Category: Addiction & Recovery

Group Therapy: A Comprehensive Resource Guide

A group therapy resource guide with recommended books, topic ideas, group activities, practical tips, and more.

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Initially, the idea of group therapy terrified me. What if I can’t “control” the group? What if I can’t think of anything to say? And the overly dramatic, What if everyone gets up and walks out?

Group facilitation wasn’t always comfortable, and I made many mistakes, but I grew. I realized it’s okay to be counselor and human; at times, humans say dumb stuff, hurt each other’s feelings, and don’t know the answer.

This resource guide provides practical information and tools for group therapy for mental health practitioners.

Image by StockSnap from Pixabay

Group Therapy Guidelines

Group therapy is an evidence-based treatment for substance use and mental disorders. An effective group calls for a skilled clinician to meet treatment standards.

Professional associations, such as the American Group Psychotherapy Association, have developed best practice guidelines based on scientific data and clinical research. The Association for Specialists in Group Work created best practice guidelines for group work and guiding principles.

Additionally, SAMHSA promotes research-based protocols and has published several group therapy guides for best practice, including TIP 41: Substance Abuse Treatment: Group Therapy, Substance Abuse Treatment: Group Therapy – Quick Guide for Clinicians, and Substance Abuse Treatment: Group Therapy Inservice Training (a training manual), in addition to group workbooks/facilitator guides for anger management, stimulant use disorder, and serious mental illness.

Book Recommendations

Disclaimer: This section contains affiliate links. As an Amazon Associate I earn from qualifying purchases.

group exercises for addiction counseling

The book itself is small in size but packed with helpful information and creative ideas.

This guide provides detailed instructions for each activity along with thought-provoking discussion questions.

Textbooks

Groups: Process and Practice (2017) by Marianne Schneider Corey, Gerald Corey, & Cindy Corey

groups-process and practice

The Theory and Practice of Group Psychotherapy (2020) by Irvin D. Yalom & Molyn Leszcz 

theory and practice of group psychotherapy

(For additional book recommendations, see Resources for Mental Health Professionals and Must-Read Books for Therapists.)

Icebreakers & Activities

Fun Facts: My favorite icebreaker activity involves passing out blank slips of paper to each group member and instructing them to write a “fun fact” about themselves, something no one else in the group would know.

Depending on the crowd, you may want to tell clients not to write anything they wouldn’t want their peers to know. (I adopted this guideline after a client wrote about “sharting” himself.) Once everyone has written something, have them fold their papers and place in a container of some sort (a gift box, paper bag, plastic bowl, etc.) Group members take turns passing around the container (one-at-a-time) and picking a slip to read aloud. They must then guess who wrote it. (Give them at least three guesses before turning it over to the rest of the group.)

Icebreaker Question Cards: A similar but more structured activity is to write out questions ahead of time and have clients take turns drawing and answering the questions. Questions can be silly, thought-provoking, or to illicit a strong emotional response (depending on audience and goals).

People Search: This activity utilizes a list of traits, feats, talents, or experiences. Each client receives the list and is given x amount of time to find someone in the group who is a match; that individual will then sign off. The first person to have their list completely signed sits down; they win.

(Prizes optional, but always appreciated.) During the debriefing, it’s fun to learn more (and thereby increase understanding and compassion).

First Impressions: This works best with group members who don’t know each other well. It’s important for group members to at least know each other’s names (or wear name tags). Each group member has a sheet of paper with various “impressions.”

Clients write other group members’ names for each impression. In addition to enhancing a sense of community, this activity provides an avenue for discussing harmful stereotypes and stigma.

Affirmations Group: Affirmations groups can be powerful, generating unity and kindness. The effect seems to be more pronounced in gender-specific groups. There are a variety of ways to facilitate an affirmations group, ranging from each person providing an affirmation to the client on their right to individuals sharing a self-affirmation with the group to creating a self-affirmation painting.

Another idea is to give each client a sheet of paper. (Consider using quality, brightly-colored paper/posterboard and providing markers, gel pens, etc.) Clients write their name on it and then all the papers are passed around so each group member has the opportunity to write on everyone else’s sheet. Once their original paper is returned to them, they can read and share with the group. This can lead to a powerful discussion about image, reputation, feeling fake, etc.

Most Likely & Least Likely to Relapse: This activity works best with a well-formed group and may require extra staff support. It’s good for larger groups and can be highly effective in a therapeutic community.

Clients receive blank pieces of paper and are tasked to write the names of who they think is most likely and least likely to relapse. After writing their own name on the sheet, they turn it in to staff (effectively allowing staff to maintain a safe and productive environment). Staff then read each sheet aloud (without naming who wrote it). If they choose, clients can share what they wrote and provide additional feedback. (Most do.) Clients selected as “most likely” (in either category) have the opportunity to process with other group members and staff.

Access more group therapy worksheets and handouts here.

Additional Group Activities

Psychoeducation & Process Groups

In need of fresh material? It can be easy to fall into a rut, especially if you’re burnout or working with a particularly challenging group. The following three PDF downloads are lists of ideas/questions for groups.

Additional Ideas for Psychoeducation & Process Groups

Practical Tips for Psychoeducation & Process Groups

As a group facilitator, consider incorporating some sort of experiential activity, quiz, handout, game, etc. each group to engage clients and keep them engaged.

A sample agenda for a 60-minute group:

  • Group members check in (5 minutes)
  • Handout review (clients take turns reading) (5-10 minutes)
  • Group discussion/processing (10-15 minutes)
  • Restroom/smoke break (5 minutes)
  • Roleplay or short video clip (to visually present what was covered in the handout/discussion) (5-10 minutes)
  • Facilitator summarizes and asks group members how they will incorporate what they learned or how they’re feeling (5 minutes)
  • Group members have the opportunity to respond (5-10 minutes)

If an experiential or interactive exercise isn’t feasible, provide coffee or snacks; sitting for 45 minutes is difficult for some, and 90 minutes can be unbearable.

Another idea is to have a “fun” or “free” group. Ideas include going bowling, having a potluck, Starbucks run, game group, escape room, nature walk, etc.

Dealing with Challenges

Clients are not always willing therapy participants; some are court-ordered to attend or there to have privileges restored. Some attendees may be there “voluntarily,” but only to save their marriage or keep a job, not believing they need help. In residential treatment, clients attend mandatory groups as part of the daily schedule.

