Alcoholism

Families Need Support Too

We always encourage family members to seek counseling, because active addicts, along with inactive ones who are not in recovery (dry drunks), make everyone around them a little bit crazy.  The uncertainty, disappointments, emotional and — often — physical mistreatment, and the other aspects of loving an addict are not the ingredients of good emotional and physical health.  And then there’s the anger.

Anger is a perfectly normal emotion with an essential purpose: it keeps us from becoming incapacitated by fear.  Along with denial, it gives us the energy to work our way past the obstacles that we run across in life.  If we believed every negative thing that was said about us, or if we allowed ourselves to be stymied by the many obstacles that crop up in our day to day existence, we’d never get anything done.  

These things hinder us not only because they’re in our way, but because they bring fear along with them — fear of failure, fear that we’ll look bad, fear that we won’t measure up to our own self-image or the expectations of others, and fear of economic, social, or physical injury.  Anger and its little sisters indignation and annoyance give us the energy to overcome those fears, big and small, real or imagined, and to move onward.  To put it another way, no one functions well when they feel powerless or vulnerable, and anger helps us feel powerful.

Of course when anger gets out of control (rage), or we allow it to become habitual (resentments), it causes problems.  This can happen because we enjoy the feeling of power, or — because one of the characteristics of anger is tunnel-vision — it can help us overlook our own part in things, and make it easier to shift blame to the other party.  Anger depersonalizes our adversaries and makes it easier for us to justify our own behavior toward them.  All of these things have their uses, but they can obviously be seriously misused, as well.  Furthermore, over time, these ways of thinking about individuals and the world can become ingrained, and extremely difficult to change when they are no longer of use.  

Finally — but by no means least important — the physical changes that are produced by unresolved anger (undischarged energy) can be long-lasting and can create physical problems that are often fatal.  Stress-related diseases such as cardiovascular complications, eating disorders, other addictive disorders, diabetes, depression, frequent illness, and non-specific pain issues such as chronic head, neck and back pain can all be results of unresolved anger.

Anger doesn’t go away by itself.  If it isn’t discharged by physical and/or emotional release, or if it isn’t dug out, examined, and allowed to run its course, it will continue to produce stress and make life difficult.  This is especially difficult for family members of alcoholics and other addicts, because it isn’t “nice” to be angry in our culture, especially at family members, and practically never at authority figures lest they discharge some of their own anger issues in our direction.  Children are required to respect older people, for example, even when they have irrevocably proven themselves unworthy.  Talk about powerless…

So, families of addicts almost always have anger issues to address.  There are probably other things as well.  Children, in particular, have a tendency to blame their parents' problems on themselves, and those things need to be addressed.  Emotionally abused family members can add self-esteem issues to their anger, and everyone has resentments: birthdays missed, money misspent, obligations unmet…and on, and on.

It’s imperative that these things be put to rights.  Whether or not the alcoholic/addict stays clean, whether or not the family stays together, every one of the members have their lives irrevocably changed.  Unless the damage of those changes is dealt with, none of them will have the lives they deserve.  In the next article, we’ll discuss some options.

 

What About People, Places and Things?

Q. How can you stay away from people, places and things when they are family or significant others?

Q. If my boyfriend drinks and does coke occasionally, what should I do about it?

These really translate into the same question: How much do I value my sobriety?

Let's first ask ourselves, why did we get sober? Why did we go to AA, NA, treatment, detox or whatever? Was it because we were having fun while we were using? Was it because our lives were completely under control? Was it because we could pick up a drink or a drug and then stop whenever we wanted to? Could we go into a bar, or to a party, hang with our friends, and choose whether or not we were going to get high?

If any of those answers were yes, then there's no need to worry about it. Why should we? Everything's great!

But if we got  clean because our life was in the toilet; if we were afraid we were going to die, or hurt someone else; if we got clean and sober because we couldn't stand the idea of continuing in the direction we were going, then if we want to remain clean we have to put that idea ahead of everything else in our life.  That doesn't mean we have to live in meetings forever, or that we can't ever have fun again, but it does mean that we may have to change the ways we deal with others, in order to protect our sobriety.

Those people who are able to do so will normally take pains to avoid things that might cause us problems. If they are unable to do that, or won't, the reasons don't matter. We can't change them; we can only make changes in ourselves, and the only sensible thing for us to do is to put our welfare first, and stay away from them.

There are family situations that are so uncomfortable for us, even if alcohol or other drugs are not involved, that we are emotionally unprepared to handle them in early sobriety. If our family drinks or uses drugs, if our friends hang out in bars or hit the restroom five times an evening, if our significant other drinks (and does coke occasionally), it's no business of ours. Our business is taking care of us, and if we believe there's a danger in those people, places and things, then we need to distance ourselves until the conditions change.  We can't take the chance unless we're willing to do the detox and treatment thing all over again — if we survive.

Even if we have children, we may need to stay away for a while. Those kids may need us, but if we can't remain clean they may never have us. Let's face it, we were absent even when we were with them. Isn't it worth a bit more time to help insure that we won't be leaving them again?

