Show Notes

• The Tara Clinic – website
• Professor Paul Gilbert Unstress Episode
• Paul Dillon Unstress Episode

Timestamps

• [00:00:00] Introduction

  • Dr. Ron Ehrlich introduces the episode, acknowledges traditional custodians of the land, and sets the stage for the discussion on addiction.

  [00:01:35] Definition of Addiction

  • Tara Hurster defines addiction, emphasizing that it extends beyond substances to behaviours and habits that provide short-term relief from distress.

  [00:04:15] Diagnostic Criteria

  • Discussion on the DSM-5 criteria for diagnosing addiction, highlighting the complexity and common misconceptions about addiction.

  [00:11:17] Scope of Addiction

  • Examination of how widespread addiction is, with Tara explaining that addiction can affect anyone, regardless of socioeconomic status.

  [00:18:01] Recognizing a Problem

  • Tara explains how individuals often recognize addiction in themselves and the importance of acknowledging the issue.

  [00:24:12] The Brain and Addiction

  • A detailed explanation of how the brain responds to addictive behaviours and substances, and the role of dopamine in reinforcing these behaviours.

  [00:31:25] Similarities Across Addictions

  • Tara discusses how different forms of addiction, whether substance-based or behavioural, have similar underlying mechanisms in the brain.

  [00:36:02] Treatment Approaches

  • Comparison between the 12-step program and Tara’s therapeutic approach, emphasises empowerment over powerlessness.

  [00:42:30] Stages of Change

  • Tara outlines the six stages of change: pre-contemplation, contemplation, preparation, action, maintenance, and recovery.

  [00:54:48] Personal Experience

  • Tara shares her journey with addiction and recovery, illustrating the stages of change in action.

  [01:01:22] Practical Tips

  • Practical advice for listeners on how to identify and address potential addictive behaviours in their own lives.

  [01:01:25] Conclusion

  • Dr. Ron Ehrlich wraps up the episode, emphasizing the importance of compassion and reality-based approaches in overcoming addiction.

Tara Hurster: A Refreshing Approach to Addiction

Dr Ron Ehrlich [00:00:00] Hello and welcome to Unstress. My name is Doctor Ron Ehrlich. Now, before I start, I’d like to acknowledge the traditional custodians of the land on which I am recording this podcast. Custodians that have been on this land for tens of thousands of years, that is the gadigal people of the Eora Nation and pay my respects to their elders, past, present and emerging, whom we have a great deal to learn from about connection for people and country. The two are inseparable. Well, today we are going to explore addiction and we are talking about much more than just alcohol, cigarettes and drugs. As you will learn, the list is long and you may have in passing said to yourself, wow, I’m really addicted to. Well, maybe you are, but it does raise some interesting issues and we cover many of those issues and how to deal with them in this program. It is a really interesting perspective on mental health in general and addictions in particular. My guest is Tara Host, and now Tara is a psychologist whose clinic is in Sydney, the Tara Clinic. And as you hear the Tara in the clinic stands for more than just Tara’s first name up and you will hear the list of addictions are very long. We explore what addictions are, what addictions there are, and how to go about overcoming them. I hope you enjoyed this conversation I had with Tara. Host. Welcome to the show, Tara.

Tara Hurster [00:01:36] Hi. Thank you so much for having me.

Dr Ron Ehrlich [00:01:39] Tara. Addiction is a big problem. I think certainly we hear a lot about it and there’s some stereotypical images of what that means. But let’s go back to 101 here. How do we define an addiction?

Tara Hurster [00:01:52] You’re right there. There is a lot of a lot of problematic language around addiction and the narrative that’s really sort of being put forward in, in Australia and in the world is that it’s an illness or it’s a weakness or it’s some kind of defective character that only plagues those from lowest socioeconomic backgrounds. And the reality is that that’s just not true. It’s it’s not it’s not the case what addiction is. If we get down to the real sort of nitty gritty of it is it’s, behaviour or, an action that we have practised regularly enough that it becomes a habit that is providing short term, almost instantaneous relief of some form of big feeling or distress. Now, that means that when we come to the DSM five sort of diagnostic criteria, we’re looking at things like, hang on, let me get the list out for you, because then I can I can be yeah.

Dr Ron Ehrlich [00:02:57] Yeah. Well, the DSM five is a topic we’ve recently discussed with psychiatrist Mark Horowitz. And, it’s a it’s a big topic. I mean, everybody, we all seek I guess that’s the question. Are we all. Is anyone normal?

Tara Hurster [00:03:11] Well, that’s the thing. There is no such thing as normal because everybody is so unique. So in the DSM five, each of the addictions in inverted commas, sort of separated out into their own kind of category. And I’ve got a list here of sort of smushing them all together to sort of have more of a generic thing. So in order to be quote unquote, labelled with an addiction or diagnosed to have an addiction, you need to meet at least two of the following criteria over a 12 month period. So there’s a few here. So get ready. So consuming or doing more of the substance or behaviour for longer than was originally intended. So that might be a situation such as I had a physical injury and I needed specific pain medication to manage the pain as a result of that injury or surgery. And then I’ve continued using that medication for longer than what was initially intended. Right. So that’s an example.

Dr Ron Ehrlich [00:04:16] Okay. Just read that one again. Again, because I think that’s an interesting one before we even kick off.

Tara Hurster [00:04:22] Absolutely. So consuming or doing more of this substance or behaviour and for a longer than it was originally intended.

Dr Ron Ehrlich [00:04:30] I don’t.

Tara Hurster [00:04:31] Know if if you, if you think about the more part is, perhaps you might say, I’m going to have two drinks tonight and then you end up sort of finishing the night with ten drinks, and you’re doing that regularly. That’s also another indicator. Yeah.

Dr Ron Ehrlich [00:04:47] You’re right. Next one.

