Facing down co-dependence: five steps to

Transcription

The Psychology of Addiction
Clarifying Codependency: Finding a New Language
for an old term From 1978 to 2013
Pain Medication and Addiction
Tough love…. A blessing in disguise
Facing Down Co-Dependence:
Five Steps to Emotional Freedom
The 30 Day Myth - Shouldn’t Rehab
Only Take 30 Days?
From Dark to Light: My Journey to Recovery
Adolescents, Brain Development
and the Turkey Model
Anger Management for Court Appointed
Culture and Addiction
TEARS
YOUR CHILD DIED FROM DRUGS?
IT CAN HAPPEN TO ANYONE
The role of case management in
substance abuse treatment
Focus on Individual Needs of Each Client Makes
Wayside House Successful
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A LETTER FROM THE PUBLISHER
Dear Readers,
I welcome you to The Sober World magazine. This magazine is being
directly mailed each month to anyone that has been arrested due to drugs,
alcohol and petty theft in Palm Beach County. It is also distributed locally to
all Palm Beach County High School Guidance Counselors, Middle School
Coordinators, Palm Beach County Drug Court, Broward County School
Substance Abuse Expulsion Program, Broward County Court Unified Family
Division, Local Colleges and other various locations. We also directly mail to
many rehabs throughout the state and country.
We are expanding our mission to assist families worldwide in their search for
information about Drug and Alcohol Abuse.
Our monthly magazine is available for free on our website at
www.thesoberworld.com.
If you would like to receive an E-version monthly of the magazine, please
send your e-mail address to [email protected]
Drug addiction has reached epidemic proportions throughout the country and
is steadily increasing. It is being described as “the biggest man-made epidemic”
in the United States. More people are dying from drug overdoses than from any
other cause of injury death, including traffic accidents, falls or guns.
Many Petty thefts are drug related, as the addicts need for drugs causes
them to take desperate measures in order to have the ability to buy their
drugs. The availability of prescription narcotics is overwhelming; as parents
our hands are tied.
Doctors continue writing prescriptions for drugs such as Oxycontin, and
Oxycodone (which is an opiate drug and just as addictive as heroin) to young
adults in their 20’s and 30’s right up to the elderly in their 70”s, thus, creating
a generation of addicts.
Did you know that Purdue Pharma, the company that manufactures
Oxycontin generated $3.1 BILLION in revenue in 2010? Scary isn’t it?
Addiction is a disease but there is a terrible stigma attached to it. As family
members affected by this disease, we are often too ashamed to speak to
anyone about our loved ones addiction, feeling that we will be judged. We
try to pass it off as a passing phase in their lives, and some people hide their
head in the sand until it becomes very apparent such as through an arrest,
getting thrown out of school or even worse an overdose, that we realize the
true extent of their addiction.
provide medical supervision to help them through the withdrawal process,
There are Transport Services that will scoop up your resistant loved one
(under 18 yrs. old) and bring them to the facility you have chosen. There are
long term Residential Programs (sometimes a year and longer) as well as
short term programs (30-90 days), there are Therapeutic Boarding Schools,
Wilderness programs, Extended Living and there are Sober Living Housing
where they can work, go to meetings and be accountable for staying clean.
Many times a Criminal Attorney will try to work out a deal with the court to
allow your child or loved one to seek treatment as an alternative to jail. I
know how overwhelming this period can be for you and I urge every parent
or relative of an addict to get some help for yourself. There are many groups
that can help you. There is Al-Anon, Alateen (for teenagers), Families
Anonymous, Nar-Anon and more. This is a disease that affects the whole
family, not just the parents.
These groups allow you to share your thoughts and feelings. As anonymous
groups, your anonymity is protected. Anything said within those walls are not
shared with anyone outside the room. You share only your first name, not
your last name. This is a wonderful way for you to be able to openly convey
what has been happening in your life as well as hearing other people share
their stories. You will find that the faces are different but the stories are all
too similar. You will also be quite surprised to see how many families are
affected by drug and alcohol addiction.
Addiction knows no race or religion; it affects the wealthy as well as the poor,
the highly educated, old, young-IT MAKES NO DIFFERENCE.
This magazine is dedicated to my son Steven who graduated with top
honors from University of Central Florida. He graduated with a degree in
Psychology, and was going for his Masters in Applied Behavioral Therapy.
He was a highly intelligent, sensitive young man who helped many people
get their lives on the right course. He could have accomplished whatever he
set his mind out to do. Unfortunately, after graduating from college he tried a
drug that was offered to him not realizing how addictive it was and the power
it would have over him.
My son was 7 months clean when he relapsed and died of a drug overdose.
I hope this magazine helps you find the right treatment for your loved one.
They have a disease and like all diseases, you try to find the best care suited
for their needs. They need help.
I know that many of you who are reading this now are frantic that their loved
one has been arrested. No parent ever wants to see his or her child arrested or
put in jail, but this may be your opportunity to save your child or loved one’s life.
They are more apt to listen to you now than they were before, when whatever
you said may have fallen on deaf ears. This is the point where you know your
loved one needs help, but you don’t know where to begin.
Deaths from prescription drug overdose have been called the “silent
epidemic” for years. There is approximately one American dying every 17
minutes from an accidental prescription drug overdose. Please don’t allow
your loved one to become a statistic. I hope you have found this magazine
helpful. You may also visit us on the web at www.thesoberworld.com.
I have compiled this informative magazine to try to take that fear and anxiety
away from you and let you know there are many options to choose from.
I Would Like To Wish Everyone A Happy Thanksgiving.
There are Psychologists and Psychiatrists that specialize in treating people
with addictions. There are Education Consultants that will work with you to
figure out what your loved ones needs are and come up with the best plan
for them. There are Interventionists who will hold an intervention and try to
convince your loved one that they need help. There are detox centers that
To Advertise, Call 561-910-1943
We are also on Face Book at The Sober World and Sober-World Steven.
Sincerely,
Patricia Publisher
[email protected]
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IMPORTANT HELPLINE NUMBERS
211 PALM BEACH/TREASURE COAST
211
www.211palmbeach.org
FOR THE TREASURE COASTwww.211treasurecoast.org
FOR TEENAGERSwww.teen211pbtc.org
AAHOTLINE-NORTH PALM BEACH
561-655-5700
HOPE. BELIEVE. RECOVER.
www.aa-palmbeachcounty.org
AA HOTLINE- SOUTH COUNTY
561-276-4581
www.aainpalmbeach.org
FLORIDA ABUSE HOTLINE
1-800-962-2873
www.dcf.state.fl.us/programs/abuse/
AL-ANON- PALM BEACH COUNTY
561-278-3481
www.southfloridaalanon.org
AL-ANON- NORTH PALM BEACH
561-882-0308
www.palmbeachafg.org
FAMILIES ANONYMOUS
847-294-5877
(USA) 800-736-9805
(Local) 561-236-8183
Center for Group Counseling
561-483-5300
www.groupcounseling.org
CO-DEPENDENTS ANONYMOUS
561-364-5205
www.pbcoda.com
A STRUCTURED, WOMEN--ONLY
COCAINE ANONYMOUS
954-779-7272
www.fla-ca.org
TRANSITIONAL HOUSING PROGRAM
COUNCIL ON COMPULSIVE GAMBLING
800-426-7711
www.gamblinghelp.org
IN DELRAY BEACH, FLORIDA
CRIMESTOPPERS
800-458-TIPS (8477)
www.crimestopperspbc.com
CRIME LINE
800-423-TIPS (8477)
Millie Tennessee,
www.crimeline.org
Executive Director
DEPRESSION AND MANIC DEPRESSION
954-746-2055
561-302-9584
www.mhabroward
FLORIDA DOMESTIC VIOLENCE HOTLINE
800-500-1119
www.fcadv.org
FLORIDA HIV/AIDS HOTLINE
800-FLA-AIDS (352-2437)
FLORIDA INJURY HELPLINE
800-510-5553
GAMBLERS ANONYMOUS
800-891-1740
www.miracles-do-happen.net
www.ga-sfl.org and www.ga-sfl.com
HEPATITUS B HOTLINE
800-891-0707
JEWISH FAMILY AND CHILD SERVICES
561-684-1991
www.jfcsonline.com
LAWYER ASSISTANCE
800-282-8981
MARIJUANA ANONYMOUS
800-766-6779
www.marijuana-anonymous.org
NARC ANON FLORIDA REGION
888-947-8885
www.naranonfl.org
NARCOTICS ANONYMOUS-PALM BEACH
561-848-6262
www.palmcoastna.org
NATIONAL RUNAWAY SWITCHBOARD
800-RUNAWAY (786-2929)
www.1800runaway.org
NATIONAL SUICIDE HOTLINE
1-800-SUICIDE (784-2433)
www.suicidology.org
ONLINE MEETING FOR MARIJUANAwww.ma-online.org
Overeaters Anonymous- Broward Countywww.goldcoast.oagroups.org
Overeaters Anonymous- Palm Beach Countywww.oapalmbeachfl.org
Ruth Rales Jewish Family Services
561-852-3333
www.ruthralesjfs.org
WOMEN IN DISTRESS
954-761-1133
PALM BEACH COUNTY MEETING HALLS
Miracles DO Happen
central house 2170 W Atlantic Ave.
SW Corner of Atlantic & Congress
Club Oasis
561-694-1949
Crossroads561-278-8004
www.thecrossroadsclub.com
EasY Does It
561-433-9971
Lambda North Clubhousewww.lambdanorth.org
The Meeting Place
561-255-9866
www.themeetingplaceinc.com
The Triangle Club
561-832-1110
www.Thetriangleclubwpb.com
BROWARD COUNTY MEETING HALLS
12 STEP HOUSE
954-523-4984
205 SW 23RD STREET
101 CLUB
700 SW 10TH DRIVE & DIXIE HWY
LAMBDA SOUTH CLUB
954-761-9072
WWW.LAMBDASOUTH.COM
POMPANO BEACH GROUP
SW CORNER OF SE 2ND & FEDERAL HWY
PRIDE CENTER
954-463-9005
www.pridecenterflorida.org
WEST BROWARD CLUB
954-476-8290
WWW.WESTBROWARDCLUB.ORG
4
Wishing Everyone A Safe, Sober & Clean Holiday Season
320 CLEVELAND STREET, HOLLYWOOD, FLORIDA
WWW.SOBERLIVINGRESORT.COM
954-925-3553
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1.888.80.SOBER
5
The Psychology of Addiction
By Lance Dodes, MD
Marion put down the phone after hearing her husband’s command to
prepare dinner for him and a group of business guests that evening. Now
she would have to shop and prepare instead of going to the gym. As she
stood there she felt the familiar, nearly overwhelming, urge to take some of
her Percodan’s. The question is: Why?
what led to his addictive behavior. Other people have different defenses
when stressed: they withdraw, become defensively angry, rationalize why
they’re doing things, or something else. The good news is that people can
become quite good at knowing how their own defenses work so they can
spot these key moments quickly.
Psychology can’t be reduced to the biology of the brain any more than
biology (life) can be reduced to the chemicals that comprise it. Like other
complex behavior, addiction has to be understood in psychological terms.
Marion’s story provides a good illustration. Virtually all addictive acts are
triggered by emotionally significant events, and Marion’s situation is typical.
She felt that she was in a trap. For emotional reasons of her own (arising
from her past) she was unable to defy her husband’s insistent demands.
But she couldn’t simply comply with them, either. The helplessness she felt
was too deeply enraging. She had to do something to feel less helpless.
For her, that something had always been taking her pills.
But what can you do when the addictive urge is upon you? The basic idea
here is remarkably simple. If addictions are just displaced actions -- substitutes for doing something to directly deal with feeling helpless or trapped
-- then it is only necessary to undo this substitution and take a more direct
action. One woman felt she had to comply with her husband’s demands to
create a dinner for many guests on short notice. Usually, she meekly accepted these demands, and then drank. But one day, after she’d come to
understand how her addiction worked, when her husband called again to
instruct her to prepare dinner for guests, she was able to come up with a
more direct solution. She said, “I know I should have just told him to make
his own damn dinner, but at least I figured out another way out!” I asked
her what she’d done. “I ordered take-out Chinese food,” she said. At that
moment, she reported, her addictive urge vanished. There was no magic
here. She had just taken a more direct action to deal with her helplessness
trap, so she didn’t need her addictive act. Later, as she worked more on
her meekness, she was able to be even more direct and indeed tell him
to make his own damn dinner. But the point is that she didn’t need to have
everything worked out to master her addiction.
