Beyond Addiction: How Science and Kindness Help People Change

In 2019, I was invited to do some teaching on addiction in the United Kingdom. To be most helpful in addressing this topic in that context, I knew I needed to be more aware of the differences between the US and UK when it comes to counselling (notice I spelled it correctly!).

In the US, our understanding of therapy has been shaped largely by Sigmund Freud. That is why those of us in the US tend to focus on “talk therapy.” The UK was shaped by empirical science and medicine. As a result, there is some skepticism for “talk therapy” or counselling in the UK. Instead, they send people to a “clinician.” Often, that means a doctor who can prescribe medication. While that may be an oversimplification and while that is changing, it does represent a significant difference. Because of this, I thought it wise for me to strengthen my understanding of the physiological nature of addiction.

I started doing some research on the topic of addiction with an emphasis on the brain and body. What is the nature of addiction from a physiological point of view? That is where the following book, Beyond Addiction: How Science and Kindness Help People Change, was so helpful.

If you have little or no training in human physiology you will be greatly helped and encouraged with what you find in the first section of the book. If you are a pastor, youth group leader or family member of someone who struggles with addiction, you would benefit greatly from this book. There are 4 major sections in the book that are directed to the loved one who is living with someone who struggles with addiction.

I. What To Know
II. How To Cope
III. How To Help
IV. Live Your Life

Here are some helpful portions taken from Part I: What To Know

I. What to Know: This section of the book provides one of the most helpful and accessible understanding of the nature of addiction and how it impacts the brain. This section is tremendously helpful because it explains the grip a substance or behavior can have on a person when the Nucleus accumbens (the reward center of the brain) gets high-jacked by an over influx of dopamine. Here is how the book describes what is happening in the addiction cycle:

1. What Is Addiction

Dopamine balance in the brain is not the only thing that gets disrupted by repeated use of a substance. It also affects key structures in the brain, such as the prefrontal cortex and limbic system. The prefrontal cortex is where we assess risks, weigh consequences, and make plans--in other words, make considered decisions. It manages input from the other parts of the brain like the limbic system and bodily regions and has been dubbed the braking system of the brain because it makes possible the judgments and decisions that go along with saying no to an impulse. When flooded with a substance, this part of the brain basically shuts down. (Teenagers have a distinct disadvantage here, as their young cerebral cortexes aren't even fully developed.)

The limbic system, in contrast, is where our sense of drive and urgency come from, generated through emotion, motivation, and in some ways the formation of memories. In the context of substance use or compulsive behaviors, this part of the brain gets excited into overdrive. So a brain that finds its limbic system acutely activated and anticipating the reward of using, and its judgment and decision-making pre-frontal cortex more or less disabled, is a brain that’s likely to go forward with the impulse and desire to use—no stop and all go. A brain in this state will register the smell of marijuana being smoked, the desire to smoke it, and anticipate the feeling that comes along with smoking, while the reasons not to smoke disappear.

The Notion of Permanent Brain Damage

We now know that our brains are constantly evolving, even as adults. According to the old model of brain function, there were our formative years in early childhood and adolescence, after which, sometime in our twenties, we coasted and declined. Now we know that our brains continue to hone old pathways and activity and forge new ones long into adulthood. This is good news for everybody—old dogs not only can learn new tricks, they should, if they want to optimize their brain functioning—and it is especially good news for people affected by substance problems.

The Brain and a Broken Leg

Think of the brain like a broken leg. A bone breaks, and with help—a cast and crutches to prevent reinjury while the person returns to a normal routine, physical therapy to regain strength and flexibility, and family and friends to help and to keep up morale—the bone heals and the person can work, play, run, and jump again. The leg may be more vulnerable to breaking after all that, and the person will need to take care to protect it, but the person can adapt and, for the most part, the body heals. The brain is no exception. (p 31-32)

As you can see, the book is always hopeful, even in the face of an often brutal struggle. The rest of Section 1 focuses on 2. Motivation: Why Do People Change, and 3. Change: How Do People Change.

