Showing posts with label 12 Steps. Show all posts
Showing posts with label 12 Steps. Show all posts

Tuesday, April 10, 2012

Death and dying...

I found out yesterday that one of my patients died on Easter Sunday by a drug overdose. It's never easy when someone you know dies, but it seems so much worse when that person was in your care and you could have virtually predicted his death.

This 30 year old man came for his third treatment episode last month. He was well-known within the institution where I work because he had been treated a few times there and had always come back following another of his frequent relapses. When I first saw him I felt strongly that this was going to be a tough case. He was a gentle and kind man without bitterness toward anyone, who always seemed to have something good to say about his relationship with you. Yet, deep down, there were signs of trouble and my antennae were vibrating the first day I saw him.

He had little trouble grasping the intellectual parts of a program of recovery. He knew he was biologically addicted to heroin and benzodiazepines, and he knew he was going to go through a range of physical withdrawal symptoms in the early part of his recovery. He also believed in the 12 Step program, but there was a tragic flaw in this belief system: He felt strongly that the 12 Step program works to help some people stay clean and sober, but somehow it would never work for him. And, he had a sadness about him due to this despair. On the last day we met for a private session on March 30 we worked hard for more than an hour to identify the sources of this negative belief system where he told himself he could never get well. We labored over his thoughts and beliefs about the events that happened in his life. We challenged those false beliefs with the truth. We identified that he felt sad and hopeless when he would cling to ideas about how he might never get clean and sober, and, while he wanted to remove these negative feelings from his life, he could not feel a change in his emotions for the better when he thought about changing these negative beliefs. In other words, he had a belief that no matter what he said or did, nothing would get better.

He also proved to himself that he was an excitement junkie...he loved the thrill of the chase to get his drugs and he loved the pleasure his heroin gave him. He even admitted to me that he loved the idea that this might someday kill him...there was an exhilaration that he felt every time he thought about using. No matter how hard we tried that day, he could not remove this from his mind or see a way to neutralize the tremendously damaging effects of such thinking.

At that moment, I knew he was in deep trouble. I asked him to review his anti-depression medications with his psychiatrist and he said he would. I asked him to surround himself with positive recovering people who had been where he was and turned themselves around. He said he would. And, I asked him to talk about this to anyone he knew who might help him shed the weight of this negative, self-destructive thought. He said he would.

He didn't do any of those things after leaving me that day. Instead, a few days later, he started to use again and he overdosed on Easter Sunday morning at his home.

I resist the temptation to think of what more I could have done to help him. I understand that there is only so much another person can do when you are confronted with the disease as strongly as he presented. But...I know what I felt that day when he left my office and, as unreasonable as it sounds, I wanted to hold him there that day, arrange for him to go back into primary treatment, and protect him from himself by wrapping my arms around him and assuring him it was going to be OK. I wanted to jump up and down and tell him that this negative thinking was only going to end one, bad way. And, because a man's life was at stake and I did not do any of that, I am left with regret, remorse, and anger.

Of course, over the span of 24 years as a counselor, it is not the first time one of my patients has died while in my care. I know this will all pass as I focus on the future and the people still in my care who may be at just as much risk for dying of the disease of addiction. But, it doesn't get any easier each time it happens. I immediately think of Chris, Wendell, Becky, Rose, Bob, and, most of all, Kristine whenever this happens.

I have also become a lot more rigid in my thinking about how to treat this illness. I vow to react more aggressively toward the obvious signs of relapse, and to not allow a person to lull me into believing that extreme sadness and hopelessness will somehow work itself out. And, I plan to do more meditating and praying for guidance in how to deal with this kind of case.

So long as I follow that way, I have nothing to fear.

Roger W.

Wednesday, January 18, 2012

The Program in a Nutshell...

One of my duties as a counselor is to conduct group therapy sessions for newly recovering addicts and alcoholics twice a week. During the first half of a three-hour session, I teach about the 12 Step programs. I am continuously amazed at how difficult this is to do for a number of reasons.

