Addiction Treatment Homework Planner E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: Practice Planners
• Sprache: Englisch

Seitenzahl: 465

Veröffentlichungsjahr: 2017

Beschreibung

Help clients suffering from chemical and nonchemical addictions develop the skills they need to work through problems. The Addiction Treatment Homework Planner, Fifth Edition provides you with an array of ready-to-use, between-session assignments designed to fit virtually every therapeutic mode. This easy-to-use sourcebook features: * 100 ready-to-copy exercises covering the most common issues encountered by clients suffering from chemical and nonchemical addictions, such as anxiety, impulsivity, childhood trauma, dependent traits, and occupational problems * A quick-reference format--the interactive assignments are grouped by behavioral problems including alcoholism, nicotine dependence, and sleep disturbance as well as those problems that do not involve psychoactive substances, such as problem gambling, eating disorders, and sexual addictions * Expert guidance on how and when to make the most efficient use of the exercises * Assignments that are cross-referenced toThe Addiction Treatment Planner, Fifth Edition so you can quickly identify the right exercise for a given situation or problem * All exercises are available online for you to download and customize to suit you and your clients' unique styles and needs

Leseprobe

Table of Contents

Cover

Title Page

WILEY PRACTICE

PLANNERS®

SERIES PREFACE

PREFACE

USING THIS BOOK

SECTION 1: ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS

EXERCISE 1.A: ADDRESSING ACA TRAITS IN RECOVERY

EXERCISE 1.B: UNDERSTANDING FAMILY HISTORY

SECTION 2: ANGER

EXERCISE 2.A: IS MY ANGER DUE TO FEELING THREATENED?

EXERCISE 2.B: IS MY ANGER DUE TO UNMET EXPECTATIONS?

SECTION 3: ANTISOCIAL BEHAVIOR

EXERCISE 3.A: BENEFITS OF HELPING OTHERS

EXERCISE 3.B: TAKING INVENTORY OF DESTRUCTIVE BEHAVIORS

SECTION 4: ANXIETY

EXERCISE 4.A: ANXIETY TRIGGERS AND WARNING SIGNS

EXERCISE 4.B: COPING WITH STRESS

SECTION 5: ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)—ADOLESCENT

EXERCISE 5.A: DEVELOPING A RECOVERY PROGRAM

EXERCISE 5.B: STAYING ATTENTIVE AND OTHER NEGOTIATING SKILLS

SECTION 6: ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)—ADULT

EXERCISE 6.A: FROM RECKLESSNESS TO CALCULATED RISKS

EXERCISE 6.B: GETTING ORGANIZED

EXERCISE 6.C: SELF-SOOTHING: CALM DOWN, SLOW DOWN

SECTION 7: BIPOLAR DISORDER

EXERCISE 7.A: EARLY WARNING SIGNS OF MANIA/HYPOMANIA

EXERCISE 7.B: MANIA, ADDICTION, AND RECOVERY

SECTION 8: BORDERLINE TRAITS

EXERCISE 8.A: FORMING STABLE RELATIONSHIPS

EXERCISE 8.B: SEEING THAT WE’RE ALL JUST HUMAN

SECTION 9: CHILDHOOD TRAUMA

EXERCISE 9.A: CORRESPONDING WITH MY CHILDHOOD SELF

EXERCISE 9.B: SETTING AND MAINTAINING BOUNDARIES

SECTION 10: CHRONIC PAIN

EXERCISE 10.A: COPING WITH ADDICTION AND CHRONIC PAIN

EXERCISE 10.B: MANAGING PAIN WITHOUT ADDICTIVE DRUGS

SECTION 11: CONDUCT DISORDER/DELIQUENCY

EXERCISE 11.A: HOW DO YOU DO THAT?

EXERCISE 11.B: TRADING PLACES

SECTION 12: DANGEROUSNESS/LETHALITY

EXERCISE 12.A: ANGER AS A DRUG

EXERCISE 12.B: MANAGING RISK

SECTION 13: DEPENDENT TRAITS

EXERCISE 13.A: BUILDING MY SUPPORT NETWORK

EXERCISE 13.B: HOW INTERDEPENDENT AM I?

SECTION 14: EATING DISORDERS AND OBESITY

EXERCISE 14.A: CREATING A PRELIMINARY EATING AND HEALTH PLAN

EXERCISE 14.B: EATING PATTERNS SELF-ASSESSMENT

SECTION 15: FAMILY CONFLICTS

EXERCISE 15.A: CREATING POSITIVE FAMILY RITUALS

EXERCISE 15.B: IDENTIFYING CONFLICT THEMES

SECTION 16: GAMBLING

EXERCISE 16.A: CONSEQUENCES AND BENEFITS

EXERCISE 16.B: UNDERSTANDING NONCHEMICAL ADDICTIONS

SECTION 17: GRIEF/LOSS UNRESOLVED

EXERCISE 17.A: AM I HAVING DIFFICULTY LETTING GO?

EXERCISE 17.B: MOVING ON AFTER LOSS

EXERCISE 17.C: WHAT WOULD THEY WANT FOR ME?

SECTION 18: IMPULSIVITY

EXERCISE 18.A: HANDLING CRISIS WITHOUT IMPULSIVITY

EXERCISE 18.B: LEARNING TO THINK THINGS THROUGH

SECTION 19: LEGAL PROBLEMS

EXERCISE 19.A: HANDLING TOUGH SITUATIONS IN A HEALTHY WAY

EXERCISE 19.B: WHAT’S ADDICTION GOT TO DO WITH MY PROBLEMS?

SECTION 20: LIVING ENVIRONMENT DEFICIENCY

EXERCISE 20.A: ASSESSING MY ENVIRONMENT

EXERCISE 20.B: WHAT WOULD MY IDEAL LIFE LOOK LIKE?

