbedded behaviors, and relapse does not mean treatment has failed. For a person recovering from addiction, lapsing back to drug use indicates that treatment needs to be reinstated or adjusted or that another treatment should be tried.28

What are the principles of effective substance use disorder treatment?

Research shows that combining treatment medications (where available) with behavioral therapy is the best way to ensure success for most patients. Community support grouos are also important in supporting long-term recovery.

How can medications help treat drug addiction?

Different types of medications may be useful at different stages of treatment to help a patient stop abusing drugs, stay in treatment, and avoid relapse.

    Treating Withdrawal. When patients first stop using drugs, they can experience a variety of physical and emotional symptoms, including depression, anxiety, and other mood disorders, as well as restlessness or sleeplessness. Certain treatment medications are designed to reduce these symptoms, which makes it easier to stop the drug use.

      Staying in Treatment. Some treatment medications are used to help the brain adapt gradually to the absence of the abused drug. These medications act slowly to stave off drug cravings and have a calming effect on body systems. They can help patients focus on counseling and other psychotherapies related to their drug treatment.

        Preventing Relapse. Science has taught us that stress, cues linked to the drug experience (such as people, places, things, and moods), and exposure to drugs are the most common triggers for relapse. Medications are being developed to interfere with these triggers to help patients sustain recovery.

        How do behavioral therapies treat drug addiction?

        Behavioral treatments help engage people in substance use disorder treatment, modifying their attitudes and behaviors related to drug use and increasing their life skills to handle stressful circumstances and environmental cues that may trigger intense craving for drugs and prompt another cycle of compulsive use. Behavioral therapies can also enhance the effectiveness of medications and help people remain in treatment longer.

        Treatment must address the whole person.

        How do the best treatment programs help patients recover from the pervasive effects of addiction?

        Gaining the ability to stop abusing drugs is just one part of a long and complex recovery process. When people enter treatment for a substance use disorder, addiction has often taken over their lives. The compulsion to get drugs, take drugs, and experience the effects of drugs has dominated their every waking moment, and abusing drugs has taken the place of all the things they used to enjoy doing. It has disrupted how they function in their family lives, at work, and in the community, and has made them more likely to suffer from other serious illnesses. Because addiction can affect so many aspects of a person’s life, treatment must address the needs of the whole person to be successful. This is why the best programs incorporate a variety of rehabilitative services into their comprehensive treatment regimens. Treatment counselors may select from a menu of services for meeting the specific medical, psychological, social, vocational, and legal needs of their patients to foster their recovery from addiction.

        Cognitive Behavioral Therapy seeks to help patients recognize, avoid, and cope with the situations in which they are most likely to abuse drugs.
        Contingency Management uses positive reinforcement such as providing rewards or privileges for remaining drug free, for attending and participating in counseling sessions, or for taking treatment medications as prescribed.
        Motivational Enhancement Therapy uses strategies to evoke rapid and internally motivated behavior change to stop drug use and facilitate treatment entry.
        Family Therapy (especially for youth) approaches a person’s drug problems in the context of family interactions and dynamics that may contribute to drug use and other risky behaviors.
        Relapse Prevention Therapy: Helps peopld to identify and mamage the early warning signs that leD from stable recovery back into addictive use.

        What Is The Difference Between the Term “DISEASE” and “DIDORDER?”

        If you look up disease (medical psychobabble) and disorder (psychological psychobabble) they both mean the same thing (two of the following four criteria): 

        (1) known etiology, 

        (2) progressive course of predictable symptoms, and 

        (3) predictable course — acute, chronic, or terminal; and 

        (4) a course of treatment With the goal of remission or palliative care (maximum comfort and symptom management until death.) 

