Life sucks, they're embarrassed, and they're unsure of themselves - but they accept it. They deal with it. They live with it. They welcome it. They adapt to it. They expect it. They know it's part of the process. Your path will never be perfect. It will never be perfectly flat. It will never be perfectly straight. It will never be a smooth finished surface you can coast on. Instead of having the mindset of a finely-tuned Ferrari that needs perfect conditions for success or it'll break down, develop the mindset of a 4x4 truck that can handle any nasty environment with ease. It may not go as fast, but nothing stops it from moving forward. Something will always be in the way. Something will always be trying to stop you and kill your motivation. Something will always seem more "fun" and worth your time. When things are going so good they seem perfect, something will come up and ruin it. When things are bad, more bad things will happen. I like to think of the "meaningful engagement of talents" as what happens to all of us when we become engrossed in life, relationships, work, and play. Time passes quickly, everyday pains and bothers fade away, boredom evaporates, and our mind is transported in pleasurable ways.

What I have described here are some anodynes, effective alternatives, and means of countering the mental malaise and emptiness that can create the conditions for the use and abuse of substances. Have you wondered how a (good) clinician, psychiatrist, addiction expert, psychologist, social worker, or independently licensed nurse comes up with his or her recommendations for treatment? What is the critical thinking underlying these recommendations? As an example, let's look at a comprehensive treatment plan for drug and alcohol addiction--or, more properly, for what is now termed a substance use disorder (SUD). An SUD is characterized as the overuse or dependence on a drug with adverse effects on that person's physical and mental health, as well as negative consequences on others. The use of the substance, whether it is cocaine, OxyContin, heroin, alcohol, marijuana, or any other drug, persists despite clear and serious problems with family, work, and personal relationships. Legal problems also tend to accrue. Two related fields of science, biological and cognitive neuroscience, have substantially informed the treatment of an SUD, which includes the use of both legal and illicit drugs. Our understanding of the brain, still the most complex organ and system we know of, has grown vastly in recent decades. We have come to understand far better the various parts of our brains, their respective functions, and their neurochemistry and circuitry, as well as how to impact them. We are far from claiming mastery of the central nervous system, but that need not keep us from acting on what we know. Knowledge is what a good doctor or clinician brings to a clinical encounter with a patient and should inform and provide confidence to a patient and family when seeking help. Working together, doctor, patient, and family are what make for the best chance of a successful treatment. For people who have experienced the agony of a panic attack or prolonged anxiety, the idea of Xanax or beta blockers can seem like a dream come true. Many feel that having access to drugs that can immediately "knock out" a panic attack if one starts to form is now a central plank of their sense of personal safety. While some medications can be helpful in defeating anxiety, therefore, they can also be counterproductive. Carrying around fast-acting medications can lead people to believe that they are not "safe" without these drugs. This can lead to a feeling of powerlessness, helplessness, and dependence on the presence of the drug that can be very disempowering. This feeling, in turn, can prevent people from realizing that they are capable of managing their anxiety and panic, even in the absence of the drug, and that they have the methods to regulate their emotions within themselves and their own bodies. Medication, therefore, may not always be the best resort in treating anxiety and panic.