Even when attendance is truly voluntary, a group member may be in a bad space. Maybe they’re stressed about the rent or just got into a fight with their significant other. Or what if the AC is broken and the group room is 80 degrees?

Anticipating challenges is the first step to effectively preventing and managing them.

Click here for a helpful article from Counseling Today that addresses the concept of client resistance.

Tips for Dealing with Challenges

1. If possible, co-facilitate. One clinician leads while the other observes. The observer remains attuned to the general “tone” of the group (e.g., facial expressions, body language, etc.)

2. Review the expectations at the beginning of every group. Ask clients to recall the guidelines (instead of you telling them). This promotes a collaborative spirit.

3. After guidelines are reviewed, explain that while interrupting is discouraged, there may be times when you interject to maintain the overall wellness and safety of the group. (Knowing this, a client is less likely to get angry or feel disrespected when/if it happens.)

4. And if during group you must interrupt, apologize and explain the rationale.

5. Avoid power struggles at all costs, especially when a client challenges the benefits of treatment. Challenging the efficacy of treatment (or you as a clinician) is a defense mechanism. If the group is relatively healthy, you may want to illicit feedback from other group members before responding. Sometimes, the best response is simply “okay,” or none at all… and keep moving to avoid the group becoming a complaint session. You could also acknowledge the client’s perspective and ask to meet with them after group to discuss.

6. If a client becomes angry or tearful, give them time to vent for a moment or two (don’t “Band-Aid”); they may be able to self-regulate. (If they do self-regulate, share your observations and offer praise.)

7. If a client’s anger escalates to a disruptive level, ask them to take a break. At this point, their behavior is potentially triggering other group members. Don’t raise your voice. Stay calm and be respectful but firm. Direct them to step out and ask them to return when they’re ready.

8. If a client is disrespectful (cursing at you or another client, name-calling, insulting, etc.) while escalated, let them know it’s not okay, but don’t attempt to provide feedback. (A simple, “Hey, that’s not okay,” will suffice.) Bring it up with the client later when they’re able to process.

9. Once the escalated client exits the room, acknowledge what happened and let the group know you intend to follow up with that person. If a group member wants to talk about it, ask them to limit their share to how it made them feel, but stress that it’s not okay to talk about an absent group member. (“How would you feel if we talked about you when you weren’t here?”) Strongly suggest that they wait until the person returns (and is open) to have a group discussion (if appropriate).

10. After a major blow-up (and once everyone is calm), it can be beneficial for the group to process it with the person who escalated. Group members can empathize/relate, share their observations and/or how it made them feel, and offer feedback.

11. If other disruptive behaviors occur in group (side conversations, snoring, etc.) address them in the moment objectively (without shaming). Point out the behavior and explain how it’s disruptive to the group. Refer back to the group guidelines. Ask group members to comment as well. If you let a behavior persist, hoping it will eventually stop, you’re sending the message that it’s okay, not only to the person who is disruptive, but to the entire group. This impacts the integrity of the group and opens things up for additional disruptive behaviors.

12. For clients who monopolize, are constantly joking, or who attempt to intentionally distract by changing the topic, objectively point out your observations. When appropriate, ask other group members to comment on your observations and provide feedback to their peer.

13. If, on the other hand, one or several clients seem disengaged or unmotivated, consider asking why, privately or in the group, whichever is clinically appropriate.

14. If there’s a general level of disengagement, bring it up in the group. Remain objective and state your observations.

15. Anticipate that at times, people may not have much to say. (Consider that while there’s always something to learn or process, that doesn’t mean someone is ready to or has the emotional energy to.) Maybe they’re distracted or tired or feeling “talked out.” It’s good to have backup plans: watch a psychoeducational film, take a walk in the park, listen to meditations or music, provide worksheets, education reading material, or coloring sheets.

16. Always keep in mind a client’s stage of change, their internal experiences (e.g., hearing voices, social anxiety, paranoia, physical pain, etc.), external circumstances (e.g., recent medication change, loss of housing, conflict with roommates, etc.), and history of trauma. What looks like resistance may be something else entirely.

Tips-for-Dealing-with-Challenges

Professional Group Therapy Organizations

Academic Articles

Online Articles

Additional Links

  • Center for Group Studies | The Center provides a unique method of group training. Principles and techniques are based on the theory that the group is a powerful agent of change.
  • Group Dynamics | This blog provides some links and book chapters on various topics related to the study of groups. You can also find teaching resources related to group dynamics. 
  • Management Library | This site provides free resources for managers, entrepreneurs, and leaders. Much of the content on facilitation and teams is applicable to group facilitation.
  • My Group Guide | A great tool for those who do not have the time to find worksheets/handouts for their clients, group activities, and other resources.
  • Resources in Group Psychotherapy | Helpful resources and links for group psychotherapy from the Sacramento Center for Psychotherapy, including an online forum.
  • Systems-Centered Training & Research Institute | SCTRI is an non-profit organization with members from all around the world that supports training and research in the systems-centered approach. 
group therapy

6 Powerful Movies About Addiction & Mental Illness

A list of movies about mental health and substance abuse with printable discussion handouts

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watching TV
Image by mohamed Hassan from Pixabay

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.

Ben Is Back (2018)

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.

📂 Ben Is Back – Discussion Questions

Girl, Interrupted (1999)

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.

📂 Girl, Interrupted – Discussion Questions

Pay It Forward (2000)

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.  

📂 Pay It Forward – Discussion Questions

The Perks of Being a Wallflower (2012)

103 minutes (1 hour, 43 minutes), PG-13 rating

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.

📂 The Perks of Being a Wallflower – Discussion Questions

Rachel Getting Married (2008)

113 minutes (1 hour, 54 minutes), R-rating for language and brief sexuality

Summary: Anne Hathaway plays Kym, a troubled young woman, who returns from rehab to her family home for her sister’s wedding. The film portrays how Kym’s addiction has placed strain on the family.

📂 Rachel Getting Married – Discussion Questions

When a Man Loves a Woman (1994)

126 minutes (2 hours, 6 minutes), R-rating for language

Summary: Meg Ryan plays Alice, a woman with an alcohol use disorder. The film is about how Alice’s addiction impacts her family and how she recovers.

