I have seen enough episodes to ask the question, “Why?”

What draws people to watch faithfully every week or watch every series every week? What satisfaction is had by watching women backstab each other, trash-talk each other behind each other’s backs, steal each other’s men, lie and manipulate others for attention, and flaunt their excessive lifestyles?

In short, what is to be gained by watching women treat each other so poorly?

This type of show seems only to feed the drama and stereotypes often associated with female friendships. Somehow it has become “entertaining” to watch women beat each other up mentally, emotionally, and in some cases physically each week in the “entertainment” boxing ring.

In an effort to learn more about the appeal of the “Real Housewives” antics, I started to wonder if those addicted to the show related in any way because of their own real-life friendships. Do the most loyal fans watch to find out why these women behave the way the do, or do they watch because they can resonate with them or find aspects about the “characters” they relate to or even secretly admire in some cases? Loyal fans have their favorites and in most cases fans seem to be drawn to the most outrageous, vindictive, and despicable woman among the group.

Some fans argue they watch the show because it is like a train wreck that they can’t help but watch. However, the difference between a train wreck and the “Real Housewives” is that unlike a train wreck, which is a horrible accident, the “Real Housewives” is a horribly staged event with the sole intent of setting women up to knock each other down.

So for all of you who Real Housewives fans, I challenge you to take this mini-quiz to see how your real-life friendships stack up to the ones on this widely popular show.

1. Do you spend most of your time with your friends gossiping and judging other friends or people in general? Or do you find the time you spend with your friends is often spent listening to them gossip about and judge other people?
2. Do you gossip about your friends behind their backs rather than talk to them directly about something that’s bothering you or about some ongoing conflict? Or do your friends gossip to you about friends they are having issues with versus talking to that person directly?
3. Do you get defensive if a friend tries to communicate to you their feelings or take it as an insult or criticism? Or do you find that when you try to talk to your friends about something they said or did that upset you, they react in ways that make you feel like you did something wrong and even some cases they stop talking to you?
4. Do your loyalties shift depending on which friend you happen to be with at the moment? Or do you find your friends’ loyalties seem to shift depending on who they are around?
5. Do you find you have very little to say to a friend if you aren’t gossiping about another friend or passing judgment on others in general? Or do you find your friend has very little to say to you other than sharing gossip or criticisms of others?

If you have answered “yes” to any of these questions, then it may be time to take a closer look at the quality of your friendships, and even how your friends would rate you as a friend. Are these the type of friendships you want to put your energy into, and is this the type of friend you want to be considered as by others?

If you are guilty of any of these “Real Housewives” types of behaviors, it is pretty safe to assume that the ones you are exhibiting this behavior with are doing the exact same thing with the other “housewives” in your group when you are not around.

Maybe they’re being secretive and have even stolen money from your wallet. Maybe their physical appearance has changed with rapid weight loss or red eyes. Maybe you’ve noticed a change in their sleep habits, energy level and mood. Maybe you’ve actually found marijuana or other drugs in their room.

Naturally, the thought and possible confirmation of your child using drugs trigger a rush and range of emotions: anger, frustration, disappointment, sadness, fear.

If you think your child is using drugs, how do you approach them? Where do you start?

Two parenting experts shared their insight below.

1. Be direct and calm.

“This issue is too serious for subtlety,” said John Duffy, Ph.D, a clinical psychologist and author of the book The Available Parent: Radical Optimism for Raising Teens and Tweens. He suggested readers approach their kids “directly and immediately.”

Avoid letting your anger and frustration spill over into the conversation. According to Lisa Kaplin, Psy.D, a psychologist and life coach who teaches parenting classes, “The best way to approach your child is with delicacy, not drama. If you approach them with panic, anger, aggression or accusations, you can be sure your child will tell you absolutely nothing.”

Yelling, threatening and lecturing your child typically leads them to withdraw, sneak around and lie, she said.

Duffy also suggested approaching your child “from an emotional space of genuine concern for well-being.” He understands that being calm and centered is a lot to ask of parents. “But it is, without a doubt, the approach that works best in my experience.”

It’s common for kids to deny their drug use, or to respond casually (e.g.,” It’s just pot, and I don’t smoke it that often, anyway”). If this happens, “give a brief response in which you tell them that you do not want them to use drugs of any kind,” Kaplin said. Reiterate your house rules about drugs and alcohol use and “the consequences that come with that behavior.”

2. Talk when your child is lucid.

Don’t try to have a serious conversation when your child is drunk or high, Duffy said. “This might seem like common sense, but I have worked with many parents who have attempted to lecture an inebriated teenager.”

3. Ask open-ended questions.

It’s more likely that your child will be honest, and talk about their drug use if you ask open-ended questions. According to Kaplin, these are several examples: “Can you tell me more about that?  How did you feel in that situation? What will you do if that happens again? How can I help you with this?”

If your child admits to using drugs, again, “ask them with open-ended, non-judgmental questions about what drugs they have used, how often, and if they plan on using again.” You also can ask “for their input on how to proceed.”

4. Don’t punish your child.

Avoid punishing your kids, Duffy said. It rarely works. For instance, “Taking a cell phone away will never keep a drug user away from using.”

5. Show your support.

If your child reveals their drug use, “Thank [them] for being honest with you,” Kaplin said. Let them know that you’re “here to help them. Tell them you love them.”

