Episode #39: New Research on the Use of Substances to Regulate AffectEpisode #39: New Research on the Use of Substances to Regulate Affect
Beyond the Two Pillars of Recovery
Norwegian addiction specialist Dr Sunniva Christiansen discusses how people use substances to regulate affect, how they understand “self-medication” and which non-substance strategies can support emotional balance. The conversation highlights visual models, body-based basics and person-centred dialogue as ways to strengthen recovery.
46:49•31 Jul 2026
Self-Medication, Feelings and Sobriety: Rethinking Affect Regulation in Recovery
Episode Overview
- People with substance use disorders often describe their use as “self-medication” specifically when substances help them feel more functional, such as working, calming down or engaging with family.
- The window of tolerance and core affect models give simple, visual ways to understand over-activation, under-activation and the pull towards pleasurable states.
- Basic physical needs like regular meals, hydration, sleep, movement and a sense of safety can significantly support affect regulation and reduce emotional volatility.
- Non-substance strategies such as exercise, peer groups, mentalisation-focused work and long, person-centred conversations can help people build sustainable ways to manage feelings.
- Talking openly about both the helpful and harmful effects of substances did not increase cravings in Sunniva’s interviews; participants often felt more motivated to use alternative strategies.
“What we found when we talked to our patients was that well I use my substances as self-medication… they introduced the term but they only introduced that term when they talked about how they use their substances to be more functional.”
Curious about how others manage their sobriety journey when emotions are running the show? This conversation with Norwegian addiction specialist Dr Sunniva Christiansen takes a calm, curious look at how people with substance use disorders use substances to regulate their inner world – and what happens when professionals actually ask them about it.
One striking moment comes when she explains, “what we found when we talked to our patients was that well I use my substances as self-medication… they introduced the term but they only introduced that term when they talked about how they use their substances to be more functional.” People describe using amphetamines for productivity, alcohol to calm down enough to talk to family, and then also using substances simply “to fly away from my trouble.” The episode speaks strongly to anyone in recovery who’s ever felt “hangry” or wired and on edge, then reached for a drink or drug to cope.
Host Jeff Kane, joined by co-host Aaron Wesley, talks with Sunniva about her path through drug and addiction medicine, child and adolescent psychiatry, and her PhD research on affect regulation. Instead of quick questionnaires, she sat down for long, person-centred conversations, using visual tools like Daniel Siegel’s “window of tolerance” and James Russell’s “core affect” model to help people map their emotional ups and downs.
Sunniva keeps bringing it back to basics: sleep, food, safety, movement, social connection and practical supports like exercise, peer groups and mentalisation-based approaches. There’s also a gentle challenge to treatment culture: her research interviews, technically “data collection”, often felt more helpful than standard sessions, simply because patients were invited to talk honestly about both the helpful and harmful sides of their substance use.
If you’ve ever wondered what your substance use was doing for you before it started working against you, this conversation might give you a new question to carry into your own recovery work.
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