Tara Hurster [00:04:49] The next one is wanting to cut down or stop or have tried unsuccessfully to cut down or stop. So that’s really where we’re going. All right. I’m not going to drink tonight or I’m having fed fast or dry July or whatever it is. And that’s a real struggle. Or you’ve you’ve tried to cut down going from ten drinks to three drinks. And it’s just a real challenge to do that. The third point is spending a lot of time thinking about seeking out, using or coming down from a substance or behaviour. Right. So the example might be planning or or getting excited about Thursday night because we get to. Finish work early and we go out for drinks. If there’s a lot of time planning and there’s a lot of time sort of focusing on that, then we’re drinking for an extended period of time. Is a long time actually consuming this substance. Then there’s a period of time of, you know, detoxing from that substance or hangovers, things like that. So Friday morning into Friday midday you feeling really hazy and it’s all just kind of blur and is the technical term. And then looking, looking for, you know, how are we going to do that the next day? Right. So that’s that sense of sort of planning, thinking about basically spending a lot of time in and around this behaviour. That’s the third one. The fourth one is experiencing cravings or a strong desire to use or act out. So that’s where we get that real urge, right? We get that urge or desire to to to drink or use, gamble, have sex, eat food, watch porn, do work, whatever it happens to be, whatever the problematic behaviour is, because addiction is not solely, chemical based process. It’s not just drugs or alcohol. There are also things called process addictions, which is where it’s, a behaviour. And so, you know, on on our website, you mentioned that there’s a big list on this.

Dr Ron Ehrlich [00:06:56] And I want to explore some of those.

Tara Hurster [00:06:57] Yeah. Yeah, absolutely. So some of those are shopping, some of those are work. Some of those are screens. These things aren’t necessarily putting into your system a specific substance. However the interaction with that behaviour, it basically switches on the brain in the same way as if you were to drink alcohol or use cocaine or, you know, whatever it is. So yeah, experiencing the cravings or a strong desire to use or act out. Fifth one is using or acting out is getting in the way of being able to fully engage in work relationships or daily duties. So often with clients that come to the tar clinic, they’re usually, you know, very successful in high pressure positions of power or prestige in the community. And so they have a real sense of, you know, needing to work or needing to be the centre of attention at the party, the life of the party, whatever is right. But by doing those things, by drinking to excess or using drugs to excess or working to excess, it’s actually getting in the way of their relationships or perhaps their health or their safety. It might be getting, in the way potentially, of their finances as well. So this is where we’re doing it. Even though it’s giving us a bad outcome, we’re still doing it anyway. Right? So that’s that one. The next one is so continuing to use or act out despite it negatively impacting on or causing problems for you socially or interpersonally. So that’s sort of similar though. It’s it’s kind of more the first one is more about noticing the immediate impact of, of of this problematic behaviour. The second one is more about it being a long term issue. And even though it’s a long term issue, we’re still doing it. So it’s sort of like immediate risk versus ongoing, problems. Then important social, occupational or recreational activities are given up or reduced due to using or acting out. So this is really where we stop doing the things that we used to love doing. Right. Or we feel like we don’t have time for the things that we used to love doing, because all we’re doing is working as an example. Using or acting out is impacting on your physical safety or well-being. So that might be that we are using a cocktail of drugs and alcohol, and that could be, impacting on you in terms of your health and well-being. You might be drinking and driving, which is also putting yourself and others at risk. So these are some of those those examples for that one. Then, continuing to use even where there are physical or psychological problems that are likely caused or exacerbated by using the substance or doing the behaviour. So a great example of that is liver function tests, right? If you have poor liver function and you still continue to drink alcohol, then that is demonstrating that there’s a problem here. The second last one is noticing a tolerance to the substance, or noticing you feel you need more of the substance, or doing a higher risk taking behaviour to get the same buzz, or having the same amount doesn’t impact you as much as before. So, for example, first time you drink alcohol, you know, maybe you were a teenager. You had a beer. It kind of got you all fuzzy in the head and you would, you know, giggling like crazy. Now, if you have one beer, you have a tolerance, right? So it’s not it’s not giving you the same impact as what it did when you first started to drink. So, when we look at tolerance, it could be either drinking more to try and get that buzz or just noticing that you don’t get the buzz at all. And it’s almost like you drink to feel normal. So that’s that’s kind of what’s happening there. And then the last one is experiencing withdrawals from the substance you’ve used or, you know, behaviour. So it’s almost like if you go on holidays and you absolutely can’t on unwind or switch off, then there might be a problem there with regards to your work because you’re struggling to kind of, detox in the comments.

Dr Ron Ehrlich [00:11:18] And if I’m not mistaken, the DSM five you’ve listed out there, what about ten different, criteria? And if you tick two of those boxes, two, you have an illness which, which is opens up a whole lot of other discussion about what the DSM five was really all about, whether it was about reaction or pathologizing and making it an illness which gave psychiatrist, a bigger hat to wear. But but, I mean, I think as people would listen to that would go. Okay. Interesting that. Yeah. And not quite maybe, but really, out of those ten, all you need is to tick two of those boxes and hey, guess what? You’re addicted. Which leads me to almost a rhetorical question. How big a problem is addiction? Yeah.