6. Get your child treatment.

It’s key to take your child to see a qualified therapist who specializes in working with teens and young adults. When talking about professional help, don’t negotiate with your child, or take “no” for an answer, Duffy said.

Instead be brief, firm and clear, he said. Duffy gave the following example of what you might say to your child: “It is clear to us that you have been using something, and we are really concerned for your safety. As your safety is our domain as Mom and Dad, we are going to pull rank here and schedule an appointment for someone for you, and all of us, to talk to about this issue.”

Depending on the situation, you can “give [your child] options regarding therapists or treatment centers,” Kaplin said.

Even if your child is over 18 years old, Duffy suggested having a similar conversation. While you can’t force your older child to attend therapy, you can leverage other things, such as your financial position, he said.

It’s also important to get clear on your limits, communicate them to your adult child and follow through, Kaplin said. For instance, “can your child still live with you if they’re using drugs? If not, when must they leave and will you help them with treatment or other living arrangements?”

Knowing your child is possibly using drugs is stressful, scary and painful. And it can be incredibly hard to have a calm conversation. If you feel yourself losing control, take a break, and return when you’ve cooled off. Whether your child admits to using drugs or not, having them see a qualified therapist is critical.

Further Reading

Here’s more on symptoms of teen substance abuse, what parents can do, and reasons your child might use drugs and how to help them.

Co-dependence is one of those psychological terms that describes a dysfunctional way of behaving in important relationships in one’s life. It is primarily a learned behavior from our family of origin. Some cultures have it to a greater degree than others — some still see it as a normal way of being.

Yet the costs of co-dependence can include distrust, faulty expectations, passive-aggressiveness, control, self-neglect, over-focus on others, manipulation, and a slew of other unattractive traits.

Wondering if you might be involved in a co-dependent relationship? Read on…

These are some signs of codependent behavior:

• taking responsibility for someone else’s actions
• worrying or carrying the burden for others’ problems
• covering up to protect others from reaping the consequences of their poor choices
• doing more than is required at your job or at home to earn approval
• feeling obligated to do what others expect without consulting one’s own needs
• manipulating others’ responses instead of accepting them at face value
• being suspicious of receiving love, not feeling “worthy” of being loved
• in a relationship based on need, not out of mutual respect
• trying to solve someone else’s problems, or trying to change someone
• life being directed by external rather than internal cues (“should do” vs. “want to do”)
• enabling someone to take our time or resources without our consent
• neglecting our own needs in the process of caring for someone who doesn’t want to care for themselves

Many feel that they will lose who they are if they are not codependent. In reality, we become more ourselves when we are less of what others expect from us. To come out of codependence is a huge gift we give to ourselves — the victory of growing away from it will balance out our responsibility to ourselves and to others.

The key to repairing and ending codependency is to start protecting and nurturing ourselves. That might sound like a selfish act, but it will return us to a place of balance. Others will understand that we now respect and are protecting ourselves from overcommitment or abuse.

They may be careless and capricious or outright reckless. They “forget” about appointments. They’re chronically late. They neglect to plan ahead. They’re financially irresponsible. They don’t take care of their stuff. They make rash decisions that get them into trouble. They ignore deadlines. They act as though others should bail them out of whatever trouble they get into.

We all know people like this. And they’re not all adolescents. It could be a friend, a family member or a colleague. We may love them yet we experience them as terribly frustrating. We want to shake them. Yell at them. Knock some sense into their brains. But none of this seems to make a difference to them. They shrug it all off.

Why? Because they have Responsibility Deficit Disorder (RDD), a much-needed diagnostic category that I have just created.

RDD is prevalent in our society and is a growing problem. Those who have it do not “suffer” from it. Quite the contrary. The people who “suffer” are those loved ones who must deal with the rat’s nest that is so often dropped in their laps.

If all this sounds familiar to you, here’s what you must do to save your own sanity.

• Be direct with them.

  Don’t mince words. Not all irresponsible people realize the chaos that they are causing. Be specific about how their actions (or lack of actions) create havoc for you. They may blow you off, or accuse you of nitpicking, or of being judgmental. Think about their responses. They may have a point. But if you know, with your head and your heart, that their irresponsible behavior is what’s causing the difficulty, trust your own judgment.

• Know what you will do the next time you feel dumped on.

  Irresponsible people tend to be irresponsible. Duh! That’s obvious. But sometimes you forget, especially if you’re an incurable optimist. So, make sure that you know what you will do and what you won’t do the next time an RDD person leaves his mess (literally or metaphorically) for you to deal with. Though it may be tough for you, stick to your guns — even if you are called all kinds of reprehensible names.

• Know where your power lies.

  Reflect on where your power lies with this particular person. If you’ve been cleaning up his mess, don’t. Let him suffer the consequences. If you’ve been enabling her behavior by bailing her out – once again, don’t. Sure, you may feel guilty that you are no longer doing what you used to do. But that’s how you change the game. It’s much harder for people to be irresponsible when nobody steps in to make it all OK.

• Make them an offer they can’t refuse.

  Hey, it works for the Mafia. Why not for you? If the person really wants what is in your power to give, use it. I don’t mean that you continue to enable his irresponsible behavior. I mean you offer him a bribe (or reward) if and when he changes his behavior.

• Sidestep the problem by being less involved with your RDD person.

  It may make you feel bad if you are an inclusive person and you begin to exclude. You don’t ask her to go on vacation with you because you don’t trust that she won’t bail out at the last minute. You don’t go out to dinner with him if he will expect you to pick up the bill once again. Excluding is a preemptive survival mechanism. Use it when it feels appropriate.