SECTION 21: MEDICAL ISSUES

EXERCISE 21.A: COPING WITH ADDICTION AND OTHER MEDICAL PROBLEMS

EXERCISE 21.B: PHYSICAL AND EMOTIONAL SELF-CARE

SECTION 22: NARCISSISTIC TRAITS

EXERCISE 22.A: BEING GENUINELY UNSELFISH

EXERCISE 22.B: GETTING OUT OF MYSELF

SECTION 23: NICOTINE USE/DEPENDENCE

EXERCISE 23.A: ASSESSING READINESS AND PREPARING TO QUIT

EXERCISE 23.B: ADDRESSING RELAPSE TRIGGERS

EXERCISE 23.C: USE OF AFFIRMATIONS FOR CHANGE

SECTION 24: OBSESSIVE-COMPULSIVE DISORDER (OCD)

EXERCISE 24.A: INTERRUPTING COMPULSIVE THOUGHTS AND URGES

EXERCISE 24.B: REDUCING COMPULSIVE BEHAVIORS

SECTION 25: OCCUPATIONAL PROBLEMS

EXERCISE 25.A: INTEREST AND SKILL SELF-ASSESSMENT

EXERCISE 25.B: WORKPLACE PROBLEMS AND SOLUTIONS

SECTION 26: OPPOSITIONAL DEFIANT BEHAVIOR

EXERCISE 26.A: ANALYZING ACTING-OUT BEHAVIOR

EXERCISE 26.B: LEARNING TO ASK INSTEAD OF DEMAND

SECTION 27: PARENT–CHILD RELATIONAL PROBLEM

EXERCISE 27.A: AM I TEACHING MY CHILD ADDICTIVE PATTERNS?

EXERCISE 27.B: WHAT DO I WANT FOR MY CHILDREN?

SECTION 28: PARTNER RELATIONAL CONFLICTS

EXERCISE 28.A: COMMUNICATION SKILLS

EXERCISE 28.B: RELATIONSHIP ASSESSMENT

SECTION 29: PEER GROUP NEGATIVITY

EXERCISE 29.A: CREATING RECOVERY PEER SUPPORT

EXERCISE 29.B: WHAT DO I NEED AND HOW DO I GET IT?

SECTION 30: POSTTRAUMATIC STRESS DISORDER (PTSD)

EXERCISE 30.A: COPING WITH ADDICTION AND PTSD OR OTHER ANXIETY DISORDERS

EXERCISE 30.B: SAFE AND PEACEFUL PLACE MEDITATION

SECTION 31: PSYCHOSIS

EXERCISE 31.A: COPING WITH ADDICTION AND SCHIZOPHRENIA SPECTRUM DISORDERS

EXERCISE 31.B: PLANNING A STABLE LIFE

SECTION 32: RELAPSE PRONENESS

EXERCISE 32.A: EARLY WARNING SIGNS OF RELAPSE

EXERCISE 32.B: IDENTIFYING RELAPSE TRIGGERS AND CUES

EXERCISE 32.C: RELAPSE PREVENTION PLANNING

SECTION 33: SELF-CARE DEFICIT AS A PRIMARY PROBLEM

EXERCISE 33.A: ASSESSING SELF-CARE DEFICITS

EXERCISE 33.B: RELATING SELF-CARE DEFICITS TO MY ADDICTION

SECTION 34: SELF-CARE DEFICIT AS A SECONDARY PROBLEM

EXERCISE 34.A: FILLING IN SELF-CARE GAPS

EXERCISE 34.B: WORKING TOWARD INTERDEPENDENCE

SECTION 35: SELF-HARM

EXERCISE 35.A: UNDERSTANDING SELF-HARM AND ADDICTION

EXERCISE 35.B: SELF-HARM RISK FACTORS, TRIGGERS, AND EARLY WARNING SIGNS

SECTION 36: SEXUAL ABUSE

EXERCISE 36.A: IT WASN’T MY FAULT

EXERCISE 36.B: INTERNAL AND EXTERNAL RESOURCES FOR SAFETY

SECTION 37: SEXUAL PROMISCUITY

EXERCISE 37.A: IS IT ROMANCE OR IS IT FEAR?

EXERCISE 37.B: WORKING THROUGH SHAME

SECTION 38: SLEEP DISTURBANCE

EXERCISE 38.A: ASSESSING SLEEP PROBLEMS

EXERCISE 38.B: IMPROVING SLEEP HYGIENE

SECTION 39: SOCIAL ANXIETY

EXERCISE 39.A: UNDERSTANDING THOUGHTS, WORRIES, AND FEARS

EXERCISE 39.B: ACTION PLAN TO ADDRESS SOCIAL ANXIETY

SECTION 40: SPIRITUAL CONFUSION

EXERCISE 40.A: UNDERSTANDING SPIRITUALITY

EXERCISE 40.B: FINDING A HIGHER POWER THAT MAKES SENSE

SECTION 41: SUBSTANCE-INDUCED DISORDERS

EXERCISE 41.A: USING MY SUPPORT NETWORK

EXERCISE 41.B: EXPLORING TREATMENT AND RECOVERY OPTIONS

SECTION 42: SUBSTANCE INTOXICATION/WITHDRAWAL

EXERCISE 42.A: COPING WITH POST-ACUTE WITHDRAWAL (PAW)

EXERCISE 42.B: USING BOOKS AND OTHER MEDIA RESOURCES

SECTION 43: SUBSTANCE USE DISORDERS

EXERCISE 43.A: CONSEQUENCES OF CONTINUING ADDICTIVE LIFESTYLES

EXERCISE 43.B: ALTERNATIVES TO ADDICTIVE BEHAVIOR

EXERCISE 43.C: PERSONAL RECOVERY PLANNING

EXERCISE 43.D: TAKING DAILY INVENTORY

EXERCISE 43.E: MAKING CHANGE HAPPEN

EXERCISE 43.F: BALANCING RECOVERY, FAMILY, AND WORK

SECTION 44: SUICIDAL IDEATION

EXERCISE 44.A: PROBLEM SOLVING AND SAFETY PLANNING

EXERCISE 44.B: WHY DO I MATTER AND WHO CARES?

SECTION 45: TREATMENT RESISTANCE

EXERCISE 45.A: ADDRESSING READINESS AND MOTIVATION

EXERCISE 45.B: PROBLEM IDENTIFICATION: IS IT ADDICTION?

