Insider’s Guide to Early Abstinence

If you want – or are required – to abstain from substances or behaviors, research and its logical implications offer clear guidance on what is helpful. The statements below are written in straightforward language and imperative mood, but honoring each individual is intended. In parentheses is an explanation or explanatory clinical term.

Important: Medical care is assumed and may be sufficient.

Research is clear on what can be helpful

Reassuringly, doggedly, determinedly – relentlessly, when necessary – do these things:

  1. Educate yourself. Don’t believe anybody or any source that doesn’t cite research. (“Personal experience” is anecdotal data, not research data.)
  2. Become the leading expert on yourself. Learn yourself fully, inside and out, so you can know exactly with what you need help. (ancient wisdom: “Know thyself”; logic)
  3. Turn the volume on the intensity of your inner state up or down towards stability. When you sense signs of “flooding,” intervene on your own behalf. (emotion regulation)
  4. Command your attention. (autonomy over automaticity)
  5. Identify thoughts as helpful and unhelpful. Shift your attention to helpful thoughts. (cognitive theory)
  6. Revise false beliefs with facts. (cognitive theory)
  7. Train. Learn skills, then drill and test. (autonomy over automaticity)
  8. Give yourself the mercy that substances or behaviors gave you using your own mind and your own heart. Use your self as the tool. (logic)
  9. Create a life that outcompetes a life with substances or problematic behaviors. People use substances for reasons. The reasons reemerge during abstinence. Life without substances needs to be better than life with them. (logic; NIDA)
  10. However, for now, “good enough” may have to do. Achieving and maintaining abstinence can be a painstaking process requiring attention and endurance. Awards may come later rather than sooner. (delay discounting)
  11. Co-travel with longing. (logic; research on bonding; acceptance of reality)
  12. Approach reality rather than avoid it so strategies are fact-based. (cognitive theory)
  13. Identify problems and solve them. While some are more difficult to put down or stop than others, substances and behaviors don’t make people use or do them. People use substances and engage in behaviors to solve problems, usually to relieve an inner experience of an inner state that feels unbearable. Get to the problem, solve it alternately, and the need for the substance or action may be eased or absent. (logic)
  14. Consult your inner wisdom before speaking or acting. (DBT “States of Mind”)
  15. Specifically, use your inner wisdom to do a cost-benefit analysis with rank ordering before choosing what to say or do – or not say or not do. (cognitive theory)
  16. Lead, follow, and choose based on your values and priorities. (DBT emotion regulation)
  17. Identify automatic patterns of feeling, thinking, behaving, and interacting and replace them with sequences of conscious choices. (autonomy over automaticity)
  18. Mind your energy. Say “yes” to activities, work, study, and relationships that may take short-term effort but provide long-term stability or growth. Say “no” to what includes a thought of “should” and depletes rather than restores. (logic)
  19. Strengthen the whole system through self-care. (backed by about a billion research studies)
  20. Get help with what you can’t do yourself. (belief-freed logic)
  21. Gently but firmly know that if you want to, you can’t. Only when using the substance or engaging in the behavior is no longer automatic or desired might an experiment be conducted. Indulgence may feel merciful in the short-term, but it usually weakens, not strengthens. (autonomy over automaticity)
  22. Surround all your efforts with self-kindness. (research on the interrelatedness of brain functions involving persistent behaviors and bonding, attachment, and love)

While some links are provided, a clinical summary of the research underpinning the statements above and the self-guided program Sanjay Kishore, M.D. and I have co-authored, free for all to use –  Help That Helps: A Kind, Research-Informed, Field-Tested Guide for People with Substance Use Concerns is here.

Self-help is not an evidence-based treatment for substance use disorders. Any self-help guide for substance use concerns is to be used in tandem with medical care.

Harm reduction is the standard of care for substance use concerns but is rarely permitted. This guide is intended to be of supportive, direct help to the many people who are mandated to abstain by the criminal justice system, child custody agencies, employers, and universities.

Last revised 9/25/19

Anne Giles, M.A., M.S., L.P.C., is a counselor in  private practice in Blacksburg, Virginia.

The views expressed are mine alone and do not necessarily reflect the positions of my colleagues, clients, family members, or friends. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Derivation of a Counseling Protocol for Problematic Substance Use
A Kind, Research-Informed Guide for People Seeking Abstinence from Substances