• Unfortunately, change begins with you.

  Why should you have to change? It’s the RDD person who should change. You don’t want to stop doing what you’re doing. You simply want the other person to be more responsible. Great fantasy! Terrible reality! Dream on that the other person will change. He’s got it good – especially if you’re enabling his dysfunction. Why should he change if you’re always there to rescue him? So, as much as you dislike it, know that the change process begins with you.

Dr. M. had previously helped me understand that worry is an addiction — it hits the same pleasure center of the brain that other addictions, such as alcohol, do.

The more I worry, the more it reinforces me to worry. Ever the pleasure-seeker, I worry more and perpetuate the cycle. Yet, once I understood the worry addiction, I worried less.

While I am inclined toward overindulging in pleasurable activities (In my mother’s words. “Susan, you’re an extremist!”), I am also driven to avoid the consequences in the quest for maximum pleasure.

It took only one hangover to make me decide never to experience that feeling again. My attraction to pleasure also includes never wanting to feel full or be overweight or slowed down by the effects of smoking.

So, I feel pretty bad at the end of a day spent, not on writing, but on addictive flitting back and forth between Facebook and Twitter, seeking that serotonin surge I get from seeing that someone commented on my fan page or RT’ed my tweet.

Here’s what Dr. M. advised:

1. Give yourself a daily limit for checking Twitter. You can have a chart next to the computer in order to track the frequency. You can also print the word STOPin bold red at the bottom of the chart to serve as a reminder to stop.
2. Track what increases this particular checking behavior. Like any other habit-related or addictive behavior, it is important to understand what brings it on. What emotions, thoughts, or behaviors activate your desire to check Twitter? For instance:
   • Do you begin to feel anxious and then check?
   • Do you begin to feel bored and then check?
   • Do you begin surfing the Net and then find yourself having an increased urge to check?

   Find out what elicits the behavior and begin to modify them to decrease the likelihood of the behavior occurring.

3. Give yourself a reward for not engaging in the behavior. Remember that checking Twitter may be intrinsically rewarding; therefore, every time you check, you reinforce the behavior. Replace the reward of checking with another reward.

Thanks, Dr. M. Knowing that I’m feeding an addiction every time I look for a retweet helps me rethink doing it so often.

I often have thought of getting a fresh start somehow. I got that opportunity, but in an unfortunate way.

A failed suicide attempt left me completely disabled, unable to work and with a severe hypoxic brain injury that affected many aspects of my life. I had to start from rock bottom and completely rebuild my entire life.

Before the suicide attempt, I had a great job, made great money, bought a new car and had lots of friends that I hung out with often. In retrospect, I had everything and I was proud of myself for working so hard and doing so well.

Behind the scenes, I had a bad drinking problem and was constantly self-medicating my anxiety and depression.

Now I have no job, car, or friends. But I no longer have a drinking problem and do not self-harm or attempt suicide. It is so frustrating having to wait on things that are out of my control and coping with daily life along with a mental illness and a physical disability.

When I asked for a fresh start, I never imagined this would be it. It’s a thousand times harder than it was before, when I had a great life.

I didn’t consider what happened if I survived drinking antifreeze and taking hundreds of anti-anxiety pills. I don’t have a clue where I got the idea or the impulse to do that. I have no recollection of doing it and had no plans to kill myself in the past.

The previous week I was in a great mood, got along great with my family and didn’t feel overly depressed or down. I had just stopped taking a powerful anti-depressant anti-anxiety medication that I had been on for awhile because I switched jobs and lost my health insurance and the medication was outrageously expensive.

Because of that choice I made, I got what I wished for — and a whole lot more that I wouldn’t wish on my worst enemy. I went from being extremely independent to being completely dependent on everybody for everything. I went from working 40 to 60 hours a week to sitting in bed all day, bored and broke.

Eventually, I will work again and function like my old self, but the wait is nearly agonizing on a mind that is so used to being busy. Patience has never been a strong asset of mine, but the last year and a half of having no choice but to wait has taught me that patience truly is a valuable virtue.

Some days it’s impossible for me to see past the clouds of depression to the other side of the storm where it is sunny and calm and holds peace of mind. But I know I can make it through this day, too, and nothing lasts forever — especially emotions. Feelings aren’t facts and too often I trick myself into forgetting that and jump to impulsive, extreme conclusions.

I have to remember that this is a journey and it isn’t always pleasant. I can’t lose sight of my dreams or give up on hope, because then I have nothing to work toward or look forward to.

More than one third of U.S. adults currently are obese, according to the Centers for Disease Control and Prevention. Physicians and other health care professionals urge us to lose weight or risk becoming vulnerable to a host of diseases, including diabetes, high blood pressure and heart disease. Weight loss has become a national conversation.

On an individual basis, most of us either have tried to lose weight or are actively engaged in maintaining a healthy weight.  Why we struggle with weight and how best to lose weight are hotly debated topics.  The nation’s current weight struggles have been attributed to a range of biological, societal and personal problems such as unhealthy school lunches, media advertising, too much corn and corn syrup in our diets, sugar substitutes, lack of willpower, overreliance on fast and prepackaged foods and many more.

But what gets in the way of your ability to lose weight?

