Despite a large body of scientific research, myths and misconceptions about addiction remain prevalent in today’s society, contributing to stigma, barriers to treatment, and higher health burdens. The following is a list of common misconceptions.
15 COMMON MISCONCEPTIONS ABOUT ADDICTION
1. Misconception: Addiction is choice.
Fact: Addiction is widely recognized as a primary disorder of the brain. According to the American Society of Addiction Medicine, “Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.” Heavy and continuous use of drugs/alcohol damages the brain, increasing the likelihood of addiction.
Despite this, choice can play a role in long-term sobriety, similar to how lifestyle decisions (i.e. treating symptoms, exercising, eating well, etc.) play a role in the management of other chronic illnesses such as diabetes or heart disease.
2. Misconception: Addiction is a character flaw or weakness.
Fact: The idea that addiction is a moral failing is based on the moral model of addiction. The reality is that addiction has little to do with moral conviction; both inherently “good” and “bad” people are susceptible to developing a substance use disorder.
That being said, a person in active addiction may act in contrast to their values; but that doesn’t mean they’re morally flawed. The moralization of addiction and associated stigma only contribute to guilt, shame, and a decreased willingness to seek treatment.
3. Misconception: Addiction is the result of a lack of willpower (and if someone “wanted it enough,” they would quit).
Fact: Like other chronic illnesses, addiction cannot be “willed” away. Individuals with substance use disorders are not compromised in willpower or lacking in self-discipline.
“The mentality and behavior of drug addicts and alcoholics [are] wholly irrational until you understand that they are completely powerless over their addiction and unless they have structured help, they have no hope.”
4. Misconception: Some people have “addictive personalities.”
Fact: While relapse is relatively common, it doesn’t have to be a part of recovery. There are many contributing factors, both biological and environmental (i.e. stressors), that increase the chances of relapse.
Successful relapse prevention plans involve the avoidance and/or management of risk factors. Also, the less severe the addiction, the more likely someone is to avoid relapse altogether.
7. Misconception: Abstinence is the only path to recovery.
Fact: Recovery is not one-size-fits-all. For some, abstinence may be the only acceptable route, but for others, a reduction in use or the use of a less harmful substance is the desired outcome.
8. Misconception: You have to attend 12-step meetings and work the steps to get sober.
Fact: While AA and NA are often part of sustained sobriety, they are not the only way to stop using drugs or alcohol. Alternative evidence-based treatments for addiction include cognitive behavioral therapy, medication, family therapy, and group therapy.
9. Misconception: You have to be “ready” to stop using in order for treatment to work.
Fact: Addiction is characterized by ambivalence (i.e. you want to get sober and at the same time, you want to get high). Motivation comes and goes. A person may enter treatment with no intention of quitting, and then undergo a significant transformation. Or, someone may feel 100% ready to stop only to later change their mind. Ambivalence is normal.
That being said, the consequences of addiction (or costs of using) are oftentimes what tip the motivational balance, leading to increased motivation.
“When you can stop, you don’t want to, and when you want to stop, you can’t.”
10. Misconception: You have to want recovery for yourself before you can get sober.
Fact: External motivators (i.e. the threat of losing a job, divorce, legal consequences, etc.) frequently precipitate treatment, and motivation is then internalized during treatment.
11. Misconception: You have to hit “rock bottom” before you can recover.
Fact: Sustained sobriety can be attainedwithout experiencing severe consequences. While the costs of using are often what motivates someone to get sober, there’s no rule that you have to “bottom out” first. This misconception can be deadly; you may die waiting (or death may be your “rock bottom”).
“Remember that just because you hit bottom doesn’t mean you have to stay there.”
Robert Downey, Jr.
12. Misconception: If you’re receiving medication-assisted treatment (MAT), you aren’t really sober.
13. Misconception: Needle exchange programs and safe injection sites enable continued use.
Fact: Harm reduction methods reduce HIV/HCV infections and decrease overdose deaths. According the the CDC, “the majority of syringe services programs (SSPs) offer referrals to medication-assisted treatment, and new users of SSPs are five times more likely to enter drug treatment and three times more likely to stop using drugs than those who don’t use the programs.” SSPs are proven and effective, and aren’t linked to increased drug use or crime.
14. Misconception: Narcan enables continued use.
Fact:Narcan (an opioid reversal medication) enables life. It gives someone a chance for recovery.
15. Misconception: “Once an addict, always an addict.”
Fact: Having a substance use disorder increases your chances of becoming addicted to other substances, but the belief that you’ll forever be an “addict” can be counterproductive or harmful. People grow and change, and may stop viewing themselves as “addicts” when they leave the lifestyle behind.
The belief that “once an addict, always an addict” also depends on the recovery model you subscribe to; for example, AA/NA principles support the idea of the “lifelong addict,” but those who believe in other models may prefer to call themselves “ex-addicts” or simply say, “I don’t drink.”
“Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending.”
An interview with JS, a substance abuse counselor who works with people from all walks of life.
JS is a certified substance abuse counselor who works at a residential treatment center in northern Virginia. The following article is about his work, thoughts on relapse, what it’s like to lose a client, stigma, and valuable advice for anyone considering a career in addiction counseling.
Interview: “They Are Just People”
JS works at an intermediate-length residential center for adults with substance use and mental health disorders. The clients live in shared dorms and adhere to a daily schedule that includes counseling, psychoeducation, groups, 12-step meetings, and medication therapy.
Once a client successfully completes the inpatient portion of treatment, they transition to “re-entry.” In re-entry, clients reside in sober living homes and receive continuing care services. They are able to look for employment, start working, and “re-enter” the larger community. JS provides counseling and support services for this component.
Inspired to help
JS has personal experience with addiction. “I am a person in recovery… About a decade ago I found myself in a very dark place and had to get help… I met a substance abuse counselor [who] changed my life. He educated me, engaged me, and challenged me. He was instrumental in turning my life around.”
With his counselor’s encouragement and support, JS made the decision to get back on track. He realized that he wanted to help others who struggled. “My own experiences with addiction allow me to have an incredibly deep empathy for the clients I serve and the fulfillment I receive in return is unreal.”
“Addiction does not discriminate”
JS works with people from all walks of life. He’s worked with individuals who are homeless to young fathers to successful businessmen; from people in their teens to adults in their late 80’s. “There is no age, sex, gender, race, sexual orientation, religion, occupation, or economic class that is safe from addiction.”