I have found that virtually all addictive acts have this form. This psychology
that drives addictions can be summarized in three elements:
I. Every addictive act is preceded by a feeling of helplessness or powerlessness.
The issues that precipitate these overwhelmed states of helplessness are
unique to each person (this is why treatment must also be individualized
toward understanding these issues). Addictive behavior functions to repair
this underlying feeling of helplessness. It is able to do this because taking the
addictive action, or even deciding to take this action, creates a sense of being
empowered - of regaining control - over one’s emotional experience and one’s
life. Drugs are particularly good for this purpose because altering (and thereby
controlling) one’s emotional state is just what they do. However, non-drug
addictions can be shown to work in exactly the same way, since they are also
acts that work to change (and therefore control) how one feels. The reversal
of helplessness achieved by these addictive acts may be described as the
psychological purpose of addiction.
II. States of overwhelming helplessness, such as the feelings that precipitate
addictive acts, produce a feeling of rage. This rage is actually a normal
response to the serious emotional injury of losing a sense of being in control
over oneself and one’s life. This rage is the powerful drive behind addiction.
And we know something about great anger at powerlessness: it has the
capacity to overwhelm a person’s judgment while he or she is in the throes of
the rage. It is precisely the presence of this rage at helplessness that gives
to addiction its most defining characteristics: great intensity with loss of usual
judgment and seemingly irrational destructive behavior.
III.In addiction, the rage at helplessness is always expressed via a substitute
behavior (a displacement). If this feeling were expressed directly, there
would be no addiction. For example, if a man were flooded with feelings of
intolerable helplessness when he was unfairly criticized by his boss (because
the criticism touched on old sensitivities, for instance), and he then charged
into his boss’s office furiously complaining, there would be no addiction. But
if he displaced his need to reverse his helplessness, and instead of charging
into the boss’s office he went home to drink, then his drinking would be driven
by the same rage he would have expressed toward his boss. If drinking were
the way he regularly dealt with states of overwhelming helplessness then he
would have a repetitive, intensely-driven, apparently irrational drive to drink.
We call such compulsive behavior an addiction.
In Marion’s case, she could not take the direct action of telling her husband to
make his own dinner, or find another way to directly deal with her helplessness.
Instead, she reacted with her usual emotional mechanism to deal with the
emotional trap in which she lived. She suffered with an addiction.
Treatment for addictions has had a relatively poor success record in large
part because this psychology of addiction has not been well understood.
But once a person understands how his or her addiction works, the way is
open to mastering it – which is just what Marion did (her full story is in The
Heart of Addiction). How to go about doing this can be described in a series
of steps (detailed in Breaking Addiction: A 7-Step Handbook for Ending Any
Addiction). Here are some of the most important points.
Since the path toward addictive behavior always begins before it actually
occurs, often hours or even days before, it is crucial to identify the very
first moment when the thought comes to mind. I call this the “key moment”
in addiction. Sometimes doing this is pretty easy, of course. But the key
moment can be harder to spot, because of the way we all have learned
to manage difficult feelings: our emotional defenses. For example, a man
who dealt with feeling overwhelmed by anxiety by becoming confused (“I
can’t remember what the doctor told me”) was unable to identify these moments for what they were: terrifyingly helpless feelings which were exactly
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Sometimes, though, finding the more direct action is more complicated,
such as when there is no clear action that will solve the problem. A man
with heroin addiction found that his urge to use the drug became nearly
overwhelming when he realized that his girlfriend was going to break up
with him. Here, there was no clear direct action he could take to reverse
the helplessness he felt, since he couldn’t stop her from leaving him.
He needed to think about his helplessness trap in a different way: from
the standpoint of what this loss meant to him, rather than just the loss of
his girlfriend. He had suffered many serious losses in his life, and each
new one precipitated his old, utterly helpless feeling. Refocusing on the
reasons for his strong reaction would enable him to have a new perspective on the current situation; and perspective is itself a way out of feeling
trapped. As it turned out, with some help, he could do that and avoid another addictive episode.
The final step in breaking addiction is to work out long-term strategies.
These involve not just knowing how to identify the key moment on the path
to addiction and how to manage the urges when they occur, but how to
anticipate when they will occur and thereby avoid even having to reach the
stage of intense feelings. Many people have shown they can do this, once
they know what to look for: the situations that will provoke the specific intense helplessness to which they are vulnerable. When they have reached
that point, their addiction is broken.
There has been a great deal of pessimism about breaking addiction. But
we are embarking on a new era in understanding and treating this very
common problem. There is now very good reason for hope.
Lance Dodes, M.D., Training and Supervising Analyst Emeritus, Boston
Psychoanalytic Society and Institute, Former Asst. Clinical Professor of
Psychiatry, Harvard Medical School (retired)
Author, The Heart of Addiction and Breaking Addiction: A 7-Step
Handbook for Ending Any Addiction and forthcoming: The Sober Truth:
Debunking the Bad Science Behind 12-Step Programs and the Rehab
Industry (March, 2014).
The Sober World would like to offer its condolences to the family
of David Anderson, 84, longtime resident of West Palm Beach
and primary benefactor of the Triangle Club, Inc.
He passed away on
October 4, 2013.
A “Celebration of Life” memorial service was held on October
20th at the Triangle Club.
In lieu of flowers, it was David’s hope that much-needed
donations be made to the Triangle Club, Inc.
1369 Old Okeechobee Road, West Palm Beach, FL 33401
7
Clarifying Codependency:
Finding a New Language for an old term From 1978 to 2013
By Ann W Smith MS, LMFT
I must admit that I identified myself as codependent over 30 years ago
although it has been many years since I regularly used the term. Today I
prefer to address the issues of codependents in other ways unless I am
working with a client who uses the term and is comfortable with it.
By 1990 anyone who had a problem in a relationship or who struggled with
letting go of someone, was labeled or self-diagnosed as codependent. The
term was losing its meaning and becoming a catch all for everything, particularly in women.
Early in my personal journey toward wellness I realized that I found comfort
in therapy and self-help groups where adult children of alcoholics shared
the struggles and consequences of growing up in an alcoholic family. The
problem for me was that I did not have that history. My parents were not
alcoholics nor were my siblings. I was frustrated and wished to be a member
of a group where my background would be understood. For me, and many
others, Codependency groups became a logical choice.
Fortunately time passed and new experiences, training, and research began
to enlighten professionals in a way that made sense and de-stigmatized
those who were considered codependent. For me, two thought processes
lead me away from use of the popular label:
The term codependent gave me and many others a place to receive support
and understanding without having an alcoholic family history. It was helpful
that groups related to Codependency were more often focused on current
issues in relationships. Anyone was welcome and qualified to use the label.
The term Codependency was officially defined in September 1989 at the
first National Conference on Codependency held in Scottsdale, Arizona by
a committee of about 20 experts in the Codependency and Adult Children
of Alcoholics field, including myself and Sharon Wegscheider-Cruse as well
as other authors and treatment providers from across the US. After much
discussion and brainstorming the group arrived at this definition:
Codependency is a pattern of painful dependence on compulsive behavior
and on approval seeking, in an attempt to gain safety, identity and self worth.
Recovery is possible.
Working on this definition provided us with an opportunity to find common
ground that we could then share with those who called themselves Codependent. Unfortunately this final version was not as clear or comprehensive
as hoped and it did not serve as a useful diagnosis for the long term.
My definition in my writing and lectures at that time was:
Codependency is a condition or state of being, that results from adapting
to dysfunction (possibly addiction) in a significant other. It is a learned response to stress which, over a person’s lifetime, can lead to the development
of the following characteristics:
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•
•
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External Focus
Repressed Feelings
Comfort with Crisis
Boundary Conflicts
Isolation
Stress related Illness
Compulsive Behavior
This description was useful for many years until it became obvious to me
and others that the people who were calling themselves codependents were
really no different than anyone who was dealing with relationship challenges
regardless of the specific problem. We no longer believed it was about association with addiction.
Today the term codependency is used at times in a haphazard manner in
popular culture and is still taken seriously in counseling offices when clients
have self-diagnosed and are seeking help for relationship issues they do not
understand. Some clients find the label offensive and shaming, others find
it helpful as a description of a cluster of symptoms they are experiencing.
Overall, professionals seem to agree that the term is vague, misunderstood,
sometimes shaming and certainly overused. When asked for a definition,
most do not have a precise answer.
Early perceptions of codependency were that it was caused by association
with someone who was an addict or abusive. It was seen as an abnormal,
dysfunctional response to a stressful situation. Identifying with the label had
a negative connotation implying that there was something wrong with you
if you were codependent. Codependents were (and still are) called peoplepleasers, controllers, compulsive caretakers and enablers. They were
described as being incapable of minding their own business. Loving too
much was seen as a bad thing that may even cause addiction and mental
illness to worsen.
The culture of the late 70’s through early 90’s contributed to the stigmatizing
of anyone who exhibited symptoms of codependency. During that period,
individuality was valued and sought after. A healthy person was expected to
be self-reliant, assertive, independent, differentiated, self-responsible and
emotionally detached.
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Family Systems theory which is simply the belief that when one person in a
family is hurting all will show signs of pain
and
Attachment theory which is based on the fact that human beings are hard
wired to attach and need loving connection with others in order to be healthy
The conclusion in both theories is that it is normal and natural to seek the
comfort of those we love when we are hurting, and to feel anxious when we
are separated or abandoned, regardless of the cause. Whether addiction,
mental illness or high stress is the cause, fear changes our behavior in a
way that is meant to protect and preserve our connection. When the parents
of an adult child in an active addiction are supporting the child in ways that
are no longer helpful, they are in a natural state of fear, even terror, of losing
the child, regardless of the child’s age. They need help, not judgments or
labels to find a better way.
When a spouse or partner of an addict denies or minimizes the problem,
they are trying to keep their relationship from imploding. They hope that love
and commitment will heal what is wrong.
When addicts are in their addiction, they are not immune to the problems
other family members are experiencing. They too are trying to preserve loving attachments while at the same time facing guilt and shame. The diagnosis of codependency appeared to exclude the addict and instead of viewing
them as a member of the family, would blame him or her for making everyone around them sick. An addict does not intentionally harm their family and
deserves the same respect and compassion as any member of the family.
They need help to rebuild loving relationships, not only to maintain sobriety.
When a family is dealing with ongoing problems of any kind, negative stress
increases and they begin to live in a survival mode. They develop patterns
that are an attempt to decrease anxiety and increase attachment. Although
they may appear to be dysfunctional, these patterns of attachment are
meant to protect the emotional well being of each person and the family unit.
Of course, if continued for too long, they become a painful way of living.
Patterns of attachment are individual and varied depending on innate tendencies, birth order and the degree of stress in the family. A sensitive child
who is an extravert may use his or her gifts in academics or sports to feel
better and gain love and approval. A child who is a natural leader and compassionate, may start to help parents and guide younger siblings. Another
with a feisty nature may become a “truth teller” proudly informing others of
the error of their ways in an attempt to make things better. This may rock the
boat but it does get the attention they seek. A quiet introvert may withdraw
or choose to engage with peers away from home.
If family stress continues, these patterns, especially in children, will be
overused out of necessity and may become a permanent way of coping with
attachment anxiety in adult life. Those who use withdrawal to cope will have
trouble handling intimacy or conflict and may have superficial relationships.
Those who are prone to caretaking may see everyone as a problem and
spend their lives trying to fix what is wrong in hopes of someday feeling ok
and safe.
Recovery from the anxiety of broken relationships is multi-faceted. At times
it is an individual experience of getting to know oneself, acknowledging that
the desperate actions we took in the past may have been all wrong. At the
same time, we may also notice that when we are not taking care of ourselves, we resort to those actions again and again.
We use our gifts and our weaknesses to try to gain stability and may fall
back repeatedly until we learn how to pause…. And look inward at our fears.
