"The Heart of Addiction"

"The Heart of Addiction: How psychology drives addictive behavior" Here is a series of Blog posts from the magazine, Psychology Today. Lance Dodes, MD goes into the myths behind addiction and that it is about far more than the physical addiction to the "drug". I wish I had read his book before I started to quit smoking!

Too Much Energy

I know, I know...your thinking, no such thing. For me though, it can be a big problem.

There are problems to having too much energy. First, I am totally unproductive. My mind starts to race, I think of all the things I want to do, accomplish but then it gets away from me. I become over-whelmed and I shut down. I sit on the couch and stare, thinking of all the things I "should" be doing. My mind is cluttered, disorganized, unfocused. This is when I would smoke. After a cigarette, my mind would slow down and I would be able to focus again. Now that I don't smoke, I had to figure out another way of slowing my mind down. Even three and half years after quitting, it's still something that I struggle with daily.

Second, I become irritable and reactive (think lethal PMS). I can only keep a lid on it for so long, then I blow. My husband is a saint! I am am so thankful for his patience and our ability to communicate. I can tell him "Honey, I think it's best to give me some space".

When I feel myself "escalating", the first thing I do is look around and see what things around me are contributing to my level of arousal: light, sound, touch. I turn down the lights, shut off the TV, computer, radio etc. Is there a fan blowing? A fluorescent light humming? Ear plugs are a godsend. I have learned to not even try to wear clothes that aren't comfortable. Ideally, if I can just sit in a quiet / dark room for 10 minutes, it's enough to calm me down. I come out feeling calm and refreshed, like I just took a nap even though I didn't sleep. Unfortunately, that is not always an option.

Other times, I need to do something more. I have a bag of self-calming tricks (not listed in any particular order) that I use. Go for a walk, take a shower, knit, drink alcohol, take a Xanax, eat, pet my dogs, neurofeedback, drink a cup of (non-caffeinated) tea, say the Serenity Prayer. Obviously, some of these are healthier options than others. I try to use the less healthy options sparingly but there are times that it best for everyone that I use them.

These are the times that I sooo miss smoking. I miss the instant calm it gave me. I didn't need "self-calming strategies" or a "bag of tricks". I just needed a smoke. It was sooo much easier.

Good Things Happen to Good People

There are have been several "turning points" in my life. Interactions with people that have made a profound influence on my life.

I was working at a physical therapy job that for many reasons was not a good fit. I was still married to my first husband and life was not going real well (early 2005). Although, if you had asked me at the time, I'm not sure I could have told you that. I was truly just going through the motions, trying to get through the day. It was a point in my life when I couldn't wait until Friday but then when Friday came, I couldn't wait until Monday.

I had quit this job and it was my last day, my last patient of the day. Keith and I were the only ones left in the clinic. Keith was not one of "my patients", I was seeing him for another therapist. We knew each other but not at all well. We hadn't talked about anything of significance during the session. As he was leaving, halfway out the door. He paused and said to me "Good Things Happen to Good People" and walked out the door.

I still cry when I think about this story. Why he said that, I may never know. The sad part is...I didn't know I was "good people". I didn't think I deserved "good things". But, Keith got me thinking...maybe I was "good people" and I deserved "good things". He planted a seed in me that would take awhile to grow, but grow it did. A few months later, I started making some dramatic changes in my life and withing the year, I was divorced.

I may never get to thank Keith directly, but I hope Karma shines upon him.

Logic or Excuse?

I was working as a PT in Home Health and was taking an elderly woman for a walk in her neighborhood. One of her neighbor's home always had a bunch of cars at it. I asked her about it and she explained that a large extended family all shared the home. She said very matter of fact "They live differently than I do." There was no judgement in her statement. When I find myself being judgmental, I think of her.

One of the things I have struggled with is the idea of "logic" vs. "excuse". When I explain why I smoked, do you hear "logic" or "excuse"? What's the difference? For me, understanding the logic is understanding where some else is coming from, understanding the why of something. It's looking at things from another point of view. This concept has been instrumental in my growth as a person and in relationships. In our "nose to the grindstone" culture though, I think sometimes giving a "logic" is perceiving as giving an excuse.

