Psycho-Education

Intro

Welcome to psychoeducation. Each week you will be introduced to a new topic. There are 12 themed topics spread over 12 weeks of treatment. It recommended that you focus on a topic a week to gain the most from the program. Each theme has some written information and a feedback section for you to reflect on and bring to counselling.

Here are the topic themes:

Topic1. What is dependance?

Topic 2. Cycle of dependance.

Topic 3. Cycle of change.

Topic 4. Beginning the process of change.

Topic 5. Recovery is about getting your life back- all of it.

Topic 6. Physical health and wellbeing

Topic 7. Psychological health and wellbeing

Topic 8. Emotional health and wellbeing

Topic 9. Social health and wellbeing

Topic 10. Spiritual wellbeing, health, and happiness.

Topic 11. Maintaining recovery- staying stopped and staying well.

Topic12. Celebrating your success and your recovery.

Topic 1

What is dependance?

This week we are focusing on beginning to understand dependance. Our clear message is that dependance to any substance is a health issue, and that effective treatment is available and can help you recover.

Our first key message for you is that dependance to alcohol or drugs is a health problem, not a moral problem. We are not to blame if we have a problem with drug or alcohol dependence. We would not blame someone for having diabetes or heart illness and you are not to blame if you have a problem with alcohol or drugs. 

Drug or alcohol dependance has two key characteristics: 

1) We sometimes use more than we would like to use & 

2) We continue to use despite negative consequences.

People use drugs or alcohol to escape, to relax, or to reward. But over time, our dependance to drugs and alcohol makes us believe that we cannot cope without them, or that we cannot enjoy life without using.

Approximately 10% of any population suffers from a form of substance use disorder in their lifetime. It is more common than diabetes, which occurs in approximately 7% of the population.

Substance use disorder crosses all socio-economic boundaries 10% of teachers, 10% of plumbers, and 10% of CEO's and 10% of our own family have a dependance.

Key characteristics of dependencE

1. Tolerance. Do you use more alcohol or drugs over time?

2. Withdrawal. Have you experienced physical or emotional withdrawal when you have stopped using? Have you experienced anxiety, irritability, shakes, sweat, nausea, or vomiting? Emotional withdrawal is just as significant as physical withdrawal.

3. Limited control. Do you sometimes drink or use drugs more than you would like? Do you sometimes drink to get drunk? Does one drink lead to more drinks sometimes? Do you ever regret how much you used the day before?

4. Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-worth, health, job, or family?

5. Neglected or postponed activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?

6. Considerable time or energy spent. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spent a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?

7. Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?

The terms alcohol dependance, alcoholism, and alcohol dependence are interchangeable. Drug dependance or drug dependence is also the same. These terms all mean the same thing. Whatever label we use to describe our struggle with dependance is not important and you may use ANY term you are comfortable with. 

What is dependance?

Dependance is an illness. It is a chronic illness that affects around 10% of the population. Dependance is a brain condition that involves compulsive use of a substance. People who have the illness of dependance are unable to stop their use despite potentially catastrophic consequences. 

Dependance is not a moral failing. It is a health issue driven by obsessional thinking and compulsive behaviors. Nobody sets out to become dependent on a substance. No one decides to become an alcoholic, a heroin dependent person, or an ice dependent person. No one thinks that taking Valium will lead them to becoming so dependent that they start lying to doctors to get more. Dependance is a disorder of choice. As the illness of dependence progresses the dependent person becomes unable to control their use. When we are dependent, our choices become flawed because we start to choose the substance over everything important in our lives.

Dependent people look like you or me. There is no typical dependent person. We are rich, poor, young, old, university educated or left school at 14. We are women, men, gay, straight and from all cultures and religions. Dependance does not discriminate.

We have learnt a lot in recent years about the brain science behind dependance. There are two main systems involved: the limbic system which drives the behavior and the frontal cortex, which should stop the behavior but does not because it is not working as it should. 

Some people have a vulnerability to developing a dependance because of a family history of alcoholism or dependance or experiences of trauma. Science is not clear exactly why some people are more likely to become dependent than others. We do know that around 90% of all adults suffering from dependance started to abuse substances as teenagers. Teenagers have overly sensitive developing brains and are at particular risk developing the illness of dependance if they abuse drugs throughout adolescence. 

Remember, dependance is an illness. It is not a weakness or a moral failing. It is an illness, and it requires treatment. 

Topic 2.

What is the Cycle of dependance?

Dependance Cycle

The Dependance Cycle is a way of understanding how the illness of dependance affects both our mind and body. As dependent people, we get caught in a vicious cycle and are unable to break free on our own. Understanding the dependance cycle will help us realize how this illness operates and why we need to look outside ourselves for a solution to recover.

Characteristics of the Cycle of Dependance

1. Emotional pain, stress, frustration that leads to anxiety and a demand for relief
2. Fantasizing about using alcohol and drugs to find relief 
3. Obsessively thinking about our next drink or drug and how it will make things OK. Thinking that we need relief, a chance to relax, a reward.
4. Using drugs, drinking alcohol, or engaging in other activities to find relief 
5. Losing control over the dependent person’s behavior- not being able to stop, using/drinking/spending more than intended
6. Experiencing feelings of remorse, guilt, and shame, leading to feelings of dissatisfaction and unhappiness.
7. Making a promise to oneself to stop the behavior or substance use.
8. Then, after a period, the pain returns, and the dependent person begins to experience the same ideas of how good it would be to use substances again. “Just once more,” “I will start again tomorrow” 

The cycle of dependance rotates differently for different users. If you are a binge user your cycle will be slower. Daily users may rotate through the cycle of dependance daily or several times throughout the day. This cycle can be arrested at any point after the dependent person or alcoholic decides or is forced to get help. Sometimes, the consequences that arise (legal, financial, medical, or social) force the dependent person or alcoholic to stop using. However, in the absence of outside help, such as alcohol or drug detox followed by dependance treatment help, substance abuse or dependent behavior is likely to return.