As for the substances abused, the list is never ending, but JS regularly sees people addicted to alcohol, opiates (including heroin), cocaine, methamphetamine, and PCP. Many of the clients he counsels also have mental illness such as depression, anxiety, or bipolar disorder.
No typical days
According to JS, “typical” days don’t exist where he works. “There is no way to describe a typical day in this field. One day I could be [providing therapy] and another day could involve a trip to the emergency room or helping out with chores… I never know what to expect and I never get bored.”
Effective treatment planning is important for substance abuse counselors; JS meets with his clients to develop an individualized service plan. Clients come up with their own goals, and JS supplies interventions to help them achieve their goals over the next couple of months.
According to JS, client goals vary, ranging from attending 12-meetings to obtaining a driver’s license to enrolling in school; basically, a goal can be any life skill a person may need for success. Corresponding interventions could include providing bus tokens to get to AA meetings, linking to driving school, and helping to fill out college applications and apply for financial aid.
JS explained that adults who have been incarcerated or dealing drugs for a living miss out on major milestones such as learning to drive, attending college, renting an apartment, etc. Furthermore, basic skills that many of us take for granted, such as filling out an online form or depositing a check can be overwhelming for someone newly in recovery who never learned how.
JS meets with his clients at least once per week for therapy sessions. I asked what comes up in a typical session and his response was “anything and everything.” Sessions may involve reviewing goals, learning coping skills, poop jokes (his clients are all men), or processing childhood trauma.
Substance abuse and relapse
“Not good” was JS’s response when I asked what the success rate was for someone who completes re-entry. He explained that this is a reflection of the general rates of recovery in substance abuse, which are low. “It can be disheartening, working with someone for months and when they leave, they relapse in less than a week.”
JS explained that while relapse is a deterrent to the field for some counselors, he sees it differently. “For me, it will never be a deterrent. My battle with addiction was not easy, nor was it accomplished in a single attempt. Relapse is a part of my story. I would not be here if people gave up or lost hope that I could get better. For that, I will never give up or lose hope that my clients can recover, no matter how many times they relapse.”
For JS, losing a client, not relapse, is the hardest part of the job. “I’ve worked with many clients who didn’t make it. I’ve lost clients to overdose, suicide, and homicide. It never gets easier.”
JS grieves for his lost clients. “I find myself wading through the stages of grief until I reach some level of acceptance.”
What everyone needs to know about substance abuse
“The people I work with are just people. They are your sister, your cousin, your neighbor, or the guy in line at the grocery store. They are people with families, jobs, hobbies, and dreams.”
JS discussed ignorance and stigma; he shared that individuals with substance use disorders are often subjected to mistreatment, even from professionals in the field. “There are substance abuse counselors who perpetuate harmful addiction myths, once widely accepted as fact, but discredited by the scientific community decades ago.”
“The lack of compassion when it comes to substance abuse is mindboggling and painful to encounter. Often, it stems from a lack of understanding or knowledge about substance abuse and those with substance use disorders. They are just people who are struggling with something far beyond their control. And those in treatment? They are just people trying to get better. And in case I didn’t make it clear; they are just people.”
Advice for new substance abuse counselors
“Be willing to learn. The field of addiction treatment is constantly changing. Standard practices from 20 years ago are now ineffective and outdated. If you want to do this work, be open to learning the newest treatment models, medications, and research on addiction. This field is not static, and we do our clients a major disservice when we quit learning.”
As a last piece of advice, JS suggested self-care for substance abuse counselors as a way to combat burnout. “Identify ways to decompress. This job is not easy. Some of the people you help will die. Compassion fatigue is a real thing and you must take care of yourself to care for others.”
As a counselor, you probably have a few “go-to” therapy metaphors that you use in sessions. For example, the “airplane oxygen mask” metaphor is a powerful analogy that demonstrates the significance of meeting your own needs before attempting to help others.
Another example of a therapy metaphor is the “rearview mirror” analogy. If you’re driving, and your entire concentration is on what’s behind you, you’ll crash. Good drivers, in contrast, focus ahead, but also regularly check the rearview mirror. The “rearview mirror” metaphor effectively illustrates how recovery from drugs and alcohol requires learning from, but not dwelling on, past mistakes and regrets.
Powerful Therapy Metaphors: Analogies in Counseling
The following is a list of helpful therapy metaphors and analogies for growth, self-care, emotions, addiction, grief, counseling, and life.
Forming a new habit is like carving a path in the jungle. You trod through the undergrowth and take the same route over and over again, until a clear path is formed. Meanwhile, older pathways become overgrown and wild, disappearing from sight with unuse.
A habit forms the way water carves a new stream or river.
You can’t see the grass growing, but after a week or so, you can see that the lawn needs mowing.
You can’t pour from an empty cup.
Mind the “check engine” light in your car. It indicates that something is wrong; if you ignore it, the problem will likely become worse. The longer you ignore internal cues, the greater the damage to your “car.”
A plant requires the right amount of water, sunlight, and fertilizer to grow and thrive.
You are a battery that needs to be recharged every so often.
Metaphors for Emotions
Our emotions are like a thermometer in the window. You can see clouds or rain or sun, but without a thermometer, you won’t know if it’s 90 degrees or 17 below. Emotions impact how you experience the outside world.
Life is like a heart monitor; there are ups and downs. If it goes flat, you’re dead.
The more you bottle up your emotions, the more likely you are to explode.
Repressing anger is like stuffing trash in a garbage can. Eventually, it’s going to spill over if you don’t take out the trash.
When you resent someone, it’s like drinking poison and expecting them to die.
Anxiety is a hungry monster that gets bigger when you feed it.
Worrying is like riding a stationary bike; you can peddle as hard as you can, but you’ll never get anywhere.
Therapy Metaphors for Addiction
Addiction is a disease of the soul.
When you’re in active addiction, you’re a shadow of yourself.
Addiction is like being in a toxic relationship. It’s all-consuming, lust-worthy, and even thrilling at times… but at the cost of your health and well-being. You have to break up in order to move on with your life.
Addiction is like a tornado, ravaging everything in its path. After the storm, it’s time to rebuild. It won’t look exactly the way it did before the tornado hit… but there’s potential for things to be even better.
