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Posted by on in Alcoholism

 

b2ap3_thumbnail_causes-of-addiction_mini.jpg

 

This was originally written as a feature article for Keys to Recovery Newspaper in 2018.

This article addresses how 12 step recovery treats the emotional disorder which underpins the “spiritual malady” that drives alcoholism.

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Posted by on in Recommended Reading

“We’re here to connect.”

 

 Will Smith’s character, Howard Intlet, makes this declaration during the movie Collateral Beauty. After experiencing a great tragedy, his character seeks answers from the universe. And just like Howard, many of us are seeking answers and trying to understand the importance of connecting to one another.

 

For those of us who are battling an addiction and working towards recovery, we are often told to “stay connected.” We hear it in our recovery circles. The speaker likely means to return to a meeting and to stay in contact with people who will support us.

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Posted by on in Alcoholism

Arming yourself with information about the way myths and stigmas affect addicts and how people respond to them, can go a long way in supporting people to find recovery. Effective treatment for substance use disorders requires an understanding of the myths and stigmas of addiction. I'd like examine a few myths that surround addiction and foster a misunderstanding of how to best support people to find recovery.

 

<strong>1. Everyone needs to reach bottom before quitting.</strong>

Early in my career I worked with adolescents. One of the clients on my caseload was a 17 year-old girl who had a long history of prostitution, a significant legal history, and a span of alcohol and drug use that began when she was five. During treatment she spent time talking about her alcohol and drug history and how that affected the decisions in her life. She had various opportunities to quit using chemicals but she reasoned that she wasn’t ready. While she came to a place where she was able to give up her chemical use, she never escaped her history of prostitution. She was able to develop a motto that supported her to quit using alcohol and drugs: <em>your bottom is when you stop digging.</em>

 

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Posted by on in Drug Addiction

A friend writes to say he is feeling blue. He is not in recovery so his blues are not as dire as mine, but they are just as painful. When I ask what is wrong, he replies, “life.” Life – the whole befuddling catastrophe; he and I share a tragic worldview. I have written previously about the German word for such an existential crisis: weltschmertz – worldpain.

Eager to help, I dash off a breezy response about all we need to be grateful for that seems as brittle and unsubstantial as the falling leaves outside. The Buddha tells us that pain has four sources: Death, disease, old-age and poverty. These are what Siddhartha saw from his palace window that compelled his quest for the relief of suffering. Note that the first three are inevitable; the fourth, poverty, seems reparable, but I suspect the Buddha means despair a spiritual poverty that accompanies grinding want.

I have never been impoverished myself but am intimately acquainted with despair. When you have a true depression it is never far away, lurking on the periphery out of sight but never out of mind. Think of Prufrock’s yellow smoke rubbing its muzzle on the windowpane. Prufrock notes it in a lovesong, for surely wanting another invites suffering. How many others have I dreamed of, pursued, cherished briefly and lost? Smoke evaporates but leaves a scent behind. It is the lingering smell of longing that causes suffering or as the Buddha describes it . . . our attachments.

Last year I attached myself to a man, one who lives 1000 miles away and was clearly out of my league. He seemed interested, I fantasized, wondering if this was a person who could really know, who would finally see me for me. The secret places of the heart long for such recognition, to be seen as the self sees itself without blemish or flaw. Of course such a disembodied love is impossible; bodies meet where souls never do. Hence the lovesong, a paean not to one person but to the ineffable shadow that lives in our imaginations.

He went back to his perfect life. I hear that he has a new lover of over a year. His facebook page is studded with smiling selfies on exotic backgrounds. “In the room the women come and go talking of Michelangelo.”

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Posted by on in Alcoholism

This is certainly not a comprehensive list.  Feel free to add anything I have missed in the comments. I omitted AA/NA as they are well-known and I wanted to focus on groups that people might not yet know about.  The formatting on this list is wonky.  I'lll return to the list at a later date to fix the formatting.  