When I understand the "logic", I am better able to be empathetic. With my anxiety, I tend to ruminate, to obsess. One of the things I can obsess about is when someone does / behaves in a way that is "Not what I would do". I have found it helpful to dig deeper and find out (or even just take some guesses) why they may do what they do. It helps to stop the obsessing and accept the situation for what it is and not try to change it.

When I understand the logic, I am in a much better position to be supportive and as needed, helpful.

A Woman's Struggle with Postpartum Depression

Here is an article from a mom in the UK who has a great message. Click Here

Smoking Cessation with Vets and PTSD

I just found an article from the VA on smoking cessation. They found higher quit rates when they addressed Post Traumatic Stress Disorder (PTSD) symptoms concurrent with traditional smoking cessation. Yeah!!! This is what I'm talking about. The core treatment for PTSD is reducing reactive irritability, stress management, anti-anxiety / anti-depression medication etc. Treatment is not short lived and is best done intensively, over a period of time.

This is a start.

Missing the Boat

There is an article in USA Today about smoking and it's harmful effects. The article goes into great detail about how bad smoking is, how much is costs healthcare and how the tobacco companies have made smoking more appealing. I don't disagree with any of it. But...again, nothing about why people really smoke.

Smoking is AWFUL!!! I knew it was bad for me. I've seen all the nasty pictures. As a healthcare worker, I have worked with people DYING from smoking, struggling to get their next breath. But I did it anyway.

I was discussing the new ad campaign with a fellow former smoker. He thought it was a good idea. He said seeing a nasty picture got him to quit...for six months. The current anti-smoking campaigns, I believe, accomplishes two things. First, keeps some kids from ever starting. Secondly, gets people to quit smoking. BUT...Quitting is only the first step. STAYING quit is where the shit hits the fan. Where is the information to help accomplish that???

Instead, the information I had was that I needed to put on a patch and if I had a nicotine craving, I needed to take a deep breath. Give it five minutes, it will pass. It really upsets me the lack of comprehension and more importantly acceptance of what we are dealing with. This is not about a moral short-falling or lack of information. I am not a bad or stupid person because I smoked. I was desperate to calm my anxiety and smoking was my solution.

Irritable Nervous System

I now understood that I had anxiety or better described as an "irritable nervous system". The anxiety is not because I was withdrawing from nicotine (a part was but in fact a small part). I was like this before I started smoking. Looking back at my life, I have always used something to self-calm. This is one of those huge misconceptions that I want to dispel. It's not about just getting over the addiction to nicotine, or "withdrawls". Months after I inhaled my last cigarette, I was still having anxiety. My system had long gotten past the withdrawls.

The thing I like about the term "irritable nervous system" is that it gives me a better visual as to what is going on. My nervous system is irritated, hypersensitive. I am much more aware of and prone to have a heightened response to sensory input (Light, sound, touch, taste etc.). With that now understood, I now needed to do two things.

First was to decrease the sensory input in my environment. Especially light and sound. I found that I felt much better when my house quiet and lights turned low. If I tried to open the blinds or turn on the radio, I would feel my anxiety increase. When I would shut them off, I would immediately feel relief. It was a very fascinating experience.

The second thing I needed to do was to decrease my bodies response to my environment. This is what nicotine / smoking did for me. Now I needed to figure out a way to do it for myself. I knew medication was an option but I wasn't ready to go down that road. In desperation, I tried a form of biofeedback, called neurofeedback. At the time, I had no idea what is was or what it was supposed to do. All I knew was I felt better after doing it, a lot better. It came as close to how I felt after smoking as anything did.

This became the focus of my life. I really don't think I could have quit otherwise. I quite literally withdrew from the world for 9 months after my last cigarette. I am completely aware of what a luxury this was for me to be able to do this. I was essentially single (my relationship was long distance), my job was low stress but paid well, no kids. It makes me understand how some people truly can't quit.

A Political Cartoon

Please click the link: Steve Breen on Creators.com - A Syndicate Of Talent

This political cartoon just made me laugh. There is a lot to be said about reverse psychology.

It's a "Cindy" Problem

So the headline in the paper today is... "761 arrests, big seizure didn't curb drug trade... After 40 years and $1 trillion, the US and Mexico continue to fight a losing battle". I don't know much about economics but I do understand basic supply and demand. As long as there is a demand...people will continue fill the supply. The problem is not with drugs, it's the people who take them. Help them and demand will decrease.