Addiction is like other chronic health conditions in that there’s no cure, but it’s 100% manageable with treatment and lifestyle changes.
The longer you sit and stare at a plate of cookies, the more likely you are to give in to temptation. Set yourself up for success by avoiding triggers when possible.
If you hang out in a barber shop long enough you’ll end up getting a haircut.
Temptation is like a muscle that grows weaker with use until it finally gives out.
Living life without drugs or alcohol is like any skill; you first learn how to do it and then you have to practice. You may slip up, but don’t give up; learn from your mistakes. You can’t excel at anything without practice.
Cravings are like waves; ride them out until the wave recedes.
Attempting to save someone from drowning is dangerous. In their frantic efforts for oxygen, they’ll claw over and push the person trying to help underwater. This is an unconscious survival instinct. When your loved one is in active addiction, they’ll fight anyone and anything that gets in their way of a gulp of air.
Metaphors for Grief
Grief is a deep wound that takes time to heal. The wound is raw and painful, but will eventually scab over, although leaving behind a permanent scar.
Every person you lose takes a little piece of you with them.
Metaphors for Counseling
Going to therapy is akin to filling your toolbox with tools.
In a car, your therapist is a passenger in the front seat, but you’re behind the wheel. A passenger offers assistance with reading the map and providing directions, but it’s up to you to choose the turns you’ll take, and ultimately, the destination.
A counselor doesn’t provide the answers, but offers the tools to find them.
Going to therapy is like going to the gym; you may feel sore and you won’t see immediate effects, but the long-term results are gratifying and well-worth the investment.
Therapy Metaphors for Life
Problems in life are like bad smells; you can attempt to mask them or cover them up, but you have to remove the source before they can truly go away.
You can’t choose the canvas or paint in life, but you decide the picture you’ll paint.
Your life is a book with many chapters and pages. Every day is a new page. You write your own story.
Life is like a “choose your own adventure” book. You make decisions, but you can’t always predict the outcome.
Sometimes you’re dealt a really sh**** hand. How are you going to play your cards?
The only difference between a rut and a grave are the dimensions.
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Recommended Memoirs About Mental Illness & Addiction
UPDATED MAY 22, 2021
The Big Fix: Hope After Heroin (2017) by Tracey Helton Mitchell
Amazon Description: “After surviving nearly a decade of heroin abuse and hard living on the streets of San Francisco’s Tenderloin District, Tracey Helton Mitchell decided to get clean for good.
With raw honesty and a poignant perspective on life that only comes from starting at rock bottom, The Big Fix tells her story of transformation from homeless heroin addict to stable mother of three—and the hard work and hard lessons that got her there. Rather than dwelling on the pain of addiction,Tracey focuses on her journey of recovery and rebuilding her life, while exposing the failings of the American rehab system and laying out a path for change. Starting with the first step in her recovery, Tracey re-learns how to interact with men, build new friendships, handle money, and rekindle her relationship with her mother, all while staying sober, sharp, and dedicated to her future.
A decidedly female story of addiction, The Big Fix describes the unique challenges faced by women caught in the grip of substance abuse, such as the toxic connection between drug addition and prostitution. Tracey’s story of hope, hard work, and rehabilitation will inspire anyone who has been affected by substance abuse while offering hope for a better future.”
Come Back: A Mother and Daughter’s Journey Through Hell and Back (2008) by Claire Fontaine & Mia Fontaine
Amazon Description: “In powerful parallel stories, mother and daughter give mesmerizing first-person accounts of the nightmare that shattered their family and the amazing journey they took to find their way back to each other. Claire Fontaine’s relentless cross-country search for her missing child and ultimate decision to force her into treatment in Eastern Europe is a gripping tale of dead ends, painful revelations, and, at times, miracles. Mia Fontaine describes her refuge in the seedy underworld of felons and addicts as well as the jarring shock of the extreme, if loving, school that enabled her to overcome depression and self-loathing. Both women detail their remarkable process of self-examination and healing with humor and unsparing honesty.
Come Back is an unforgettable true story of love and transformation that will resonate with mothers and daughters everywhere.”
Drinking: A Love Story (1997) by Caroline Knapp
Amazon Description: “It was love at first sight. The beads of moisture on a chilled bottle. The way the glasses clinked and the conversation flowed. Then it became obsession. The way she hid her bottles behind her lover’s refrigerator. The way she slipped from the dinner table to the bathroom, from work to the bar. And then, like so many love stories, it fell apart. Drinking is Caroline Kapp’s harrowing chronicle of her twenty-year love affair with alcohol.”
A Drinking Life: A Memoir (1994) by Pete Hamill
Amazon Description: “Hamill explains how alcohol slowly became a part of his life, and how he ultimately left it behind. Along the way, he summons the mood of an America that is gone forever, with the bittersweet fondness of a lifelong New Yorker.”
Drunk Mom: A Memoir (2014) by Jowita Bydlowska
Amazon Description: “Three years after giving up drinking, Jowita Bydlowska found herself throwing back a glass of champagne like it was ginger ale. It was a special occasion: a party celebrating the birth of her first child. It also marked Bydlowska’s immediate, full-blown return to crippling alcoholism.
In the gritty and sometimes grimly comic tradition of the bestselling memoirs Lit by Mary Karr and Smashed by Koren Zailckas, Drunk Mom is Bydlowska’s account of the ways substance abuse took control of her life—the binges and blackouts, the humiliations, the extraordinary risk-taking—as well as her fight toward recovery as a young mother. This courageous memoir brilliantly shines a light on the twisted logic of an addicted mind and the powerful, transformative love of one’s child. Ultimately it gives hope, especially to those struggling in the same way.”
Dry: A Memoir (2003) by Augusten Burroughs
Amazon Description: “You may not know it, but you’ve met Augusten Burroughs. You’ve seen him on the street, in bars, on the subway, at restaurants: a twentysomething guy, nice suit, works in advertising. Regular. Ordinary. But when the ordinary person had two drinks, Augusten was circling the drain by having twelve; when the ordinary person went home at midnight, Augusten never went home at all. Loud, distracting ties, automated wake-up calls and cologne on the tongue could only hide so much for so long. At the request (well, it wasn’t really a request) of his employers, Augusten lands in rehab, where his dreams of group therapy with Robert Downey Jr. are immediately dashed by grim reality of fluorescent lighting and paper hospital slippers. But when Augusten is forced to examine himself, something actually starts to click and that’s when he finds himself in the worst trouble of all. Because when his thirty days are up, he has to return to his same drunken Manhattan life―and live it sober. What follows is a memoir that’s as moving as it is funny, as heartbreaking as it is true. Dry is the story of love, loss, and Starbucks as a Higher Power.”