Topic 2 Worksheet- Exploring your cycle of dependance

1. How would you describe your use of drugs or alcohol? Do you use daily? Weekly? Are you a binge user, a daily user, or a top up user? 

1. When you have tried to stop using or cut down in the past what has led you back to picking up a drink or a drug?

1. What do you say to yourself when you are fantasizing about drinking or using drugs? 

1. Have you sometimes got relief from using or drinking?

1. What happens next? More relief or do things start to go wrong?

1. Describe a time when you are drinking or using brought you more trouble than relief.

1. What promises have you made to yourself or others about cutting down, controlling, or stopping your drug and alcohol use?

1. What do you say to yourself just before you pick up again? Have you ever said: “Just once more,” or “I’ll start again tomorrow”?

Topic 3.

Cycle of Change

The cycle of change is a way of understanding the way we change our unhealthy behaviors. This model is based on observations of how people who struggle with dependance to drugs or alcohol move through stages of getting ready for change and then making and maintaining that change. 

The first stage is called Precontemplation. Individuals in the precontemplation stage of change are not even thinking about changing their drinking or drug using behavior. They may not see it as a problem, or they think that others who point out the problem are exaggerating. 

There are diverse types of precontemplators. Some people are reluctant precontemplators- they are not fully aware of the extent of the problem or not motivated to change. Others are rebellious and do not want to be told what to do. Some people are resigned; they have given up hope that change is possible for them. Finally, some people are rationalizers. They can argue that drinking or drug use might be a problem for some people, but it is not for them. 

The second stage of change is Contemplation. In this part of the cycle people are willing to consider that there might be a problem, but they are still hanging on to what works about their use of alcohol and drugs. If you are at this stage, it might want to sit on the fence. You might say to yourself “Yes there are some problems.”  You might have a lengthy list of regrets and other negatives, but you have not yet committed to change. This is a suitable time to consider the pros and cons of staying the same as well as the pros and cons of changing.

The third stage is called Determination. This stage is where we commit to change. We have moved through the ambivalence of contemplation and are no longer sitting on the fence. An important process in Determination is making a realistic and thorough plan. You will have the opportunity to make this plan as part of your HomeHab program. 

Action: Implementing the Plan comes next. If you have reached this stage of readiness for change- congratulations! You will be working on your plan to change your drinking and drug use with your counsellor and through working your way through the HomeHab program. An important part of putting your plan into action is making a commitment to change. You can do this here through your HomeHab program with your counsellor. We also encourage you to tell supportive family members or friends that you are putting into action your plan to change your drinking or drug use. Starting to attend 12-step meetings such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) is also important at this stage. 

Maintenance, relapse, recommitment. The maintenance stage of recovery is where we are living our lives free from active dependance. Alcoholism and dependance are chronic illnesses and there is always a chance of relapse. With a strong maintenance program any relapse does not need to spell disaster. You can re-enter the cycle at any stage and return to your recovery. 

Worksheets- Topic 3 the Cycle of Change 

Where are you on the Cycle of Change? Write below about where you think you are now and what you can identify with from the description above of the various stages of change.

Contemplation exercise

In the contemplation stage people make a risk-reward analysis. They consider the pros and cons of their using behavior, and the pros and cons of change. They think about the previous attempts they have made to stop drinking or using drugs, and what has caused failure in the past.

Complete the table below asking yourself what are the 

(1) advantages and (2) disadvantages of staying the same and what are the (3) disadvantages and (4) advantages of change?

The behavior I want to change is my:

Complete your own Advantages/Disadvantages table. You can bring this to your counsellor this week to explore what you have learnt about yourself from this exercise. 

Topic 4.

Beginning the Process of Change

Congratulations for making it to Week 4! Fantastic work. This is the week where you put into action the plans you have made in the previous weeks. If you have not already, this is where you begin your detox, start attending 12-step meetings, start your exercise plan and begin the rest of your life.

ANCHORS & GOALS

An important part of change is identifying our anchors and goals. Once we have done this, we are more likely to succeed in making the changes we want to see in our lives. 

Our anchors are the values that reflect what we find meaningful in life and identifying these values is an important part of the change process. Our values underpin our goals and are the reason we care about our goals. Our values are the direction we want our life to head in. Our goals are how we get there. For example, we might have a value of being a good parent and have specific achievable goals of getting our children to school on time or making sure they eat their vegetables. Or we might have the goal of going for a jog or going to yoga while placing value upon our health. 

Values are what you care about, deep down, and what you consider to be important. Everybody’s values are different, and they can change over time. They reflect how we want to engage with the world, with the people around us, and with ourselves. 

Goals are the steps we take to live a life in line with our values.

TIP Start small and achievable. SMART goals are an amazingly effective way to begin the process of change.

S Specific                    (Exactly what are you going to do?)

M Measurable  (How many times?)

A Achievable    (Can I do this?)

R Realistic                   (Can I do this in this timeframe?)

T Time oriented           (Within a particular period)

For example, I want to feel better is not a SMART goal.

SMART goals look like this:

I am going to stop drinking and get healthy with these SMART goals:

• I am going to three 12-step meetings this week: Tuesday (7pm), Friday (2pm) and Saturday (6pm).
• I am going to yoga on Monday at 10am and Thursday at 6pm.
• I am going to stay drug and alcohol free one day at a time.

Ask yourself what might get in the way of you achieving your SMART goals and then produce some strategies to solve these problems. This way when you are confronted with barriers to achieving your goals you are ready for them.

Identify your values- Circle the values that fit for you

What kind of person do you want to be?

Sensitive          loyal     reliable warm                courageous

What kind of family member do you want to be?

Dependable     loving providing           caring  kind

What kind of career do you want?

Meaningful       profitable         interesting       challenging       balanced

What do you value for your physical health?

Strong              flexible             respectful        committed       nurturing          

What do you value for your mental health?

