Webb Therapy Uncategorized Addiction Theories

Addiction Theories

There have been various theories and models proposed over time to help us understand why individuals use alcohol and other drugs, and why some people become dependent or ‘addicted’ but not others. The following are several models or theories of addiction. They reflect the political, medical, spiritual, and social forces of those times in history.

The Moral Model

Alcohol and tobacco was introduced in the Western countries during the 1500’s. The widespread use and misuse of chemical substances resulted in a range of social problems and it was thought by some that substance use was “problematic” and “morally wrong” (Lassiter & Spivey, 2018). The moral model viewed AOD dependency as a moral and personal weakness that involved a lack of self-control, and was often viewed as a potential danger to society (Stevens & Smith, 2014).

The moral model considered addiction a “sin” and a result of free, yet irresponsible, choice. Therefore, many politically conservative groups, religious groups, and legal systems tended to punish the individual who uses AOD. The moral model or attitude towards addiction can still be seen today in certain cultures. Those who still believe addiction is morally “wrong” tend to perceive the most appropriate way to treat the individuals who use AOD are through legal sanctions, such as imprisonment and fines. For example, in many countries, drivers who are caught under the influence of alcohol or other drugs are not considered for treatment programs but instead receive court sentences as punishments (Fisher & Harrison, 2017).

This model has been rejected by alcohol and other drugs professionals as unscientific and contributes to the stigma surrounding addiction and substance use (White, 1991, cited in Fisher & Harrison, 2017).

The Disease Model

This model takes up the medical viewpoint and proposes addiction as a disease or illness that an individual has. It proposed that addiction is a disease that is progressive and chronic whereby the individual holds no control as long as the substance use continues. In other words, their addiction will continue to deteriorate with the continuous AOD (Thombs & Osborn, 2019). It also proposes that individuals who uses AOD can never be cured from addiction, though it can be readily treated through sustained abstinence such as self-help fellowships and treatment community. 

In the 1940s, Jellinek proposed a disease model in relation to alcoholism, arguing that it is a disease caused by a physiological deficit in an individual, making the person permanently unable to tolerate the effects of alcohol (Stevens & Smith, 2014). Jellinek identified signs and symptoms and clustered them into stages of alcoholism, as well as progression of the disease, which form the basis of 12-step or Anon-type programs (e.g., Alcoholics Anonymous and Narcotics Anonymous; Stevens & Smith, 2014). 

Under the disease model, treatment requires complete abstinence. Once an individual has accepted the reality of their addiction and ceased substance use, they are labelled as being in recovery, but are never ‘cured’ (e.g., “Once an alcoholic, always an alcoholic”; Thombs & Osborn, 2019). Whilst originally applied to alcohol dependency, it has now been generalised to other substances and many traditional substance use treatment models are based on this model (Capuzzi & Stauffer, 2020; Stevens & Smith, 2014).

The disease model offered an alternative to the moral theory, helping to remove the moral stigma attached to addiction and replacing it with an emphasis on treatment of an illness (Capuzzi & Stauffer, 2020). Disease theory helped to explain how some people experience the physiological effects of addiction such as dependence, tolerance, and withdrawal more than others, and how these mechanisms are caused by a biochemical abnormality in an individual which increases their likelihood of developing a dependency (DiClemente, 2018). 

While the disease model was well received by a range of professionals, many criticised it because research did not find that the progressive, irreversible progression of addiction through stages always occurs as predicted (Capuzzi & Stauffer, 2020). Additionally, many in the AOD field argued that the model did not address the complex interrelated factors that accompany dependency (Stevens & Smith, 2014). Finally, some professionals argued that the concept of addiction being a disease may also convey the impression to some individuals that they are powerless over their dependency and/or not responsible for the consequences of destructive addictive behaviours, which can be counteractive to treatment (Capuzzi & Stauffer, 2020).

Genetic and Neurobiological Theories

These theories suggest that some people may be genetically predisposed to develop drug dependency. For example, individuals usually begin substance use on an experimental basis. They then continue using because there is some reinforcement for doing so (e.g., a reduction of pain, experience of euphoria, social recognition, and/or acceptance, etc.). Some people may continue to use substances in a controlled or recreational manner with limited consequences while others progress to non-medical use and eventually develop a dependency. Why? Genetic and neurobiological theories propose that this is the result of a genetic predisposition to drug dependency (Fisher & Harrison, 2017). 

Factors being considered by researchers in the genetic transmission of dependency on alcohol include neurobiological features such as an imbalance in the brain’s production of ‘feel good’ neurotransmitters or in the metabolism of ethanol, which is the key component of alcohol (Stevens & Smith, 2014). Other researchers explored genetic differences in temperament and personality traits which they argued may lead to certain individuals becoming more vulnerable in the face of challenging environmental circumstances, leading to AOD use (Stevens & Smith, 2014). Genetic predispositions such as these may explain why some individuals develop dependency on AOD while others in similar situations do not.

