The Descending Limb

Author: IAFF Staff

September 5, 2017

Remember your first real hike? Trudging up a very steep trail toward a serene lake high in the mountains, comforted every step of the way by the thought that the hike back down would be so much easier? This is referred to as coping: the process of thinking or doing something positive to help you stay the course, regardless of how uncomfortable, in the present moment. In this example, it is cognitive coping — or more colloquially, thinking thoughts that assist you with a current stressor.

The stressors of this hike may be different for everyone. Maybe you’re carrying more weight (physical stressor 1) after having veered too far from proper nutrition. Now your quads and hamstrings are screaming (physical stressor 2), and you feel like your heart is pounding out of your chest with rhythms you know aren’t ideal (physical stressor 3).

You’re also keenly aware that you are alone on the trail (psychological stressor 1). You’re anxious to get to the end of the hike and join old friends (psychological stressor 2), but also embarrassed that your lack of physical fitness will be evident to those you haven’t seen for many years (psychological stressor 3).

Finally, it is unusually hot and humid (environmental stressor 1), your father’s Army Surplus down sleeping bag keeps escaping its ties and exploding like a giant green worm (environmental stressor 2), and you’re wearing boots that are a size too small because this is your first big hike (environmental stressor 3).

So, here’s the score: Coping = 1, stressors = 9. The stressors are winning. But what if, in this story, you make it to the top, with the one easy coping strategy: “Tomorrow there will be a softer, easier way.”

Anyone who has hiked anywhere can see the catch in this story. The way down, especially when you are worn out from the way up, is meaningfully more painful! This applies to addiction, too. Addiction to alcohol and drugs of many varieties can start as a behavioral coping strategy. On the ascending limb (the uphill climb) of intoxication, alcohol and drugs decrease pain and anxiety and increase happiness and sense of well-being.

That’s coping, right?

Wrong. When it comes to addiction, it’s all about the descending limb. The way down the lonesome trail can be a long, painful walk to endure. When someone is in the throes of addiction, the withdrawal, depression and overwhelming fatigue of the descending limb of intoxication begs for more drugs. The thought that “This drink will make me more comfortable at the party” is just as flawed as my idea that the way down the mountain would be easier.

For fire fighters and paramedics, stress is a way of life. Physical challenges, equipment failures, struggles with management, and worries about family and finances are but a few of the daily hassles they face. Sometimes, the job results in physical and psychological trauma exposures that can cause acute pain that cries out for rapid response.

People in recovery are hard pressed to develop adaptive coping in response to cumulative or acute stress. But this is an absolute necessity for anyone overcoming addiction. Figuring out accurate, useful and nimble means of coping with stress is one of the very best forms of relapse prevention. For some, it can be as simple as staying as far away from the mountains as possible. For others, it means getting boots that fit. Maybe it’s staying on track with nutrition, exercise and sleep. Why not ditch the Army Surplus sleeping bag for a more modern, functional sleeping bag designed for this purpose? With this approach, you are navigating a tough climb and not lying to yourself about the way down. That is adaptive coping.

Lyrics from the Brandi Carlile song “The Eye” say it well: “And did you think the bottle would ever ease your pain?” Carlile is challenging the cognitive coping of an addict. Challenge your own coping strategies. Be sure that your coping is in service of your recovery, not in service of your addiction.

If you’re in need of treatment for substance misuse, PTSD or any other co-occurring behavioral health issue, contact The IAFF Center of Excellence for help.