Many years before I found my way into a group room or sat in a chair before a client, I listened to a recording of Dr. King and his "I Have a Dream" speech.  Having listened to his speech I knew I wanted to help people in some way and I knew I wanted to affect change, I just didn't know how. I had a dream of supporting clients to find a way to exit addiction. I suspect I must have found a way to reach my goal as more than 28 years later I continue to support people to find a way to to achieve sobriety. When I was wandering about trying different careers, I tried selling cars for a bit.  The work didn't engage me, but in some way I latched on to the idea of sales.  In some way I sell sobriety.  I am able to highlight the various features of recovery and like car maintenance, I am able to show clients what they need to do to achieve lasting recovery.  Taking care of your car is a choice, much like recovery is a choice. To stay sober you need to do many little things on a regular basis that support you to abstain from chemicals or support you to make a decision to use in spite of all of the evidence to the contrary.  It's not much different than maintaining a car.  If you neglect the maintenance your vehicle will cease to run. To this end I think that everybody has the ability to make a choice and find sobriety.

Over 32 years ago I made a conscious decision to quit using chemicals.  I found a way that worked for me with the help of my grandparents.  The way they supported me to remain sober looks very similar to the way I have been able to help clients find sobriety.  Throughout my career I have seen various trends in the field of addiction recovery.  While the addiction treatment industry was borne out of the self-help movement, things have changed.  While I can see the benefit of attending support groups, most research has not affected the way support groups and the 12-step movement operate.  However,  great strides in modern science have brought many changes in the way addiction treatment and mental health services are delivered. We have seen the the advent of anti-craving medications, the creation of various cognitive behavioral therapies, motivational interviewing, the creation of the Transtheoretical Model (stages-of-change) short-term therapy, goal-based treatment, and the implementation of peer-led support.

While I think many changes in the addiction treatment industry have been helpful, I have seen an intensification in the negative attitudes from some folks in various support groups or clinicians in the recovery community suggesting the "new methods" are essentially harmful.  I don't think this is the case.  I think that many people who see the "new therapies" as harmful are misinformed and narrowly focused.  It seems to me that at times people forget that recovery looks different for everybody.  I am not sure how attending 12-step meetings gives a person special insight over someone who found recovery though a therapist and anti-craving medications.  It seems to me that recovery is a choice.  How we get there shouldn't matter - what matters is that we find a way and that we get there.

This might be a contentious statement for some folks, but my sense is that recovery alone is not a job qualification.  I don't think that being sober gives us any special insight into the addicted mind or the behavior of an addict.  In some ways we could suggest that a period of recovery without a professional and educational background to complement our experience could be seen as a hindrance and allow us to be less than objective?  Perhaps recovery alone positions us to be too close to the issue at hand and would serve as a deterrent for a sober person trying to run a group in a treatment facility.  I don't think that being sober makes us special, just different.

Many times I will hear someone in recovery suggest that 'only an addict or alcoholic can understand another addict or alcoholic'.  I don't think this is the case and is essentially an urban myth.  When I think of addiction I think of people feeling helpless, powerless, and being held captive by their dark side. My sense is that we don't need to be brilliant to understand the mind of an addict, just human.

Developing skills to manage your emotional states is crucial if you want to develop long-term sobriety.  While the initial phase of recovery is often met with a 'Pink Cloud' or Honeymoon period, it is very likely that once the newness of recovery wears off the newly sober addict or alcoholic will encounter depression, mood swings, confusion, memory loss and an inability to regulate their emotions due to brain chemistry that has yet find homeostasis.  In this article I offer concrete and specific ways you can approach your "emotional mess" and posit solutions for managing feelings that are distressing to you.

If we take the position that addiction is largely the result of brain chemistry, it makes sense to me that we would approach a medical problem with a medical solution.  Make an appointment with your medical provider to discuss the possibility of being assessed for anti-depressants.  The effect of chemical use tends to create an experience where your world can feel very small.  I suspect this is due to your brain's inability to produce the required brain chemistry for normal cognitive and emotional functioning. A lack of the appropriate neurotransmitters can make you feel like you don't have the needed emotional bandwidth required to face the day-to-day challenges.  Utilizing the available pharmacology and today's research can go a long way in helping you develop a sense of ease in your recovery.