Foremost in amazement is the fact that few of the 20-24 people in attendance each night want to hear anything about the steps of recovery. The sit, blank-faced and bored as I talk about how it is that the steps of recovery can so completely change a person that there is no longer any reason to drink or take drugs. There are usually few questions and virtually nobody initiates their own experience with the steps. In many respects, this part of the work is a tremendous challenge for teaching.

I've tried many different methods of teaching the steps over the years with little change in the results. I've even abandoned the process of trying to teach about them with the hope that people will naturally seek out information about whatever system might be out there to help them overcome the cravings and urges to use drugs. That didn't work either. If one adopts the idea that "When the student is ready, the teacher will arrive," then it's pretty clear to me that I ought not teach about these steps to recovery because the vast bulk of newly recovering people are not ready.

But, there's the rub: There are usually a few in every group who are ready. It is for them that I teach about the steps they can take to emerge from the darkness of addiction. And here's why.

The 12 steps are a program of recovery for people that is analogous to a recipe. It is a method that, step by step, will transform a person from one dependent on drugs of any kind (and this includes the drug alcohol) to one who does not use drugs and lives a happy and productive life. It accomplishes this by outlining the way to make that kind of sweeping change. Here's the abridged form of the steps of recovery...

  • In steps 1-3 we are given a gift of the ability to look at ourselves very carefully and come to believe there is hope for recovery
  • In steps 4-9 we are given the chance to repair the damage that our lives of chemical abuse has caused, and
  • In steps 10-12, we are given a chance to live a new life as people who do not use drugs of any kind and live life on life's terms.
The confounding thing for most of us who no longer use drugs is that many people who do use - and, who also have some remarkable negative consequences as a result of being addicted - do not see the wisdom in making changes in their lives. No, they seem to prefer to suffer. We call this denial, but it seems so much more profound than simply lying to themselves. It's really turning away from the grace that has been bestowed upon us through either God or the serendipity of life simply unfolding. For some inexplicable reason that makes this disease the most challenging of its kind, manu addicted people don't see the need to use this recipe for success in living a healthy, happy and productive life.

I guess that's where people like me come in. Our job seems to be to persevere through the denial, the indifference and the outright loathing most newly recovering people have for the steps of recovery. Our job is to try to make sense for these people that the suffering can end and that through the exercise of a few simple principles these steps are based upon they can change the direction of a damaged life.

All the best, Roger W.

Tuesday, April 27, 2010

Relationships are the key...

Studies show that if a recovering addict does absolutely nothing after s/he has been to treatment, no meetings, no spsonsor, no step work, no spiritual practice, no involvement with others in a healthy way, etc., then the chances of them staying clean for a year after treatment are very poor. We are talking about 2-3% of the group will stay clean and sober. That is a very, very small percentage of people of get well after treatment. This is cause for concern.

The same studies show that if a recovering person does one simple thing after treatment, their chances of recovery at the one year mark go up dramatically: About half of the people finishing a treatment program will stay clean and sober for a year or more. That one thing is to make a bond with at least one other person whom you know well, and knows you, and wants to help you in your recovery. Simple and easy to understand. But, for some remarkable reason, few addicts and alcoholics take this step.

Now, among the many things that makes the 12 Step program a product of the genius of Bill W. and Dr. Bob, the one thing that fits well with these modern concepts is their insistence on a recovering person having a sponsor. Sponsors are people who know you, and you know them, and they want to help you with your recovery. Sponsorship is the very thing that can improve the chances of staying clean and sober from 3 people out of a hundred to 50 people out of a hundred. I don't know about anyone else, but I would rather be among the group of 50 than the group of 3.

Sponsorship is all about relationship. Addicts and alcoholics are notorious for having poor relationships. After all, a career of drinking and drugging needs lying, deceit, manipulation, self-centeredness, and grandiosity as tools to get what the addict or alcoholic wants...the ability to use and protect the supply. Add to these overt behaviors the fact that most addicts and alcoholics have very poor boundaries, co-occurring mental health issues, and personal histories that are usually full of abuse and neglect and it is easy to see why building relationships is so hard to do. In fact it is generally true that the only real relationships addicts and alcoholics have are built on resentments - anger about some event from the past - that keeps a person tethered to another person based on the sickness of dislike and sometimes hatred of the other.