        See What is a disease: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1299105/pdf/5-7400195.pdf 

        GORSKI BOOKS: www.relapse.org


        Mindfulness-Based Relapse Prevention

        March 11, 2015
        
        1. The integration of mindful awareness (mindfulness) is being used and integrated with Relapse Prevention Therapy (RPT), a cognitive-behavioral therapy for changing addictive behaviors related to addiction, a wide variety of compulsive behavios, and the change of self-defeating habitual behaviors. The article below is an excellent description of Minfulness-Based Relapse Prevention (MPRP). This article is reposted from the Website: http://www.mindfulrp.com/default.html I strongly recommend this website for addition information on MPRP. 
        ~ Terence T. Gorski (Gorski’s Books on Relapse Prevention: http://www.relapse.org 

        MBRP (Bowen, Chawla and Marlatt, 2010) is a novel treatment approach developed at theAddictive Behaviors Research Center at the University of Washington, for individuals in recovery from addictive behaviors. 

        The program is designed to bring practices of mindful awareness to individuals who have suffered from the addictive trappings and tendencies of the mind. MBRP practices are intended to foster increased awareness of triggers, destructive habitual patterns, and “automatic” reactions that seem to control many of our lives. The mindfulness practices in MBRP are designed to help us pause, observe present experience, and bring awareness to the range of choices before each of us in every moment.  We learn to respond in ways that serves us, rather than react in ways that are detrimental to our health and happiness. Ultimately, we are working towards freedom from deeply ingrained and often catastrophic habits.

        Similar to Mindfulness-Based Cognitive Therapy for depression, MBRP is designed as an aftercare program integrating mindfulness practices and principles with cognitive-behavioral relapse prevention. In our experience, MBRP is best suited to individuals who have undergone initial treatment and wish to maintain their treatment gains and develop a lifestyle that supports their well-being and recovery.

        The primary goals of MBRP are: 

        1. Develop awareness of personal triggers and habitual reactions, and learn ways to create a pause in this seemingly automatic process. 

        2. Change our relationship to discomfort, learning to recognize challenging emotional and physical experiences and responding to them in skillful ways. 

        3. Foster a nonjudgmental, compassionate approach toward ourselves and our experiences. 

        4. Build a lifestyle that supports both mindfulness practice and recovery.  



        This website and these resources are maintained by gifted funds. Any contributions are greatly appreciated!  Your generosity allows us to continue to offer many of our services at no cost.  (Please note: since we do not have nonprofit status, gifts are not tax deductible.)

        Anger Management

        February 14, 2015

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        “Anger management is a critical skill for all addiction professionals. These online courses from SAMHSA are important resources.” ~ Terence T. Gorski (The Publications of Terence T. Gorski)

        SAMHSA Newsletter on Anger Management Courses

        Everyone experiences anger from time to time. It’s a normal emotion. But intense or prolonged anger can jeopardize employment, relationships, education, and even freedom. Those who struggle to control their anger are increasingly finding their way to behavioral health professionals for assistance. It is precisely for this reason that SAMHSA has created resources and a new a online course to help.

        We see it in our schools, workplaces, families, and out in public – the person who yells, hits, or throws things – and sometimes sparked by something as small as a missed parking space. In a culture where time is short, anger can surface quickly and with intensity. And anger can erupt into physical violence.

        – The Centers for Disease Control’s 2010 National Intimate Partner and Sexual Violence Survey, found that one in ten 9th to 12th graders had been physically hurt on purpose by a boyfriend or girlfriend.

        – SAMHSA’s 2012 National Survey on Drug Use and Health: Mental Health Findings revealed that nearly 19 percent of youth receiving mental health services have trouble controlling anger.

        – In 2009, the Bureau of Justice Statistics’ National Crime Victimization Survey reported more than a half million nonfatal violent crimes took place at work.

        – Prisons and jails are even worse, where 38-50 percent of inmates experience persistent anger and irritability. When the problem results in an arrest or other disciplinary action, there often is a referral or requirement to engage in some therapy or treatment to help manage the intense emotion and prevent additional similar experiences.

        The Anger Control Plan
        (excerpt taken from SAMHSA’s new Anger Management for Substance Abuse and Mental Health Clients course)

        1. Take a time out (formal or informal).
        2. Talk to a friend (someone you trust).
        3. Use the Conflict Resolution Model to express anger.
        4. Exercise (take a walk, go to the gym, etc.).
        5. Attend 12-step meetings.
        6. Explore primary feelings beneath the anger.