Developing skills to reframe what you are thinking is crucial if you want to stay sane.  One of the biggest lessons we learn in recovery is that we need to come to a place where we don’t personalize everything. There's a host of information available on the web if you'd like to do further study, but I would like you to consider the following ideas:

1) Take responsibility for your distress.  While negative events happen, it is important to realize that you are only responsible for your part in the situation.  Make an effort to talk to a trusted friend to get clarification on your part in a situation as well as where your responsibility ends.
2) Remind yourself that you cannot control the timing, the outcome, or how you, feel. You are only responsible for what you think.  By focusing on what you think you can change how you feel.
3) Try to see the good in every situation.  My grandparents lived through four years in a Nazi concentration camp.  When something negative happened to my grandmother after she and grandfather were released from Auschwitz, she would talk about "seeking the gift" in every situation.  She suggested there were three reasons people were unable to seek the gift: 1) the problem (or opportunity) doesn't come wrapped in the package you're used to seeing, 2) sometimes the opportunity doesn't happen on your time table, and 3) sometimes the problem doesn't happen for us, it happens for someone else, and we are merely the conduit.  My grandmother made sure that every time I was upset that I remembered that a gift existed in every situation

Realize that bad stuff happens.  My wife has Cancer. I do not see this as karma nor do I believe that 'everything happens for a reason'.  I see 'everything happens for a reason' as a trite way to wrap your brain around something you do not understand.  My wife has a family history of Cancer on both sides of her family.  It was very likely that no matter what she did, she would have contracted this horrible disease. I do not spend a lot of time thinking about why bad things happen, they just do.  Recognizing that bad stuff happens regardless of what we do or believe lets me remember that bad stuff happens, and it's okay

For over 27 years as an addiction treatment professional I have applied various treatment approaches in various communities.  In helping my clients find success I have learned that treatment approaches should vary not only by community, but also by client experience and milieu.  Many clients find success as a member of a community mental health team.  Homebound clients are not only mobility challenged they experience uncontrolled and unexpected occurrences that negatively impact long-term success.  Their case specific needs require different treatment approaches to support long term recovery.   In this article we will explore various reasons for this lack of success and posit some suggestions about the best way to engage homebound clients.

I have been fortunate enough to support client success in many environments, but I find additional compassion for the homebound and concern for their long term success.  Most of my homebound clients are unable to make it appointments outside of their home due to conditions such as chronic illness, a lack of social/familial support, diffuse mental health problems, lack of transportation or clinician resistance.  A focused team of health and social welfare clinicians can coordinate client specific treatment approaches.

As clinicians we can be easy become set in our ways and become numb to the strife of others.  We travel from place to place being creatures of habit.  It takes conscious effort and new situations requiring our attention to change.  Out of the items I mentioned above the last two items (lack of transportation or clinician resistance) can be overcome by education and community research to assist a homebound client.

The lack of personal or immediate access to transportation need not be a limitation to treatment for homebound clients.  Many communities have numerous community transportation programs.   In Seattle clients have options such as Access Transportation, Hopelink, Community Transportation, Taxi Script, or even subsidized bus passes.  The surrounding cities also have transportation assistance for community members.  I would also recommend checking with an area’s Chamber of Commerce. Some of these programs require that a medical practitioner verify that a client is disabled by completing an assessment and signing a form that a client can being to a transportation provider.

Visiting a client at their residence or at a community site can be very helpful, especially when a lack of transportation is a result of conditions beyond his or her control.  The idea of having a private and personal visit can instill not only client investment, but also a sense of control.  Many homebound clients are mentally ill and have manifestations which make it impossible for them to leave their home.  For example, schizophrenic clients can be plagued with command hallucinations that tell them to jump off a bridge or in front of traffic.  These clients stay home because the outside world is not safe.

If I’m to be honest answering this question, there will be no quick way through it. I could say I became a sober coach because I was tired of going to bed at 6am and sick of having to shout over loud music to be heard  - but that’s only part of it.