While addiction is a whole person struggle, knowing more about the brain/body component can be immensely helpful as you seek to help others. If you are a loved one who wants guidance with how to help someone who is struggling with addiction, or if you work with youth or are a pastor, I highly recommend this book.

Leadership and Emotional Intelligence

The reality of life is that your perceptions--right or wrong-- influence everything else you do. When you get a proper perspective of your perceptions, you may be surprised how many other things fall into place.
-- Dr. Roger W. Birkman 1919-2014

If you are connected on LinkedIn or any other leadership website or forum, you probably have noticed quite a bit of talk about Emotional Intelligence or EQ. EQ is a way of talking about two things:

1. Self-Awareness: How do I understand my own emotions and exercise self-control?
2. Other-Awareness: How do I understand others and interact in ways that are beneficial?

Both of these perspectives are critical for all relationships, but especially in the workplace where personalities can often clash with one another due to a lack of personal awareness and other awareness.

If you lead a church staff, work for an organization, or are in any relationships with people, growing in emotional intelligence should be a critical desire and goal. So, how do we begin to achieve that goal?

In a recent blog by Daniel Goleman, author of Emotional Intelligence, he gives these examples of a leader adjusting their leadership style to fit the need of the moment:

At 9 a.m., Emma met with a skilled team effective on day-to-day assignments but lacking a broader view of the company’s goals. She articulated a shared mission and the big picture, which got them motivated and headed in the right strategic direction.

At 10 a.m., she joined a group having a crisis after an overnight fire destroyed the warehouse of one of the company’s key suppliers. She knew that an emergency like this meant she needed to take a directive approach; she tasked group members to plan work-arounds and initiated a customer service response to manage delayed deliveries.

At 1 p.m., Emma headed to a session with a team that had lost most of its senior members after a recent wave of reassignments. She adopted a coaching role, helping the group recognize their missing skills and devising a way to quickly build the team’s capabilities.

By mid-afternoon Emma had already used three different leadership styles. To be an effective leader in today’s changing world, you need more than a one-size-fits-all approach to leadership. You must adjust your leadership style to face the challenges of the moment.

First, a quick review. Here are several leadership styles that produce a positive work climate and outstanding performance:

Visionary leaders articulate a shared mission and give long-term direction.
Participative leaders get consensus to generate new ideas and build commitment.
Coaching leaders foster personal and career development.
Affiliative leaders create trust and harmony.

In the short-term, directive leaders who simply give commands and pacesetters focused only on hitting targets (like the emergency situation Emma confronted) can be effective. In the long-term, however, such styles produce a negative climate and very poor performance.

In March of 2015, I pursued certification to use a tool called the Birkman Method to help leaders and teams grow in Emotional Intelligence. In addition to learning how to use this tool to help others, my training also allowed me to grow in greater self-awareness and learn how my own leadership style could be both productive and not so productive given the situation. I wished I had been exposed to this while I was in seminary preparing for leadership in ministry.

Humility is always an important key to good leadership. I have worked with dozens of pastors, leaders and staff to help them work better together.

Here are some practical outcomes that can emerge as a result of using the Birkman Method:

• Improve communication
• Increase management effectiveness
• Build cohesive teams and reduce conflict
• Improve sales
• Discover hidden potential of current employees for greater productivity
• Reduce turnover
• Develop accurate job descriptions

If you are interested in finding out more about the Birkman Method and what others are saying about how it has helped them and their teams, follow this link or click on the image to the right.

Copyright © 2017 Timothy S. Lane

Four Things That Could Be Hurting Your Marriage This Year

We all know what makes for a good marriage; a climate of grace, good communication, healthy disagreements resolved in ways that honor the other, forgiveness, empathy, good companionship and intimate sex. But are you as keen to spot the things that could be slowly destroying your marriage?