My smoking problem wasn't a smoking problem it was a Cindy problem. Smoking was just my solution. I needed to find another solution. Now that I realized that my fight was not with the cigarette but with myself, a new fear arose. Addiction transference. Would I just become addicted to something else? Would I just replace smoking with another vice: food, alcohol, shopping??? It reiterated my desire that I had to get to the root of the problem and not just put a band aid on it.

So, the obvious solution was I had to learn how to relax. The next several months I supplemented my current cessation regime (mostly just the patch) with relaxation techniques. This included deep breathing, exercise, decreasing the sensory stimulation in my environment ( noise, light etc), less caffeine, hot baths, decreasing work load etc. I had a renewed sense of focus.

It wasn't enough. I kept starting again. I don't like to let my mind wander back those times that led to starting again. It is unpleasant and I keep thinking I should be embarrassed to reveal this but I'm not. It's just the truth. My mind would start spinning, heart racing. I had all this energy. But it was scattered, unfocused. I kept thinking deep breathes, exercise harder! Give it five minutes and it will pass. I let myself scream, throw things, jump up and down (the stories my dogs could tell). I even let myself drink too much, it would help but the spinning wouldn't stop.

Ultimately, autopilot would kick in and I would drive to Maverick to buy a pack of smokes. RELIEF!!! The sweet feel of the smoke burning my throat, filling my lungs, my mind and body reclaiming peace.

A New Direction

As I progressed through this journey of quitting, I had to face a lot of assumptions that really weren't true. This is a large part of why I wanted to write the blog. I was so frustrated because society kept telling me that to quit smoking I needed to do two things. 1) Get over the physical addiction to nicotine and 2) Break the routine of smoking. For some people, that's really all there is. If I heard one more person tell me "I just decided one day to quit. I just threw the cigarettes away and never looked back". (Profanity Alert) Well fuck you!!! That was not MY experience. I've thrown away hundreds of dollars in cigarettes. Why did I keep starting again??? Every time I quit and then started again I felt there was something more to all this.

The something more was that I self-medicated with nicotine. It was my "fix". It was my "downer". There were a lot of things I didn't really know about myself until I tried to stop taking my "downer". I started to face the reality that I had pretty severe anxiety. But no..."I am a pretty chilled, laid back person. Aren't I???" "Oh God, maybe I'm not!!!" I am feeling frantic...gotta do something. I was soooo confused.

What am I? Who am I? Talk about midlife crisis. And I was only in my 30's. I was trying to put all this together and I knew this would be the missing piece that I needed to figure out to quit successfully. As I sat with the reality of my anxiety, a lot of things started to make sense. I mean A LOT of things started to make sense.

So, the focus of my quitting changed. Yes, I still needed to do those two things I mentioned before (that was the easy part) but now I had to figure out how to replace nicotine. To replace the anti-anxiety effect that nicotine had on my body. Now my journey took a new direction.

There is nothing "wrong" with me

So, a persistent feeling I have had my entire life is that there is something "wrong" with me. I never really felt like I fit in. I was never comfortable in my own skin. I think that was one of the things smoking did for me, for a period of time (until the nicotine wore off), I was comfortable in my skin. In my last blog I talked about the 3 A's: Awareness, Acceptance and Action. My life was all about action. As long as I kept "doing", I didn't have to feel this discomfort of something "wrong".

So, as I started to have periods of time without my "distraction" (nicotine), I began to have to experience the awareness of the "wrongness" in me that I worked so hard to avoid. Awareness is a double edged sword. On the one hand, it is the first step in finding solution to a problem but on the other hand it's like having a band-aid ripped off. OUCH!!!

Some days, I wanted to go back into my state of denial. Before I had other skills at my disposal, I did just that and started to smoke again. But I as I progresses through this journey, I was forced to find other ways to deal with that feeling of "wrongness".

I remember a period of time when I was quitting that I would wake up in the morning with this pit in bottom of my stomach. I wasn't even out of bed yet! It took several days until I realized that even before I got out of bed, I felt like I already failed for the day. I knew I wasn't going to be a "good enough" friend, relative, employee, mom to my dogs, etc. Uggg! Why even get out of bed.