When I got clean in 1988, I placed all bets on my writing. This meant that instead of taking a job that would have career advancement, I stuck with freelance work, doing anything that could finance large chunks of uninterrupted writing time. I came up during the late 70s and 80s among a scene of underground artists, musicians, and filmmakers, many of whom went on to mainstream success. After I got clean, I became the go-to girl for anyone from my previous life wanting to get off drugs. This lead to my first coaching jobs inside the entertainment industry. The calls were so random that I never considered it a real employment source. In between coaching gigs, I continued to take on whatever work paid the bills. Coaching and sober companion work felt like the right fit but I never gave it much thought as a career. At the time it was controversial and renegade.


As the years passed, I continued to write and perform. Although my work was being published and optioned, I still hadn’t made it through the “big doors". It killed me to watch my friends’ lives successfully moving forward while mine seemed, at least outwardly, frozen in time. What was i doing wrong?  My moment of clarity came at fifteen years clean. It occurred to me that I had never stopped directing my romantic and financial affairs and those two areas were not changing. I needed to let go (as they say in 12 step programs) but I didn’t know how. I definitely couldn’t think my way into a new life. I suppose I needed a spiritual experience but being an atheist this was difficult to imagine.

Right as my screenplay was gaining momentum and I was being flown back and forth across the country, the writers’ strike happened. Out of money, I went back to working in bars. The loud music and crazy hours were killing me. Like my final days with drugs, I was absolutely miserable and hopeless. At seventeen years clean, I was back at square one. Then the most amazing thing happened - I ran out of ideas on how to run my life. I was having tea with an old friend from the music industry when I asked him “You know me really well – what do you think I should do for a living?” It didn’t take a minute before he said, “You’d be perfect as a sober companion.”  I had no idea that sober coaching had come into its own as a profession. The renegade rock and roll days had paved the way and now treatment facilities, therapists, and psychiatrists were seeing positive results from setting up clients with sober companions. My friend suggested I contact a couple LA friends to see if anyone had leads.

The stars aligned and within 24 hours I had my first client outside of the entertainment industry. What was interesting to me was how everything I’d ever learnt in my life came into play - not just my personal experience in recovery but the information I’d amassed on nutrition, exercise, meditation, dealing with anxiety, insomnia, and depression. Every aspect of my life had prepared me to do this work.

The real test came on day three when my client’s prominent psychotherapist called for an update. Until then I had been working intuitively and unlike managers, agents, and the people I was used to dealing with, the person on the other end of the phone was skilled in mental health work. If I was a fraud she was going to call me out. Nervous, I took a deep breath and told her honestly what I saw and what I was working on with the client. The phone went silent and my stomach flipped. “I have been working with ___ for three years and you nailed every single item on my list”. His words confirmed that I was exactly where I was supposed to be.

For me, falling into coaching was a spiritual experience. When I finally “let go” sober coaching came into my life. I loved it and had great results with clients. From that point on, doors kept opening. One day I got a call from the producers of Intervention about a new mini-series they were casting. Over night, this semi-secret career of mine became very public.

The television series shifted the direction of my life yet again. I received many heartbreaking emails from addict viewers who were without financial resources for treatment. I decided to set up a website and share freely what I do with clients. Currently I’m in the process of writing several books on recovery. What started as a part-time job to finance my writing has become the subject of my writing. No one could be more surprised by this than me.

To read what I do with clients as a sober coach, visit http://pattypowersnyc.com/sobercoac/

A random poll among newly sober clients, recovery counselors, and people who have achieved years of clean time would probably produce a varying consensus about the most pressing need for successful recovery.   Most respondents, however, would likely agree that relapse is often an indicator of stress.

The process of recovery, like the process of grief, is fluid and dynamic.  Exploring relapse before it happens is a good way to identify potential problems so you can be prepared for them.  Thorough preparation can help you minimize or even avoid issues may hinder your recovery.

Most people don’t think though the actions which eventually bring them to the point of relapse .  They simply had a desire to drink, and acted upon that without any thought for the consequences.  If they did indeed have any thoughts and feelings about the consequences of use, those thoughts and feeling were ignored or rationalized away.

In the recovery process, your recognition of that lack of forethought and insight should be a powerful lesson.  You can learn that anticipating the ultimate results of your behaviors will help you make much better choices.