Most couples can usually intuitively tell that things aren’t right but often can’t name with specificity what is hurting their relationship. For more than four decades, John Gottman has done some significant research on what makes relationships work and what destroys those same relationships in his “Love Lab” located in Seattle, Washington. Through interviews, monitoring blood pressure, heart rates, amount of sweat and video-taped interactions between couples, Gottman and his associates have uncovered some obvious but illusive conclusions. Here is one:

The determining factor in whether wives feel satisfied with the sex, romance and passion in their marriages is, by 70%, the quality of the couple’s friendship. For men, the determining factor is, by 70%, the quality of the couple’s friendship. So men and women come from the same planet after all (p. 19)

Four Marriage Defeaters

Since friendship is so important, Gottman has sought to find out what hinders and helps couples develop that friendship or what he calls “attunement.” In one section, he specifies four things that negatively impact the friendship. He calls them “the four horsemen of the apocalypse.” They are:

1. Criticism: Gottman says that there is a difference between a complaint and a criticism. All marriages have complaints. It’s when a complaint turns into a criticism that indicates something serious is going wrong. A complaint focuses on a specific behavior. “I’m really upset that you didn’t call to let me know you were going to be late. Going forward, can you please let me know?” That is a complaint. It has 3 parts: 1. How you feel (I’m really upset); 2. About a specific behavior (You did not call to let me know you were going to be late) 3. And here is what I need/want/prefer (Could you please call going forward?). Gottman defines the difference between a complaint and criticism: In contrast, a criticism is global and expresses negative feelings or opinions about the other’s character or personality (p.33). Criticism is an attack on one’s character. It is much more severe in its conclusions. It sounds like this, “You are always late. You never give me a heads up. You are always just thinking about your schedule and your needs!” Can you see how criticism can destroy your marriage?
   

2. Contempt: Gottman says that “the second horseman arises from a sense of superiority over one’s partner. It is a form of disrespect.” He goes on to say that “sarcasm, cynicism...name-calling, eye-rolling, mockery and hostile humor are all forms of contempt. In whatever form, contempt is poisonous to a relationship because it conveys disgust. It’s virtually impossible to resolve a problem when your partner is getting the message you’re disgusted with him or her. Inevitably, contempt leads to more conflict rather than reconciliation (p.34).”
   

3. Defensiveness: While it may make sense that you would want to defend yourself in the face of criticism and contempt, Gottman says that “research shows that this approach rarely has the desired effect. The attacking spouse does not back down or apologize. This is because defensiveness is really a way of blaming your partner. You’re saying, in effect, ‘The problem isn’t me, it’s you.’” There is a difference between healthy disagreement which leads to helpful resolution and Gottman’s definition of defensiveness. He spends most of his time helping couples engage with one another.
   

4. Stonewalling: the fourth horseman, stonewalling. is when one or both give up and just walk away and go silent. Gottman says, “criticism, contempt, and defensiveness don’t always gallop into a home in strict order. They function more like a relay match--handing the baton off to each other over and over again if the couple can't put a stop to it (p.37). The final horseman indicates that the couple has stopped trying and is moving away from one another. Stonewalling usually arrives later in a marriage. That’s why you may not see it in a newly married couple but you can spot it in a couple who has been married for a longer period of time.”

The Four Horsemen and James 4

John Gottman has done countless marriages a big favor through his research and writings. I have seen this in my own marriage as well as others I have counseled and taught. His observations bring specificity and concreteness to what thoughts and behaviors are at work in a marriage that is not growing. These observations alone can help a couple move away from letting the four horseman into their relationship. And yet, Scripture gives us an even deeper diagnosis. In James 4:1-3, it says that we fight and quarrel because of “desires that battle within us.” Criticism, contempt, defensiveness and stonewalling are tied to deeper motives that are driven by a heart that has strayed from God. What needs to be addressed includes thinking and behavior but also matters of core commitments. This is where the grace of God breaks in and rescues us from ourselves and others from us!