But, there it was...Awareness. With just knowing what the feeling was came a sense of relief. Now, I needed to accept where I was. That is the hard part. Getting to that peaceful place of Acceptance. I used to always think acceptance meant I had to approve of the situation. I have learned (another great lesson from Lois' friends) that acceptance is just acknowledging the reality of the situation. I don't have to be good with it, just know it's there. Once I reach that peaceful place, then I can make changes. Another VERY counter-intuitive skill for me.

So, I needed to accept that there was nothing "wrong" with me. I am me, with all my quirks. I didn't need to be anyone other than that. I just needed to do the best I could that day. Sometimes by best was half-ass but truly there are days when that is all I am capable of. And that's ok.

Something from Nothing

I have been pondering over the last week as to what to write about next. There is so much but at the same time my mind is blank. So, I decided to rely on a skill I have learned over the last few years...do nothing about it! This is one of the most challenging and counter-intuitive skills for me. My whole life I have been a "Doer", a "Thinker", a "Figure it out at all costs" kind of person. To just let something be, to "Let it Go"...perish the thought!!!

It wasn't until about 6 years ago, when my life was at an all time low, that I reached out and met some really wonderful people. They started to teach me some skills, one of which was that doing nothing, was really doing something. They taught me that I didn't have to have everything figured out. That, most of the time, things would work themselves out (usually for the better) if I leave them alone. There is a process to things. First is awareness, then acceptance and after that...then action. I tended to skip right to the action.

So, for me, when I am at a crossroads, I have learned to do nothing. It is amazing to me what productivity comes from doing nothing. Give it a try.

Fears about Quitting

As much as I wanted to quit, there was a lot I feared. "Could I really quit???" Fear of failure was huge. I struggled with whether or not to tell people I was quitting. What if I started again??? Over the 16 months of quitting it became a subject I dreaded. "Please don't ask how my quitting is going", I would think to myself. I was on and off the wagon so many times. On the other hand...I needed support. My fear of people knowing I failed won out and I began to withdraw socially.

Then there was the fear of weight gain. I have never been "skinny" but I was fairly comfortable with my weight. I was at the top of my "comfortable" range though. So...I thought "Maybe I should lose 10 pounds first then quit". But, I never quite got around to weight loss because my mind was pretty focused on quitting smoking.

Another big fear was losing my "friend". I been through a difficult year; divorce, 2 job changes, moving. Was I really ready to say goodbye to the companion that had "helped" me through all of that? No matter what time of day or my state of mind, there was always some level of comfort going outside for a smoke. There was the routine, and with that consistency of routine, was comfort.

Uppers and Downers

The world is full of uppers and downers. No, I'm not talking about illegal drugs, although they do fit into those categories. I'm talking about things we encounter or do everyday. There are things that bring you "up": coffee, laughter, music with a fast beat, lights etc. There are things that brings you "down": quiet, darkness, soothing music, alcohol. They can be different for one person than another. As I progressed through my time quitting smoking, I started to become more sensitive to these things. I started to realize that it was the "ups" that were what drew me back to smoking. This didn't make any sense to me. In my mind, nicotine was an "upper".

It is interesting how certain conversations stick with you and make a lasting impression. I was talking to a friend (a fellow smoker) in college about smoking. I was still a pretty casual smoker but I remember telling him that I found smoking relaxing. He had a shocked look on his face and said that smoking energized him. Blindly, I thought "well, he must be right". From then on, I thought I smoked because I was tired, lethargic. This blind faith is a whole other issue, but again, this was my reality. I trusted someone else to tell me how I felt.

It never again crossed my mind that I smoked to relax. That is, until I stopped. But even then, I had to go through several cycles of stopping and starting before I started to grasp the concept of smoking to relax. Not to say that there weren't occasions that I smoked as an "upper". But, by and large, I smoked to relax. That is how talented nicotine is. It can serve as both an "upper" and "downer". This is the beast with which I struggle with. The struggle I still have today is how do I stay in the middle.

The Stopping and the Starting

I spent 16 months stopping and starting smoking. I would quit anywhere from 1 day to 10 days. I had one stretch when I quit for 3 months. Just as important as figuring out how to stop smoking was figuring out why I kept starting again. That was going to be the secret to staying quit.