📂 When a Man Loves a Woman – Discussion Questions

Bonus: The Netflix original films Heroin(e) (2017) and Recovery Boys (2018) have PDF discussion guides with a summary, questions, and resources posted on the Recovery Boys website.

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.

movies about addiction

200+ Sites with Free Therapy Worksheets & Handouts

An extensive list of 200+ sites with free therapy worksheets and handouts on various topics, for clinical use or for self-help.

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This post is archived; I will no longer be updating this page. For the newest edition of this guide, please see 250+ Sites with Free Therapy Worksheets.

(Updated 11/28/23) If you’re a counselor or therapist, you’re probably familiar with Therapist Aid, one of the most well-known sites for providing no-cost therapy worksheets. But Therapist Aid isn’t the only resource for free clinical tools! This is a list of over 200 sites with free therapy worksheets and handouts.

free therapy worksheets
Image by Free stock photos from www.rupixen.com from Pixabay

See below for links to websites with free therapy worksheets and handouts for clinical use and self-help.

Click here for therapy worksheets, handouts, and guides posted on this site. Access additional free printables by joining Mind Remake Project’s Facebook group, Resources for Mental Health Counselors & Social Workers. 🆕

Sites with Free Therapy Worksheets & Handouts

Therapy Worksheets for Mental Health

Therapy Worksheets for Substance Use Disorders & Addiction

Depression, Stress, & Anxiety

Trauma & Related Disorders

Psychosis

Grief & Loss

Anger

Self-Esteem

Values & Goal-Setting

Wellness & Resiliency

ACT, CBT, & DBT Therapy Worksheets

Therapy Worksheets for Children & Youth

Therapy Worksheets for Adolescents & Young Adults

Therapy Worksheets for Marriage/Relationships & Family

Additional Therapy Worksheets & Handouts

🔝

Please contact me if a link isn’t working or if you’d like to recommend a site with free therapy worksheets!

free therapy worksheets

Alcarelle: A Hangover-Free Alternative to Alcohol

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!

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Alcarelle

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.

Nutt, who specializes in the research of drugs that affect the brain, especially in the areas of addiction, anxiety, and sleep, discovered the substance while researching alcohol’s effects in hopes of developing a “sober up” (alcohol antagonist) pill.

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.    

Image by congerdesign from Pixabay

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.”

DC Area Locals: Ride Free This Holiday Season

Ride free (and safe) this holiday season with Lyft using the SoberRide promo code!

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Don’t drink and drive! From 10:00 p.m. to 4:00 a.m., use WRAP’s Holiday SoberRide Promo Code (valid 12/20/19-1/1/20) for a free Lyft ride (up to $15).

In Virginia, a first offense DWI can cost up to $2,500 in fines plus court costs. Drunk driving may also result in license suspension and jail time (not to mention death!) #NeverWorthIt

According to WTOP, 4 out of 10 traffic fatalities during the holiday season involve drunk driving. Be safe and stay alive this year!

5 Effective Self-Care Strategies for Addiction in the Family

Self-care is not a luxury; it’s necessary for survival when your loved one has a substance use disorder. By taking care of yourself, you gain the energy and patience to cope with your problems. Self-care promotes wellness and emotional intelligence; it puts you in a better space to interact with your loved one. Strategies include developing/building resilience, practicing distress tolerance, keeping perspective, and recognizing/managing your triggers.

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Image by DanaTentis from Pixabay

When your loved one has a substance use disorder (SUD), it can be overwhelming, distressing, and all-consuming. When we’re stressed, we forget to practice basic self-care, which in turn makes us even less equipped to cope with the emotional chaos addiction generates. This post is about self-care strategies for when your loved one has an addiction.

In the book Beyond Addiction: How Science and Kindness Help People Change (A Guide for Families), the authors discuss the importance of self-care. This post reviews the authors’ recommended self-care strategies.

(Side note: I strongly recommend reading Beyond Addiction if your loved one has an SUD or if you work in the field. This book will increase your understanding of addiction and teach you how to cope with and positively impact your loved one’s SUD by using a motivational approach. This is one of the best resources I’ve come across, especially for family members/significant others.)

Image by Pexels from Pixabay

Based on the premise that your actions affect your loved one’s motivation, taking care of yourself is not only modeling healthy behaviors, it’s putting you in a better space to interact with your loved one. Chronic stress and worry make it difficult to practice self-care. Self-care may even seem selfish.

However, by taking care of yourself and thus reducing suffering, you gain the energy and patience to cope with your problems (and feel better too). Furthermore, you reduce the level of pain and tension in your relationships with others, including your loved one with a SUD.

Self-care strategies include developing/building resilience, practicing distress tolerance, keeping perspective, and recognizing/managing your triggers. Therapy and/or support groups are additional options.

“An empty lantern provides no light. Self-care is the fuel that allows your light to shine brightly.”

Unknown

Self-Care Strategies When Your Loved One Has an Addiction

Resilience

The definition of resilience is “the capacity to recover quickly from difficulties” (Oxford Dictionary). Doctors Foote, Wilkens, and Kosanke wrote that having resilience is a way to “systematically reduce your vulnerability to bad moods, lost tempers, and meltdowns.”

While you cannot “mood-proof” yourself entirely, resilience helps when facing life’s challenges, setbacks, and disappointments. To maintain resilience, one must practice at least the most basic self care practices, which are as follows:

  1. Eat well
  2. Sleep well
  3. Exercise enough
  4. Avoid mood-altering drugs (including alcohol)
  5. Treat illness (with prescribed medications, adequate rest, etc.)
Image by Irina L from Pixabay

Self-care is not something you can push in to the future. Don’t wait until you have more time or fewer obligations. Self-care is not a luxury; it’s a necessity. The authors of Beyond Addiction pointed out that self-care is something you have control over when other parts of your life are out of control. If you find it challenging to implement self-care practices, tap into your motivations, problem-solve, get support, and most of all, be patient and kind with yourself.

“Taking care of yourself is the most powerful way to begin to take care of others.”

Bryant McGill

Distress Tolerance

On tolerance, Doctors Foote, Wilkens, and Kosanke suggested that it is “acceptance over time, and it is a cornerstone of self-care.” Tolerance is not an inherent characteristic; it is a skill. And like most skills, it requires practice. However, it’s wholly worth the effort as it reduces suffering. By not tolerating the things you cannot change (such as a loved one’s SUD), you’re fighting reality and adding to the anguish.