Gottman and the Gospel

The Seven Principles for Making Marriage Work: A Practical Guide from the Country's Foremost Relationship Expert

By Gottman PhD, John, Silver, Nan

Buy on Amazon

What are we to make of this? Gottman helps us discern what specific thoughts and behaviors look like when a marriage is either growing or dying. These insights can be wonderfully freeing for the more relationally obtuse! And yet, the Scriptures gives us more. In the Bible, we meet a God of grace who treats us in the exact opposite ways from the four horsemen. Jesus comes to seek and save. Romans 5:8 says that, “while we were still sinners, Christ died for us.” He comes to redeem what is most broken in us; hearts that have strayed from God. When that takes place, there is a whole new dimension to life and change that enables us to follow Jesus’ example and to say no to criticism, contempt, defensiveness and stonewalling. Instead, we can move towards one another with gentleness, encouragement and grace because this is how Jesus, our Bridegroom, has moved towards you and me.

For further reading about John Gottman and his work, the following book will serve as a helpful introduction.

Copyright © 2016 Timothy S. Lane

What Should We Make of Personality Disorders?

What does the average pastor do when confronted with someone who exhibits troubling behavior that disrupts relationships and creates bedlam in the church? Unfortunately, because training for these types of issues is minimal, the response can create more problems. These types of inflexible thinking and behaviors have been placed into a modern category called Personality Disorders.

What is a personality disorder? Here is a definition from Chuck DeGroat’s book, Toughest People to Love:

Experts define a personality disorder as an "enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment." In theological terms, personality disorders reflect that long-term and chronic relational pattern Martin Luther describes as "homo incurvatus in se" – "people turned in on themselves (p. 46)."

Another way of defining these patterns is found in Allen Frances’ book Essentials of Psychiatric Diagnosis: Responding to the Challenges of DSM-5:

Our characters strongly influence our fate. How we see the world and respond to it very much determines how the world sees and responds to us. “Personality” is an enduring pattern of thinking, feeling, interacting, and behaving that is who we are; it provides the texture of our relations with other people. Personality Disorders cause vicious cycles of negative expectation and self-fulfilling prophecies. Normal personality traits become Personality Disorders when they are inflexible and make people unable to adapt to the needs of the moment. The diagnosis of a Personality Disorder is made only if the resulting problems cause clinically significant distress or impairment (p.131).

Note the emphasis on inflexible and unable to adapt. For someone with a personality disorder, their normal personality has been geared to see and do life through a single lens (schemas) which incapacitates them from thinking and behaving differently according to the situation. The cause is not fully known, but most say that it is a combination of biological and situational factors. Situational factors can include some kind of childhood trauma.

Frances offers a very simple but helpful diagnostic question to determine if you or another person suffers with a Personality Disorder:

“Do you have a style of doing things and relating to people that gets you into the same kind of mess over and over again?”

The DSM-4-TR has 3 clusters that I find more helpful than the more current DSM-5:

• Cluster A. Odd/Eccentric: paranoid, schizoid, and schizotypal personality disorders.
• Cluster B. Dramatic/Emotional/Erratic: antisocial, borderline, narcissistic, and histrionic personality disorders.
• Cluster C. Anxious/Fearful: avoidant, dependent, obsessive-compulsive personality disorders.

These were classified as Axis II disorders along with the developmental disorders. The most recent DSM-5 offers 12 different types of Personality Disorders:

1. Borderline Personality Disorder
2. Antisocial Personality Disorder
3. Narcissistic Personality Disorder
4. Histrionic Personality Disorder
5. Obsessive-Compulsive Personality Disorder
6. Avoidant Personality Disorder
7. Dependent Personality Disorder
8. Paranoid Personality Disorder
9. Schizoid Personality Disorder
10. Schizotypal Personality Disorder
11. Personality Disorder Due to Another Medical Condition
12. Unspecified Personality Disorder

Allen Frances also provides a basic definition and description of each that is worth considering. The ultimate goal is not to find labels for people but to understand them so that you might engage in skillful ministry.

The Implications for Local Church Ministry

It doesn’t take long to serve in a leadership capacity in ministry to see these traits in certain congregants. Statistics reveal that about 10% of the population fit the various categories of personality disorders. That means that leaders need to be exposed to and aware of these various forms of struggle. It is necessary to be aware of these issues because, unfortunately, it is not uncommon for these individuals to do great harm in churches, either as leaders or attenders.