The Psycho-dynamic Model

This model proposes that substance use may be due to an unintentional response to some difficulties that an individual experienced in their childhood. This explanation is based on the theory that was put forward by Sigmund Freud, whereby the problems of whether we are able to cope with difficulties as adults are linked to our childhood experience. Many counselling approaches today are based on this theory which aim to seek understanding of people’s unconscious motivations and to enhance how they view themselves (Capuzzi & Stauffer, 2020).

The Psycho-dynamtic model also believes that AOD use is often secondary to a primary psychological issue. In other words, alcohol and other drugs is a symptom rather than a disorder, and AOD use is a means to temporarily relieve or numb emotional pain. For example, an individual suffering from depression might self-medicate with stimulants to relieve the enervating effects of depression or manage their anxiety by using benzodiazepines (Fisher & Harrison, 2017). 

There is evidence to support this model, whereby childhood traumatic events are associated with mental health problems and substance use disorders. Wu et al. (2010) conducted a study among 402 adults who were receiving substance use disorder treatments. They revealed that almost all (95%) of the participants experienced one or more childhood traumatic events, and 65.9% of them experienced emotional abuse and neglect from their childhood. The authors also reported that the higher the number of childhood traumatic events experienced, the higher the risk of substance use disorders and mental health problems such as post-traumatic stress disorder. 

Personality Traits

Some theorists suggest that certain individuals have certain personality traits that are linked to AOD dependency. For example, dependency on alcohol has been associated with traits such as developmental immaturity, impulsivity, high reactivity and emotionality, impatience, intolerance, and inability to express emotions (Capuzzi & Stauffer, 2020).

Social Learning Model

This model suggests that social learning processes such as observing other peoples behaviours (i.e., modelling) and cultural norms are important in the process of learning behaviours. Albert Bandura proposed Social Learning Theory which would argue that substance use is initiated by environmental stressors or modelling people around you with “perceived status”. For example, a child observes their parents use alcohol in social situations and the child is therefore more likely to perceive that AOD use for social situations is appropriate (Harrison & Fisher, 2017); the association between socialisation and alcohol has been established.

The social learning model also recognises the influence of cognitive processes such as coping, self-efficacy, and outcome expectancies. Some researchers are currently focusing on how an individuals expectation of the effects of drugs influence the pattern of AOD use and resulting dependency. Russell (1976, cited in Wise & Koob, 2013) suggested that dependency on substance is not only chemical (biological) but also behavioural and social in nature. 

It has also been suggested that substance use occurs when an individual thinks substance use is a coping mechanism. This can be learned from television and film, social medial, peer influence, or messages from caregivers during childhood. The individual hopes the AOD use will relieve from them from stress (Stevens & Smith, 2014). 

Socio-cultural Model

Different from the previous models, the socio-cultural model perceives substance use as an issue of society as a whole instead of focusing only on the individual. People tend to overestimate the influence of internal and psychological factors while underestimating the external and environmental factors, even among some alcohol and other drugs workers (Gladwell, 2000, cited in Lewis, Dana, & Blevins, 2015). Thus, this model highlights the importance of how society shapes substance use behaviours, such as cultural attitudes, peer pressures, family structures, economic factors, and more (Bobo & Husten, 2000). For example, Coffelt et al. (2006) found that parents’ alcohol use are associated with their children’s drinking behaviour, whereby when the adult’s alcohol problems increased, the likelihood of their adolescent child’s alcohol use increased. 

The Biopsychosocial Model

Substance use behaviour cannot be explained or understood scientifically or spiritually based on a single variable, antecedent, or “cause”. Biological, psychological, learning, social and cultural context all contributes to explaining why addiction develops and maintains. The interactions between these factors are presented in The Biopsychosocial Model – arguably the most commonly used model to explain addiction today. The model suggests that substance use and the progression of substance dependency can be explained by recognising that the body and mind are connected within a social and cultural context (Skewes & Gonzalez, 2013).

The model allows any combination of biological, psychological, social and cultural factors to contribute to AOD misuse and dependency, rather than a single dominating factor. This is much more holistic and integrative when attempting to understand the determinant of addiction (Stevens & Smith, 2014).

References:

