Category Archives: addiction

Summer Counseling Institute @ BTS

The BTS Graduate School of Counseling has 2 course offerings this summer: a course on addictions and a course on counseling interventions that move beyond talk therapy. Both are equal to 1 credit or 9 CE credits for professional counselors. The addictions course (Jessica Hansford, LPC, CAADC) will be entirely online and delivered over the course of the month of July. The beyond talk therapy course (Heather Drew, LPC) will be delivered live July 21-22 at our Hatfield campus (with pre and post course work due for those who want graduate credit).

If you want to refresh your counselor knowledge and skills, both courses will give you some new ways to engage counselees.

Link above provides course descriptions. To apply, click here.

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Filed under addiction, Biblical Seminary, continuing education, counseling skills, Counselors, teaching counseling, Training

Ruminating: The Mental Health Killer

I teach a course on psychopathology. Each week we consider a different family of problems. We explore anxiety disorders, mood disorders (depression, mania), and anger/explosive disorders in the first few weeks in the class. Later on, we look at eating disorders, addictions, trauma, and psychosis.

While each of the presentations of problems vary widely from each other, there is ONE symptom that almost every person with a mental health problem experiences–repetitive, negative thought patterns. Rumination.

The content of the repetitive thoughts may change depending on the type of problem (i.e., anxious fears, depressive negative thoughts, illicit urges, fears of weight gain, hypervigilance, irritability, etc.) but the heart of the problem in most mental health challenges are negative thought patterns leading to an experience of either impulsivity or paralysis. These patterns can look like obsessional worries about germs (triggering ruminative “why” questions as to the root causes of the obsessions). The pattern can look like repeated negative self-attributions for perceived mistakes. Whatever the pattern, the person finds it difficult to break out of the negative thoughts and attempts at distractions seem futile since the thought or feeling returns in seconds to minutes.

Is there anything that helps?

Yes, there are things that you can do to reduce the “noise” level of these repetitive thoughts. It is important, however, to remember two important factors

  • patterns in place for years or decades are harder to change. Give yourself the grace to fail as you work to change them.
  • As with pain management, the goal should not be the complete elimination of negative thoughts and feelings. Realistically, anxious people will have some anxiety. Depressed people will feel darker thoughts. Addicts will have greater temptations. But lest you give up before you start, this does not mean that you must always suffer as you do now.

Consider the following three steps as a plan of action to address the problem of rumination.

  1. Build a solid foundation of health. Every house needs a foundation if it is going to  last. Your mental health foundation starts with your physical body: Exercise, diet, and sleep. Did you know that daily exercise, getting a good 8 hours of sleep each night, and eating a diet rich in protein supports good mental health and may even prevent re-occurrence of prior problems? Will this solve all your problems. No! But failing to get good sleep and eat a balanced diet of proteins will exacerbate your problems. Sleep is especially needed. The lack of it will multiply your problem. Of course, getting sleep is difficult when you are worrying or depressed. Thus, work to develop a different bed-time routine. Shut off your electronics, do mindless activities like Sudoku, develop rituals that help promote sleep. If you are having trouble with this or your diet or exercise, find a trusted person to review your situation. And avoid all/nothing thinking that often leaves us paralyzed when we can’t reach our goals. On this point, read the next step.
  2. Prepare for change by accepting your struggle. What, I thought this was helping me out of my struggle? Acceptance is the beginning of change. Consider this examples. You struggle with intrusive negative thoughts about your belly. You don’t like how it looks. You’ve tried dieting and exercise, but still it is flabby. Every time you look at yourself, every time your hand rests on your belly, you hear (and feel) that negative narrative. The first step in change is to accept the body you have and to find ways to like it, even love it. Sounds impossible but it is necessary to accept all your parts. This does not mean that you won’t continue to exercise and eat well. Marsha Linehan suggests that one part of change is to accept the problem as it is. In her Dialectical Behavior Therapy model she speaks of choosing willingness over willfulness. Willingness opposes the response “I can’t stand this belly” by saying, “my belly is not as I would like but it is not all of who I am.” “I can’t stand it…” becomes a willful and yet paralyzing response. Whereas acceptance acknowledges the reality and chooses goals that are within one’s power to achieve (e.g., healthy eating choices). Acceptance is not giving up but preparing for realistic change.
  3.  Start to move. Consider these action steps as the beginning movements you undertake in a long process towards the goal:
    1. “So what?” Our ruminations are often filled with interpretations and assumptions. There are times we can challenge them by attacking the veracity of the assumptions. But we can also ask, “so what?” So what if I have OCD? So what if have to fight every day to stay sober? So what if I have to manage my schedule so as to not trigger a bipolar episode? Challenge the worst thing that you are afraid of.
    2. Develop a counter narrative. Rumination is a narrative. Begin by writing and rehearsing a counter narrative. It won’t have much power at first compared to your internalized rumination but it will gain power over time. Work to refine it. Choose to repeat it as often as you see the trigger for the rumination. Make sure your counter narrative doesn’t include self-debasing or invalidating comments. If you have trouble writing one, use Scripture passages that speak of God’s narrative, through Christ, for you. Be encouraged that developing alternative storylines has shown capacity to alter chronic nightmares. If nightmares can be changed, then even more thoughts and feelings during the day.
    3. Practice being present. Much of our lives are run on auto-pilot. When we are in that mode, it is easy to fall into rumination. Work to stay present, to be mindful and attuned to your surroundings. Notice ruminations but let them slide on out of view and bring yourself back to the present. Use your senses that God gave you to enjoy the world he made. Smells, sounds, sights, taste, and touch all give you means to enjoy that world. Start practicing staying in tune with it, a few minutes at a time and build your capacity as you go.