Girl, Interrupted (1993) by Susanna Kaysen
Amazon Description: “Kaysen’s memoir encompasses horror and razor-edged perception while providing vivid portraits of her fellow patients and their keepers. It is a brilliant evocation of a “parallel universe” set within the kaleidoscopically shifting landscape of the late sixties. Girl, Interrupted is a clear-sighted, unflinching document that gives lasting and specific dimension to our definitions of sane and insane, mental illness and recovery.”
Go Ask Alice (1971) by Alice
Amazon Description: “It started when she was served a soft drink laced with LSD in a dangerous party game. Within months, she was hooked, trapped in a downward spiral that took her from her comfortable home and loving family to the mean streets of an unforgiving city. It was a journey that would rob her of her innocence, her youth—and ultimately her life.”
The Heroin Diaries: Ten Year Anniversary Edition: A Year in the Life of a Shattered Rock Star (2017) by Nikki Sixx
Amazon Description: “When Mötley Crüe was at the height of its fame, there wasn’t any drug Nikki Sixx wouldn’t do. He spent days—sometimes alone, sometimes with other addicts, friends, and lovers—in a coke- and heroin-fueled daze.
The highs were high, and Nikki’s journal entries reveal some euphoria and joy. But the lows were lower, often ending with Nikki in his closet, surrounded by drug paraphernalia and wrapped in paranoid delusions.
Here, Nikki shares the diary entries—some poetic, some scatterbrained, some bizarre—of those dark times. Joining him are Tommy Lee, Vince Neil, Mick Mars, Slash, Rick Nielsen, Bob Rock, and a host of ex-managers, ex-lovers, and more.
Brutally honest, utterly riveting, and surprisingly moving, The Heroin Diaries follows Nikki during the year he plunged to rock bottom—and his courageous decision to pick himself up and start living again.”
Lit: A Memoir (2010) by Mary Karr
Amazon Description: “Lit follows the self-professed blackbelt sinner’s descent into the inferno of alcoholism and madness–and to her astonishing resurrection. Karr’s longing for a solid family seems secure when her marriage to a handsome, Shakespeare-quoting blueblood poet produces a son they adore. But she can’t outrun her apocalyptic past. She drinks herself into the same numbness that nearly devoured her charismatic but troubled mother, reaching the brink of suicide. A hair-raising stint in ‘The Mental Marriott,’ with an oddball tribe of gurus and saviors, awakens her to the possibility of joy and leads her to an unlikely faith. Not since Saint Augustine cried, ‘Give me chastity, Lord-but not yet!’ has a conversion story rung with such dark hilarity. Lit is about getting drunk and getting sober, becoming a mother by letting go of a mother, learning to write by learning to live. Written with Karr’s relentless honesty, unflinching self-scrutiny, and irreverent, lacerating humor, it is a truly electrifying story of how to grow up–as only Mary Karr can tell it.”
Loose Girl: A Memoir of Promiscuity (2008) by Kerry Cohen
Amazon Description: “Loose Girl is Kerry Cohen’s captivating memoir about her descent into promiscuity and how she gradually found her way toward real intimacy. The story of addiction–not just to sex, but to male attention–Loose Girl is also the story of a young girl who came to believe that boys and men could give her life meaning.”
A Million Little Pieces (2005) by James Frey
Amazon Description: “At the age of 23, James Frey woke up on a plane to find his front teeth knocked out and his nose broken. He had no idea where the plane was headed nor any recollection of the past two weeks. An alcoholic for ten years and a crack addict for three, he checked into a treatment facility shortly after landing. There he was told he could either stop using or die before he reached age 24. This is Frey’s acclaimed account of his six weeks in rehab.”
My Fair Junkie: A Memoir of Getting Dirty and Staying Clean (2018) by Amy Dresner
Amazon Description: “Growing up in Beverly Hills, Amy Dresner had it all: a top-notch private-school education, the most expensive summer camps, and even a weekly clothing allowance. But at 24, she started dabbling in meth in San Francisco and unleashed a fiendish addiction monster. Soon, if you could snort it, smoke it, or have sex with it, she did.
Thus began a spiral that eventually landed her in the psych ward–and then penniless, divorced, and looking at 240 hours of court-ordered community service. For two years, assigned to a Hollywood Boulevard “chain gang,” she swept up syringes (and worse) as she bounced from rehabs to halfway houses, all while struggling with sobriety, sex addiction, and starting over in her forties. In the tradition of Orange Is the New Black and Jerry Stahl’s Permanent Midnight, this is an insightful, darkly funny, and shamelessly honest memoir of one woman’s battle with all forms of addiction, hitting rock bottom, and forging a path to a life worth living.”
Parched: A Memoir (2006) by Heather King
Amazon Description: “In this tragicomic memoir about alcoholism as spiritual thirst, Heather King—writer, lawyer, and National Public Radio commentator—describes her descent into the depths of addiction. Spanning a decades-long downward spiral, King’s harrowing story takes us from a small-town New England childhood to hitchhiking across the country to a cockroach-ridden “artist’s” loft in Boston. Waitressing at ever-shabbier restaurants, deriving what sustenance she could from books, she became a morning regular at a wet-brain-drunks’ bar—and that was after graduating from law school. Saved by her family from the abyss, King finally realized that uniquely poetic, sensitive, and profound though she may have been, she was also a big-time mess. Casting her lot with the rest of humanity at last, she learned that suffering leads to redemption, that personal pain leads to compassion for others in pain, and, above all, that a sense of humor really, really helps.”
A Piece of Cake: A Memoir (2007) by Cupcake Brown
Amazon Description: “There are shelves of memoirs about overcoming the death of a parent, childhood abuse, rape, drug addiction, miscarriage, alcoholism, hustling, gangbanging, near-death injuries, drug dealing, prostitution, and homelessness.
Cupcake Brown survived all these things before she’d even turned twenty.