While we work on recognizing our attachment patterns, we need to also
work at connecting with our loved ones. This does not involving asking them
to change or trying to fix them. It is simply a time of accepting what is and
Continued on page 30
9
By KJ Foster, MPS
When I finally broke down and attended my first Al-Anon meeting, I was
eight months sober and it had been a long time coming. I was attending AA
meetings every day, working with a sponsor and doing my step work, but
my approach to life and my problems was still very much the same as it had
always been. I was fighting against the tide of suggestions from my sponsor,
my friends and my support group, and was trying to manage my son’s drug
addiction with the same faulty thinking I used to manage my own. I thought
I knew better. I thought I could handle it on my own. After all, what more did
these people want from me. I wasn’t drinking and I was taking all the other
suggestions. I was even doing those darn steps. I admitted I was powerless
over alcohol and my life was unmanageable (Step 1), I believed that a power
greater than myself could restore me to sanity (Step 2), and I was willing to
give my will and my life over to the care of God as I understood him (Step
3). I even did that excruciating inventory they suggested to find my character
defects and begin making amends to those I had harmed (Steps 4-9). And
now they expect me to go to Al-Anon too. Don’t they understand I’m a single
Mom, working a full-time job, trying to stay sober myself? It’s just too much
for me to handle! Are they crazy?! And this is exactly where the problem
lies. They… all those people who listened to me cry and complain at every
single AA meeting I attended, wallowing in my own self-pity… the ones who
came up to me after the meeting and told me, “you need to go to Al-Anon,”
“Trust me,” “Believe me,” “It’s going to help you.” They were not the crazy
ones. It was me! Because they were right. I just had to be in enough pain to
be willing to take the suggestions and go. It took eight months.
At that first Al-Anon meeting the speaker was a young man in his late
twenties who was sharing his experience having a mother who was an
alcoholic. This hit me like a ton of bricks. The realization of just how much
my drinking affected my two boys was overwhelming. I was overcome
with guilt and remorse for my own inadequacies as a mother but reminded
myself of why I was there. I was determined to stick it out and have the
opportunity to share about my son. I identified myself as an alcoholic with
eight months of sobriety, struggling with the downward spiral of my 19 year
old son into drug addiction, starting with his drinking and use of pot at 14
and ultimately progressing to a daily addiction to heroin. I began to cry,
par for the course, as I shared about my attempts to get him counseling,
his refusal to admit he has a problem, and the impact it was having on my
younger son, his 13 year old brother.
After the meeting was over, I was approached by an elderly gentleman
who began sharing with me about the similarity of his own experience with
his son and how his son was ultimately able to recover and is now married
with his own children. Very encouraging I thought, but still felt little hope.
Especially when the man started to tell me how I was enabling my son by
allowing him to live under my roof and continue to use drugs. He talked
about detaching with love. I told the man that I couldn’t possibly kick my son
out of the house. After all, what if he dies? I remember starting to cry, yet
again, and saying “I can’t do it. I just love him so much” at which point the
man grabbed me firmly by the shoulders, looked me square in the eyes and
replied, “You don’t understand. If you don’t do this you are going to love him
to death.” I was both horrified and speechless! The man went on to share
more about his story with his son and how it took, what he described as,
“tough love,” in order for his son to get better and explained to me how my
“helping was hurting.” After he finished feeding me the harsh reality of my
situation, the man looked at me with a sincere and gentle kindness in his
eyes and said, “do you realize how courageous and strong you are?” As I
stood there wiping away the tears, I hardly felt courageous and just looked
up at him trying to gain back my composure, along with whatever dignity I
had left. I think he could see the questioning in my face. He went on…”from
what you described here tonight you are going through hell with this kid
and yet you haven’t picked up a drink in eight months. Do you know how
incredible that is? That’s something to be very proud of!” I didn’t realize
it at the time but looking back I see that this man was doing something I
now do today as a therapist at a treatment center working with the families
of alcoholics and drug addicts. It was just recently described to me very
succinctly at a seminar I attended this week… the speaker put it this way,
”you’ve got to slap’em in the face while you pat’em on the back.” And this
is just what this man did for me and exactly what I needed. I never saw
the man again, but it was a powerful moment and a turning point for me. I
realized that I needed to start practicing tough love.
Over the next six months I would have to change the locks on my house
three times, as my son made attempts to go to both NA and AA for a month
or two and then relapsed. I filed two Marchman Acts that I didn’t follow
through with when I was assured by my son over and over again that he
10
really meant it this time; he was going to go back to AA and was going
to stay clean and sober. Finally, in August of 2009 when my younger son
came home from school to find his brother shooting heroin in his room, I
knew I had to do something drastic. By the time I got home from work he
was gone, so I sat and waited. Watching from the kitchen window, I saw my
son pull up into the driveway. When he got out of the car and approached
the house, I could tell immediately that he was high. Before he was able to
even get up to the house I was standing on my front door step with several
garbage bags filled with his belongings (a first for me to take it this far) and
proceeded to give him the tough love speech for the last time. As he stood
before me, a hollowed-out shell of the vibrant young person he once was,
I begged him to let me take him to treatment. He adamantly refused and
proceeded to scream obscenities at me, telling me that any mother who
would do this to her son couldn’t possibly love them. It shot through my
heart like a knife. I knew this person standing before me was not my son,
but the disease. My son is sweet, my son is compassionate, and my son
is loving. This time though, was different than the other relapses, my son
was completely gone. No sign of him or his kind soul were anywhere in
sight. What stood before me was a dark, empty, lifeless shell of a human
being. His disease had finally taken away all that was left of him. I thought
he would surely die if he didn’t get some help, but he didn’t want any help.
All he wanted to do was continue using. I turned and left him there on the
steps continuing his screaming and his ranting. Just before turning to go
back in the house I told him that if he didn’t leave I was going to have to call
the police. It took every ounce of strength I had in my being to leave him
standing there. I went back into the house and fell to the floor in a heap of
tears. What if he dies, what if I’ve just killed my son? The voices of my AlAnon and AA supports rang out in my head, “if you let him stay, he will die,”
“you are robbing him of his bottom,” “he needs to face the consequences of
his actions.” It sounds good in theory, but putting it into practice was one of
the hardest things I have ever had to do.
A month went by and my son was nowhere to be seen. All the other times
when I had told him to leave I would get reports from his friends that he
had shown up at their house or I would at the very least have friends report
sightings of him around town. This time, there was nothing. He had virtually
disappeared off the face of the planet and I feared the worst had happened.
I began calling hospitals and police departments in an effort to find out what
happened to him. Based upon his condition when he left and the fact that
absolutely no one had seen him in weeks, I was convinced he was lying in a
ditch somewhere and no one had found his body yet. I went into an emotional
tailspin like nothing I had ever experienced before. I cried for three days
non-stop, couldn’t eat or sleep. Looking back on it I feel as though I was so
convinced he had died that I was literally already mourning his death. After
three days of crying, it was just after midnight on September 18 and I knelt
down on my bedroom floor with my forehead to the ground and begged God
to find my son. I promised God that I would accept whatever his will was for
my son even if it meant that he had in fact died. I told God that I would try to
understand that perhaps my son had to die in order for others to get well, as
difficult as that may be to comprehend. I would try. And I promised I wouldn’t
drink and thanked him for keeping me sober through all of it. I was 14 months
sober and I had finally surrendered everything. Not only my own life, but
the lives of my children. They are not mine to own or to keep. They are gifts
from God who belong solely to God. I love them. I cherish them. But I am
powerless over everything and everyone, except my own actions. All I can do
is my very best to lead by example. After my prayer, I got into bed and slept
better than I had slept in my whole 14 months of sobriety. I awoke the next
morning to my phone ringing. It was my sponsor. She was at Barnes & Noble
and told me that she thinks the boy sleeping on one of the benches outside
is my son. I told her not to let him move and I’d be right there. I jumped out
of bed, threw on my clothes and raced to the store to find him sitting outside
next to my sponsor. My sponsor went inside and I sat with him pleading to let
me take him to detox. I read him a poem I had written the day before and told
him that I would do anything to help him and that he didn’t have to live this
way anymore.
I Can’t Stop Crying
I can’t stop crying thinking of you dying
This pain in my heart is tearing me apart
What have I done to my beautiful son?
Feels like only yesterday your life had just begun
Precocious and so smart
Struggling with addiction?
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11
Pain Medication and Addiction
By Dr. Michael J De Vito
It is the beginning of a hot summer in 1863. The aromas of a three day
battle hang in the air. Robert E. Lee is in retreat with what is left of his
army. Gen. Lee is heading south from Gettysburg. He orders a portion of
his medical staff to stay behind to care for Gen. Longstreet’s dying and
wounded men quartered in the Black Horse Tavern and a nearby barn that
are now both, a makeshift field hospital. Surgeon, Dr. Simon Baruch is
among them. They all are soon to be captured by the Union Forces under
the command of Gen. Meade. Until then they care for the wounded and
dying. With only minimal understanding of infectious diseases they focus
on the triage, anesthesia, amputations and pain control. At their disposal
are short supplies of chloroform, some morphine tablets and opium, along
with herbal substitutes and a rationed supply of moonshine whiskey. More
pain medication would come once captured. Union forces had greater
supplies of morphine and opium including syringes for injections. Drugs
were liberally used, first with their own wounded and then with the captured
Confederates.
Since the development of the hypodermic needle in 1855 the ability to
introduce the highly refined opium in the form of the more powerful morphine
directly into the blood stream improved the ability of battlefield surgeons to
control pain. This advancement in treatment, although beneficial, often resulted
in the unintended consequences of a greater degree of chemical dependence,
abuse and addiction among the Civil War veterans. Chemical dependence,
abuse and addiction continued long after the end of the nation’s war.
Opiate and alcohol addiction in the later 1800s was in epidemic proportions.
Shortly after the Civil War morphine kits were readily available and widely
distributed into the early twentieth century. Morphine tablets were now less
expensive than whiskey and sold in most every general mercantile and drug
store. By the turn of the century The Bayer Company took advantage of the
recent discovery to be able to refine heroin from morphine. Bayer marketed
heroin, a more concentrated opiate, as a cure for coughs, lung consumption
and pain. They even promoted it as a cure for morphine addiction and
alcoholism. These refinements from opium to morphine to heroin lead to
a greater effect on pain control due enhanced concentrations yet a more
rapid progression towards addiction. All of these refinements were done
with good intensions for the purpose of alleviating pain but with little or no
understanding of the chemical dependency risks and the addictive process.
The first recorded use of opium for pain relief was by the Sumerians around
4000BC and later by the Egyptians. The form was a crude unrefined gum
and paste made from the milky white substance from the dried poppy
bulb. The taste was bitter. It was usually mixed with fermented potions and
drunk for their medicinal pain killing and euphoric values. The Greeks and
Romans also made use of the therapeutic benefits. With the bitter taste
and weaker concentration associated with the unrefined opium gum the
potential for abuse and addiction although present was greatly reduced.
The more the opiate is refined, with each refinement, a greater risk of abuse
and addiction occurs regardless of any medicinal therapeutic benefit.
Now we are well into the twenty first century, far from the days of the Civil
War and even more removed from the Sumerians and ancient Greeks.
What do we have available in our world to alleviate pain? Are we better off
now? Let’s take a look.
Our pharmaceutical advancements, which are many, have not only brought
us greater refined concentrations of opiate pain relievers, we have learned
to synthesize and duplicate what nature once provided those Sumerian and
Egyptian healers.
Methadone is a synthetic opioid, first synthesized in late 1930’s Germany
prior to World War II in anticipation of a need for pain killers. Germany was
then a country gearing up for a European war. They were looking for an
effective pain killer with a low potential risk of addiction.
Methadone use began in the United States in 1947 distributed by the Eli
Lilly Company. It is now widely prescribed as a pain killer and used for
treatment of heroin addiction promoting the harm reduction concept of
Methadone Maintenance clinics throughout the United States. As it turns
out, Methadone is highly addictive and it is more complicated to detox than
heroin. The opiate receptors in the brain although receptive to Methadone
do not like synthetics. Sixty people were hospitalized in Colorado due to
synthetic marijuana. Many of them on life support. The brain does not like
synthetics. Methadone is a simple opioid molecule and it is chemically
different than morphine or heroin. However, it does combine with opiate
receptors in the brain and therefore, it is effective for pain. The question
being, is it worth the risk? According to the Center for Disease Control and
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Prevention in the year 2009, 15,500 deaths occurred due to the overdose of
prescription pain killers, 5,000 of those deaths were caused by Methadone.
That is the number of deaths in just one year. The numbers are on the rise
since then.
Other synthetic prescribed pain medications include Darvon, Fentanyl,
Demerol, and Talwin. We even have a berry flavored lollipop form of
Fentanyl called Actiq. Honest, I am not kidding, opiate candy!
