Insanity (on relapse)

This was meant to be a comment that turned into an essay.

I’ve walked a fine line between being kind to myself, realizing that I have mental illness, but at the same time not being tolerant (or rather, too tolerant) of relapsing.

Hangovers and the way I’ve dealt with them (isolation, rest) have lent well to having the space to think, to critique the reasoning leading to the relapse and assess whether the galavanting was worth the ensuing pain. The answer is always unequivocally no.

But is it because “the fun is over?” Because you are paying debt owed on something you’re not enjoying anymore? The question must be viewed in a more abstract, “higher order” way: is the fun worthwhile enough to do this in future and take with it the future suffering.

It’s curious how the answer to the question posed that way changes as one distances themselves temporally from the suffering. A week later, the formulation might yield “yes.” What’s changed?

Interestingly, the drinking hangover cycle marches on (in theory) because of the distance in time between the events. The brain’s reward mechanism scarcely connects the two. That, or the reward is so great, the more primitive part of us sees fit to ignore the physical calamity or doesn’t adequately value the social damage endured.

Paradoxically, as we continue forward in time, both the reward and suffering should be conflated, should meld together, and the pain should enjoy taking priority in our all too human recency biases.

So then why. Just as Einstein characterized repeating the same thing seeking difficult results as insanity, any thorough analysis of a relapse would arrive at it being insane (in a folksy sense).

Carrying it out seems a contradiction unless one of our model assumptions are incorrect. Perhaps we don’t always seek to minimize pain. Perhaps relapse is unconsciously (I hope) self-destructive.

I think this notion of pain and pleasure being measurable is flawed. If the particular indulgence is perceived to be your only chance at happiness, even temporary, we may embrace and tolerate significant pain and loss to experience brief nirvana.

It may be that your drug of choice is the only pathway to securing some level of hedonistic pleasure. Recovery, as I’ve come to understand it, is divorcing yourself from being manipulated from within by a reward mechanism that doesn’t understand what it is to be human. That doesn’t value your potential and social capital. That doesn’t play the long game.

A depressed person is susceptible because this cancerous mode of thought, this blindness toward or disregard for the self, has taken root consciously as well as subconsciously. You have to love and value life to not give it away so cheaply. That is why the ultimate expression of depression is suicide.

So to the person that asked about relapse, assuming it’s not insanity, it’s because you aren’t convinced of a reason to live. That is, to “live” in the sense that you believe you can find fulfilment and actualization as a person. As a thinking, feeling, loving human. Being unconvinced of it fosters addiction.

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Part of this is my attempt at a faux intellectual rebuttal of AA’s big book. Or less aggressively, trying to reason out why I agree that addiction is a “spiritual” issue without being one that should be laid at the doorstep of a God.

Or maybe trying to make rational the stunningly irrational…

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Some interesting thoughts there. I have other, more “mechanical” thoughts on that “why?” question.

It sounds like basically, you’re touching on the topic of time inconsistency from behavioural economics. We estimate the pros and cons of our choices, but each of those change their value to us with time. Often, it’s enough to make the balance shift from negative to positive, or vice versa. Our own impermanence and that of the pain or pleasure we expect to experience make us factor time into everything.

Then there’s also the bias we put on definite vs. uncertain outcomes. We tend to be pessimistic about uncertainty to protect ourselves from spending our energy and resources on something that may not pan out. We don’t know how much our recovery will cost us on the whole, but we believe we have a better idea of what it will cost to delay it another day, and eat a known cost to avoid an unknown we fear might be greater.

Not to mention all the neurological processes going on to affect our utility estimates in the first place. Operant conditioning, the neurotransmitter system we still understand so little of, hormone cocktails, etc. I find ΔFosB gene expression particularly intriguing as it relates to addiction specifically, drug and behavioural addictions alike.

We also don’t think it will get worse as fast as it does, because we don’t notice the change in between individual drinks. We simplify based on current circumstances, and predict that the next drink will reward as much as the last, and harm us as much as the last. Over time, we are wrong.

Plus, we’re not even going to be engaging in full rational decision-making once we’ve been sufficiently tempted. That’s more of a prospective forebrain process, like “what shall I do today”. In contrast, often we’ve already decided what we want already. We’re just looking for stand-out reasons not to go through with it, which works differently. You need a really strong incentive (danger, for example) to abort the decision at the later stages, not lofty theoretical ideals. If you see a relapse as legitimately dangerous, you’ll be driven farther to prevent it from happening.