SECTION 46: UNIPOLAR DEPRESSION

EXERCISE 46.A: CORRECTING DISTORTED THINKING

EXERCISE 46.B: GRATITUDE

APPENDIX A: ALTERNATE ASSIGNMENTS FOR PRESENTING PROBLEMS

APPENDIX B: SUGGESTED BIBLIOTHERAPY

APPENDIX C: ALPHABETICAL INDEX OF EXERCISES

ABOUT THE AUTHORS

ABOUT THE DOWNLOADABLE ASSIGNMENTS

End User License Agreement

Guide

Cover

Table of Contents

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Wiley PracticePlanners® Series

Treatment Planners

The Complete Adult Psychotherapy Treatment Planner, Fifth Edition

The Child Psychotherapy Treatment Planner, Fifth Edition

The Adolescent Psychotherapy Treatment Planner, Fifth Edition

The Addiction Treatment Planner, Fifth Edition

The Continuum of Care Treatment Planner

The Couples Psychotherapy Treatment Planner, with DSM-5 Updates, Second Edition

The Employee Assistance Treatment Planner

The Pastoral Counseling Treatment Planner

The Older Adult Psychotherapy treatment Planner with DSM-5 Updates, Second Edition

The Behavioral Medicine Treatment Planner

The Group Therapy Treatment Planner

The Gay and Lesbian Psychotherapy Treatment Planner

The Family Therapy Treatment Planner, with DSM-5 Updates, Second Edition

The Severe and Persistent Mental Illness Treatment Planner, with DSM-5 Updates, Second Edition

The Mental Retardation and Developmental Disability Treatment Planner

The Social Work and Human Services Treatment Planner

The Crisis Counseling and Traumatic Events Treatments Planner, with DSM-5 Updates, Second Edition

The Personality Disorders Treatments Planner

The Rehabilitation Psychology Treatment Planner

The Special Education Treatment planner

The Juvenile Justice and Residential Care Treatment Planner

The School Counseling and School Social Work Treatment Planner, with DSM-5 Updates, Second Edition

The Sexual Abuse Victim and Sexual Offender Treatment Planner

The Probation and Parole Treatment Planner

The Psychopharmacology Treatment Planner

The Speech-Language Pathology Treatment Planner

The Suicide and Homicide Treatment Planner

The College Student Counseling Treatment Planner

The Parenting Skills Treatment Planner

The Early Childhood Intervention Treatment Planner

The Co-Occurring Disorders Treatment Planner

The Complete Women’s Psychotherapy Treatment Planner

The Veterans and Active Duty Military Psychotherapy Treatment Planner, with DSM-5 Updates

Progress Notes Planners

The Child Psychotherapy Progress Notes Planner, Fifth Edition

The Adolescent Psychotherapy Progress Notes Planner, Fifth Edition

The Adult Psychotherapy Progress Notes Planner, Fifth Edition

The Addiction Progress Notes Planner, Fifth Edition

The Severe and Persistent Mental Illness Progress Notes Planner, Second Edition

The Couples Psychotherapy Progress Notes Planner, Second Edition

The Family Therapy Progress Notes Planner, Second Edition

The Veterans and Active Duty Military Psychotherapy Progress Notes Planner

Homework Planners

Couples Therapy Homework Planner, Second Edition

Family Therapy Homework Planner, Second Edition

Grief Counseling Homework Planner

Group Therapy Homework Planner

Divorce Counseling Homework Planner

School Counseling and School Social Work Homework Planner, Second Edition

Child Therapy Activity and Homework Planner

Addiction Treatment Homework Planner, Fifth Edition

Adolescent Psychotherapy Homework Planner, Fifth Edition

Adult Psychotherapy Homework Planner, Fifth Edition

Child Psychotherapy Homework Planner, Fifth Edition

Parenting Skills Homework Planner

Veterans and Active Duty Military Psychotherapy Homework Planner

Client Education Handout Planners

Adult Client Education Handout Planner

Child and Adolescent Client Education Handout Planner

Couples and Family Client Education Handout Planner

Complete Planners

The Complete Depression Treatment and Homework Planner

The Complete Anxiety Treatment and Homework Planner

Wiley PracticePlanners®

Addiction Treatment Homework Planner

Fifth Edition

James R. FinleyBrenda S. Lenz

Cover image: © Ryan McVay/Getty Images

Cover design: Wiley

Copyright © 2014 by James R. Finley and Brenda S. Lenz. All rights reserved.

Published by John Wiley & Sons, Inc., Hoboken, New Jersey

Published simultaneously in Canada

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Library of Congress Cataloging-in-Publication Data:

Finley, James R., 1948 – author.

Addiction treatment homework planner/James R. Finley and Brenda S. Lenz.–Fifth edition.

1 online resource.–(PracticePlanners series)

Includes bibliographical references.

Description based on print version record and CIP data provided by publisher; resource not viewed.

ISBN 978-1-119-27804-7 (pbk), 978-1-119-27806-1 (ePub), 978-1-119-27805-4 (ePDF)

1. Substance abuse–Treatment–Handbooks, manuals, etc. 2. Substance abuse–Treatment–Planning. I. Lenz, Brenda S., author. II. Title.

RC564.15

616.86'06–dc23

                                                                      2013039176

For Matthew Raymond Hernandez—budding artist, dreamer, beloved grandson—you did more living in nine years than some do in decades, and you’ll always live in our hearts.Love, Grandpa Jim

—JRF

To my family, who supports me so that I am able to do the work I love.

—BSL

WILEY PRACTICEPLANNERS® SERIES PREFACE

Accountability is an important dimension of the practice of psychotherapy. Treatment programs, public agencies, clinics, and practitioners must justify and document their treatment plans to outside review entities in order to be reimbursed for services. The books and software in the Wiley PracticePlanners® series are designed to help practitioners fulfill these documentation requirements efficiently and professionally.