Oh, if only Dr. Simon Baruch had that at Gettysburg.
Some of the semisynthetic and more refined pain medications would be
Oxycodone ( OxyContin, Percodan), Hydrocodone ( Lortab, Vicodin),
Dilaudid, and Codeine. Codeine being a more refined extract from
Morphine. Do we need pain medication? Yes, sometimes we do.
The proper use of prescription pain medications is necessary and has
benefited millions of people around the world. It may have been a benefit
to you or members of your family. Is it over prescribed, misunderstood
and frequently abused? Absolutely-Yes. It is abused by those who
prescribe and by those who use. That abuse has extended to addicts and
abusers combining prescribed pain medications with other drugs, such as
mixing alcohol or benzodiazepines (Valium, Xanax, Klonopin) with pain
medications. And yes if you were wondering, alcohol is a drug. The result of
this activity is devastating.
According to the National Institute on Drug Abuse in 2009 there were 4.6
million drug related visits to hospital emergency rooms nationwide. Of those
50%, over 2 Million, were due to prescription medications that were taken
properly as prescribed. Another 45% were due to the abuse of alcohol and
other drugs including prescription pain medications that were abused. The
rate of increase over the 5 year period from 2004 to 2009 was 98%. Almost
double in 5 years. We are now almost 5 years later and the rate of increase
is continuing along with deaths due to the use and abuse of alcohol,
prescription medication and other drugs.
Perhaps it is time we did something different. Could we manage pain
differently? Not all pain is due to trauma or injury like that experienced
at Gettysburg. Not all pain is traumatic and acute requiring pain control
intervention. Much of it is chronic in nature. We may be able to reduce,
manage and control pain in other ways. Maybe even prevent it before it
happens. Not all pain is physical. Much of it is mental pain. Do we need to
control every mental or physical malady with a prescribed medication? Is
there another way? We are over- medicated and it is getting worse not better.
Our children are over-medicated, our seniors are over-medicated and the way
it appears to me some of our political leaders are over-medicated as well.
If we have a chemical dependency or addiction, maybe switching to another
drug is not the answer. And certainly switching to a drug that is the same
or worse than the one you were on, for example Heroin to Methadone or
Suboxone, does not sound like recovery.
Let me take a real leap here, maybe you don’t need any medications on a
regular basis, or at all. Maybe you just need to make a change in your life.
The question I ask all of my patients is what camp do you want to be in?
Are you in the camp that seeks out a pill for every problem or are you in
the camp that is empowered, taking charge of your own life. What camp
do YOU want to be in? How can you make a change that brings you, your
family, and our community a better life?
Dr. Michael J. De Vito is a diplomate and is board certified in
Addictionology. He is a graduate of Mansfield University of Pennsylvania
and Northwestern Health Science University in Minneapolis, Minnesota.
He has been an instructor of Medial Ethics, Clinical Pathology, Anatomy and
Physiology at the College of Southern Nevada.
Dr. De Vito has over 30 years of experience in successfully guiding patients
and clients on the path of Recovery Consciousness.
He is the founder and program director of NewStart Treatment Center
located in Henderson, Nevada. He is presently in private practice helping
patients from all parts of the world attain and successfully live a life
of recovery from substance abuse and addictive behavior. NewStart
Treatment Center utilizes a drug free and natural approach to addiction
treatment. www.4anewstart.com
Dr. De Vito is the author of Addiction: The Master Keys to Recovery
www.AddictionRecoveryKeys.com
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13
Adolescents, Brain Development and the Turkey Model
By David J. Powell, Ph.D.
Adolescents and Brain Development
For the past five years I’ve overseen an adolescent substance abuse treatment
center in southern Turkey, near the Syrian border. The boys are between the ages
of 13-20, with solvents and inhalants as their primary drug of abuse. Working with
teenage boys is a challenge—and I thought raising my own two teenage daughters
was interesting! Since the 1990s, there has been an explosion of information on
brain development. For centuries, science thought that brain development was
complete by adolescence. Emerging science has taught us that brain maturation
may not be complete until about age 25. The immature brain has less brake on its
“go system.” Regions of brain serving primary functions (motor/sensory systems)
mature the earliest. Temporal/parietal association cortices (language/spatial
attention) mature next. Higher order functions, such as prefrontal/lateral temporal
cortices that modulate basic attention, mature last.
Brain development triggers puberty, increases efficiency in energy utilization and gives
rise to cognitive development and neuro-biological functioning. For the adolescent
brain, there is often a preference for physical/sensory activities, higher levels of
excitability, activities with peers that trigger high intensity/arousal, and novelty. At a less
optimal level, adolescent brain development may have difficulty balancing emotions
and logic in decision-making, and considering negative consequences for their actions.
This leads to a greater tendency to risk-taking behavior and impulsiveness. Thus, the
immature brain equals lower brain power, and an absence of judgment. Drugs can
further hijack these activities as well as dopamine activity.
Effective Treatment Approaches
Because of the impact of drugs on the adolescent brain, over the past five years,
in the development of the Turkey treatment center, I have learned that treatment
needs to address a number of key issues:
1. We need to discuss with youth the science of neurobiology and addiction, as
well as the implications of using as a teen.
2. Provide a milieu that is teen-friendly, marked by structure, rules, recreation,
sensory activities, peer community, and novelty.
3. We need to teach skills that are not optimized yet by the teen brain, such as,
impulse control, “second thought” processes, social decision-making, how to
deal with risky situations, and how to take healthy risks.
4. Since over 50% of the youth who relapse did not expect substances to be in
use in the situation where they relapsed, did not think about using beforehand,
and use was done in the presence of new friends, treatment needs to prepare
teens for these situations.
5. 12 Step programs work well with teens because they provide an abstinence
model that allows the teen’s brain to deal with the toxicity of drugs. 12 Step
programs further promote “novelty,” new approaches to life. They offer structure
(the Steps), a spiritual component (reasons to live), and fellowship, friendship,
and sponsorship, i.e., role modeling.
6. Research has shown that Cognitive Behavioral Therapy and Motivational
Interviewing (MI) approaches are particularly helpful with adolescents because
they offer immediate, relevant, and specific problem solving, and solutions that
are realistic and concrete.
7. MI is especially helpful because it de-emphasizes labels, emphasizes personal
choice and responsibility, focuses on eliciting the client’s own concerns and
solutions, and provides goals that are negotiable and client-centered.
8. The recipe for a healthy teen brain include a good balanced diet, vitamins,
exercise, sufficient sleep, social connections, positive thinking, help to others,
and new ways of learning.
In 2008, an adolescent substance abuse rehabilitation program was begun in the
suburbs of Gaziantep, thirty minutes from the Syrian border, and two hours from
Iraq. It was named the Oya Bahadir Yuksel Rehabilitation Center. Esra Cavusoglu
from Istanbul Turkey is the primary person who is overseeing this project and the
Turkey model. Under her leadership, the project will become a model of Turkey
and perhaps Europe. I have had the privilege of playing a significant role in the
development and operations of the Center.
A significant percentage of the Gaziantep population is Turks with Kurdish heritage
who fled their homes to escape the ongoing terrorist attacks along the TurkishSyrian-Iraq-Iran borders. The population served at the Center is boys, ages 15-19,
who have, for the most part, been living on the streets of Gaziantep for several
years. Many have been separated from their abusive families for years.
Multiple problems associated with cannabis use are the norm, including alcohol use,
longtime histories of victimization, acts of physical violence and other illegal activity,
and multiple social, emotional and medical problems. Many of the boys live off of
whatever they can steal from homes, unsuspecting tourists, and their families.
14
When there is evidence of substance dependence in Gaziantep Turkey among
adolescent boys, many report health problems, acute mental distress, attention
deficit hyperactivity disorders, and conduct disorders. For boys who have run away
from home and are living on the Gaziantep streets, solvents are the drug most
often used, along with cannabis. Solvents (glue, thinner and even petroleum) are
low cost. Most boys use solvents, cannabis, alcohol, Ecstasy, “roche” (nicknamed
because of the “roche” name on the pill—benzodiazepine), and if they can afford it,
any form of alcohol.
Our Treatment Approach
There are several evidence-based practices (EBPs) with good indicators for
success. There are four that the Turkey Model has incorporated (12 Steps,
Behavioral, Family-Based, and Therapeutic Community):
• 12 Step approach. As is the case with most rehabilitation programs, the main
feature of our approach is step work; a series of treatment and lifestyle goals
that are works in groups and individually. The first 3 steps are covered in the
acute and intensive phase of treatment, while steps 4-5 are addressed in
extended care. Other components of our approach includes group counseling
(the primary mode of treatment delivery), individual counseling, lectures and
psycho education, family programming (see below), written assignments
(including step work), recreational activities, participation in Level 3 planning,
and attendance at Narcotics Anonymous (N.A.) meetings and Al-Anon
meetings for family members
• Cognitive Behavioral Therapy (CBT). Behavioral approaches focus on the
underlying cognitive processes, beliefs, and environmental cues associated
with the teen’s use of substances and teaching them coping skills to help
them remain drug-free. The goal of our behavioral approach is to teach the
adolescent to “unlearn” their use of substances and to learn alternative, prosocial ways to cope with their lives. Coping with the craving for substances
is a critical phase in our treatment. In particular, given behavior is mediated
by thoughts and beliefs, so the focus is on altering thinking as a way to
change behavior. We emphasize aggression replacement training, reasoning,
change thinking, interpersonal social problem solving, multi-systemic therapy,
multidimensional family counseling, adolescent community reinforcement, and
assertive continuing care.
Other behavioral approaches focus on the development of coping skills,
introduced and modeled by staff. Such skills training include substance
refusal skills, resisting peer pressure to use substances, communication
skills (non-verbal communication, assertiveness training, negotiation
and conflict resolution skills, anger management skills), problem-solving
skills, relaxation training, social network development, and leisure-time
management. New behaviors are tried out in low-risk situations (during
group counseling role play sessions, individually with their counselor)
and eventually applied in more difficult, “real life” situations. Homework
assignments are used to try out new behaviors or for collecting problem
situations to discuss during counseling.
Behavioral contracting is used to address behaviors to be changed. Weekly or
daily incremental goals are mutually agreed upon. As each goal is reached, the
adolescent is highly praised and reinforced through privileging. Behaviors are
explicitly defined on the contract with criteria and time limitations noted.
• Family-based approaches. Despite the history of abuse within the home,
the family plays a critical role in the development and maintenance of
substance abuse problems. In Turkey, the family is a collection of sub-systems
(e.g. parents, grandparents, step-parents, siblings, relatives, neighbors,
and community), each with a variety of roles. Our family program is multidimensional and progressive, depending on the stage of development, familial
relationships, severity of the illness and impaired relationships. Our approach
includes observing the family’s interactional patterns, identifying problems in
interactions, family education about the disease of addiction and how the family
is involved, and steps the family can take to address the adolescent’s issues.
• A Positive Peer Culture, as found in a modified therapeutic community.
Our philosophy seeks to address all aspects of the adolescent, body, mind,
and spirit, integrating these elements through a positive peer culture. Since
Turkey is 99% Muslim, theological education has been an essential part of our
rehabilitation program for many of the boys.
It is imperative that the adolescent learn how to integrate healthy behaviors into
his maladaptive drug-based lifestyle. The therapeutic community is a surrogate
family for the adolescent, providing a therapeutic and supportive environment
for the person to mature and grow. Many of the boys have known each other on
Focus on Individual Needs of Each
Client Makes Wayside House Successful
By Marlene Passell
Every woman who comes to Wayside House arrived for a different reason
– a different set of circumstances brings them to our door. And just as
their stories are unique to them, what each needs to recover is different.
Wayside House knows this and creates individual care plans to meet those
needs. It is attention to the individual that makes Wayside House’s clients
so successful in achieving and maintaining sobriety, according to Lisa
McWhorter, M.S., CAP, the organization’s clinical director.
“What makes our program successful is our structure, our attention to
individual care of the client, and services to ensure that clients have the tools
they need, not just to get sober, but to stay sober,” said Ms. McWhorter. Because structure is key to regaining healthy body, mind and spirit, staff
maintains a strict one, but with a variety of activities geared toward recovery.
With strong emphasis on the 12 steps of recovery, the program includes
exercise, chores, a variety of educational programs regarding communication,
spirituality, conflict resolution, coping skills and medication usage.