  1. Bobo, J. K., & Husten, C. (2000). Sociocultural influences on smoking and drinking. Alcohol Research and Health, 24(4), 225-232. 
  2. Capuzzi, D., & Stauffer, M. D., Sharpe, C. W. (2020). History and etiological models of addiction. In D. Capuzzi, & M. D. Stauffer (Eds.), Foundations of addictions counseling (pp. 1-22). Pearson Education.
  3. Coffelt, N. L., Forehand, R., Olson, A. L., Jones, D. J., Gaffney, C. A., Zens, M. S. (2006). A longitudinal examination of the link between parent alcohol problems and youth drinking: The moderating roles of parent and child gender. Addictive Behaviours, 31, 4, 593-605. https://doi.org/10.1016/j.addbeh.2005.05.034 
  4. DiClemente, C. C. (2018). Addiction and change: How addictions develop and addicted people recover. The Guilford Press.
  5. Fisher, G. L., & Harrison, T. C. (2017). Substance abuse: Information for school counsellors, social workers, therapists, and counsellors. Pearson Education. 
  6. Lassiter, P. S., & Spivey, M. S. (2018). Historical perspectives and the moral model. In P. S. Lassiter, & J. R. Culbreth (Eds.), Theory and practice of addiction counselling. (pp. 27-46). Sage Publications. 
  7. Lewis, J. A., Dana, R. Q., & Blevins, G. A. (2015). Substance abuse counselling. Cengage Learning.
  8. Skewes, M. C., & Gonzalez, V. M. (2013). The biopsychosocial model of addiction. In P. M. Miller, A. W. Blume, D. J. Kavanagh, K. M. Kampman, M. E. Bates, M. E. Larimer, N. M. Petry, P. D. Witte, S. A. Ball (Eds.), Principles of addiction: Comprehensive addictive behaviours and disorders (pp. 61-70). Academic Press.
  9. Stevens, P., & Smith, R. L. (2014). Substance abuse counselling: Theory and practice. Pearson Education. 
  10. Teesson, M., Hall, W., Proudfoot, & Degenhardt, L. (2012). Addictions. Taylor & Francis Group.
  11. Thombs, D. L., & Osborn, C. J. (2019). Introduction to addictive behaviours. The Guilford Press. 
  12. Wise, R. A., & Koob, G. F. (2013). The development and maintainance of drug addiction. Neuropsychopharmacology, 39, 254-262.
  13. Wu, N. S., Schairer. L. C., Dellor, E., & Grella, C. (2010). Childhood trauma and health outcomes in adults with comorbid substance abuse and mental health disorders. Addictive Behaviors, 35(1). 68-71. https://doi.org/10.1016/j.addbeh.2009.09.003 

Related Post

Nature’s Effect On Our Mental HealthNature’s Effect On Our Mental Health

Adapted from Australian Institute of Professional Counsellors, Institute Inbrief, Edition 359.

Good day readers! How are you? … Shit? Depressed? Anxious? Angry? First of all, if you’re someone who says “I feel shit”, I would encourage you to use a more accurate descriptor instead of shit. Tell your brain what emotion or feeling you are experiencing. Shit can mean a lot of things. When we’re able to identify an emotion, it’s more likely we’ll be able to regulate or manage it. When I was learning Dialectical Behavioural Therapy, they had a saying: Name it to claim it to tame it. They also encouraged us to distance our identity from our feelings e.g., “I’m having the feeling that I’m angry” rather than “I’m angry”. I know it sounds like simple fluff but there is a profound difference between observing the experience of anger, loneliness, fear, guilt etc. and believing we (the self) are the embodiment or a manifestation of an emotion.

Alright, moving along to the subject of the article. The Australian Institute of Professional Counsellors sent me their monthly (I think it’s monthly) Institute Inbrief. If you’re someone who has lived with a mental health disorder or emotional difficulties for a long time, being in nature is not really a new antidote from the field. And it’s not always as simple as just going out into nature. When I was deep in the abyss of my own depression, there wasn’t a lot that would change my mood or perception of life. But, we do these practices anyway – and that’s kind of the point. It’s a practice. It may have to be initiated using a bit of self-force. Oftentimes, motivation comes after we begin the motion.

So, here are some examples from the article that support ‘nature has a therapeutic effect for the mind and body’:

  • One study found that women who looked at pictures of nature for two minutes had lower levels of the stress hormone cortisol (Gillespie, et al., 2019).
  • Another study showed that people who walked in a forest preserve showed lower levels of hostility, aggression and anxiety than they did before the walk.
  • Gregory Bratman, PhD, an assistant professor at the University of Washington, and colleagues shared evidence that contact with nature is associated with increases in happiness, subjective well-being, positive affect, positive social interactions and a sense of meaning and purpose in life, as well as decreases in mental distress (Science Advances, Vol. 5, No. 7, 2019).

How can we most effectively reap the mental health benefits that nature offers?

Why nature?

I’m aware we’re in Covid-19 lockdown and restrictions at the moment (27/09/2021) so you will need to determine for yourself if what proceeds to be written is practical and realistic for you right now.

We need to understand that the psyche of the human-being is linked to the natural world in many important ways. The human brain constantly processes and assimilates incoming information, and it relies on external stimuli for guidance regarding how to think and behave. Not only does incorporating nature into our daily lives help us understand the world better, but it can also contextualise ourselves in accordance with this understanding; humans – as an animal – have evolved in tandem with the natural world, and thus it is able to promote the development of beneficial skills including improved visual–spatial acuity, attentional abilities, and memory (Oddie, 2019). Our world is full of beautiful and intricate natural structures, and even just a simple walk through a park can provide us with moments of joy, awe, and wonder (Fiebert et al., 1980; Lefebvre & Brucker, 2018).

Additionally, the seemingly chaotic stimulus that nature provides us with promotes creativity and abstract thought (Berman, et al., 2012); these qualities have been the cornerstone of our species’ evolutionary development over the past few thousand years, thus illustrating the primacy of our relationship with nature.