10 days of staying quit was pretty average for me. For the first couple of days, the hardest part was the routine of smoking. The transitions were the worst. Moving from one activity to another. Those were the times when I would always stop for a smoke. Waking up in the morning, after eating, getting in my car, getting home from work (yes, even though I had just had a cigarette in the car on the way home), moving from dusting to vacuuming etc. It was all part of the "routine", the "habit" of smoking. During those transitional time, I spent a lot of time laying on the couch, staring at the ceiling. That became my transition.

After those first couple of days, I would start to physically feel better. The cough would subside, I would have more energy, my throat wouldn't hurt, my breathing was better. I would head to gym and feel a "burn" in my chest. A healthy burn this time. I would think..."WOW, I feel great. I can do this!", as I was plugging away on the elliptical. I was happy. If I could just maintain this feeling, I could succeed at anything.

My physical and mental well being were in balance. This feeling of everything being right with the world would last about a week. "Why couldn't I hold onto this???" Unfortunately, my "happiness" would turn into "elation", "euphoria". Oh, this must be the "nicotine craving" I read about. Deep Breathes...isn't that what I read to do. Five minutes and it will pass. Five minutes, my ass. This would go on for hours. I was in a panic. I would be pacing around my house, I would go for a run, I would drink a glass of wine, I would clean, I would lay on the couch. My mind was racing. "MAKE IT STOP!!!" Next thing I knew I would be in the car, driving to the convenience store to buy a pack of smokes. I don't really remember making the conscious decision to smoke. I was on auto pilot.

The first cigarette was heaven. As my mind would clear, the realization of what I had done sunk in. "Shit!!!" I started again. The guilt, the remorse.

"Fuck it! I guess I am just meant to be a smoker." So, smoke I did. Unfortunately, after the first pack, I started to physically feel like crap again. I was reminded of why I wanted to quit in the first place. Within a couple of days I was resolved to quit again.

So, this was my routine. I went through this over 50 times over the next 16 months. Each time, learning something else about success and failure.

Profanity

A word about the swearing. I don't swear out loud a lot but I do swear in my head a fair amount. If the profanity bothers you, I apologize. I am a people pleaser at heart and don't want to offend anyone. But.. this is the reality of where my head was at.

Denial is Not Just a River in Egypt

The experience of quitting smoking was the hardest thing I have ever done in my life. The death of my cousin Mike was (is) the most heartbreaking experience of my life. The difference, I think, was I am able to see my powerlessness in dealing with his death. But quitting smoking I felt like I should be able DO THIS! I was so confused as to why I kept smoking again. I really hated how I felt when I smoked. But, that was all part of the process. I had lessons to learn. The most important one was "Why did I smoke?". Contrary to popular belief, it was not because I was addicted to nicotine. Yes, that was part of it but, in reality, a small part. Even as I do things that are not in my best interest, I need to look at why am I doing it? What am I getting out of this? As easy as it would be to blame the nicotine or the additives or even the Tobacco companies, I was the one ultimately putting the cigarette in my mouth and inhaling. I was getting something out of it. That was what my journey was about. Why I had to keep "failing". I hadn't learned the lesson yet. Awareness that there was a lesson to learn was just the first step.

Can I really do this?

I "officially" started trying to quit in March 2006. I had thought about quitting many times before. I never bought a carton of cigarette because that was resigning myself that I would be smoking for at least the next 10 days. I know, it was a stupid mind game but hey, it was my reality. I quit whenever I went home to visit my parents (or they came to visit). They didn't know I smoked (that is a story for another time, they know now). But as soon as I got to my first layover (usually Minneapolis) out through security I went. Ahhh, cigarette smoke and exhaust. It felt so good! That is not a sarcastic comment. At the time, it was HEAVEN. I would usually smoke at least two. Other than those occasions, I never really tried to quit.

