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Understanding Addictions

Angeline David DrPHMHSRDN

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Angeline David DrPHMHSRDN

Health Ministries Director for the North American Divison of SDA

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Conference

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  • September 2, 2017
    2:30 PM
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Dear Heavenly Father Lord we have come to you. After a very powerful morning we feel so challenge by the messages that were shared today and Lord it's the afternoon it's a warm room we just had a wonderful lunch and we'd love to take a nap but Lord you have a special message for us this afternoon and so we really need your spirit to give us strength we need your angels whether human or otherwise to not to not just if we're falling asleep but Lord we really need good clear perception because I believe that there are people in this room who are hurting and who need freedom from addictions and Lord we need to be able to share that hope with everyone that we meet so thank you for being with us thank you for leading and blessing in this this time together we pray in Jesus' name amen. OK understanding addictions so. The former U.S. Surgeon General Dr Vivek Murthy he was the U.S. surgeon general last year he. Was challenge by one of his nurses when he switched from being a physician in a hospital to working for the U.S. government and his challenge from the nurse was if there is one thing that you do if there is one thing that you do please talk about addictions please please please do something about addictions and so last year in November he and his office came out with this report facing addiction in America the surgeon general's report on alcohol drugs and health now they focused on those substance those major substance addictions that we're all familiar with but some of the principles that he shares are applicable across to all addictions but this really underscores the importance of this issue in our world today and in our in our own neighborhoods certainly perhaps even in our own churches and our own homes. Here's something of what the report says substance use disorders represent one of the most pressing public health crises of our time what is a crisis. It's a an event or a. Time or. A period of. Just absolute chaos right where there's desperation to some extent to a great extent so it is a public health crises we must help everyone see that addiction is not what it's not a character flaw it is a what is this chronic illness what is a chronic illness. Chronic illness is something that basically you're dealing with for a life time when we're talking from a clinical perspective some of the chronic illnesses we hear about are diabetes heart disease hypertension OK So they are equally meeting addiction with all of these other health problems and we'll see some data that's very interesting as we compare them. It is a chronic illness that we must approach with the same skill and compassion with which we approach there we go heart disease diabetes cancer when you learn I'm sure everybody in this room has been touched in some way by cancer someone you know a friend a coworker a friend's friend somebody you know has been diagnosed with cancer what does your heart do when you hear that when you find out someone has cancer doesn't it hurt it's extremely painful and there's a sense of hopelessness but why is it when we find out that someone has an addiction we say well why can't they just stop why can't they just get themselves together. Why do we have this duplicity in our emotional response to individuals facing this chronic illness. Going on the report says recovery has many pathways that should be tailored to the unique cultural values and psychological and behavioral meet health needs of each individual so here they're saying that this problem of addiction there are cultural issues there are psychological issues and behavioral health issues and that these are specific to each individual and these. Involve a combination of medication counseling and social support we're going to see social support come up over and over again not because I intentionally did that but simply that's just what the data shows that's what we are seeing is that addiction really to a large extent is a social issue above all we can never forget that the faces of substance use disorders are real people. We sometimes look past the person and we get more concerned about the behavior or what they're doing or not doing but we have to remember that these are real people they are you be loved family member a friend a colleague and even ourselves how we respond to this crisis is a moral test for America so he is saying that this is a moral issue for our nation so how big is the addiction problem so this is a research study that was published in two thousand and eleven so it's a few years ago so you have to think well is the problem better have things gotten better is it worse or has there been no change right now intuition will probably tell you that it's not better it is worse so in this research what they did was they looked at eleven different types of addictions and here's another key point for us to to look at here we'll talk about this more eleven different types of addictions now the first few We're going to say oh yeah of course you're going to look at that tobacco alcohol illicit drugs right we know those are problems but look at the other ones they said eating. Gambling inter-net we don't have Internet here where we are today praise the Lord we're breaking our addiction OK internet love sex exercise. OK work and shopping did we hear about shopping this morning anybody testifying of some conviction going on shopping so these eleven addictions that they looked at and then what they did was they took a lot of different studies that had been published and what they wanted to see is well how many people are actually struggling with these addictions in the U.S. How many adults specifically they found that with then a one year period. Within any given one year period forty seven percent of adults have signs of one of these addictions or maybe more forty seven to make that real. Everybody from this chair over if you could all stand up even in the back just stand up. That's about fifty percent of this room. That is how many people would be suffering from it from an addiction. Now extrapolate this to your church to your community to your state to the country to the world. Thank you so much so we mentioned briefly that there are different types of addictions let's look at this a little bit more we do have the substance abuse addictions and these are again the typical ones that we think of the tobacco alcohol illegal drugs by the way did you know that the Seventh Day Adventist Church was premier in promoting the Temperance Movement in fact we