Calm                balanced          interested        flexible compassionate

What sort of relationships do you want in your life?

Nurturing     kind             respectful              honest                   loyal

Ask yourself- what is getting in the way of you living your life in line with these values? When we act against our values, we know it. We feel miserable, alone; we experience remorse, guilt, shame, and self-loathing.

Example

My value is

I want to be a calm and loving parent

My goals in line with this value are

Within the general goal, what are some specific first steps you might take? When, where and how will these steps be taken?

Goal

My goal is to be a calmer and more connected parent

Specifically- I want to parent my children positively instead of yelling at them. I am going to catch them being good at east once each day and practice taking calm breaths before I discipline them

Measurable- I am going to make a star chart for myself and measure my progress each day- the kids can help!

Achievable- I just need to be a little bit better each day- not perfect

Realistic- I know it will not be easy and I will still get cross. I can find something good or something I love about them each day- that is easy!

Timely- I will practice this for one week and check in with my counsellor 

The ways other people can help me are:

I am working with my HomeHab counsellor 

Some things that could interfere with my plan are:

I might get angry with the kids and mess up

What I will do if the plan is not working-

I will be kind to myself, recognise that I am doing my best and start again

Change Plan Worksheet 

Topic 5.

Recovery is about 360° View.

The illness of dependance to alcohol and other drugs affects us physically, psychologically, emotionally, socially, and spiritually. To recover from dependance to drugs or alcohol we need to start to heal each of these areas. Over the next few weeks, we will be we looking at your Physical, Psychological, Emotional, Social and Spiritual wellbeing. By exploring each of these domains of recovery in depth and giving you the tools and opportunities to begin your recovery you will be laying the foundation for ongoing health and wellbeing, one day at a time. 

By identifying some of the areas where our dependance has affected us, we are able to begin to heal and strengthen those areas of our life. 

Physical

The physical costs of dependance are often easy to see and feel. We might experience hangovers or withdrawal symptoms like tremors or shakes, diarrhea, body aches, sleeplessness, or exhaustion. Withdrawals are different depending on the drug we have been taking. Withdrawal from alcohol can feel quite different to withdrawal from cannabis or from benzodiazepines. Other physical costs can be more enduring such as blood borne illnesses or organ damage. Often, we become malnourished, unfit during active dependance, and need to address these health concerns first.

Psychological

When we are talking about psychology, we are referring to our thinking and behaviors as well as our mental health. One of the main psychological effects of substance abuse is an obsession with drinking or drug use and a compulsion to use, even when we know we should stop. Let us look at the obsessional thinking –during active dependance/alcoholism we tend to think a lot about our next drink or drug. We are thinking when am I going to have it, how many will I have, how will I get more etc. People who do not have a problem with alcohol or drugs are not thinking about their next drink or drug or regretting drinking or using yesterday or last week in quite the same way. Our thinking can also become extremely negative; we might blame ourselves or blame others for our substance use problem. We might tell ourselves that we are bad people and listen to an inner critical voice that speaks to us harshly and unkindly.

In terms of behavior a key indicator that we have a problem with alcohol or drugs is that we cannot control our use despite negative consequences. We promise ourselves, and others, that next time will be different. I will not drink so much, I will come home on time, I will not use that drug again etc. And we genuinely mean it at the time. Once we start though we lose our ability to stop. One drink becomes two becomes five… Or we drink alcohol instead of using cannabis or use benzodiazepines instead of amphetamines and still end up in trouble or back on our ‘drug of choice.’ Without recovery we also lose our ability to stay stopped even when we have not drunk or used for a few days or weeks or even months. 

During withdrawal and early recovery, we may experience feelings of anxiety or depression. Some people might feel paranoid whereas others feel hopeless and as though life will never get better. Treatment for our psychological health is vital. If we do not seek help for our psychological health, we are at risk of relapse. 

Emotional

Any emotion is a good reason to have a drink or use a drug when we are in active dependance. I feel sad I will have a drink, I feel angry I will have a drink, I feel so happy I will have a drink, I have worked so hard, you guessed it, I will have a drink. We become used to managing our emotional world with drugs or alcohol or other ‘avoidance strategies.’  Some of us might eat a tub of ice cream, binge on Netflix, exercise excessively or get into conflict repeatedly, all to avoid experiencing our emotions. When we stop our problematic drug or alcohol use those feelings are going to be there and it is important, we learn how to feel them without becoming so overwhelmed we go back to our old ways of coping (avoiding). Some of the difficult feelings many of us must face include shame, fear, and loneliness. Thankfully, as we start to get well, we also start to feel relief, happiness, connection, love, and hope.

Social

When we are drinking and using, we either spend time with other people who drink and use drugs, or we are at the stage of drinking and using alone. Sometimes our friends have become worried about us and tried to help us, or they have withdrawn us. All our friends are people we drink with at the pub or use drugs with. Either way our social lives are negatively affected by our substance abuse. When we come into recovery we learn how to socialize and have fun without abusing drugs and alcohol. We experience going coming home after a social event feeling happy about our behavior and our interactions with others. 

Spiritual

Spiritual health is incompatible with substance abuse because we cannot have a healthy spirituality and be engaged in harming others and ourselves. Everyone’s spiritual journey is different- at the core of healthy spirituality is connection. At the core of active dependance and alcoholism is isolation and disconnection. We become cut off from ourselves and from others. People may describe a spiritual experience as sacred or transcendent or simply a deep sense of aliveness and interconnectedness. 

Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way we experience our connection to the moment, to self, to others, to nature, and to the significant or sacred

Spirituality can mean an honest connection with community and spirit. We reconnect with our spirituality by reconnecting with our life. 

There is a range of ways you might develop your spirituality. Some of these include: 

• Community engagement
• Attending 12 step fellowships such as AA or NA
• Connecting with your values- honesty, kindness, selflessness
• Helping others less fortunate than ourselves
• Doing something for someone else without expecting something in return 
• Random acts of kindness
• Practicing spiritual principles like honesty, openness, willingness, and humility, compassion, and acceptance.

