Do we need self esteem?


Editor’s note: This is the second of two parts.

I’ve always felt that self esteem in this field is overrated. Like Nike says, “Just Do It.” If a person spends most of their time contemplating their self worth, why can they not, through resolution and being industrious, eliminate all of their self rating?

The answer is, they can eliminate their self rating once they realize that such an absence of rating their entire worth is possible and is in fact preferable to frequent thinking and feelings like anger, rage, shame, guilt, anxiety, depression and fear. Thirty-five years ago, during the “self esteem” binge in the ’90s we were teaching, gave way to why clients at Friends of Caz Manor Halfway House to stop rating themselves and others, and to look at the forest to see if it is desirable or undesirable to go into it.

I used the analogy of the animal kingdom. When we go to the zoo, it doesn’t appear that animals there worry much about their “self worth.” We rarely see a self-esteeming alligator or a self-despising kangaroo. Animals, other than man, seem completely content as ego-less creatures, simply observing the outside world. They appear entirely free from anxieties and hang-ups suffered by their self-centered humans.

Many of my guys in REBT at Caz would argue that animals are intellectually inferior to man and possess no capacity for self esteem. Perhaps, but the “dumb” animals also possess no capacity for bigotry, astrology, superstition, or crack pot religions, i.e. remember Jim Jones!

So it is apparent that the superior human intellect often invents and adheres to unhealthy philosophical systems. It may just be possible that “self esteem,” is one of these.

Finally an anonymous letter appeared at the OBSERVER from a reader asking the question “Can a psychiatric disorder such as being bipolar be brought on by long term use of cocaine abuse dependence? Furthermore, is this a permanent condition?”

The reader did not give me a lot of information about the behaviors involved, except to say that the person in their family is “being treated” but states he is not his “old self and doesn’t feel right.”

If someone started using cocaine before they were diagnosed with a mental health disorder, the mental health disorder may have gone undiagnosed and may have been there during chemical use. As a chemical dependency counselor, I have told people in this situation that using cocaine doesn’t help. In terms of brain damage and altered mental states, the reader states “it’s a subject I haven’t heard much about.”

In the pharmacology of addiction related to drugs like cocaine, the following usually occurs. The brain is like a sponge harboring water. The brain harbors chemicals like norepinephrine, dopamine and serotonin. These chemicals serve certain functions in the brain like decision making, feelings and judgment. Like a sponge, long-term drug use drains these chemicals and rational decision making is replaced by irrational behaviors such as wanting to get and stay high 24 hours a day. It usually takes 18 to 36 months for the sacs in the brain to regenerate and fill themselves up. This is based upon abstinence from all mood-altering chemicals; getting high becomes normal. Staying abstinent is abnormal, I believe with a drug like cocaine; the withdrawal process deserves medication under a doctor’s supervision. This is to “buffer” the withdrawal process and ease the “crash.”

The problem in this society is the idea of “pain free at all times.” In recovery there will be short-term pain for long-term gain. Because someone who is being medicated “doesn’t feel right,” when medicated, doesn’t mean that the medication isn’t working. The urge to get and stay high supercedes all other urges. During long-term cocaine use, this becomes more of a mental than physical way of thinking and behaving.

In terms of “altered mental” states, long-term use of cocaine can actually change the shape of the brain. Anyone using cocaine that I ever worked with, usually stated “it was the most pleasurable drug ever used, and if everyone knew how it made them feel, everyone would use it.” Obviously, this is irrational thinking, but not to someone using or addicted to cocaine.

Most of the psychiatrists and psychologists that I worked with over the years, knew our field of chemical dependency. The drugs they prescribed were appropriate for our clients. Let me stress this to the reader, that whether the chemicals used are prescribed for chemical dependency or mental health, abstinence from all narcotics and mood-altering chemicals is the goal of recovery. Thus, when counselors and people prescribing medication that have “mutuality” as a goal, the client will benefit in terms of “is this a permanent condition?” Chemical is a permanent condition. Once crossing over from abuse to dependence, there is no reprieve. A person sober from cocaine for 35 years would begin where they left off 35 years ago. We often say in our field, that a drug is a drug is a drug. That means if someone is addicted to cocaine, they also cannot drink alcohol, smoke weed, use pills like opioids, and so forth. Again the way to recovery and the recovery process is through abstinence.

Mike Tramuta has been a CASAC counselor for more than 30 years and currently runs the REBT program on Thursday nights at the Holy Trinity Parish Center from 7 to 8:15 p.m. Call 983-1592 for more information.