The beginning of week four found me engaging in much smug, self-satisfied, back patting. I had experienced a few minor cravings here and there, but overall, I was enjoying the benefits of my month of sobriety. The end of week four found me shooting mental daggers at that overly confident woman, as I dealt with a couple of unexpected bumps in the road. It seems I've reached that age where sleeping incorrectly can produce neck injuries, so I found myself in pain, and unable to engage in my go-to stress relief - yoga. I felt my inner two year old coming out more and more - why not just have a glass of wine? The month is almost over, what are you trying to prove? After all, don't you deserve it? Spoiler alert, deserving or not, I didn't have that glass of wine, and figured this would be a great time to talk about urges, cravings, and how to manage them.
- Recognize Willfulness: Does that voice up there sound familiar to you? An important skill for managing cravings and urges is to recognize when you are being willful. Willfulness is a refusal to accept reality as it is, and a choice to remain on the sidelines of life. To continue with the example above, willfulness would be a refusal to accept that pain is a part of life. By accepting my pain, rather than insisting that it simply should not be, I am able to continue participating in my life, and can therefore make an active choice about whether or not drinking alcohol would help my situation, rather than responding to a craving, based on the anger and frustration that willfulness produces.
- Make the choice to be willing: Ok Jana, that's all well and good, but how do I do that in real life? The answer is, you make the choice to be willing. When I experience neck pain, there are three choices laid out before me, I can change the pain (if possible), I can choose willfulness and refuse to accept the pain, or I can choose willingness, accept the pain, and continue to live my life. In my case, I was doing everything possible to manage the pain, so number one was handled, yet the pain was still there. If you cannot change your situation, then you can either choose to accept it, or refuse, and stop participating in your life. Note that acceptance does not mean that you enjoy or approve, it means that at this moment in time, this is the reality that you're dealing with. It's also important to understand that choosing acceptance is not something that you do one time, it's something that you may find yourself having to do twice, three times, or hundreds of times a day. Learning to turn the mind will help you to gain mastery over this choice.
- Be cognizant of triggers: In order to learn to manage triggers to use alcohol or other substances, you must first identify what they are. Are you having an urge to drink or smoke? Notice what your behaviors, thoughts, and feelings were immediately before. Keeping track in some sort of written format is immensely helpful in terms of increasing your own self-awareness. While you can't plan for everything, knowing that you are more likely to want to use when you're feeling angry or in physical pain will help you to plan alternative coping behaviors to manage these feelings. Here's a helpful format to get you started.
- Managing urges: You may have noticed that a major theme in today's blog is acceptance. In order to learn to manage urges to use, you must first accept that they will happen. A lot of folks who struggle with substance use believe (erroneously) that once they stop using, their urges will go away, or that an urge means that they've somehow failed. None of this is true. Urges are a normal part of recovery, and although they will decrease in frequency and intensity over time, they will recur. When you're experiencing an urge, it's important to remember, that, as with all thoughts and feelings, it's temporary. Whether or not you drink or use, the urge will pass. It might help to imagine yourself surfing the urge like a wave, you'll come to a crest, and then eventually, you will crash on the shore. This blog from SMART Recovery has some helpful tips for managing urges.
- Planning for the future: But I don't wanna think about the future! There's that willfulness again. Let's recognize it, and take a moment to turn the mind, and accept, that for whatever reason, you are unable to drink moderately or abstain without planning. Once you've turned your mind towards accepting this reality, you're ready to plan for future coping. This is going to look different for everyone, but the idea is to figure out what your goals are, and how you're going to stick to them when you experience triggers, urges, and willfulness.
If you or someone you love is struggling with alcohol and/or substance abuse, there is help out there. Check out this link to find out information about treatment programs and providers in your area. Click here if you require urgent or crisis resources. Help is available 24/7 by calling the National Lifeline at 1-800-273-8255.
Dr. Scrivani specializes in the Cognitive Behavioral treatment of anxiety and related disorders, behavioral parent training, and provides tele-mental health services to residents of New York, Florida, and internationally. Call (888) 535-5671 or email [email protected] to set up a free consultation. Visit my website for more information.