Topic 5: Recovery Worksheet

1. How has your physical health been affected?

1. How has your psychological health, your thinking, and behavior been affected by your substance use? 

1. How has your emotional health been affected by your substance use? What feelings do you avoid? What feelings are relapse triggers for you?

1. How was your social life affected by your substance abuse? Did you withdraw; did you regret your behavior or feel remorseful? Were you always the ‘life of the party’ but never felt like that the next day?

1. How was your spiritual health affected by your substance abuse? Did you find yourself disconnected from the people and things that are important to you?

Topic 6.

Physical health and wellbeing.

This week we focus on building your physical health. After detoxing and beginning to live without abusing alcohol or other drugs your body and mind will benefit from gentle exercise, healthy food, and good sleep- all the basics of good physical health.

Recovery from drug or alcohol dependance is a long journey and getting well is a wonderful accomplishment. As well as impacting the brain, drug and alcohol abuse can also take a heavy toll on the body. To properly heal following recovery from dependance and help prevent a relapse, it is important to take some gradual steps to return to health and wellbeing. 

Healing Steps

Nutrition: Eating is a low priority for many of us during our drinking and using days. Once we start our recovery it is time to begin to eat well and balanced nutrition and hydration is the key. Macro- and micronutrient deficiencies can lead to depression, anxiety, and low energy, all of which can trigger a relapse.

Individualized nutrition counseling and comprehensive nutrition education programs have been found to improve three-month sobriety success rates in people with substance use issues. It is recommended that you work with a nutritionist who understands the needs of dependance recovery. You can get started here with these helpful tips.

Nutrition Tips

• Do not make major changes immediately — gradual dietary improvements will result in better compliance with your new nutrition regimen.
• Eat regular meals and snacks throughout the day.
• Choose foods that are low in fat and include adequate amounts of lean protein to help rebuild muscles.
• Eat plenty of fresh fruits and vegetables to get the necessary vitamins, fiber, and minerals.
• Avoid processed, simple carbohydrates. opt for whole grains instead.
• Vitamin and mineral supplements may be helpful during and after recovery (including B-complex, zinc, and vitamins A and C).

Exercise: Exercise is believed to stimulate some of the same circuits in the brain as many substances of dependance, therefore getting involved in physical activity may be an effective way to replace some old behaviors. When you feel ready, start incorporating exercise into your healthy lifestyle. As with nutrition, if you start out slowly, you are more likely to stick to your new exercise routine. Walking can be a terrific way to begin. Taking a daily walk with a friend or family member can help you commit to a fitness plan. You can then gradually increase the distance you walk every week.

Exercise can begin to restore the brain’s balance of “happiness-inducing” chemicals like dopamine — a balance that drug and alcohol abuse disrupts. 

Exercising releases dopamine into the brain and as we exercise more often the dopamine levels in your brain start to come back into balance. As our fitness rises, our mood rises too. Studies show that exercise and physical activity can help return dopamine levels to optimal levels. Having a regular exercise routine — and committing to completing some physical activity every week — builds physical and emotional strength and are important steps in your recovery.

What sort of exercise is right for you?

Different exercises affect the mind and body differently.

Yoga
benefits: becoming flexible and strong in mind and body. Yoga helps us return to breath and being part of a yoga community. Yoga will allow you to learn to meditate, reduce stress and anxiety and experience a natural high. 

Some of the benefits possible from yoga practice:

• Improved flexibility
• Builds muscle strength
• Perfect posture
• Prevents cartilage and joint breakdown
• Protects your spine
• Better your bone health
• Increases your blood flow
• Boosts your immune system
• Helps improve sleep
• Improves your mood
• Eases pain
• Builds psychological awareness 
• Encourages self-care 

What else can I do for my physical health?

Walking daily can boost dopamine levels and help you stay sober and drug free. Studies show that a simple 15-minute walk can help stave off cravings when they arise. A brisk stroll outside can also boost cardiovascular functioning as well as overall brain function by supporting new brain cell growth.


Strength Training Cardio exercises like walking and running get most of the attention, but lifting a few weights also has recovery benefits. Many people recovering from substance abuse suffers from insomnia, as they are not used to getting to sleep without drugs or alcohol. Moderate weight training or weight bearing exercises like push-ups can help reboot the body’s sleep cycle over time.

Team Sports Kicking a football or shooting some hoops with friends provides more than a good workout. The camaraderie built playing casual team games can be a crucial piece to long-term recovery. Forming new relationships that do not revolve around drinking or using drugs helps recovering dependent people feel integrated back into society.

Sleep

An important part of early recovery is learning to get enough sleep. Sometimes we find it hard to fall asleep or wake up repeatedly through the night. Racing thoughts can make it hard to drop off to sleep and vivid dreams can wake us up in the night. Dealing with insomnia or a disturbed sleep pattern in early recovery is quite common, and it may even increase your risk for relapse.

When your body does not get enough restorative sleep, it can lead to daytime sleepiness and “fuzzy” thinking, depressed mood and anxiety and poor control of your emotions and thoughts. Simply put, a good night’s sleep restores and heals you — and gives you a clear head so you can continue to make sound decisions that favor your ongoing recovery.

Techniques that can help improve your sleep include relaxation techniques, like mindfulness meditation and progressive muscle relaxation, to help calm your mind and body as you wind down to bedtime. Remember that many sleeping medications, e.g., benzodiazepines can be very dependent on forming. A supplement such as melatonin might be more appropriate and your GP (General Practitioner) or treating doctor can help you if you are having ongoing sleep difficulties. Another crucial part of a healthy sleep plan during recovery involves practicing healthy sleep habits. 

