Controlling Cannabis

Sarah and her husband Simon came to see me. They are in their late thirties, have been married for five years, and are now very concerned about their marijuana usage. They started smoking marijuana regularly as teenagers and realised a few months ago that they no longer had the ability to choose when they had a smoke. They had to have a smoke every night after work and constantly on weekends and during their holidays. They were unhappy that they had to buy an ounce every week and were worried about their physical, psychological and financial health.

Sarah said that they had recently tried to stop, but within a few hours they were irritable, arguing and unable to relax, and so resumed their smoking within a day. They wanted a break from smoking, but were worried that their relationship might not cope. They wanted one session with me where I would advise them of some of the steps they needed to take to be freed of their dependency and regain their ability to smoke when they chose to.

They told me more information about themselves, and then I responded. I began by saying that I could give them some general principles, but applying them specifically might prove difficult without my ongoing professional support. This is because everybody is different, equipped with different strengths and coping abilities. There is no single strategy that works for everybody. We might initially be able to develop a strategy, but, over time, the strategy would need refining.

Some people are able to do a “cold turkey” and immediately stop their problematic usage of marijuana. I don’t get to work with those people. The ones I see are the others who, for a variety of reasons, can’t stop. I raised the issue of whether they should aim to stop completely or instead focus on delaying their smoking.

I then asked if it was OK for me to try a simple psychology experiment to see their reactions. They agreed and I then commanded both Sarah and Simon to sit still and not talk! I then asked them for their internal reactions to my command. Both rebelled against it – Simon started to feel angry, and Sarah felt like arguing with me. I then explained that their reactions are very common – most people don’t like feeling controlled. So, when we try to control ourselves by telling ourselves that we are not to smoke marijuana ever again, part of us rebels against feeling controlled, setting up an internal fight – will we smoke or won’t we? People come to see me if they often lose that fight.

Therefore, for this couple to avoid the internal fight, it is much better for them to delay a smoke by saying something like “ I want to smoke, and I will smoke, but later”. In the meantime Sarah and Simon need to distract themselves and they will find that the urge to smoke eventually decreases the more they practice delaying. From being in a situation where they have NO control, they are now showing SOME control through delaying! We discuss realistic ways of delaying that will help them start to feel better about themselves. They agree to help each other to delay their smoking each day and they then leave with a realistic achievable goal to aim for. Simon says he will ring me eventually for further help when they are ready for the next stage of regaining control over their lives.

I await their call.

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