Tara Hurster [00:12:07] Look, any time I’ve read out that list on any sort of interview that I’ve done, usually the response is, well, clearly myself and everyone that I know has some form of an addiction. And you’re right, according to that, that is true. Yeah. So part of what I think is important to remember is that, like with anything, if a decision is made in a silo, then we’re not actually getting the full context of the situation. Right. So if we’re thinking about ourself and we’re thinking, okay, I, I’ve ticked two of those things, though I’m not really feeling like it’s, you know, majorly impacting, then it doesn’t mean that you have to go to rehab. You know, there are other things that you can do to explore what level of treatment or change would benefit you to build a full, rich, and meaningful life outside of these these things. So I think I heard recently or late last year that I might be fudging the numbers here, but I think it was like 78% of people with an addiction, full time employed. So high functioning individuals. You know, they could be your boss. They could be part of your team. They could be your neighbour. They could even be your partner. It could be you. Then you’re trying to pretend that it’s not happening, right? There’s. Addiction is. It doesn’t discriminate. There’s no sort of key criteria that you that that makes an addiction happen. You know, there are certain things that, may escalate the chance of you living with an addiction. But it doesn’t mean that just because you had childhood trauma, you’re going to be addicted to something or just because you had, I don’t know, an injury and were given opiates for your for your pain management that you’re going to automatically become addicted to heroin. You know, these things. It’s not a linear thing. It really comes down to the skills and tools and strategies that you have learned and and regularly implement in your day to day life that allow you to manage stress and distress. And really, that’s when when I look at how I treat addiction, I, I don’t actually talk about the problem at all, like the symptom, which is the drug use or the alcohol use of this porn or the sex or whatever it is that I don’t really focus on that. I focus on the driver behind the behaviour. What is what, what’s the purpose of the use and what are you trying to get out of it? So for example, let’s use alcohol because it’s a pretty common one. You know, we drink alcohol when we get home from work because we feel stressed and we want to relax. Right. So the driver behind the behaviour is stress. And the outcome that you’re after is relaxation or a release. So if we go, all right, let’s just take alcohol out of this equation for a second. You’re experiencing stress, which you’re trying to manage in order to receive a release or relaxation. So where can we start to implement some problem solving and management strategies ahead of time to manage the stress before it happens? And what are some other ways that we can implement relaxation or release so that we’re getting the the true outcome? Because alcohol doesn’t actually fix the problem, and alcohol doesn’t actually give you the result that you’re after. It’s it’s a muscle relaxant, which sort of makes the brain believe that I’m relaxed, but it’s actually just the physiological interaction between the chemicals and the way that your body deals with those chemicals. That it’s that that’s why having a drink at night, in inverted commas, is giving you relaxation. It doesn’t solve the problem that caused the stress in the first place, and it doesn’t actually give you relaxation. So if we just remove that and focus on all right, well what is the stress that’s happening. Is there a way that we can delegate something. Is there a way that we can communicate early and often to to set expectations more effectively? Is there you know, increasing our exercise or our mindfulness practice will help to manage stress and also will give us that release and relaxation. Can we schedule in a weekly massage? Can we, you know, do the bath tub at the end of the day, right. You know, whatever it is. Yeah, that’s that’s kind of how I look at it.

Dr Ron Ehrlich [00:17:12] Yeah. But before we go into that approach and I know, you know, I love the fact that Tara Clinic, apart from your own name, stands for Therapeutic Addiction Recovery Assistance. And we want to talk about that, but I want to come back still to the addiction itself, because you’ve listed out ten, criteria. And according to the DSM five, which is the Bible of psychiatry, and mental illness, you only need to take two of those boxes. So let’s put that aside for a moment, because, you know, we could talk about what a great business model that is. But, but but in your experience, when clients come to see you, how do, how do you assess whether this addiction is a problem? I mean, in in a nutshell.

Tara Hurster [00:18:01] Well, the the the the biggest and most obvious indicator that there’s a problem is the fact that they’re in front of me to begin with.

Dr Ron Ehrlich [00:18:09] Okay.

Tara Hurster [00:18:10] Because most of the time people aren’t going to seek out support for something if they don’t perceive it as an issue in some way. And I feel that while, yes, I am an expert in this field, and yes, I am highly. Highly, experienced and confident and competent in being able to do all of this. The reality is that the person sitting in front of me is the expert in their life. They are the expert in their story, and so they are going to know whether or not what is going on for them is actually a problem or not. So the way that I look at it is I don’t like to assess someone and tell them something that they’re not ready to hear because, you know, you’ve got the stages of change in the, in the, in the, the research. There’s five stages of change. I believe there’s six because I’ve lived it. And, you know, we can talk about that if that’s of interest to you and your audience, though the the thing that I think is important and the question that I feel you’re asking is, what does it look like to have an addiction? How do I know if I have an addiction? And.

Dr Ron Ehrlich [00:19:26] Well, I guess the the people who was sitting in front of you are coming and going. There must be a commonality in the story that they tell you that’s brought them to this point of realisation.

Tara Hurster [00:19:37] Yes. And usually the story is I am so successful in all areas of my life or I’m, you know, I, I’m pretty successful in most areas of my life, yet I can’t for the life of me solve this problem. And I don’t understand why this is so hard. That really is the main storyline that underpinning thread is. I don’t understand why I can’t get a handle on this when I’ve been able to build a multi-million dollar business or, you know, be, a mum of five kids and, you know, keep everybody alive or, you know, whatever. I, I’m successful in other areas of my life, and I just can’t seem to solve this problem. And whether the problem is, you know, too much porn use. So for example, I’ve, you know, had clients come to me, in different age groups, different genders, different, you know, work. Sort of space. And the the common thread is I’m noticing that I’m spending too much time on the computer watching porn that is impacting on my. Let’s say if I have a relationship, my sexual intimacy with my partner, if they’re single, it’s getting in the way of me having motivation to go out and date to find someone because, you know, I’ve got my toys or I’ve got my hand or I’ve got whatever it is to kind of do it myself. So I’m not getting that motivation to actively go out and seek, a relationship. So part of what tends to happen is there’s this real sense of disconnection, right? The same can be said for someone who’s drinking too much. You know, there’s arguments in the home. There’s, you know, performance issues in work and, you know, often sexually as well. You know, there’s, there’s, a lot of these things that are building this disconnection, right? There’s that these kind of the common themes is there’s this real sense of disconnection and a lot of time and energy being in the problematic behaviour.

Dr Ron Ehrlich [00:22:00] I mean, I think the I’m looking now at the list that you have on your website and it’s a really it’s a long list and I think there are some statistics, some, some examples that are just everybody acknowledges, you know, cigarettes is an obvious one. Alcohol is another one. Cocaine is another one. But I think there are some that people may not recognise as addictions that are impacting negatively on themselves and their relationships. I think technology is one we’ve explored before, but this is when you just have to look anyway to see that that has got to be the big one. One of the big ones shopping is another one, but we’ll come to that. But go on, tell us what your what your perception or what you’ve noticed in that space.

