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My patient Michael drank socially for 15 years and was able to do so in moderation. But then something changed.
“I got a huge promotion at work and was managing a lot of people,” he told me in our session. “I was dealing with a lot of stress, so I drank more at night to take the edge off, and I started drinking during the day on weekends to get myself into a better mood.”
He sighed, “I told myself I was doing it for the family.”
Each person’s journey into substance abuse is different, but one thing many people with substance use disorder (SUD) have in common is using substances to manage to numb negative emotions. Indeed, people with substance use issues often experience more negative emotions and less positive ones. Therefore, for their recovery to succeed, it would be beneficial for them to learn how to manage and regulate negative emotions and how to enhance positive ones. The question is: Do substance abuse treatments address emotional management in a comprehensive way and give people the tools to manage negative emotions and enhance positive ones?
A new study by Kang and colleagues at the University of Illinois at Urbana-Champaign looked into this question by doing a meta-analysis (a statistical method of combining the results of many studies) of behavioral SUD interventions on emotional outcomes. While only some of the studies were specifically designed to assess emotional outcomes, those that did focused on emotional regulation and mindfulness-based interventions. As a group, those studies demonstrated significant reductions in negative emotions. There were too few studies focused on positive emotion outcomes to draw strong conclusions.
The takeaways here are significant. Given how fundamentally emotional distress factors into the development and maintenance of substance abuse disorders, participants would benefit from having emotional management and regulation being included as essential elements of their recoveries. While it is unclear how many treatment programs include such modules and to what extent, many of those who come out of treatment programs sober struggle to maintain sobriety once they reengage in their lives. Providing them with actual tools to moderate negative emotions and enhance positive emotions could help their chances of success.
When I met Michael, he had already "graduated" from several treatment programs and relapsed repeatedly. What finally made the difference for him was paying attention to his emotions and their valence, learning specific emotional regulation and mindfulness techniques to manage his emotions, practicing these methods, and incorporating them into his daily routines.
To be clear, I am not suggesting that emotional management is a panacea. But it is a component of recovery programs that is not always sufficiently emphasized. Therefore, when inquiring about inpatient treatment programs for substance abuse, ask whether they have modules that address emotional management and regulation and whether they teach how to practice and implement these skills in daily life. And when attending outpatient programs that lack such a component, consider acquiring these skills on a supplemental basis.
Copyright 2019 Guy Winch