        Typically, when someone gets angry, there are responses that are physiological (becoming flushed, burst of energy and arousal, etc.), cognitive (thoughts that occur in response to an event), emotional (feeling afraid, discounted, disrespected, impatient, etc.), and behavioral (sarcasm, swearing, crying, yelling, throwing, etc.).

        Problem anger occurs when someone experiences anger as a chronic irritability or a full-on rage – as an emotion experienced too intensely or too often. The consequences of long-term anger issues can lead to arrest, injury (self or others), adverse effects on important relationships, job loss, or treatment program ejection. Some groups have a higher risk of experiencing problems with anger, including individuals with substance use disorders, traumatic brain injury, post-traumatic stress disorder, and personality disorders.

        Working with Angry Clients

        “Anger management” is currently the most searched term on the SAMHSA website. This reality speaks both to the need for support around this issue and the practical benefit of SAMHSA resources like the Anger Management for Substance Abuse and Mental Health Clients: Participant Workbook and the newly launched Anger Management for Substance Abuse and Mental Health Clients course. The course is especially designed for anyone working with a person who struggles to control anger, but particularly substance abuse and mental health clinicians.

        The Five Steps of the Conflict Resolution Model
        (excerpt taken from SAMHSA’s new Anger Management for Substance Abuse and Mental Health Clients course)

        Step 1: Identify the problem that is causing the conflict.

        Step 2: Identify the feelings that are associated with the conflict.

        Step 3: Identify the impact of the problem that is causing the conflict.

        Step 4: Decide whether to resolve the conflict.

        Step 5: Work for resolution of the conflict: How would you like the problem to be resolved? Is a compromise needed?

        The online course takes approximately two to three hours to complete and uses a cognitive behavioral approach to working with angry clients. It covers a range of topics including how people respond to getting angry (passively, assertively, aggressively, or passive-aggressively), how to manage anger with people with traumatic brain injury or post-traumatic stress disorder, and how to assess anger and readiness for anger treatment. The course also includes a description of the cognitive behavioral therapy approach, treatment model overview, and other important information about anger management. The course is based on the Anger Management for Substance Abuse and Mental Health Clients: A Cognitive Behavioral Therapy Manual (also available in Korean and Spanish) and the Anger Management for Substance Abuse and Mental Health Clients: Participant Workbook (also available in Korean and Spanish).
        In addition to behavioral health service providers, the course may also prove useful for human resource and other managers, school teachers and administrators, those working in the criminal justice system, or anyone experiencing anger issues. Upon completion of the course, certification is provided for continuing education credit.

        Resources:
        Anger Management for Substance Abuse and Mental Health Clients: A Cognitive Behavioral Therapy Manual (also available in Korean and Spanish)

        Anger Management for Substance Abuse and Mental Health Clients Participant Workbook (also available in Korean and Spanish)

        Resources on the Internet


        Lying and Second Chances

        January 18, 2015

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        By Terence T. Gorski
        Author (The Books of Terence T. Gorski)

        “For every good reason there is to lie, there is a better reason to tell the truth.” ~ Bo Bennett

        When you catch someone telling a lie, should you give him or her a second chance? Or should you follow the advice of William Shakespeare: “Trust not him that hath once broken faith.”

        This question, when approached thoughtfully, is more difficult to answer than it first appears.

        When I ask people whether they should give a second chance to someone who tells them a lie, the answers I get range from “absolutely yes” to “absolutely no.”

        Other people have developed rules for when to give a second chance and when to cut their losses by getting the person out of their life, or at least out of their box of sensitive secrets.

        The answer to the question of what to do when you discover they are lying depends upon how we define the idea of telling lies and telling the truth. So let’s ask the tough questions that are not as easy to answer as they may seem.

        What is a lie?

        Here’s the dictionary definition: “a false statement made with deliberate intent to deceive; an intentional untruth; a falsehood.
        Synonyms include prevarication and falsification. Antonyms include truth.

        What is the truth?

        The dictionary tells us that it is “the true actual state of a matter. That which is really happening or going on. Conformity with the facts or reality.” The the concept of the truth is further clarified as: “the real facts about something: the things that are true: the quality or state of being true: a statement or idea that is true or accepted as true; A statement that is supported by evidence.”