Tara Hurster [00:22:46] Yes. It’s to explain that I need to come back to the brain.

Dr Ron Ehrlich [00:22:51] Okay.

Tara Hurster [00:22:52] I have a crush on the brain. It’s one of my favourite topics to talk about. I think it’s just such a such an incredibly, intricate organ that we all possess. And. Yeah. So if I break the brain down into three really simple sections, you’ve got the back part of the head, which is really what keeps us alive as a human and as a as an individual and as a species. So the back of the brain deals with, you know, a core temperature, needing to, pee or poo, your sex drive, hunger, those sorts of things that literally keep us physically alive. The front part of the head deals with all of our higher order thinking. So problem solving, conflict management, language, personality, memory, emotions, all that stuff that makes us really human. Is it the front of our head, in the middle, attached to the bit that keeps us alive? That’s really where our natural threat response lies. So our threat response is fight, flight, freeze, feint and fawn. All five of those things are normal, natural, healthy, and helpful management techniques to implement. When we have a tiger in front of us that wants to eat our face, right?

Dr Ron Ehrlich [00:24:12] Give us, give us those five F’s again, I love that.

Tara Hurster [00:24:15] Absolutely. So we have fight. So I’m going to kill the tiger.

Dr Ron Ehrlich [00:24:19] Yep.

Tara Hurster [00:24:19] Flight. I’m going to run away from the tiger.

Dr Ron Ehrlich [00:24:22] Yep.

Tara Hurster [00:24:23] Freeze is I’m going to just stand really, really still and hope it doesn’t notice me. Faint is one of two things either you literally pass out, right? Because, you know, some people do literally pass out or you kind of almost dissociate. So you sort of step out of the reality. And yeah, that’s that’s kind of part of what feint is. And then fawn is really about, you know, in in human world, fawn is I’m going to try and make myself exciting for you or helpful for you or good for you. So I’m going to people please. Or if I’m in a threatening situation, I might try to use, you know, I might try to flirt with you if I’m feeling threatened. Right. To try and make you not feel, as threatening, you know, or whatever it is. Right. So fawn is basically trying to make yourself a pet so that you don’t get eaten, you know, or feed the tiger so that it doesn’t eat you. Right? So those things. So fight. Kill the tiger, fly. Run away from the tiger. Freeze! Hope it doesn’t see you. Faint is a the space out will drop, and then fawn is. Try and feed it so that you become useful.

Dr Ron Ehrlich [00:25:40] I love that already. Is that you run a little thing a lot. I mean, I mean fight. Flight is what we hear a lot about, and phrases certainly come up in the poly vehicle theory of Steven Porteous, etc.. But I love this, fight and fawn.

Tara Hurster [00:25:56] Yeah. Look.

Dr Ron Ehrlich [00:25:58] They not the five stages you were talking about.

Tara Hurster [00:26:00] No they’re not.

Dr Ron Ehrlich [00:26:01] That’s a different one. We’re going to come to that.

Tara Hurster [00:26:02] Yes. Or six.

Dr Ron Ehrlich [00:26:04] Stages.

Tara Hurster [00:26:05] Yes. Look, I did not make that up. That is coming from the research of how the brain deals with threats. And I would love to be able to say that I came up with that. I would love that. But, no, that is not.

Dr Ron Ehrlich [00:26:18] Good on you. Good on you. But anyway, that’s so interesting and an interesting way. And I love your dividing up of the brain. I mean, because, you know, we spend a lot of time in the threat, stage of things. And actually, one could argue that, it’s part of a great business model to keep you in the stage of threat where you look to soothe yourself in some way.

Tara Hurster [00:26:42] Well, yes. Because so here’s the thing is, when I’m not a big words person, I never have been. It’s just not my vibe. So there’s a whole heap of chemicals that are produced by the fight or flight part of your brain. And I just call it mush. Right? So when mush is in your brain, what happens is it actively switches off everything that we don’t need to run away or fight the tiger and switch is on. Everything that I do need to run away or fight the tiger. And one of the things that it switches off because it’s completely unnecessary and actually problematic if you’re dealing with a tiger situation, is it actually switches off the front part of your head. So that’s the part where you have logical thinking, problem solving, conflict resolution, language, memory, all of those things that make us really human get actually switched off when we’re in a stressful situation. Now, the brain hasn’t evolved in as fast away as what our environment has evolved. And so when we are in traffic or we have, you know, a deadline at work that we need to hit or else something happens, right? Or if we have an argument with our spouse or, I don’t know, it could really be anything. It switches on that threat response part of our brain in the same way as if we had a tiger drooling in front of us when we were in a cave. And so our brain reacts rather than responds, because responding takes time, and time is not a helpful thing to be using up. When you have teeth and claws in front of you, you want to be dealing with things really fast. So you want to react. And what happens is, is the brain remembers what helped to save our life last time in the quickest way possible. So if it’s saved our life, for example, let’s say, we were back in the days we had sabre tooth tigers trying to kill us. And we’re walking through the forest and we hear a twig crack, and we turn around and we see a tiger. Tie is probably a poor choice because it can probably climb a tree. But let’s pretend a tiger can’t climb a tree, right? So we look and we see a tiger, and we go up and we flight. So we race up a tree and sit at the top of the tree. And we watch the tiger. And it’s trying to get us. It’s trying to get us, it’s trying to get us. And after a while it gets bored and goes away. Our brain says, when I see something that looks like that, I climb a tree because that saved my life this time. And it was pretty quick. It was pretty instantaneous. Fast forward to today. We have feelings of stress and distress, and we drink alcohol. Or we have watch porn or we eat sugar or whatever it is. Our brain is experiencing a mood altering behaviour or a mood altering substance. So almost instantaneously, our brain learns, oh, when I’m feeling those feelings, I do this behaviour and I get this result really quickly, so it will then end up in a bit of a loop where anytime we feel stress, we go to that behaviour because that behaviour solved the problem in the short term last time. It doesn’t matter that our logical thinking knows that drinking alcohol isn’t going to change the fact that our boss is a douchebag, right? If that’s what’s causing the stress, right? But the brain thinks that the drinking of the alcohol actually saved our life for the next time, you know, so we can now go and deal with our next day without, well, surviving. And that’s where it’s not about the substance. And I guess that’s all the behaviour. It’s that’s not the problem. The problem is the brain has learned that by doing that behaviour you get a really instantaneous response. And it’ll just do it again because it doesn’t want to think.