Is it lack of time to prepare healthy meals?  Lack of willpower to stick to a healthy eating and exercise routine?  The intense influence of advertisements urging you to eat unhealthy foods?  Lack of interest? Not knowing how to lose weight?

The answer, according to a new survey of psychologists suggests that when it comes to dieting, weight loss and weight gain, emotions play a central role and may be the primary obstacle to weight loss.

Have you ever felt guilty after eating a cookie and then decided to eat the whole box, since you’d already blown your diet? Have you felt low and skipped exercise? Then you’ve experienced emotions interfering with your weight loss.

If we were merely cognitive beings, we’d eat the cookie, evaluate how it affects our daily calorie intake, and make adjustments to get back on track.

But we’re not merely cognitive beings. According to the survey of more than 1,300 licensed psychologists, conducted by the Consumer Reports National Research Center, understanding and managing the behaviors and emotions related to weight management is essential to weight loss.

In fact, emotional eating was considered a barrier to 43 percent of people who wanted to better manage their weight.  And it’s not just emotional eating.  Emotions can interfere with maintaining a regular workout routine and making healthy food choices.

Getting Help for Weight Loss

So what can you do, if you’ve tried to eat healthy and exercise regularly and found that it’s just not working? 

More than 70 percent of the psychologists who provide weight loss treatment identified several key treatments and strategies for addressing the underlying emotional issues related to weight gain.  Those strategies considered “excellent” included:

• Cognitive therapy: a treatment that helps people identify and address negative thoughts and emotions that can lead to unhealthy behaviors
• Problem-solving:   Finding alternate solutions to setbacks, changes and obstacles
• Mindfulness:  Using strategies to allow thoughts and emotions to come and go without judging them, and instead concentrate on being aware of the moment

Also considered important in helping clients to lose weight and keep it off were the following:

• Motivational strategies
• Keeping behavioral records
• Goal-setting

Although weight problems may be caused by an array of biological, emotional, behavioral and environmental issues, it has become clear that stress and emotions play a central role in our ability to manage our weight.  Without strategies to recognize emotional triggers and respond to our emotions effectively, we are likely to continue to struggle with our weight and health.

Now they’ve moved on to something that, in my opinion, looks a lot like deception.

In today’s email box, we found an email from “Jeffrey Redd, Project Outreach Director” with an email address of jeff@va.gov.samhsa.net sharing with us “a guide about finding treatment, free of cost.” Wow, really? A new fantastic resource from the folks over at SAMHSA?

But wait, hold on a minute. That email address doesn’t look quite right…

Here’s the, in my opinion, seemingly deceptive email:¹

SAMHSA stands for the Substance Abuse and Mental Health Services Administration — an arm of the U.S. federal government’s Department of Health and Human Services. The official SAMHSA website is at: www.samhsa.gov

SAMHSA.net, on the other hand, is a domain owned by a Search Engine Optimization (SEO) firm, Website Consultants Inc. of North Fort Myers, Florida:

[Click for larger image]

The email address “Jeff” sent from — jeff@va.gov.samhsa.net — is meant to invoke a government association with these three words: SAMHSA, “gov” (which is where all the government domains reside), and “va” which might stand for Veterans Administration (or Virginia). After I spoke with Beachway representatives on Wednesday — but before I spoke to the SEO firm — this domain’s ownership was hidden behind a proxy service.

SEO firms work to improve the search engine rankings of their clients’ websites. SAMHSA.net had a single page of content (since removed, but here’s copy of it) that had been rewritten from SAMHSA.gov’s legitimate content. The title of the deceptive page was “The Substance Abuse and Mental Health Service Administration” and there were no disclaimers to suggest that it was not an official federal government resource.

In this case, the client was a firm called Beachway Therapy Center, located in Delray Beach, Florida. I first spoke with the COO of Beachway, to understand who Jeffrey Redd was, and why he was telling me — unsolicited — about a “white paper” (about how to receive “free” treatment) that resided on Beachway Therapy Center’s domain.

The COO didn’t know anything about it and referred me instead to Stephen Howley, the admissions director of Beachway. During a brief telephone conversation, he also said he didn’t know any Jeffrey Redd, and at first suggested that this was a work of a competitor trying to steal or infringe upon Beachway’s branding.² He also suggested perhaps it was something sent out by his SEO firm, but he thought it unlikely.

Then I asked Mr. Howley for the name of his SEO firm. “Website Consultants Inc.,” he replied.

I pointed out that the exact same firm is responsible for registering the domain name, samhsa.net, and so it was unlikely this email was sent out by a competitor. “I’ll have to have a talk with them,” said Mr. Howley.

When asked if he knew of this apparently deceptive email being sent, Mr. Howley replied, “I can assure you 100% that we had no prior knowledge of this sort of thing.”

We contacted the SEO firm and spoke via phone and emails with Sean Callahan, the president and co-founder of Website Consultants. He also didn’t know who Jeffrey Redd was, so he asked for a copy of the email. After reviewing the email, he pegged the errant email on a link-building firm that he said had leased the domain SAMHSA.net: “They are obviously abusing the domain we leased to them, so we have terminated the agreement effective today.” Mr. Callahan refused to name the link-building firm, citing a non-disclosure agreement.

I understand it’s hard to get your name out there if you’re a treatment or rehab center. It’s even more difficult to appear higher up in search results. But good content gets indexed by Google and Bing, plain and simple — there are no tricks you need to employ in order to get it indexed. Yes, it takes time, and yes, it takes even more time to build up an online reputation for your domain. Seeking ways to circumvent the system or hurry up the process may work (at least temporarily, until the algorithm changes yet again) — but also may bring you unwanted publicity.

