I’ve been working with a client (I’ll call him Robert) who’s trying to stop using cocaine. We’ve had some powerful sessions lately, emotionally moving for me as well as for him. I really want to help Robert — or, more to the point, I want him to succeed, with or without my help. He’s just so miserable, so alone, so desperate.
And I recognize myself in him. Not because I’m miserable and desperate these days (I’m not) but because I know exactly what it feels like to be in that place. To continue using when the pleasure is gone and the heartache starts to geyser up before you’ve even left the house to score.
One plan that made sense for Robert was to enhance self-compassion as a means for overcoming (a massive glut of) shame…(because, as we know, more shame –> more using). But then it occurred to me that the format of the plan (in therapy or in life) is more important than the content. The content will vary from one person to the next. Yet there may be one maximally effective format for beating addiction: connecting a macro project with a micro project. What I mean is, developing some skill or resource that takes time to build and refine (that’s the macro project), and deriving from it a toolkit of strategies one can activate in the moment (the micro project).
Most important, the two have to connect. What’s going to be most useful in the moment (e.g., when your dealer calls, when you’ve just had a fight with your husband, when your best friend has to go home to his family for dinner) is going to be something you’ve worked on over time.
A case in point: developing self-compassion to beat shame
The macro project: We each have a number of different selves, or voices, or modes or moods, whatever you want to call them. Each is distinct, built on a particular emotion or emotional combo. The shameful self — that’s pretty familiar. Hating to be seen, cringing from being accused or 
despised by others…and by oneself. Shame is hot, red like a boil, painful, laced with disgust. The shamed self often gives way to anger, the famous fuck-you reaction, or defiance, the equally famous fuck-it solution. Or it opens onto 
guilt and depression. Omigod, how could I have done that?! What a bastard I am. Then there’s the anxiety about being caught, seen, punished, cast out — as familiar as background music to Robert and to just about everyone I know in active addiction. Often there’s a cascade through several of these self-states that leads straight to using. But each state is also a branch of our personality, stable and familiar — a thicket of interlaced neurons.
Yet there’s another self, built on another feeling. It’s the compassionate self, based on the feeling of nurturance. Nurturance is built into our neural hardware. It’s needed for us (great apes) to effectively raise our young, since they take forever to mature. It’s 
the feeling we feel when we comfort a child or feed a helpless animal. But, as you probably know, the compassionate self seems a fiction, a fantasy, when you’re in active addiction, especially when it comes to compassion for yourself. Maybe you never learned self-compassion deeply enough because your parents didn’t know how 
to provide it or feel it or value it. Or maybe you lost it en route. It gets worn thin by repeated bouts of shame and self-loathing.
But either way, self-compassion is pretty much the only feeling that can defeat the self-destructive agony of shame in a head-to-head fight.
In The Biology of Desire I described self-compassion as one way to connect your past self (recognizing how much you’ve been hurt) with your present self (of course I want to get high — that’s how I’ve learned to hurt less) with your future self (we’re going to get to a better place — here we go). Note the use of “we” — and (P.S.) see Peter Sheath’s and Matt’s comments directly below.
Given that self-compassion looks like a field of dead weeds, the macro project is simple. Cultivate it. Grow it. Make it more familiar, more salient, more present. There are several ways to do this. ACT and self-compassion therapy are obvious choices. Check out other therapeutic approaches suggested by readers here and here. But what I recommended to Robert was to meditate, just 10 minutes in the morning for now, and start to sense it, like an almost totally blind 
person sensing light. Feel that first bit of coziness behind your eyelids, in your body, and stay with it, let it warm you. I suggested he try using a meditation app, like Headspace, Insight Timer, or Buddhify. These apps can help by connecting us to a voice that’s comforting as well as skilled. And DO IT every day until it starts to take — usually within a week. Also, just talking to yourself in a kind voice (either out loud or silently) can be very powerful. Try it.
The micro project: Most of us know that just being off drugs or booze for a few days is already a plus. Shame and self-reproach start to recede. Maybe you get a little pride, a sense of forward thrust. Some hope. Some trust in yourself. But stopping, even for one day, can be insanely difficult, so most forms of addiction treatment try to teach mental tricks for diverting or overcoming the urge.
These tricks include “fuck no!” (sort of the opposite of “fuck it” — using defiance for good, not evil). They include distraction, finding something else to do, exercise, sports, prayer, connecting to a friend or sponsor. They include avoiding temptations, focusing on future goals, “urge surfing,” finding a replacement substance that’s easier to quit. These cognitive acts can get you through the night. They’re the things you might learn from CBT, or motivational interviewing, or DBT, or SMART. And they are valuable!
But the one cognitive trick that’s usually missing from this list is, I think, the most valuable: finding your compassionate, accepting self, right here and now, because that softens and neutralizes shame (and averts the rest of the cascade). Now you have somewhere to go that isn’t agonizing, that feels good enough to replace getting high.
And the best way to make this micro project work is to link it with the macro project of finding and cultivating the compassionate self. Which may take weeks or months. It won’t happen overnight.
So my suggestion to people trying to help people in addiction, to people in addiction (like Robert) and to my own self is: Get to work on the macro project of cultivating the compassionate self WHETHER OR NOT there’s a smidgen of “improvement” when it comes to using — or anything else. And then, when it’s time, call on that self, get it on board, at 7:45 on a Friday night or a dreary Monday morning.
But you gotta do your homework, your macro project, first — at least get it started — or the micro project isn’t going to work very well.
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