What if Problem Behaviors Served an Important Purpose?

Understanding positive reasons for negative behaviors can help you change them

Harry* has compulsively overeaten for as long as he can remember. “I don’t always enjoy what I eat,” he said. “Well, I mean I like food, and I don’t eat things I don’t like. It’s just that I can’t go for long without putting more food into my mouth.”

Gladys* is a recovering alcoholic. “I haven’t had a drink for years,” she told me. “But I still think of myself as an alcoholic. I know that if I started drinking again, I wouldn’t be able to stop. So I don’t start.”

Nina* started smoking when she was ten years old. “I can’t remember a time when I didn’t want a cigarette,” she said. “I’ve stopped a bunch of times, and with a bunch of different techniques. They all work for a little while, but then I go back.”

I have learned that even when someone comes into therapy with the express purpose of giving up a problematic behavior, helping them stop is not always as simple or straightforward as it might seem. Whether the behavior they want to change is smoking, drinking, over-eating, or drug-taking, gambling, looking at porn, engaging in a specific type of sexual activity, or something else, I discovered that in order for someone to stop, they also have to understand some of the positive things that the behavior does for them.

This attitude has become particularly meaningful as research has indicated that many of these problematic behaviors appear to have increased during the novel coronavirus pandemic.

Articles telling us why not to indulge in excessive behaviors during COVID abound. Yale Medicine experts, for example, tell us that excessive drinking has a negative impact on the immune system and the lungs, both of which are targets of the COVID-19 virus, thus potentially increasing both susceptibility to the illness and severity of the symptoms.

Yet several studies have suggested that eating disorders, for instance, can help a person manage anxiety and distress, especially when it is related to uncertainty. Research released in July tells us that the uncertainty and anxiety associated with the pandemic may, therefore be contributing to the uptick in these symptoms.

I have written about the ways that a number of different addictive and risky behaviors are used for self-soothing. Other authors have described the ways that some potentially dangerous behaviors – like skydiving – can be ways of getting in touch with otherwise inaccessible feelings.

Interestingly, the use of problematic behaviors for self-soothing is an adaptive use of these behaviors – meaning, that they help that person function better in everyday life. This seems like a contradiction in terms, sense these behaviors often also make it hard for that person to function well. But recognizing that problematic behaviors may have a role in helping an individual maintain their emotional equilibrium is important for anyone suffering from or working with someone suffering from any of these disorders.

Especially right now, as we negotiate the uncertainty and confusion surrounding COVID-19, there are two important key ideas to keep in mind right now for anyone who is trying to manage any of these symptoms.

1. It is important to recognize that you developed these symptoms for a very good reason, and therefore to stop beating up on yourself for them. As we’ve seen, the symptoms are often an effort to manage, or regulate, difficult feelings like sadness, anger, frustration, fear, and worry. Although happiness isn’t usually thought of as a painful or difficult feeling, there are times when excitement and happiness feel too good. In those times, the feelings threaten to overwhelm our nervous system. We’re just too enthusiastic or we feel just too energized, and we need something to help us regain some kind of equilibrium. You may have seen this with a child who has gotten over-excited at a family event or on a special holiday.

When your mood is too sad or depressed, you may need help with what is called “up regulating,” or bringing yourself back up to a more stable, steady mood-state. And when you are too excited, you may need help “down regulating,” which is also simply bringing your emotions back to a stable position after being too agitated or excited.

As children we learn to regulate ourselves from our parents, teachers, and even older siblings. When the adults in our lives have troubles regulating themselves, however, they cannot teach us how to do it.

And that’s often where problem behaviors come in. While they unquestionably create difficulties, these behaviors also help with emotion regulation. For some people, they are the most effective tools that they have ever found to help them deal with overwhelming, intolerable pain, sadness, anger, and agitation.

It’s important to give yourself credit for making use of those tools. One recovering alcoholic recently told me that she had learned not to criticize herself for her drinking behavior in the past, even though it created serious problems for her, because it had also been her way of trying to manage an impossible situation in her life.

Once you recognize that the behaviors grew out of an effort to manage the unmanageable and to tolerate the intolerable, you can then begin to look for other ways to cope with those difficult feelings.