For
women
by
women
Many women arrive with co-occurring issues, so women who need it also
attend specialty groups to deal with eating disorders, or trauma associated with
abuse. And part of recovery is regaining physical and emotional strength, so the
program also includes yoga, equine, horticulture and art therapies.
All treatment is geared toward the next steps. Emphasis is on family
involvement, including Saturday visits for families and children. And women
receive vocational services to help them find employment.
And, of course, to help support women’s transition back into the community,
Wayside House provides a variety of other services including eight weeks of
intensive outpatient services and aftercare services. Women not ready for the
90-day program can also receive outpatient services through Wayside House.
For further information, please contact Wayside House at 561-278-0055 or
see our website at www.waysidehouse.net
Marlene Passell is a journalist and communications professional who serves
as communications consultant for Wayside House.
waysidehouse.net
561-278-0055
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Anger Management for Court Appointed
By Marty Brenner, RAS CAMS11
Any judge who orders anger management classes to be taken by a person who
is brought before his bench, is giving that person a break. No one goes before
a judge unless he has broken the law and has been charged by the police. The
first step in anger management is to recognize that you have been charged
with committing a crime and are before a judge who can substitute jail time for
anger management classes.
However, if you were charged with striking somebody who called you a
name, a bad name or who swore at you, and the person you struck wasn’t
seriously hurt, the judge might consider sentencing you to complete an anger
management class before going any further with your trial. Anger management
can also be a condition for husbands who have a history of bullying their wives
and whose wives will not press charges. Their actions have necessitated
police action and the husband was charged for disturbing the peace. Another
scenario might be if you were arrested for reckless driving and you were found
not to be drunk, but angry, anger management classes might be another option
that a judge might take.
Although you might be thinking that a fine, a heavy fine might be a deterrent,
that really isn’t always the case. In individuals whose threshold of tolerance
for being personally insulted, demoralized, or harassed is low, a fine will be
forgotten at the time of the next incident, but six months of anger management
classes will not easily be forgotten.
The interesting part of anger management is that even if the therapist instructor
isn’t the best, just the fact that you have to show up every week for six months
initiates a change in your everyday activities. Forcing of your personality to
commit to a program that you might find ridiculous will however impact your
automatic response system. The requirement of attending anger management
classes has also been shown to help alleviate intermittent explosive disorder
which can prove to be a real problem in learning to adjust to everyday stress.
If you are being court appointed to attend anger management classes, you
can make arrangements with a psychiatrist on your own who will appear with
you if you pay him, to testify that you are under treatment and that you pose
no threat to yourself or to others. Also, if he prescribes a short-term anxiety
reliever medication that might sway the judge to reconsider mandating anger
management classes.
But, basically, anger is a debilitating disorder. It can rob you of your dignity and
more than that it can cost you time in jail. Repeated acts caused by built up
anger that explodes also known as intermittent explosive disorder will probably
cost you your marriage, if you are married. There really is no definite cure for
anger without anger management and/or medication. Your family might have
become adjusted to baiting you willfully or through habit. They are not going
to change, but you must learn to build up your acceptance of their habits or
lose them. The most important thing to remember is that without a structured
program of targeting your emotional ups and downs and teaching you how to
resolve anger without violence, you will never change your behavior by yourself
unless some catastrophic act happens to you that causes you to stop. And,
even then, studies have shown that once the shock of the act has passed,
people with anger problems go back to old habits if they do not follow anger
management techniques and/ or medication.
I specialize in Anger Management classes, Domestic violence counseling,
Alcohol Addiction, Drug Addiction, Life Skill development, Problem Solving
skills, Coordinator Support, Relapse Prevention, Risk Management,
Interpersonal communication skills.
I work with Individuals challenged with various addictions including but not
limited to - substance abuse, alcohol, and anger. I am a certified chemical
dependency counselor and anger management facilitator. If you, a family
member or someone you know is in trouble with substance abuse or anger, we
can work together to determine what the best course of action to take on behalf
of you and that individual who is seeking help.
I can help, call me when you need to talk: 213-500-8865. For more information
about Marty and his practice , visit his web site at www.martybrenner.com
Adolescents, Brain Development
and the Turkey Model
By David J. Powell, Ph.D.
Continued from page 14
the streets. In some cases, they protected each other in dangerous situations
or fought with each other.
Our program is highly structured, with days scheduled from early morning
through the evening and weekends. Idle time is the worst enemy for the
adolescent’s recovery. Days are filled with school classes and tutoring, peer
groups, group counseling, individual therapy, recreation, vocational and skills
training and occupational training. Management of the community rests, in
part; on the resident/adolescent himself and all are assigned tasks and jobs.
Through progress and productivity, they rise through the hierarchy to positions
of coordination and leadership. Rewards are an integral part of the program.
Given the nature of an adolescent treatment program, there are unique issues that
arise in clinical supervision:
• Duty to warn situations. What do to in a culture that has unclear “duty to warn”
regulations? How to respond when the teen asks that their “secret” not be
shared with anyone else, especially their parents?
• Providing culturally-responsive supervision. Given the cultural differences
between American and Turkish models of treatment, how do we design a
management, treatment, and supervision system that reflects cultural variables?
• Dealing with supervisee counter transference toward addicted teens, especially
for those who manifest significant family pathology and potentially dangerous
home situations.
• Facing counselor boundaries and limitations when working with a difficult
patient population. When is a relapse just a slip? How many readmissions
should the Center offer an adolescent?
In sum, I have learned a great deal about working with adolescents with long
histories of drug abuse, physical and sexual abuse, in an environment where
training and clinical supervision has rarely been provided.
David J. Powell, Ph.D. is Assistant Clinical Professor, Yale University School
of Medicine and President of the International Center for Health Concerns,
Inc. He has been a mental health and substance abuse professional since
1965 and is widely regarded as the leading expert on clinical supervision in the
substance abuse field.
18
The Sober World was a sponsor for
Suncoast Rehabilitation Center’s 2nd
annual charity Golf Tournament. This
tournament was to help Suncoast reach
its goal of raising $50,000 for their
scholarship program. This scholarship
program will benefit Florida residents
addicted to drugs and alcohol by
providing financial aid to them.
ANGER ADDICTION
COUNSELING SERVICES
If you, a family member or someone
you know is in trouble for
Anger or Drug/Alcohol Abuse
Call Marty
TALK TO
Marty
• Court Approved for Anger
in Florida
• Individualized sessions
• Addiction Recovery and
Life Coaching
213-500-8865
Marty Brenner, CCDC
Anger Management Specialist ll
Certified Addiction Therapist C.A.T.ll
Cer
Con
Conveniently Located in Del Ray Beach
[email protected]
www.martybrenner.com
“People can change”
19
The Role of Case Management in Substance Abuse Treatment
By Myles B. Schlam, Jd, Cap/Ccjap/Icadc
Case Management is one of the most overlooked and underestimated
components of clinical Addiction treatment. Many people are not aware
that in the State of Florida, an agency must be licensed by the State in
order to provide Case Management services. An agency licensed for Case
Management is held to all the same licensure requirements as any addiction
treatment facility.
Many people have asked me, “What services does a Case Manager actually
provide?” There are different types of Case Managers in the Addiction
treatment milieu. There are the internal Case Managers within individual
treatment centers whose duties include linkage of clients to ancillary services.
There are Case Managers who work within the Drug Court system to monitor
compliance of clients and out of county transfers. What most people do not
know is that Case Management is considered a type of Intervention and a
clinical component for substance abuse treatment. Even though most Case
Managers are not licensed by the State, it is legally required to be licensed by
the Florida Dept. of Children and Families to provide such services. A Case
Manager must also have professional liability insurance coverage. Advocare
Solutions, Inc. is unique in that we are an agency licensed in and specifically
devoted to Case Management. We have developed a program which is
centered around strong, intensive Case Management. After years of working
in the Addiction field and in the court system, I observed that strong Case
Management was severely lacking and this was a primary cause of clients
“falling through the cracks”.
Our job is to ensure that clients do not fall through the cracks by ensuring
that the Continuum of Care is followed – that clients have a smooth transition
from one phase of treatment to the next. The best analogy I can give for my
job as Case Manager is that of the head coach of a football team. Addiction
clients have many “ancillary” or outside needs that must be addressed which
cannot necessarily be done within the treatment center. This is where “linkage”
is necessary. ASI has a large network of resources to refer our clients to for
a wide range of “outside” issues. Our job is to oversee the entire process.
We generally have a client on our caseload from 6 to 18 months. During
that time we may place a client into detox and subsequently place that client
into another facility for PHP (residential). Upon completion of PHP we may
determine that a client should stay at that facility for IOP (Intensive Outpatient
Treatment) if they have that component, or we may place that client into a
separate IOP facility in conjunction with a sober-living facility.
In making these determinations, it is important to place the clinical needs
of the client first and foremost. The first step is a Screening and full biopsycho-social Assessment performed on each new client. The Assessment
is important because that is how we determine the appropriate modality and
level of treatment for each client based on individual factors. As a licensed
Case Management Agency, we are required to maintain a clinical chart
for every client which we must keep for 7 years. We must also meet with
each client for an individual session at least once per month. A Treatment
Plan which is called an “Intervention Plan” must be formulated with each
client containing both short and long-term goals and objectives along with
Interventions to be provided by ASI. A review of the Intervention Plan must
be conducted with the client every 60 days. Upon discharge, there must be a
solid Discharge Plan for every client.
Another duty we take very seriously is providing quality assurance to the
clients while they are in treatment. We are in frequent contact with the primary
therapist and case manager at the treating facility to staff each client’s case
and provide input to the treatment plan and give suggestions. We only work
with treatment centers that provide quality individualized treatment and have a
good teamwork approach. As Forensic Case Managers we are also in frequent
communication with the courts, probation officers, prosecutor, and defense
attorneys to ensure that all court requirements are met and to give status
reports on clients. Serving as the liaison between the treatment facility and the
courts is one of our primary responsibilities. It is important as Case Manager
to always be available to all the various parties. Because I am personally in the
courts 3-5 days per week, the Judges feel comfortable with the fact that I can
always be reached when necessary.
Our job extends to placing clients in a sober-living facility upon completion
of treatment while continuing to oversee their case. We work with a network
of attorneys who specialize in various areas of the law whom we call upon
to represent our clients. Because Addiction is a family disease, Case
Management also includes communications with the family of the client and
keeping them informed and involved in the process. Clients may have other
health issues that need to be addressed which would also be coordinated by
the Case Manager. The client may have vocational issues, including dealing
with the EAP at work or a boss who is at his wits end. They may need
20
assistance in utilizing the FMLA (Family Medical Leave Act). Other clients
have educational issues and need direction in obtaining their GED or getting
back into college after a leave. We always encourage our clients to continue
with Aftercare upon completion of treatment and often provide them with one
of our network therapists for follow up.
One reason it is so paramount to have an Independent Case Manager steering
the ship is because there are conflicting priorities. For example , the defense
attorney on board is looking at the case from the perspective of “beating the
case” or doing as little time as possible…that’s his job and that is what he is
trained to do. His opinion may be in complete conflict with the therapist. The
therapist’s opinion may be in conflict with that of the Psychiatrist. In some
cases there are spouses or family members who have their own opinions
regarding course of action. As the Case Manager, our job is to be completely
objective and neutral, helping the client to weigh out the pros and cons always keeping their best interest as the primary concern. At the end of the
day however, the client will have to make their own decision and we can only
hope they follow our suggestions.
In sum, a strong and effective Case Manager can greatly improve a client’s
chances of successful recovery. When a teamwork approach is taken and
all the elements are working together, we can have a profound impact on
somebody’s life. It can go from a catastrophic situation to one where the client
comes out the other end with a good foundation underneath them, and a great
deal of hope in their life to create something positive for themselves.
If you or a loved one have a case pending in the court system or are just
seeking the best individualized treatment alternatives for Alcoholism or Drug
Addiction, ASI is available for a free consultation. Both in and out of custody
evaluations are provided by appointment only.
*Myles B. Schlam is a nationally recognized expert in Drug Addiction and the
Criminal Justice System and an Internationally Certified Alcohol and Drug
Counselor (ICADC). He is one of approximately 100 Criminal Justice Addiction
Professionals (CCJAP) in the State of Florida. Mr. Schlam is a graduate from
St. Thomas University School of Law (Class of ’02) where he specialized in
criminal law and interned with the Public Defender’s Office. ASI is licensed by
the Florida Department of Children and Families and operates throughout the
State of Florida.