Self-care strategies and techniques for distress tolerance include distracting yourself, relaxing, self-soothing, taking a break, and creating positive experiences. (The following skills are also taught in dialectical behavior therapy (DBT), an evidence-based practice that combines cognitive behavioral therapy techniques and mindfulness. For additional resources, visit The Linehan Institute or Behavioral Tech.)    

Distract Yourself

  1. Switch the focus of your thoughts. The possibilities are endless; for you, this could mean reading a magazine, calling a friend, walking the dog, etc. The authors of Beyond Addiction suggested making a list of ideas for changing your thoughts (and keeping it handy).
  2. Switch the focus of your emotions. Steer your emotions in a happier direction by watching corgi puppies on YouTube, reading an inspirational poem, or viewing funny Facebook memes. The writers of Beyond Addiction suggested bookmarking sites in your Internet browser that you know will cheer you up.
  3. Switch the focus of your senses. This could mean taking a hot shower, jumping into a cold pool, holding an ice cube in your hand, walking from a dark room to one that’s brightly lit, looking at bright colors, listening to loud rock music, etc. Also, simply walking away from a distressing situation may help.
  4. Do something generous. Donate to your favorite charity, pass out sandwiches to the homeless, visit a nursing home and spend time with the residents, express genuine thanks to cashier or server, etc. By redirecting attention away from yourself (and directing energy toward positive goals), you’ll feel better. In Beyond Addiction, it’s noted that this skill is especially helpful for individuals who tend to ruminate. Also, it’s important to brainstorm activities that are accessible in the moment (i.e. texting a friend to let them know you’re thinking about them) that don’t take multiple steps (such as volunteering).
Image by congerdesign from Pixabay

Relax

“Body tells mind tells body…” Relaxing your body helps to relax your mind. It also focuses your thoughts on relaxing (instead of your loved one’s addiction). What helps you to relax? Yoga? A hot bath? Mindful meditation? (I recommend doing a mindful body scan; it’s simple and effective, even for the tensest of the tense, i.e. me.)

Soothe Yourself

In Beyond Addiction, self-soothing is described as “making a gentle, comforting appeal to any of your five senses.” A hot beverage. Nature sounds. A cozy blanket. A scenic painting. Essential oils. A cool breeze. A warm compress. A massage. Your favorite song. Find what works for you, make a list, and utilize as needed. Seemingly small self-care strategies can make a big difference in your life by creating comfort and reducing out-of-control emotions.

Take A Break

“Taking a break” doesn’t mean giving up; it’s a timeout for when you’re emotionally exhausted and is one of the best self-care strategies you can have. Learn to recognize when you need to step away from a situation or from your own thoughts. Find a way to shift your focus to something pleasant (i.e. a romantic movie, a nature walk, a day trip to the beach, playing golf for a few hours, traveling to a different country, etc.)

Image by Free-Photos from Pixabay

Create a Positive Experience

Doctors Foote, Wilkens, and Kosanke refer to this as “making it better,” not in the sense that you’re fixing the problem (or your loved one), but that you’re making the moment better by transforming a negative moment into a positive one. Suggested self-care strategies for creating a positive experience include the following:

  1. Half-smile. Another mind-body technique, half-smiling tricks your brain into feeling happier.
  2. Meditate or pray. As explained in Beyond Addiction, “meditation or pray is another word for – and effective channel to – awareness and acceptance. Either one can open doors to different states of mind and act as an emotional or spiritual salve in trying moments.”
  3. Move. By moving, you’re shifting your focus and releasing energy. Stretch, run, play volleyball, chop wood, move furniture, etc.
  4. Find meaning. The authors of Beyond Addiction wrote, “Suffering can make people more compassionate toward others. Having lived through pain, sometimes people are better able to appreciate moments of peace and joy.” Suffering can also inspire meaningful action. What can you do to find meaning?
  5. Borrow some perspective. How do your problems look from a different viewpoint? Ask a trusted friend. You may find that your perspective is causing more harm than good.

Perspective

Perspective is “an understanding of a situation and your reactions to it that allows you to step back and keep your options open… [it’s] seeing patterns, options, and a path forward” (Beyond Addiction).

When Trish married Dave nearly 20 years ago, he rarely drank: maybe an occasional beer over the weekend or a glass of wine at dinner. After their fist daughter was born, his drinking increased to a few beers most nights. Dave said it helped him relax and manage the stress of being a new parent.

By the time their second daughter was born several years later, his drinking had progressed to a six-pack of beer every evening (and more on weekends). Currently, Dave drinks at least a 12-pack of beer on weeknights; if it’s the weekend, his drinking starts Friday after work and doesn’t stop until late Sunday night.

Dave no longer helps Trish with household chores or yardwork as he did early in their marriage. He rarely dines with the family and won’t assist with the cooking/cleanup; he typically eats in front of the TV. Dave occasionally engages with his daughters, but Trish can’t recall the last time they went on a family outing, and it’s been years since they went on a date.

Dave struggles to get out of bed in the mornings and is frequently late to work; Trish is worried he’ll get fired. They frequently argue about this. Dave is irritable much of the time, or angry. Most nights, he doesn’t move from his armchair (except to get another beer) until he passes out with the television blaring.

Trish is frustrated; she believes Dave is lazy and lacks self-control. When she nags about his drinking, he promises he’ll cut back, but never follows through. Trish thinks he’s not trying hard enough. She can’t understand why he’d choose booze over her and the kids; sometimes she wonders if it’s because she’s not good enough… maybe he would stop if she was thinner or funnier or more interesting?  At times she feels helpless and hopeless and others, mad and resentful; she frequently yells at Dave. She wonders if things are ever going to change.  

Image by Luis Wilker Perelo WilkerNet from Pixabay

A different perspective would be to recognize that Dave has an alcohol use disorder. He feels ill most of the time, which affects his mood, energy level, and motivation. He wants to cut back, but fails when he tries, which leads to guilt and shame. To feel better, he drinks. It’s a self-destructive cycle.