The Wiley PracticePlanners® series includes a wide array of treatment planning books including not only the original Complete Adult Psychotherapy Treatment Planner, Child Psychotherapy Treatment Planner, and Adolescent Psychotherapy Treatment Planner, all now in their fifth editions, but also Treatment Planners targeted to specialty areas of practice, including:

Addictions

Co-occurring disorders

Behavioral medicine

College students

Couples therapy

Crisis counseling

Early childhood education

Employee assistance

Family therapy

Gays and lesbians

Group therapy

Juvenile justice and residential care

Mental retardation and developmental disability

Neuropsychology

Older adults

Parenting skills

Pastoral counseling

Personality disorders

Probation and parole

Psychopharmacology

Rehabilitation psychology

School counseling and school social work

Severe and persistent mental illness

Sexual abuse victims and offenders

Social work and human services

Special education

Speech-language pathology

Suicide and homicide risk assessment

Veterans and active military duty

Women’s issues

In addition, three branches of companion books can be used in conjunction with the Treatment Planners, or on their own:

Progress Notes Planners

provide a menu of progress statements that elaborate on the client’s symptom presentation and the provider’s therapeutic intervention. Each

Progress Notes Planner

statement is directly integrated with the behavioral definitions and therapeutic interventions from its companion

Treatment Planner

.

Homework Planners

include homework assignments designed around each presenting problem (such as anxiety, depression, chemical dependence, anger management, eating disorders, or panic disorder), which is the focus of a chapter in its corresponding

Treatment Planner

.

Client Education Handout Planners

provide brochures and handouts to help educate and inform clients on presenting problems and mental health issues, as well as life skills techniques. The handouts are included online for easy printing from your computer and are ideal for use in waiting rooms, at presentations, as newsletters, or as information for clients struggling with mental illness issues. The topics covered by these handouts correspond to the presenting problems in the

Treatment Planners

.

Adjunctive books, such as The Psychotherapy Documentation Primer and The Clinical Documentation Sourcebook, contain forms and resources to aid the clinician in mental health practice management.

The goal of our series is to provide practitioners with the resources they need in order to provide high-quality care in the era of accountability. To put it simply: We seek to help you spend more time on patients and less time on paperwork.

Arthur E. Jongsma, Jr.

Grand Rapids, Michigan

PREFACE

The long-awaited and recently published fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the first major change in the DSM since DSM-IV was published in 1994 and slightly amended with the text revision to the DSM-IV (DSM-IV-TR) in 2000. The DSM-5 includes changes in the diagnostic criteria and organization of disorders in several categories related to substance dependence and/or abuse.

This edition of the Addiction Homework Planner, in turn, reflects both the changes in the DSM and the continued emphasis on consumer-centered, assessment-driven, evidence-based treatment in the field of psychotherapy. We have continued to emphasize the importance of client motivation and shaped the content of this planner to help people in treatment move ahead in their readiness to work for positive change. Each exercise was designed to address motivation, with some educational content to increase knowledge and awareness of addiction and to include a skills component.

We are retaining the previous edition’s use of an Appendix A listing additional assignments for each problem area, essentially the counterpart to the lists of additional problems in the exercise overviews. Rather than listing exercises based on American Society of Addiction Medicine (ASAM) criteria, we have made Appendix B a bibliography listing books for assignment to clients as bibliotherapy, for reference by clinicians, or both; each book’s entry lists the problem areas for which it will be useful.

We have again updated and retained most of the exercises and problem areas from the fourth edition, and further condensed nearly all of the lengthier exercises to make them no longer than two pages. We have also replaced several homework assignments to bring this book’s content into closer alignment with the Addiction Treatment Planner and to address nine new or modified problem areas in response to new developments in the field and the DSM-5, to increase the 88 assignments in the fourth edition to a new total of 100 exercises in 46 problem areas.

At the same time, there is more demand for treatment strategies and interventions to be evidence-based, and we have sought to reflect this trend. We believe that clinicians need to include evidence-based therapeutic homework in treatment more each year for several reasons. Already-tight funding and other resources for treatment keep diminishing, while demand keeps growing. This is particularly true in the arena of substance abuse and the problems that come with it, as new synthetic drugs have made a dramatic impact, even in the short time since the fourth edition was published.

As always, homework between sessions helps clients keep their therapy in the forefront of their awareness and makes it easier to bring it into their daily lives at home, work, school, and social settings, so that they meet the inevitable questions and challenges and bring them back to therapy quickly and solve these issues in a supported and collaborative way.

USING THIS BOOK

This revision is a companion to the fifth edition of the Addiction Treatment Planner. You can use the website to download the assignments on your computer as Microsoft Word documents and print them as they are designed or customize them by rewording items, adding a logo or other art, or however else you choose. For further instructions, please see “About the Downloadable Assignments.”

As always, if you have suggestions, want to tell us which features you find especially useful, or would like to suggest topics to cover in future volumes, please contact us via this publisher. We are always eager for feedback we can use to make this a better resource with each edition. There is no work more important than helping people. Thank you for serving the people with whom you work, and through them, your communities and the world.

SECTION 1:ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS

Therapist’s Overview

ADDRESSING ACA TRAITS IN RECOVERY

GOALS OF THE EXERCISE

Implement a plan for recovery from addiction that reduces the impact of adult-child-of-an-alcoholic (ACA) traits on sobriety.

Decrease dependence on relationships while beginning to meet one’s own needs.

Reduce the frequency of behaviors that are exclusively designed to please others.

Choose partners and friends who are responsible, respectful, and reliable.

Overcome fears of abandonment, loss, and neglect.

Understand the feelings that resulted from being raised in an addictive environment and reduce feelings of alienation by seeing similarities to others raised in non-addictive homes.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL

Borderline Traits

Dependent Traits

Partner Relationship Conflicts

Sexual Promiscuity

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT

The “Addressing ACA Traits in Recovery” activity is for clients with patterns of co-dependent relationships, enmeshment, boundary issues, and burnout in love, friendship, and workplace relationships. It teaches clients about addictive relationship dynamics, then heightens motivation by focusing on the threat this poses to recovery, ending by directing clients to further exploration of issues of codependency. Follow-up may include discussing the issue with the therapist, group, and sponsor; support group referrals; bibliotherapy; and videotherapy (e.g., Rent Two Films and Let’s Talk in the Morning by John W. Hesley and Jan G. Hesley, also published by Wiley).

