Advise patients to stop comparing

We all compare ourselves to others. It’s a natural part of being human. As social creatures, we observe others to better understand how we fit into our environment, our peer group, our workplace, our family.

This is also a way to learn. We can emulate behaviors that seem to work for others, particularly if we feel lacking in those skills. But for individuals with an addiction, comparing can get in the way of recovery.

Judging others harshly

This occurs when our patient focuses on people worse off than him—saying in effect, “I’m not as bad as so-and-so.” For newcomers, this behavior can keep a person in the precontemplative stage of change, rendering him unable to connect his circumstances with his drug use.

For those with longer-term sobriety, judging others is an invitation to complacency. (“I’ve got this handled. I don’t have cravings anymore. I wasn’t that bad.”) Addiction professionals must remind overconfident patients to remain focused on their side of the street, and to avoid becoming distracted by others' behaviors.

Judging others harshly also can lead to gossiping (a very bad habit) and not recognizing the good characteristics of the person we’re criticizing. At this point, we should encourage our patient to think more kindly toward people less fortunate—to go out of his way to help those in need. There’s nothing like the “gift of giving” to make a person feel humble.

Judging oneself harshly

Here, our patient focuses on the strengths of others, often with envy. People with an addiction are notoriously hard on themselves, using phrases such as, “I never fit in. I always felt less than. I’m just a loser.” The stigma of addiction delivers shame and guilt, even though we’re dealing with a brain disease and not a moral failing.

It is not surprising that many patients have low self-esteem, particularly if they have been hearing criticism since they were toddlers. The consequences of their addictive behavior only reinforce the mistaken idea that they are lacking in willpower, intellect or maturity. And media (programming and advertising) continues to promote images of beautiful people socializing joyfully (often with alcohol), driving nice cars, wearing the right clothes, etc.

This is a pivotal time for our patients. Emotions are raw, confusion reigns and the messages they receive are often conflicting. It also may be the patient's first time socializing without drugs. It's no wonder they’ll be comparing to others.

It’s not a competition

Although group therapy and self-help meetings are wonderful forums for recovery, they also are a potent breeding ground for unhealthy comparisons. It is here where our patient will listen to another addict tell his “drunkalog” with funny stories and compelling circumstances. Unfortunately, some speakers romanticize arrests, jail time, lost careers and relationships. When this happens, our patient may question if he really belongs, saying things such as, “My stories aren’t as entertaining. I’m not a low-bottom drunk. I’m a lousy public speaker.”

A very important message for patients: The one thing people in recovery have in common is pain. It’s not about the number of arrests, detoxes or barroom brawls a person has accumulated. It’s about the pain—and we can’t quantify pain. No one comes into recovery on the wings of victory. The man who appears to be completely serene could be ready to jump off a bridge. The woman with a “happy marriage” may be on the verge of a heartbreaking divorce.

Another area of comparison is length of sobriety. The “one day at a time” approach is useful here. People with decades of sobriety can, and do, relapse. Ironically, a newcomer might be better able to relate to someone with short-term sobriety than with a long-timer. People in recovery learn from each other, regardless of length of sobriety.

Positive psychology

We need to find praiseworthy attributes in our patients, and to mention those accomplishments often and with sincerity. It's really not that difficult to do. However, disingenuous praise can do more harm than good. Our patients usually are quite skilled at recognizing BS.

Often, I’ll say to a patient: “You made it through high school! You played clarinet in the school band! You helped your mother raise your younger siblings! Your drawings are fabulous!” But I’ll say these things only if I really mean it.

As addiction professionals, our job is to demystify the idea of life without drugs, to demolish the thought that willpower will keep a person sober, and to guide our patient as she struggles to find her place in the recovery community. She doesn’t have to be a charismatic speaker (she doesn’t even have to speak if she doesn’t want to.) She just needs to accept herself as she is—a sick person trying to be well—and to chase recovery with energy, humor and an open mind.

The most valuable skill our clients can learn is to identify with the feelings shared by others in recovery, but not to compare the stories. Your patient’s story is her own story. If and when she’s willing to share her story, it’s likely that someone in the room will be helped by what is being said.

Brian Duffy, LMHC, LADC-I, is a mental health counselor at SMOC Behavioral Healthcare in Framingham Mass. His recent articles addressed the “chaos habit” as well as how to share secrets. Duffy's email address is bduffy@smoc.org.