Stress is a primary cause of relapse. We need to avoid stressful situations until we are able to handle them.  We also know that just the sight of (or merely thinking about) drugs or alcohol can cause changes in our brain chemistry that cause cravings.  The sight of a guy standing on the corner where we used to cop, a bar where we used to drink — even the recliner where we used to collapse — can do the same thing.

The very fact of wondering about it is a pretty good indication that we aren't ready yet. As much treatment as we can afford, a stay in a halfway house or sober living facility, working at a low-stress job for a while — along with a lot of support from our peers — can better prepare us to go back to the “real world.”

If going home right now worries you — or even if it doesn't — it probably should.

We Don’t Have To Give In To “Stinkin’ Thinkin'”

Everyone in recovery knows someone who tried to go back to “occasionally” using alcohol or other drugs — with predictable results. Many of us have personal experience. It often starts out with being sober for a few months, but it can happen in a program that has gone smoothly for years. We begin to think that we've been feeling so good lately that maybe we aren't an addict after all. Maybe we can “handle it.” Of course, now that we know all about addiction, we won't let it get the best of us.

Sometimes we try it, sometimes not, merely teetering on the edge for a bit. Those of us who did try tend to have the most interesting stories, and they all center around the idea that we convinced ourselves that we didn’t need to remain abstinent, or that we concentrated on some terrible thing that someone had done to us, dwelling on that instead of the good things in our lives.  Or perhaps we simply forgot to look for the good and concentrated on the bad, so that drinking or using drugs seemed like a reasonable alternative to the way we were feeling. Professionals call these ideas “reservations.”  But call it that, or a “dry drunk, “stinkin’ thinkin’” or whatever you will, it is the main component of relapse. (Remember, we relapse before we use.)  And it causes a lot of misery, even though we may technically remain clean and sober.

But it doesn't have to work that way.

Photo: DigitalZen

When we are active in our addictions, we dwell on our problems.  After all, they give us a marvelous excuse to use.  And, as we progress in our addiction, we learn to project our feelings about ourselves onto others.  It is much easier for me to resent the fact that my spouse spends all her time at work than it is to admit that if I got off my butt and found a job, she wouldn't have to work so hard.  Thinking like that would threaten my drinking and drugging, and I need to avoid that at all costs.  This way of thinking rapidly becomes a habit, because it allows us to feel more comfortable despite evidence that we shouldn't be. Eventually it affects our entire view of the world.

But after we're clean and sober, we no longer need to protect ourselves that way. One of the things I’ve learned through years of meditation is that I actually do have a reasonable amount of control over what I think. When we meditate, we try to concentrate on something without intellectual content — our breathing, say — to the exclusion of outside thoughts. This allows our subconscious to percolate uninterrupted, and we begin to gain some insight about ourselves.

To begin with, it’s hard. Thoughts about all sorts of things come along. We get really pissed off at our inability to do anything about it. Then someone tells us that it's a normal part of meditation. The idea is not to fight the stray thoughts, but to just let them arise, and then bring our mind back to the breathing, mantra, rosary, or whatever we’re using as a meditation tool. The key is that I can’t stop thoughts from coming to my mind, but I can control whether or not I concentrate on them, even if they come back over and over again.

Instead of drinking the poison of resentment and then waiting for the other guy to die, I can choose to turn my mind to something else. I can do it over and over again, until eventually I’ve distracted myself into thinking about other things entirely. The same is true of obsessions like drinking, or unsatisfied sexual urges, or the new toy that I think I need. It is entirely within my power to control those thoughts — not to pretend that they don’t exist, or fail to acknowledge them, but to choose not to dwell on them. In doing so, I rob them of their power, instead of giving them mine.

A Look At Sunrise Ft. Lauderdale, Our New South Florida Facility

Today I was able to stop in at the Open House for our new facility at 2331 N.E. 53 St., in Ft. Lauderdale.  I snapped a few pictures, and I thought you all might like to see how it looks.  We expect to begin receiving clients in mid to late June.

Click the thumbnails for larger images.

 

Do I Really Need A Program Of Recovery?

If there is one form of denial that is common to most folks who aren’t sure if they really want to stay clean and sober, it’s “I don’t need a program.  I can do it myself; all it takes is willpower;” or, “I have plenty of support at home, I don’t need to go to meetings.”  Hard on the heels of that idea is “I don’t like (insert 12-step program here), it’s too (insert excuse here).”

You don’t have to spend much time in recovery to hear folks make these statements, and if you work in the recovery field, you hear it all the time.  It usually doesn’t take too long for those people to fade out of sight, and sometimes we see them come back, weeks, months or years later, with a better attitude.

Often we don’t.

There are a couple of secrets to making it in recovery.  One is to do whatever we can to get over the habits, both mental and physical, that led us to, or reinforced the use of, our drugs of choice.  Without going into detail, some of those are:

  • using at certain times and in certain places, or with particular people
  • making excuses to justify our using (“I deserve it; If you were married to her, and so forth)
  • “drinking at” people, using booze or drugs to withdraw and let them know we don’t need them
  • always smoking a cigarette when we’re on the phone, if that’s the addiction we’re working on
  • we could continue the list ad infinitum.