And that’s when things got interesting. . .
Orphaned by the death of her mother and left in the hands of a sadistic foster parent, young Cupcake Brown learned to survive by turning tricks, downing hard liquor, and ingesting every drug she could find while hitchhiking up and down the California coast. She stumbled into gangbanging, drug dealing, hustling, prostitution, theft, and, eventually, the best scam of all: a series of 9-to-5 jobs.
A Piece of Cake is unlike any memoir you’ll ever read. Moving in its frankness, this is the most satisfying, startlingly funny, and genuinely affecting tour through hell you’ll ever take.”
Prozac Nation: Young and Depressed in America (1994) by Elizabeth Wurtzel
Amazon Description: “Elizabeth Wurtzel writes with her finger in the faint pulse of an overdiagnosed generation whose ruling icons are Kurt Cobain, Xanax, and pierced tongues. In this famous memoir of her bouts with depression and skirmishes with drugs, Prozac Nation is a witty and sharp account of the psychopharmacology of an era for readers of Girl, Interrupted and Sylvia Plath’s The Bell Jar.”
Smashed: Story of a Drunken Girlhood (2005) by Koren Zailckas
Amazon Description: “Garnering a vast amount of attention from young people and parents, and from book buyers across the country, Smashed became a media sensation and a New York Times bestseller. Eye-opening and utterly gripping, Koren Zailckas’s story is that of thousands of girls like her who are not alcoholics—yet—but who routinely use booze as a shortcut to courage and a stand-in for good judgment.”
Tweak: Growing Up on Methamphetamines (2009) by Nic Sheff
Amazon Description: “Nic Sheff was drunk for the first time at age eleven. In the years that followed, he would regularly smoke pot, do cocaine and Ecstasy, and develop addictions to crystal meth and heroin. Even so, he felt like he would always be able to quit and put his life together whenever he needed to. It took a violent relapse one summer in California to convince him otherwise. In a voice that is raw and honest, Nic spares no detail in telling us the compelling, heartbreaking, and true story of his relapse and the road to recovery. As we watch Nic plunge into the mental and physical depths of drug addiction, he paints a picture for us of a person at odds with his past, with his family, with his substances, and with himself. It’s a harrowing portrait—but not one without hope.”
With or Without You: A Memoir (2014) by Domenica Ruta
Amazon Description: “Domenica Ruta grew up in a working-class, unforgiving town north of Boston, in a trash-filled house on a dead-end road surrounded by a river and a salt marsh. Her mother, Kathi, a notorious local figure, was a drug addict and sometimes dealer whose life swung between welfare and riches, and whose highbrow taste was at odds with her hardscrabble life. And yet she managed, despite the chaos she created, to instill in her daughter a love of stories. Kathi frequently kept Domenica home from school to watch such classics as the Godfather movies and everything by Martin Scorsese and Woody Allen, telling her, “This is more important. I promise. You’ll thank me later.” And despite the fact that there was not a book to be found in her household, Domenica developed a love of reading, which helped her believe that she could transcend this life of undying grudges, self-inflicted misfortune, and the crooked moral code that Kathi and her cohorts lived by.
With or Without You is the story of Domenica Ruta’s unconventional coming of age—a darkly hilarious chronicle of a misfit ’90s youth and the necessary and painful act of breaking away, and of overcoming her own addictions and demons in the process. In a brilliant stylistic feat, Ruta has written a powerful, inspiring, compulsively readable, and finally redemptive story about loving and leaving.”
Collaborates with Harvard Health Publications to provide a wide range of unbiased, motivating resources and self-help tools for mental, social, and emotional. 100% nonprofit; dedicated to Morgan Leslie Segal, who died by suicide when she was 29.
An extensive, completely free collection of articles on social skills and getting past social awkwardness. It’s written by someone who’s struggled socially himself, and who has degrees in psychology and counseling.
The Sober Survival Guide provides readers with an opportunity to explore their drinking habits and determine if an alcohol-free life may be right for them. It also serves as a handbook for coping with everyday life situations that may lead to cravings or relapse. (Includes a quote from the author and exclusive details about his next book, which is set to be released by the end of this year!)
“I didn’t ever set out to write a book, but as my blog grew and more people were visiting my website and finding the articles I was writing helpful, I was getting a lot of comments that I should do something more substantial, from here the book began to evolve.
The more I wrote, the more immersed I became in writing a book that I felt would have helped me at the time I wanted to quit. Right through the process I asked myself ‘would this help someone who wants to change their relationship with alcohol?’, if the answer was no, I removed it.
I wanted to create something unique in the ‘quit lit’ sector, that would not only help readers learn the best strategy for quitting drinking that worked for me, but would also help set them up for long-term success when it comes to dealing with the challenges that arise in the months and years after getting sober.
I decided to split [The Sober Survival Guide] into two parts. The first part deals with the process of actually quitting drinking and guides readers along the path to freedom, the second part addresses specific situations that come up after quitting, such as social events, vacations, parties and events, relationships with friends, partners and family and dealing with ‘coming out’ about being ‘alcohol-free’.
My whole approach to sobriety is around our mindset, I believe that living alcohol-free should be seen as a positive lifestyle-choice that we make for ourselves, rather than feeling like we have been deprived and have to get by on willpower because we have had something special taken away from us.
I recently completed the manuscript for my second book – How to Quit Alcohol in 50 Days, which is a one-chapter a day roadmap to becoming alcohol-free and I am excited about the release at the end of this year.”
-Simon Chapple, August 7, 2020
Can you relate to any of the following statements about alcohol?
“I can’t have fun without it. Imagine going to a party without drinking!”
“It makes me feel less anxious or depressed.”
“It helps me sleep.”
“I can’t relax without it.”
“It makes me entertaining to be around.”
“It fits the lifestyle of my boozy friends.”
“I like the taste.”
“It’s cool and sophisticated.”
“I’m not confident enough to talk to new people without it.”
“It helps me deal with all the problems that life throws my way.”
“It stops me from worrying, especially about how much I’m drinking.”
-Source: The Sober Survival Guide, pg. 6
Maybe you’ve questioned your drinking habits or wondered if you have a problem with drinking. Maybe you’ve thought about quitting, but can’t imagine a life without alcohol. You may, at times, wonder if you’re an alcoholic, but are quick to dismiss the idea because you haven’t hit “rock bottom” and you can’t relate to the 12-step concept of being utterly powerless over a disease.