Dr Ron Ehrlich [00:31:06] So essentially the addictive behaviour is almost irrelevant. Yes. Yeah. I mean that’s what you would say because technology seems so different to consuming alcohol or cannabis or or cocaine. Yes. And yet and yet. No, that’s not that different.

Tara Hurster [00:31:25] Exactly. So this is where the brain comes back in again. Because when I have got up the tree and got away from the tiger and I’ve watched the tiger live, I get flooded with these really happy hormones. Right? It’s called dopamine. And there’s a few other ones, but I just sort of stick with dope. Makes it easy to say so when when we get flooded with dopamine, that’s how brain going that worked. I’m going to remember that. So I’m going to feel good and relate it to that behaviour because that saved my life. So it’s the same reason that orgasms feel really good because they save humanity. It’s through orgasms that procreation is, you know, there’s a motivation to procreate and there’s also the act of procreation. So the, the, the good feeling is literally linked to survival. So when we think about dopamine, you know, poker machines, have got loads of research on how dopamine is, is being produced as a result of the way that those machines work. The same can be said for social media algorithms. They’re very closely linked to how casinos work. It’s really interesting. I think there was a podcast on Rogan. Yes, but.

Dr Ron Ehrlich [00:32:53] There’s a plug for Joe is though. He needs it on my podcast. Yeah. That’s right, that’s okay.

Tara Hurster [00:32:59] But yeah, so there was there was a guest that came on to his podcast once that I happened to come across, and he was talking about how, the way in which casinos are run and the research that’s being done in casinos was actually being extrapolated out into Facebook and Meta and all of those things. And it really is about providing, the brain with, consistent buzz of dopamine. So when we experience boredom. Back in the day when we didn’t have phones and computers literally in our pocket. We would draw, paint, sing, play. We would go and, you know, build something or, go for a walk or hang out next to a tree. Those things gave us the dopamine hit, but those things took take more time to give us the dopamine hit. So our brain is all about using the small and smallest amount of calories when it is stressed as possible, because calories literally keep us alive, right? So if our brain needs to use a lot of calories to get to the life saving outcome through going for a walk or hugging a tree or, you know, going for a swim, whatever it is, then all of a sudden realises, oh, if I flick through Facebook, I get distracted and then I feel really good. It’s going to say, well, I’m not going to spend the time going for the walk. I’m going to do the shorter option because I save more calories that way. And again, back in the OG days, calories were not as easy to come by as they are these days. We didn’t have supermarkets and fast food and Deliveroo and all of those things. We literally had to go out and either forage for our food or kill it, and both of which took calories. So the brain is really a primitive thing that we are trying to navigate a very modern world, using this primitive sort of resource.

Dr Ron Ehrlich [00:35:05] And, and of course, you talking about instant gratification as a way of satisfying that. And of course, that is what, we have in our modern world. I mean, instant gratification. And I guess one could include technology, shopping, porn, gambling, all on those, on those levels there. And, but coming back to, overcoming addiction. I mean, I think we’ve established, that it is a problem and there are many aspects to it, but it really has a common and a commonality to whatever addiction we have. And I come back to your Tara Clinic for therapeutic addiction recovery assistance. And I think people are familiar with the 12 step program of I, although I must say, I mean, I know of it. How does that it’s how does that differ from the way you would approach this problem? I mean, maybe be worth just saying what it is first and then how you would approach.

Tara Hurster [00:36:02] Sure, absolutely. So the 12 step program started back in sort of the 1940s, I think, in, in America. And it was started by these two men who had experienced a lot of problems with alcohol, and they came together and sat on their porch together and spoke about all the awful things that that that had come about as a result of their alcohol use. And what they found is that by doing that every day, they noticed that each day they were able to sort of be held accountable and they were able to, choose not to drink alcohol for another day. And they found that in this sense of kind of community and connection that they were building, that they were able to step away from the behaviour that they didn’t want to do anymore. And that is really where the 12 step program kind of came to be. They wrote the big book, which is the 12 steps. I don’t.

Dr Ron Ehrlich [00:37:05] You don’t have to go through the 12 steps yet.