Crystal Meth Anonymous:    www.crystalmeth.org

Strength  Over Speed          www.strengthoverspeed.org    (seattle based)

Other supports:

Lifering: www.lifering.org
Smart Recovery:         www.smartrecovery.org
Women for Sobriety:          www.womenforsobriety.org
Smart Recovery:         http://rational.org
Secular Organization for Sobriety:  www.cfiwest.org/sos/index.htm
Jews in Recovery:        http://www.jacsweb.org
Chemically Dependent Anonymous: http://www.cdaweb.org
Methadone Support: http://www.methadonesupport.org
Moms off Meth http://www.momsoffmeth.com
Recoveries Anonymous: http://www.r-a.org/
Recovering Couples Anonymous: http://www.recovering-couples.org/
Afirm: http://www.afirmfwc.org/  (methadone focus)

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Tagged in: 12 steps Support Sites
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Posted by on in Recommended Reading

As anyone who has been to drug rehabilitation knows, it can be difficult making new habits to stay clean and sober.

Changes in daily life and lifestyle take time, and patience is not just important, it’s the most valuable tool at your disposal. This is the essence of drug addiction treatment. And you may not be able to see the benefit at first, but over time, the people close to you—family, friends and even acquaintances—will often see positive changes before you do.

However self-destructive some things may have been in your life (not to mention your ability to grow and thrive), some old habits are hard to let go of. Like an old friend, most likely they’ve been at your side a long time, and without them you fear you may be left feeling like the proverbial hole in the donut. Far from suggesting you enter the monkhood and renounce all earthly attachments, there are a few easier, more realistic ways to create new habits in your life starting the day you leave the drug treatment center:

1) Make your bed in the morning, every morning. There’s a reason those in drug rehabilitation centers are asked to do this. It’s a way of creating a positive habit for yourself the first thing you do, setting the tone for the day.

2) Sit down for breakfast, lunch and dinner at the same time, every day. Again, it may sound simple, but it creates consistency for you, which, hopefully, you’ll be grateful for, even if you’re still in drug detox.

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Posted by on in Alcoholism

 Nine Candid Thoughts About Substance Abuse Treatment and the 12 Steps

I am 24 years sober today, and of those years, 20 of them have been working in the substance abuse/behavioral health field. I’ve gathered a random sampling of thoughts on treatment and AA. If you agree with all of them, then I have either bored or failed you. Check them out:


1. Cliche to say, but treatment works. It saves lives and ripples to save families. You will hear all sorts of stats, sometimes as low as only 1 in 10 who participate in substance abuse treatment will stay sober for a whole year after discharge, but there are other stats that state almost 50% of those in treatment at any given time will be sober ten years later. It just may take a few attempts for it to stick into long lasting recovery.

Also, ‘treatment’ is such a broad term describing such different levels of interventions. The question is what type of treatment works best, and when. I’ve always felt that inpatient or residential treatment squeezes folks a bit harder to get to some necessary truths and insight. (For when you squeeze an Orange, you get Orange Juice, because that's what’s inside. Well, when you squeeze an addict, you get what’s inside as well.) Inpatient treatment can do this squeezing best in a safe situation and stop a relapse in the early days so that long term recovery can take roots.  Yet less restrictive modalities such as day treatment programs and intensive outpatient give the therapist and client real life scenarios to process and do not offer the fantasy scenario of living 24 hours in a therapeutic environment. In general, the world out there wants you go get high, so go fight it, (with friends at your side) and come back to report.

2. Treatment doesn't work, for some folks, at least in a traditional 12-step model. I believe that substance abuse treatment has cast too wide a net, and that there are many patients in substance abuse specific treatment who are actually primarily personality disorder or other diagnoses that are ill-served by giving them traditional CD treatment. For these folks, using drugs or drinking is just one of many symptoms that often include other anti-social traits.