Simon Chapple is not an alcoholic, nor is he in recovery; he is a person who doesn’t drink. In his book, The Sober Survival Guide, Chapple explains that he doesn’t deem it necessary to carry a label for the rest of your life (as many in AA and NA do). “Remember that you hold the power to be who you want to be, and you can choose what labels you use for yourself” (pg. 11).
In The Sober Survival Guide, Chapple shares about his personal journey as a heavy drinker to discovering sobriety and living an alcohol-free life. He discusses alcoholism and the stigma surrounding certain labels (i.e. “alcoholic”) in the first part of the book, which “sets the scene for you to explore what an alcohol-free life might look like for you” (pg. 21). You are also given the opportunity to examine your relationship with alcohol along with your beliefs about drinking.
The second part of the book serves as a practical handbook for anyone who wants to stop drinking; it includes helpful tips for navigating everyday life situations that could trigger a desire to drink. Some of the problems and challenges you may face include stress, accountability, special events/parties, boredom, sleep, and sober sex, among others.
Throughout the book, Chapple encourages the reader to examine their core beliefs about drinking by asking thought-provoking questions. These questions can serve as journaling prompts for the person who is wondering, “Am I an alcoholic?”
The Sober Survival Guide is an easy read with clearly-presented information. The book has a non-judgmental feel to it, unlike much of the 12-step literature that suggests your drinking is related to character flaws. (The language and concepts of AA can be off-putting and difficult to relate to for individuals at the lower end of the alcohol use disorder spectrum.)
Furthermore, The Sober Survival Guide empowers the reader to make changes; you don’t have to admit powerlessness over a disease and turn your will over to a higher power to quit drinking. Chapple’s message is hopeful and inspiring; plus, many of his strategies are based on evidence-based practices, including CBT and mindfulness.
If you are currently questioning whether or not your drinking habits are “normal,” The Sober Survival Guide will provide answers. This book will lift you up and inspire; as you read through the chapters, you may also feel an enormous sense of relief. Furthermore, you will be equipped with a wealth of effective strategies if you do choose to cut down or quit drinking. (Quitting drinking is not easy, but 100% doable, providing you put in the effort and have supports.)
I recommend reading The Sober Survival Guide if you’ve ever wondered if you’re an alcoholic. (You may not see yourself as a “problem drinker,” but you sometimes experience problems related to your alcohol use.) I also recommend this book if you’ve already made the decision to quit or cut down on alcohol. And if you’re a heavy drinker, but are unsure if you want to stop, The Sober Survival Guide has the power to motivate and inspire. Friends and family members of a heavy drinker will also benefit from this book.
Additionally, The Sober Survival Guide is recommended for anyone working in the mental health field. If you have a client who is worried about their drinking or unsure if they have a problem, this book offers answers while providing a refreshing perspective on alcohol use. (It’s proven that people are better equipped to make sustainable change when presented with a variety of options instead of just one. Don’t contribute to the myth that AA is the only way to get sober!)
Is there anyone who should not read this book? In some ways, The Sober Survival Guide oversimplifies addiction; it does not take into account the complex relationship between trauma and substance use. Some of the techniques described in the second part of the book are not trauma-informed. Additionally, if you’ve been diagnosed with a serious mental illness (i.e. major depressive disorder, bipolar disorder, schizophrenia, etc.), your recovery requires a co-occurring approach in order to treat both the addiction and the mental disorder. Lastly, if you have a severe addiction and are physically dependent on alcohol, it’s likely you’ll require extensive, ongoing treatment in order to fully recover; the tips in the book aren’t sufficient (which is noted by the author).
In sum, if you’re tired of the role alcohol plays in your life, consider reading The Sober Survival Guide! You have nothing to lose, but much to gain.
For Simon’s newest book (Kindle version), How to Quit Alcohol in 50 Days: Stop Drinking and Find Freedom, which is set to be released by the end of this year, click here! Check back for an exclusive review on Mind ReMake Project prior to the release date.
Journal Prompts from The Sober Survival Guide
Chapple recommends journaling as a tool for reflection and change. The following prompts are based on material from The Sober Survival Guide. (Download a printable PDF version below.)
What are your drinking habits now? How much? How often? What drinks do you have? What were your drinking habits one year ago? What were your drinking habits five years ago? (Compare your answers. Are you drinking more now than you were before?) (pg. 29)
Calculate the time (per week) you spend drinking alcohol. Consider calculating the time spent planning to drink or recovering from the effects of alcohol. (pg. 147)
List the reasons your life is better because of alcohol. Next, challenge each reason. (pg. 44)
Does labeling yourself as an “alcoholic” or “addict” help or harm you? Why? (pg. 10)
Do you believe you have to hit “rock bottom” to recover? Why or why not? (pg. 41)
Have you ever hit “rock bottom”? Describe the incident in detail. If you haven’t had a “rock bottom” experience, what do you think it would look like? (pg. 41)
What are your current beliefs surrounding alcohol? For each belief you list, write a challenging statement. (Example: “I fail at everything I do – I doubt I can [quit alcohol].” Challenge with “If I don’t try, I won’t ever know. I’ll approach this with an open mind and a sense of curiosity.”) (pg. 38)
Record your current feelings surrounding drinking. (pg. 58)
List specific fears you have about quitting drinking. (Examples: What if my friends think I’m boring sober? What if I fail? What if I can’t have fun anymore?) (pg. 79)
Create a cravings log. List the times of day you experience cravings and what is happening at those times. (pg. 78)
List the pros and cons of drinking. (pg. 77)
List some of the reasons you want to stop drinking. Write about how you want your life to change. (Be specific!) (pg. 25)
List the ways alcohol has negatively impacted your health. Include health concerns you may not have experienced yet. (pg. 28)
List all of the occasions or special events you’ve put alcohol ahead of and reflect on your answers. (pg. 33)
List all of the people, situations, and events you’ve neglected in favor of drinking. Then, for each item, write how the same situation/event would have looked like if you hadn’t been drinking. (pg. 36)
List your justifications for drinking. (Examples: “I work hard; I earned this drink.” “It’s just a beer, not hard liquor.” “I never drink alone.” “I only drink on weekends.”) (pg. 32)