Filed under addiction, christian counseling, christian psychology, Cognitive biases, counseling skills, mental health, Mindfulness, Uncategorized

Giving Grace To Yourself When Change Is Slow

Have you ever struggled to change a habit, attitude, or thought process and wondered, “Why can’t I just change this in my life?” Maybe you wish to think different thoughts or feel differently about a person. Maybe you want some cravings to go away. But it just seems you aren’t improving as you hoped.

Without excusing your flaws or ignoring bad patterns that need change, you may find that giving grace to the challenge of change actually helps you make the change more quickly.

Consider this silly example of change. The seminary where I work poured a new walkway between my small building and our main classroom building. Now, instead of a step up to get in the building, it is all level ground. I have used this walkway for fifteen years as I walk from my car into the building and for the past two as I have walked between the two buildings.

Here’s the problem. I am almost falling down every time because my brain wants to step down when leaving the building and to raise my leg up higher as I enter the building. Either I am tripping as I leave, stepping down only to find that there is no step or I am entering gingerly trying not to look foolish. My body and brain have one expectation and unless I concentrate, I keep doing what I have always been doing, which no longer works.

If this is true about a walkway change, it stands to reason that other more emotional and relational changes would be even harder to manage. Consider some of these

  • the loss of a loved one: coming to terms with someone who is no longer there
  • trusting someone who has shown themself in the past to be trustworthy
  • trigger fears in public spaces after a trauma
  • eating habits after years of over or under control of food
  • having a positive thought after years of negative rumination upon waking
  • avoiding porn when bored
  • choosing a soft response when angry instead of yelling

So, change is hard. How does giving grace to myself help me? 

Imagine for a minute that you make a mistake. Now, consider both of these self responses and how it would impact your capacity to keep working at change:

  1. Stupid, stupid, stupid! Why are you such a failure. You are a waste of space and energy in this world. Lots of people change, why can’t you? You say you are a Christian but I fail to see any maturity. 
  2. [sigh]. Change is so hard. You’ve been thinking and responding to this situation like this for decades. So, it’s not surprising change comes slowly. Good thing God is gracious. Lord, I may not be able to stop the first thought but thank you for helping me catch myself just a bit sooner. Now, deep breath, try again, here is what I want to think/do/say…”

Which of the above two examples of self-talk will help you move forward and which one leaves you stuck in a perception of failure?

Notice the problem that keeps us stuck longer is shame (and our responses to it) more so than our particular changes that may be coming slower than we want. Sometimes pride is the barrier more than the behavior we want to change.

Today, watch your self-talk and instead of beating yourself up with shame talk, just acknowledge the flaw/failure/sin and remind yourself that right now, you can choose a different response. See how that influences your attitude and your energy for change.


Filed under addiction, christian counseling, christian psychology, Uncategorized

Of Dogs and Christianity…

I have 2 new posts at our Biblical Seminary faculty blog: one about what my dog teaches me about shame and desire and another about a rethinking of Christianity through the lens of evangelisation of the Masai–not into a Western-style church but into their own expression of church and community. You might not have any interest in a tribe from Tanzania, but I think you will find Father Donovan’s book an opportunity for you to re-think what the Gospel is all about.