have a passage from Ellen White where she says that we even made a political statement now we know we don't mix politics and religion right but she said that if there is a government official official running for office who does not promote temperance you should vote against them and she goes on to say this you should go vote even if it's the Sabbath. This is how important she believes the temperance issue was and so supporting the women's temperance movement of course we don't subscribe to everything that those organizations uphold but certainly the issue of temperance is something where we can actually lend voice to them illegal drugs now we currently have in the United States a huge issue on prescription drugs and opioids opioids are the things like morphine that are given to to patients to ease their pain Well it's very easy to become addicted to morphine. There. Front So this this issue is actually very very important and where. Really the U.S. government is really looking that's fine thank you looking for a lot of resources and and help in battling this particular addiction and of course there are many out there as well substance abuses but again as I said earlier I want to really focus on. What are called process or behavioral addictions these are process or behavioral addictions Now let's look at this list this is a short list this is a short list gambling. Sex kleptomania computer or a gaming. Internet again pathological in picking skin picking workaholism. I'm sure there might be some people smiling or cringing food addictions or binge eating. Exercise again shopping How about ministry. Is it possible that ministry can be an addiction you know as we heard during the divine service if we are doing things out of our own works that could actually maybe be a symptom of a ministry addiction. Knowledge and Power How about knowledge and power do we know people who are addicted to knowledge or to power. And also relationships now that is a very important one. And we're going to talk about one type of emotional or relationship. Later on. But it is possible that people are that to relationships and I think this is an important one to talk about because we live in a world where we are so interconnected aren't we we are hyper connected and yet we are so separated aren't we so that's an important one too OK. If we summarize this that again that was a short list but we could basically saying that you can be addicted to anything that we feel we cannot live without. And it leads us to live an unbalanced lifestyle regardless of the harm it causes to us or to others I just cannot live without watching this T.V. show and I will stay up till two am watching bingeing on this T.V. show. Because when I go to the office they're going to be talking about it. You know or I just cannot give up this. Exercice. I actually have a friend a good friend that I used to work with who is an ultra triathlete and I've told him several times you know you're addicted to exercise. And he says yeah I know I am. You know and we're going to talk about how addiction happens and why it is that we can be addicted to things that aren't even good for us OK So leads to an unbalanced lifestyle regardless of the harm it causes so what is an addiction this is the definition from the American Society of addictions medicine they say addiction is a primary meaning that's the that's the main health issue the person is facing it's a chronic disease we saw that already. What it what's involved here brain reward motivation memory and all the other things that happen with that it sounds rather complex We'll look at some of that now dysfunction in these brain circuits leads to these different things biological OK so your physical body manifestations psychological your emotions social. How we interact with others and interesting Lee spiritual manifestations Now these are the people who are not religious but they are saying that there is a spiritual component to addictions and they go on to say that the these manifestations are reflected in an individual path to thought pathologically pursuing reward and or relief by substance use and other behaviors so those two types of addictions substance abuse behavior. So they go on to say these are some of the things those manifestations that they were talking about these are some of the things we see the inability to consistent consistent as abstain So in other words OK I can give up watching that T.V. show for two weeks but I'm back to it you know as soon as the new season opens or whatever maybe impairment in behavioral control they're just not able to get themselves together not able to just really control their what they do it's not that they're meaning to do bad things. Craving. Diminished recognition of significant problems they start to justify in their mind and it doesn't seem that bad what they're doing they're not able to really see that this is a problem. Significant problems with their behavior with interpersonal relationships again we're seeing that social component come up over and over again and a dysfunctional emotional response so what's affected your body your brain your emotions how you relate with others. Like other chronic diseases addiction often involves cycles of relapse and remission in other words they may go through a time where they are free from that direction but they're very likely to actually fall back into the addictive behavior again and in the next section we will talk a little bit more about that without treatment or engagement in recovery activities addiction is progressive if it gets worse over time and can result in disability or premature death is this a problem. This is absolutely a problem disability poor quality of life and certainly premature death these are big problems for us to worry about. OK. Now usually what they say is they want to see three or more of these different symptoms happening in a in a person over a twelve month period this is part of the diagnosis tolerance to the substance in other words it takes more to get the same Hi. There you know at first they start with just a little bit but they need more and more and a greater dose and a more intense dose in order to get the same emotional or physical high withdrawal you take it away they stop taking it and they have symptoms kind of like when you stop drinking coffee for a few days and you get the headaches right OK I just had to throw that in there they used in larger amounts than intended they didn't intend to use that much but they just couldn't stop themselves they desire. To have to cut down but they have unsuccessful attempts at actually stopping and they spend a lot of time procuring this substance Now I mentioned this morning that I am a dietician by by training and I did actually counsel with with many of my patients some of whom probably were very close to have a food if food addiction and something that you see is that they're often thinking