Saturday, October 30, 2010

Exercise for the Choice Muscle

[Originally posted Sept. 4 2010 on]

My friend Alex saw the Light.  He made the Big Decision not to drink any more.  Ever.  On the way home from church, he passed his favorite liquor store.  He made the small decision to turn into its parking lot. 

My friend Sandy had had it with drugs.  While walking in the park, she made the Big Decision to get clean.  At the edge of the park, she could turn left or right.  She decided to turn left, where she usually ran into her dealer.

Moral:  the Big Decisions need the support of the small decisions, or they crash.  The old alcoholic support groups came close to this lesson with the slogan, “One day at a time.”  But at the beginning, it’s more like one minute at a time, or even one second.  What matters is the choices we make while the clock ticks.  The small decisions.  

Addiction is the enemy of decision-making.  Addiction is dictatorial.  As we saw in my previous blog entry, chronic use of addictive substances impairs the brain’s synaptic plasticity.  Major brain circuits become rigid, sclerotic, like arthritic joints.  Our decision-making muscles become enfeebled. 

De-addiction, it follows, must exercise the choice circuits in the brain.  We need to give the prefrontal cortex, the center of executive functionality that makes our brains anatomically human, a steady progression of challenges to think, weigh, and choose.  Repeating slogans and formulas or reciting memorized life stories won’t do a thing for our decision-making organ.  Only persistent decision-making exercise will strengthen its capacity. 

Let’s begin with the body.  Do I have externally visible marks of my substance use?  Do I have red veins in my face, drug stains on my fingers, receding gums, puncture marks, etc.?  Do I have hidden body damage, such as liver damage, heart problems, malnutrition, etc?  Is my diet what it should be?  Am I getting the exercise I need?  Are my teeth properly cared for?  Is my mental state satisfactory?  And if not, what exactly should I do about all of that?  What is my plan? 

Let’s consider my immediate surroundings.  Are there drugs (including alcohol) in my home?  In my car?  At school or work?  Do I have objects that trigger thoughts of drinking/using in my environment?  Where are the ‘hot spots’ of danger in my daily travels, and how can I avoid them?  Make a map!
How do I spend my time?  What about the people with whom I associate?  What is the condition of my emotional life?  Is my lifestyle helpful to my recovery, or not?  What aspects of my personal history are assets to my new life, and what aspects drag me back?  Am I prepared to handle the many mixed messages about drinking/using in my culture?  Is my treatment and support group program optimum for my needs?  Am I prepared to handle near-relapse situations?  Make a plan! 

Our LifeRing meetings focus on the small decisions that people make from day to day.  In my years of attending LifeRing meetings, I’ve heard literally thousands of detailed, particular questions that have challenged all kinds of people in recovery.  I’ve distilled and organized these questions into nine major topic areas and put them into a workbook, Recovery by Choice.  It’s an exercise book for the prefrontal cortex.  It’s like a body-building gym on paper.  Your sober self enters as a 90-lb weakling, and comes out as buff as Aniruddha.  

[The reference is to Aniruddha Bose, a founder of]

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