I’m so glad for neuroplasticity and our ability to change the way we think. With time and effort (“doing the work”), we learn over time to think in ways that lead us to be non-drinkers. Recovery programs, CBT, engagement in healthy behaviours, social influence, etc. and most of all abstinence itself, provide practice in this from a number of angles. We’re not stuck in our stupid relapse-seeking decision-making process. We can re-flash some of those chips and reprogram ourselves.

Of course, it’s a process and we don’t just wake up all fixed. But we can change.

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One and the same. We are talking spiritual as in you. The human spirit.
Having faith does not necessarily mean belief in God as the Bible tells us and this is where I get annoyed when people use this as an excuse not to go to AA. Just get over it!
After all if we keep relapsing and are not trying everything we can, keeping an open mind, is this not insanity
Forget the word God.
Forget the prayers, unless you find affirmations work for you.
A type of prayer in my book.
Meditating on something?
A type of prayer in my book.
Both designed to lift one’s spirit. To raise our spirituality

I keep banging on about all the great advice and information I read on here, that first weekend when I couldn’t get off the sofa because I was just weak all over, body and mind.
Learn to love oneself!
Learn to live with onesself, everything about yourself.
The shit as well as the good.
Ever since I can remember there have been self help books of one type of another. Be a better boss, better Husband/wife. Be a better you! People have made millions off of it.
The thread about CBT or Rational Recovery and AA being similar. Yes they are because they are designed to help you overcome character defects to become a better person. But you have to be open to accepting what is being said to you.

The spiritual side relates to having faith in ourselves as being capable of being who we believe we can be if we put our minds to it.
I mean you could write out uplifting quotes and leave them around your home so you read them everyday. ( Affirmations)
You could meditate, to clear the mind to focus on your spirit, to better yourself.
We can go to counseling sessions.
The problem I see is if we are not open to the concept of change we can do all of the above but nothing would change.
Working on one spiritual growth starts inside ourselves. Being open to the concept of change.
However that works for us.

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I appreciate the response. The problem is whenever I don’t identify with AA in some way, either how badly I drank, or where my rock bottom was, or what I think is really wrong (biological vs spiritual or both) I withdraw and the temptation is there to carry on in my old ways.

I know I need to not drink, that it only does damage, but what I laid out is the explanation from my point of view. I think there’s a niche of problem drinker not spoken for in the high drama environment of AA.

That all said, I think it’s also an attempt to identify with what they’re talking about. Saying that I have genetic alcoholism isn’t the whole story and knowing that alone isn’t going to solve anything. But asking for Deliverance is overkill. Somewhere in the middle, I have to link everything together, and name the problem I need to work on.

Brad, to my mind, and this is my own personal view. Take from it what you will bud. At the end of the day and as you so rightly said above

Here I go again with the " what I took from reading on here" thing but people talked about getting out of one’s comfort zone. Doing something you wouldn’t normally do because your " normal " is is where the problem is.
The other thing is does it really matter where, how or why you have a problem?
After accepting that I had a serious problem, that I am an alcoholic! Life for me became so much easier.
I’m not bothered, now, with the fact that I am an alcoholic, I’m not all that bothered why I’m an alcoholic, I’ve accepted it and moved on to trying to make myself a better person without it.
As I said mate, you do you.

I can identify with this. We naturally seek connection, and when it’s slow in coming, it’s discouraging, disappointing, frustrating. Even more so in the case of depression. I commend you for giving AA a new chance, and for continuing to seek out connection here. No one should go it alone.

I’ve got obstacles of my own that make AA a difficult environment for me too, though probably not to the same extent and mostly to do with my anxiety. But I know I need people, and I want more than just TS for support, so I’m keeping it open and going to meetings as I can bring myself to do so.

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Yes that’s what I tried to say but put more succinctly than my late night rambling. Like I said, I think completely removing the spiritual element and depersonalizing the issue is wrong (although it’s what I’ve mostly done to this point).

AA recognizes the “allergy” to alcohol but then goes into angels and demons and provides a roadmap for people to salvage a life destroyed. I’ve felt like an imposter at meetings. Even the atheist one. I get that AA is officially for anyone not wanting to drink.

I like TS. Frankly I think sober friends would be good enough. All the crazy drinking is on my own. Most people don’t get wasted. Even at my birthday party a few people drank a couple drinks but most have families and just don’t do that anymore.

So my isolation from normal people makes things worse, and sadly, more isolated.

I’m searching for a personal philosophy that works, because I know deep down none of it is logical.

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