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Life and the lies of a high functioning addict.

The picture of addiction

Hollywood has certainly often painted the picture of addiction and functioning addicts in a certain stereotypical fashion. We as an audience are shown addicts as down and out people, the afterthoughts of society, often dregs of a community. Or on the polar opposite side of society as the big rock star who falls from the fame pedestal into a swamp of despair or more commonly seen, and used as a metaphor far too often, as the rock bottom moment in life.

But as we also know – Hollywood, entertainment and even the media, in general, aren’t always the bearers of the whole truth…The reality of the matter is that addiction can be likened to a candle, slow burning and with a myriad of complex issues leading to a disability which an addict deals with. In fact, recent studies have shown that those who are high functioning addicts are actually quite hard to pin down and define.


So what is a high functioning addict?

Functioning or high functioning addicts are people who often despite their addictions, still project an outward appearance of normalcy. Yes, normalcy is a hard one to define but what we mean by that is that they enjoy reasonable to good societal norms and even seem to reach high degrees of success. They are employed; they have lives outside of their work space and dress the part of a regular functioning adult in society.  That is however a really well constructed illusion and despite what the outward appearance may show, inside there is a raging war, and it is very real and very dangerous. A majority of addicts are not able to sustain this façade, and their habits for ever and eventually a knock at the door of health, relationships and quality of life will be heard.

How does a high functioning addict keep up appearances?

Good question. A High functioning addict will often be highly skilled at hiding their issues and problems – especially from those close to them. There is of course a fear that if their dark “secret” is discovered, the buildings of success (career, reputations, relationships) which they have built will come crumbling down.

A high functioning addict’s façade however is not perfect. There are chinks in the armour and those tell signs are clues to revealing the true story behind the addict.

Here are some of those clues:

  1. A high functioning addict will often escalate their consumption intake with increasing frequency.
  2. As the negative and draining effects of addiction begin to wear down the energy of a high functioning addict, you may start to see less care being taken around their appearance. Often someone who once looked neat and professional has over time come to appear dishevelled and untidy or even messy. This is because as the addiction takes over, health suffers and there is less energy to keep up appearances.
  3. It is commonplace in terms of behaviour for an addict to react with denial and even excuses when it comes to their addiction. Often, they are characterised as having actual reasonable sounding excuses and justifications. These are used to convince themselves as much as anyone else that they do not have a problem. Have you heard someone say: “I work harder than anyone else in the room? I don’t cut corners, and I deserve to unwind and have some fun.”
  4. A High functioning addict will often work in ‘enabling’ environments. The saying, “Birds of a feather, flock together” has never been more apt. An addict will hang out with other addicts so they can both validate their own behaviours and to share the source of their addiction. Take a cocaine user in a high stress office situation. He or she will hang out with someone in a completely different department because they have common ground, even if they barely interact as a result of their work requirements.
  5. A high functioning addict will probably use up as much of the sick card as possible. It’s blindingly obvious actually. Think of why: Terrible hangovers, nausea, anxiety, headache, sweating, fatigue and post nasal drip which are all common withdrawal symptoms from drugs and after effects of drug abuse to the body. As a result, work performance may drastically drop off, and they can become unreliable when it comes to tasks they previously aced. Also, a high functioning addict may stop doing the things they once loved or where known for, like hobbies or pastimes. Remember the guy in sales who always raved about fishing on the weekends? Why hasn’t he fished for months and hasn’t spoken to anyone about fishing for ages? Social engagements and activities will also start to dwindle from their calendars, especially the ones which don’t involve using or consuming a drug. What follows may be best described as isolation from work or home.
  6. Brain functions such as memory issues are also common as substance abuse takes hold of the high functioning addict. They may find themselves trying to remember or put together pieces of a situation, like a big night out or have what is often described as a “blackout” – where total loss of memory is experienced. This is a massive indicator that the substance abuse is already at a stage where it is affecting a person’s normal brain functions.
  7. The money begins to dry out. Many high functioning addicts end up with financial issues, and guess who they turn to? The people close to them, often loved ones who in turn enable them by providing a source of income. Someone who has a decent job that pays well – and doesn’t have a lot of expenses shouldn’t find themselves in financial difficulty – so look behind the curtain. And, a word of advice, this should be checked before the inevitable legal issues come knocking.

A final note to remember is that a high function addict can and will become a non-functioning addict with time. Addiction has many golden rules to follow and remember in order to conquer it – but remember this one: An addict is not a lost cause and that means neither is a high functioning addict. With love, support, and treatment, recovery is definitely possible!