about OK how my going to get the food that's the question Where am I going to get this but if I change my diet how my going to get the food so there's this preoccupation of where am I going to get it how my going to get it. And there's a decline or in a limit nation of significant social work and recreational activities they're withdrawing from society. OK. So an addiction can alter the functioning of the chemical pathways in the brain we'll see a little bit of that and can artificially create a pleasurable state this is why you're get addicted to it because it makes you feel good the problem is that it is a temporary feel good it's not long term it's not fulfilling and the end result is that you actually feel worse than you did before. This is what makes an addiction really important to talk about because sometimes we may go to the extent of saying well if it makes you feel good you shouldn't do it. But you know it's really not a bad thing necessarily to feel good Did God give you taste buds. Why so you can enjoy the food right so it can be a pleasurable experience now is that a problem if we are driven by our taste buds and not by reason and what we know is good and bad right there's the problem when things are taken to excess and. I know we do have some young children here the intimate relationship between a husband and wife is that bad. Did God create a husband and wife to have that capability. But when it's taken to excess or taken outside of the bounds that he has given then it becomes a problem right so God created us to be able to enjoy things he wants us to enjoy so let's not demonize people because they're trying to feel good and we'll see why it is they're trying to feel good the problem is when it gets out of control. Or when it becomes the driving factor OK the five stages of addiction there are five stages one experimentation now this is probably what you heard when you were you know a little kid in elementary school just say no say no to drugs or whatever because we know that one little taste might precipitate future use and we actually know I think I have this on here that the younger people when you experiment at a younger age you're much more likely to develop that into an addiction but the experiment OK I'm just going to trade one little gulp of alcohol it's a wedding my friend's wedding I'm just going to try a little bit of the champagne whatever it is I'm just going to watch that that risk a T.V. show just. For five minutes OK experimentation so we want to this is often a stage that we we may not notice other people are experimenting because it doesn't necessarily alter their behavior or anything like that and we want to watch out for reasons that people may give sort of excuses that they may give for for trying something something like this. The next stage is regular use so this is when they start incorporating this into everyday life. They're you know drinking every day they're watching whatever every day they're on dare I say it social media heavy day. And this may be difficult to discover also because people might be pretty good at hiding their daily habits or it may be the point where we are starting to notice that this is becoming problematic maybe they're starting to participate in the behavior and not participating in other important activities of life. The third stage is risky use and this now everybody defines risky differently so that's a challenge in knowing when a person is that risky use but their behavior begins to alarm you. When I can't believe they just did that what's going on this is usually when we start noticing it and we get concerned but this is stage three already. And it's important at this point to discover ways to help before the problem escalates this is where we can actually intervene and make some significant give them significant help that isn't necessarily medical or treatment you know clinical kind of care but once they get past this point number four is dependence this. Is where they just cannot survive without it and at this point the chemical changes and physiological changes that have happened in the brain are so well in grained in their system that it's going to take a lot to break them from this to free them from this. Treatment options at this point are really really important very important that they are getting the treatment because again remember it's psychological changes that have been happening over time this has happened over a period of time nobody becomes an addict overnight. I should say probably ninety nine percent of people. Some people do but it has had a ground in an earlier time period and earlier exposures. And so we really need to get them professional help at this point to free them and the last stage is addiction is what we really call addiction and it's continual abuse that will continue to lead to the addiction this is where progression gets worse and worse and worse and this is really I mean this is at this stage people may need to actually go to live in centers I mean they may need you know medical treatments medication treatments This is very intense now the process of these five stages is very individual. It's very individual and it can be affected by the user genetics there is a genetic predisposition to some addictions particularly if you think about alcohol if you think about alcohol biology personality age of onset of use again earlier starting earlier on means you're more likely to become addicted and expectations expectations that they may have of themselves others may have of them as well now the drug itself How potent is the drug what are the concentrations they're using How. What is the effect of the drug itself and then the environment again social. Social setting is an important factor in how and when a person will go through these stages of addiction group expectations that's that expectations from others and then cultural context now this is really key for us as a church body because this is our opportunity this is our opportunity right here to really do something positive let's talk a little bit about the physiology of addiction your brain our brain everyone's brain has a pleasure center that God created us with this is that place that feels good it gets triggered when happy things are going on OK this this is where the addiction begins to work now researchers Peter Milner and James in one nine hundred fifty four they did a research study using rats and in their study what they did was they connected some electrodes to the rat and every time the rat went to a certain part. Of the cage they stimulated this this area the pleasure center with an electrical current and what they thought is that that would not be a good thing to the rat the rat would nod like that so the rat would stay away from that area the cage they would learn that going here gets gives me this feeling and I don't like it I'm going to stay away but very interesting really what they found