When a person decides to get sober the idea of staying sober can be overwhelming.  The fear of relapse looms large.  A quick review of the literature suggests that the success rate is relatively small when compared to the number of people who attempt to find sobriety.  According to a 2003 study, the Caron Foundation documented that nearly 50-90% of people relapse within the first year after treatment or involvement in a 12-step program. Precursors to relapse can include anger, frustration, stress, or positive emotional states. The National Institute of Drug Abuse have determined that relapse rates from addiction can be compared to those suffering from other chronic illnesses such as Type I diabetes (30 - 50%), Hypertension (50-70%) and asthma (50 to 70%). Drug addiction should be treated like any other chronic illness, with relapse indicating the need for renewed intervention.

It is important to make the distinction between addiction and dependence.  Addiction is a change in behavior to accommodate or obtain the chemical, while dependence is indicated by measurable physical symptoms that arise when the chemical is not consumed. It is the general opinion of many addiction specialists that addiction is largely biochemical and that relapse is largely the result of cravings and proximity to alcohol/drugs or uncomfortable feelings.

Another skill which can be utilized to support recovery is the application of mandates and injunctions. A mandate is a set of thoughts that direct the addict to engage in using behavior when they have an urge to use.  An injunction is a set of criteria that provides the recovering person a way to think about their recovery so they don’t compartmentalize the skills and gifts they bring to their sobriety. In its simplest form it’s a part of a relapse prevention plan.

This approach is another way a clinician can help a client develop additional skills to maintain abstinence. Part of this includes an emergency sobriety card and an accountability contract. An emergency sobriety card provides a brief list of specific and concrete instructions that a person in recovery can refer to anytime when he or she needs help. It’s a small discreet tool that helps the addict find and build confidence in their ability to remain sober. The accountability contract is a set of permissions that an addict gives to his or her family and friends when its determined their recovery is in trouble.  The inclusion of family and friends as part of an addict’s recovery can provide support and help an addict get back on track.

Recovery need not be overwhelming and can be managed successfully. Matching a client to a recovery program is paramount, as we understand that recovery looks different for everyone.  In recovery from addiction, it is important to change your lifestyle to include abstinence from alcohol and drugs; involvement in healthy relationships; good nutrition, rest and exercise; and working to resolve one's personal problems.  Being mindful to incorporate the philosophy of mandates and injunctions will go a long way to build confidence in your recovery program.

You know the drill: you have spent countless hours in meetings, on the phone with your sponsor asking endless questions about your desire to use.  You have worked the steps and you’ve even consulted specialists.  In a moment of desperation you found help by attending treatment. You’re able to rack up six to twelve months, but eventually you find yourself in the throes of your addiction. None of this seems to work.  You find yourself questioning your commitment and ability to stay sober.  Maybe your sponsor was right when he said you lack willingness.

Not so fast….

What you are likely experiencing is Post Acute Withdrawal Syndrome or PAWS.

PAWS consist of a set of impairments that occur immediately and at times simultaneously after the withdrawal from alcohol or other substances.  These impairments affect three distinct areas of functioning and last six to eighteen months from the last use of alcohol or drugs as your brain tries to regain homeostasis.

Long-term sobriety requires personal engagement in your recovery.  Real engagement goes beyond just attending meetings or calling your sponsor.  Engaged recovery requires that you constantly learn new, concrete skills which support long-term sobriety. When I think of concrete skills that support recovery, several things come to mind:

Resilience - This generally refers to a person’s ability to cope with adversity, or the ability to bounce back from problems and setbacks. Research has shown resiliency to be a dynamic process.  Resilient individuals adapt to changing and unexpected events even under the duress of adversity. You can develop your own resilience by establishing good problem-solving skills, or by seeking help and building social support.  Fostering a belief that there are things you can do to manage your feelings and cope, and finding positive meaning in trauma, are other strategies for building your resilience.

Delayed gratification – Usually, people who can abstain from alcohol or drugs, or people who have managed to stay out of prison, have found ways to delay their gratification. People use chemicals to change the way they feel, so if you learn skills to act on your emotions in healthy ways, including offseting a need for immediate gratification, you can manage to fulfill your needs through avenues other than chemical use.