Tara Hurster [00:37:07] Because I was going to say Russell Brand wrote, modern version of the 12 step, program, and it’s it’s literally there. It’s literally called recovery. So if you look up, if you’re interested in the 12 step program, Russell Brand is a very big advocate for the 12 step philosophy. So the book is called recovery. And he kind of rewrote the 12 steps to the sort of more modern language, and he swears a lot. So it’s kind of funny to, to read, but basically what it talks about is that you, first of all, need to acknowledge that you, that you are powerless over this addiction. And, the biggest difference between the 12 step framework and the TR clinic is that I don’t believe in powerlessness. I believe in empowerment. And by the way that I look at it is when you feel when when someone who is quite highly successful is told that they have to, you know, believe that they are actually powerless over something that’s such a clash with their worldview that it can be really quite problematic. And, and they can become resistant to that. So it’s not that the 12 step program is bad, it’s just that it doesn’t work. For everyone because not everybody aligns with that notion of powerlessness. For some people, it’s really valuable to have the 12 step program because it’s very clear this is what you’re allowed to do. This is what you’re not allowed to do if you do the things that you’re not allowed to do. You have relapsed, and therefore you need to go back to the beginning and start again. The Tara Clinic doesn’t look at it like that. I actually look at I’ve completely changed the language. So in the research and in the 12 step program, well, the 12 step program only uses the term relapse. And in the research the, the terms lapse and relapse. So lapse at the tar clinic, I call it a lesson. So you have a lesson when you have made a decision, for example, that you don’t want to drink alcohol tonight, all of a sudden you have a drink in your hand, you’ve had a couple of sips, you go, oh, shit. Hang on. I didn’t actually want to do that. And then you pull the drink out, you put the glass away, and then you go and do something helpful, right? That is a lesson that’s an opportunity for learning. And from my perspective, I feel it is a fundamental, fundamental aspect of the foundation of learning in early recovery. Whereas with the 12 step program, the moment that you’ve had a lapse or a relapse, you have to start counting from day one again. So there are people who have had, you know, ten years worth of sobriety and they have a lesson, and then they have to go down to day one. And the way that I look at that is it can be quite problematic because it is almost through the language. It’s negating the the learning and the development that someone has had over that last ten years and pretending that doesn’t exist or it doesn’t count for anything. Whereas from my perspective, I feel that it’s through those lessons that we can work out. What were we doing really well? What could we do differently next time, and what were the things that we learned that we had no idea what triggers for us as a result of this lesson? So the 12 step program is very much abstinence based. And that means that if you are experiencing problems with, say, alcohol, then the expectation is that you’re going to stop smoking. You’re going to also stop doing any form of drug use. And in some cases, it might even go so far as sugar and caffeine and, and prescription medication for, you know, anti-depressants and things like that. It depends on which sort of community you’re part of as to how strict it kind of can become. And the idea is that you identify as an addict. So each time you attend a meeting, you say, hi, I’m Tara, I’m an alcoholic. I’ve been sober for 743 days. And let me tell you all about all the bad things that happened to me when I was drinking. That’s kind of the the framework of a, an AA meeting where the way that I look at it is our words mirror our thoughts. Our thoughts impact on and are impacted by our belief systems, and our actions and outcomes are driven by all of those three things. So if I say that I’m an alcoholic, therefore I think about myself as an alcoholic and I believe that I’m an alcoholic. So that means that my actions are going to be as someone who is an alcoholic, which might be filled with fear around alcohol and desperately trying to avoid it all the time. Or it could be, you know, self-sabotaging and then going down the rabbit hole of alcohol use because, you know, I’m an alcoholic and that’s what an alcoholic does, is they drink to excess the moment they have a sip. Right. So this this belief system can sometimes actually get in the way of true holistic recovery. The I guess this is where the, the stages of change can actually.

Dr Ron Ehrlich [00:42:31] Yes, I was going to I knew they would come in. So let’s go. Six. You’re not five, as you pointed out, but six states.

Tara Hurster [00:42:37] Absolutely.

Dr Ron Ehrlich [00:42:38] Changed. Go on. Tell us about those.

Tara Hurster [00:42:40] Absolutely. So.

Dr Ron Ehrlich [00:42:42] Because, Tara, I must say, you know, people, you know, where you get up. I am an alcoholic. I wonder whether, you know, saying I’m an addict would open you up to a whole, can of worms. Because if you’ve substituted alcohol for a socially acceptable thing, like, say, shopping or technology. Yeah. Which I can imagine a lot of addicts would do. You know, that’s another thing. But go on, talk about the six stages of change.

Tara Hurster [00:43:09] Yes. So I’m going to use a visual aid. So for those of you who are watching, awesome. Those of you who are listening, maybe find the video. But this is really the stages of change. So the pre contemplation stage is really kind of seen as denial or no hope feeling like this I don’t have a problem or. There’s no solution. So why would I even bother trying? Right in here is when we’re actively living within our addiction. Then we have the contemplation stage. So contemplation is really acknowledging that there might be a problem here, or there could be an option for a solution, but I’m not really ready to do anything about it yet. I’m just sort of acknowledging that something’s kind of there. You know, that could be an issue or there could be a solution. So then we move into the preparation stage of change, and the preparation stage can really be like, all right. I’ve acknowledged that there’s an issue and I’m exploring my options, or I’m starting rehab or I’m starting therapy, or I’m reading some things, or I’m doing some courses, I’m learning about it, but I’m not implementing yet.

Dr Ron Ehrlich [00:44:21] Sorry. That fourth stage again. So we had contemplation.