is the rats actually liked that area they liked that stimulation they liked feeling good. Anybody else like feeling good. So this was in the limbic system which controls your emotion behavior and memory so the rats returned to that part of the cage over and over again despite the fact that they were getting an electrical shock basically but it felt God So they did it over and over again now later on what they did is that they actually allowed the rat to self stimulate. There was a bar and the rat just had to push the bar to get the current and so the rat would stand there hitting the bar because it liked that stimulation and even when the rat was hungry and it was given the option of eating food or the stimulation you know what they choose chose the stimulation the food was not as pleasurable. Because it wasn't directly hitting that certain area of the brain the rats wanted the immediate gratification and isn't that the same with us whether or not we have an addiction. The faster we can get what we want the better right. So this so this is where we started realizing that we actually have portions of our brain that want to feel good and that make us feel good so a little bit of brain physiology here the nucleus accumbens Septic is critically involved in addiction behavior and it's right around here right under the preferred prefrontal cortex now you've probably heard about the frontal cortex but it's pretty close by all addictive chemicals and behaviors are known to affect that area every single one we know affects this area of the brain so there is a physiological response happening in the brain. In fact if we look here at what is happening you've heard of dopamine what is dopamine known as. The feel good hormone that's the hormone that actually is working in this area and what happens normally I'm sorry you guys can maybe not be able to see this but there is no dopamine floating around just a little bit floating around between the cells OK here's one cell talking to the cell and the dopamine floats around and when the dopamine attaches to the cell it stimulates that feel good now with something like cocaine or other drugs or addictive substances or behaviors you get a rush of dopamine into this area and this is all happening in that that nucleus accumbens you get a rush of dopamine in there so you're hyper stimulating and you're getting a greater response and and stimulation for those feel good. Rewards now the orbital frontal cortex which is close by and under the prefrontal cortex this controls our impulses so do you think it's important to have control over impulses. So this is what this guy does it also helps us recognize social and cultural More's In other words what is socially acceptable or not this area of the brain helps us to realize that would that be helpful if it's functioning well with that be helpful in preventing addictive behaviors you think. And also the ability to appreciate the consequences of your actions how important is that. And we talked about earlier someone who's addicted they are not able to recognize what the consequences are they don't have that clear judgment anymore so so that areas not functioning as well. The prefrontal cortex we know is the executive function this is where decisions are made this is where the pros and cons are weighed it prioritizes behavior it adapts to change and interesting really works for delayed gratification Oh bother Let's talk about Delayed Gratification Here's a research study of little children you've probably you may have seen videos of this little children put in a room one by one and you sit them down at a table and there's a plate and there's one little marshmallow sitting on the plate and you sit the boy or the girl down and you say OK you just sit here I'm going to go to the other room and all be back now there's a marshmallow here but when I come back I'll give you one more marshmallow but you can't eat this one you have to wait till I come back OK so you can eat this one now or when I come back you get two. So the adult leaves the room it's interesting really that two thirds of the children give in immediately you're not even out the door and the marshmallow is and when you see videos of this you'll actually see some of the children fondling. And just looking wistfully at it I think there's one that even smells it you know. But one third of them can actually resist the temptation and get a second one later so delayed gratification maybe this is something we need to practice a little bit more strengthen. That part of the brain. So physiology again there are new many neurotransmitters involved in this the dopamine that we talked about also Sara Tonin opioid peptides these are opioid molecules nor epinephrine or or nor adrenaline. This might explain why exercise can be an addiction OK adrenaline excess and adrenaline. And. The brain areas again the limbic system the nucleus accumbens and we didn't talk about the glob but we'll move on we have a lot more to cover here OK so let's. I like this quote This is a quote from Dr turban Torben Berglund he is the health minister director for the trans European division and a psychiatrist so he has worked with people with addictions a great deal and as he says that addiction is a result of attempts to fill real needs with fake fillers. At the bottom line this is what an addiction comes from substances and these fake fillers are substances or behaviors that for a time appear to provide what the person is seeking but in the end it cannot truly fulfill them and this Vishal vicious cycles are then created since the fake fillers cannot truly fulfill the person is left what frustrated and empty out of lack of true fillers here's a key out of lack of true fillers the person turns to the addictive substance or behavior to an extent that it is harmful to functioning and the quality of life and I want to read here because there is some biblical grounds for this in Jeremiah Chapter two if you have your Bibles you can turn in there and Jeremiah chapter two. And verses eleven through thirteen. It says here has a nation changed their gods which are yet no gods. Changing from the true God to those who are not gods. But my people have changed their glory from for that which does not profit that which does not truly fulfill be astonished Oh you happens at this and be horribly afraid be very desolate saith the Lord for my people have committed to evils they have forsaken me the fountain of living waters and hewed them out cisterns broken cisterns that can hold no water you see people in this world are dying for a lack of knowledge of God. And I don't mean just. Superficial knowledge. Oh there's a God but a truly intimate fulfilling personal relationship with God And so what they are doing is they're trying to fill it with fake gods if you will some people turn to alcohol others turn to smoking some may turn to relationship after relationship others may turn