Volunteer work - My experience has shown me that volunteer work is a great way to feel better about yourself, develop a community of peers who share similar interests, and be of service to others.  If you want to raise your self-esteem, do things you’d be proud to tell other people.

Harm reduction is a way of helping the alcoholic manage their drinking.  For instance, if an alcoholic is prone to drinking and driving, maybe he should move close to a bus route or a subway line so that driving isn’t necessary.   Not drinking is, well, not drinking.  Harm reduction has its very strong proponents.

As for me, when working with someone, I’m always thinking not just about the harm I want to help them reduce, but about completely replacing harm with life.  No change that. Life: with a capital L.  This is much like the OCD client’s I have that are consumed with reducing risk in their life so they stop going out … it’s a wonder they even get out to see me.  The idea is to be free of the addiction.

When I think of the client who stops drinking at 26, gets a productive job, becomes supportive and loving spouse and father.  The ripple effects of all the people that this person touches in a positive way are literally infinite.  There is no comparison to that and if he had learned how to manage his drinking, and shrunk his life into a small flat near the bus line, working the system for what meager funds he could pull together to drink alone in his apartment until he died.  One is a giver of life and the other is a parasite on society and a downer even unto himself.

Are there times when I’ve engaged in harm reduction?   Yes.  Productively, I can see harm reduction as beneficial if it is seen as the pre-contemplative phase of recovery.  In other words, it is something that is useful once they have become a nuisance to themselves and society but before they are ready to throw in the towel.  In those cases I will help with harm reduction.  Having said that, it is something that I do with trepidation, because addiction is very unpredictable.  Just because an alcoholic moves near the subway line so that he won’t drive drunk, is not guarantee that the once drunk, he/she won’t rebel against the who system and drive anyway.  Or like one young man I worked with who fell alone in his apartment, bashing his head on the corning of his stereo and bleeding to death.  Ultimately, the concept of managing addiction or alcoholism is very arrogant.  Sadly, sometimes, as a professional, it is the only tool I have.  While I will use the tool if that is the only place the client will meet me, it is, in essence, a lousy tool.

Sobriety is such a blessing with so many rewards - rewards that are measured in reunited families, careers that never would have been, in spiritual enlightenment that is bigger than any of us – when I am backed into the corner of harm reduction, I feel so impoverished, a little like Dr Kevorkian.

Hi, I'm Dee.

I mentioned on a Facebook page that I've written a new book about the Twelve Steps from a Pagan perspective, and someone suggested that I make an excerpt available here.
If you would care to look at a preview, the first 20 or so pages are available here: http://www.lulu.com/product/file-download/the-pagan-in-recovery-the-twelve-steps-from-a-pagan-perspective/15925326?productTrackingContext=author_spotlight_104954579_

So what is this book about? Well, the title pretty much says it all, but let me explain a little. When I first entered the halls, I nearly ran out. While I know now that the Twelve Steps were written to be accessible to all, the truth is that in the rooms and in the texts, a very Christian attitude does exist. This is unavoidable because, especially in the United States, Christianity is the majority religion. Bill W. and Dr. Bob were also steeped in Christian tradition, and the program itself is a descendent of the Oxford Group - a Christian program.

So, as a Pagan, I was a little put off by a very Christian attitude. So often I'd hear "My higher power, who is Jesus Christ". The Lord's Prayer, a very Christian prayer is said at most meetings. AA's 12&12, and the Big Book mention Christian prayers and concepts quite often.

While, as a Pagan, I found this favor toward a specific religion and little mention of others a bit disturbing, I also knew that my very survival depended on recovery. My last outing found me waking (or regaining consciousness) in an intensive care ward at my local hospital. I didn't have much farther down to go. Quite simply, I needed to make this work - the alternative wasn't merely unpleasant - there was no longer an alternative.

As I worked the program, I came upon other Pagans - many who had left the program, many who were struggling. I spoke about the possibility of writing such a book, and the enthusiasm for this book was almost deafening. About a year later, this book was ready.

The Pagan in Recovery isn't a new program. Rather, it's a book that explains how ANY existing program can be used effectively by a Pagan. Let me know what you think; I'm interested in people's opinions. If you have questions about Paganism, or how a Pagan can utilize the steps, I'd love to talk about that too!