My divorce was finalized just a few weeks before. So, probably not the best time to try to quit. But hey...I was starting over. I wanted a fresh start and part of that was putting smoking behind me. Not such a smart plan but one of MANY lessons I learned. I thought, I just need to get past this dumb addiction to nicotine and then I could move on. So, I slapped on a patch. From what I read, if I got a nicotine craving I just needed to take a deep breath and in five minutes it would pass. I expected it was going to be tough but I also expected that over the next several weeks and months, it would progressively get easier. HA HA HA HA HA

So, the cycle began. I would go through my quitting routine. I would last anywhere from a day to 10 days. It was discouraging, baffling, enlightening, frustrating etc. It would not be until June 9, 2007 that I would have my last cigarette.

Blog Inspiration

The FDA recently announced that they are adding graphic labels to cigarette packages in hopes of getting current smokers to quit and preventing kids from taking their first drag. I find these labels quite condescending. REALLY...smoking is bad for me??? It could kill me??? Wow, I never realized that. Sorry if I drip with sarcasm. While I do believe in education for young people about the dangers of smoking. They have to learn it somewhere. I think this strategy is really missing the boat. I smoked for a reason. Because it made me feel good. I knew it was bad, I knew if I kept doing it, it could kill me. I coughed, I smelled bad, I had no energy and I knew it was all related to my smoking. But, I kept doing it. My goal for this blog is to help people understand why some people smoke. It is only understanding why we smoke that we can successfully quit ourselves and provide encouragement, love and understanding to people wanting to quit.

Fighting Failure

"Failure is only the opportunity to begin again more intelligently" This was in the wrapper of a Dove chocolate I had last night. It took me back to trying to quit smoking. I spent an entire year trying and "failing" to quit. I never went more than 5 days without trying to quit. Not half ass trying to quit either. In the evening I would go through all the reasons I wanted to quit. Sometimes writing them down.

1) I feel like shit...tired, coughing, scratchy throat, smelly, no energy etc.

2) It's expensive

3) Smoking controls my life. I need to have a cigarette every two hours whether it's convenient or not. I am always running out at the end meetings, sneaking outside at social events, is this movie over yet???

4) It's not good for my health. Duh!

5) My boyfriend doesn't like it.

I would have one "last" cigarette. I would then ceremoniously break all the remaining cigarettes in the pack and go to bed. The next morning I would put on a patch with renewed resolve...This time was it!

The longest I would typically last was 10 days. Failure...again. So, quiting took me a year. I went through this ritual over 50 times.

What kept me trying? Interestingly, I never really felt like a "failure" through that whole process. Something inside of kept telling me I wasn't meant to keep smoking. Each time I wasn't able to quit, I learned something. "Failure is only the opportunity to begin again more intelligently" This quote hit me because that was the attitude I had. I had a lot to learn about myself during that year. Discontinuing to inhale cigarette smoke was only the beginning of my journey. This is why I wanted to write this blog. Smoking is NOT about the cigarette. It is about so much more. In order to quit successfully, I had to learn what it was about, for me. Everyone is different . This is my story.

Background

A little background. I am 37 years old. I am a graduate of the University of Wisconsin-Madison with a degree in Physical Therapy. I tell you that not to "impress" you but to let you know that I am an educated professional that "should know better". I started smoking in college, mostly when I went out to the bars. I ultimately smoked a pack a day for 10 years. I NEEDED a cigarette every two hours. It was crazy how it hit me like an alarm clock. It was the first thing I did in the morning and the last thing I did before going to sleep. Another common statement I hear from people is "YOU smoked???" I don't "look" like a smoker. Whatever that means. What are we supposed to look like?

Introduction

It's a question I have been asked many times since I quit smoking three and half years ago. "Do you miss smoking?" No, I don't. What I do miss is how smoking made me feel. Ahhhhh, relaxed, calm, at peace. I struggle to find that feeling everyday. All throughout the day, I work to find peace within myself. I've been wanting to blog for awhile now but hadn't quite found my voice, my purpose. I love the title of Lance Armstrong's book "It's not about the bike". That is how I feel about smoking. "It's not about the cigarette". So, what is it about? That what I want to share in my blog. I want to try to dispel a lot of myths surrounding smoking. This is all based on my personal experience and will reflect my personal opinions about smoking and addiction in general. Research bores me but I will try to find some of that but I am all about the anecdotal evidence. So...you have been warned. I love to hear other opinions. I may not agree but I will do must best to listen and keep my mind open.