to shopping whatever it may be there is a void that they know they have and yet they don't know how to fill it so they fill it with what seems to be the easiest thing. We need to remember the person. People do not become addicts because they are bad people we want to remember this it's not because HELLO ALL have sinned. Have sinned and come short of the glory of God they become addicts because they are suffering the addictive substance or behaviors relieve suffering caused by too much feelings or not enough feelings. Interesting the emotional baggage here they work short term these addictive substances are behaviors they work short term but long term they cause much more harm than good so who is that risk who is at risk of developing an addiction despite the advances and understanding of the process at present there is no certainty as to who will become. And this is from I forget which website I took this from it might have been the government's drug facts page. There's no certainty. We can't just line people up and say yeah you're prone to you're going to become an addict you are we just don't know because look at how complex the process is. What we do know that there are factors that do affect our risk of becoming addicted and this is important because these are the areas that we can actually do something about early life exposures I mentioned this earlier that frontal lobe when when does your frontal lobe actually match your rate when does it become more mature thirty. Thirty years of age OK so. How many people are getting into trouble before they're thirty. So during those young adolescent preteen years when our young people I'm so thankful for the ones who are here this weekend but when those young people are in that experimental stage aren't thing aren't they trying things out we may not know it but very possibly they could be trying things out as Remember that the addiction affects the brain itself and the morphology of the brain the connections in the brain so if they are trying these things out during those ages when the brain is still forming and maturing it's much more likely for them to become addicted. Genetic factors these account for half of the like likelihood that an individual will develop an addiction I believe this was specifically for alcohol environmental factors into these interact with the person's biology and affect the extent to which genetic factors in their influence your environment does in fact affect your genetics I know one one person says genetic your genes load the gun. But your lifestyle pulls the trigger your environment is part of your lifestyle what affects your lifestyle I mean we just need to go a few hours down the road to a certain big city right and to see what is the environment that these people are struggling in when they're very life is that danger. And what are they using to cope. Because they have nothing else. Mission to the cities as an important role resiliency is will talk about resiliency the next session these affect the extent to which the genetic predisposition can lead to that behavior and other manifestations of addiction so we'll talk about raises resiliency is a little bit more and then culture. You know we all have our own culture don't we looking around this room I love seeing the diversity of culture. It's going to be like this and heaven. Every single culture has beautiful things about it every single culture has some things that should be changed to be quite frank. All cultures because not one is a perfect representation of heaven culture now you know God brought the church to life so that we as a church could be the representation of the heavenly culture didn't he because he doesn't want you to be bound by your cultures of this world that you just happen to be born into but he wants us to be transformed into the culture of heaven but why is it that even our churches. We could be promoting addiction just go to a board meeting just sit at a potluck table. And hear the discussion between Should you have cheese or not at the table. You know and I'm not so I don't want to minimize issues and conversations and nor do I want to aggrandize you know just simple conversations but maybe we need to be considering what is our effect what is my effect on the others in this church. Am I a savior of life and to life. Right here in the church. OK Another important risk factor. Are what what are called adverse childhood experiences or Ace's adverse childhood experiences it seems that these are really a very strong driving factor when it comes to addictions So what are Ace's there are three types of abuse now this could be physical abuse emotional or sexual abuse during childhood neglect. Neglect and this could be physical or emotional neglect maybe we should say spiritual neglect too you know where we are not intentionally caring for that child we're not intentionally demonstrating our love and our care for them. Or we're not doing it in a way that they understand. We think. I'll just leave it at that family challenges we know that children who are living in a family that is facing severe challenges such as mental illness in the family a loved one who's incarcerated or the mother treated violently. If the mother is treated violently. Or divorced in the family there can be a greater likelihood that they may have to mate that they may resort to an addiction to find coping sixty percent of adults or more so more than fifty percent of adults report that they have experienced at least one of these cases during their childhood two thirds of the population have had suffering in their childhood years those formative years where all the world is supposed to be rosy and full of possibility but there they struggled. They had a serious serious pain in their childhood. And we know from the science that preventing these cases look at what what can result when we actually prevent these cases we reduce the levels of early sex behavior in young people unintended teen pregnancies smoking binge drinking illicit drug use violence incarceration and I love this poor diet we can actually reduce the poor diet simply by caring for young people. Co-dependency So I want to spend. The last little bit of time. Talking about two particular types of addictions that. That these are behavior or process addictions and these are ones that maybe we don't really talk about or we're not very much aware of. But let's just go over this by the way let me do a time check we're here to time. Well for OK we might be done a little early so that's OK you can get some exercise OK codependency. OK you may have a problem with codependency Now I'm not encouraging you to self diagnose right now but some awareness points OK you may have a problem with codependency if you are easily absorbed by the pain and problems of others I remember meeting a lady once few years ago who I believe I think I was working in Guam at the time and there was some kind of