Tara Hurster [00:44:25] Yes. Correction is the third stage of change. Yeah. So we’ve got pre contemplation which is denial or there’s no solution. Contemplation which is. There might be an issue that I’m not ready to do anything about it yet. And then preparation is the third one which is where we’ve acknowledged there’s an issue with acknowledge there’s some options. We’re exploring those options, but we’re not necessarily implementing them yet. You’ll see that there is, sort of a darker colour moving towards a lighter colour. And what that’s what that’s sort of demonstrating there is that we’re starting to explore the option of moving away from the addiction and towards recovery. But the biggest change in colour is between preparation and action, which is the third and fourth stage of change. So the action is a completely new interaction with ourself and with the behaviour. Action is where we’re actively implementing some of the strategies. We’re truly starting to do the work. So in preparation we might be doing some of the learning, some of the understanding, some of the, you know, we’re kind of interested in it and we might stop because stopping and changing are two very different things. So we might stop, which might mean we do, you know, dry July for a month or something like that. That would be in the preparation stage of change, because we’re kind of holding on and white knuckling it for a month, and then we get to the end of the month. We go, well, I did it. Let’s have a drink to celebrate, right? That’s quite often what happens. So in action, that’s where we’re truly starting to change. We’re starting to look at all areas of our life and our identity in a new and unique way. So we’re thinking about things like, all right, how are we setting boundaries, how we communicating to people in a healthy and assertive way? What kind of relationships are we building and maintaining, and which ones are we moving away from? What are some of the behaviours that we’re choosing to do the past times that we’re interested in all of those sorts of things. We’re actively starting to do the work. Then we move into maintenance. Now in the research, maintenance is the final stage of change. However, from my perspective, I don’t agree. Maintenance is really where we’re still doing the work, but it’s not as hard because we’re kind of becoming more used to it. It’s sort of becoming more of our day to day lifestyle, right? However, in the maintenance stage of change, you will still experience a lesson here and there, and that’s really valuable. It’s really valuable because over time our lifestyle changes. So our style of living and you know, what we’re doing and who we are interacting with and the stresses we may overcome, they’re going to change. So there will be times where we will be faced with a situation where we think, oh shit, I don’t know how to handle this. I’ll have a drink and then go, oh no, hang on, I don’t. I’ve got other things that I can do. Right. And then you start to implement those things. So in maintenance, we’re still kind of doing the work. It’s just it’s not that hard anymore. Recovery is where in the diagram you literally flick off and you move away from this cycle completely. And the recovery is where you have completely redefined the nature of your relationship to your own identity and also to the world around you. You have replanted yourself into such a way that you are living a full, rich, and meaningful life in the way that works for you, rather than the way that society believes you should be doing it, or your friendship circle believes you should be doing it, or media says you should be doing it right. You are building the life that you want. Now, if I use my own example. So I’m in recovery and I literally forgot that I was in recovery until last year. That’s what I mean by recovery. You can literally forget that you lived with an addiction. It’s still part of your story, but you don’t identify with it in the same way as when you’re in the stages of change. So when I was in year six, I was picked on a lot because I was the tallest in, in my school. I was always very tall when I was born. I was, the doctor said it’s a long before it’s a girl. So I was always destined to be very tall. And I was picked on, and I heard that smoking stunted your growth. So I started smoking when I was in Essex to solve that problem. Well, when I got into early adolescence, I started to identify as a smoker. So it was part of being cool. It was part of who I was. I was also I had a purpose because I being tall and looking the way that I did when I was a teenager, I looked like I was 19, so I was also able to purchase all of the cigarettes for everybody else. That. Wasn’t able to purchase cigarettes. Right. So there was this sort of purpose driven, there was this connection that was built between this group of kids that I was a part of. When I got to sort of 16 years old, I started to notice little sort of wrinkles on on my, on my lip. And I was really unhappy about that. So I moved into contemplation. All right. So I moved out of pre contemplation into contemplation. So I saw that there might have been an issue, like I wasn’t okay with being a 16 year old girl and having little wrinkles on my lips because of smoking for that long, but I wasn’t ready to do anything about it right then as I moved into sort of year 11. So 16 was sort of you ten year 11, sort of 17 ish. That was when I started to move into the preparation stage. So I just noticed that I naturally started to sit with different people. I would still go and have a cigarette at lunchtime and recess time in the smokers group, but then I’d leave and I’d go and spend time with other people and, you know, different friends and do my schoolwork and all those sorts of things. As time progressed into, year 12, I noticed that my body just naturally moved into the action stage of change. So in the middle of my, HSC trial exams, I, I literally gave up smoking. And in the most stressful time of a teenager’s life was when I moved away from cigarettes, which is meant to, quote unquote, relax you. And what I realised is that it’s actually 3 to 5 minutes of deep breathing exercises in an environment away from a stressful situation because I wasn’t allowed to smoke inside. So while I was, I wasn’t allowed to do it while I was studying. Right. So when I realised all of those things, I started to swap things out. So I would use a long straw. I’d stuck on a straw and it would give me the same sensation as a cigarette, but it wouldn’t be harming me, right? It wouldn’t have the same smell, it wouldn’t have the same taste, all those things. And my body was already ready to move on from it. The the things that I noticed during that action stage are changes that I needed to put specific, practical steps in place to make it easier for me to follow through with the action I was taking. I used to always hide my cigarettes in my car because I purchased my car. I had the keys in my car. My mom was not allowed in my car because it was mine. So that was where I would keep my cigarettes because before I had my car, she would always find them and tear them up, and then I’d have to buy another pack and it was really annoying. So when I had my car, they were always in the glovebox or the centre console. So when I was starting to move away from cigarettes, I noticed that I would automatically get into the car, open the centre console, go to reach for my packet of cigarettes that wasn’t there anymore, and it made me realise, oh, if I had a packet of cigarettes still sitting in there, just in case, I would probably be smoking right now that because I didn’t put cigarettes in there, it made me realise that my body was just naturally going through that habitual thing of reaching in for the cigarettes. So I was putting strategies in place to help myself achieve the outcome that I was asked of, which was to not smoke anymore. I was in the maintenance stage of change till probably about midway through my 20s, and what I noticed was that they were lessons that were occurring in. In a pattern. The pattern was that I would tend to buy a packet of cigarettes if I had a break up, or if it was university, exam time or like assignment time. And I was really stressed. Those were the two times where I would notice that I would buy a packet of cigarettes, and I would have maybe 1 or 2 and then be grossed out and throw them away. And I was and I was thinking about it over my 20s. I was thinking that, what is going on here? Why am I still doing this? And then I clicked, oh, I’m not living in a compassionate way when I’m in those situations. So when I was having a break up, I was smoking to hurt myself because I wanted to wallow in the deep, dark pit of despair that was that. I’m never going to love again, right? Because that’s what it feels like when you’re young. And when I was in stressful situations with uni, I was using it as quote unquote coffee, a stimulant, to try and keep myself awake so that I could finish the the activity that I needed to do. And when I realised those two things, I thought, well, hold on a second. I don’t actually want to hurt myself. So when I’m feeling really sad, maybe I can lean in with compassion and I don’t actually want to be pushing myself that hard. So when it comes to university, maybe I can implement some more time management strategies. That means that I don’t have to be doing things the night before and needing cigarettes to keep me awake because I don’t drink coffee, right? So when I realise those things, it was almost like an over the overnight change. And I haven’t had a cigarette since, but I’ve been drunk with people who was smoking that would totally be happy to give me a cigarette, and it hasn’t even entered my mind to ask them for life. So that’s what true recovery is. You don’t have to be scared of the thing. It just doesn’t matter anymore for you.

Dr Ron Ehrlich [00:54:49] Yeah, it’s so interesting to hear you say that and use that word compassion. We’ve actually explored this with, Professor Paul Gilbert, who’s written the book The Compassionate Mind. He’s he’s world expert on it. But self-compassion is the key. And self-compassion, it must be such an important part of this six stages of recovery. And overcoming addiction. Self-compassion.