Our neurobiology is extremely complex, and as such cannot be reduced to simple terms. However, we can say with some certainty that our brains’ sophisticated processing systems are enhanced by our interactions with nature. Our brain naturally integrates external stimuli into existing mental frameworks—this is referred to as “cognitive recursion” (Oddie, 2019). This means that if we spend our time in environments that were designed and created by the human mind, then we are putting ourselves in an echo chamber of stimulus and will not receive new information to broaden our mental capabilities. If we spend time in nature surrounded by structures and patterns that are born of unfathomably complex and foreign processes, then our minds can assimilate this new content into its existing understanding of reality.

Basically, if you spend your days in a white cube (i.e. a house) then your mental framework will be limited to the creative potential that a white cube suggests. If, however, you spend your days in an ever-changing fractal world of colours and shapes (i.e. natural environments) then your mind will reflect this, and adopt an expanded creative potential in order to perceive and understand its surroundings. This is a powerful reality; understanding how our connection with nature nourishes our minds is where spirituality meets both science and intuition.

What benefits does nature offer?

Perhaps the most important and relevant aspect of an active lifestyle in nature is its ability to reduce stress. Studies have shown that taking a walk in a park could decrease stressful thoughts, and even reduce blood pressure (Bush, et al., 2016; Robins, 2020). This finding demonstrates that simply being exposed to nature can decrease stress levels, and implies that returning to nature may be an effective way of keeping our mental health at its best. And here’s the kicker: any amount of time spent in nature is net-gain for your mental wellbeing (Robins, 2020). There is no threshold or minimum a dosage of nature that will have an effect on you – even just spending a short time sitting in your backyard enjoying nature will likely have a positive impact on your mental health.

Other studies have also shown that exposure to nature has an effect on our emotional outlook; particularly in regards to relieving us from pessimistic and fearful thinking (Lefebvre & Brucker, 2018). Life in the modern world is full of consequential decisions and options, the outcomes of which can dictate the quality of your entire life. Decision making is one of the more neurologically complex and taxing processes that our brains undertake, and research has shown that we make 35,000 choices per day (Huston, 2018).

This process involves assessing each option for its individual merit, sorting each option into a hierarchy in relation to every other option, making predictions about every possible positive and negative outcome of each option, and then weighing each outcome against that of every other option; golly, how exhausting! The fear and pessimism arises because each option invariably comes with the potential for myriad negative outcomes, and we are constantly coerced into assessing these. Thankfully, nature offers respite from all this noise. Spending time in nature relieves us from overthinking by presenting us with very few options, each with relatively inconsequential outcomes; ‘where will I sit while I drink from my water bottle?’ or ‘should I take the path leading towards the lookout, or the waterfall?’ are not taxing decisions to make, and will not prompt fearful or pessimistic thought patterns. There is an easiness to natural environments in which things seem to flow along their own course, and we are able to simply jump into the stream and flow along with it.

Aside from experiential benefits, time in nature can help us orient ourselves in the world in more grounded and productive ways. In today’s society, our attentional abilities are sapped by large corporations who profit from our distractibility, and it seems as though a way to remedy this mental breach is routine contact with nature. Attentional abilities are bolstered by spending time in nature (Ebata & Izenstark, 2017), making you less susceptible to the temptations of modernity (i.e. problematic social media scrolling, binging streaming services, etc).

Thus, making time in nature a priority in our lives – especially when we do not even feel stressed or anxious – can help us orient ourselves to the world around us and find a sense of personal empowerment. Taking time to be immersed in nature can help us regain confidence, ground us in a personal sense of meaning, and re-establish our wellbeing. Being in nature is correlated with increased positive emotions and feelings of control over one’s life (Chowdhurry, 2021), so even if we do not believe we need some sort of mental intervention, the benefits are there for everybody to experience.

How can I fit more nature-time into my life?

For the most part, we only need to reflect on our daily behaviours to see how we can incorporate time in nature into our lives. James Clear, in his wildly popular book Atomic Habits (2018), suggests incorporating a “budding habit” into an existing habit.

So for instance, if you have a lunch break during the work day, you could spend it outside on a park bench instead of in the staff room. If you come home at the end of the day and like to sit on the couch with a book, go outside and sit on the grass instead. These are simply ways to adopt more nature-time into your life, without having to add another separate activity to your schedule. In a 2017 study (Austin, et al., 2017), some participants were asked to take a brief walk in nature once per day, and other participants weren’t. The results showed that those who walked daily had higher levels of positive emotions and well-being than those who walked less. It doesn’t take a lot of time to nourish our minds in the deep ways that only nature offers us, and it seems to be a worthwhile habit to form.

Making the time to experience nature is easy to ignore in lieu of more ‘important’ tasks. That walk in the park you planned on taking this afternoon suddenly seems overshadowed by a looming deadline or a sink full of dirty dishes. For this reason, it can be beneficial to keep yourself accountable by planning nature-time with other people. Planning to go for a walk with friends means there is a lower likelihood of cancelling. Better yet, if you can join a weekly community group or class of some sort then you won’t even have to continually plan your time in nature.