If Trish understood this, she could learn to not take his drinking personally or question herself. Her current reactions, nagging and yelling, only increase defensiveness and harm Dave’s sense of self-worth. Alternative options for Trish might include learning more about addiction and the reasons Dave drinks, bolstering his confidence, and/or creating a supportive and loving environment to enhance motivation.

Triggers

In recovery language, a “trigger” is anything (person, place, or thing) that prompts a person with SUD to drink or use; it activates certain parts of the brain associated with use. For instance, seeing a commercial for beer could be triggering for a person with an alcohol use disorder.

You have triggers too. For example, if your loved one is in recovery for heroin, and you notice that a bottle of opioid painkillers is missing from the medicine cabinet, it could trigger a flood of emotions: fear, that your loved one relapsed; sadness, when you remember the agony addiction brings; hopelessness, that they’ll never recover. It’s crucial to recognize what triggers you and have a plan to cope when it happens. Being aware of your triggers is a self-care strategy.

Therapy & Support Groups

Lastly, self-care strategies such as therapy and/or support groups can be a valuable addition to your self-care regime. Seeing a therapist can strengthen your resilience and distress tolerance skills. Therapy may provide an additional avenue for perspective.

(Side note: A good therapist is supportive and will provide you with tools for effective problem-solving and communication, coping with grief and loss, building self-esteem, making difficult choices, managing stress, overcoming obstacles, improving social skills/emotional intelligence, and better understanding yourself. A good therapist empowers you. A bad therapist, on the other hand, will offer advice and/or tell you what to do, disempowering you.)

Image by HannahJoe7 from Pixabay

Regarding support groups, there are many options for family members, friends, and significant others with a loved one who has a SUD, including Al-Anon, Nar-Anon, and Families Anonymous. Support groups provide the opportunity to share in a safe space and to receive feedback, suggestions, and/or encouragement from others who relate.

“I have come to believe that caring for myself is not self indulgent. Caring for myself is an act of survival.”

Audre Lorde

In sum, self-care is not optional; it’s essential for surviving the addiction of a loved one. Self-care enhances both overall wellness and your ability to help your loved one; in order words, take responsibility for your health and happiness by taking care of yourself. Commit to engaging in at least one or two of the self-care strategies you learned about in this post.

For additional self-care strategies and more information on how you can help your loved one, visit The Center for Motivation and Change.

self-care strategies

Book Review: Staying Sober Without God

Munn wrote this book because, as a nonbeliever, he felt the 12 steps of AA didn’t fully translate into a workable program for atheists or agnostics. This inspired him to develop the Practical 12 Steps.

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I stumbled upon Staying Sober Without God while searching for secular 12-step literature for a client who identifies as atheist. Jeffrey Munn, the book’s author, is in recovery and also happens to be a licensed mental health practitioner.

Munn wrote the book because as a nonbeliever he felt the 12 steps of AA didn’t fully translate into a workable program for atheists or agnostics. (For example, the traditional version of Step 3 directs the addict to turn his/her will and life over to the care of God as they understand him. If you don’t believe in God, how can you put your life into the care of him? Munn notes that there’s no feasible replacement for a benevolent, all-knowing deity.)

The whole “God thing” frequently turns nonbelievers off from AA/NA. They’re told (by well-meaning believers) to find their own, unique higher power, such as nature or the fellowship itself. (The subtle undertone is that the nonbeliever will eventually come around to accept God as the true higher power.)

In Staying Sober Without God Munn asserts, “There is no one thing that is an adequate replacement for the concept of God.” He adds that you can’t just replace the word “God” with “love” or “wisdom.” It doesn’t make sense. So he developed the Practical 12 Steps and wrote a guide for working them.

The Practical 12 Steps for staying sober are as follows:

  1. Admitted we were caught in a self-destructive cycle and currently lacked the tools to stop it
  2. Trusted that a healthy lifestyle was attainable through social support and consistent self-improvement
  3. Committed to a lifestyle of recovery, focusing only on what we could control
  4. Made a comprehensive list of our resentments, fears, and harmful actions
  5. Shared our lists with a trustworthy person
  6. Made a list of our unhealthy character traits
  7. Began cultivating healthy character traits through consistent positive behavior
  8. Determined that the best way to make amends to those we had harmed
  9. Made direct amends to such people wherever possible, except when to do so would cause harm
  10. Practiced daily self-reflection and continued making amends whenever necessary
  11. We started meditating
  12. Sought to retain our newfound recovery lifestyle by teaching it to those willing to learn and by surrounding ourselves with healthy people

The Practical 12 Steps in no way undermine the traditional steps or the spirit of Alcoholics Anonymous. Instead, they’re supplemental; they provide a clearer picture of the steps for the nonbeliever.

Before delving into the steps in Staying Sober Without God, Munn discusses the nature of addiction, recovery, and the role of mental illness (which is mostly left untouched in traditional literature). He addresses the importance of seeking treatment (therapy, medication, etc.) for mental disorders while stressing that a 12-step program (secular or otherwise) is not a substitute for professional help. In following chapters, Munn breaks each step down and provides guidelines for working it.

The last few chapters of the book provide information on relapse and what the steps don’t address. Munn notes that sustainable recovery requires more than just working the steps, attending AA meetings, and taking a sponsor’s advice. For a balanced, substance-free lifestyle, one must also take care of their physical health, practice effective communication, and engage in meaningful leisure activities. Munn briefly discusses these components in the book’s final chapter, “What the Steps Miss.”

Staying Sober Without God is well-written and easy to read. The author presents information that’s original and in line with current models of addiction treatment, such as behavioral therapy (an evidence-based approach for substance use disorder). Working the Practical 12 Steps parallels behavioral treatments; the steps serve to modify or discontinue unhealthy behaviors (while replacing them with healthy habits). Furthermore, a 12-step network provides support and meaningful human connection (also crucial for recovery).

In my opinion, the traditional 12 Steps reek of the moral model, which viewed addiction as a moral failure or sin. Rooted in religion, this outdated (and false) model asserted that the addict was of weak character and lacked willpower. The moral model has since been replaced with the disease concept, which characterizes addiction as a brain disorder with biological, genetic, and environmental influences.

The Practical 12 Steps are a better fit for what we know about addiction today; Munn focuses on unhealthy behaviors instead of “character defects.” For example, in Step 7, the addict implements healthy habits while addressing unhealthy characteristics. No one has to pray to a supernatural being to ask for shortcomings to be removed.