 


For more information on dealing with addiction and getting yourself or a loved one  into rehab to start a new life, call Houghton House now:

office hours:  011 787 9142

24/7 emergency help line: 079 770 7532

Click on the green envelope below and fill in our contact form, and one of our professional staff members will get back to you via email or phone, respecting your anonymity at all times.

using, Signs of someone using Drugs,

 

synthetic marijuana

Understanding Synthetic Marijuana (Spice, K2, Mojo)

Everything you need to know about Synthetic Marijuana

The chemicals in synthetic marijuana are designed to have similar qualities to that of tetrahydrocannabinol (THC), which is the psychoactive ingredient in marijuana. Most commonly spice is ingested via smoking but it can also be added to drinks or added to food as an edible drug.

Marijuana is a drug which comes from a plant right? Yes. Well sort of.

Continue reading “Understanding Synthetic Marijuana (Spice, K2, Mojo)”

rage

What Happens At Rage Stays At Rage

Wrong! 

That’s in a perfect world. What happens at Rage goes on Facebook, Instagram, Snap Chat, Twitter the types of social platforms goes on and on. Pictures of you doing things that may embarrass you for years to come will be out there on the internet forever. Not to mention the live options that we are all using these days. When you’re intoxicated and feeling fab, live is the way to go, right? Wrong, you’ll regret it tomorrow…

Continue reading “What Happens At Rage Stays At Rage”

12 STEPS A PRACTICAL INTERPRETATION

12 Steps Recovery from addiction has been described as a ‘voluntarily maintained lifestyle characterised by sobriety, personal health and citizenship’

 


David Webb 12 Steps

While in the right setting, such as a 12 steps rehabilitation clinic, many addicts have little trouble stopping drinking or using drugs, most, if not all, find maintaining sobriety, especially after reintegration back into society and return to normal life, much more difficult.
For the majority, without the long-term support and constant vigilance to curtail impulsive behaviour, it is impossible. In some addicts, incentive salience driven by changes in the limbic brain presents a lifelong vulnerability to relapse.


12 STEPS FURTHERMORE, THE HORRENDOUS CONSEQUENCES AND CHAOTIC LIFE CREATED BY YEARS OF ACTIVE ADDICTION, SOMETIMES COUPLED WITH LOSS OF FAMILY AND SOCIAL SUPPORT, FURTHER COMPOUNDS PRE-EXISTING LOW SELF-EFFICACY, LOW SELF-ESTEEM, POOR EMOTIONAL REGULATION AND HOPELESSNESS. IF ADDICTS ARE TO REMAIN SOBER, THEN THESE ASPECTS OF THEMSELVES NEED TO BE ADDRESSED AND THEIR THINKING STYLE AND SOCIALITY NEED TO CHANGE SO THAT THEY AREMORE FUNCTIONAL.

The 12 steps of addiction recovery (Table 1), originally described by Alcoholics Anonymous in 1939, is a framework for a learned lifestyle characterised by self-awareness, self-compassion, self-development, improved resilience and enhanced psychological wellbeing.2,4-6 By encouraging social participation and working with other recovering addicts, the 12 step process provides the recovering addict with a sense of common humanity and belonging, motivation to remain sober and an opportunity to find meaning and purpose.

At first sight, the 12 steps appear to be overtly religious, as is the Christian-based approach of the original text.4 The process has been criticised for this, along with (inaccurate) perceptions that recovery through the 12 step process requires admissions of powerlessness and to moral character defects or failings.7 Nevertheless, a contemporary interpretation of the 12 step process does not necessitate religious identification or belief in a god. Furthermore, some of the words from the 1939 text are used differently in the present day and it is helpful to understand the original context in which they were intended.

The following is a brief non-religious interpretation of the 12 step process, which forms a practical adjunct to treatment of addiction to alcohol and other drugs and an ongoing lifestyle to help maintain a less chaotic life and long-term sobriety.