There are volunteer groups who aid revegetation in nature reserves, there are community gardens who need people to tend to plants and crops, and there are clean up groups who dispose of discarded rubbish in bush-lands. If volunteering isn’t appealing to you, then you could change your routine by canceling your gym membership in lieu of outdoor exercise classes or yoga, or even new activities like cycling or rowing. Making scheduled appointments to spend time in nature can assist those who have trouble achieving this with sheer willpower, and your mental health will thank you for it.

Our acknowledgment of the value of time spent in nature is growing each day, which is why more urban living environments are incorporating ‘green spaces’ into their design. Using the latest neuroscience research, we are able to determine which types of natural environments compliments our mental states the most effectively. For example, it has been found that areas with high levels of biodiversity can alleviate symptoms of anxiety and depressions more-so than those with low levels of biodiversity (Wyles, et al., 2019). Similarly, people who watched videos featuring a diverse array of flora and fauna reported lower anxiety and higher vitality than those who watched videos of less biodiverse landscapes (Wolf, et al., 2017).

Findings like these offer valuable insight into how we can engineer our surroundings to best facilitate the highest levels of wellbeing possible. It is clear that spending time in nature is invaluable for our mental health, but a half-hour lunch break doesn’t give us time to go hiking through a biodiverse mountain landscape; what we can do, however, is have access to green spaces which replicate the stimulus that we would receive if we were in nature. This has proven to be an eloquent solution to the pressing issue of depression rates in urban CBD areas (Ebata & Izenstark, 2017).

Summary

In conclusion, the role of nature in our lives is of paramount importance to our health and should be a priority for us all. Although it may feel like adding a daily walk outside to our schedules would be in futility, the positive mental health benefits outweigh the costs significantly. Making time in nature a priority, no matter how little, can greatly increase our overall sense of wellbeing, and remind us that we are interconnected to the living world around us.

There is no minimum threshold required to reap the benefits of nature, so we can all find a way to capitalise on just a little bit of time in natural environments. As a species, it is our natural disposition to enjoy the outdoors, and the benefits are more abundant than you might expect. So pop on a pair of joggers, Google search ‘hikes near me’, phone a friend, and get out there amongst the fresh air; you can thank us later!

References:

  1. Berman, M. G., Kross, E., Krpan, K. M., Askren, M. K., Burson, A., Deldin, P. J., . . . Jonides, J. (2012, November). Interacting with nature improves cognition and affect for individuals with depression. Retrieved from: Website.
  2. Bush, R., Dean, J., Lin, B., & Fuller, R. (2016). Health Benefits from Nature Experiences Depend on Dose. Scientific Reports.
  3. Chowdhury, M. (2021, February 19). The Positive Effects Of Nature On Your Mental Well-Being. Retrieved from: Website.
  4. Clear, J. (2018). Atomic habits: An easy and proven way to build good habits and break bad ones. London: RH Business Books.
  5. Hunter, M. R., Gillespie, B. W., & Chen, S. Y. (2019, March 15). Urban Nature Experiences Reduce Stress in the Context of Daily Life Based on Salivary Biomarkers. Retrieved from: Website.
  6. Huston, M. (2018). How Many Decisions Do We Make Each Day? Retrieved from: Website.
  7. Izenstark, D., & Ebata, A. (2017). The Effects of the Natural Environment on Attention and Family Cohesion: An Experimental Study. Children, Youth, and Environments.
  8. Wyles, K. J., White, M. P., Hattam, C., Pahl, S., King, H., & Austen, M. (2017). Are Some Natural Environments More Psychologically Beneficial Than Others? The Importance of Type and Quality on Connectedness to Nature and Psychological Restoration. Environment and Behavior, 51(2), 111-143. doi:10.1177/0013916517738312

Understanding self-harm, self-injury, and self-destructionUnderstanding self-harm, self-injury, and self-destruction

What is meant by self-harm?

Self-harm is any behaviour that involves the deliberate causing of pain or injury to oneself without the intention to end your life. Self-harm can include behaviours such as cutting, burning or hitting oneself, binge-eating or starvation, or repeatedly putting oneself in dangerous situations. It can also involve abuse of drugs or alcohol, including overdosing on prescription medications. Self-harm is usually a response to distress, whether it be from mental illness, trauma, or psychological pain. Some people find that the physical pain of self-harm helps provide temporary relief from emotional pain (extract from Self harm (lifeline.org.au)).

People who engage in self-harm will profess that they have no intention of dying and that their self-harming behaviour is a coping strategy, however, there are incidents of accidental suicide. The act of self-harm can develop into an obsessive-compulsion experience which can be very difficult to stop, like addiction, without outside intervention. This can result in feelings of hopelessness and possible suicidal thinking. Like building a tolerance to a drug, when self-injury does not relieve the tension or help control negative thoughts and feelings, the person may injure themselves more severely or may start to believe they can no longer control their pain and may consider suicide.