The other — perhaps the biggest — secret, isn’t really a secret at all.  It’s bounced around the rooms all the time, but somehow some of us manage not to hear it.  That’s to keep an open mind!  If we don’t like what we’re hearing, we need to remember two things:

  • there are no rules in the 12-step rooms, only suggestions; no right and wrong way to do it, only ways that we have found — through 70-odd years of experience — work for most people; and
  • use common sense.

The common sense part is obviously open to interpretation.  For example, the “no romantic relationships in the first year” suggestion is a good one.  A new relationship is about the most distracting thing that can happen to anyone, and we don’t need distractions.  On the other hand, if we’re already in a relationship that hasn’t soured completely, that suggestion obviously doesn’t apply.   However, if we used with our partner, (or used them as an excuse to use) maybe we need to re-think that, too.

Another example would be the “Higher Power Issue.”  If you want the god of a particular religion as your higher power, that’s fine.  If you don’t, that’s fine too.  The thing is, we need to admit that we can’t do it alone, and surrendering to a higher power has terrific symbolism.  It works for a lot of people.

If it doesn’t work for you, great.  Just remember that part about not doing it alone.  It’s nearly impossible to recover without the support of other recovering people.  We need to remember, too, as long as we’re on the subject, that just as we have a right to choose what we believe is right for us, so do others.  So if they want to talk about their god, that’s OK.  It isn’t catching.  If we can’t be that flexible, we’re in trouble already.  After all, tolerance is the first step toward a spiritual life.

Ask yourself these questions: Do I really want to get clean and sober?  Do I want to have a full, satisfying life?  Do I want to improve my self-esteem, clean up some of the wreckage, and generally become a productive human being — or do I want to die in my active addiction?

That, my friend, is the most important question you will ever ask yourself.  Don’t answer too hastily.

Easy Does It

Every so often — too often — I run across a newcomer with a few months or even a couple of years, who has decided to become an addiction professional or otherwise involved in the field, and help save all the poor folks who are still “out there.”

It scares the hell out of me.

The last thing a person in early recovery needs is more stress, and let me tell you: going back to school, working as a tech and picking up contact hours, and then the life of a newly-hatched counselor or therapist is not conducive to good, long lasting recovery.  As much as it seems like these things would enhance one's understanding of the disease and the recovery process, the exact opposite is true.  It puts us directly in a position of being unable to see the forest for the trees, distracts us from the steps, practicing the principles, and generally focuses us on other people at a time when we should still be focusing on ourselves.  Not only that, but it can fool us into believing that we know all that we need to know about recovery.  I'm here to tell you that is rarely the case even for old-timers. I learn new stuff every day — often from newcomers who have done the research for me and lived to tell about it.

Goodness knows that if several folks with good recovery hadn't gone on to become professionals and been there to help me, I'd be dead. I like to think the same is true of my efforts, in at least a few cases.  But, without any exceptions that I can think of, the truly good counselors and therapists are the ones who had several years of recovery under their belts before they became immersed in the field.  I'm sure this isn't the case with all, but I am willing to state unequivocally that it is true of most.  The experience that makes recovering people some of the best therapists needs time to develop, and if you don't have the fundamentals down for yourself, then you don't have anything to give to others.

So all you folks who are living in the fast lane, holding down a job or two, maybe trying to raise kids, and planning to hit the books — please think about what you're doing.  I've seen that kind of recovery end abruptly, sometimes years down the road.  And you know what?  It's really hard for those folks to get back.

Take care of yourself, or you won't be able to take care of anyone.  And remember, anything you put ahead of your own recovery, you are likely to lose.

 

Medical Schools To Offer Residencies In Addiction Medicine

An article published July 10th in the New York Times heralds a much-needed addition to addiction treatment, aimed at making it a recognized specialty like surgery, endocrinology, obstetrics, etc.

In a move that recognizes addiction as a disease, rather than simply a psychological or moral problem, the program will provide a one-year residency in addiction medicine for doctors who have complete their basic training and are aiming for a specialty. They will spend their residency studying addiction and its connection with heredity, brain chemistry, and psychological issues while treating a broad variety of addictions ranging from alcohol and prescription drugs to nicotine.

According to Nora D. Volkow, of the National Institute on Drug Abuse, the prior lack of this kind of education for doctors was “a gap in our training program…a very serious problem.”

The American Board of Addiction Medicine (ABAM), formed in 2007 to address the issues surrounding medical training in addiction, expects to accredit 10 to 15 additional institutions this year.  Those currently accredited are:

Boston University Medical Center
University of Florida College of Medicine
St. Luke’s-Roosevelt Hospital in New York
New York University at Buffalo School of Medicine
University of Maryland Medical System
University of Cincinnati College of Medicine
University of Minnesota Medical School
University of Wisconsin School of Medicine and Public Health
Marworth Alcohol and Chemical Dependency Treatment Center in Waverly, PA
and the John A. Burns School of Medicine at the University of Hawaii

Kudos to these institutions, ABAM, and the people in the medical and other professions who worked long and hard to accomplish this great stride forward in the understanding and treatment of addiction.