EXERCISE 1.A

ADDRESSING ACA TRAITS IN RECOVERY

Adult children of alcoholics, or ACAs, are adults who grew up in families where one or both parents chronically abused alcohol and/or other drugs, suffered from other mental illness, or had other problems that made them unable to meet their children’s needs. When those children become adults, they may have feelings and behavior patterns that resemble those of their parents, especially in relationships. This can happen whether or not they abuse alcohol or other drugs—ACAs often become “addicted” to unhealthy patterns and people in their love, friendship, and work relationships. They are drawn to situations that feel in some ways like their childhood family life, and to people who treat them in ways similar to the ways their parents treated them and others. ACAs often fall into the trap of trying to please, “fix,” or “save” others, and their own lives are left in turmoil. Their motives are caring, but their efforts to please or rescue others seldom work. The results cause these ACAs great emotional pain and may put them in dangerous situations or lead to a work-related cycle of starting new jobs with great hope and energy but ending up burning out on those jobs or careers. No one can really control anyone else; other people’s troubles are mostly caused by patterns only they can change, so trying to change them leads to one painful disappointment after another. As part of your recovery, this activity will help you learn to recognize and change these patterns, which are also often called codependency.

There are reasons we’re drawn to relationships in which we try harder to solve other people’s problems than they do. If we are ACAs, these patterns often echo those we experienced in our families as children. It’s as if we’re trying to replay the same story and get it to have a happy ending. Have any of the feelings listed here drawn you into painful relationships or situations in love, friendship, and/or workplace situations?

_____ You felt sure that if you tried hard enough, you could win approval.

_____ You felt needed.

_____ It was intense and exciting from the start.

_____ You felt intensely and magnetically drawn to the other person.

_____ They made you feel strong, smart, and capable.

_____ The sex was incredible.

_____ You identified with the hardships they’d suffered.

_____ You felt that you could help them and change their lives.

Here are signs of this kind of relationship. Please check off any you’ve experienced:

_____ Manipulation and mind games take up a lot of time and energy.

_____ You’re held responsible (by others or yourself) for things you can’t control.

_____ You see that you keep getting into high-risk or no-win situations, but you can’t help finding those are the only ones that attract you—safe people and jobs bore you.

_____ You’re often worried that the relationship will fall apart, feeling you can keep the peace if you just say and do only the right things.

_____ You keep your partner away from your other friends and family because they don’t get along, or you don’t think they would.

_____ You spend a lot of time and energy solving other people’s problems, over and over, often with little or no appreciation or recognition.

_____ You try hard to impress your partner and keep secrets; you fear that your partner would reject you if they knew about parts of your life or past.

_____ You get in heated arguments that don’t make sense to either of you.

_____ The relationship became very intense very fast when you first got together.

_____ One or both of you feel a lot of jealousy and insecurity.

_____ The relationship is never boring, but it’s usually stressful.

_____ You go back and forth between feeling abandoned and feeling smothered.

How does this relate to getting and staying clean and sober? Well, common sense tells us there’s a strong connection between stress and relapse, and research confirms that link. Looking at the items you checked for question 2, think about how stressful those relationships were or are. How could these stresses lead you to relapse, and how do you feel about that risk?

Most people who get into addictive relationships don’t just do so once. What unhealthy patterns do you see in the people you find attractive?

Consider participating in 12-step recovery programs specifically for ACAs. Identify three reasons this could be beneficial to you.

Be sure to bring this handout back to your next session with your therapist, and be prepared to talk about your thoughts and feelings about the exercise.

Therapist’s Overview

UNDERSTANDING FAMILY HISTORY

GOALS OF THE EXERCISE

Implement a plan for recovery from addiction that reduces the impact of adult-child-of-an-alcoholic (ACA) traits on sobriety.

Reduce the frequency of behaviors that are exclusively designed to please others.

Eliminate behaviors that are dangerous to self or others.

Eliminate self-defeating interpersonal patterns in occupational and social settings.

Choose partners and friends who are responsible, respectful, and reliable.

Understand the feelings that resulted from being raised in an addictive environment and reduce feelings of inferiority and/or alienation from others who were raised in nonaddictive homes.

Obtain emotional support for recovery from family members.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL

Borderline Traits

Childhood Trauma

Family Conflicts

Parent-Child Relational Problem

Partner Relational Conflicts

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT

The “Understanding Family History” activity may be used effectively with clients who are experiencing shame, confusion, or anxiety as a result of seeing themselves repeat negative behaviors seen in childhood caretakers. It may be useful in couples therapy, because many ACA individuals form relationships with partners with similar backgrounds. For clients struggling with acceptance and forgiveness of their parents or of themselves, this activity may help in understanding the roles of addiction and powerlessness in distorting values and behaviors. It may also be useful for clients who have parenting issues in recovery to understand the roots of their children’s behaviors.

EXERCISE 1.B

UNDERSTANDING FAMILY HISTORY

It’s important to understand the role of family history in addictions—not to blame those who raised us, but for our own recovery and our families’ futures. This exercise looks at how family history affects us.

As a child, what did you learn about drinking, drug use, or other addictions in your family?

What problems, if any, did your family have because of these behaviors (e.g., violence, divorce, financial problems, dangerous or illegal activities, or other worries)?

Please describe the typical atmosphere in your family when someone was drinking, using drugs, or engaging in other addictive patterns, and its effects on you then and now.

Below are some common patterns in families struggling with addictions, related to the unspoken rule “Don’t talk, don’t trust, don’t feel” that develops as other family members try to avoid confrontations or disappointment caused by the inability of addicted adults to be nurturing and dependable, or to cope with the emotional pain that is the result of that inability. For each pattern, give an example from your childhood and an example of how you can make healthy changes now.

Dishonesty/denial

Childhood example:

Working for healthy change:

Breaking promises

Childhood example:

Working for healthy change:

Isolating/withdrawing

Childhood example:

Working for healthy change:

Emotional/physical/sexual abuse and neglect

Childhood example:

Working for healthy change:

Influencing others to act in self-destructive ways

Childhood example:

Working for healthy change:

Confused roles and responsibilities (e.g., children taking caring of adults, people blaming others for their own actions, etc.)

Childhood example:

Working for healthy change:

No family is completely dysfunctional, and nearly all of us remember our parents or other adults who raised us doing some good things we want to do for our children in turn. What good relationship patterns from your childhood do you want to continue and pass on?

Consider the strengths you obtained from growing up in your house with your family. How can you use these strengths to facilitate your own recovery efforts?

Be sure to bring this handout back to your next session with your therapist, and be prepared to talk about your thoughts and feelings about the exercise.