The Practical 12 Steps exude empowerment; in contrast, the traditional steps convey helplessness. (The resulting implication? The only way to recover is to have faith that God will heal you.) The practical version of the steps instills hope and inspires the addict to change. Furthermore, the practical steps are more concrete and less vague when compared to the traditional steps. (This makes them easier to work!)

In sum, Munn’s concept of the steps helped me to better understand the 12-step model of recovery; the traditional steps are difficult to conceptualize for a nonbeliever, but Munn found a way to extract the meaning of each step (without altering overall purpose or spirit). I consider the practical steps a modern adaptation of the traditional version.

I recommend reading Staying Sober Without God if you have a substance use disorder (regardless of your religious beliefs) or if you’re a professional/peer specialist who works with individuals with substance use disorders. Munn’s ideas will give you a fresh perspective on 12-step recovery.

For working the practical steps, download the companion workbook here:

📂 STAYING SOBER WITHOUT GOD: WORKBOOK

Note: The workbook is meant to be used in conjunction with Munn’s book. I initially created it for the previously mentioned client as a format for working the practical steps. The workbook is for personal/clinical use only.

Kratom: A Safe Alternative to Heroin?

Kratom is a tropical tree native to Southeast Asia. It’s becoming increasingly popular in the United States. It’s used for pain relief, mood enhancement, and to manage opioid withdrawal symptoms or reduce/stop opioid use. This post explores the use of kratom as a potential treatment for opioid use disorder.

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Kratom (mitragyna speciosa) is a tropical tree native to Southeast Asia and, like coffee, is part of the Rubiaceae plant family. Ingesting the leaves produces a high. Taken in small amounts, it leads to stimulant-like effects (i.e. increased energy and focus – stronger than caffeine, less intense than cocaine). When taken in larger doses, the high is similar to that of an opioid (euphoria, drowsiness, “pinned” pupils, dry mouth, sweating, nausea, constipation, etc.) Kratom is unique in that it produces both stimulant and opioid-like effects.

Note: “Opioid” is the term used for any drug that binds to the opioid receptors in the brain. An “opiate,” on the other hand, is a naturally occurring chemical found in the poppy plant, such as morphine or codeine. All opiates are opioids.

Image by GOKALP ISCAN from Pixabay

In the United States, kratom users cite pain relief as a primary motive for use. It’s an opioid agonist, and works by binding to opioid receptors in the brain. It can be effective for both acute and chronic pain. Others report using kratom for energy, increased focus, lower levels of anxiety, to reduce/stop the use of opioids, to reduce symptoms of PTSD or depression, and to elevate mood.

Kratom is legal in Virginia; it’s sold at vape or “head” shops as a loose powder or in capsules. (Alternatively, kratom can be purchased online.) Packaging is typically labeled “botanical sample only; not for human consumption.” The extremely bitter powder can be sprinkled over food or brewed into a tea. It’s easily swallowed in capsule form.

What does kratom mean for the opioid epidemic in America? Will it one day play a key role in the treatment of opioid use disorders? Or will it fall into the “harm reduction” category? Is it a natural pain medication, a safe alternative to highly addictive opioid pain killers?

Or, will we find that kratom, like heroin, is habit-forming and deadly? Currently, the research is mixed.

An Alternative to Opioid Drugs

The results of a 2019 survey published in Drug and Alcohol Dependence revealed that 90% of respondents found kratom effective for relieving pain, reducing opioid use, and easing withdrawal symptoms.  

In 2011, researchers discovered that kratom alleviated morphine withdrawal symptoms. A more recent study indicated that it may reduce morphine use.

Earlier this year, researchers found that kratom use was associated with significant decreases in the occurrence and severity of opioid adverse effects; it lessened the discomfort of opioid withdrawal. Multiple studies have substantiated these findings, suggesting that it could be a useful medication for opioid addiction and withdrawal.

Interestingly, in 2007, it was found that kratom reduced alcohol withdrawal behaviors. More recently, researchers discovered that it was associated with decreased alcohol use; this suggests that it may help those with alcohol use disorders (AUD) in addition to opioid addiction.

Image by Abel Tadesse from Pixabay

Harm-Reduction

Compared to heroin, kratom is less addictive and has milder withdrawal symptoms. Furthermore, the risk of overdose is low. A 2018 literature review indicated that it may have harm-reduction potential for individuals who want to stop using opioids.

Dangerous & Addictive?

According to the CDC, there were 152 kratom-involved deaths between July 2016 and December 2018 (“kratom-involved,” meaning it was a factor). In seven of those deaths, kratom was the only substance found in toxicology tests (although it should be noted that the presence of other substances was not fully ruled out). It’s possible to overdose on kratom, and when combined with other drugs or medications, it can be fatal.

In rare cases, kratom has been linked to liver toxicity, kidney damage, and seizures. In the case of a 32-year-old woman who was using it for opioid withdrawal, it was likely the cause of acute lung injury. Use may also cause cardiac or respiratory arrest.

Image by Simon Orlob from Pixabay

Kratom’s harmful effects are not limited to the body; a 2010 study linked chronic use to alterations in working memory. In 2016, researchers found that kratom use was associated with cognitive impairment. An additional 2016 study supported previous findings that it may affect learning. In 2019, researchers found that high doses were linked to memory deficits. In contrast, a 2018 study indicated that high kratom consumption was not related to long-term cognitive impairment. That same year, researchers found that long-term kratom use did not appear to cause altered brain structures. More research is needed in this area.

Regarding whether or not kratom is addictive, multiple studies have found that regular use leads to dependence, withdrawal symptoms, and cravings. Kratom cessation may also cause psychological withdrawal symptoms, such as anxiety and depression.

Image by StockSnap from Pixabay

Bottom Line

Will kratom step up as the hero of today’s opioid epidemic? Doubtful. And for kratom to be a viable treatment option, more conclusive research is needed. Additionally, researchers must study the safety of long-term use.

While it’s unlikely, kratom use could lead to adverse health effects or cognitive impairment; it could also fatally interact with other substances or medications. Furthermore, long-term use may lead to addiction. In sum, the majority of the literature suggests that kratom is, by no means, safe.