Filed under addiction, Biblical Seminary, Christianity, church and culture, Doctrine/Theology

What advice to give those who love addicts?

I’m working on a project to help those who are loving and living with addicts. As you can imagine, the being the loved one of an addict is difficult. It is like watching a slow-motion crash over and over again, just hoping that it ends differently. It is hoping for change and yet hopeless at the same time. It is a time of confusion and pain. “Should I try ‘tough love’ or should I give her another chance?”

So, if you are in relationship with an addict and looking for more help and a bit of sanity…what would you want to read about? What would be helpful to you?


Filed under addiction, christian counseling, christian psychology, counseling

Remember the “crack babies”? Results you might not expect

My local paper ran this essay this week: “Crack Baby” Study Ends With Unexpected But Clear Result. After 23 years, the study is over and the results might interest you. Turns out, cocaine is not the worst thing for you. It did not create underdeveloped children, mentally retarded children, emotionally disturbed children. Researchers found no evidence that cocaine accounted for clinically significant differences between exposed children and non-exposed children.

The Clear Result?

The clear result is not that cocaine has no negative impact (it does contribute to premature births and some other problems, but it doesn’t appear to contribute to life long problems in children born at full term.

The clear result is that both controls and exposed children were from the same environment: urban, minority, poor communities. The clear result is that POVERTY and VIOLENCE are significant contributers to things such as low IQ, exposure to traumatic experiences, etc.

Listen to some of these stats:

  • At age 4, control group average IQ: 81.9; exposed children average IQ: 79.0 (both significantly lower than average IQ of national population of children same aged
  • At age 6, 25% of kids in each group scored in abnormal range in math and letter/word recognition
  • By age 7, 81% had seen someone arrested, 35% had seen someone shot, 19% had seen a dead body outside
  • Drug use did not differ between groups: 42% had used pot (as young adults)

But some stats that astounded me:

Of the 224 kids, the researchers have kept track of 110. Here’s some additional data:

  • 2 dead, 3 in prison
  • 6 have college degrees, 6 on the way to getting a degree (these are the ones who they kept in touch with! I expect the percentage of college degrees to not would go down!)
  • and this one: 60 children born to the 110 participants (remember the ages of the participants must be between 23 and 26!)

Mix poverty with failing schools, fractured families, and you get folks who have few options to make it. Without much hope for a future, it is easy to give in to any pleasure or comfort for the moment. Thus, you see higher drug use and babies.

Good to remember that when we see a simple equation between problem and cause, we probably have it somewhat wrong.

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Filed under addiction, news, Uncategorized

Of dogs and addictions

Our six-year-old cocker spaniel has learned a new trick. After having lived with us for over 1.5 years, she has figured out that she can open the pull-out cabinet drawer that contains our trash. This only happens when we leave her penned in the kitchen. I suspect we left some wonderful smelling meat scraps in it one night and the desire enabled some higher level problem-solving skills (she’s not the brightest dog in the world). Now that she has learned how to do this, we’ve taken to bungy cording the drawer. A few nights ago, we forgot and came home to a mess of coffee grounds and torn up trash all over the floor.

Interestingly, our dog responds in quite a predictable manner. Normally, when we come home, she is at the door to greet us by dancing around and putting her front paws on our legs. But each time we have come home to a mess she has made, we see her cowering and ready to bolt. The last time we came home to this mess, she squeezed out the door before we could get into the house so she could run away. No, we don’t beat her. She knows she has done wrong.

I’ve wondered what goes on in her head during the time she is into the trash. Does she know it is wrong? When does she start feeling bad. The moment we arrive? Has she been cowering and feeling guilty as soon as she spreads trash around? One more funny behavior: when we send her to her crate (in the basement) for a time out, she goes right away. But then, after a bit, we see her outside of her crate but sitting patiently. Then, she’s at the bottom of the stairs looking to see if we will let her up. Then, her front paws on the first step, waiting in anticipation that we’ll say all’s forgiven.

And this relates to addictions how?

Most individuals who struggle with an addiction have the strong feeling of guilt even as they partake. Guilt rarely is enough to stop us from acting out. Even knowing that we may well be caught does not stop us as much as you might think it would. The desire to have what is right at our fingertips can easily overwhelm all sensibilities and logic–that will race back to us as soon as we finish partaking or as soon as someone finds out. Our initial response may include running away. Guilt and shame prevail for a time and then we creep back into life hoping that the troubles we have caused will blow over and life will return to normal.