Sometimes rehab centers get a bad name because of their aggressive strategies for trying to attract new patients. It’s no wonder.

1. I left off the legally-meaningless confidentiality notice that nobody reads — including me — from this email copy. But the SEO guy pointed out that buried in the middle of it was this sentence, “We are in no way related, or representing any government agency.”
2. Which can be a legitimate concern in this cut-throat industry.

But it gets worse — fully 20 states in the U.S. don’t require any degree, or don’t even require addictions counselors to be certified or licensed in any way.

Is it any wonder then that many addiction or rehab programs still rely on an outdated model that’s directly dependent upon how long companies are typically reimbursed for treatment — 30 days? Or that many programs still use treatment methods largely unchanged from the 1950s — not research-backed, modern approaches to treatment?

A groundbreaking report published last year from Columbia University lays out the sad facts of addiction treatment in the U.S. As the report notes, “Some [treatment programs] promise “one time” fixes; others offer posh residential treatment at astronomical prices with little evidence justifying the cost. Even for those who do have insurance coverage or can pay out-of-pocket, there are no outcome data reflecting the quality of treatment providers so that patients can make informed decisions.”

These eye-opening facts come from a report published last summer by the National Center on Addiction and Substance Abuse at Columbia University. The New York Times has the story, including noting that one of the most popular myths about effective addiction treatment is that you have to go to an addiction or rehab center in order to be treated:

“The truth is that most people recover (1) completely on their own, (2) by attending self-help groups, and/or (3) by seeing a counselor or therapist individually,” she wrote.

Contrary to the 30-day stint typical of inpatient rehab, “people with serious substance abuse disorders commonly require care for months or even years,” she wrote. “The short-term fix mentality partially explains why so many people go back to their old habits.”

Just over 43 percent of addiction treatment spending is spent at those specialty addiction treatment centers — the ones that inevitably discharge patients after 30 days, whether they’re successfully treated or not. That’s the biggest chunk of the addiction spending pie.

Successful addiction treatment is difficult — just 42 percent of those who seek out treatment for addiction complete it. That’s not surprising given the characteristics of addiction, and the fact that more often than not, an actual addictive substance is involved. But a system that focuses on evidence-based treatments could do a better job and substantially increase that number.

This profound gap between the science of addiction and current practice related to prevention and treatment is a result of decades of marginalizing addiction as a social problem rather than treating it as a medical condition. Much of what passes for “treatment” of addiction bears little resemblance to the treatment of other health conditions.

Much of what is offered in addiction “rehabilitation” programs has not been subject to rigorous scientific study and the existing body of evidence demonstrating principles of effective treatment has not been taken to scale or integrated effectively into many of the treatment programs operating nationwide.

Addiction treatment in the U.S. is yet another orphan system in the overall health care system — kind of like the mental health system’s little, sometimes neglected brother. One of the report’s recommendations is to bring the addiction treatment system into the larger mainstream health care system — mainstream it, if you will.

That’s a recommendation I can get on board with. Effective addiction treatment needs to be brought out into the spotlight in order to highlight what research shows actually works and is effective. We’ll highlight some of those findings in the coming months.

Read the full New York Times article: Effective Addiction Treatment

By inhibiting a small region of the prefrontal cortex — region of the brain responsible for planning and thought — the scientists were able to break the mice’s habits, but, to their surprise, the mice immediately began forming new behavior patterns.

Until now, psychologists and behavioral therapists believed that habits were hidden in the illusive “subconscious.”

But the MIT study shows that the brain is not just aware of habits: it controls them completely, moment by moment. And no matter how long the habits have existed, we can now shut them off, as by the flip of a switch.

The researchers formed habits through repetition and aural cues in mice running through a simple maze over the course of a few weeks. Once they had shown that the habit was fully ingrained, the researchers broke it by interfering with a part of the prefrontal cortex known as the infralimbic (IL) cortex. Using optogenetics, a technique that allows researchers to inhibit specific cells with light, the researchers blocked IL cortex activity for several seconds as the rats approached the point in the maze where they had to decide which way to turn.

The mice’s brains turned from a reflexive, habitual mode to a more cognitive and engaged mode, focused on a goal. Once the mice had broken their old habits, they formed new ones, which the researchers were then able to break again. But the researchers were in for another surprise: the mice immediately regained their original habit. This suggests that habits are never really forgotten, just overwritten or replaced with new ones.

From an evolutionary standpoint, habits make survival simpler by allowing us to make decisions almost automatically, freeing our brain to think about other things as we perform routine tasks. Our brain tends to find familiar, repeatable behaviors out of a sense of security. The problem with “automatic” behaviors is that they leave us vulnerable to forming negative habits, such as procrastinating on bigger projects or smoking cigarettes when driving.

Many fledgling habits go unnoticed because people rarely engage in meta-cognition when undertaking everyday tasks, where habits are likely to form. In fact, as behaviors are repeated in a consistent context, there is an incremental increase in the link between the context and the action — the behavior becomes more automatic. Our habits are a reflection of how we choose to spend time interacting with the world, guided by our short and long term goals — some of which we have had since childhood or seem inexplicable.