SECTION 2:ANGER

Therapist’s Overview

IS MY ANGER DUE TO FEELING THREATENED?

GOALS OF THE EXERCISE

Develop a program of recovery that is free from substance abuse and violent behavior.

Terminate all behaviors that are dangerous to self or others.

Decrease the frequency of occurrence of angry thoughts, feelings, and behaviors.

Verbalize core conflicts that lead to dangerous/lethal behaviors.

Recognize the first signs of anger and use behavioral techniques to control it.

Think positively and realistically in anger-producing situations.

Learn that anger is a secondary emotion responding to fear or anxiety in response to a perceived threat.

Learn to self-monitor and shift into an introspective and cognitive problem-solving mode rather than an emotional reactive mode when anger is triggered.

Shift from a self-image as a helpless or passive victim of angry impulses to one of mastery and taking responsibility for responses to feelings.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL

Conduct Disorder/Delinquency

Dangerousness/Lethality

Oppositional Defiant Behavior

Posttraumatic Stress Disorder (PTSD)

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT

The “Is My Anger Due to Feeling Threatened?” activity is suited for clients who are capable of introspection and who desire to change their reactive patterns of anger. It may be useful when clients describe perceptions of being unable to control their anger, have patterns of impulsive anger disproportionate to the triggering events or situations, or express regrets over their actions when angry. Follow-up can include keeping a journal documenting angry impulses and the client’s use of this process to manage their reactions. Teaching relaxation strategies, mindfulness strategies, and self-soothing strategies would be beneficial in conjunction with the client working on recognizing and managing their anger.

EXERCISE 2.A

IS MY ANGER DUE TO FEELING THREATENED?

A wise person once said that every problem starts as a solution to another problem. Once we see this, it’s easier to let go of the anger and find another solution for the original problem that works better. What kind of problem makes anger look like a solution? When is anger useful? It’s good for energizing and preparing us to fight. It’s the “fight” part of the fight-or-flight instinct that is any creature’s response to perceived (whether real or not) danger. When we feel angry, chances are that we feel threatened.

This instinct developed in prehistoric people over thousands of generations and is shared by many self-aware animal species as well. Nearly all of the threats they faced were physical (e.g., wild animals or hostile strangers), and in those situations anger served them well.

Some dangers are still physical, but more often we face threats we can’t fight physically. There are threats to our self-images and our beliefs about the world, which can feel just as dangerous as threats to our safety or health.

In this exercise, you’ll think about a situation that has triggered your anger and identify both the threat that the anger wants to fight and another solution that will work better.

First, it’s important to recognize anger as soon as it starts to develop. To do this, you need to watch for the early warning signs of anger, both physical and mental.

Here are some common physical effects of anger. Please check any you experience when you are starting to get angry:

____

Muscle tension or shaking

____

Rapid heartbeat

____

Rapid, shallow breathing

____

“Butterflies in the stomach”

____

Reddening of the face

____

Agitation and restlessness

Our thinking changes with anger, often in these ways. Again, check any you experience:

____

Impulsiveness and impatience

____

Feelings of power and certainty

____

All-or-nothing thinking

____

Taking things personally

____

Inability to see others’ perspectives

____

A sense of having been wronged

Now think of a situation that has been an anger trigger for you over and over or that has led to serious consequences because of your angry actions. Briefly describe the situation and the consequences.

Study the situation, and identify the threat that triggered your anger. Were you at risk of not getting something you wanted, or of losing something you already had and valued? Were you responding to “programmed” ways to react when situations feel similar? The item under threat could be physical well-being, a relationship, a career or life goal, your self-image, or even your values and beliefs about the way the world works. Explain how this situation threatens you.

Think of a solution that will give you better results and cause fewer problems than acting in anger. Describe the solution and how you’d put it into action.

After you’ve thought about triggers and solutions, what are your thoughts and feelings about the situation? Do you feel more in control?

There are some situations in modern life where expressing anger is still appropriate, but not with physical violence. Please think of a way you can constructively express anger to be assertive and not submit to mistreatment, but do so without violence.

When you feel your anger building, pause, take a breath and ask yourself, “Where’s the threat, and what else can I do about it?” This way, you can take control of your feelings and actions. This is difficult at first, but if you keep doing it, the pause and the question become automatic, just as the flash into rage was automatic. When you pause automatically and think this way, you control your anger, rather than it controlling you. At first, reminders help; think of someone you trust to help you with this. Explain what you’re doing, and ask them to watch your mood and if you start looking angry, remind you to pause and find the threat. Who is that person, and when will you talk with them about this?

Be sure to bring this handout back to your next therapy session, and be prepared to talk about your thoughts and feelings about the exercise.

Therapist’s Overview

IS MY ANGER DUE TO UNMET EXPECTATIONS?

GOALS OF THE EXERCISE

Develop a program of recovery free from substance abuse and dangerous/lethal behaviors.

Terminate all behaviors that are dangerous to self or others.

Decrease the frequency of occurrence of angry thoughts, feelings, and behaviors.

Verbalize the core conflicts that lead to dangerous/lethal behaviors.

Recognize the first signs of anger and use behavioral techniques to control it.

Think positively and realistically in anger-producing situations.

Learn and use stress-management skills to reduce stress and the irritability that accompanies it.

Learn to self-monitor and shift to a thinking and problem-solving mode rather than a reactive mode when anger is triggered.

Increase self-esteem and sense of purpose for living, and learn how to help others in recovery.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL

Antisocial Behavior

Attention-Deficit/Hyperactivity Disorder (ADHD)—Adolescent

Attention-Deficit/Hyperactivity Disorder (ADHD)—Adult

Borderline Traits

Dangerousness/Lethality

Family Conflicts

Oppositional Defiant Behavior

Parent-Child Relational Problem

Partner Relational Conflicts

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT

The “Is My Anger Due to Unmet Expectations?” activity is suited for clients who are capable of introspection and who desire to change their reactive patterns of anger. It may be useful when clients report feeling unable to control their anger, have patterns of impulsive anger disproportionate to triggering events or situations, or express regrets over their actions when angry. Follow-up can include keeping a journal documenting angry impulses and use of this process to identify trigger expectations and manage reactions.