a hurricane or tragic disaster here in the US and every day she would say to me I feel so bad for them I just keep praying for them I just I mean it just tears me apart what they're going through and you know we should feel bad for people who are going through these problems Absolutely but when it consumes us. When it's what we're thinking about over and over again I feel so bad I feel so that I feel so bad but we're not doing anything about it you know we're addicted to those emotions of feeling for someone you submerge yourself in fixing or rescuing needy people. Oh boy now it's not a bad thing to help people we should be helpful but when this is what I've got to go help them they're not asking for your help I need to go help them anyway. You know we need to learn to regulate even how much help we give to people we should absolutely help but there's a time for everything. You depend on sources outside of yourself for meaning identity and value now as we talked about this morning our identity our value our purpose comes ultimately from God That's not what we're talking about here recognizing that is what gives us all to Mitt meaning and purpose. But when we are depending on another human being and this is especially what leads to relationship addictions I just cannot be without a relationship I have to have a boyfriend or girlfriend or maybe several. You know I just cannot live without somebody texting me all the time I have to have fifty people like my post on Facebook otherwise I feel like a failure. And I'm being a little bit silly just to demonstrate you know a little bit of how what we may be missing what we may be missing but this can be very serious too codependency is really a pretty serious issue. You take care of other people's pain and problems while ignoring your own how many of us internalize our problems and we say I will pray and it will be OK. Prayer has power but God does not want us to ignore the problems and to suppress them and to pretend like they are not there that's not how we get healing this maybe is a tendency for a lot of Christians is that we feel like you know it's going to be OK God will take care of that vengeance is mine saith the Lord. Absolutely that is a fact. But the truth of the matter is that God does not want you to put yourself in danger. He's not calling us we cannot call ourselves to be martyrs. Only God can determine who is a martyr but we. Are so ready to take care of other people. While we ignore our own issues and maybe this is also part of the addiction to ministry. Right we're we're so we're going to serve in the church we're going to do multiple everything that the nominating committee asked us to do we're going to say yes we're going to do every single thing that comes to us. And you know I I'll share a little story I actually had a moment like this when I first moved to India. To be a student there I I came from being very active in my church and I loved it I came to Loma Linda and I said I'm not taking a single responsibility after about six months I said OK I'm getting spiritually fat I need to exercise my spiritual muscles I need to get involved in ministry and so I actually decided to fast and pray every Friday until God told me what ministry he wanted me to do within a matter of three weeks I had four offers for I said I'm stopping to pray anymore the do much. But I loved ministry it was such a powerful experience to me to be part of ministry I don't like being up front I like the back stage well it just so happened those four opportunities I accepted three of them. I thought I'll be moderate. All except. I thank God that one of the three that I accepted fell through and nothing happened so I had to ministry responsibilities and that was that was the right amount for me at that time but I was so driven that I remember even thinking which of these should I accept I just kept thinking well I can make time for that one I'll just I can squeeze and you know I was a full time student. And but sure I'll take three ministry responsibilities that will do it. But you know we have to realize our limitations that we are human. And that even when it comes to ministry I've learned to say if there's nobody to do the job let the job go undone. And let God raise up the laborers sometimes what we need to do is pray for the laborers rather than being the labor ourselves. Now if you're not doing any ministry. Other problem OK but we're not talking about that today so you help others at your own expense or the expense of your family this probably is a big issue for our pastors our ministers right sometimes they sacrifice their own families for the sake of the good of the church and we as a church have a responsibility to not make them feel guilty when they take a day off. Or when they spend time with their family or when they don't answer a phone call at two am. We need to allow them to have the rest that they also need. Another. Way you may have a codependency issue is you say yes when you mean. You say that's what I want to do but OK. How do. You know it's OK to say no that it's OK everybody together it's OK to say. OK great I don't think you know to God OK that's the problem but if God is leading you to do something then he's got everything else under control. All we need to make sure is that he's the one asking us to do it it's not our own internal drive. Co-dependence What is it interesting two or more sick people getting worse together. Is just where we're all just in this together making it's each other worse and worse. Originally the word co-dependence was used to describe a person whose life was affected as a result of their involvement with another person who had a chemical dependency they were an alcoholic or drug addict therefore the the two people together were considered to be co-op or CO Addicks co-dependence. But what it is is it's a pattern of painful dependence on people substances approval to find your safety your self-worth and your identity there is no human being on the earth who can give us self worth. Not a single human being has enough self-worth on their own to share with us our worth comes from God. And even if he says I have loved you with the never lasting love we just need to accept that and say Thank You God I don't understand it but I'm going to accept it and live by it. Here's the good news is that recovery from codependency is possible. Co-dependence is the disease of being an immature child in an adult body right as children do we want our children to have a level of dependence on us absolutely because that's why God gave us to them we are here to help them guide and grow and understand and learn but during every stage of childhood should there be increasing independence and if we are training them well that independence will be a good thing it will not be a rebellious independence but it will be being able to think. On their own. How many of you how many of you are parents. Good