When we enjoy certain stimulation, chemicals such as dopamine are released into the brain, relieving stress, improving mood, and providing a sense of reward. But as we repeat the behavior, our tolerance builds, requiring more stimulation to trigger the dopamine receptors.

Sometimes we keep using just to feel normal (dependence), but if the consequences of our behavior become significant and harmful, and the behavior cannot be controlled, our habit is then considered a behavioral addiction, or a process addiction; if it involves illegal or misused substances, it is considered a drug addiction. Those who form “drug habits” often struggle with them for the rest of their lives due to the lasting effects of dependence and dopamine withdrawal on the brain. Like the mice, our old habits are always lurking in the back of our minds.

The ability to break habits in mice may seem like the nexus of a “cure” for addictive behaviors, but it is unclear how inhibiting the IL cortex will affect humans, whose prefrontal cortex is considerably more complex. It is not absurd to imagine a surgery or drug which could hinder the IL cortex in humans, allowing us to escape our negative habits and live reasonably, consciously, unburdened by our old, learned behaviors, but it may not be necessary.

The key to breaking bad habits is becoming aware of the behavior (through friends, family or any support group available); identifying the factors which trigger and encourage its persistence; and altering them however possible.

Similar to describing the feeling of a dream, the context of a habit is important, too: look for indicators and symbols in your everyday life that may stand for something of greater significance and purposefully change their meaning. Keeping a varied schedule is also a passive way to curb habit formation (variety is the spice of life!).

Once you’ve broken the habit, however, remember the mice: you must seek new, positive behaviors that give you a cerebral boost, such as exercising creativity or problem-solving, to keep your brain balanced and healthy.

Or not.

The holidays are stressful. There are the challenges of too much family, not enough family, not enough money, continual exposure to food and alcohol, and perhaps worst of all, the gap between our actual life and our fantasy life. As if gazing into the perfect happy scene within a snowglobe, we might fall into a trance of how our life should be.

We might feel torn apart by nostalgia and grief over the good times and good people of the past, and wracked with guilt and inadequacy for failing to create a more wonderful life for ourselves. We might feel scared about our dissatisfaction and hypnotized by the promise of fulfillment just beyond the hard glass.

Addictive and codependent behaviors thrive during this season of fantasy.

We use our drugs and habits to escape the pain, while imagining how we will miraculously make changes, always tomorrow, or next week, or next year. We frantically try to keep our idea of the all-good holiday alive through our codependent behaviors, imagining that we have the power to make sure that everyone else is happy and no one gets upset, while suppressing our own feelings of anger and disappointment.

So what should we do about our addictive or codependent behaviors during the holidays? Should we just give up and wait until January 1? Or is there hope for progress now?

One option involves using the holiday season to take an honest and compassionate look at our current behaviors. Instead of using up all of our mental energy imagining how our life used to be better, or how our life should be different, or how we need to change, we can turn our minds and eyes toward simply observing present reality.

We can watch our relationships with alcohol, marijuana, cigarettes, chewing tobacco, prescription and non-prescription drugs, gambling, pornography, video games, television or Internet videos, social media, food, exercise, work, and shopping. We can ask ourselves: How much are we using? How much of our time does it consume? How much money are we spending on our habits? How long have we been using? Is it increasing, decreasing, or remaining constant?

We can watch our relationships with our loved ones. We can ask ourselves: How much of our energy is being devoted to worrying about or trying to control other people’s addictive behaviors? How much are we being controlled by fear of others’ reactions to our boundaries or limits?

Then we can ask ourselves: why are we doing this? What purpose does it serve? What immediate rewards do we attain? In what ways are our behaviors fulfilling our needs? Are there feelings of shame, anger, sadness, loneliness, anxiety, or depression tangled up in our habits? How do these feelings lead to our behaviors? How do these feelings result from our behaviors?

How are our habits affecting our physical health? How are our behaviors affecting our relationships with others? How are our drugs, habits, or relationship patterns affecting our work life? What are the short- and long-term benefits and costs?

As we watch and explore our behaviors in an open and neutral manner, we set the stage for our growth toward increased health. We emerge into the New Year with information about ourselves that we need in order to develop a plan of action, if we so choose, toward change. And by being more honest with ourselves and more present in the life we currently are living, we have broken the paralyzing spell of fantasy: We have begun moving toward a better life.

“When tempers need to be controlled… Why be irritated? Light an Old Gold!”

Times certainly have changed. Societal views on cigarettes, and toward those who smoke them, have been flipped upside-down. Smokers are segregated. They must stand fifty feet away from shopping centers, hide in a bush when they see a child, douse themselves in perfume or cologne before leaving their homes.

Sarcasm aside, smoking isn’t popular anymore, nor is it attractive.

I came across a small article by Karen Schrock in Scientific American Mind entitled “How Smokers Think about Death”. What a headline that is!

Let me preface this by telling you I smoked cigarettes for over 10 years. I’m 27 now and I’m pretty sure I cannot tell you how I think about death. Actually, I cannot think of a single smoker whose claim to fame would be knowing more about death than the nonsmoker sitting beside them. Mortality isn’t really a casual lunch conversation.

The article asks the question: “Do graphic warning labels on cigarette packages really deter people from lighting up?” Schrock explains that, “In 2012 the U.S. will join dozens of nations around the world in labeling cigarette packages with large photographs of diseased organs, amputated limbs and other gruesome images. Previous research has borne out the idea that when people see images of cigarette-induced ailments, they are reminded of their own mortality.”