The following extract by Tracy Alderman Ph.D explains the physiological response to physical pain:

“Physiologically, endorphins are released when we are injured or stressed. Endorphins are neurotransmitters that act similarly to morphine and reduce the amount of pain we experience when we are hurt. Joggers often report experiencing a “runners high” when reaching a physically stressful period. This “high” is the physiological reaction to the release of endorphins – the masking of pain by a substance that mimics morphine. When people self-injure, the same process takes place. Endorphins are released which limit or block the amount of physical pain that’s experienced. Sometimes people who intentionally hurt themselves will even say that they felt a “rush” or “high” from the act. Given the role of endorphins, this makes perfect sense” (Oct 22, 2009).

Please click on the link for the full article Myths and Misconceptions of Self-Injury: Part II | Psychology Today Australia

The first step is to distinguish between self-harming and suicidal behaviour by paying attention to a person’s underlying motivation. When working with self-harming behaviour it is important to remember that this behaviour serves a purpose. In collaboration with the client, try to identify what problem self-harm solves for the client. For example, from the client’s perspective:

  • To make me feel real (counteracts dissociation)
  • To punish me (temporarily lessens guilt or shame)
  • To stop me from feeling (when strong feelings are too dangerous)
  • To mark the body (to show externally the internal scars)
  • To let something bad out (symbolic way to try to get rid of shame, pain, etc.)
  • To remember
  • To keep from hurting someone else (to control my behaviour and my anger)
  • To communicate (to let someone know how bad the pain is)
  • To express anger indirectly (to punish someone without getting them angry at me)
  • To reclaim control of the body (this time I’m in charge)
  • To feel better

Tips for helping yourself in the moment
It can be hard for people who self-harm to stop it by themselves. That’s why it’s important to get further help if needed; however, the ideas below may be helpful to start relieving some distress:

  • Intense exercise for 30 seconds, 30 second break, repeat, up to 15 minutes – Exercising intensely will help your body mitigate unpleasant energy that can sometimes be stored from strong emotions. Transfer this energy by running, walking at a fast pace, doing jumping jacks, etc. Exercise naturally releases endorphins which will help combat any negative emotions like anger, anxiety, or sadness.
  • Delay — put off self-harming behaviours until you have spoken to someone.
  • Distract — do some exercise, go for a walk, play a game, do something kind for yourself, play loud music or use positive coping strategies.
  • Deep breathing — or other relaxation methods.
  • Cool your body temperature – Cooler temperatures decrease your heart rate (which is usually faster when we are emotionally overwhelmed). You can either splash your face with cold water, take a cold (but not too cold) shower, or if the weather outside is chilly you can go outside for a walk. Another idea is to take an ice cube and hold it in your hand or rub your face with it.
  • Listen to loud music
  • Call someone you trust or one of the services available like LifeLine 13 11 14, MensLine Australia 1300 78 99 78 and BeyondBlue 1300 22 4636 [see below].
  • You could write an email to yourself to express your emotions, or journal your feelings, if that’s something that might be effective for you.
  • Watch humorous Youtube clips

New, healthier coping strategies may not be as effective as the one you’re trying to replace so it may take practice. Bring lots of compassion to yourself, okay.

You may find that some of these strategies work in some situations but not others, or you may find that you need to use a combination of these. It’s important to find what works for you. Also, remember that these are not long-term solutions to self-harm but rather, useful short-term alternatives for relieving distress.

Mental health services infographic

Emotional Intelligence (EI)Emotional Intelligence (EI)

Emotional intelligence is defined as the ability to understand and regulate your own emotions, as well as identify and influence the emotions of others’. The term was first coined in 1990 by researchers John Mayer and Peter Salovey and was later popularised by psychologist Daniel Goleman.

Emotional intelligence (EI) is the ability perceive, control, and evaluate your emotions. Some people can do this with ease while others require practice in this area. This ability is necessary for anyone who wants to function effectively in a society – it pertains directly to our ability to interact well with others and respond effectively when situations are outside our control.

EI is best described as a way of thinking that enables people to perceive their own emotions, understand the emotional states of others, and behave appropriately in response (Cherry, 2022). People with high EI can feel empathy for others, determine their own emotional responses (including the process of suppressing an emotion as a defence mechanism), and think through situations before responding emotionally. Emotional intelligence is strongly linked to many positive outcomes. Those with high EI are likely to become financially stable, have meaningful and healthy relationships, respond effectively to stress, and maintain desirable physical and mental health (Salovey & Mayer, 1990). They are also likely to avoid dangerous situations (such as driving under the influence), interrupt negative thinking patterns, and use healthy coping skills rather than self-destructive or maladaptive coping mechanisms.