EXERCISE 2.B

IS MY ANGER DUE TO UNMET EXPECTATIONS?

People in treatment and recovery programs often say that anger always boils down to fear: That they’ll lose something they want to keep, or that they won’t get something they want. These aren’t usually life-and-death matters, but they often react as if they were.

When we look at this closely, we usually see that when possible losses or disappointments have triggered rage, we expected something different and are shocked and disappointed by what actually happened. Sometimes our expectations are based on what we feel is right and fair, what some call the “shoulda-woulda-couldas” (e.g., that the person in the next lane should let us merge instead of speeding up to crowd us out, or that people should be honest and considerate). Also, sometimes we just want something badly and convince ourselves that it should happen the way we want it to.

But our expectations are often unrealistic. That’s why many old-timers in Alcoholics Anonymous and other recovery programs define an expectation as “a premeditated resentment.” They mean that when we form expectations, we often set ourselves up for disappointment and the anger that follows.

Do you want to avoid getting angry unnecessarily? Anger interferes with our judgment, making us more likely to act impulsively and do things that damage relationships, undermine recovery, and weaken our immune systems. This exercise will help you avoid unrealistic expectations, to feel calm more of the time and angry less often.

Please think back to the most recent time you got angry over an unrealistic expectation, a “shoulda-woulda-coulda” experience. Describe what happened.

Was the event that triggered your anger something you felt should not have happened the way it did? If so, what was your expectation, and why did you have that expectation?

We often expect things that aren’t likely (e.g., expecting someone who is usually late to be on time). If experience told you that what you expected was unlikely, what would have been a more reasonable expectation?

Our expectations are often just mistakes in our thinking. If we learn not to make those mistakes, accepting what does happen is easier. Remember, accepting something doesn’t mean we like it or believe it’s right; it means admitting things are the way they are, and deciding to act on reality rather than our fantasies. If you run into the same situation again but expect what experience tells you is likely to happen, rather than what you hope for or feel should happen, how will you react differently?

Here are some mistaken expectations we often get angry over. Please give your own examples:

Expecting people to behave differently than the way they usually act (e.g., expecting love, warmth, and consideration from a person who is normally cold, selfish, and sarcastic)

Example:

Taking things personally or expecting to be the center of someone else’s world

Example:

Perfectionism: Expecting ourselves or others to do things perfectly the first time, rather than accepting that we all make mistakes

Example:

Overoptimism (e.g., expecting everything to go the way we want, though it seldom does)

Example:

Other emotions that arise when we form unrealistic expectations are self-pity, discouragement, and anxiety. How have these been triggers for your past addictive behaviors?

These emotions are setups for relapse. Recovery depends on managing them; it helps not to set ourselves up to get angry. The fewer expectations we have, especially unrealistic ones, the easier it is to stay in recovery. Please describe a plan to monitor your thoughts and emotions, avoid unrealistic expectations or correct them when they arise, and regain your serenity.

Be sure to bring this handout back to your next therapy session, and be prepared to talk about your thoughts and feelings about the exercise.

SECTION 3:ANTISOCIAL BEHAVIOR

Therapist’s Overview

BENEFITS OF HELPING OTHERS

GOALS OF THE EXERCISE

Learn the importance of helping others in recovery.

Understand the importance and the benefits of a program of recovery that demands rigorous honesty.

Identify the benefits to relationships and self-esteem in taking responsibility for one’s own behavior.

Develop a program of recovery that is free of addiction and the negative influences of antisocial behavior.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL

Attention-Deficit/Hyperactivity Disorder (ADHD)—Adolescent

Attention-Deficit/Hyperactivity Disorder (ADHD)—Adult

Conduct Disorder/Delinquency

Impulsivity

Legal Problems

Narcissistic Traits

Oppositional Defiant Behavior

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT

The “Benefits of Helping Others” activity is for clients with patterns of antisocial behaviors. It teaches clients about the benefits they could get from cultivating patterns of generous and dependable behavior. It also teaches clients some ways they can both get guidance from people in recovery with whom they identify and begin to test the waters by trying small positive behavioral changes and monitoring the results. Follow-up may include discussing the issue with the therapist, group, and sponsor, using role-playing activities to rehearse actions the client is considering, and reviewing the outcomes of any behavioral changes the client tries.

EXERCISE 3.A

BENEFITS OF HELPING OTHERS

When you hear the words “Getting out of myself,” you may wonder why you should be interested in doing so. How will being more generous and considerate toward others be beneficial to you? One place you can look for answers is to other people who’ve been in situations like yours and found that being more kind made their lives better. On the most basic level, the way people live their lives in addiction is risky to their personal health, their legal situations, their relationships, how they feel about themselves, and sometimes their overall survival. People die because of their addictions, whether through accidents, violence, overdose, or their bodies just breaking down a lot sooner than they otherwise would have. Even when the stakes aren’t that high, you may find that you like the way your life goes better when you live it in a less self-centered way. Other people may treat you better, you’ll get in less trouble, and you might even like yourself better. There are a couple of easy ways to find out: Talk to other people who’ve been where you are and are doing better, and start trying it out in small ways and see what happens. This activity will give you some ideas on how to do that.

What benefits could you see to helping others in both service work and/or in a community support group program, like AA or NA?

You may have attended meetings and may have a sponsor by now. If not, seek out someone you see in recovery who has been at it awhile and whom you can relate to. Ask them or the group about the benefits of helping others in both service work and/or within the program. Write what you learn below:

What do you hear others saying about the benefit of working a program of rigorous honesty, accountability for your own behavior, and accepting and using the emotional and spiritual support of others and a Higher Power?

What doubts, reservations, skepticism, or fear do you have about this concept of “getting out of yourself” and helping others?

The things we say to ourselves, about ourselves or others and situations (self-talk) have a significant impact on how we feel and act. What self-talk statements do you hear yourself making that keep you from trusting others, being generous, helping others, and taking responsibility for your actions? List five of them.

What positive thoughts challenge those you listed in question 5?

Below is a sampling of some small steps you can take toward increasing the benefits of positive relationships and having healthy self-esteem and self-worth:

Be honest about ways you’ve hurt, used, disregarded, and manipulated other people.

Keep small commitments and promises to build reliability and trust.