When I purchased cigarettes before I quit smoking, the images on them, certainly gruesome, would bother me for about five seconds. Give or take five more seconds. I just wanted a cigarette. But I also wanted to take a black marker to the package and scribble out the pictures. I was not reminded of my own mortality but was instead embarrassed.

The author explains that Jamie Arndt, a psychologist, “…had student smokers complete questionnaires designed to induce either thoughts of their own mortality or thoughts about failing an exam… the researchers offered the students a cigarette and measured every person’s smoking intensity — each puff’s volume, flow and duration.”

I kept reading, hopeful that I might learn something, anything at all at this point.

Schrock continues, “Students who did not smoke often indeed smoked with less passion after being reminded of their own mortality, as compared with the light smokers who read about failing an exam… the infrequent smokers may have been responding to thoughts of death by trying to reduce their own vulnerability… Students who were heavy smokers reacted to thoughts of death by taking even harder drags on their cigarettes.”

So what have we learned courtesy of a 284-word article in a consumer-friendly magazine?

That’s open to debate, much like the impact graphic images have on those who smoke. But it’s safe to say that those who smoke probably do not “think about death” in any fantastical or behavior-changing way.

In the end, whether a person smokes or not, we all question our mortality. That’s part of the human condition. And so are articles that try to figure the whole thing out — life, such as it is.

Reference

Schrock, K. (2010, September 28). How smokers think about death. Scientific American Mind. Retrieved from http://www.scientificamerican.com/article.cfm?id=how-smokers-think-about-death

I was able to stop drinking but, like many recovering addicts, I find holidays particularly tough. They can be a dangerous time when recovering from addiction.

My family and friends celebrate the holiday season as many people do — with lovely meals and gifts, gratitude and festive drinks.

I recall my first Christmas sober, three years ago, and the concerted effort my family made, celebrating with more eggnog and less rum. They knew that, early in my sobriety, I was triggered by even the sight of alcohol. Driving past a liquor store would cause my heart to beat quicker. But as the years have passed, and I have become more comfortable in my sobriety, so have they.

Last year, I was surrounded by the bottles I once loved, the liquids I still adore in memory, as my family held their annual Christmas party. No longer did they tip-toe ’round my sobriety and while I was grateful for this sense of normalcy, I was frightened.

I was not frightened because I felt I would relapse and pour rum in my eggnog. I was frightened because alcohol, once a fast and best friend, surrounded me.

I spent a couple of hours talking to people, just enough to pass for being social, and then locked myself in a spare room with a book. The hours passed and laughter become light conversation until the house was blissfully quiet again.

With this year’s holiday season quickly approaching, I plan to deal with the situation differently. I plan to stay sober, just as in previous years, but with less fear.  I have, thankfully, found and maintained relationships with those who are also recovering addicts. I asked them how they felt about sobriety and the holidays. They find it difficult as well. It’s a bit like walking into a bar except you cannot walk quickly away.

A friend who has over a decade of sobriety under her belt told me that the longer one stays sober the easier it becomes to attend events with alcohol and not feel anxious and afraid. Another, new in his sobriety, recognizes his limitations. If he feels uncomfortable in a situation he gracefully leaves. Maintaining sobriety is the most important thing a recovering addict can do.

Addiction is a dangerous disease and the road to recovery is paved with events, holidays and gatherings that remind us that we may still be fragile. But it is this knowledge that allows us to grow.

This year, when I see a bottle of red wine, I will not hide in a spare room with the door locked. I will remember that my sobriety is defined by sanity and in order to stay sober I need to expose myself to the things which scare me.

Someone enjoying eggnog and rum? That’s a good place to start.

There’s a space between normal behavior and an official diagnosis called “almost addicted” that has serious consequences, according to Dr. J. Wesley Boyd, MD, Ph.D, an assistant professor at Harvard Medical School and author of the book Almost Addicted: Is My (or My Loved One’s) Drug Use a Problem?

People who are almost addicted still struggle because of their drug use. They may have problems in their personal or professional lives. They also might meet criteria for drug abuse or dependence in the future — at which point it becomes tougher to treat. Intervening now can lead to healthy changes and prevent a full-blown crisis, said Dr. Boyd, also a staff psychiatrist at Cambridge Health Alliance.

Warning Signs of Almost Addiction

People with drug problems are easy to spot. This is actually the biggest myth about drug use, Boyd said. One of his first patients was a professional who was using hundreds of milligrams of oxycontin, every day, for over a year. His wife had no idea. His co-workers had no clue. And there were no complaints about his work performance.

(He finally got caught after a pharmacist called the police. Fortunately, after treatment, years later, he was still drug-free.)

But there are signs to look for. In Almost Addicted Boyd features the Drug Abuse Screening Test (DAST) along with other key questions. These are some of the obvious and not-so-obvious signs he mentioned:

• Abusing prescription drugs
• Inability to get through the week without using drugs
• Feeling guilty about drug use
• Having loved ones worry about your drug use
• Being told by loved ones that your behavior is strange
• Losing friends over drug use
• Losing a job over drug use
• Engaging in illegal activities to get drugs
• Not giving your full effort at work because of drug use
• Writing work emails or doing other things online while under the influence and regretting them later
• Divulging important information about work while under the influence
• Embarrassing your family
• Berating loved ones while under the influence
• Cheating on your spouse while under the influence

How Loved Ones Can Help

There are many things loved ones can do, Boyd said. These are his suggestions:

Don’t enable the behavior. Don’t make it easy for your loved one to keep abusing drugs, Boyd said. Consider how you might be feeding their habit. Take the example of a mom who was giving her teenage son money for lunch and the mall. He kept asking for more money more often. Turns out, as he told Boyd, he was using the cash to buy drugs.