Of course, we are not dogs and so we must use the gifts God has given us (a brain capable of higher order planning, the Spirit) to learn from our mistakes and misdeeds. We can

  • remove ourselves from proximity to the addictive agent
  • plan for accountability, especially during vulnerable times
  • examine the roots, shoots, and fruits of our addictions with a trusted friend/counselor
  • remind ourselves of the power to say no and the foolish, false promises of addiction

For more of what I have written about addictions and interventions search the word in the seach box at the top of this page.

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Filed under addiction, christian counseling, christian psychology, counseling, Psychology, sexual addiction

Protecting Desire in an Age of Gluttony

[These thoughts on living with unfulfilled desire were first published here back on October 20, 2006. Since I am teaching on addictions and the need to protect (no slake nor deny) desire this week, I thought I might resurrect this introduction to a short series on the topic of protecting desire. To read the remaining posts, follow the links at the bottom of the post.]

I have a confession to make: desire, not cotton, is the fabric of my life. I crave foods, comfortable living, excitement, time with my wife without interruptions, sex, prestige, freedom from illicit temptations (or is it freedom to indulge without penalty?), free time, obedient children, and employment that doesn’t seem like work. Satisfaction is the name of my game. And with 4 decades of experience in achieving at least partial satisfaction, I still find it ever elusive, never lasting more than a moment in time. Even when I get what I want, it’s never enough. Continue reading


Filed under addiction, Biblical Reflection, Desires

Help and Hope For Porn Addiction: 2 Questions

Recently, I made a presentation to a group of men about the problem of porn use/addiction. It proved to be a lively conversation and I didn’t get an opportunity to get through all of the content. Below are 2 questions I was asked. Consider these answers:

  • What is wrong with watching porn with my wife? We both enjoy it and it spices up our sex life?

Besides the clear command to avoid all sexual immorality and to not lust after another? Supposing you want more than that here are some additional thoughts. God has given us imagination as a tool to be used for our good and our pleasure. Therefore, it stands to reason that imagination is highly important in the bedroom. However, it should be used as a tool to honor each other and to promote oneness. As soon as our eyes our off our spouse (whether in a literal sense or a figurative sense), we are seeking to use another for our sexual pleasure. Porn necessarily brings images of others into your bedroom thus moving away from reality and oneness. The images porn uses are not accurate or real and only encourages disappointment in the real thing.

And may I note that I have only heard this question from men. Given my experience of hearing so many wives who have been hurt by their husband’s interest in bringing porn into their own lovemaking, I am suspicious that the wife enjoys it as much as might be thought. At the end of your lovemaking and/or porn use, does she feel special? Does she feel honored? Does she feel she cannot measure up to what is not the screen?

Despite the injunction against porn use by Christians, do not take this to mean that the sex life of Christians must be boring. Seeking to satisfy the pleasures of your spouse gives ample room for creative fun in the bedroom.

  •  How long can I enjoy looking at [name of well-known female star]  and not begin to lust? Is it always wrong to enjoy female beauty?

Of course there is no specific answer that can be given as to how many nano-seconds are pure and at what point the look ogle turns lustful.  Is it possible to enjoy beauty in a person not your spouse? Yes. I would suggest that it is impossible not to notice beauty when you see it. However, I would quickly add that some forms of beauty are more likely to turn lustful in a split second. Noticing Beyoncé’s lovely singing voice probably won’t turn to lust. Noticing her Super Bowl attire…that is another matter.

Here’s what I would like you to consider. The question you are asking, “how long can I look before sinning” may reveal a dangerous motive. It seems that you might be asking, how close can I get to the cliff without falling over? Is it okay to have one foot on solid ground but lean over the edge? Can you see the danger in this thinking? Instead, we ought to humbly recognize that it is easy for us to move from momentary admiration to fantasy. It is good to accept that we will notice beauty and that we must guard our very next thought.

One more thought for you. While noticing beauty is part of who God has made you, is it possible that you have well-trained yourself to search for beauty? Is your head on a swivel? Have you long practiced taking the second and third look? If so, then you are likely not merely noticing beauty but actively looking for images you can use for your own fantasy.  


Filed under addiction, pornography, self-deception, Sex, sexuality, Uncategorized

Stopping addictive behavior: What works?