Sleep experts recommend the following tips for getting to sleep and slumbering soundly all night:

• Stick to a regular sleep schedule and go to bed and get up at the same time each day (even on the weekends).
• Create a ritual for bedtime. Use the 30 minutes before you go to bed to do something that relaxes you, such as taking a warm bath, meditating, listening to calming music or reading an enjoyable book (not on your iPad).
• Avoid eating substantial amounts before bedtime and cut down on your caffeine intake. Caffeine and nicotine can interfere with sleeping
• Get some exercise every day. By committing to a regular exercise regimen, this can be as simple as a brisk daily walk. You are likely to get to sleep faster and sleep more soundly. Avoid vigorous exercise just before bedtime
• Eliminate light and sound as much as possible. Turn off computers and laptops and do not have your mobile phone in the bedroom, even if it is charging.
• Once you are in bed and have switched off the light, spend a few minutes reflecting on what you are grateful for today. Whether it is your family, job, sponsor or just the fact that you have made it through another day, there may be a lot to be grateful for. 

Topic 7:

Psychological health and well being

Positive Psychology

This week we are going to explore a branch of psychology called Positive psychology. We have spent a lot of the previous weeks looking at dependance and how we have been harmed by our dependence on drugs or alcohol. Now we are going to explore some of your strengths and assets. 

Positive Psychology is the scientific study of human flourishing, it studies how we can function at our best. It can be thought of as the study of the strengths and virtues that enable individuals, communities, and organizations to thrive.

Positive Psychology is based on the belief that people want to lead meaningful and fulfilling lives, we all want to cultivate what is best within us, and to enhance experiences of love, work, and play.

This approach is not about putting on a happy face all the time. Life can be hard, and disappointments and challenges are inevitable. We can learn strategies and skills that allow us to navigate the challenges of life more effectively and enjoy life despite the upsets. 

Positive psychology aims to help us connect with the sources of psychological wellness, such as positive emotions, positive experiences, positive environments, and human strengths and virtues.

Major aims of Positive Psychology: 

• Rise to life’s challenges; make most of setbacks and adversity
• Engage and relate to other people 
• Find fulfillment in creativity and productivity
• Look beyond ourselves and help others to find lasting meaning, satisfaction, and wisdom 

Here are some practical strategies to increase your psychological wellbeing:

1. Enhancing pleasure by Savouring: Savouring means we are aware of pleasure and that we give deliberate conscious attention to the experience of pleasure. 

How you can enhance pleasure by savoring the moment:

Share with others – tell people how much you value the moment. By connecting with others about something we enjoy we can experience the pleasure we feel more deeply

Memory building - Take mental photographs, or even a physical souvenir of the event, and reminisce about it later with others 

Self-congratulation -Tell yourself how great you are proud of yourself; you are doing well! 

Absorption - Allow yourself to become totally immersed and try not to think, just feel

2. Engagement 

Mindfulness: We send a lot of time not being mindful- driving places without noticing how we got there for example. By being more mindful we can contact the moment, the feel of warm sunshine on our backs, seeing the blue of the sky, hearing laughter. When we engage through mindfulness, we are more present in our lives. 

Nurture relationships: Our personal relationships have a much greater effect on our psychological wellbeing than the amount of money we have. Make sure that you invest time and energy in your friends and family. 

Identify and use your strengths: What are your personal strengths and how can you use them in your everyday life? 

3. Create meaning

Keep a gratitude diary: Take the time each day to write down three things that you are grateful for.

Thank a mentor: Write a letter of thanks to someone who has helped you in some way. 

Learn to forgive: Is there anyone you can extend forgiveness to? Do you need to forgive yourself? 

Perform small acts of kindness: Being kind to others is a spiritual practice that builds wellbeing in us and in our communities. 

Topic 7: Psychological health and wellbeing Worksheet

Positive Psychology 

This worksheet is an opportunity to reflect on what you have learnt about positive psychology and how you can begin to practice some positive psychology strategies in your life.

What experience of pleasure can you savior this week?

What relationships will you put more effort into this week?

What are you grateful for this week? 

Identify Your Strengths 

Things I am good at:

Challenges I have overcome:

Compliments I have received:

I have helped others by:

What I like about myself:

Topic 8.

Emotional health and wellbeing

This week we are going to talk about emotions and are also going to introduce the topic of Post-Acute Withdrawal Syndrome or PAWS, a phase of early recovery that we can enter after our acute withdrawal from drugs and alcohol. 

When we stop using drugs and alcohol after using over prolonged periods of time one of the first things that happens is that we start to experience our feelings. We all come into recovery with a backlog of unresolved emotional issues- guilt, shame, remorse, and often deeply buried feelings about traumatic events. These events may have happened to us or be related to harm we have inflicted on others. Feelings of shame and anxiety may relate to things that happened to us before our dependance or during our dependance. Whatever they are, they are not the cause of our dependance. Although if left unresolved these feelings can lead us to relapse by driving the cycle of dependance and adding fuel to the painful stages of this cycle. 

Feelings:

What feelings are you most comfortable with? What feelings would you rather avoid? Usually, we like to feel emotions like happiness, calmness, and confidence and do not like difficult feelings like anxiety, resentfulness, or irritableness. That makes sense. Unfortunately for us though, we are going to have those more uncomfortable feelings whether we like it or not. In the past we might have had a drink or a drug when feeling stressed or angry or when we wanted to reward ourselves. In Recovery we learn how to feel our feelings and emotions without using drugs or alcohol to dampen them down or build them up. To feel our feelings safely we need to learn about emotions: We learn to identify what we are feeling and what we can do about it.

American psychologist Robert Plutchik (1927-2006) developed a theory of emotions where he described eight basic emotions: happiness, confidence, fear, surprise, sadness, disgust, anger, and anticipation. Plutchik suggested that our emotions move from less intense to more intense. The more basic emotions 

Plutchik drew a wheel of emotions, which consisted of eight basic emotions (happiness, confidence, fear, surprise, sadness, disgust, anger, and anticipation) that combined give rise to eight advanced emotions (love, submission, shock, disappointment, remorse, contempt, malice, and optimism), each composed of two basic emotions. Emotions are combined to form dyads that form the advanced primary emotions, secondary and tertiary dyads that result in even less frequent emotions.