        Wow! These are really circular definitions that essentially tell us “the truth is what is true!”

        These definitions of truth beg a very important issue: the truth is rarely absolute and is usually relative to what is accepted as truth at the time and the “truth as we see it from our point of view.”

        Most of the time to “tell the truth” means to “explain our best understanding given our point of view, the extent of our knowledge, and the currently best known and most widely accepted evidence.”

        Honesty and lying are as much about the intent to deceive as it is about giving mistaken information.

        If you make an honest mistake in solving a mathematical problem, it is usually not considered a lie. It is a mistake or unintentional error. It might be a lie if you deliberately falsify the answers for some secondary gain.

        So, in my opinion, it would make sense to make the distinction between an honest mistake (I believe that what I am saying to be factual or true) and a lie (I know what is true and deliberately try to tell you something else).

        I find that most people who tell one lie (i.e tell others that something is true when they know that it is not), tend to tell other lies as well. They use lies as an habitual tool to gain things of value in life or to deny some painful truths.

        Sometimes the habitual liar can convince themselves that a lie is actually true. This can be a useful skill if you have to pass a lie detector test. Some people are skilled at catching people who are telling lies. This can be a useful skill to recognize and avoid getting hurt by con men and habitual liars.

        Most actively addicted people tell lies about their alcohol and other drug use. They minimize how much they use and try to cover up the damage caused by their use.

        Some addicts don’t actually lie, they just block out some aspects of reality so they are intentionally ignorant. This is called being sincerely deluded.

        Must alcoholics, for example, never count the number of drinks they have or add up how much money they are spending on alcohol or drugs. They keep themselves willfully or intentionally ignorant in order to avoid facing the truth.

        The truth is a continually evolving thing based upon our best understanding at the time. All we can really tell someone is our best understanding of the truth as Wevsee it at the current time and then explain why we believe it to be true (i.e. Present the evidence we have that makes us believe that it is true).

        In the everyday world we operate on a common-sense definition of truth.

        – I did or did not do this!
        – I was or was not at a certain place at a specific time!
        – This is what has happened in the past !
        – This is what is happening now!
        – This is what I believe will happen in the future!

        Anyone who tells you they know exactly what will happen in the future is guessing or is sincerely deluded. No one can be certain about the future.

        Many people have beliefs without evidence. They accept things are true without any real proof. Every culture teaches thousands of truths, both little and big, that people are supposed to accept as true.

        So what should you do if you believe someone is lying to you?

        The first step is to ask the question again and make sure you are understanding their answer. Many accusations of telling a lie are based in poor communication and misunderstanding.

        Tell the other person very clearly that you don’t believe it is true and present your evidence. Tell them you are open to reconsider if they have better evidence. This gives the people their day in court. They get to describe the “truth as they see it from their point of view.”

        Before jumping to conclusions it is helpful to detach, back up, observe, and investigate. The serious problem is not a single lie told in isolation to deal with a specific situation. The most serious problem is the person who uses deceit and dishonesty as a habitual way to cope with life.

        If there is a pattern of lying, it is foolish to trust. Many people are habitual liars. In other words they are in the habit of twisting the truth to get what they want.

        Trust must be earned. It must be built little by little, one step at a time. When building a relationship, it is best to self-disclose a little bit at a time. If the person responds by self-disclosing at the same level to you, go back a try again. If they continue self-disclose at the level that you are they are, they are probable trustworthy. If they don’t reciprocate, be wary and ask yourself if they are trying to hide something or to get you at a disadvantage by knowing more about you than you know about them.

        If what you told them in confidence ends up on the grapevine, run the other way. People who gossip and tell you the secrets of others that were told to them in confidence will almost certainly do the same to you.

        Recovery demands a policy of rigorous honesty this means:

        – The willingness to look honestly at yourself and your past behavior;
        – The intent to be honest by reporting the truth as you believe it to be while acknowledging that “I might be wrong.”
        – To promptly admit mistakes and be willing to correct them;
        – To look with a critical eye at what you believe and the evidence you have to support that belief; and
        – To be willing to act in faith upon your best understanding of the truth until you find new and more compelling evidence that causes you to change your mind.

