My client yesterday reminded me that over the years I have come to recognize various categories of smokers. This man I would classify as using smoking as a crutch. I wonder if other therapists would agree?
This smoker was very defensive about his smoking. On a scale of one to ten he only managed a seven on wanting to give up. One a scale of one to ten about how much he believed he could give up he said ' a two and a nine'. He was clearly conflicted about wanting to stop.
Smoking to avoid thinking
I asked how he felt on a plane when he couldn't smoke for three hours. He said he won't go on a plane because he would have to be hours without a cigarette, and couldn't accept that. It was an issue with his wife: she wanted to go abroad on holiday and he had never agreed. He told me that he used to wake up in the middle of the night, just so that he could have a smoke.
Every night, he makes sixty roll ups for the next day. That way he will have one ready instantly all day. He cannot imagine voluntarily being without tobacco in the house. If he had no tobacco, even if he had some smokes to hand, he would have to go and get some. Even it meant an hour's drive or more. He says that he smokes when he has nothing to do, or when he isn't sure what to do next.
I spent a long time trying to find out what he was getting from smoking. But he wouldn't or couldn't go into his reasons. He was very hard to get into, although a very pleasant man. He would rather talk about his opinions or experiences than delve into his own emotions. His father had been very distant. I asked him if he ever got a hug as a child and he couldn't answer.
He appears to be the type who smokes for something to do. I think that he needs to always feel that he has something to do to stop his mind coming up with some awful feeling. I think he has a deep childhood issue with having to do things in order to get love. But I could be wrong.
I think that smoking is something he does because it guarantees him that whenever that feeling of doubt comes up, his feeling of self worth, he knows he can avoid facing it, because his cigarettes are there to give him an instant distraction.
Maybe I am reading too much into it, but I have spent several hours thinking about this man and his behavior. I am getting more and more convinced that smoking is not simply an addiction. For this man it has been a psychological crutch for him all his life.