Review your list of current beliefs surrounding alcohol. Assign an emotion to each belief. (Example: “Without drinking each day, I’ll never be happy.” The underlying emotions are worry and sadness.) Next, replace each belief with a truthful statement, something that could become. (Example: “I am happy because [insert reason(s) here], but I have a hard time not drinking every day. So I’m working on this to become stronger.”) (pg. 47)
Write a “breakup” letter to alcohol. (pg. 55)
List all the things you want to do or experience once you are alcohol-free. (pg. 69)
Create a list of ways you can celebrate your success. (Be sure to calculate how much money you’ll save by quitting drinking.) (pg. 84)
Create a sober bucket list. (pg. 148)
List everything you may lose if you start drinking again. (pg. 83)
Create a personal accountability statement. (pg. 83)
List ways you can respond to others when they ask why you’re not drinking. (Examples: “I’m driving.” “Not now, no thanks.” “Not tonight, maybe another time.”) (pg. 74)
When you have an upcoming event that’s potentially triggering, visualize what you will do, say, etc. Write your detailed vision in your journal. (pg. 97)
Create a list of coping skills for when you’re experiencing a low mood. (pg. 116)
Create a gratitude list. (pg. 117)
Create a daily thought log. What are some of the thoughts you have about drinking throughout the day? (pg. 120)
If you experience a lapse or relapse, describe what happened. Pinpoint the exact moment you decided to drink. (pg. 66)
Review what you wrote (in the previous entry) about your lapse or relapse. Identify the triggers you experienced. (pg. 78)
Write a statement of commitment to an alcohol-free life. (pg. 168)
Bonus Material: Checklist for the Problems and Challenges You’ll Face
(Updated 5/20/20) A list of movies about mental health and substance abuse – includes PDF printable discussion questions
The following is a list of movies about addiction and mental disorders that are appropriate to show in treatment settings. This post includes movie summaries and downloadable PDF handouts with questions for discussion.
Please note that some of the films on this list are graphic and may not be appropriate for children or adolescents.
Hint: The handouts contain spoilers; do not provide until after the movie ends.
Movies About Addiction & Mental Illness
Disclaimer: This post contains affiliate links. As an Amazon Associate I earn a small commission from qualifying purchases.
103 minutes (1 hour, 43 minutes), R-rating for language and drug use
Summary: Julia Roberts plays a mother, Holly, whose 19-year old son, Ben, surprises her by returning home for Christmas. Ben is newly in recovery; his addiction has placed a tremendous strain on the family in the past. Ben’s younger siblings are happy to see him, but Holly, fearing that he is not ready, is apprehensive. That evening, the family attends church. When they return, they find their home burglarized and the dog missing. Ben blames himself, believing someone from his past took the dog to get his attention; he leaves to look for the dog. Holly goes with him, but they’re later separated, and Holly attempts to track Ben. Eventually, she ends up at an abandoned barn where she finds her son on the floor, unresponsive. The movie ends with her administering Narcan to Ben.
127 minutes (2 hours, 7 minutes), R-rating for strong language and content relating to drugs, sexuality, and suicide
Summary: Winona Ryder plays Susanna, a young woman with borderline personality disorder, who is sent to a psychiatric hospital after a suicide attempt in the late 1960s. She befriends Lisa (Angelia Jolie), who carries a diagnosis of sociopathy (antisocial personality disorder). Initially, Susanna is in denial about her mental condition and is not open to treatment. However, she reaches a turning point after a tragedy.
123 minutes (2 hours, 3 minutes), PG-13 rating for mature thematic elements including substance abuse/recovery, some sexual situations, language, and brief violence
Summary: Trevor (Haley Joel Osment) starts a chain reaction of goodness for a social studies project with a plan to change the world for the better. In this film, Trevor is a high school student whose mother, Arlene (Helen Hunt), struggles with alcoholism and whose father is abusive. He rises above unfortunate circumstances with the kindhearted idea to do a good deed, but instead of requesting payback, asking the receiver to “pay it forward” to at least three people – and on and on. While the movie has a bittersweet end, the message is uplifting and powerful.
Summary: Charlie is an unpopular high school freshman, a “wallflower,” who is befriended by two seniors, Patrick and Sam (Emma Watson). The movie is about their friendship and Charlie’s personal struggles with the recent suicide of his friend and his own mental illness. Throughout the film, Charlie has flashbacks of his aunt, who died in a car accident when he was 7. It’s eventually revealed that Charlie’s aunt molested him; a sexual encounter with Sam triggers Charlie’s repressed memories. Charlie has a mental breakdown.
Other great resources for using clinical films as therapeutic interventions include the book Movies & Mental Illness: Using Films to Understand Psychopathy, 4th ed. (by Danny Wedding and Ryan M. Niemiec) and the site Teach With Movies.
If you’re a counselor or therapist, you’re probably familiar with Therapist Aid, one of the most well-known sites providing free therapy worksheets. But Therapist Aid isn’t the only resource for free therapy tools! This is a list of additional sites with free therapy worksheets and handouts.
See below for links to over 100 websites with free therapy worksheets and handouts for both clinicians and consumers.
(Click here for free worksheets, handouts, and guides posted on this site.)
Stress Management – Patient Handouts | A collection of handouts on stress management; some of the other sections, including “General Health and Wellness” and “Nutrition” have links to handouts as well (Source: UMASS Medical School Department of Psychiatry)
Attitudes and Behaviour | 9-page PDF packet on criminal thinking (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
Motivation To Change | 16-page PDF packet on motivation to change criminal behavior (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
Peers & Relationships | 12-page PDF packet on how associates impact criminal behavior (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
Personal Development | Handouts on resilience, communication, etc. (Source: Workplace Strategies for Mental Health)
A list of uncommon strategies for coping with stress, depression, and anxiety. Includes a free PDF version of the list to print and use as a handout.
Effective coping skills make it possible to survive life’s stressors, obstacles, and hardships. Without coping strategies, life would be unmanageable. Dr. Constance Scharff described coping mechanisms as “skills we… have that allow us to make sense of our negative experiences and integrate them into a healthy, sustainable perspective of the world.” Healthy coping strategies promote resilience when experiencing minor stressors, such as getting a poor performance review at work, or major ones, such as the loss of a loved one.