number of you how many of you are either and aunt or an uncle. You've seen some young kids grow up. Now when you when you hear that young person say something and you're like where did you come up with that. It's their own brains are gathering information and processing and formulating new thoughts and that's a beautiful process to see that is the kind of independence we want to help them learn. And there's a different level of independence throughout the different stages of growth. Co-dependence is the pain in adulthood that comes from being wounded in childhood and it leads to a high probability of relationship problems and compulsive behaviors codependents here goes again the four components of addiction it's the social emotional emotional and spiritual pathology that occurs when children grow up in an environment characterized by high stress. Nurture high stress low nurture how many of our children in the world. Grow up in high stress environments without anybody to care. And to demonstrate that care and in order to recovery they need low stress and high nurture So recovery is possible even for co-dependence. Some of the things that people me may experience when they have low self-worth. I have difficulty making decisions. We have a hard time. Do you want pasta or do you want potatoes do you want to go to this Ivy League school or the highly Ivy League school I mean it may be very simple decisions but where we're dependent on someone else to make the decision for us sometimes I judge everything I think say or do harshly or as never good enough. I just gave a wonderful sermon at church it just wasn't God Everybody says it was good but it was. You know what is I I helped organize this wonderful event in the community came out and they all said they were all blessed by it but it just wasn't good enough I can't believe I messed up. You know we even We're all going to have failures right we're all going to have something that we're not very good at. Often the problem arises when we compare ourselves to other people. But their they have different talents than we do we shouldn't compare. Low self-worth I am embarrassed to receive recognition praise or gifts Now if you're getting too much of this you know that can be a problem too but even just good solid heartfelt you know nothing wrong with it you did a great job thank you so much for for taking care of the potluck you wash those dishes so well you know we should be accepting of those kinds of simple compliments from P.. It becomes a problem when we're overly you know praiseworthy of people I do not ask others to meet my needs or desires and this is a problem with people in relationships often is that I give an I given a give Well what are you getting out of the relationship well we're friends I mean I just don't ask because you know he's so busy and you know he does all this stuff for other people but what are you getting out of it. Maybe we don't think that we are worth the effort but we are I value others approval of my thinking my feelings my behavior even over my own. Or I do not perceive myself as a lovable or worthwhile person now it's it. There's a little bit of a conflict I believe in the Christian mind because we know that we are not what God created us to be and every time we fail we are not what he wants us to be. But there's a difference between recognizing our need for God. And recognizing that other people. Have value on us does that make sense let me try to say that again there's a difference between realizing the worth that God has placed on every single one of us because you would have died even if we were the only center. And he is preparing a mansion for you. Everybody else too but for you it's got your name on it your crown has your name not anybody else's name. There's a difference between between recognizing the skills that he has given you the talents that he has in trusted to you the abilities that he wants you to develop. And receiving praise and honoring glory from others does that make sense. There's a difference between using everything that God has given us to benefit the world. For His glory. And using them for our own self. Our own selfish needs. So we we want to have a high sense of our worth. Without getting to the place where we are. Putting ourselves above does that make sense I will be honest with you that's a mental gymnastics that but even I have to do what does that really mean how does that really look but I think it's an important conversation that we need to have with God Lord what does it mean for me to accept your call for my life. What does that mean when I'm not supposed to be pushing myself out there I'm not supposed to be promoting myself what how does that look like think those are important conversations for us to have with God OK The other type of addiction I want to talk about is food addiction very briefly now food addiction is interesting because some people argue that it's not a true addiction we really can't call this a clinical addiction but at the same time there are some similarities that we see between food addictions and and these other compulsive behaviors so let's look at food addiction there is for a true food addiction a bio chemical dependency on food did you know that your brain likes certain types of food. Yeah you know what they're called. Fat. Sugar. And salt. Your body loves those and some of you one more than the other. If you're unfortunately like me you like I'm. So fat salt and sugar and you know why we know that your body likes these it's because our friendly food manufacturers have done some wonderfully intricate research studies because they want to know what will help you. Buy what they're producing. And so they have done the science to know what is the proportion of sugar fat and salt that needs to go into that put potato chips so they can tell you with one hundred percent guarantee that you can't eat just one they know they can say that because they have the science behind it so are the food that we eat if you remember one of the pictures we showed earlier on food also produces the dopamine in our brain but when we have it in the right amounts again that's part of the good pleasure that God wants us to have. So what are the experiences that we have with food addictions a physical craving a mental obsession I mentioned before my patients who were obsessed with the thoughts of where they're going to get their next meal and distortion of Basic Instinct and will power you know you don't need to eat the second slice of chocolate cake. You know that having a bowl of ice cream every single night is not what your body needs. You know X.Y.Z. you fill in the blank. So am I food addicted Well here's some things that we may want to consider is there a history of diet and regaining weight you go on the weight loss roller coaster up and down up and down. Is there a history of psychotherapy but that has no effect on your behavior so