This condition cannot hold if a person is to live life happy, joyous and free. We must reach out to others and make healthy bonds with them that are fostered either through the needs of recovery or the desire to help another person. We need to go up to someone at a meeting and tell them how much we admire what they have shared in the meeting, asking them to be our temporary sponsor so a connection can be forged. And, we need to let go of the past so we can rejoin with our families and friends who have long supported us, even when we did not know they truly cared about our lives.

To be part of the larger percentage of people who make it past a year clean and sober, we are going to need to constantly reach beyond our comfort zone and find someone to bond with. Doing that is like vaccinating someone against the horrors of relapse. Such relationships made a big difference in my early recovery and continue to fortify me today.

All the best, Roger W.

Thursday, April 1, 2010

New ideas...

The are some who say that the recovering person really has no need for new ideas, and that he or she gets along best with the same, old, recognized ideas they have already. For me, this could not be further from the truth.

Recovery depends on stretching beyond the known realm of my presentation to the world into the relatively unknown realm of emotions. This is really not a new idea even though some say that the notion of peeling back the outer shell of our defenses is a radical idea. Oh, many give lip service the the concept of disclosing feelings, but most people are content to live with the idea that he or she does not have to reach out to others for help, not bond with people who suffer the same problems as they do, and survive with their old defenses. For them, it is a dramatically new idea that recovery depends on emotional unity with others.

I was thinking about this the other day when it suddenly struck me how I have isolated many of my emotions in recovery. I spoke earlier in this journal of how fellowship is an imporant part of 12 Step recovery, but I fear that I have held back and not joined emotionally with my brothers and sisters in recovery as much as I should. In other words, I have not peeled back the outer shell enough for most others to see and experience. I have not expressed many different emotions to people except those that I give myself permission to express such as superficial anger or happiness. I have withheld them because I have the mistaken, old, recognized idea that people will not understand my deeper emotions or even care that I have them. There is also the lingering fear of humilitation, of having people say, "See...he's not as healthy as he appears", or "You can't go to him for guidance...he's as messed up as I am." These old ideas keep me sick and set up unnecessary pressures inside of me.

The new idea that Bill W. and Dr. Bob brought to the world of addiction was that we cannot recover alone. They proved that we need other addicts and alcoholics to help us through the problems of everyday life that are relapse warning signs, triggers or high risk situations that threaten our recovery. This is a new idea I have come to accept - on the surface - but, I sometimes don't find myself digging deeper to dislodge those critical emotions with other addicts such as loneliness, fear, dread, worry or confusion. I think this is what Bill and Bob were actually saying: We must get absolutely real with our friends in recovery and risk telling them exactly what is on our minds and in our hearts. Sharing this may not be comfortable, but it is necessary to ensure that these negative emotions lying beneath the surface of my life get expressed so I can strengthen my bonds with other addicts in recovery.

Therefore, I plan to do that very thing tonight when I speak at a meeting inside a local jail where those of us on the Narcotics Anonymous Hospitals & Institutions committee carry the message of recovery to men who cannot get out to regular NA meetings. I plan to get real with my emotions and tell them how numb I can sometimes feel, or how lonely it can be as a single person in this world, or how complacent I can become. I expect that more than one of them can relate to these feelings and, thereby, we can form a bond that is strong, enduring and precious. I know that as long as I follow the new ideas laid out for me by the principles of the NA program, I have nothing to fear.

All the best, Roger W.

Tuesday, March 9, 2010

Power...

I am continually impressed by the power of the disease of addiction. Each day I am confronted by the power that the disease holds over people who otherwise are lovable, personable and well-intentioned. Instead, they become unendearing, disagreeable, mean-spirited people who are driven to satisfy self ends. I'm certain the someone would get the Nobel Prize if they could pin down why this happens for certain, but there are clues.