Tara Hurster [00:55:14] Absolutely. And the stages of change is not solely for addiction. It’s for any behaviour change. If you want to, you know, be more intimate with your partner or connect more with friends or set some boundaries around your work schedule. All of these things go through that same flow. We we acknowledge there’s an issue. We explore what our options are to make changes. We actively stop making changes. We follow through. And then all of a sudden we’re living a new way. That’s that’s how it works. But yeah, self-compassion and taking off your judgement pants. I always talk about take off your judgement pants and put on your reality pants, because shame and guilt actually take you back to the pre contemplation stage of change. Which means that when you’re beating yourself up for doing something, in your opinion that’s wrong, all you’re doing is getting in the way of you continuing to progress through those stages of change. You’re taking yourself back to the beginning anytime you experience shame or guilt. So instead, just lean in with compassion. Put on your reality pants what is actually going on here and how can I do things differently next time?

Dr Ron Ehrlich [00:56:26] Listen, this has been terrific. I mean, it’s such a huge issue, particularly when we look at it in a more broader sense. But, I just wanted to finish up because, you know, we’re obviously going to have links to your, your Tara clinic and your website and all your resources. But if someone was listening to this, who may not have considered they have an issue or whatever, just, how what would be a couple of tips that you would give people who are thinking, maybe I need to go on, give us some, give us a 2 or 3 tips that we could do. Well, I mean, the six stages is a great one.

Tara Hurster [00:57:03] Yeah, well, being able to identify where you are on that stages of change is really helpful. There’s a free results on my website, actually, that that helps you to identify where you are on the stages of change. So in terms of practical tips, I think one of the most valuable things to do is actually to track your behaviour. And if you track, say, alcohol or work or whatever it is that you’re sort of unsure about, there are certain apps that you can use. There’s not sort of one app that I would say this is the best app to use, because it kind of depends. They’re all sort of different at the moment, than if you were to track, you know. How often you drink. How much you drink? What time of the day? What day of the week? What week of the month? What month of the year? If you start to see. Oh, there’s a pattern here, I thought I was only having a couple of drinks a couple of nights a week, but actually, most weeks I’m drinking five, six, seven nights a week. And I thought I was only having a couple of glasses of wine, but actually, I’m usually finishing the bottle, and I’m not even aware of it. Right. Being able to just open your eyes and see what’s actually happening, it gives you a really brilliant foundation to sort of leapfrog into, well, where do I want to go? What do I want my life to look like? How would I like that to happen? The this the second tip, I think, is look at the the two reset buttons of the brain. So I spoke about the brain. I spoke about mush. Mush has two reset buttons, kind of like an Xbox or a or a PS5. It’s probably, more recent PlayStation than PS5. I might be showing my age.

Dr Ron Ehrlich [00:58:58] Rebooting is a is a technical fix all anyway, so I think people can relate to the reboot like a reset idea. Go on.

Tara Hurster [00:59:05] Excellent. So if we go back to the days when we had the sabre Tooth tigers and we were either killing it or running away from it, that meant that we were physically exerting our body to quite a high level for a short period of time, and then afterwards we relaxed. Sounds familiar exercise. So the more that we do exercise, but we do it in a way that our mind is connected to the fact that I’m moving my body for the benefit of my mental wellbeing, or for my stress management, or for whatever it is. Then you will start to notice that the muscle starts to go away from your brain. Your the front of your brain starts to switch back on again. You can start to make more logical decisions. So exercise is the first reset button of the brain. The second reset button of the brain is actually mindfulness meditation. I prefer mindfulness over meditation because meditation is literally sitting down, you know, with your legs crossed and doing the meditation thing. Where is mindfulness? You can actively engage in mindfulness strategies. Once you’re once you’re really well equipped with your mindfulness strategies, you can actually implement it while you’re washing your hands, while you’re brushing your teeth, while you’re having a shower, while you’re going for a run. Right? You can implement mindfulness anywhere, whereas meditation is usually more of a sitting still in your spot doing the thing right. And that’s yeah, not everybody wants to do that. But mindfulness, what it does is it uses your mind to cool down your body, and exercise uses your body to cool down your mind. So if you’re doing both of those things together, you’re making educated and, and, and open, decisions, through, through a clear mind. And that’s, that’s going to help you to see from my perspective, it will help you to see more what what the reality of your situation is. You’re putting on your reality pants. You know, how often am I drinking? How often am I watching porn? How often am I working outside of the hours that I really want to be working?

Dr Ron Ehrlich [01:01:14] Yeah. Tara, thank you so much for joining us today. And sharing your knowledge and your wisdom and your personal experience. Thank you so much.

Tara Hurster [01:01:22] It’s my absolute pleasure. Thank you. Run.

Dr Ron Ehrlich [01:01:25] Well, I love that positive message that this is about, a journey through, pre contemplation, contemplation, preparation, action, maintenance and recovery. And that if you stray, it’s a lesson. You lapse, but you don’t relapse. I also love the, whole empowerment. Rather than being powerless, I love that concept because it’s such an important message for us all on our health journey. Now, we’ve done programs, as I mentioned, with Paul Dillon on drug and alcohol, addiction. And we’ve also done a program with Professor Paul Gilbert on compassion and particularly self-compassion. And we may really rerelease those. I mean, I’m wanting to rerelease some relevant podcasts because there is such a back catalogue of pearls and gems, and if you are a member of the unstressed health community, we, we are going back and, re-edit and editing and and re and putting together topics that are giving you the highlights. So rather than having to sit through maybe, five episodes on Women’s Health, we will be condensing the pearls from each of those episodes for our members only. And that’s in the, stress health community. There are courses, there are webinars, there are Q&A is there’s access to health coaches. I’d encourage you to. Doing that. We will, of course, have links to the tower clinic, and, and, and if you feel that there is something there for you. Well, obviously, Tara has a unique approach to addictions that goes beyond the 12 step program you may have heard so much about. I hope this find you will. Until next time. This is doctor Ron Erlich. Hey. Well, this podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice, or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences and conclusions.