you've actually tried to seek help for this problem but it really has not affected your behavior and Are there foods that you cannot live without her not willing to give a everybody could probably subscribe to that one right there are foods that I just can't live without this food. Are there foods that I cannot stop eating you know your body was created with this amazing mechanism to actually tell you when you when you should stop eating. And there are hormones that are produced there are sensations physical sensations that are produced but the problem is that sometimes we don't we don't hear those cues we're not a tuned to the cues that say OK you're full you can stop eating now or we're our body is so used to eating foods that are not good for you that it just those those mechanisms are not working anymore. There are certain types of foods that actually promote your feeling of fullness and your ability to recognize that and to stop eating there are other foods that depress that sensation and we don't have time to do an electron nutrition. But basically eat whole foods. Will stop there OK. Symptoms about eating and I have seen some of this in previous patients lying about what they eat to others and themselves my patients lied to me all the time. You know you anybody you ask what did you have for breakfast Oh I had a grapefruit. You know they don't it was just you know. I always appreciated the patients who said I'm going to tell you the truth. So lying about it to others or themselves breaking moral code stealing food things like that powerless over food progress as it gets worse over time feeling numb high or drugged. Numb higher. Food. Maybe we ate a little too much OK or anxiety and these are the serious ones right anxiety depression sleepiness inability to sleep when you get rid of that food item withdrawal symptoms again. So the food and food in the brain a little bit of physiology here your hypothalamus part of the brain is what controls your it's your food control center it controls your hunger and fullness your appetite your metabolism hormones sleep cycles Homeostasis is is the regulation of your body keeping your body at a normal state over time. And we mentioned serotonin about general addictions right we mentioned this it's a nice neurotransmitter similar to dope Amine neurotransmitter meaning it works in brain cells low levels of Sarah to. In are associated with depression anger. And carbohydrates can increase your serotonin levels so simple carbs Here's a little nutrition fact simple carbs are things like refined grains white rice white bread. Those are simple carbs anything that came in a crinkly package. Is probably a simple car refined sugars. These can increase your so on but remember they have those addictive properties those those crinkly packages specially fruits vegetables nuts seeds tofu these all increase tripped a fan which then increases your serotonin and these do it naturally and these do it to a point that is not harmful. And exercise and sunshine also can increase your serotonin naturally dopa mean we talked about this it's responsible for movement pleasure reward emotion planning. It may have a role in in some of these diseases that we're seeing in older ages Parkinson's Alzheimer's so many of these mood disorders that are affected by these these hormones. Here we go cocaine meth and methamphetamine caffeine. Insulin sugar can all work on dopamine drug abuse or obesity can decrease your sensitivity of your dope I mean reward system what does that mean. You need more dope I mean to get the same feel good sensations so you're going to be dependent on more and more of the drug or even in cases of obesity. Yes. This is the. I don't know what this is. It's a smoking smoking gun that's for sure it's a fish in a chicken with a cigarette and I put this on here because I want to very quickly talk about the connection that we may not realize between addictive substances and food OK you ready for this OK a little bit a nutrition here there was a study research study done by Duke University of two hundred nine smokers now these people were chain smokers more than one pack of cigarettes a day so this was high high consumers and they had smoked for an average of twenty one years twenty one years now they were asked just to list the foods that either enhance or worse in their smoking experience either you're smoking was better when you eat these foods or you're smoking just wasn't as good when you ate other foods What did we find. They found that seventy percent said certain foods did make their food to eat certain foods did make the cigarettes taste better. There were food that increased their desire for smoking basically right. You want to know what those foods were. You sure good thing were here a kind Springs ranch for a couple more days caffeinated drinks alcoholic drinks and need to. Increase their desire to smoke well I should say the desire but the taste of the cigarettes so of course that will then increase their desire right why give it up when it tastes so good anything on their look like you might find it in somebodies refrigerator you know. All right what about the other side by the way these foods also increase your body weight. These are the. OK we'll do nutrition some other time now forty five percent of the same people said that there were other foods that actually made their cigarettes taste worse do you want to know what these are. Water and even one hundred percent for these cigarettes taste worse so. If by the way these foods also help you control your body weight these are the foods that also help control your hunger and your feelings of satiety these are the good stuff OK so it's amazing how God created this package meal for us that promotes life promotes health and also promotes avoiding harmful things. You know when God makes things he's got a whole big picture planned his plans are greater than our plans his ways are greater than our ways there is no way you could put all of this into a pill. Absolutely no way. And it would be too expensive anyway it's really about coming back to God's original plan for us you know as we talk about addictions God didn't want us to be caught up with anything. That enslaves us in slaves our mind our emotions our heart but we live in a broken world don't we. We we sadly gave up that power and every day as we make decisions we are either giving up more power. Or we are claiming the power of God to set us free as I said earlier. Very likely that half of the people in this room are struggling with an addiction of some type. The other half of us. Maybe we just haven't gotten there yet. Or maybe we have been able to have the type of environment and experiences and growth and surrender that has just set us free. It will ultimately be the experience for every. If the sun. We're going to take a break and then we're going to come.

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