All young
people deserve
an educational
experience that leads
to an
excepTIonAl lIfe.
Allynwood Academy is an accredited, non-sectarian boarding school for students in grades 9–12,
providing exceptional college preparatory education with individualized platforms of therapeutic
support and independence. The Bridge is Allynwood’s premier college transition program.
It combines personal guidance with academic, therapeutic and recovery support to help students
ages 17–20 successfully navigate the passage to college.
www.allynwood.org
21
TEARS
By Valerie Belew
TEARS
Huge tears were rolling down those perfect youthful cheeks. At thirty-four, my youth
was coming to an end, her budding womanhood only beginning. Somehow her eyes
appeared greener through the tears, the tears my life had caused. The youthful heart
had believed in me, even through my recent insanity, even through my present loss of
contact with reality. I placed a flower-covered journal into her small hands.
“Take this,’ I said softly. “It is yours now. It is a copy of every song and story I ever wrote.
I want you to have it. I want you to always know I love you. Your big sis loves you no
matter what, and always will.”
I had written a short note inside the journal, an offering of its contents to her. I was
on my way to a psychiatric unit, and it was not my first time. I had been there before,
and my troubled lifestyle was now calling for an encore. Jessie had only been a
newborn my first trip around, hardly more than a neonate, incapable of this type of
emotional pain. But she would experience much more of the same before her young life
developed into that of a legal adult.
“It’s okay,” I consoled, though I hadn’t a clue of how it was going to be okay. I was hardly
even in contact with reality, yet I continued to understand the concept of love, and its
pull on the heartstrings. “Don’t cry, Jessie. Big sis is going to be just fine.”
Her beautiful youthful tear-streaked face was the last thing I saw as I walked out the door,
and those small hands holding the flower-covered journal tight and close to her heart.
EMERGENCE OF HOPE
Magic happens with the emergence of hope. I never really planned to stay drug free.
My life was broken, but I hadn’t a clue of how to repair it, and seriously doubted I was
actually addicted to a drug. I found my way into twelve step meetings quite by accident,
knowing nothing of the relationship between alcohol, drugs, depression and other
mood swings. I had experienced what was diagnosed as a manic episode, not once,
but twice, seven years apart. I had created chaos in the lives of my parents and siblings
who had all but given up, and allowed me to enter a state supported group home after
being discharged from Georgia Regional Hospital the second time at age thirty-four.
There was nothing more they could do.
Several residents of the group home became my friends, and were convinced I was an
addict. Was I addicted? I still don’t know, but it ceases to matter. What I do know is that I
do not want to return to the life I experienced before my second admission into Georgia
Regional. Whether I was actually an addict or not didn’t matter, twelve step programs
began the process that was to save my life, the process of hope. Today I regret that
twelve step programs often pressure people into labeling themselves as addicts or
alcoholics, which is totally unnecessary. All that is necessary is to listen to the stories of
others, and find your own story within them.
“I always quit jobs,” the sandy haired young man reported to the local Narcotics
Anonymous support group. “I start thinking I’m going to get fired, and stop going in. I’ve
never felt I did anything well and live in fear of being terminated every day. When the
fear gets to be too much, I just stop going in.”
“It was always the same for me,” shares a tall blonde female from the corner of the
room. “I’d panic every time the boss wanted to talk to me, assuming I was about to
get canned. Then one day, I left after lunch and did not return because my supervisor
had said she needed to talk to me.” She grinned ever so slightly. “Later I learned from
former coworkers she had planned to increase my hours. Boy did I blow that one. I’ve
been on my present job for ten months now, and many times I’ve thought I was going to
get fired, but I haven’t run away, and I’m still there.”
A small kernel of hope was born in me during that meeting. Maybe if I didn’t quit next
time I feared being terminated, I would discover I wasn’t really being fired at all. Maybe
it was only in my head. The truth was that I did not know because I had always quit to
avoid taking the risk of being fired. I didn’t know if I was an addict or not and actually
doubted it, but suddenly I wanted to be an addict, because if I was an addict my
addiction might be causing this all too familiar scenario. If only I could be an addict,
all I needed to do was do what these people told me to do. And if that were the case,
maybe I didn’t have to feel like a “loser” any more.
I committed to sobriety that day, not because I believed I was an addict, but because
I was experiencing hope that I could change, and in order to fit in with this group, I
had to stay sober. Twenty-eight years later, I have obtained a Master’s Degree and a
Certification within the field of addiction. I have served first as an addiction counselor,
then moved on to supervise and direct addiction programs, and finally to publish my
first novel. And it all began in a twelve step meeting with the emergence of hope.
Valerie Belew is the published author of Undercover: Our Secret Obsessions. Visit her
website at www.valeriebelewundercover.com
YOUR CHILD DIED FROM DRUGS? IT CAN HAPPEN TO ANYONE.
By Linda Sherman
America, look what’s going on! Thousands of teens and 20 something’s are dying
from the likes of illicit drugs like cocaine, heroin, crystal Meth, ecstasy, and dozens
of other drugs out there. Many of them also suffer from mental illnesses.
At the same time, there’s a steadily growing grassroots movement by parents
especially on the Internet, to memorialize their children and make the world aware
of the disease of drug addiction and mental illness.
Just Say No, a preventative education and anti-drug program that began 35-40
years ago in schools and communities, has not worked. We’ve viewed pot as a rite
of passage and see drug use glorified on TV. There is a deep disconnect between
the drug addicted mind, behavior and the mission of rehabs. It just doesn’t work.
Past strategies are not enough. We need to enter a deeper way of communicating
that convinces.
It could be medication or some new behavioral therapy we haven’t thought of yet.
Research into addiction tells us it’s not all in one’s head. Let’s encourage genetic
research and pressure our leaders to release money for that vital research.
When a young man or woman dies a soldier of war, they are called ‘heroes.’
But what does one call those sons and daughters who die of drugs?
There is a terrible stigma one faces when losing their child to drugs and I couldn’t
accept it. I was outraged being a parent of a child who died from drugs.
We all have different ways of dealing with our lost children. Some idolize their lost
prodigy in perpetual adoration. Some become activists, like Ginger Katz “Courage
to Speak” out of Connecticut; Maureen Morella, whose son is paralyzed, speaks
publicly in the New Jersey schools, and Sherry McGinnis from Florida, with her
collection of parents’ gut-wrenching stories of their lost children in I am your
Disease: The Many Faces of Addiction.
Some of us, like me, are just ripping mad and want to shout it from the rooftops.
I thought society had the stigma of looking down at self-medicating, clinically
depressed people. The stigma, I found out, was in me. I couldn’t accept it.
My poor son suffered Attention Deficit Disorder; Learning Disabilities; Obsessive
Compulsive Disorder, anxiety and depression with bipolar affect. He couldn’t
tolerate all these demons together. I didn’t understand the full scope and depth of
these problems. I didn’t realize they were so grave.
22
Despite this, our son managed to touch many lives while alive. A good friend tells
me his life was a success. We know he did the best he could with what he had.
He had a good family, a wonderful social life, and didn’t commit crimes. Like all
parents, we love our children dearly.
Our psychiatric world throws these buzz word conditions around so much that it is
hard to take them seriously. How can it be that so many children have ADD? But
these are grave conditions that affect mood, outlook and one’s ability to navigate
a naturally nebulous life. Any one of those mental disorders wreaks havoc, much
less having all of them together. Many of the young men and women, who suffer
from these conditions, turn to illicit drugs to self-medicate, and unfortunately
become addicts, and many will die. It just doesn’t seem fair that in these modern
times, the 3rd millennium that we still haven’t figured out drug addiction and
mental illness. They obviously go hand-in-hand and the ones who become
addicted, those whose brains are in lockdown and held hostage by the drug,
those whom scientists tell me, have brains tricked into believing their bodies need
the drugs like they need air and water remain lost.
USA Today recently gave a sterling endorsement of the National Alliance for
Research into Schizophrenia and Depression. 100% of the money they raise goes
into research for depression, mental disorders and substance abuse.
Mental illness and drug addiction is a double-edged sword. Some afflicted
persons commit suicide, some self-medicate, some wind up behind bars, and
some live quiet medicated lives out of desperation. With all due respects, there
are also some mentally ill people who, under a doctor’s care live normal lives with
the legitimately proper prescribed medication.
Unfortunately, mental illness and drug addiction often destroy the lives of those
afflicted and those who love them. Although intense research is going on all over
the world in universities and medical centers, we as a global community, can no
longer bury our heads in the sand. We need courage to face these maladies and to
understand what makes the brain “tick” so we can best help and support those who
suffer from the terrible disease of substance abuse, addiction and mental illness.
Linda is a freelance writer who lives on Long Island with her husband and looks to
the day when every addicted person recovers and chooses life over death.
23
Culture and Addiction
By Allen Berger, Ph.D.
In this article I want to discuss how our culture sets us up for becoming
an addict. Before I do it’s important to realize we are all in a trance. We
are hypnotized by our culture. This is not necessarily a bad thing; it just is
the way things are. It happens in every culture, it has to.
Culture is transmitted through the family. Parents teach their children a
world view. This world view is like a filter, it defines what is real and what
isn’t, it proscribes what is appropriate behavior and what isn’t; it dictates
how we should be and what we should feel. It defines what is and what
isn’t. It creates a socially constructed reality. The way this world view is
taught in any particular family is unique because it is also influenced by
the dynamics that shaped our parent’s in their childhood.
The first world view we must discuss is how our culture is excessively
focused on “having.” This focus emerges from the fact that our culture
is based on capitalism. Capitalism needs consumers. We are all
indoctrinated in the idea that more is better so we will want to buy a new
car, new clothes, the latest mobile phone or tablet. In fact Erich Fromm
observed that we internalize this attitude. We measure our personal
success by the quality and quantity of the material things we possess like
money, homes, cars, and adult toys. I’m sure you heard that quote, “He
who finishes with the most toys wins.” So this attitude can be summarized
as “I am more, the more I have.” We end up believing that our self-worth
is determined by what we have, rather than on who we are. We have lost
sight of the importance of character.
This obsession with “having” influences how we relate to our self and
others. We end up treating ourselves and others as objects. We become
obsessed with how marketable we are. Women are typically viewed
as sex objects and relate to themselves in this manner too. While men
are usually viewed as success objects and also relate to themselves
in this way too. A big problem in our society is that what makes a man
successful on his job makes it nearly impossible for him to have a warm
and loving intimate personal relationship. Any woman who treats herself
as a sex object cannot be intimate with someone because she is overly
concerned about her looks. This is part of the insanity. Our self-worth
becomes other validated. We become dependent on our environment to
make us feel good about ourselves. We never learn to validate ourselves.
This insanity also creates another problem. We become obsessed with
having more. More is better, isn’t it? This is the nonsense we learn in our
culture. And this is one of the ways our culture sets us up for addiction. I
remember the moment I realized that we are all taught that more is better.
It was one of those moments of clarity when I realized that this is at the
heart of addiction. Addiction is the experience of believing that more is
better. If one beer makes me feel good than more than one will make me
feel even better. If partying one night is great than partying every night
is better. Unfortunately this nonsense applies to nearly everything in our
lives. We are rarely satisfied with what we have or who we are.
We are obsessed with becoming something we are not. True self-esteem
is rare; we just don’t feel good enough as we are. Our idealized image
of who we should be is corrupted by our world view. We are driven to be
perfect. To fit into our idealized image of who we should be. It becomes
all about more, more and more and more. We spend millions of dollars
on the latest exercise equipment so we can become more attractive and
have a better body. (Unfortunately most of it is gathering dust underneath
our beds, closets or garages.) We pursue schemes to get rich so we can
have more money which in some magical way will make us feel more
secure. Women spend billions of dollars on plastic surgery to have the
“perfect body.” Men are also visiting the plastic surgeon more than ever
before. Men become workaholics because they are devoted to having a
successful career to have a better life. It’s all about having, not being. We
turn into humans, doing and performing, rather than humans, being (sic).
What a tragedy!
Another nonsense that is promoted in our culture is that life should be
easy and gratification instantaneous. We become obsessed with seeking
to find the easier, softer way, and then hope for instantaneous results.
We have lost the ability to wait, to have patience. Well life isn’t easy
and most worthwhile things don’t come easily. But nobody tells us that.