That being said, when compared to shooting heroin, kratom is safe (a safer alternative, at least). And if someone chooses to use it to reduce/stop their opioid use, I’ll view it as harm-reduction. Until we have more answers, I will hold to the harm-reduction view… it has the potential to save lives.

kratom
  • References
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  • Burke, D., Shearer, A., & Van Cott, A. (2019). Two cases of provoked seizure associated with kratom ingestion. Neurology, 92(15), 4.5-030.
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  • Halpenny, G.M. (2017). Mitragyna speciosa: Balancing potential medical benefits and abuse. ACS Medicinal Chemistry Letters, 8(9), 897-899. DOI: 10.1021/acsmedchemlett.7b00298
  • Hassan, Z., Muzaimi, M., Navaratnam, V., Yusoff, N.H.M., Suhaimi, F.W., Vadivelu, R., Vicknasingam, B.K., Amato, D., von Hörsten, S., Ismail, N.I.W., Jayabalan, N., Hazim, A.I., Mansor, S.M., & Müller, C.P. (2013). From kratom to mitragynine and its derivatives: Physiological and behavioural effects related to use, abuse, and addiction. Neuroscience & Biobehavioral Reviews, 37:2,138-151, ISSN 0149-7634. https://doi.org/10.1016/j.neubiorev.2012.11.012
  • Hassan, Z., Suhaimi, F., Dringenberg, H. C., & Muller, C. P. (2016). Impaired water maze learning and hippocampal long-term potentiation after mitragynine (kratom) treatment in rats. Front. Cell. Neurosci. Conference Abstract: 14th Meeting of the Asian-Pacific Society for Neurochemistry. doi: 10.3389/conf. fncel (Vol. 58).
  • Hassan, Z., Suhaimi, F. W., Ramanathan, S., Ling, K. H., Effendy, M. A., Müller, C. P., & Dringenberg, H. C. (2019). Mitragynine (kratom) impairs spatial learning and hippocampal synaptic transmission in rats. Journal of Psychopharmacology, 0269881119844186.
  • Hemby, S. E., McIntosh, S., Leon, F., Cutler, S. J., & McCurdy, C. R. (2018). Abuse liability and therapeutic potential of the mitragyna speciosa (kratom) alkaloids mitragynine and 7‐hydroxymitragynine.  Addiction Biology, https://doi.org/10.1111/adb.12639
  • Hughes, R. L. (2019). Fatal combination of mitragynine and quetiapine–a case report with discussion of a potential herb-drug interaction. Forensic Science, Medicine and Pathology, 15(1), 110-113.
  • Jaliawala, H. A., Abdo, T., & Carlile, P. V. (2018). Kratom: A potential cause of acute respiratory distress syndrome. DRUG INDUCED LUNG DISEASE: CASE REPORTS, A6604-A6604, American Thoracic Society.
  • Khor, B.S., Amar Jamil, M.F., Adenan, M.I., & Chong Shu-Chien, A. (2011). Mitragynine attenuates withdrawal syndrome in morphine-withdrawn zebrafish. PLOS ONE 6(12):e28340, https://doi.org/10.1371/journal.pone.0028340
  • Kumarnsit, E., Keawpradub, N., & Nuankaew, W. (2007). Effect of mitragyna speciosa aqueous extract on ethanol withdrawal symptoms in mice. Fitoterapia, 78:3, 182-185. ISSN 0367-326X, https://doi.org/10.1016/j.fitote.2006.11.012
  • Meepong, R., & Sooksawate, T. (2019). Mitragynine reduced morphine-induced conditioned place preference and withdrawal in rodents. Thai Journal of Pharmecutical Sciences, 43:1, 21-29.
  • NIDA. (2019, April 8). Kratom. Retrieved from https://www.drugabuse.gov/publications/drugfacts/kratom on 2019, July 19
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  • Palasamudram Shekar, S., Rojas, E.E., D’Angelo, C.C., Gillenwater, S.R., & Martinez Galvis, N.P. (2019). Legally lethal kratom: A herbal supplement with overdose potential. Journal of Psychoactive Drugs, 51(1), 28-30.
  • Raffa, R.B., Pergolizzi, J.V., Taylor, R., & Ossipov, M.H (2018). Nature’s first “atypical opioids”: Kratom and mitragynines. J Clin Pharm Ther, 43: 437-441. https://doi.org/10.1111/jcpt.12676
  • Sakaran, R., Othman, F., Jantan, I., Thent, Z. C., & Das, S. (2014). An insight into the effect of mitragyna speciosa korth extract on various systems of the body. Global J Pharmacol, 8, 340-346.
  • Saref, A., Suraya, S., Singh, D., Grundmann, O., Narayanan, S., Swogger, M.T., Prozialeck, W.C., Boyer, E., Chear, N.J.Y., & Balasingam, V. (2019). Self-reported prevalence and severity of opioid and kratom (mitragyna speciosa korth) side effects. Journal of Ethnopharmacology, 238, 111876. ISSN 0378-8741, https://doi.org/10.1016/j.jep.2019.111876
  • Singh, D., Chye, Y., Suo, C., Yücel, M., Grundmann, O., Ahmad, M. Z., … & Mϋller, C. Brain magnetic resonance imaging of regular kratom (mitragyna speciosa korth) users: A preliminary study.
  • Singh, D., Müller, C.P., & Vicknasingam, B.K. (2014). Kratom (mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug and Alcohol Dependence, 139, 132-137. ISSN 0376-8716, https://doi.org/10.1016/j.drugalcdep.2014.03.017
  • Singh, D., Narayanan, S., Müller, C.P., Swogger, M.T., Rahim, A.A., Abdullah, M.F.I.L.B., & Vicknasingam, B.K. (2018). Severity of kratom (mitragyna speciosa korth) psychological withdrawal symptoms. Journal of Psychoactive Drugs, 50:5, 445-450. DOI: 10.1080/02791072.2018.1511879
  • Singh, D., Narayanan, S., Müller, C. P., Vicknasingam, B., Yücel, M., Ho, E. T. W., … & Mansor, S. M. (2019). Long-term cognitive effects of kratom (mitragyna speciosa korth) use. Journal of Psychoactive Drugs, 51(1), 19-27.
  • Swogger, M.T., & Walsh, Z. (2018). Kratom use and mental health: A systematic review. Drug and Alcohol Dependence, 183, 134-140. ISSN 0376-8716, https://doi.org/10.1016/j.drugalcdep.2017.10.012
  • Tayabali, K., Bolzon, C., Foster, P., Patel, J., & Kalim, M.O. (2018). Kratom: A dangerous player in the opioid crisis. Journal of Community Hospital Internal Medicine Perspectives, 8:3, 107-110. DOI: 10.1080/20009666.2018.1468693
  • Veltri, C., & Grundmann, O. (2019). Current perspectives on the impact of kratom use. Substance Abuse and Rehabilitation, 10, 23–31. doi:10.2147/SAR.S164261
  • Yusoff, N. H. M., Suhaimi, F. W., Vadivelu, R. K., Hassan, Z., Rümler, A., Rotter, A., Amato, D., Dringenberg, H. C., Mansor, S. M., Navaratnam, V., & Müller, C. P. ( 2016). Abuse potential and adverse cognitive effects of mitragynine (kratom). Addiction Biology, 21:98– 110. doi: 10.1111/adb.12185