THE STEPS

12 STEP 1: Alcoholics Anonymous points out that alcoholism is characterised by two behaviours.4 Despite a conscious desire to abstain, the alcoholic is unable to leave alcohol alone for any extended period of time, and once they take a first drink, he/ she cannot stop. The drinking episode culminates in blackout and loss of consciousness. In other words, the addiction hijacks the addict’s sense of free will, in that they are no longer free to choose whether or not to drink or how much to consume.
This view is consistent with dopamine reward prediction error, incentive salience and post-use dysphoria mechanisms of addiction neurobiology.3,6,8-14 In contrast to being addicted to the high, in the absence of anticipated reward, the brain ‘wanting’ (distinct from ‘liking’) the addictive substance and post-use dysphoria, drive repeated, compulsive and excessive consumption. In this context, incentive salience, in which emotions are powerfully salient, also explains why addicts may relapse after even many years of sobriety.
Therefore, in these respects, the alcoholic is powerless over (his addiction to) alcohol. He/she cannot stop drinking by him/herself (without assistance). The addiction to alcohol is more powerful than the willpower of the individual.
It is important to note that, in contrast to the concept of ‘powerlessness’ in general that is too often mentioned as a criticism of this step, step 1 does not suggest that the individual is powerless. Clearly one retains considerable efficacy over one’s own life, whether or not to seek and be open to assistance and whether to participate in the recovery process.
Clearly the alcoholic’s life is unmanageable when they are drinking. However, due to poor coping skills, low self-efficacy and self-defeating thinking characteristic of the addictive psyche, and chaotic consequences of repeated intoxication, the alcoholic’s life is almost certainly unmanageable in between drinking episodes as well. This sets up a vicious cycle of adverse consequences and negative emotions and drinking to escape those that further contributes to chronic alcohol use.


12 STEP 2: What is a power greater than myself? Simply put, it is not me. I need assistance to recover. Even if the alcoholic is able to sustain sobriety for short periods, they inevitably return to drinking. They may tell themself that now they have it under control, that they will be able to moderate their drinking. The AA text describes this inability to learn from past experience and the conviction that, despite all evidence to the contrary, this time will be different, as ‘insanity’.4,5
There is no suggestion in the 12 steps that alcoholics should blindly accept from the outset that the 12 step process will enable them to recover. It is merely suggested that, with assistance, they give it a chance. Through seeing the benefits of the program in the sobriety of others, and in experiencing the positive changes that occur in their own lives as a consequence of implementing this lifestyle, they gradually come to understand (we came to believe) that a sober, rewarding life is achievable and sustainable.


12 STEP 3: If life is to change, and relationships and consequences of behaviour are to improve, and if one is to break the cycle of chaos and drinking, then it is intuitive that the alcoholic should have at their disposal a functional reference framework within which to act in future. Self-centered motives that inform impulsive decisions and behaviours need to be replaced with more mature functional thinking and actions. Step 3 offers the alcoholic a framework from which to start.
Although many alcoholics may identify with a God, others do not. The 12 step program refers to “God as I understood him”. Regardless of religious or spiritual convictions, alcoholics are invited to define for themselves what God, if he/she were to exist, might be like. A typical list of ‘godly’ characteristics (or principles) might look like that presented in Table 2. It is then suggested that they begin to make decisions and act based on these characteristics that they have identified as desirable. They are invited to “act like the person you want to become”.12 STEPS


12 STEP 4: In contrast to criticisms of this step that suggest that alcoholics are made to admit to ‘moral failings’, the ‘moral inventory’ referred to in step 4 is not intended as a judgement on character. Step 4 is an invitation to ‘discover the truth’ where unawareness and pursuing one’s own motives has led to negative consequences, dysfunctional relationships, resentment and reactionary drinking. The alcoholic is asked to identify episodes of past anger, regret, guilt or embarrassment and where they were responsible in these situations. Note that they are not asked to identify their ‘part’.
If I have a part, then you must have a part, and if you have a part, then my part is justified: “Putting out of our minds the wrongs the others had done, we resolutely looked for our own mistakes. Where had we been selfish, dishonest, selfseeking and frightened? Though a situation had not been entirely our fault, we tried to disregard the other person entirely”.4 Through identification of self-seeking motives, the alcoholic is in a position to adjust future behaviour by substituting these motives with the principles identified in step 3. Introspective, carefully considered decision-making based on principles rather than motives informs more functional behaviour with less chaotic consequences. Life becomes more manageable. Furthermore, compassion for others facilitated by step 4 may increase the capacity to accept compassion from others and the ability to show greater compassion to self.15 12 STEPS


12STEP 5: Talking to another person about the inventory established in step 4 is helpful in a number of ways. It helps to establish a sense of common humanity, to put events into perspective and to invite an opportunity for council. Addiction is characterised by dysfunctional thinking and behaviour, associated with shame and a sense of isolation. Talking to another (recovered) addict, discovering that one is not alone, is cathartic, reduces feelings of isolation, fosters self-acceptance and opens the door to healing.
It engenders a sense that one can be forgiven and can forgive. It creates a sense of humility, honesty and willingness to change without descending into selfpity.5 Although there is no substitute for one addict talking to another, other appropriate people who may be helpful in step 5 include addiction counsellors, healthcare professionals, friends, family members and religious advisors. Steps 6 and 7 represent, with humility, a commitment to maintain the framework for decision-making that has been outlined in step 4.