A loved one also might make excuses for a family member who misses work after a night of drug use. “Covering for the behavior allows it to continue longer than it might,” Boyd said.

Talk to your loved one – and stick to the facts. When approaching your loved one, be as straightforward and objective as possible, Boyd said. It’s certainly easier said than done, but try to keep your emotions out of the conversation.

“Whether they’re almost or full-on addicted, most people live in denial,” he said. So if you tell someone “I think you’re abusing drugs,” they’ll likely just deny it. Instead, let the facts drive your conversation. Say “I noticed your eyes were bloodshot and you showed up late to work.”

Ask others to step in. If your loved one is in denial, gather support. For instance, if the person is religious, ask a clergy member to speak to them, Boyd said. If they’re not religious, ask a primary care physician, he said.

Employ leverage. If your loved one refuses help — or again is still in denial — Boyd encourages families to employ any leverage they can (within legal limits, of course). In the adolescent substance abuse program at Boston Children’s Hospital, Boyd and his colleagues use the 7 Cs of leverage: cash, credit card, checks, car, cell phone, computer and curfew.

When you have little or no leverage, rely on the law. For instance, while it’s incredibly difficult, if your loved one is facing legal charges, Boyd advises families to “let the law run its course.” Often, he said, these individuals will be put on probation, which includes drug testing. As he said, “any period of enforced sobriety is better than no sobriety.”

What You Can Do

If you’re the one who’s almost addicted, consider your relationship with the drug openly and honestly, Boyd said. See a mental health professional who specializes in substance use or a primary care physician, he said. Attend support groups such as Narcotics Anonymous or Alcoholics Anonymous. “The only request for going to these meetings is the desire to stop using your substance,” he said.

Some people may be able to quit on their own, Boyd said. For instance, since her teenage years, Boyd’s mom smoked two packs of cigarettes every day. After learning she had early emphysema, she quit cold turkey.

However, if any aspect of your life is at risk – such as your ability to work or keep your home – or there’s an immediate threat to your health, seek professional help right away, he said.

No one is immune to addiction, Boyd said. One of his supervisors, a substance abuse expert, used to say, “As far as I know the reason I’m not a heroin addict is that I haven’t tried heroin.”

Even casual use can become too much. If you’re almost addicted, seek help. If your loved one is almost addicted, offer help.

Learn more about Dr. J. Wesley Boyd at his website. More on the book Almost Addicted here.

One of the possible hypotheses put forth about these kinds of technology addictions back in 1999 was that what we were seeing wasn’t a behavioral addiction at all. Instead, it was suggested we were seeing the predictable adaptive behaviors of humans to unfamiliar stimuli in their lives. In this case, that stimuli was entertainment technology.

Emerging evidence suggests that this may be the case. And the really good news?

Video game addiction may resolve itself on its own — simply with time.

The new research was a three-stage, longitudinal study designed to measure participants over an 18-month period. A total of 393 participants took part in an online survey advertised on Australian gaming websites. They were then asked to complete followup surveys at 6-month and 18-month intervals, with 117 participants doing so.

The surveys collected demographic information, video game playing behaviors, administered a problematic video game playing test, and depression, anxiety, and stress scales.

So what did the researchers find?

At baseline, there were 37 self-identified problem gamers, and 80 self-identified normal gamers. A criterion validity check found that problem gamers scored significantly higher on a test of problem video gaming symptoms (i.e., PVGT) at baseline than normal gamers. [...]

Both groups experienced a significant decline in problem gaming symptoms over an 18-month period, controlling for age, gaming activity, and psychopathological symptoms.

In other words, the self-identified problem gamers at the beginning of the study significantly reduced their problem gaming behavior 18 months later. So much so, they looked just like the “normal” gamers at the end of the study – their video gaming addiction had simply disappeared.

Previous research has found that problem gaming as a teen is the strongest predictor of future problem gaming as an adult. The current study, however, didn’t look at teens — only adults.

Nonetheless, the researchers have some theories as to why they saw problem video gaming disappear:

An explanation for this general decline in problem gaming symptoms in both groups is not readily apparent based on these data although the concept of maturing out over time is well established in the addiction literature. Inspection of problem gaming trajectories may suggest that a spontaneous recovery effect occurred among all gamers, as has been observed in studies that have monitored problem gamblers not receiving treatment.

It may be that problem gaming symptoms at baseline generally represented the most severe stage of respondents’ problem gaming habit, at which point problem symptoms remitted naturally over the course of the study.

The new study suggests that for most adults, video game addiction may very well resolve itself on its own over time.

If you can’t wait (or your relationship or work or studies can’t wait) for this possibility, it never hurts to see a mental health professional for a problem like this. A therapist can still help with problems of this nature, even if it’s not a formal diagnosis.

Reference

King, D.L., Delfabbro, P.H., & Griffiths, M.D. (2012). Trajectories of Problem Video Gaming Among Adult Regular Gamers: An 18-Month Longitudinal Study. Cyberpsychology, Behavior, and Social Networking. -Not available-, ahead of print. doi:10.1089/cyber.2012.0062.