TPC Journal V7, Issue 4 - FULL ISSUE

The Professional Counselor | Volume 7, Issue 4 323 participants. Participant 15, who abstained from soda, described hearing a soda dispenser and the physical effect she noticed in her body for the first time, “It was odd to note that I had a sensation go through my entire body as I heard it. It made me think and consider Pavlov’s dogs. Truthfully, I thought about Diet Coke the rest of the day.” Cravings were often accompanied by withdrawal in participants who had given up substances they had consumed over long periods. Participant 12 reported, “Today I was run-down and fatigued, and I developed a low-grade headache that stayed with me all day. And even though I ate more than I usually eat in a day, I felt like I was starving.” Reading through the 17 participants’ journals, researchers found consistent patterns of subthemes often occurring in a sequential order. The subthemes order was descriptive of a trigger or cravings, followed by relapse, justification for the relapse, and finally shame and guilt over the relapse. Upon review of the participants’ transcripts, this pattern was found in 15 of the 17 participants and occurred between one and three times per participant. Participant 13, who abstained from sugar, described a cycle of trigger, craving, relapse, justification of relapse, and shame over relapsing: “Tonight was Superbowl Sunday. My aunt made a gluten free cake with dulce de leche and strawberries on top, and I ate two slices . . . I felt like I deserved it because I was doing so good on this abstinence assignment.” Participant 13 further recalled, “I feel a little bad about it now, but I honestly feel like it was justifiable and I plan on going back to the no sugar and no gluten thing again tomorrow anyway.” Instances of complete breakdown on the students’ abstinence goals often appeared. These especially occurred with students who chose substances like grains, carbs, or sugar. The defining elements of these complete breakdowns were a sense of low self-efficacy and overwhelming guilt and shame. Participant 10, who abstained from fast food, expressed, “I have eaten at fast food restaurants three times since last Thursday . . . I literally feel disgusted at myself that I haven’t been able to control my cravings or at least have enough self‐control to just be mindful about my choices.” The experience of emotional and physical symptoms related to abstaining from a behavior or substance prompted students to begin exploring effective personal strategies for dealing with their cravings. Theme Two: Dealing With Cravings Paralleling the experience of individuals in the early stages of recovery, participants actively dealt with cravings in various ways, including healthy and unhealthy coping mechanisms. When participants selected strategies that were unhealthy or unhelpful, the researchers labeled these as replacement behaviors. These behaviors often consisted of replacing their substances with other substances. For example, switching from sugary foods to fatty or salty foods, and avoiding a trigger or cravings by staying overly busy. These behaviors are not new to professionals working with clients with addictions. Below are examples of the participants engaging in these replacement behaviors. Participant 1, who abstained from soda, described noticing her behaviors as, “I ate a lot more . . . than I normally do. Because of how many chips I was eating I realized that I had replaced my drink [soda] with chips and salsa.” Noticing the pattern was a valuable learning experience that helped the participant to confront her substitution later in the assignment. However, other students were unable to observe the ties connected to these behaviors and future relapse. Participant 5, who abstained from social media, reported, “I was also very busy the last couple of days because I’ve been preparing for my counseling presentation. Maybe I’ve successfully distracted myself from the temptation.” Nearly all participants reported engaging in replacement behaviors at some point in their experience. However, many of these participants discovered more successful ways to cope with triggers and cravings. When participants reported positive craving coping strategies, the researchers labeled these experiences as relapse avoidance strategies. These strategies often involved the elimination of potential triggering events or objects within the participants’ environments, relying