What is Post-Acute Withdrawal Syndrome? 

There are two stages of withdrawal. The first stage is the acute stage, which usually lasts at most a few weeks. During this stage, you may experience physical withdrawal symptoms. But every drug is different, and every person is different. The second stage of withdrawal is called the Post-Acute Withdrawal Syndrome (PAWS). During this stage you will have fewer physical symptoms, but more emotional and psychological withdrawal symptoms. Post-acute withdrawal occurs because your brain chemistry is gradually returning to normal. As your brain improves the levels of your brain chemicals fluctuate as they approach the new equilibrium causing post-acute withdrawal symptoms.

Most people experience some post-acute withdrawal symptoms. Whereas in the acute stage of withdrawal every person is different, in post-acute withdrawal most people have the same symptoms.

Common Symptoms of Post-Acute Withdrawal:

• Mood swings
• Anxiety
• Irritability
• Tiredness
• Variable energy
• Low enthusiasm
• Variable concentration
• Disturbed sleep

Post-acute withdrawal feels like a rollercoaster of symptoms. In the beginning, your symptoms will change minute to minute and hour to hour. Later as you recover further, they will disappear for a few weeks or months only to return. As you continue to recover the good stretches will get longer and longer. But the bad periods of post-acute withdrawal can be intense.

Each post-acute withdrawal episode usually lasts for a few days. Once you have been in recovery for a while, you will find that each post-acute withdrawal episode usually lasts for a few days. There is no obvious trigger for most episodes. You will wake up one day feeling irritable and have low energy. If you hang on for just a few days, it will lift just as quickly as it started. After a while you will develop confidence that you can get through post-acute withdrawal, because you will know that each episode is time limited.

Post-acute withdrawal can last for about 2 years. This is one of the most important things you need to remember. If you are up for the challenge, you can get through this. But if you think that post-acute withdrawal will only last for a few months, then you will get caught off guard, and when you are disappointed, you are more likely to relapse. 

How to Survive Post-Acute Withdrawal

Be patient. You cannot hurry recovery. But you can get through it one day at a time. If you resent post-acute withdrawal, or try to bulldoze your way through it, you will become exhausted. And when you are exhausted you will think of using it to escape. Post-acute withdrawal symptoms are a sign that your brain is recovering. Therefore, do not resent them. 

Go with the flow. Withdrawal symptoms are uncomfortable. But the more you resent them the worse they will seem. You will have lots of good days over the next two years. Enjoy them. You will also have lots of bad days. On those days, do not try to do too much. Take care of yourself, focus on your recovery, and you will get through this.

Practice self-care. Give yourself lots of little breaks over the next two years. Tell yourself "What I am doing is enough." Be good to yourself. That is what most dependent people cannot do, and that is what you must learn in recovery. Recovery is the opposite of dependance.

Sometimes you will have little energy or enthusiasm for anything. Understand this and do not overbook your life. Give yourself permission to focus on your recovery.

Post-acute withdrawal can be a trigger for relapse. You will go for weeks without any withdrawal symptoms, and then one day you will wake up and your withdrawal will hit you like a ton of bricks. You will have slept badly. You will be in a bad mood. Your energy will be low. And if you are not prepared for it, if you think that post-acute withdrawal only lasts for a few months, or if you think that you will be different and it will not be as bad for you, then you will get caught off guard. But if you know what to expect you can do this.

Being able to relax will help you through post-acute withdrawal. When you are tense you tend to dwell on your symptoms and make them worse. When you are relaxed it is easier to not get caught up in them. You are not as triggered by your symptoms which means you are less likely to relapse.

Topic 9.

Social health and wellbeing

As human beings we are social creatures. Our psychological and emotional health is linked to our social health. A particularly important part of our recovery is establishing healthy social connections that help us thrive. In active dependance many of us became isolated from friends and family and our social world narrowed. Our main social connection was often with people who drank and used like us. Some of us socialized with people who were heavier users than we were- this helped us feel better about our use- I am not as bad as he is! Or we associated with people who could help us access drugs and alcohol. Others of us used alone as we were too ashamed of all the times, we had gotten drunk in front of our friends or did not want to face one more lecture from well-meaning family about their concerns for us. Regardless of the pattern, our use of substances was often the driving force around our social life. In recovery we start to build relationships based on our values and our desire to live free from active dependance.

It can be useful to do an audit of your social life and take time this week to think about what sort of relationships you would like to nurture and what relationships you can let go of. One of the most significant triggers for relapse can be associating with people we used to drink or use with. 

Social support is also a key component of maintaining change. Attendance at 12 step meetings, exchanging phone numbers with members and going to coffee after meetings helps us form new friendships and support networks with others on the path of recovery. 

This week-Can you get some phone numbers of people from meetings & go out after a meeting with group members.

Topic10.

Spiritual wellbeing, health, and wellbeing

Spirituality exists in all cultures and all traditions. For all people, our spiritual development is connected to our growth as people. Spiritual health really means connection. When we are spiritually healthy it means, we are connected to ourselves and connected to others. Being spiritual does not mean the same thing as being religious, although for some people it might. Being spiritual does not mean believing in a god, although some people do. Everyone’s spirituality is unique to them. One person might be in awe watching a sunrise and feel connected to nature and the world around them. Someone else might see a sunrise as a reflection of their God’s love for them and feel connected in this way. There is no right or wrong way to build your own spirituality. A lot of the work we have been doing in the previous weeks has been around building connections with self and others. This week we are going to look at this connection and think about what spirituality means to you.

