"The emotional sensitivity of the addict may be similar to the hypersensitive skin of a sunburn victim."

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Episode 152 -- Septemver 27, 2021

You are Enough: How To Change a Negative Self-Image

Most of us in early recovery are learning how our substance use may have caused distorted versions of reality. We may not be aware of some of these distortions. Other distortions may involve bending the truth to fit our view of the story. Even when we're sober, it may be hard to let go of these distorted ways of thinking—especially about ourselves. This can be doubly difficult when we're new to recovery and only beginning to really feel our emotions instead of numbing them with substances.

In his book Addictive Thinking: Understanding Self-Deception, Dr. Abraham Twerski describes how self-deceptive thoughts threaten sobriety. He offers insight and hope to those of us seeking a healthy and rewarding life in recovery.

In the following excerpt, Twerski explores distortions of self-image and describes how low self-esteem, feelings of discomfort, and hypersensitivity often precede substance use and the development of addiction, and then deepen as addiction progresses. We can use this information to help us identify and sort through our distortions and correct our negative self-image.

This excerpt has been edited for brevity.

A Distorted Self-Image
The biggest distortion is in the addict's self-image. In one or more ways, the addict feels grossly inadequate.

  • A drug-addicted young woman will not date or look at herself in the mirror because she believes she is ugly.
  • An addicted man who is the author of a textbook on medical pathology is extremely anxious lecturing to physicians because he's afraid someone might disagree with him, although he is the acknowledged international authority.
  • An alcoholic, a highly skilled attorney, lives in terror because she thinks what she is doing isn't good enough. "My life is like walking through a minefield," she says.

When the layers of veneer are peeled off, an addict has an extremely low self-esteem. If the distorted self-concept is not corrected, the addictive thinker will find it difficult or impossible to maintain recovery and could develop psychosis, neurosis, or a substitute addiction.

The misconception addicts have of themselves precedes the development of addiction, often by many years. The low self-esteem that comes with the use of substances is of a different kind—it is not related to a misconception about reality. There is nothing elevating about forgetting what happened yesterday, having a hangover, being a public spectacle, or waking up in jail. These are legitimate reasons why addicts might develop low self-esteem.

Changing a Negative Self-Image
Susan, a thirty-seven-year-old teacher, was admitted for treatment following a suicide attempt. She had just lost her job due to addiction. She had tried to conceal the alcohol on her breath by drinking vanilla extract, but her insobriety was apparent nevertheless, leading to her dismissal.

Susan was extremely depressed and very much down on herself. When I asked her to list some of her personality strengths, she could find no redeeming traits in herself.

I then pointed out to Susan that she had graduated summa cum laude and had won the Phi Beta Kappa award. "The least you could have reported," I said, "is that you are intellectually bright. After all, they don't give such awards to stupid people."

Susan shook her head sadly. "When they told me that I'd won the Phi Beta Kappa award, I knew they'd made a mistake."

Changing the negative self-image of an addict, the low self-esteem that preceded substance use, requires that the addict come to believe he or she really is an adequate person. This is a major challenge for someone whose life is in ruins. And we must remember that it is not only the low self-esteem of this "ruined" person that needs correction but also even that of the pre-"ruined" person. Many addicts seek escape in substances because they feel they cannot cope. They must learn they do have healthy coping capabilities.

To better understand the attitudes and reactions of the addict, it is important to have a grasp of the person's background. We can understand a person's extremely unusual reactions to a certain experience only if we understand the conditions surrounding the experience.

If we were to see someone reacting angrily to what appears to be hardly noticeable contact, say, brushing against someone in a crowded elevator, we would probably wonder, What's wrong with that person? Or we might think this person has a very short fuse. We would likely consider the angry reaction unwarranted.

Suppose, however, that the person involved had a blistering sunburn. The entire picture now changes. What appeared to be superficial contact was enough to elicit excruciating pain, and even if the angry outburst was not justified, at least we can understand why it occurred.

While a sunburn is apparent to everyone who can see, people's emotional sensitivities are not. We may therefore fail to understand an intense reaction if we are not aware of a person's circumstances.

I have often wondered why some people resort to using alcohol and other drugs to feel better and others do not. Genetic and physiological differences in people play an important role in the development of addictions. But these are certainly not the entire answer.

Relief from Feelings of Distress and Discomfort
Though many people use alcohol and other drugs to get high, many others use substances just to feel normal. For these people, alcohol and other drugs are emotional anesthetics as they seek relief from feelings of distress and discomfort

Certainly, just about everyone's life has plenty of stressful circumstances. But most people do not use alcohol or other drugs to cope with their distress.

Some people seem to have greater sensitivity to stress. These people apparently feel emotional discomfort more acutely than others. Many addicts are emotionally hypersensitive and are likely to have more intense emotions than nonaddicts. People with substance use disorders or who are experiencing addictions often seem to be almost inordinately sensitive with emotions of extreme intensity. When they love, they love intensely, and when they hate, they hate intensely.

The emotional sensitivity of the addict may be similar to the hypersensitive skin of a sunburn victim. A stimulus that might not produce emotional pain in a nonaddict can produce great distress in an addict.

Many addicts are loners. On the surface, they may seem to be antisocial and enjoy solitude, but that isn't necessarily true. Human beings by nature crave companionship. The loner doesn't really enjoy isolation but sees it as the lesser of two evils. Mingling with people exposes the addict to the possibility of rejection. While rejection wouldn't be pleasant for anyone, to the addict it is devastating. The addict often anticipates rejection, whereas someone else may not even think of it.

Ironically, the anticipation of rejection may result in the torment of suspense, which may be so intolerable that the addict becomes abusive and provocative, provoking the rejection in order to be relieved of the suspense. At other times, addicts seek to avoid rejection by being clingy and possessive. Social withdrawal, abusive behavior, and fanatic jealousy are thus often found among addicts. Earlier, I mentioned that distorted, addictive logic is not always a consequence of substance use but often precedes it. The same is true of emotional hypersensitivity.

"I Didn't Belong with You-All"
A man in his nineteenth year of recovery said in a Twelve Step meeting, "When I got to be about nine years old or so, I began to feel that I was different from you-all. I can't tell you why I felt different, but that is just the way I felt. If I walked into a room full of people, I felt I didn't belong with you-all, and that didn't feel good. I just didn't belong. Years later, shortly after my introduction to drugs and alcohol, I suddenly felt the world was right with me. I belonged." This example vividly illustrates the intense feelings of being different that most addicts experience even before they use their first drug.

As sensitive as a sunburn may be, a sunburnt person knows that although someone's touch may elicit sharp pain, usually no offense was intended. Hypersensitive addicts, however, often aren't aware of their extreme emotional sensitivity, so they see hostile intent in innocent acts or remarks and are apt to react accordingly.

When we observe the reactions of a person using addictive logic, let's keep in mind the example of the sunburnt person. It may help us to better understand.

About the Author:
Rabbi Dr. Abraham J. Twerski was the founder and medical director emeritus of Gateway Rehabilitation Center, a not-for-profit drug and alcohol treatment system in western Pennsylvania, cited nationally as one of the 12 best drug and alcohol treatment centers by Forbes magazine and as one of the top 100 rehab centers in the guide to treatment, The 100 Best Treatment Centers for Alcoholism and Drug Abuse.

© 2000 by Abraham J. Twerski, M.D.
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