Steering a path through addiction lessons from tobogganing Marc Lewis As a

Steering a path through addiction lessons from

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Steering a path through addiction: lessons from tobogganing Marc Lewis As a developmental psychologist, I tend to see mental health issues and personality patterns as trajectories that continue to progress and modify their direction (as constrained by their own histories) from within, over the lifespan. Addiction can be viewed as a trajectory that emerges, becomes ingrained, and then in most cases evolves further (people quit or learn to control their use) over time (Lewis 2017 ). Indeed, most people in addiction eventually quit, and a majority of those do so without treatment (Heyman and Mims 2017 ). When treatment is pursued, it is compromised by the dominant medical model of addiction, which tends to ignore the importance of personal empowerment for recov- ery. The help addicts need isn't medical; it's psychological. Certain cognitive, emotional and social skills are particularly useful for voluntarily steering one's path out of addiction. In this contribution I explore some of these skills through the use of a metaphor. These skills are similar to those needed to steer a toboggan racing down a hill. What are the parallels between steering one's drug use and one's toboggan run? 1. There is a strong force pulling the path in the present direction. For tobogganing it's gravity the slope of the hill; for addiction it's habit strength the recurrence of the addictive urge. The force of gravity translates to speed in tobogganing; the force of habit translates to intensity or duration in addiction. The better we under- stand these forces, the more easily we can help those whose momentum is propelled by them. 2. Techniques for steering have remarkable similarities. On a toboggan, you'd best use small, subtle movements, like leaning in one direction or sticking your elbow in the snow. If you try a sharp turn, say by leaning too force- fully or thrusting your foot out, you will surely topple. In addiction, it is also useful to apply subtle cognitive tricks, like choosing the street you take home from work to avoid the liquor store, or telling yourself you can get through a day at a time. Gentle self-directed nudges and self-talk work far better than I must never do this again! (Snoek et al. 2016 ). For both tobogganing and addiction, precision and timing are more important than brute force. 3. For both tobogganing and addiction, the contribution of other people especially those at hand is critical. Toboggans can be more easily steered when all three or four passengers lean in the same direction at the same time ( in sync ). In addiction, interpersonal advice, emo- tional availability, and support work best when they are in sync with the addict's own plans, intentions, and tim- ing. That's why we need to be ready to help when some- one is ready to quit.
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