I am not talking about the bipolar or depression diagnosed client where the two disorders feed off of each other and make both set of symptoms worse. I am referring to some axis 2 personality disorders or affective disorders. We throw them into the mix and treat them the same, and it’s a set up for failure for both client and clinician. Asking a client with narcissistic personality disorder to get humble and ask for help is cruel and unusual punishment for all involved. An untreated borderline personality diagnosed patient with acute symptoms sits at a first step table and nobody gains. What happens is, many of the social arenas provided in treatment, including groups and 12 step support meetings, are actually just another stage for the narcissist or anti-social personality disorder member to practice their pathology. This is especially prevalent as cluster B personality disorder traits, who end up in the criminal justice system, are mandated chemical dependency treatment.

3. There are too many recovering addicts treating other addicts. Okay, maybe I contributed to the problem, but I find that when folks become ‘experts’ and well-versed at AA or NA, they tend to expect others to work a program or get sober exactly as they did. These are the folks who do way too much self-disclosure, and every moment is an aa/na meeting, and they have a slogan for every situation. Treatment center staff who gain a masters degree only as an excuse to further their own personal agenda, which is pushing their own way of treatment onto others. Ironically, these therapists are often the most popular and heralded at treatment centers, but maybe not the most effective. They often have a fervent desire to spread their recovery gains to others, and you can’t deny the enthusiasm, but many times it could stay at the tables rather than inside facilities.

4. AA and NA itself is not treatment
Let me explain. The focus of treatment needs to be on clinical issues such as negative, self-destructive thoughts, inability to manage emotions or self-soothe without substances. (just as an example, for there are tons others.) Treatment is facing cognitive distortions, behavioral patterns, and cognitive reframing to find hope amidst despair, as well as identifying concrete and tangible behavioral changes and skills. Treatment should not be a boiler plate of writing out ones first step, listing 3 examples of powerlessness, writing an autobiography, getting a sponsor, identifying a higher power, watching a Father Martin video, etc... These things are essential, I believe, but they are a supplemental. Too often, the steps are seen as the only form of therapy.

5. AA and NA saves lives and understands addicts better than any Counseling theory.

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Posted by on in Alcoholism

 

In our previous blog we wondered if some commentators, who have co-occurring disorders may be puzzled at how having a “spiritual malady” could be related in any way to have a co-occurring condition?

This is a pretty valid question?

In fact this may be at the heart of the issue in many cases  of feeling the need to take medication  for so-called co-occurring conditions?

Seeing alcoholism as partly the product of a spiritual malady, instead of the affective disorder I believe it to be, may influence certain AAs to seek additional help for supposed additional conditions when the manifestation of these conditions may actually be part of the emotional disorder of alcoholism?

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Posted by on in Drug Addiction

The Retreat: Not Just for Weekends Anymore, by Daniel D. Maurer

 

 

b2ap3_thumbnail_retreat_bullshit.jpgWhen I first got married, my wife and I moved to a tiny hamlet in eastern Montana. It was her hometown and she had a job at a local community college teaching public speaking. My job was at a rinky-dink bank playing customer service rep and twiddling my thumbs in the back room pretending to work with the computers. It wasn’t bad, but definitely not a dream job. At least I had plenty of time after work to drink when wifey was off teaching in the evenings.

We belonged to a church where my wife had been baptized as a baby and where the two of us were married. I had aspirations to one day become a pastor in the denomination we belonged to, so I endeavored to act as if any and all church-related activities were compulsory.

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Posted by on in Alcoholism

 

In a recent blog a few days ago I challenged some of Gabrielle Glaser's "evidence" in her article   “The Irrationality of Alcoholics Anonymous “, which purported to demonstrate the so-called effectiveness of "controlling drinking".

Glaser cited the following in her article

“ To many, though, the idea of non-abstinent recovery is anathema. No one knows that better than Mark and Linda Sobell, who are both psychologists. In the 1970s, the couple conducted a study with a group of 20 patients in Southern California who had been diagnosed with alcohol dependence.

Over the course of 17 sessions, they taught the patients how to identify their triggers, how to refuse drinks, and other strategies to help them drink safely. In a follow-up study two years later, the patients had fewer days of heavy drinking, and more days of no drinking, than did a group of 20 alcohol-dependent patients who were told to abstain from drinking entirely."

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