Challenge self-talk that is negative, skeptical, critical, or blaming.

Find a sponsor to begin the practice of establishing a stable and accountable relationship within a program of rigorous honesty.

Avoid therapy-interfering behaviors (i.e., being late for treatment, failing/canceling appointments, not completing assigned tasks, acting guarded in sessions).

Take responsibility for your actions versus blaming others.

Find ways to help others without expectation for praise or reward.

Please try each of these behaviors in the next two weeks and make notes below about the results so you can talk about them with your therapist, group, home group, or sponsor.

How would the trust of others benefit you, your recovery, and your relationships?

What 12-step work from your community support group meetings (i.e., AA, NA, ACA, CA, GA) would also challenge you to do this work?

Be sure to bring this handout back to your next session with your therapist, and be prepared to talk about your thoughts and feelings about the exercise.

Therapist’s Overview

TAKING INVENTORY OF DESTRUCTIVE BEHAVIORS

GOALS OF THE EXERCISE

Decrease antisocial behaviors and increase motivation to practice more respectful thoughts and behavior toward others.

Learn how antisocial behavior and addiction is self-defeating.

Develop a program of recovery that is free from addiction and the negative influences of antisocial behavior.

Develop a greater willingness to try behaving in more respectful and considerate ways toward others.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL

Attention-Deficit/Hyperactivity Disorder (ADHD)—Adolescent

Attention-Deficit/Hyperactivity Disorder (ADHD)—Adult

Conduct Disorder/Delinquency

Impulsivity

Legal Problems

Oppositional Defiant Behavior

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT

The “Taking Inventory of Destructive Behaviors” activity is for clients with patterns of impulsively destructive, dishonest, or malicious behavior that affects other people. It is framed in terms of self-interest, because this is often an effective way to initiate the development of motivation for change in clients who are not invested in the feelings or well-being of others. Follow-up should be ongoing and include discussing the issue with their therapist, group, and sponsor.

EXERCISE 3.B

TAKING INVENTORY OF DESTRUCTIVE BEHAVIORS

Which of the following behaviors have you engaged in?

_____ Rule or law breaking and/or disregard for rules, often related to alcohol/other drugs

_____ Blaming others for your problems and actions

_____ Being dishonest

_____ Having to tell more lies to cover up previously told lies

_____ Manipulating and intimidating others with aggressive behavior

_____ Having a lack of regard for others’ feelings (lack of empathy)

_____ Thrill-seeking without regard for safety of self and/or others

_____ Self-centeredness and always pushing to get your way

_____ Seeking power over others

_____ Having a sense of entitlement

_____ Intentionally violating the rights of others

_____ Impulsive decision making without thinking about consequences for others

How do these behaviors impact your relationships with others? If you cannot come up with an answer, ask someone close to you for feedback and write it below.

List three ways these behaviors are self-defeating and backfire on you.

How are these behaviors related to your addiction or substance use?

Which of the following negative consequences have you experienced due to these behaviors?

_____ Loss of or lack of respect from others

_____ Few or no intimate relationships—many broken relationships

_____ No sense of achievement or accomplishment

_____ Increased isolation or feelings of alienation

_____ Frequent legal difficulties

_____ Others (please list in space provided):

Select one of the items from question 1 and think about a specific situation related to it. Analyze the chain of events by identifying the decisions you made before your action, the outcome of it, how others responded, how you felt about yourself and the negative consequences that followed.

The refusal to acknowledge and take responsibility for these behaviors leads to making the same mistakes over and over again, getting more of what you’ve already gotten. Revisit question 6. What alternative thoughts/behaviors would interrupt the chain or result in a more favorable outcome for you?

Describe the benefits that would come from practicing alternative thoughts and behaviors like those you listed in question 7 on a more consistent basis.

Be sure to bring this handout back to your next session with your therapist, and be prepared to talk about your thoughts and feelings about the exercise.

SECTION 4:ANXIETY

Therapist’s Overview

ANXIETY TRIGGERS AND WARNING SIGNS

GOALS OF THE EXERCISE

Maintain a program of recovery free of addiction and excessive anxiety.

Understand the relationship between anxiety and addictive behaviors.

Increase insight and awareness related to feelings and processes associated with anxiety.

Decrease anxious thoughts, overall stress, and muscle tension, and increase positive self-talk.

Strengthen belief in the capacity to self-manage anxiety without returning to addictive behavior.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL

Childhood Trauma

Chronic Pain

Eating Disorders and Obesity

Posttraumatic Stress Disorder (PTSD)

Relapse Proneness

Sleep Disturbance

Social Anxiety

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT

The “Anxiety Triggers and Warning Signs” activity is for clients who experience anxiety but feel helpless to change it. Educating clients about anxiety and normalizing healthy levels of it is important in treating anxiety. This activity helps explain to clients that we all need anxiety for certain things, because it can be adaptive and motivating. There is a point when the benefits of anxiety tip toward more detrimental effects. This is the result of thinking things are more threatening, serious, or worse than they really are, avoiding things that make us uncomfortable, or misreading physical cues. First the exercise asks the client to identify how he or they experience anxiety physically, behaviorally, cognitively, and emotionally. Second, it asks the client to develop a hierarchy of least to most anxiety-producing experiences. Finally, it asks the client to develop a plan for coping with anxiety. Follow-up can consist of teaching relaxation, imagery, mindfulness, and biofeedback techniques to deal with all levels of anxiety.

EXERCISE 4.A

ANXIETY TRIGGERS AND WARNING SIGNS

Everyone experiences anxiety, ranging from mild worry to intense fear. Some people are very aware of their anxiety; others aren’t conscious of it until it’s overwhelming; and others are overly aware of their anxiety, which often results in increasing it. Some experience anxiety mainly over specific situations, whereas others have more general feelings of anxiety. We’re nervous when we do things for the first time: going on dates, speaking to groups, or starting new jobs. For some, anxiety is short-lived and does not interfere in their lives other than causing mild discomfort. For others, anxiety causes panic, stops them from enjoying many activities, and interferes with daily living. Anxiety is related to addiction in two ways: We often feel anxiety when we practice new non-addictive behaviors, and we try to reduce anxiety with addictive behaviors.