I recently had a patient who had been sober from alcohol for two years come in seeking help for depression, anxiety, acid reflux and intense anger. He had switched to a vegetarian diet, and was exercising on a regular basis. Despite his efforts he was still struggling, a lot.

I commended him on his lifestyle changes and sobriety, and told him this was a powerful step to addressing his issues, but it was only half the picture. I explained to him that I could treat a person for carpal tunnel syndrome, but if they keep doing the same repetitive motion over and over, there is a limit to recovery. In his case, we need to understand what his stressors are and address the aggregates in his environment that are triggering these symptoms. He confessed his biggest stressor was his family—they were the embodiment of all the things he wanted to free himself from, but regardless, they were his family. He felt overwhelmed, and didn't know what he could do to improve his disposition so it wouldn’t affect him as much.

As we talked, I put needles in to help calm him down. I told him his guarded and defensive poses were appropriate responses given the environment. This protective, hyper-aware system may have secondary consequences of stress, anger, anxiety, and acid reflux, but that these secondary consequences may be a far better trade-off than being relaxed and vulnerable in a threatening, uncertain environment. Often times people look to do or be something to maintain peace in their current environment, but I think this is unrealistic.

So I asked him, in your experience, is it realistic for someone who is an alcoholic to become a vegetarian, exercise, and socialize in a bar with their alcoholic friends, and expect to stay sober?

He laughed and said there's no way.

If we apply sobering up from the drug of alcohol as an analogy, how can one expect to sober up from the drugs of anger, anxiety and depression while changing diets and exercising, but still hanging out in the “bar” of anger, anxiety, and depression with one's friends, who are addicts of anger, anxiety and depression?

He paused, and said, "It’s not going to happen."

Ok. So you have all of the tools to sober up. Apply them here.

His challenge is a potent reminder that changing one’s internal resonance necessitates a change in the corresponding external resonance, in order to be able to maintain the new reality. If you want to stop drinking, don't hang out in the bar or with the people who enable that reality; find the support to make the change. If you want to free yourself of anxiety, depression, and anger, don't hang out in the bar of anxiety, depression, anger, with the people who enable that reality. Otherwise, you are going to be stuck, and your treatment is going to be the same every time.