If you see a mental health professional and they do not recommend medication, this should not necessarily alarm you or cause you to look elsewhere. Indeed, it is often much better to start with cognitive behavioral therapy, which addresses the root causes of anxiety and panic, rather than just the symptoms, by altering the underlying thought patterns that fuel anxiety. The degree of success in treatment you can attain from this method alone may pleasantly surprise you. Annoyed at the mess, I reacted by doing the only thing a skilled and practiced procrastinator could do. I put my coat back on and went out into the brisk and chilly November evening to a twenty-four-hour convenience store to purchase a supply of paper plates, plastic utensils, and Styrofoam cups. Looking back on it now, it's difficult to decide what was the oddest aspect of that situation. Was it my refusal to deal with the dishes at the start, or how I had allowed the sink to get into that condition? Or, perhaps worst of all, why did going out to buy those disposable items seem like the perfectly logical action to take? After all, which would have taken the greatest amount of energy: cleaning the dishes, or going out into the cold night air to go shopping for plastic ware and paper plates after coming home from a long day at work? What's funny about this situation is that by avoiding the problem in that way, I delayed having dinner far longer than if I had just stayed home, cleaned one pot, began cooking, and then cleaned the rest. However, at that particular moment, my actions actually did make sense to me because not only did I not want to deal with the dishes--I also felt "I just couldn't." In reality, I could have washed the dishes, however, by habitually procrastinating, I had convinced myself that I really was incapable of cleaning the dishes at that particular time, and probably as much in the foreseeable future too. In other words, as long as I had my disposable utensils, I no longer had an immediate need to deal with the situation in my sink. "After all," I rationalized, "I paid good money for those items--so, I might as well make use of them." And, there the clogged sink stood, its contents secure, while the mold continued to grow. A few days later a more distinct odor began wafting from the sink and it was only when the stench became overpowering that I finally gave in, cleaning the accumulated items, not with dishwashing liquid but with scouring powder--all the while wearing long rubber gloves. Grant Cardone says, "See, most people think success is a straight line. I'm gonna get out of high school, I'm gonna get a job, and everything's gonna be fine. That's not how it plays out. This is how it plays out - you decide you want something and the line gets all squiggly. That's really what success looks like." U.S. Navy SEALs are so scary to the enemy because they train in their "green world" more than anything else.

They learn how to operate and execute with precision in the dark. You may not see them, but they'll see you and you'll be dead before you even know they're there. Handle dark moments in the same fashion. When bad things happen, it's night training. It's time to train in the dark. It's time to practice your navigations skills when you can't see 5 feet in front of you. In the dark moments, put on your night vision, push forward, and keep moving. Get used to operating and executing in the dark. 97% of us don't have it together because we don't learn to navigate, operate, and execute in the dark. Instead of moving forward with caution and using our hands to feel where we're going, we give up because we can't see anything and fear stops us. The lights go out and we experience hardship, and we give up. We quit working as hard. We quit making an effort. The 3% of us who do succeed get down on our hands and knees and crawl through the dark. We walk slowly and feel our way through the dark. We walk face first into things if we have to. The dark doesn't stop us. Fear of not seeing doesn't stop us. When problems pile up and the lights go out, we think, "Good. Time to train.

Time to get stronger. Time to learn how to move faster in the dark." As an example, let's consider a person dependent upon heroin or a prescription analgesic (such as OxyContin, Percodan, or Vicodin), now well recognized as an epidemic in the United States and other countries. The mainstay of SUD treatment has traditionally been 12-step programs such as AA and NA, but today these should only represent but one of a number of interventions that can make a critical difference. That's where neuroscience comes in. Your doctor or other medical or behavioral health professional can, and should, offer more than AA or NA alone. A well-trained clinician can now consider the underlying brain mechanisms driving the addiction and its self-destructive behaviors. With an understanding of how the brain works when dependent on a drug, an informed clinician can develop a comprehensive treatment plan for a person with a substance use disorder. The reward circuit within the brain, shown here with important regions marked, can powerfully influence addiction. Scientists and mental health clinicians understand that our brains have a reward circuit that powerfully drives our behaviors. We can use this knowledge to build a treatment plan and to explain to a patient and a family, not just to a fellow clinician or neuroscientist, how to think about and treat addictions. Emotional Regulation. In this stage, the therapist helps you learn some of the simple techniques that you can use to manage and reduce your panic or anxiety response in the moment of a panic attack. We will discuss these methods in greater detail later on this chapter and in Chapter 6. Gradual Exposure. This is the heart of the cognitive behavior technique. When many people hear about it, however, they become alarmed. Exposure to the thing they fear is exactly what they don't want. That's why it's important to emphasize that the exposure methods used in this form of therapy are gradual and consensual. A person who is afraid of snakes is not immediately asked to hold one, for instance. Many people, when they hear about exposure methods, assume they will be asked to simply "face their fears." Sometimes, well-intentioned but unhelpful people will give the advice to people struggling with anxiety that they should just "face what their afraid of" and the problem will go away.