80 Powerful 12-Step Groups for Recovery

(Updated 5/15/21) 12-step recovery groups, while not a substitute for treatment, can play a crucial role in recovery and continued sobriety. AA/NA (and similar) meetings are available all over the world and are open to anyone with a desire to stop using or drinking.

12-Step Recovery Groups

The following list is comprised of links to both well-known and less-familiar 12-step and similar support groups for recovery.

Support Groups for Addiction

For Families & Others Impacted by Addiction & Mental Illness

Secular Alternatives

Faith-Based Alternatives

Additional Support Groups & Organizations

AA Sites for agnostics and atheists: AA Agnostica and AA Beyond Belief

Do you know of a 12-step support group not listed here? Share in a comment!

12-step

Click below for a downloadable PDF version of this post.

12-STEP RECOVERY GROUPS

40 Worst Comments About Mental Illness on Quora

What questions are people asking about mental health? Quora posts indicate that misconceptions and myths related to mental illness and addiction prevail. Read the top 40 most unsettling questions on Quora.com.

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I turned to Quora (an online platform for asking questions) to see what people today are asking about mental illness. What I found ranged from thought-provoking to comical to disturbing, illustrating how common misconceptions are. Here are some of the worst comments and questions I came across:

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Photo by Ivan Oboleninov on Pexels.com

40 Worst Comments & Disturbing Posts About Mental Illness (on Quora)

1. “Is mental illness really an illness?”

2. “Is mental illness catchable?”

3. “Do people with mental disorders have friends?”

4. “Are people who self-harm just looking for attention?”

5. “Is drug addiction really just a lack of willpower?”

6. “Can a person be intelligent and a drug addict?”

7. “Should drug addicts be left to die?”

8. “Why can’t drug addicts just stop? What compels a person to continue with a destructive behavior despite the obvious problems their behavior causes?” (Note: Addiction is a brain disease, which is why someone struggling with substance abuse can’t “just stop.”)

9. “Why should one feel sorry or sympathetic for drug addicts, given most of them chose this life?”

10. “Instead of ‘rescuing’ drug addicts who have overdosed, wouldn’t society as a whole benefit from just letting nature take its course?” (If that was the case, shouldn’t we then withhold all types of medical treatment and preventative or life-saving measures… to allow nature to take its course?)

11. “Is there any country in the world that won in the war against drugs by killing the users or the drug addicts?”

12. “Why should we lament drug addicted celebrities dying of drug-related causes? It’s their fault for starting a drug habit.”

13. “Why save drug addicts from overdosing? From my experience they were problems for their families, a drain on society from their teen years, and won’t get better once addicted.” (All diseases are a drain on society to an extent; that doesn’t mean lives aren’t worth saving.)

14. “How do you differentiate between drug addicts and real homeless people when giving money?” (You don’t; find other ways to help.)

15. “What are the best ways to punish an alcoholic?”

16. “Don’t you think it’s time we stop spreading the myth that alcoholism is a disease? You can’t catch it from anyone. One chooses to drink alcohol.”

17. “Why do people who are oppressed/abused never defend themselves and have pride?”

18. “Why don’t I have empathy for people who end up in abusive or unhealthy relationships? I feel that they deserve it for being such a poor judge of character.”

19. “Why do most women put up with domestic violence?” (Most women?? “Put up”??)

20. “Are schizophrenics aware they’re crazy?”

21. “Are schizophrenic people allowed to drive?”

22. “Do people who become schizophrenic become that way because they are morally conflicted?”

23. “Are schizophrenics able to learn?”

24. “Can a schizophrenic be coherent enough to answer a question like ‘What is life like with schizophrenia?’ on Quora?”

25. “Can one ‘catch’ schizophrenia by hanging out too long with schizophrenics?”

26. “Can schizophrenics have normal sex?” (Yes, or kinky, whichever they prefer)

27. “Why do people ignore the positive impact spanking has on raising children?” (See #28)

28. “Is being spoiled as a child a cause of mental illness such as depression?” (No, but spanking is linked to mental disorders and addiction in adulthood.)

29. “Should mentally ill people be allowed to reproduce?”

30. “Should people with mental illness be allowed to vote?”

31. “Are we breeding weakness into the gene pool by treating and allowing people with physical and mental illnesses to procreate?”

32. “Why are we allowing mental illnesses of sexual orientation disturbance and gender identity disorder that were changed for political reasons, to be accepted like race?”

33. “Why do some people with mental illness refuse to work and live off the government when they are perfectly capable of working?”

34. “Why are mentally disturbed women allowed to have children?”

35. “I feel no sympathy for the homeless because I feel like it is their own fault. Are there examples of seemingly “normal” and respectable people becoming homeless?”

36. “How is poverty not a choice? At what point does an individual stop blaming their parents/society/the government and take responsibility for their own life?” (White privilege at its finest)

37. “Why are mental disorders so common nowadays? Is it just an “excuse” to do bad or selfish things?”

38. “Are most ‘crazy’ people really just suffering from a low IQ?”

39. “Why do some people have sympathy for those who commit suicide? It is very cowardly and selfish to take your life.”

40. “Is suicide part of the world’s survival of the fittest theory?”

worst comments

Please leave your thoughts/feedback in a comment!