        Rigorous honesty is a skill that needs to be learned and practiced. This is because, as fallible human beings we are prone to lie to ourselves and it others. It is also because the truth is hard to find.

        LIVE SOBER – BE RESPONSIBLE -LIVE FREE

        Don’t miss Terry Gorski’s books and workbooks on recognizing and managing denial.

        Denial Management Counseling (DMC)

        The Books of Terence T. Gorski


        Burn Out: What I Do To Avoid It

        January 11, 2015

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        By Terence T. Gorski
        Author, my books can be found at www.relapse.

        “The two most important days of your life are the day you were born and the day you find out why.” – Mark Twain

        I keep myself from burning out and becoming jaded by doing my best to focus my mind on the following things:

        1. Praying: My primary repetitive prayer is: “God teach me of your will for me and give me the courage to carry that out.”

        2. Renewing My Commitment To Help: I keep reinforcing that “we keep it by giving it away.” When we help others without trying to control those we are helping and without allowing ourselves to be exploited it helps me keep a balanced perspective.

        3. I Dream Big: I see myself as a part of the revolution of the human spirit and human consciousness that will slowly, one person at a time, create a sober and responsible world.

        4. I Manage My Expectations: I hope for the best when doing my work. I am prepared for the worst.

        5. I Keep Perspective: I can’t do it alone, I can only do my part. I realize the power of a team of people working in harmony towards the same goal is powerful. I strive to stay focused on building a sober and responsible world one day at a time with the help of others.

        6. I Take Time For Myself: I have areas of interest that focus my mind on many other things that I find inspiring or helpful. I read voraciously and take the lessons from everything I read that can lift my spirits and give me a positive and heroic fantasy life — kind of like I am “The Walter Mitty of the Addiction Field.”

        7. I Dream Big: I strive work day-by-day to contribute things to others that will leave the world a better place. This is called building a legacy in the minds and hearts of others.

        8. I Deal With Reality: I Deal With the immediate reality that confronts me by trying to do the next right thing to keep moving toward creating my life goal.

        9. I Transcend Fear: I have developed the habit of facing fear without letting the fear control me. My favorite tool for this is Frank Herbert’s Litany Against Fear: “I must not fear. Fear is the mind killer – the little death that brings total obliteration. I will face my fear. I will permit my fear to pass over me through me. When it has gone past I will turn my inner eye to see its path. Where the fear has gone there will be nothing. Only I remain.

        10. I copiously reflect upon the deep meaning of The Serenity Prayer: God grant me the serenity to accept the things I cannot change, to change the things I can, and the wisdom to know the difference.”

        11. I Collect Quotable Quotes: My two favorites are: “One person can make a difference and every person should try.” ~ John F. Kennedy; and “Great spirits have always encountered violent opposition from mediocre minds. ~ Albert Einstein.

        12. I Don’t Take Myself to Seriously: I try to learn something from everyone I meet and everything I do. I strive to be humble by “accepting the things I cannot change, changing the things that I can, and learning to know the difference.” I act upon my strengths without asking for permission. I overcome or compensate for my weaknesses by asking for and receiving help.

        To sum it up, I recognize that I am a fallible human being; that I will die and have limited time to live; and that it’s up to me to do the best I can with the cards I am dealt in life. I know that I might be wrong so I stay open to learning, changing and growing. I accept the fact that I am responsible for my life, what I choose to do and not do, and what U choose to focus my mind upon. I look up all words I read or hear to understand what they mean. I realize that language programs the brain/mind so I careful about what I say to myself and others.

        Carpe Diem!

        Illigitimi non carborundum!

        I also renew myself by escaping into Criminal Minds (Spencer is my favorite character) and NCIS (my two favorite character are Gibbs and McGee).

        I want to leave a positive legacy and have given a lot of thought to what I want to pass forward to future generations. Here are twenty-five Ideas I want to pass forward to the next generation.

        Gorski Books: www.relapse.org

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        Fear, Silence, and Speaking Out

        January 10, 2015

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        Don’t let anyone frighten you into silence.

        See the blog on arrogance and courage
        https://terrygorski.com/2013/10/18/arrogance-has-a-place/


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