Many of the great spiritual leaders in the world are associated with religions. You might think of the Dalai Llama and Buddhism or the Pope and Christianity, your local Imam is the spiritual leader for the Moslem community or rabbi for the Jewish community. There are also spiritual leaders such as Deepak Chopra, Jack Kornfield, Anne Lamott or Pema Chodron who write and share their experiences of spirituality and connection.

Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way we experience our connection to the moment, to self, to others, to nature, and to the significant or sacred

Spirituality can mean an honest connection with community and spirit. We reconnect with our spirituality by reconnecting with our life. Some people might see themselves as a spiritual warrior: someone who fiercely protects themselves, other beings, and the planet. Your spirituality is a deeply personal and individual part of who you are and who you can become. 

There is a range of ways you might develop your spirituality. Some of these include: 

• Community engagement
• Attending 12 step fellowships such as AA or NA
• Connecting with your values- honesty, kindness, selflessness
• Helping others less fortunate than ourselves
• Doing something for someone else without expecting something in return 
• Random acts of kindness
• Practicing spiritual principles like honesty, openness, willingness, and humility, compassion, and acceptance
• Meditating
• Practicing yoga

Spirituality worksheet

What does spirituality mean to you?

What concerns do you have about developing your spirituality?

What will you commit to doing this week to grow your spiritual connection?

This could involve meditating, giving to others, taking care of yourself, praying, 

practicing gratitude.

List 5 things you will do this week to build your spiritual health:

Topic 11.

Maintaining recovery

Over the last 10 weeks we hope that you have developed an understanding of dependence and that you have begun your Recovery. These early days are full of change and new experiences and can feel like a rollercoaster ride- fabulous one day and plummeting to earth the next. This topic we are focusing on the skills we all need to maintain recovery from our dependence to drugs and alcohol.

Let us look at some of the key strategies that are important for all of us as we maintain recovery; how we stay stopped. 

Stick to the Plan

You have been working on a daily plan that has looked like check in, meditation, 12 step meetings, good nutrition, and sleep. Each day in early recovery it is a promising idea to plan your day and then stick to your plan. Try and not pack too much in at first, remember easy does it. We did not get dependent in one day and it takes time to get used to living each day without drugs or alcohol. 

The New Normal

Life is different without a dependence always dragging us down and pushing us around. In many ways life is so much better, but it will not always be easy. Recovery gives us tools to cope with life without the use of drugs and alcohol. Unfortunately, it does not promise that everything will be rosy all the time. The new normal may feel wobbly at first as you practice calling a sober friend, going to a 12-step meeting, a yoga class or meditating when feeling stressed or upset. We all learn to use our recovery tools one day at a time and gradually these strategies will become like second nature. 

KISS

Keep it Simple Sweetheart is a good motto for life and especially life in early recovery. Often, we want to overcomplicate things or keep pushing when something is not going the way we want. In recovery we learn to let go of trying to control and manage every situation to our advantage. We talk about ‘getting out of our own way’ and ‘letting go.’  This does not mean we give up or do not have a say in our lives. It means we learn not to sweat the small stuff and focus instead on our values and important goals. A great strategy is to ask yourself: “how important is it?” Ask yourself am I keeping it simple or am I overcomplicating things?

Recognize your Achievements

Pay attention to your successes. We build success by recognizing what we did well and then keeping on doing that. When we focus too much on mistakes or setbacks, we can lose motivation or feel like a failure. Every hour, every day sober is an achievement- be proud of yourself!

Avoid temptation

The people we used to use and drink with, the places where we used or drank are best avoided, especially at first. Do not put yourself around people or places that make it easy to drink or drug – no matter how strong you may feel. Our brains are wired to have cravings when we are reminded of our using or drinking. Smells, feelings, sounds, and other associations are all powerful reminders and can trigger a relapse. In time, you will be able to go to a party where people are drinking or see live music where a joint is being passed around and not feel tempted to use. Right now, in early recovery, this is not a promising idea. Instead, stick with the friends in recovery you have met – and maintain sobriety together.

Talk about what is going on with you

When you run into a challenge it is important to talk about it, do not keep it to yourself. It is good to let your feelings out and share what you are going through with recovering friends, a sponsor, or at a 12-step meeting. We learn that sharing what is happening to us helps us and can often also help someone else. Remember, when we were drinking and using drugs, we hid our problems and did not ask for help. We are all in recovery together because none of us can do it alone. 

The Stages of Relapse

We know we are not maintaining our recovery as well as we should when we enter the stages of relapse. 

Relapse does not just happen unexpectedly. It is important to understand the stages of relapse so we are aware of when we are slipping into relapse behavior, and we can go back into recovery behaviors instead. 

A relapse usually starts weeks or even months before we pick up a drink or a drug. There are three stages of relapse:

• Emotional relapse
• Mental relapse
• Physical relapse

Emotional Relapse

In emotional relapse, we are not thinking about using but we are emotionally off track, and vulnerable to a relapse in the future. 

Emotional relapse warning signs:

Anxiety

Intolerance

Anger

Resentments

Defensiveness

Mood swings

Isolation

Pretending we are OK

Avoiding meetings

Poor eating habits

Poor sleep habits

Post-Acute Withdrawal Syndrome (PAWS) 

The signs of emotional relapse are also the symptoms of post-acute withdrawal syndrome or PAWS. If you understand PAWS, it is easier to avoid relapse, because the early stage of relapse is easiest to pull back from. Once PAWS progresses it gets harder to avoid a relapse. So, we need to recognize the early warning signs and act on them. 

Emotional Relapse Prevention

Relapse prevention at this stage means recognizing that you are in emotional relapse and changing your behavior. Notice that you are isolated and remember to ask for help. Notice that you are anxious and practice your relaxation techniques. Notice that your sleep and eating habits are slipping and practice self-care.

The HALTS Hungry Angry Lonely Tired Stressed

We talk about getting the HALTS- being too hungry, angry, lonely, tired, or stressed. We need to avoid getting stuck in the HALTS. If we stay too long here, we will become exhausted, our coping skills will shrink, and we will want to escape by using drugs or alcohol.