2. Find alternative ways to soothe yourself, to calm yourself when you are upset, anxious, or angry, to relax when you’re agitated, and to give yourself some energy when you’re feeling down or depressed.

One of the important things to recognize is that addictions maintain themselves because they are very good at managing those painful feelings – sometimes, at least in the beginning, much better than anything else you will try. Throughout the pandemic we have all struggled with difficult emotions that needed to be regulated, which is, I believe, why there has been an uptick in alcohol use and eating symptoms, and probably in other addictive behaviors as well.

As businesses and schools in parts of the world open up and we are moving, in some cases with a lot of anxiety, back into a more “normal” lifestyle, there is an increase in uncertainty, confusion, doubt, and – as cases of COVID-19 increase, fear. More than ever, we need tools for self-soothing.

It is important to note, however, that self-soothing does not mean ignoring either your feelings or the dangers you face. Soothing yourself, either by down- or up-regulating, makes it possible to make some of the difficult decisions you may be facing right now – like whether or not to send your children back to school or to go back into your office, or to go to a party or socialize indoors. Self-soothing allows you to rationally weigh the often-confusing data with which we are being presented, and to decide for yourself whether or not you should wear a mask in public or stay in the presence of people who choose not to wear them.

If you are ready to begin to look for alternative ways to manage your emotions, there are many tools available to help. But again, it is important to recognize as you start that nothing will seem to work as well as the behaviors you are trying to change.

Time and practice will make you comfortable with new techniques, and as you continue to work with them, you will find that eventually it will be easier to give up the old behaviors, because you won’t need them as much anymore. But it’s important to give yourself that time, without judging yourself for how long it takes. Remember – if you’ve been using a particular behavior for self-soothing for a long time, your body and your mind aren’t going to easily let it go. Stick with it, though. Be kind to yourself and eventually you can get there.

There are so many possible tools to use that you will need to explore different possibilities and gradually find what works best for you. This is another reason this process can take time.

Below are just a few ideas that I encourage my clients to try, followed by some excellent books to give you more ideas. (In normal times I suggest things like massage, getting together with supportive friends and family, and other things that involve more contact than is necessarily safe or comfortable in these times, so I am leaving them out here.)

· Take a warm shower or bubble bath

· Slather skin lotion all over your body

· Cuddle up in a heavy blanket

· Drink a cup of hot tea with milk and honey

· Read a fun, diverting book

· Listen to an interesting, diverting podcast

· Listen to music

· Dance to music

· Do yoga, go for a run, or do some other form of exercise

· Talk to someone – a friend, a colleague, a family member. You may or may not want to tell them how you’re feeling, depending on your relationship with them and how they are at responding to your feelings. But sometimes talking with someone about something completely outside of the realm of your emotions can be the most soothing. Pay attention to your own instincts on this.

· Meditate

· Join a support group (there are many online resources available in almost every area that you might be interested)

· Cook something healthy and delicious

· Take an online course (again, one of the upsides of the COVID period has been the proliferation of online classes on just about any topic that interests you – I just took an online class for people who want to learn to crochet, for example)

· Crochet, knit, do an art project – even if you, like me, are a complete beginner at something

· See a therapist

· Consult with a psychopharmacologist to find out if medication might help you

Here are some books I suggest you check out, but there are others, as well as podcasts (some with some of these authors) and online sites for you to explore.

- Susan Albers: 50 Ways to Soothe Yourself Without Food offers a variety of potential substitutes for any addictive behavior used for self-soothing.

- Guy Winch: Emotional First Aid: healing, Rejection, Guilt, Failure and Other Everyday Hurts

- Russ Harris and Stephen Hayes: ACT Made Simple

- Lane Pederson: The DBT Deck for Clients and Therapists: 101 Mindful Practices to Manage Distress, Regulate Emotions & Build Better Relationships.

The most important part here is to simply start trying to build alternative patterns – and to give yourself credit for having found something that worked, even if it had negative consequences. Because the negative consequences would have been far worse if you had never been able to soothe yourself at all.

*names and identifying information changed to protect privacy

copyright@fdbarth2020