What would you have to give up if you stopped blaming yourself?

I heard this question asked during a podcast by Tara Brach, who teaches topics on meditation. She was making the point that so often the voice that appears and reappears in our head has the tone of Aversive Judgment. This voice is not like the Wise Discrimination voice that cleanly processes problems to arrive at solutions; this is the voice that is telling - if not shouting - the story of What's Wrong With Me.

When we are stuck in Aversive Judgment mode, it's uncomfortable. We want to escape. No one wants to stick around to hear a critic going on and on, blaming us for choices we've made, mistakes that have hurt others or ourselves, making comments about how we look, how we should look, where we should be in life by now, etc. - whether the critic is in our world or in our head.

We can become peculiarly complacent, almost having a nervous treaty with this blaming aversive judgment voice; after all, it's familiar. It's the known enemy, and we've got our wary dance steps down. When the voice becomes intolerable, there is great justification to escape: opiates, booze, benzos, food, porn, gambling. . . easy to run from discomfort into the familiar, habitual choices.

But behaviors that rise from self-hatred only make things worse.

Yesterday I got a call from a patient I am very fond of. He's been a professional athlete and he is the main person in his family caring for an aging parent with severe dementia. He has relapsed several times. He hasn't ever truly allowed himself to go much past the first layer of recovery; continuing to convince himself all he needs to do is a rapid detox without rehab. Like many of our patients, he believes that keeping himself busy will keep him sober.

He called with such shame to 'have' to be calling me yet again. He's been using regularly for a few months now. He had spent $700 the night before last on heroin and cocaine, stayed up til the morning then went to work. He made it through the day, collapsed when he got home and called me the following day.

"I'm so disgusted with myself. When I think of the money I've spent and what I could have now. . . I'm sick of not being successful. . .I'm sick of not achieving. . . I'm sick of not having a girlfriend. . . "

Tara Brach talks about staying present beyond the blaming. A tender look beyond the blaming often reveals fear, shame, guilt, sadness, and disappointment; "All the flavors," she says, "of vulnerability."

After his last detox, I sent this guy information on signing up for a cognitive therapy based mindfulness class offered throughout the year. I really believe in the power of this approach, of watching our raggedy-ass thoughts (i.e. Aversive Judgment) with compassion, eventually, hopefully, and learning to be kind to ourselves. Learning to accept some level of discomfort whether it takes the form of mental, emotional or physical pain.

Since my patient has had three rapid opioid detoxes at the Coleman Institute, you may correctly conclude the detox itself is far less painful than the suffering he endures by listening to and believing the cruel voices in his head that can only temporarily be relieved by substances. He's returning to the Coleman Institute next month for another rapid opiate detox. Hopefully he'll go beyond the detox and beyond the blaming this time and find some real peace. We'll certainly be there to support him.

Joan Shepherd, FNP