The number one reason for the self-changers I referenced in the last chapter quitting or modifying their substance use was, overwhelmingly, that it was no longer “worth it.” Using was too much hassle, too much trouble, and was causing too much discomfort and pain in their lives, relative to the benefit they were receiving from the drug. As it was their number one reason, it was also their number one motivation for self-change. With motivation, almost any program will work, or, in the case of 75% of former addicts, no program at all, as long as the addict has reached the point when he or she realizes that the costs outweigh the benefits.
The problem for treatment centers and self-help groups has always been how to motivate those who come to the groups without first reaching this conclusion. Not everyone who shows up at an AA meeting, NA meeting or treatment center really wants to quit drinking or using, that’s why their efficacy rates are so dismal. Some are sent by the courts, some are threatened by loss of job or marriage, and some enter treatment to hide from legal problems. AA’s primary motivational tool is fear, telling the alcoholic that they are powerless over their disease, and that without total surrender and commitment to the program, the only possible outcomes are death, incarceration, or mental institutions. Treatment centers do very little more, as they all use the 12-step disease model.
What, then, was the actual mental process used by the overwhelming number of addicts who quit on their own, that led them to the decision that the benefits of using no longer outweighed the consequences? More importantly, to you and I, at least, can this process be reduced to a method anyone can learn and apply to themselves? We know it has to be a cognitive process, because drinking or using is a choice, and one that those addicts who quit on their own proved, beyond the shadow of a doubt, is not one that we are powerless over!
Fortunately, for all of us, it turns out that the process we use to make choices such as this is a common one, and one that we use all the time. You may not know it by its “technical” name, and you may have never done if formally, but it’s one you may already be familiar with.
Some of you may know what a “Cost Benefit Analysis,” (CBA) is, but if not, think of it this way: Whether you realize it or not, you perform some kind of CBA for virtually every decision you make in your life, no matter how trivial it seems. If you’re considering a purchase, a move, a job change, where or what to eat for dinner, or what TV show to watch, at some point you weigh the advantages and disadvantages of doing it, not doing it, or doing something else instead. Some are easy, these we call the “no-brainers,” others we agonize over for weeks before we finally make a decision one-way-or-the-other.
There are those with substance dependency problems who move through this stage very rapidly, but there are many others who linger here, some for years, before they finally decide that the costs of their addictions outweigh any benefits they might be receiving from the alcohol or other drug. To those who have never experienced addiction, the decision to quit seems like it would be one of those “no-brainers,” but to the addict, it is something entirely different. The drug brings relief, in the short term, for what is, for some, unbearable pain. The benefits of not using are more long-term, and that’s the problem that must be overcome. The decision involves shifting one’s focus from the short-term gratification gained by feeding the habit, and the achievement of one’s long-term goals, if any. In other words, the decision necessary to move from stage two to stage three is actually, in many ways, a decision to grow up!
If you are having some difficulty understanding the concept of the Cost Benefit Analysis, I would like to propose that you try this simple exercise. If you give it a shot, you might be surprised at what you may find out about yourself. Take a clean sheet of paper, any paper will do, and a pen or pencil. Draw two lines, one dividing the paper in half vertically, and the other dividing it in half horizontally. your paper should now have a big “plus” sign on it, dividing it into two rows and two columns. At the top of the left-hand column, write the word “Pros,” and at the top of the right-hand column, write the word “Cons.” On the left-hand side of the first row, write the word “Using,” and below it, on the left-hand side of the second row write the words “Not Using.” Your CBA should look like figure 1 below. Now, fill it in, and as you do, note if the effects are short or long term. For instance, if you write “gives me a hangover” as a “con” for using, note if it’s effect is short term (ST) or long term (LT). A couple of examples of “pros” for using might be, say, “Helps me deal with social situations,” or “Makes me feel like I fit in.” A couple of “cons” might be: “Hangover,” or “Potential legal or health problems.” Either of the last two could be short or long-term.
Some “pros” for not using might be: “Makes wife happier,” or “I can make it to work on time.” Some “cons” might be: “I can’t function socially as well,” or “I can’t hang out with my friends.” The point is, the pros and cons will be a little different for everyone, and, don’t forget, as you write them down, note whether they are short or long-term.
We will spend a lot more time on CBA’s in Chapter 7, but if you do this little exercise now, and you are honest about it, you will find that the pros of using are short term, while the cons are both short and long term; and the pros of not using are both short and long term, while the cons (if any) are all short term. This is the exact same process that all self-changers go through, some on a formal basis, some not, but whatever the method, the conclusion they all came to is the same: There are no long term pros for using, and there are no long term cons for not using!
As I progressed in my own dependency, my drug-of-choice, alcohol, took many things away from me. The process was so gradual, however, that at the time, I hardly noticed it was happening. As my progression went on, alcohol became more important than almost all of my prior activities slowly supplanting reading, writing, learning, woodworking, outdoor sports, spending time with non-drinking friends and family, and finally, work, marriage, and even my own health and well-being.
What amazes me still, all these years later, is that I never made the connection between all of those losses, the pain that I was in, and the drug. Never! Not until the day I quit. Oh, I might have had some fleeting thoughts, but they were quickly and easily dismissed, because I would just accept what I was becoming, and I thought I was completely normal. That’s why I never judge people who are still abusing drugs and alcohol, and can’t see what it’s doing to their lives. It took me years to begin the change process, so I have only empathy and understanding for those who are still struggling. All I can do is what any of us can do – make the tools and support available, because you never know when someone will sincerely wish to take advantage of them.
Making the decision to change your behavior is, of course, the key, as nothing will work for you until you are convinced that you need to change. From this decision comes the motivation for the entire rest of the process, and, no matter what method you finally decide to use, if you do not reach this conviction at some point, none of them will work for you. Some of the available methods address the motivation issue specifically, and we will talk in more detail about them later on.