Using drugs changes the way the brain works because addiction is a brain disease. In effect, drug users' brains are broken. Addled by the drugs (to paraphrase Eugene O'Neill), people are saddled with the effects. The brain becomes confused: It thinks that the enormous pleasure and relief that comes from the drug is the normal process for its functioning and it becomes used to them in the system. Some drugs create their own demand in the nerve cells and alter them to fit the way the drug wants the cell to behave. All drugs create a condition in which tolerance and withdrawal become a chief characteristic of the nerve's functioning. To be able to change nerve cells - and ultimately the way the brain functions - shows the substances have enormous power. Moreover, this power compromises one of mankind's greatest assets, willpower, and the person is most often left with no capacity to repair this broken system on their own.

Thus, the second stage of the drug's power kicks in even when the person is technically not using any drugs. When abstinent, the nerve cells throb for attention and demand the drugs they had become so accustomed to feed on. When not there, the nerves goes crazy, and this is what we call the cravings and urges to use that overcome many people. Relapsing, bringing drugs back into the broken nerve cells, is often the only thing that can quell the screaming tantrum that nerve cells exhibit when deprived of their drug. Willpower is immobilized, frozen into a state of panic, and it's only value to the relapsing addict or alcoholic is to find a way to get more and use drugs. This is the reason that other people often see the signs and symptoms of relapse much earlier than when the person is often using and we have called this stage the "dry drunk sundrome".

How to restore power to willpower is the chief motive for drug treatment. To fix a broken brain requires the infusion of the food upon which willpower derives its energy...principles, ideas, morals, values, and meaning in life. Absent these things we have a situation about which we discussed earlier when we talked about having meaning in life that Viktor Frankl spoke about (see posting February 27, 2010). The parts of the brain that deal with meaning in life had been hijacked by the drugs and now must be restored to their rightful place as the governing forces of the brain's activity. In other words, willpower must be given the power to act in the addict's best interest which is to thrive, prosper and ultimately to live.

Those of us who believe in the 12 Steps of recovery feel strongly that this power can come from working through the steps. One gets power restored to their brains that can overcome the cravings and urges to use. Yes, it happens every day to milions of recovering people that their willpower to live can override the willpower to use. This ability is restored particularly through the process of Step Two whereby a person gets an infusion of spirituality necessary to have a meaningful life. When principles, morals, values and meaningfulness come back into a person's life, they become lovable, personable and well-intentioned. Their brains become whole again and their addiction is arrested so that it can no longer run and ruin the person's life.

That capacity means power can be restored and the power of the addiction can be rendered impotent. And, that is quite a miracle to watch everyday for which I am very grateful.

All the best, Roger W.

Saturday, March 6, 2010

Addiction treatment referral service...

I'm usually not one to attempt to dramatize the effects of drinking or using drugs on the average person. I believe strongly in Step One of the 12 Step programs that says we must admit to ourselves that we are powerless over the drug and that our life is unmanageable before much progress can be made in lifelong recovery. So, ordinarily, I will let them decide for themselves whether or not their drinking or drug use is causing them serious enough problems for them to stop using. Everyone hits their own bottom when it comes to drug use or alcoholism.

But, there is a way to intervene into someone's life and help them come to that realization sooner rather than later. In recovery we call that raising the bottom for someone so they do not have to fall as far as they could. Such is the spirit behind a video I caught recently published by the National Drug and Alcohol Treatment Referral Routing Service which is a central telephone system that will connect people to treatment services in their area or throughout the United States. The video is designed to help someone detect if they - or someone they know or love - has a drinking problem. Some parts of it are a bit corny and over the top, but the spirit is good and worthwhile watching...

Alcoholism is a preventable disease of the brain. Just because someone can't see straight when they are "blind drunk", or walk straight when they are "tipsy" does not mean it is an eye disease or a leg disease. It's a brain disease. Millions of Americans have this disease and, were it any other disease known to mankind, there would be outrage at the number of people who suffer from it. Efforts to help people detect the signs and symptoms of the disease ought to be applauded.