In DeGroat’s book, he highlights four of the personality disorders that are most troublesome and are often the reason many leave the ministry (p. 46-47). They include Narcissistic, Borderline, Obsessive-Compulsive and Histrionic Personality Disorders. Below are DeGroat’s descriptions of each:

Borderline Personality Disorder: the volunteer who spent years praising and supporting you, only to viciously turn on you, sending critical emails to everyone in the church.

Obsessive-Compulsive Personality Disorder: the nagging parishioner who gives a lot but pesters you with daily emails asking for specific details about the organization’s accounting. She is unable to see her own obsessiveness or to realize that her emails cause you anxiety and give you heartburn.

Narcissistic Personality Disorder: the power broker who intimidates you after you challenge him in a marital counseling session, demanding to see your notes from each session and threatening to get a lawyer to investigate you and the church.

Histrionic Personality Disorder: the leader who seems to ooze drama and is a magnet for each and every crisis in your church.

To these four, I would add one more:

Antisocial Personality Disorder (psychopath/sociopath): We typically relegate this category to serial killers but antisocial congregants often do their “killing” in other ways. These individuals are very adept at pairing off with others to breed suspicion and mistrust within a church in an effort to “kill” a leader.

Wisdom and Love

The call of every leader is pastoral care that incarnates the love of Christ. This is to be combined with great wisdom. In Matthew 10:16, as Jesus prepares the disciples to go and do ministry, he says, “be as shrewd as snakes and as innocent as doves.” In other words, as you go about your work as a pastor be aware that troubled people are in your midst. Don’t be paranoid but wise. Don’t be antagonistic but be wise in the way you interact with everyone.

Finally, as pastors and spiritual leaders encounter troubled people, be aware of the fact that some are uniquely challenging. Mark Yarhouse has this to say in his helpful resource Modern Psychopathologies: A Comprehensive Christian Appraisal:

The pastoral or leadership team also needs to be fully informed about problematic behaviors so there will be no manipulation or conning (Miller and Jackson 1995). Processing (debriefing and defusing) strong feelings of ambivalence and confusion, even anger and intense frustration, is often necessary. Further education about personality disorders, coupled with good professional consultation, can also be helpful. Ideally, they can help the pastoral or leadership team attack the problem(s) rather than the person (which would alienate or isolate those directly affected). In the long run, such an approach is much more helpful than to spiritualize the problem or to offer religious interventions that are misinformed about the painful realities of rigid, inflexible patterns of relating (p.285).

In short, pastors, elders, deacons and leaders in local churches need to find those who can help them grow in wisdom as they pastor and shepherd the flock. This is a short blog raising big issues and questions. What would you add to this conversation? I would love to hear your thoughts.

Copyright © 2015 Timothy S. Lane

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Resources mentioned:

• Toughest People to Love by Chuck DeGroat
• Essentials of Psychiatric Diagnosis: Responding to the Challenges of DSM-5 by Allen Frances
• Modern Psychopathologies: A Comprehensive Christian Appraisal by Mark Yarhouse

Is Worry Making Us Sick?

Any quick search in Google or Amazon will confirm what we all already know; worry is harmful to our bodies. Here are a few physical symptoms associated with worry:

• Difficulty swallowing
• Dizziness
• Dry mouth
• Fast heartbeat
• Fatigue
• Headaches
• Muscle aches
• Muscle tension
• Nausea
• Rapid breathing
• Sweating
• Trembling and twitching

You can almost get exhausted and anxious reading that list. All of these can be experienced to varying degrees depending on how severe your worry is. Most of you can probably identify many of these as you reflect on an anxiety-producing experience in your life.