12 STEPS 8 AND 9: Active addiction is characterised by behaviours that are self-centered and dishonest. Almost inevitably during that time others are maltreated, harmed or compromised in various ways. By carefully reviewing where their behaviour may have caused harm to others or society and, where possible making amends for that, the alcoholic is able to free themself from associated guilt and shame and pre-empt or avoid repercussions of past activities that may adversely affect their life in future and compromise efforts at sobriety.
Decisions about who to approach, how to approach them and how it may be possible to make amends should be objective and carefully considered. Consequently, discussion with appropriate counsellors is encouraged before approaching others.


12 STEPS 10 AND 11: As previously implied, the steps, rather than being discrete actions, are a framework for a maintained lifestyle. They are separated and numbered so that the lifestyle can be taught, understood and learned. Steps 10 and 11 inform a daily practice of a nonjudgemental, carefully considered review (mediation) of emotions, thoughts and events, and planning for the day ahead, based on the principles of steps 3, 4, 8 and 9.


“WHEN WE RETIRE AT NIGHT, WE CONSTRUCTIVELY REVIEW OUR DAY…with the 12 STEPS;


On awakening, let us think about the twenty-four hours ahead”.4 The intention is to non-judgementally identify where motives rather than principles continue to inform behaviour and to proactively correct errors before they occur or are allowed to escalate.
STEP 12: The result of the 12 step lifestyle is a personality change (spiritual awakening) to a happier, more capable individual who is able to grow and flourish. Assisting and guiding other recovering alcoholics to achieve the same provides a sense of purpose and meaning that supports long-term sobriety.2,4-6


FINAL WORDS

Participation in 12 step-based social groups, such as Alcoholics Anonymous or Narcotics Anonymous, provides valuable support for long-term sobriety. Although a 12 step process may not be appropriate for all addicts, it is helpful for clinicians to have an informed working knowledge of the 12 step process so that they may encourage it where it is appropriate and support those who are already participating in such groups.12 STEPS

David Webb


References 1. Belleau C, DuPont RL, Erickson CK, et al. What is recovery? A working definition from the Betty Ford Institute. The Betty Ford Institute Consensus Panel. J Substance Abuse Treat 2007; 33: 221-228. 2. Moos R, Timko C. Outcome research on twelve-step and other self-help programs. In Galanter M, Kleber HO (Eds.). Textbook of substance abuse treatment (4th ed). Washington, DC: American Psychiatric Press; 2008. pp. 511-521. 3. Robinson MJF, Robinson TE, Berridge KC. Incentive salience and the transition to addiction. In Miller P (Ed). Biological Research on Addiction (1st ed). Amsterdam: Academic Press; 2013. 4. Alcoholics Anonymous (4th ed). New York: 12 STEPS Alcoholics Anonymous World Services, Inc; 2001. 5. Twelve steps and twelve traditions. New York: Alcoholics Anonymous World Services, Inc; 2009. 6. U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016: pp 2-1 – 2-26; 5-8 – 5-10. 7. Mendola A, Gibson RL. Addiction, 12-Step programs, and evidentiary standards for ethically and clinically sound treatment recommendations: What should clinicians do? AMA Journal of Ethics 2016; 18(6): 646-655. 8. Schultz W. Dopamine reward prediction error coding. Dialogues Clin Neurosci 2016; 18: 23-32. 9. Berthet P, Lindahl M, Tully PJ, et al. Functional relevance of different basal ganglia pathways investigated in a spiking model with reward dependent plasticity. Front Neural Circuits 2016; 10:53. doi: 10.3389/fncir.2016.00053 10. Morita K, Kawaguchi Y. Computing reward-prediction error: an integrated account of cortical timing and basal-ganglia pathways for appetitive and aversive learning. Eur J Neurosci 2015; 42: 2003-2021. 11. Ostafin BD, Palfai TP. When wanting to change is not enough: automatic appetitive processes moderate the effects of a brief alcohol intervention in hazardous-drinking college students. Addict Sci Clin Pract 2012; 7: 25. http://www. ascpjournal.org/content/7/1/25 12. Gardner EL. Addiction and brain reward and anti-reward pathways. Adv Psychosom Med 2011; 30: 22-60. 13. Nestler EJ. Cellular basis of memory for addiction. Dialogues Clin Neurosci 2013; 15: 431-443. 14. Volkow ND, Koob GF, McLellan T. Neurobiologic advances from the brain disease model of addiction. N Engl J Med 2016; 374: 363-371. 15. Jazaieri H, Jinpa GT, McGonigal K, et al. Enhancing compassion: A randomized trial of a compassion cultivation training program. J Happiness Stud 2013; 14(4): 1113-1126.