If you or someone you know has this brain disease, call the National Drug and Alcohol Treatment Referral Routing Service at 800-662-4357. When I called the other day to do a test run of the phone number for this blog, I found a friendly young man at the service who directed me to two treatment programs in my city. It doesn't get any simpler than that.

Tuesday, December 8, 2009

Ramblings of the Mind...Buddhism

How quickly the time passes! I've heard from a number of friends who have seen The Happy Hour and they've passed along some wonderful good wishes for the site. Hopefully they will join in with the fun of sharing in some cyber-fellowship about recovery.

I'd like to add some Ramblings of My Mind from time to time as short ways to communicate some ideas about recovery, review a book, share thoughts and feelings, or just ramble on.

I can start things off by telling you about a book I just finished reading. As most of you know, I'm in a Ph.D. program in Psychology at Capella University, and I'm doing some advance research on my dissertation. I picked up an interesting book 12 Steps on Buddha's Path: Bill, Buddha, and Weand couldn't put it down. Laura S. is the author and her use of this pseudonym immediately attracted me to a book about recovery from addictive disease. It's not often that you find a book written by someone in recovery who uses a pseudonym, so I thought this would be a candid look inside the author's mind and heart about recovery. It was.

The 12 Step program of Alcoholics or Narcotics Anonymous are often regarded as being similar to Buddhist teachings. Sometimes this puts people off because they feel that this ancient, Eastern spirituality is too far out for their tastes. I have found that this is largely because people don't take the time to investigate about Buddhism and how it might relate to their life. For those in recovery, this book offers an inside look not only into how the 12 Steps relate to Buddhism, but also how they can bring fresh eyes to the 12 Steps of recovery.

Laura starts out by giving the reader a quick overview of each of the 12 Steps. This is a good look at what she went through on the journey of her own recovery that started out in the basement of a church in New York City. There, after a failed suicide attempt, 33-year-old Laura found herself in a strange world of recovery after years of decline due to alcohol. She had been a remarkably successful business woman who thought herself invincible and certainly a person above the rank and file of the recovering people she found in that church basement of her first AA meeting. She complained to a sponsor she had found at that meeting (a person who is a spiritual guide through the program) that she had nothing in common with those people and the sponsor told her she was right...they knew how to stop drinking and she didn't! From that moment on, as difficult as some times became, Laura stayed in the AA rooms and managed to not drink.

Strangers loved her back to life, she says, and those strangers also introduced her to the world of spirituality based on Buddhist principles. As Laura tells it, there are Four Noble Truths in Buddism, and they guide the recovering person through the suffering that active alcoholism causes. The First Noble Truth is that the nature of our existence is how stress, dissatisfaction, discomfort and impatience is a part of everyday life and can cause suffering. The Second Noble Truth is that the cause of this suffering is the desire we often have that things be different than they are. The Third Noble Truth is that the end of suffering is letting go of the craving to have things different. And, the Fourth Noble Truth is that the way to end suffering is to follow The Eight Fold Path...wise understanding, wise thought, wise speech, wide livelihood, wise effort, wise mindfulness and wise concentration.

This small space doesn't permit a full explanation of the Truths or how they relate to the 12 Steps, yet there is a real connection that is so clear that some claim Bill W. and Dr. Bob took some of the principles from Buddist teachings. I can't verify that, but certainly, drinking and drugging cause suffering, and that suffering is generally caused by the craving to either possess extreme pleasure or remove some kind of pain.

This book describes the basic idea of recovery based on living by principles, not personalities, and that recovery is available to anyone who makes an attempt to change the focus of their life. Buddhism certainly would represent a major change in focus for most people who seek to make change in their life. Laura S. claims - and I think she's right on here - that the promises from Alcoholics Annonymous list in the Big Book are not only compatible with Buddist teachings, but they are the logical consequence of a life lived to its fullest according to healthy principles.

12 Steps on Buddha's Path is a good, easy and short read. I recommend it to anyone who wants to expand their spiritual horizon.

Roger W.