Like any skill, coping is important to practice on a regular basis in order to be effective. Do this by maintaining daily self-care (at a minimum: adequate rest, healthy meals, exercise, staying hydrated, and avoiding drugs/alcohol.)
As an expert on you (and how you adapt to stressful situations), you may already know what helps the most when life seems out-of-control. (I like reading paranormal romance/fantasy-type books!) Maybe you meditate or run or rap along to loud rap music or have snuggle time with the cats or binge watch your favorite show on Netflix. Having insight into/awareness of your coping strategies primes you for unforeseeable tragedies in life.
“Life is not what it’s supposed to be. It’s what it is. The way you cope with it is what makes the difference.”
Virginia Satir, Therapist (June 26, 2019-September 10, 1988)
Healthy coping varies greatly from person to person; what matters is that your personal strategies work for you. For example, one person may find prayer helpful, but for someone who isn’t religious, prayer might be ineffective. Instead, they may swim laps at the gym when going through a difficult time. Another person may cope by crying and talking it out with a close friend.
Note: there are various mental health treatment approaches (i.e. DBT, trauma-focused CBT, etc.) that incorporate specialized, evidence-based coping techniques that are proven to work (by reducing symptoms and improving wellbeing) for certain disorders. The focus of this post is basic coping, not treatment interventions.
On the topic of coping skills, the research literature is vast (and beyond the scope of this post). While many factors influence coping (i.e. personality/temperament, stressors experienced, mental and physical health, etc.), evidence backs the following methods: problem-solving techniques, mindfulness/meditation, exercise, relaxation techniques, reframing, acceptance, humor, seeking support, and religion/spirituality. (Note that venting is not on the list!) Emotional intelligence may also play a role in the efficiency of coping skills.
A sport psychology study indicated that professional golfers who used positive self-talk, blocked negative thoughts, maintained focus, and remained in a relaxed state effectively coped with stress, keeping a positive mindset. Effective copers also sought advice as needed throughout the game. A 2015 study suggested that helping others, even strangers, helps mitigate the impact of stress.
Examples of coping skills include prayer, meditation, deep breathing, exercise, talking to a trusted person, journaling, cleaning, and creating art. However, the purpose of this post is to provide coping alternatives. Maybe meditation isn’t your thing or journaling leaves you feeling like crap. Coping is not one-size-fits-all. The best approach to coping is to find and try lots of different things!
The inspiration for this post came from Facebook. (Facebook is awesome for networking! I’m a member of several professional groups.) Lauren Mills sought ideas for unconventional strategies via Facebook… With permission, I’m sharing some of them here!
Unconventional Coping Strategies
Crack pistachio nuts
Fold warm towels
Smell your dog (Fun fact: dog paws smell like corn chips!) or watch them sleep
Peel dried glue off your hands
Break glass at the recycling center
Pop bubble wrap
Lie upside down
Watch slime or pimple popping videos on YouTube
Sort and build Lego’s
Write in cursive
Observe fish in an aquarium
Solve math problems (by hand)
Use a voice-changing app (Snapchat works too) to repeat back your worry/critical thoughts in the voice of a silly character OR sing your worries/thoughts aloud to the tune of “Happy Birthday”
Listen to the radio in foreign languages
Go for a joy ride (Windows down!)
Watch YouTube videos of cute animals and/or giggling babies
Walk barefoot outside
Draw/paint on your skin
Play with (dry) rice
Do (secret) “random acts of kindness”
Play with warm (not hot) candle wax
Watch AMSR videos on YouTube
Recite family recipes
Find the nicest smelling flowers at a grocery store
Use an app to try different hairstyles and/or makeup
People-watch with a good friend and make up stories about everyone you see (Take it to the next level with voiceovers!)
Wash your face mindfully
Buy a karaoke machine and sing your heart out when you’re home alone
On Instagram, watch videos of a hydraulic press smash things, cake decorating, pottery/ceramics throwing, hand lettering, and/or woodwork
Shine tarnished silver
Create a glitter jar and enjoy
Tend to plants
Color in a vulgar coloring book for adults
Click below for a PDF version of “Unconventional Coping Strategies.” This handout can be printed, copied, and shared without the author’s permission, providing it’s not used for monetary gain.
Alcarelle is a synthetic version of alcohol, providing all the “feel-good” effects of alcohol with none of the associated risks; this alcohol-alternative may be available in a bar near you within the next five years!
Alcarelle, providing liquid courage without the consequences of alcohol: no hangover, no calories, and no harmful impact on your health. Sound too good to be true? Maybe… but maybe not.
Alcarelle is a substance that mimics the effects of alcohol; the Alcarelle website proclaims, “Like alcohol, but better.” Essentially, it’s a synthetic, non-toxic version of alcohol that activates the same neurotransmitters as booze, inducing the “warm fuzzy” feelings of tipsiness. Created by English neuropsychopharmacologist, David Nutt, the active molecule in Alcarelle provides the relaxing and social lubricating qualities of alcohol with none of the associated dangers.
According to a 2019 interview in Men’s Health, the Alcarelle effect “plateaus” after three drinks. The implications are that you won’t get hammered or black out when you drink it.
Currently, Alcarelle is in the development stage. Nutt’s plan is for the alcohol-free substitute to be available within the next five years; it will likely be offered in the form of a concentrated extract to mix into drinks.
What role will Alcarelle play in the treatment of substance use disorders? It’s unknown if someone could build a tolerance for or become dependent on it. Could Alcarelle be the next harm-reduction or treatment method for alcohol use disorders? Could its use help with other addictions or mental health disorders? Could it potentially reduce the rates of alcohol-related accidents and diseases?
On the other hand, Alcarelle could lead to abuse and/or dependence (similar to how methadone, a treatment for opioid use disorders, produces powerful addictive effects). Also, it could end up being the equivalent of a “gateway” drug, increasing the user’s chances of later developing a substance use disorder.
Bottom line: too much is unknown at this point. Alcarelle may not make it past the testing phase. (Currently, only a prototype of the synthetic molecule exists and funding for the project is limited.)
While I’m hopeful that an alcohol-alternative could advance the treatment of substance use disorders (especially since I believe the ultimate treatment, while yet undiscovered, will be pharmacological), I don’t anticipate Alcarelle being a magical “cure-all.”