Instead we are bombarded with messages that tell us to take a magical
pill and your headache will immediately disappear. There is no need to
figure out a better way to handle your stress. If you are depressed take
an antidepressant it will make you feel better. No need to figure out what
you are doing that makes you depressed. We buy weight loss medication
from the infomercial on TV that promises to help us lose weight while we
24
sleep, so there is no need to spend hours in the gym. It’s easy.
If we turn to drugs they really work. I mean really work, instantaneously
we feel better. We are sexier, more fun, more comfortable, more relaxed,
and more spontaneous. We are free from fears and concerns. We are
free from the false-self that develops to fit into this insane culture. I had
a friend who stated that he didn’t know if he was born an alcoholic but
the moment he took his first drink he knew that an alcoholic was born. It
worked. It was easy. It set him free from all of this nonsense.
We are set up to become addicted. We become addicted to drugs
including alcohol, to sex, to gambling, to compulsive overeating or
restricting. We become addicted to spending money, buying new clothes,
finding a better boyfriend or girlfriend, wife or husband. We become
addicted to more.
I may sound paranoid but there is a cultural conspiracy that undermines
the development of our true, spiritual self. We are encouraged to abandon
our true-self and become an idealized self-riddled person with our
culture’s proscription of who we should be. We sell out but deep down
inside we know something is wrong.
The fact that is that we aren’t satisfied with all of this nonsense and how
we have let it shape us into someone we are not is good news. Maybe
this is what we really mean when we say we have a “dis-ease.” We are
dissatisfied with who we are and how we are living our life. Don’t run from
this pain. It means that something is “right” about you. Jung described
us as having a “spiritual thirst.” It is our spiritual self or our real-self
that is reaching out to us, to be actualized. It is like an alarm clock that
will continue to ring until we wake up. So it’s what is right about us that
doesn’t allow us to completely abandon ourselves to all of this nonsense.
Recovery helps us find our lost, true-self. It helps us reconnect with who
we really are. Recovery is about “being,” not “having.” It’s an incredible
journey that begins with shattering our false-self. This opens the door
to discovering our true spirit. Every spiritual discipline is concerned with
“being” not “having.” That’s why the 12 Steps work so well in helping
those who suffer from all different types of addictions. They facilitate a
spiritual experience based on a pedestal of hopelessness as Bill Wilson
noted.
In recovery we experience a 180 degree shift in our attitude and
perceptions; this is a remarkable personal transformation. Recovery
is paradoxical, which means that it is beyond belief. We shift from an
obsession with “having more” to a focus on “being,” and living a life
guided by spiritual principles. We become concerned with developing
character and integrity. This breaks the trance and cures our cultural
sickness. We, like Alice in Wonderland, come to realize that what is, isn’t,
and what isn’t, is. What an amazing journey.
Allen Berger, Ph.D is the Popular Recovery Author of 12 Stupid Things
that Mess up Recovery, 12 Smart Things to do When the Booze and
Drugs are Gone, and 12 Hidden Rewards of Making Amends.
Destinations to Recovery is a dual-diagnosis
residential rehabilitation and treatment
center for teens (13-18 years old) affected by
drug abuse and/or mental health disorders.
Our mission is to empower our residents to
control their future and to build an open and
healthy relationship with their families.
Call for a free insurance verification
Family & Growth
Individualized personal and
family therapy
Regular psychiatric evaluation,
maintenance and support
Group therapy
Experiential therapy
12 step integration
Pre and Post planning and
support
Academics
The Destination to Recovery
Aspire Education Program
WASC accredited curriculum
On-site
One-on-one support
Virtual classrooms
Credit repair
GED and College Prep
Life/Vocational Skills training
20851 Cheney Drive, Topanga, CA 90290 | Toll Free: 877.341.3225 | www.destinationstorecovery.com
25
Facing Down Co-Dependence: Five Steps to Emotional Freedom
By Barbara Altman
Life in the Altman family revolved around taking care of my father and
brother. Ever since my first exposure to my alcoholic father, I assumed the
roles of caretaker and lost child. I was the one who retreated into a corner,
fanatically obeying the family injunction to “keep our family issues within
the family.” Silence was golden. A closed mouth was honored and secrecy
reigned big time. Over the span of the next twenty three years I learned to
place my goals and dreams in second place. The first order of the day was
to make sure my father was happy.
Typically, I submerged myself in my father’s dysfunction. I was happy if he
was sober. Sadness engulfed me if he was drunk. And anger raged every
time he drank. Misery was the name of the game from Monday to Friday
since he drank each and every one of those nights for at least fifty years.
Even the weekends were spent in various stages of misery since he was
a dry drunk. He always said that weekends were his family time. I think his
priorities were backwards. Every father I knew spent every night with his
family. Mine did not. He preferred drinking and his tavern buddies to his
family. It was a real love triangle.
Dysfunction is not defined by caretaking issues. We all have times when
taking care of someone is a part of life. Parents take care of their children;
Adults care for their parents; and communities meet the needs of citizens.
It becomes problematic when we deny our priorities in an effort to care
for someone else. Typically, children and spouses of alcoholics lose
themselves to the well-being of the addict. This can impact families in
several ways including:
• Failure to realize and develop one’s talents and innate gifts
• Failure to satisfy your emotional needs
• Failure to plan financially
• Failure to develop intellectually
• Experiencing developmental delay
Let’s take a look five ways to face down co-dependence.
• Learn to build your life around your special gifts and strengths.
Dr. Martin Seligman, renowned expert in positive psychology, has
a program called Strength Builders. Google his name for more
information. When you live in line with your talents, you develop
a sense of autonomy that remains independent of the alcoholic’s
dysfunction and illness.
• Look inward and ask yourself what you need to find happiness and
fulfillment. Then proceed to meet those needs yourself. Children of
alcoholics often need to parent themselves and fill in the emotional
blanks.
• Learn what your financial needs are and make plans to meet them.
Depression and anxiety can interfere with both educational and career
choices. Look into mental health and community resources that can
support you in these critical areas.
• Find out what you need to do to develop and sustain your mind. Beyond
career education, there are plenty of opportunities out there to further
your education.
• Recognize stages of life and plan accordingly. I would like to relate a
story in my life that points to this challenge.
I was twenty eight years old when I finally learned to drive. Stuck in the
teenage need to separate myself from my family, I failed to take the
steps needed to do this. The anxiety and accompanied depression kept
me in a state of dependence. I was absolutely terrified to drive. I also
told myself that if my father had to pick me up from work, he would not
be out drinking. How co-dependent was that! I sacrificed my self-esteem
to the urge to keep him out of the taverns.
Dear Readers: I’m open to other ideas on facing down codependence. Feel
free to go to my website and make comments. This article will be on there
as a blog post.
Barbara Altman is the author of “Recovering from Depression, Anxiety, and
Psychosis: My Journey through Mental Illness” originally published in 2011
under the title “Cry Depression”. This is available on Amazon.
www.Depressiontorecovery.com
The 30 Day Myth - Shouldn’t Rehab Only Take 30 Days?
A Drug Education Article by Suncoast Rehab Center
There is an idea in society that drug rehabilitation should only take 30
days. This idea says that, after only 30 days of withdrawal and treatment,
the individual should be clean and sober for the rest of his or her life –
and if they don’t remain sober, there is something wrong with that person.
This “30 day” standard of treatment is not workable for many
people. According to the National Institute on Drug Abuse (NIDA),
in these shorter rehab programs 40-60% of people return to drugs
and alcohol. This is because the amount of time withdrawal and
rehabilitation takes is actually individual, it can’t be penned into a
cookie-cutter 30 day program.
You might be very surprised to learn that the idea of a 28-30 day
course of treatment has no medical or scientific basis. These timelimited programs were originally created to accommodate very specific
circumstances – those of the US Air Force. The amount of time a
person serving in the US Air Force could be away from duty without
having to be reassigned was 28-30 days. This is how the “30 day”
treatment program was born.
However, it is rather catchy and it seems convenient. An office or job can
agree that an employee leaving for a set 30 days does not seem as bad
as a longer, less definite time period. It may seem hard for a family to
face the absence of a loved one for longer than 30 days. Plus, 30 days
seems like quite a long time all by itself.
Withdrawal and recovery periods can vary, depending on the drug,
how much has been used, and for how long. Most physical withdrawal
symptoms stop after a week or so for many individuals. This is separate
to the action of rehabilitation. This is simply stopping the ongoing
onslaught of harmful drugs which are poisoning the person’s body.
Not only does an individual need to stop feeling the physical effects
of the drugs, they need to overcome the mental effects, they need to
rebuild their health, and they need to discover the underlying reason
they began taking drugs. After they have achieved this, they need to
work out how to go on living without drugs or alcohol. This time of self-
26
discovery and rebuilding does not have a time limit upon it. It is different
for every person.
Evidence-based methodology and procedures are being practiced and
supported more and more in the field of drug addiction services, but the
temptation to try a “quick fix” is always there. In fact, we are coached as
a society to pursue the fast solution, the pill that will resolve it all. This is
why such unworkable ideas as the “30 day rehabilitation program” spring
up and stick.
When dealing with drug and alcohol addiction, faster isn’t better. One
needs time to carry out a complete step by step treatment to get to the
desired end result—kicking the habit for good.
At Suncoast Rehabilitation Center we give a person exactly that—a
long-term program that helps the individual handle the damage done
to the body through drug and alcohol abuse. We utilize exercises and
counseling which work to help a person discover and handle the root of
their drug addiction.
It takes longer than 30 days for a body to heal and build back the lost
vitamins and minerals from the depletion and deficiencies caused by
drug use. So, our first focus is on just that: building the body back up
and making the person physically strong. Then we move on to the mental
and emotional, therapeutic part of the program. We use this powerful
combination to help a person overcome their addiction; a detoxification
of the body, which removes the remnants of drugs in the system to keep
cravings from causing a constant battle, along with cognitive therapy and
counseling to help a person get back in control of their life again.
And there is nothing more rewarding than seeing a person who is now
drug-free and eager to live their new life. For more information on our full
service rehabilitation program, contact us at (866) 572-1788.
27
From Dark to Light: My Journey to Recovery
By Ronnie Steele
I was born and raised in New Haven, CT with my sister and mother. My
father was removed from the picture as a direct result of his alcoholism
and I have no recollection of him as a young child. My mother worked
very hard; two to three jobs at a time, but she still struggled financially.
We lived in a ramshackle of a house which was nicknamed “the shack”
by the neighborhood kids. I was scrawny with large brown-framed
glasses and was bullied in and out of school on a daily basis.
The years of daily bullying led to anxiety and depression at a very
young age. I’d play sick quite often from school just to get a break from
the abuse. When alone in my room, I’d often break down and cry. There
seemed to always be a void that I was trying to fill in my life. I’m unsure,
even now, if it was the void of not having a father or maybe something
totally different. All I knew was that there was a hole in my soul that
needed to be filled and I was on a mission to do just that.
Alcoholism and drug abuse was prevalent within my family and as I
grew older I knew that using and drinking was definitely not a path
that I should follow. I entered high school and although I ditched the
glasses and wiry frame of a body, I still felt as if I did not belong.
Something was still missing. By age fifteen I had turned down drugs
and alcohol on more than one occasion but by my junior year I
succumbed to my peers and lit up a joint for the first time. I enjoyed
the high but it wasn’t until I took my first sip of alcohol at age sixteen
that I felt my life was finally complete.
It was a moment that I will never forget. When that cold beer began to
cloud my brain I felt as if alcohol was the void that was missing in my
life all along. My shyness and lack of self-confidence quickly retreated
into a different section of my mind and I became social and confident.
I guzzled down about eight beers and took a few swigs from a whiskey
bottle and eventually found myself in a blackout on the floor of the
bathroom amongst puddles of vomit.
My heavy drinking continued when alcohol was present but at age 17
it was hard for my friends and I to score booze on a consistent basis.
Scoring bags of weed was much easier and smoking pot became a
nightly routine throughout my senior year of high school. I really didn’t
get into much trouble smoking pot although it did affect my grades
at school and I spent the latter half of my senior year unsure if I was
going to graduate.
It was at my senior prom where my life took a downward spiral into
the harrowing depths of drug and alcohol addiction. My friends scored
some Xanax, a benzodiazepine, and I was hooked immediately. As
much as I loved booze, I loved these little blue pills even more. In true
addict fashion, I took too many and drank too much that night -- and
made a complete fool out of myself at the prom nearly passing out in
my dinner plate.
