Now Fill in the Blocks with a Listing of Answers to some, many, all of the Following Discussion



COST/BENEFIT ANALYSIS

Jonathan von Breton, CCMHC, CAS, MAC
Professional Advisor, SMART Recovery Online

These 4 questions can provide you with a lot of useful information to make decisions about major life changes. They can be applied to a wide variety of situations. The more honest and complete your answers, the more this exercise will help you.

1.What do I enjoy about my addiction, what does it do for me (be specific)?
List as many things as you can that you liked about whatever you are/were addicted to.
a. Where possible, find alternative ways of achieving the same goals.
b. Recognize positive thinking about the addiction as a potential relapse warning sign.
c. Realize that there are some things you liked about the addiction you will have to learn to live without.
d. List what you enjoy about your addiction so you can ask yourself if it is really worth the price.
e. Realize that you aren't stupid; you did get something from your addiction. It just may not be working on your behalf anymore.

2. What do I hate about my addiction, what does it do to me (give specific examples)?
List as many of the bad, undesirable results of your addiction as you can. Here it is extremely important that you use specific examples. Specific examples have much greater emotional impact and motivational force!
a. Ask yourself honestly "If my addiction was a used car, would I pay this much for it?"
b. Review this list often, especially if you are having a lot of positive, happy thoughts about all the great things your addiction did for you.

3. What do I think I will like about giving up my addiction?
List what good things you think/fantasize will happen when you stop your addiction.
a. This provides you with a list of goals to achieve and things to look forward to as a result of your new addiction free lifestyle.
b. This list also helps you to reality test your expectations. If they are unrealistic, they can lead to a disappointment based relapse.

4. What do I think I won't like about giving up my addiction?
List what you think you are going to hate, dread or merely dislike about living without your addiction.
a. This list tells you what kinds of new coping skills, behaviors and lifestyle changes you need to develop in order to stay addiction free.
b. It also serves as another relapse warning list. If all you think about is how much life sucks now that you are not doing your addiction, you are in a relapse thought pattern that is just as dangerous as only focusing on what you liked about your addiction.

This is not a do once and forget about it exercise. It is an ongoing project. Most people simply can't remember all of the positive and negative aspects of addiction and recovery at any one time. Furthermore, seeing all the negative consequences of addiction listed in one place is very powerful. On the positive side, no one really knows what they like or don't like about living free of their addiction until they have done so for some time. I know of people who continued to add items to all four questions for a full 6 months.

UNDERSTANDING AMBIVALENCE

Motivational Interviewing, by William Miller and Stephen Rollnick (1991), is probably one of the most important books on addiction and change to be published in the past 10 years. The authors uphold that ambivalence is a primary obstacle to following through with change goals. 12-step approaches often mislabel ambivalence as "denial" or "resistance." Ambivalence need not be defined by such pejorative terms. In fact, it is my contention that ambivalence to change is far from maladaptive; it is necessary for survival. If it were easy for individuals to "forget" automatic behavioral coping plans which had been repeatedly reinforced (by reducing anxiety, improving social ease, bringing about euphoria) we would undoubtedly perish. In other words, our brains are designed to push us toward that which we have stored as positive or that which reduces something negative. It is a necessary heuristic. Anyone with an addictive habit will be quick to say that this heuristic is a double edged sword, as sometimes our better judgment tells us to relinquish a behavior (such as problem drinking) and our stockpile of memories ruthlessly continues to drive us toward the behavior we wish to avoid. This conflict is composed of different kinds of information dueling for a behavioral outcome. I like to envision a see saw with two boxes on each side. On the left side we have a box labeled "benefits of not drinking" and another box labeled "costs of drinking." This is the information which is driving your change efforts. We can very often articulate this information with out problem. The other side of the see saw contains two boxes also, and this information is often less readily available, especially in the heat of an urge experience. One box is labeled "benefits of drinking" and the other is labeled "costs of not drinking" Miller and Rollnick have suggested that people can counter ambivalence by "decreasing desirability" of the behavior. And this is exactly what this exercise is designed to help you do.

This exercise will hopefully help you create a "cognitive template" for countering ambivalence in the heat of the moment. This will be done by 1. Helping you to understand the information which supports the ambivalent state: benefits of drinking, costs of drinking, benefits of not drinking, costs of not drinking. 2. Helping you understand that this information is blocking change. 3. The goal is to "tip the scale" i.e. create an imbalance such that the decision not to drink becomes more desirable than the decision to drink. You will do this by "challenging" the information which is impeding change. 4. With practice, you can learn to identify the information which is fueling an urge state and perform a cost/benefit analysis in the heat of the moment.