Here are some key features of a person with high emotional intelligence (Drigas & Papoutsi 2018):
– An ability to identify how they are feeling (i.e., the can name what they’re feeling)
– An ability to identify how others are feeling
– An awareness of strengths and weaknesses
– The ability to let go of mistakes and forgive others
– The ability to accept change
– Curiosity about oneself and others
– The capacity for empathy and compassion
– The ability to regulate emotions in the moment

The ability to regulate emotions is a skill that anybody can learn with practice.

How to develop emotional intelligence

The following tips may be helpful if you’re interested in developing or improving your emotional intelligence. Pioneers in the field Salovey and Mayer (1990) have identified four levels of emotional intelligence that are person should aim to move through in order – these are:

1. Perceiving emotions: The first step is to be able to acknowledge that emotions are occurring in the first place. This might involve understanding nonverbal signals from other people or associating internal bodily states with certain emotions. Some clients, especially those who have suffered from trauma, may have a sense of detachment from their bodies, making it difficult to discern emotional states. As such, this lack of internal data will make it harder to recognize emotional states in others. Practicing mindfulness and other self-awareness exercises can help clients to perceive their emotions more effectively.

2. Reasoning with emotions: Once an emotion has been identified, the second step is to learn how to think about emotions appropriately. Many people will shut down in the presence of strong emotions, but emotions can be used to promote thinking and cognitive activity. Developing a sense of curiosity and openness toward emotions can help to facilitate this process, and result in less aversion towards certain experiences.

3. Understanding emotions: The third step is understanding the meaning of emotions in more detail and recognising complex relationships between different emotions. Once emotions are perceived and reasoned with, a person can evaluate them and find the underlying causes of them. This is where emotional intelligence really starts to develop, as it fosters the ability to become less reactive to emotional content and learn to listen deeply to emotions and discern their origins.

4. Managing emotions: Finally, in the fourth step we learn to regulate emotions effectively. This involves a person developing their ability to problem-solve and identify healthy coping strategies for dealing with an emotion. It also involves being able to use the skills learnt in previous steps – perceiving, reasoning, and understanding – to resolve emotional conflicts peacefully. This is the highest level of emotional intelligence.

Generally, building emotional awareness through mindfulness helps to propagate EI within oneself, and learning to perceive nonverbal cues helps to attend to others; outlines of these two angles are as follows:

Building Emotional Awareness

Perceiving emotions is the foundational skill of emotional intelligence, and mindfulness has been identified by research as being one of the most efficacious ways of developing this capacity. Mindfulness involves paying attention to the present moment without judgement or interference. Mindfulness is correlated with greater clarity of feelings and thoughts, and less reactivity and distraction, making it the perfect catalyst for emotional intelligence (Feldman et al., 2007).

Mindfulness generally involves meditative exercises; you sit or lay down, and use the breath and other sensations (i.e., the feeling of feet on the floor, or sounds in the room) to anchor into the experience. As you enter an observational state, encourage yourself to simply notice how your experiences arise, change, and pass away. When using mindfulness to develop emotional awareness, specifically connect to your emotional state. The key focus here is not necessarily on the breath or on acceptance, as per common mindfulness strategies; rather, simply become familiar with the process of having and noticing feelings. If you have difficulty identifying your emotions, try to explore the characteristics of your emotions such as where it is located in the body, how it feels (e.g., warm, cold), how big or small it feels, or perhaps what colour they associate with it.

Regularly performing this exercise will habituate the brain to approach emotions with curiosity rather than avoiding or repressing them. As such, the processes of emotional functioning will become more familiar, resulting in greater emotional intelligence.

Decoding Emotions by Analysing Speech, Body, and Face

Created by Hugo Alberts, this exercise helps people to accurately identify and understand the emotions of other people through ‘reading’ their body language and other nonverbal cues. This is a very valuable skill, as research has shown that cultures all around the world express emotions through similar facial expressions (Friesen, 1972). Similarly, it has been found that deciphering body language can accurately provide insight into emotional states such as anger, fear, pride, joy, and more (Gelder & van der Stock, 2011). Speech patterns are a more nuanced area than body language and facial expressions, but valuable nonetheless; people use thousands of micro semantic terms to express their emotions beyond the words themselves (Sabini & Silver, 2005). By learning to attune to these three aspects of communication (i.e., face, body, speech), a person will be able to exercise enhanced emotional intelligence with the people in their life.


One activity to develop this skill is to use videos that you are familiar with (e.g., films or tv shows) and to spend time evaluating how the actors use speech, body, and face to communicate their emotions. Depending on your current level of EI, you might be able to identify the emotions being expressed but not understand the role of nonverbal cues to communicate this. Another strategy would be to become more self-aware of your own nonverbal conduct during different emotional experiences. Notice your posture, get a sense of your facial expression, notice your stance, hands, chest etc. You could keep a journal of what your speech, face, and body language is like during various experiences throughout the day. Over time, you will come to understand how to decipher these elements and associate them with emotional states. Please be patient with yourself. It is challenging to mindfully pause and think about your nonverbal language when you’re caught in an emotional experience. You may like to ask others whom you trust to give you feedback.

