Tools for Overcoming Substance & Behavioral Addictions
Summary
Ryan Soave, a licensed mental health counselor and Chief Clinical Officer at Guardian Recovery, discusses the nature of addiction as a solution to underlying pain rather than the problem itself. The conversation covers the full arc of addiction and recovery — from acute medical stabilization through long-term sobriety — with actionable, zero-cost tools grounded in clinical experience and neuroplasticity. The episode also explores behavioral addictions, trauma’s role in compulsive behavior, and how to build a life in recovery rather than simply abstaining.
Key Takeaways
- Addiction is a solution, not the problem — it provides relief from an underlying stressor; the real question is what the person is seeking relief from
- The litmus test for addiction: Try abstaining for 30 days — if you can’t stop thinking about the behavior while doing it, or can’t stop thinking about it while abstaining, it likely “has you”
- Detox is only the beginning — removing the substance often makes people feel worse initially because their emotional “medicine” is gone
- Building distress tolerance is the core of recovery — learning to “feel bad” without escaping is the foundational skill
- The Emotional Weather Forecast is a daily, zero-cost self-assessment tool that helps predict and prepare for emotional disturbances before they trigger reactive behavior
- Recovery must move from avoidance toward building — cutting something out is not sustainable; people must construct a meaningful life to replace the function the addiction served
- Sharing your daily plan with others amplifies accountability and makes intentions more real
- Neuroplasticity underpins recovery — the brain can change with intention and experience, meaning new emotional patterns can genuinely be formed
- Trauma is often not a single event but a set of adaptive strategies formed in childhood that become maladaptive in adult life
- Balance is dynamic, not static — recovery is about returning to equilibrium faster after disruption, not eliminating disruption
Detailed Notes
What Is Addiction?
- The DSM does not list “addiction” as a diagnosis; clinicians instead diagnose substance use disorder or alcohol use disorder on a spectrum (mild to severe)
- Not everyone with a period of problematic use is a lifelong addict — context and life circumstance matter
- Soave’s working definition: “Does it have you, or do you have it?” — is the behavior driving you, or are you in control of it?
- Addiction is reframed as a solution: the substance or behavior provides relief from discomfort, pain, loneliness, or trauma
- Quote from Dr. Silkworth (early AA advisor): “Men and women drink essentially because they like the effect produced by alcohol. I believe that effect is relief.”
- The dopamine dynamic: large, fast spikes in dopamine quickly lead to diminishing returns and deeper troughs — people chase a feeling that becomes harder to reach
Types of Addiction Discussed
- Substance: alcohol, heroin, fentanyl, methamphetamine, prescription opioids, marijuana (high-THC)
- Behavioral: gambling, video games, pornography, online shopping, work, exercise, sex, food
- Behavioral addictions can activate the brain similarly to drugs — video game withdrawal in adolescents can mirror drug-seeking behavior
- High-stimulation environments (video games, social media, pornography) create a contrast effect — real life appears dull by comparison, lowering engagement with everyday experience
Acute Treatment and Stabilization
- First priority at intake: medical assessment — alcohol withdrawal can cause fatal seizures; abrupt cessation of some drugs is medically dangerous
- If a patient is too acute for the facility, they are transferred to the ER
- After physical stabilization, clinicians assess: pattern of use, biological/psychological/social impacts, and readiness to engage
- Treatment duration: 7 to 90 days in residential settings
- Key insight: patients who arrive resistant or combative are sometimes better candidates than those who are passive — resistance signals deeper engagement with the problem
The Role of Trauma
- Trauma is often not a single dramatic event but cumulative adaptive patterns formed in childhood
- Children develop survival strategies (fight-or-flight responses) that are appropriate in their environment but become maladaptive in adult life
- Family systems assign unconscious roles to children (e.g., hero, scapegoat, caretaker) that persist into adulthood
- Using children to meet a parent’s emotional needs is described as a “covert form of abuse” — it burdens the child with the job of regulating the parent’s wellbeing
- Recovery involves identifying these patterns not to assign blame but to understand systemic causes and deploy systemic solutions
Building Distress Tolerance
- Core clinical goal: teach clients how to feel bad — building capacity to sit with discomfort without reaching for relief
- Increased tolerance for discomfort correlates with increased capacity for genuine joy and satisfaction
- The deeper someone can go into discomfort, the higher they can reach into positive emotional states
- People who can tolerate emotional pain become less reliant on external substances or behaviors for regulation
The Jellineck Curve (Alcoholism Progression)
- Described in Elvin Morton Jellinek’s work The Disease Concept of Alcoholism (1960)
- Crucial phase: tolerance increases, problems begin (hangovers, arguments, lateness) but seem manageable
- Critical phase: tolerance decreases — the person becomes physically dependent, needs alcohol to function, loses relationships and employment
- Bottom: cycle of drinking to collapse, stopping when physically forced, resuming as soon as possible
- Recovery side of the curve: with treatment and community, people gradually rebuild — tolerance for life stress grows, pleasure from living re-emerges, eventually approaching self-actualization (Maslow’s hierarchy of needs)
The Emotional Weather Forecast (Daily Protocol)
A zero-cost, daily self-assessment tool. Steps:
- Gratitude list — include at least one item that is a current challenge; gratitude is defined as meeting what is as it is, not just counting blessings
- Plan for the day — a loose overview of what is happening (not a detailed calendar)
- Current emotional state — fears, resentments, anger, guilt, shame, or positive states
- What to watch for — based on the day’s plans and current emotional state, predict which personal liabilities or reactive patterns may emerge
- What to strive for — identify ways of being (e.g., patient, tolerant, kind) rather than specific outcomes
- Optional: share this list daily with a trusted person — expressing it externally makes it more concrete and invites dialogue; Soave shares his with 10 people daily
- A nightly review of how the day went against this forecast reinforces self-awareness over time
- The goal is not to prevent emotional disturbances but to be less surprised by them and recover more quickly
12-Step Programs
- The 12-step program framework is discussed as a viable “contained environment” for recovery
- Steps include identifying character defects and virtues (assets and liabilities) — akin to a personal balance sheet
- The final step — “practice these principles in all our affairs” — means building an active life, not just abstaining
- Bill Wilson’s definition of humility from AA literature: “An honest recognition of who and what we’ve become, followed by a deep desire to become who we can be”
- The program emphasizes knowing your starting point (self-knowledge) before building direction
Recovery as Life Construction
- Early recovery = moving away from the substance/behavior
- Sustainable recovery = moving toward a life worth living
- Recovery is not the achievement of permanent peace but the ability to recognize imbalance sooner and return to equilibrium faster
- Quote referenced: “Peace is not finding calmer seas — it’s building a better boat”
- Embracing both “light and shadow” (Jungian framing) is essential — suppressing the shadow does not eliminate it
Neuroplasticity and Recovery
- Neuroplasticity — the brain’s ability to change with intention and experience — is the biological foundation of recovery
- The brain operates differently at different times of day; circuits active at 8 a.m. differ substantially from those at 4 p.m.
- External reminders (written plans, shared accountability) compensate for the brain’s variable state across the day
- Spontaneous self-regulation without any structure or reminder system is described as unreliable