If you do not change your behavior at this stage and you live too long in the stage of emotional relapse, you will become exhausted, and when you are exhausted, you will want to escape, which will move you into mental relapse.

Practice self-care. The most important thing you can do to prevent relapse at this stage is take better care of yourself. Think about why you use. You use drugs or alcohol to escape, relax, or reward yourself. Therefore, you relapse when you do not take care of yourself and create situations that are mentally and emotionally draining and that make you want to escape.

Mental Relapse

In mental relapse we start thinking about using. There is often a mental battle going on. One part of us wants to use, the other part is saying no. The early stage of mental relapse starts with fantasizing about using or romanticizing the past. Only thinking about the good times and not about the pain and anguish that brought us into recovery. In the later stages of mental relapse, we are actively thinking about using and planning to use. 

The signs of mental relapse are:

• Romanticizing our past use
• Being dishonest
• Hanging out with old friends
• Dreaming or fantasizing about using
• Thinking about relapsing
• Planning to relapse 

Strategies for Dealing with Mental Urges

Play the tape through to the end. When we think about using or drinking, we are likely to think that it will be different this time. I will be able to stop after 2 drinks, or I will just use today and then stop tomorrow. When we ‘play the tape through to the end’ we think about the consequences of our past drug and alcohol use. One drink usually leads to more drinks. We woke up the next day feeling disappointed. No one ever wakes up after a relapse feeling good about themselves. When we play the tape through drinking or using does not seem so appealing because we would be choosing to return to active dependance. 

Sometimes we might think we can use, and no one would know. We go away on a trip. That is when our dependance will try to convince us that it will be OK. Just one more, I deserve it, I will stop tomorrow etc. Play the tape through. We need to think about where our drug and alcohol use has taken us. We have already suffered and if we use again the chances are these negative consequences will all come back to us, often worse than before. Let us face it; if we could control our use, we would have done it by now.

Talk to someone- Tell someone that you feel like drinking or using. Call a friend, a support, or someone in recovery. Share with them what you are going through. The magic of sharing is that the minute you start to talk about what you are thinking and feeling, your urges begin to disappear. They do not seem quite as big and you do not feel as alone.

Distract yourself. When you think about using, do something to occupy yourself. Call a friend. Go to a meeting. Get up and go for a walk. If you just sit there with your urge and do not do anything, you are giving your mental relapse room to grow.

Delay- Wait for 30 minutes. Most urges usually last for less than 15 to 30 minutes. When you are in an urge, it feels like an eternity. With mindfulness skills we learn to ‘surf the urge.’ We can ride the wave of feeling by watching the intensity of the feeling build and then drop away. By keeping ourselves busy and doing the things we are supposed to do, the urge will be quickly gone.

Remember- we learn to live and recover one day at a time. All we need to do is stay well and sober today. We can deal with tomorrow when it gets here. 

Make relaxation part of your recovery. Relaxation is an important part of relapse prevention. When we are stressed, we tend to make mistakes and repeat old behavior. Our brains stop being open, flexible, and become rigid and reactive. Daily relaxation, even if it is just learning to take calming breaths when we feel tension build keeps us in recovery. 

Physical Relapse

We can move from feeling stressed, to thinking about relapse, and then actually picking up a drink or a drug quickly if we do not intervene. It is harder to stop the relapse once we have made the phone call to a dealer or are in the car on the way to the bar. It is possible but much harder. It is easier to practice our recovery strategies and intervene early. 

What strategies will you use when you find yourself in emotional relapse?

What strategies will you use when you find yourself in mental relapse?

Topic12.

Celebrating your success and your recovery

Congratulations! You have made it to week 12 of your HomeHab program and have made some incredibly significant changes in your life. This week we are going to celebrate your success and talk about how we celebrate recovery. When we were drinking and using any celebration was a good excuse for a drink or a drug or 10! We know it did not have to be a celebration to justify using; any excuse was a good one. Celebrations can be triggers for using because we might feel like we “deserve” a drink after all that demanding work. We might say, “I haven’t used for 90 days, I deserve to use just once more”. We know that this is relapse thinking and that if we could have used just once or been able to drink normally, we would have. 

When we think about celebrating our successes or celebrating a birthday, a recovery milestone, or a wedding in recovery we are changing the way we reward ourselves. When we think about how active dependence hurt us and hurt our families, it does not seem like much of a reward really. A reward is to do something good for ourselves, a way of acknowledging our achievement and taking a moment to give ourselves a pat on the back. In recovery we can also allow other people to celebrate with us- to acknowledge how far we have come. 

Humility

Humility is a spiritual principle where we acknowledge our strengths and successes as well as being honest about our struggles and failures. Some of us might think that it is better to focus on all that is ‘wrong’ with us and we can feel uncomfortable with the spotlight on our achievements. Well, our achievements are an important part of who we are too. In fact, if we want to keep growing and being the best, we can be it is essential we have the humility to acknowledge all of ourselves. Not just the bad or the good. There is a wonderful quote from Marianne Williamson that you might know: 

Our Deepest Fear

by Marianne Williamson

Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, who am I to be brilliant, gorgeous, talented, fabulous? Who are you not to be? You are a child of God. You are playing small does not serve the world. There is nothing enlightened about shrinking so that other people will not feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It is not just in some of us; it is in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.

Congratulations on completing the HomeHab program. There has been a lot of information, work, challenge, and growth over the last 12 weeks. Many of us find that we need to pop back into treatment for a refresher every now and then or that we benefit from going back to week one and starting again. It is OK not to get everything the first time around. Remember that we focus on progress not perfection. Take care of yourself, be good to yourself and let us know how you are going. We wish you all the best and hope you give yourself permission to shine!

From the HomeHab team 

Topic 12 worksheet

 What does the quote from Marianne Williamson mean to me?

How am I going to celebrate my recovery today?