Additional skills

Having covered the internal (emotional awareness through mindfulness) and the external (nonverbal cues), you can then use these new understandings to develop further practical skills. A person can embody emotional intelligence by practicing empathy, active listening, and assertiveness.

Empathy

Empathy is the capacity to understand another person’s experience through their frame of reference (Cuff et al., 2014). Whilst an aspect of empathy is being able to relate other people’s experiences to your own, it is further positioning yourself within the other person’s perspective and relating to them from that place. This is what is meant by “putting yourself in someone else’s shoes.” Empathy is a useful skill to practice because it both requires and fosters emotional intelligence; EI is required to relate fully to another person and is developed further through this process. It is recommended to cultivate compassion for others when developing empathy. It can be an uncomfortable experience, one which people may resist or tense up against.

Active listening

Activate listening can help conversational partners interact in more meaningful ways. It offers people space to explore their feelings, disclose important information, and feel like they are heard, validated, and cared for. Joseph Topornycky has identified some fundamental attributes of active listening (2016). These include:

  • Being non-judgmental: Reserving judgment allows speakers to exercise freedom in exploring and expressing their ideas and feelings.
  • Patience: Being patient when somebody is speaking, and not rushing them or interrupting them, is crucial for them to feel heard and understood.
  • Minimal encouragers: These are small indications of engagement, such as nods and smiles, as well as words like yep, mm-hmm, uh-huh, and more.
  • Questions: Asking the person questions will show that you are interested in what has been said and are engaged enough to want to know more.
  • Summaries: It can be a useful bonding behaviour to repeat what the person has just said back to them, but in different words.

Assertiveness

Assertiveness is often be perceived as rudeness, however, if the person communicating in an assertive way maintains a compassionate undertone, it is very effective for improving EI and self-esteem. Many people lack EI because they were never taught or encouraged to explore their emotions and express their feelings. By learning to express ourselves truthfully and appropriately, a person can validate themselves, protect themselves and set boundaries with others (Makino, 2010).


One way to practice this is through role playing with a counsellor or someone you trust. You can also practice by yourself, playing the role of both parties in an interaction. Practice expressing what is most important for you in a conversation and express the emotion e.g., “I feel worthless, like nobody cares about my opinion” and then offer yourself assurance as if you are the other person e.g., “I really value your opinion, and I am interested in hearing it.”).

If you’re someone who hasn’t been able to assert your needs, wants or feelings in the past, you may feel rude initially. Like I always tell my clients,

  1. self-awareness is always the first step so you may need to spend time meditating, educating yourself, or reflecting on what it is you’re feeling, what you want or need. The second step is to:
  2. identify what you think or feel you need to do
  3. allow that to be there (try not to resist your reality – what we resist persists)
  4. make an intention to ask for your needs or wants – or express your emotions with language
  5. act on your intention

References

Cherry, K. (2022, August 3). How emotionally intelligent are you? Verywell Mind. Retrieved from https://www.verywellmind.com/what-is-emotional-intelligence-2795423#citation-5

Cuff, B. M. P., Brown, S. J., Taylor, L., & Howat, D. J. (2014). Empathy: A review of the concept. Emotion Review8(2), 144–153. https://doi.org/10.1177/1754073914558466

De Gelder, B., van den Stock, J., Meeren, H. K. M., Sinke, C. B. A., Kret, M. E., & Tamietto, M. (2010). Standing up for the body: Recent progress in uncovering the networks involved in the perception of bodies and bodily expressions. Neuroscience and Biobehavioral Reviews, 34, 513–527.

Drigas AS, Papoutsi C. A new layered model on emotional intelligence. Behav Sci (Basel). 2018;8(5):45. doi:10.3390/bs8050045

Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J.-P. (2007). Mindfulness and emotion regulation: The development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMSR). Journal of Psychopathology and Behavioral Assessment, 29, 177–190.

Friesen, W. V. (1972). Cultural differences in facial expression in a social situation: An experimental test of the concept of display rules. Unpublished doctoral dissertation. University of California San Francisco

Gosling, M. (n.d.). MSCEIT 1 Mayer-Salovey-Caruso Emotional Intelligence. Retrieved from https://www.mikegosling.com/pdf/MSCEITDescription.pdf

Makino, H. (2010). Humility-empathy-assertiveness-respect test. PsycTESTS Dataset. https://doi.org/10.1037/t06420-000

Mayer, J. D., Salovey, P., & Caruso, D. R. (2012). Mayer-Salovey-Caruso emotional intelligence test. PsycTESTS Dataset. https://doi.org/10.1037/t05047-000

Sabini, J., & Silver, M. (2005). Why emotion names and experiences don’t neatly pair. Psychological Inquiry, 16, 1-10.

Salovey P, Mayer J. Emotional Intelligence. Imagination, Cognition, and Personality. 1990;9(3):185-211.

Topornycky, J. (2016, June). Balancing openness and interpretation in active listening – researchgate. Retrieved October 23, 2022, from https://www.researchgate.net/publication/315974687_Balancing_Openness_and_Interpretation_in_Active_Listening