Increase your happiness in a powerful way: Gratitude

Knock, knock. Who’s there? It’s gratitude!

One day, a few years ago, I was directed towards a challenge: I was asked to think about a person that had been kind and had done something beneficial for me, but that I had not thanked properly. I was told I could think far back into my life, but to think of someone who was still alive.

After reflecting for some time, I began to think about a high school teacher that had been particularly impactful for my life and my world view. I remembered how this teacher challenged my thinking and helped me remain true to myself and my opinions. He was for sure not part of the status quo; a man not afraid to shake it up and get in a little trouble while doing so.

So I wrote a letter that described the profound impact this teacher had on me and my history. I looked this person up and I found a university newspaper article from Ohio which was titled “He’s not your usual professor.” Before starting to read, I knew it was him. I wrote an e-mail and we establish contact.

Luckily enough, we were able to set up a meeting for dinner. I had my chance. I expressed openly and whole-heartedly the content of my letter. It was a highly emotional experience for me. I felt overwhelmed with gratitude and joy. The experience helped me realize that I had not been alone, not only as it related to this encounter but with many others in my life. There had always been individuals that had help guide my path, although I had not been aware of it at the time.

The man sitting in front of me, my teacher, seemed taken by what was going on. He responded by saying that he had no idea of the impact he had on my life. After seeing hundreds, if not thousands, of students in the previous eighteen years it could be difficult to discern who got the message and who did not. I hope he understood how his message transcended with me and is still with me in some shape or form.

This exercise I was challenged to complete is called “The Gratitude Visit.” If you feel up to it, maybe you can give it a try. Research has shown that this exercise provides a strong boost in happiness and a decrease in depressive symptoms after a person completes the exercise.

As a summary, the steps to follow are:

• Think of a person that is alive and that has done something positive for you. You have not thanked this person properly.
• Write a letter describing what the person did and how this has been beneficial for you. The letter could be about a page or page and a half.
• Contact the person and schedule a visit to deliver the letter and express its contents. Try to do this within one week if possible.
• Reflect on how this exercise made you feel.

Those in recovery from addiction are used to scheduling a time to admit their wrongs and “make amends.” That is an essential component of 12 step recovery. But reaching out to those that have been positively influential in our lives also seems a worthwhile effort that can contribute to our recovery and well-being.

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So you found the cause of addiction?

The complexities of addiction have long been compounded by all the discussions about what addiction is, how it develops, and the factors behind this development. Parallel to this is the discussion on how to better address addiction. Of course, these proposals on treatment and recovery are directly related to the answers someone might have in regards to the first set of discussions: what it is, how it develops, and the factors behind this development. I would term this, someone’s “personal philosophy of addiction.”

Some of the common discussions include the role of genetics, the role of social factors, the role of neurobiology, the role of learned behavior, the role of co-occurring disorders, and the role of childhood experiences. The weight a person would place on any of these factors would inform their “personal philosophy of addiction.”

Once a person has formed their “personal philosophy of addiction”, they could have a sense of what would provide a better alternative on how to address this issue. Do I believe addiction is mostly a direct result of childhood experiences that included trauma? Then I would probably place priority emphasis on the resolution of this issue as it relates to treatment and recovery. Examples as such can be made with all other factors.

When proponents of single factors that explain addiction are making their points, they usually do a great job providing rationale and isolating the factor in such a way that it provides a great opportunity of enriching knowledge on the influence this factor has on addiction. Their intention is a noble one as they attempt to find a better solution to this problem by exploring its root causes and underlying conditions.

The problem in this occurs when a proposal as such does not consider a context in which this factor interacts with many others. Reducing our understanding of addiction to one single explanation is not warranted in our attempt to improve the way we help those afflicted by addiction.

Discussion around these topics tends to be based on premises of mutual exclusivity. If this is right, then that must be wrong.

I believe the discussions should be about increasing our knowledge base and understanding. It should be about integration between all the great things we have learned so far about addiction with all the new perspectives.

Can addiction be a disease of the brain while also having been influenced by social factors and adverse childhood experiences? Why not.

One critical factor not to be left out of the conversation is the person struggling with addiction issues themselves. Each person has a story and a narrative. What could be the perceived causes of one’s addiction could be totally different that the perceived causes of somebody else’s. So let’s listen to them. Let’s try to understand where they are coming from and what they believe in. Let’s also listen to how they believe they can recover. At the end of the day, what the person struggling with addiction believes about all this is more relevant than what I believe as a helper.

Many speak about person-centered approaches, individualized treatment, integrated behavioral health, bio-psycho-social-spiritual approaches, holistic, and whole-body perspectives. Do we really believe it? Does it really show in what we do to help those in need? What do I honestly believe about addiction, how it develops, and how people recover? The answers make a world of difference.

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Ohhh noooo!! It’s a difficult client!!

So how do we react to the difficult inpatient client in our caseload? That person who acts defiantly, does not comply, seems that does not want to be there, but is. Other peers in treatment are not too keen of this client and neither is staff. Does the client follow programming? Not quite.

This scenario presents a challenge to clinicians, staff, and others participating in treatment. The client behaves in such a way that gets under everyone’s skin but is not doing enough to have their treatment terminated. Every morning the news on how clients are doing revolves around this specific person. Whaaaat now? What did the client do (or didn’t do) this time?

How is the psychic and morale of the clinician affected? Do we wish this client wasn’t here anymore? Can insurance please deny further coverage? Can we just kick this person out?

Helping the client engage in treatment can be a work in progress while meeting the client where they are at can also be challenging without the support of other staff who want you, the primary clinician, to “fix the client”. Wishing this client not be in treatment can seem like the best out, but many dynamics must be addressed if we are to remain true to the importance of patient care and ethical practice.

In an individual sense, the clinician must be aware of feelings arising from the situation, be it transference related or due to pressures from others involved. In group settings where staff is present discussing the case, the clinician must be aware of how others’ comments affect their own perspective of the situation and of the individual. Are we buying into the groupthink or are we able to maintain our individual opinions?

They all deserve the best from us, always and unconditionally, whether we like them or not, independent of our opinion, and independent of our professional prognosis.

The need for supervision seems paramount in cases as such. Easy answers should not be expected as there are many factors to consider. But if we are to speak about client care and ethical practice as a priority, the following points are of relevance:

While the client is still in treatment and under our care, this person deserves nothing but the best from us and our team. That is the warranted client care. The possibility of assessing whether the client should be in this treatment episode, or not, becomes a different conversation. Until, and if, a decision as such is made, the client is still a client, no matter anything else.

Am I as a clinician aware of the power of my expectations of the client, on the client’s outcome? There is a chance of closing down possibilities to be helpful if my expectations of this client are minimal or non-existent; if I am not as present as I can be for this person; if “I know this client will fail, so why try”. They all deserve the best from us, always and unconditionally, whether we like them or not, independent of our opinion, and independent of our professional prognosis.

Picture this scenario: I take my car for a tune-up, but I am not one of those to really take good care of the car nor to follow all preventive care suggestions. It is also a bit dirty and filled with fast food reminders. How would I feel if I found out I was not given “the usual tune up” they give everyone else because the mechanics thought I did not deserve it for not taking good care of my car? I did pay the same amount as the “worthy ones”. I don’t know about you guys, but I would not be a happy camper.

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