I taught Sunday School at my church a few weeks ago. The topic was finding practical and specific ways of escape from the cycle of addiction. If 1 Cor. 10:13 is accurate that there is “always a way of escape” for every temptation, then it was my suggestion that we ought to become experts at finding the gifts of escape offered by God.

I began with a reprise of the cycle of addiction that is often attributed to Patrick Carnes. That cycle goes something like this:

During a period of abstinence the person has the impression they would never fall prey to “old” temptations. But then,  triggers happen. These can be positive (a success) or negative (tired, hungry, lonely, angry, etc.). Triggers can be internal or external. These usually result in some immediate automatic thoughts/desires. We begin a script such as, “I need, I gotta have, if only, I can’t take this…” If we keep up the dialog for very long we find ourselves engaging in SUDs (Seemingly Unimportant Decisions). These behaviors aren’t addictive per se but they are the things we do in an unthinking way that set up us for use. So, the bored person just wants to surf the web and…surprise, surprise…they look at porn. Or, the person who has an alcohol problem is feeling lonely and so goes for drive and…surprise, surprise…they end up at their usual liquor store. After beginning to act out, the person often feels defeated and keeps engaging in the addictive behavior because they have already broken the promise they made to themselves and others. Finally, at some point the person breaks out of the acting out and often does some form of penance. This might include promising over and over to be good next time, doing good things for God and family, or punishing self to make up for the failure.

Stopping Addictions at the Last Minute

When addicts first begin to fight their cravings, they benefit from developing a list of many things they can do to avoid giving in. I recommend that individuals create very specific lists of things to do other than acting out. Most people aren’t good at brainstorming in a crisis so a solid, long list is essential. Items on the list can range from comfort actions (talking with a friend, a cup of  tea, a hot shower, listening to music, etc.) to distracting and positive activities (praying specific prayers, walks, exercise, etc.) to altruistic actions (doing something good for someone else). These lists work best when we share them with those who support our sobriety and who help us troubleshoot when the list doesn’t work well.

A Better way? Building a Different Narrative

But, aborting addictive behavior at the last-minute is a bit like running up to a cliff and hoping to stop before going over the edge. It is good to have a plan for how to stop but it is better to interrupt the cycle before it gets very far. To invoke another analogy, it requires that we change the script if we want to have a different outcome. I like the imagery of script because I think we tend to narrate our lives. Consider these examples of how we narrate life

  • Do you have a “pre-conversation” (fantasy dialog) with someone you know will be difficult? That “conversation” is rarely neutral. You imagine what you will say, what they will say, what you will say, etc. What you imagine is less about facts and more about how you have scripted them and yourself
  • Do you ever determine the unspoken motivations of another? “I know he meant to hurt me because he always does” is narrative. It may be accurate, but it is still your creation of a script and not the same as reality.
  • Do you ever replay a shame experience? A success experience? That is you narrating your life

“So, this relates to addictions how?” you might ask. Good question. Most of us script ourselves as either in a denial story or a despair story in regards to addiction.

  • Denial stories tend to focus on external causes to our acting out. It wasn’t me, it was the devil. I wasn’t going to do that but I was so tired from dealing with my mother. I was just checking ESPN when I clicked the wrong link and got to porn.
  • Despair stories tend to focus on failure and inadequacies. I’ve already failed so I might as well just keep on with my addiction. If anyone finds out I’ll ruin my reputation. No one else struggles like this.

Build A Better Narrative

  1. Identify the subtle ways you tell your own story (look at the typical thoughts, self-invalidations, fantasies, “if onlys”, comparisons, etc.). Find out how these story lines lead you down a four lane highway to your substance of choice.
  2. Practice telling new (and truthful) pieces of your story from God’s point of view. Check out with your trusted friends if they agree with these new pieces. For example, “I feel alone but what is true but God has put these people in my life. I feel like a failure the goal isn’t for me to rise above the struggle but to reach out in the midst of it.” “I am weak but God is present with me in my weakness and isn’t waiting for me to become strong.” Remember, you have practiced old and distorted story lines for many years so don’t expect that one or two attempts will dislodge solidified beliefs.
  3. These new story lines need new goals. The former goal of not using vs. getting “high” no longer works. The former goal of avoiding pain, guilt feelings, or quelling cravings do not work. New goals need to be crafted that work for you. Find one that works for you. Some create goals that focus on the next positive thing. Others focus on goals to stay connected to others during a craving. Still others focus on goals to meditate on something wholly other than their craving.


Filed under addiction, christian counseling, christian psychology, counseling, Uncategorized