From that night on Xanax became my drug of choice. Scoring the drugs
was easy as I had a friend who worked as a pharmacist tech and she
would steal bottles of pills for me to sell and in return I’d get to keep a
fair share for myself. After graduating, I was high all of the time when I
wasn’t working. My mother was catching on to my drug and alcohol use
by now and it wasn’t long before she began daily threats of kicking me
out of the house.
My using and drinking continued to escalate and I had a near fatal
overdose at just twenty years old. My mother and sister walked into
the house and found me lying face down in a pool of vomit, blood, and
urine. If they hadn’t found me -- I’m sure that I wouldn’t be alive today.
The overdose and multiple near overdoses thereafter had no affect on
my drug and alcohol consumption. In fact, I didn’t slow down at all and I
eventually moved on to even harder drugs such as MDMA and ecstasy.
I’d get high all weekend and disappear for days on end without a care in
the world.
Slowly, some of my family and close friends began to distance
themselves from me. When high, I was happy and affectionate. When
not high, my mood swings were terrible. I’d have fits of rage and
anger which showed by the holes in almost every door in my house.
Relationships would never last as I’d usually be pressured into an
ultimatum - Drugs or girlfriend - with the drugs always prevailing. I was
consumed by my addiction and nothing else truly mattered…. As long as
I was getting high.
28
My life continued this way for several more years. Eventually, I was
kicked out of my mom’s house. I was losing friends, family, jobs,
relationships, and for what? A simple high? I knew that I had a problem
with drugs and alcohol; I just did not know how to stop. Cocaine and
painkillers eventually crawled into my life and I think it was safe to say
that I was, at the time, a “garbage-head.” I would crush up and snort (or
smoke) any pill that you’d put in front of me. I was drinking a bottle of
vodka each night before bed, wallowing in my sorrows. The depression
and self-loathing eventually led to self-hatred and sadly, self-mutilation.
I became a cutter when really high or drunk. I’m unsure if it was due to
the guilt, shame, and self-hatred - or drugging myself to the point where
I was so numb that I wanted to see if I could still feel pain. Through
this destructive path I found myself in mental institutions and hospitals
on a regular basis. I was 22 years old when I finally found myself so
spiritually bankrupt, so burdened with shame, that I had to do something
in order to change my life. I entered rehab in beautiful Delray Beach,
Florida in May of 2007. I ended up completing the program and lived in
a sober house for some months after. That program helped me discover
the roots of my addictions and I was able to understand myself more
than ever. I was a very sick person who needed to get better.
Being clean and sober for the first time in years was an amazing feeling.
I looked at the world in a different light and appreciated things and
people so much more. I quickly latched onto a sponsor and went to
meetings just about every day. It was my “second chance at life” as
my mom called it. Everything in my life seemed to fall into place after
putting down the drink and drugs. Family members were coming back
into my life to support me and I had a relationship with a beautiful,
supportive girl that was going great. I eventually moved back to CT and
was even able to get my old job back.
My first daughter was born early in my sobriety and it was the single
greatest moment in my life. Unfortunately, being a father wasn’t as easy
as I’d thought it would be and I found myself leaving out my recovery as
a top priority. I even considered myself “recovered” from addiction after
only 16 months of sobriety. I went through the steps, had a sponsor,
and went to a crazy amount of meetings that I thought, I didn’t need
anymore. I was miraculously better! The combination of not going to
meetings, a stressful job, and a colicky baby was troubling my recovery
and I hadn’t a clue.
When you ask someone why they relapsed, what seems to be the most
common answer? They will tell you, they stopped going to meetings! I
eventually relapsed, went back into treatment, and by the grace of God
have been clean and sober ever since. I look back at it now and I feel
that the relapse needed to happen in order to help me get better. No
longer do I have reservations in my head that I can drink or use in a safe
manner. I know that I simply cannot do that. I know that I will have this
disease for the rest of my life. I’m a sick person and the AA meetings,
fellowship, and 12 steps are the medicine to help me get better. I have
two beautiful daughters who help motivate me to stay on the right path
and a wife who is the most supportive, loving, and caring person that I
could ask for.
It has been four and a half years since my last drink or drug and I thank
God every single day. I’m grateful for the path that has been laid out in
front of me and humbled by the trials and tribulations that I have been
lucky enough to overcome. I do not hold resentments against anyone
because all that does is slow my recovery down. How can you get better
when you have hate in your heart? You simply cannot grow in that way
and I know that whatever happens whether it be good or bad, a drink or
a drug is not the answer.
Ronnie Steele is a non-fiction writer born and raised in New Haven, CT.
He is the author of My Own Worst Enemy: A Memoir of Addiction and
the newly released Kindle eBook Misunderstood. His writing style is
raw and honest. Ronnie’s journey to recovery has been no easy feat as
described in his writings and his motivational tales prove that recovery
is possible no matter how low addiction can take a person.
29
Clarifying Codependency:
Finding a New Language for an old term From 1978 to 2013
By Ann W Smith MS, LMFT
learning to manage our own responses to them. Relationships need attention and cannot wait while we mend ourselves alone.
of the behavior that looks irrational or crazy, we begin to have compassion
and love for ourselves and those we care about.
Trying to find human love in our hearts and kindness in our words and actions does a great deal to heal deep wounds. It also improves feelings of self
worth. I was once given the advice to “Be the person you want others to be.”
Begin with monitoring your own actions rather than expecting miracles from
others. They may follow, they may not. Either way you win if you begin to
love yourself.
With sensitive and affirming language we are able to view our experiences
and choices as logical given the conditions we were in. We did the only thing
we knew to be possible to maintain our attachments and prevent a separation we could not bear. It is time to forgive your mistakes and with one foot in
front of the other, do better today.
Many individuals, couples and families find needed solutions by adding professional counseling to their recovery plan. With a skilled counselor you may
be able to shorten the process and lessen the pain.
In summary, what I once called codependency is actually human beings
doing what comes naturally - loving. When we need love and connection
and believe that our loved ones are pulling away or leaving us, we panic and
jump into our fear-fueled attachment pattern. Yes, this can become a serious
lifelong problem if it continues without help. Once we see that our pattern is
no longer effective in helping our loved ones we can let go and use support
to set healthy limits and care for ourselves One Day at a Time.
Since guilt, shame and fear are a major part of the pain we feel during a
relationship crisis, we need to be conscious of the impact of the words we
speak to others and to ourselves. When we realize that love is behind much
ANN W. SMITH MS, LMFT Executive Director, Breakthrough at Caron
Ann Smith designed and directs a weekly 5 day residential personal growth
workshop near Reading, Pennsylvania for adults who are seeking a better
quality of life. In 2011, the Innovative Breakthrough program was featured in
a one hour program on Dateline NBC.
She has a Master’s degree in Rehabilitation Counseling and is licensed as
both a Professional Counselor and a Marriage and Family Therapist. She is the author of three books titled Overcoming Perfectionism: Finding
the Key to Balance and Self Acceptance, Overcoming Perfectionism:
the Key to a Balanced Recovery and Grandchildren of Alcoholics:
Another Generation of Co-dependency (available as an e-book). Her blog
“Healthy Connections”, currently active on Psychology Today’s website is
frequently listed as an “essential read” with over 250,000 views to date.
By KJ Foster, MPS
Gifted from the very start
On stage your star burned bright
Guided by an inner light
Your future seemed certain delight
Then darkness came to call and took away it all
Spiraling down a hole your addiction took control
Body, mind and soul
I can’t live in the why, the what or the who
It doesn’t help me and it doesn’t help you
There’s nothing I can do
It’s all up to you
The more that I try
I assist you to die
I love you so
I want you to know
I’d lay down my life
To make it alright
To see you get well
Not living this hell
I can’t stop crying thinking of you dying
This pain in my heart is tearing me apart
What have I done to my beautiful son?
Feels like only yesterday your life had just begun
September 18, 2009
Both of us cried and he agreed that he didn’t want to live this way and
wanted to go to detox, but he wasn’t quite ready just yet. He had a friend
who owed him five dollars and he wanted to go collect his debt. I knew what
this meant; he wanted to go use one last time. I begged him not to go and to
come with me to detox. He assured me that he would call me the next day.
Somehow I knew he wasn’t going to call me the next day but I also realized
I was powerless over doing anything to make him come with me at that
moment. I also knew it wouldn’t do much good until he actually wanted to
stop. I, of myself, was powerless. As he walked off that day, I was strangely
at peace and no longer consumed by my fear. Hoping and praying that he
would call me at some point, I filed the necessary Marchman Act paperwork
with the courts and waited. It was four days later, a Wednesday, when he
called me late in the afternoon and said he was ready. Could I come get
him? He was finally ready to go to detox. I took him to DAF which did not
have any available beds so he wound up detoxing on our couch at home. As
soon as he was feeling well enough he began attending meetings again, got
a sponsor and got a job… all within the 10 days it took to get a court date.
My son showed up for the hearing with his sponsor by his side and a job,
30
pleading with the Magistrate who was overseeing the case to please not
send him to treatment. I have to say I found it pretty impressive, as did the
Magistrate. It was hard to tell him, with sponsor by his side and job in hand,
that he needed to go to treatment. So the Magistrate did the next best thing
and told him she wanted to see him again in three months to check his
progress. She told him she wanted his sponsor to come back and tell her
that he was still doing well and still working and she also wanted me to come
back and report on his progress. The Magistrate did this for 18 months!! For
the first year my son had to appear every three months and then after a year
she asked him to come back in six months. At eighteen months she finally
cut him loose and he has been clean and sober ever since, being restored to
the smart, creative, kind and loving soul he once was. I am forever grateful
to this wonderful woman and all the others who have helped me and my son
along the way.
At four years of sobriety I decided I wanted to do more than just give back
through sponsorship of other alcoholics. Having experienced the healing
effects and the transformation of my life and that of my son’s through
sobriety and the program of recovery, I decided to finally make use of my
Master’s degree in Mental Health Counseling and leave the corporate world
behind to embark on a career helping families suffering from the effects
of addiction. I am currently a registered licensed mental health counselor
intern working for a local treatment center and specializing in addiction as a
family disease and its effects on the family system. I meet families each and
every week who know little about alcoholism as a disease and are especially
unaware of how their attempts to help their loved one is actually hurting
them… typically, by protecting them from experiencing their consequences
and thereby feeling the full impact of their behavior. I encourage all family
members of our clients to attend Al-Anon, Nar Anon, Fam Anon and/or
Alateen. It is now my job to “slap’em in the face while I pat’em on the back.”
As odd as it may seem and as uncomfortable as this may sound, there is
nothing more satisfying when I get to see a family recover from this horrible
disease. There are far too many who are not so fortunate. I am blessed and
grateful to get to do what I do every day.
KJ Foster is a therapist at the Beachcomber Family Center for Alcoholism
and Addiction Recovery in Delray Beach, Florida. She graduated from
New York Institute of Technology with a Masters of Professional Studies
in Human Relations. KJ started writing poetry as a way of processing her
emotions and ultimately coming to terms with her addiction and that of
her son. KJ is passionate about helping other addicts, their families, and
the recovery process which she credits for transforming her life. www.
beachcomberoutpatient.com www.thebeachcomber.cc
South Florida’s premiere and comprehensive Outpatient Treatment
Together, we can recover!
Not a crash course on the 12-steps
We treat underlying core issues
Alcoholism
Drug Addiction
Trauma
Abuse
Co-Dependency
Sex & Love Addiction
Call Today!
877.659.4555
www.soberlivingoutpatient.com
31
P.O. Box 880175
Boca Raton, Florida 33488-0175
www.thesoberworld.com
The contents of this book may not be reproduced either in whole or in part without consent of publisher. Every effort has been made to include accurate data, however the publisher cannot be held liable for material content
or errors. This publication offers Therapeutic Services, Drug & Alcohol Rehabilitative services, and other related support systems. You should not rely on the information as a substitute for, nor does it replace professional
medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional. Do not disregard, avoid or delay obtaining
medical or health related advice from your health care professional because of something you may have read in this publication. The Sober World LLC and its publisher do not recommend nor endorse any advertisers in
this magazine and accepts no responsibility for services advertised herein. Content published herein is submitted by advertisers with the sole purpose to aid and educate families that are faced with drug/alcohol and other
addiction issues and to help families make informed decisions about preserving quality of life.
32

Facing down co-dependence: five steps to

Transcription

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