Unfortunately, this is not the only way we are impacted by worry. If not addressed, it can have a bigger impact on your overall health. People who worry consistently are more prone to the following physical consequences:

• Suppression of the immune system
• Digestive disorders
• Short-term memory loss
• Premature coronary artery disease
• Heart attack

In light of this, it is not surprising when we discover the original meanings of the words we use today to talk about worry and anxiety. The English word “worry” comes from the Old English word meaning “strangle.” The word “anxiety” is of Indo-Germanic origin referring to suffering from narrowing, tightening feelings in the chest or throat.

Statistics reveal that nearly 20% of people living in the United States will experience life debilitating anxiety annually. That is nearly 65 million people! In 2008, American physicians wrote more than 50 million prescriptions for anti-anxiety medications and more than 150 million prescriptions for antidepressants, many of which were used for anxiety-related conditions. It is no over-statement to say that we have a problem of epidemic proportions.

What Would Your Doctor Say?

Physicians and counselors will tell you that diet, exercise, rest and some kind of meditation is a proven help when you are struggling with anxiety. Sometimes medication, when taken wisely, can be helpful. You can use your body to fight what is actually trying to undermine it. No one can deny that. But is there another part of dealing with worry that we need? While these things are important, we also need to know how to connect to God when our worries come. We need God’s grace even if we are going to pursue exercise and diet in a way that is most helpful.

Let’s consider the most fundamental aspect that must under-gird everything else we do when taking care of our bodies.

What Would Jesus Say?

Jesus lived at a time in human history that was very unpredictable and less safe than ours. It was a world in which worry was epidemic, too. In every instance where he encouraged people not to worry, he did so with compassion because he knew first-hand what it felt like to be a human being. In Luke 12:32, he spoke these encouraging words to anxious people, Do not be afraid, little flock, for your Father has been pleased to give you the kingdom. Those simple words sum up all that Jesus said over and over again. He commands them not to worry, but his command is one of encouragement, not shame. Let’s consider these simple but profound phrases:

Do Not be Afraid

Jesus knows that worry is a serious problem. He knows it is bad for you physically, as well as spiritually, and he gets right to the point because he loves you. His commands are always for your good. Whenever you are struggling with worry, it is connected to your relationship with God. The word “worry” that Jesus uses means “a divided mind.” Within the broader context of his teaching, Jesus says that worry happens when you try to love God and something in creation at the same time. As soon as you do this, you have begun to put your hope and security in something other than God. Anything else besides God is unstable (money, a relationship, a job, education, your own moral record, obedient children, your health). Do you see why Jesus is so straightforward? He cares for you. He knows that you can’t serve two masters (Matthew 6:24).

Little Flock

At the same time that Jesus speaks strong but encouraging words, he does so with a tone that is tender in its toughness, and compassionate in its candor. Don’t let this little phrase that Jesus utters evade you. Don’t miss those two powerful words: little flock. While Jesus challenges you to not worry or fear, he speaks to you as one who belongs to him, whom he is shepherding and for whom he laid down his life. You are unimaginably dear to him and loved by him. You are one of his sheep. Be reassured—he cares for you and loves you even as you struggle with worry, even as you forget him and his care, and give in to your tendency to worry. You may be prone to wander, but you will always be part of his flock.

For Your Father Has Been Pleased to Give You the Kingdom

If the promise of Jesus’ tender care is not enough, he adds something more! Your Father is not only going to care for you now, he is in the process and will ultimately give you His kingdom. Your future is certain and you can begin to experience it even now because His kingdom has broken into your life by the presence of the Holy Spirit. He is a deposit guaranteeing that you will get it all one day. So, right now, in the ups and downs of life, the stresses and strains of the uncertain future, let the certainty of your eternal future be what you cling to.

With all of this in mind, allow the truth of God’s care for you to work its way into your daily life. We are to prioritize the kingdom by viewing everything through the lens of our faith. When you begin to live for God instead of the things of the world, you may find that your tendency to worry will lessen and your response to God and to the world, spiritually and physically, will change dramatically.

Copyright © 2015 Timothy S. Lane

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This is an adapted excerpt from Tim’s latest book, Living Without Worry, which can be purchased through The Good Book Company or on Amazon.