Sunday, February 28, 2010

Sometimes you win....

Nobody likes to lose, that's for sure. I just got finished watching a very exciting ice hockey game between the U.S. and Canada for Olympic Gold. The American played catch-up, ultimately tying in the last seconds of regulation play, forcing the game into sudden death overtime, where they lost.
Does that make them losers?
Maybe, to some. That's a word we hear a lot these days. This one, or that, is a loser. It's ubiquitous, and vague, but no one wants it applied to them. No one becomes more attractive, or important, or socially desirable, or wealthy. No one has more friends, or plays the hero, or gets the girl by being a loser.
But then we come to the 12 Step Programs. And all that talk about surrender. Surrender? Now just a minute, here! We don't surrender!
Oh yes we do. We "lose to win," we "keep it by giving it away." We "let go and let God" and "turn it over."
Are we "Losers".
No. We are Winners. And what were Winners?
Easy, they are Losers who kept on trying.
Losers who didn't give up.
So, let's not look down our noses at the losers.
Let's thank them and encourage them to keep on trying.
That way, we all win.

Saturday, February 27, 2010

Friday, February 26, 2010

Who loves you?

When I saw the heading to the Join Together article, "Friends and Relatives Provide Nearly All Oxycontin to Abusers", I have to tell you, I had a moment. Never say never, they say. I try never to say "I have heard it all" because the second you do, you hear something so beyond the pale of human logic, reason or experience that it makes you want to scream. Scream loud and long, and run like hell into the night. It makes you want to blame the messenger and curse the truth and kick a dog--anybody's dog. It brings out the worst.
But I felt like I had now officially heard it all.
Let me put it this way. The heading could have read : "97% of all sudden childhood deaths linked to friends and relatives providing rat poison to children", and it could not have hit me any harder.
I am not going to quote extensively from the article. Join Together is an excellent newsletter, committed to bringing the best and most current news in research and policy to anyone interested in drug and alcohol issues. They have been around a long time, and if they reprint research, you can take it to the bank, as we used to say in the good old days before the economy went in the tank.
I say this simply to make it clear that this is not some wild piece of tabloid crap. This is the real deal.
And what it says, in essence, is like what old Walt Kelly used to say in Pogo:
"We have met the enemy and they are us."
We're the bad guys.
That guy lurking around the schoolyard to get the kids on dope? Us.
The guy drawing in his guillible pigeons with the offer of the first one for free? Us.
The guy comforting the wounded veteran with a drug that will turn him into a zombie? Us.
Us. Us. Us.
Feeling about as crazy as I do right now?
Let me explain.
Oxycontin is a marvel of Big Pharma, containing a large dose of narcotic pain medication in a time release caplet. For people with extreme or chronic pain, it began as a godsend. It allowed people to function who had been debilitated for years by pain.
All good, until someone discovered that the time release could be beaten by snorting it. It moved into the blood and brain much faster, essentially replicating what happens when someone snorts another narcotic, popularly known as heroin. That's right, heroin: 100% addictive, tolerance increasing exponentially so a bigger dose is needed almost from the beginning; agonizing withdrawal symptoms that cause the addiction to progress so rapidly that someone using it may not realize they are addicted until they begin to experience withdrawal. Which, by the way, can come on only hours from the last use. From there on out the addict isn't using to get high anymore; he or she is using just to keep from getting sick.
Heroin. Oxycontin, both equally addictive, equally progressive, equally devastating to individuals and families, and ultimately equally lethal.
Most of us, though, are not too likely to have heroin in our medicine cabinet.
Not so with Oxycontin. They are prescribed for everything these days from headaches to backaches to kidney stones. Originally, the idea seemed to be that this was a good med for people with crippling arthritis or fibromyalgia, or some types of cancer. But like any good drug, it soon became much more widely prescribed.
And like any good mood changing drug, it began to be abused.
It seems harmless enough at first. It meets the big caveats of any denial system. It's pharmaceutical and a Doctor prescribed it. Well, darn, that's good enough for me!
Remember when Doctors endorsed cigarettes, back in the 50's? I do. But enough of that.
We are a society that takes it to heart the old dictum that we pursue pleasure and avoid pain. And man, do we avoid it. We are constantly bombarded with sophisticated advertising that tells us that physical and emotional pain are unnatural states. We take extra strength and super strength. We take meds that improve our dopamine and serotonin levels to the point where we are probably way too happy for our own good. (My old mentor as a therapist wouldn't accept happiness as a goal of therapy. History, he would point out, is full of happy ax murderers and dictators.)
So here is the bottom line. You have things in your medicine cabinet, or your night table, or bureau drawer, that are as addictive as heroin. You don't give them to your kids for sleeplessness, or your neighbor for a headache, or for a guest who drank too much (God forbid!). You don't keep them because you paid for 'em, dammit, and you might need them again. You dispose of them responsibly when you no longer need them. Your doctor can advise you about that, or the cops, or a drug counselor like me. You don't dump them down the toilet. Never mind why, just don't do it.
Become an educated consumer. Ask your doc about prescriptions, read those little inserts, look them up online at one of the many good medical sites. Do not give them to someone, or share them. These are not lightweight drugs we are talking about here, these are deadly.
And if, as the survey strongly suggests. we are the enemy, that's the news right now. It doesn't have to be the news next year. And if, by then we are the good guys, look at all the good we will do. The largest supplier will have left town, and maybe we can begin to close the book on what has been a long painful chapter--The O.C. Chapter.

Friends and Relatives Provide Nearly All Oxycontin to Abusers

Friends and Relatives Provide Nearly All Oxycontin to Abusers

Sunday, February 14, 2010

What We Talk About When We Talk About Codependency

If you read Raymond Carver, you know that I cribbed the title from his story, What We Talk About When We Talk About Love. Raymond Carver knew alcoholism and he knew relationships, and he wrote about both with great clarity and heart. Most of all, he wrote about them simply. He didn't use jargon, or cite theories, he presented his characters as full blooded human beings, not as clusters of behaviors. I go back and reread his stories often to keep me "jargon honest."
There are recovery concepts that it's important for addicts and their families to learn because they help them to conceptualize their problems differently. Instead of "I don't know what happened.," the issue becomes "I shouldn't hang around with those guys anymore. I get in trouble every time I do." (People, places and things.)
Here are some examples:

  • Codependency: Valuable concept if it helps a couple to understand that there are areas where issues of responsibilities and boundaries blur, and genuine intimacy suffers as a result. Meaningless when used broadly: "Codependent relationship," tells absolutely nothing about the actual issues and problem areas, and in fact, leads to a lot of unnecessary anxiety. Every relationship has codependent aspects to it; no relationship is entirely free of codependence.
  • Nominalizing: This is when we make a thing out of a process or person. Shiela is a "Codependent". Harry is "resistant to Treatment." Susie is "The Lost Child." Somebody around here has to be "The Scapegoat." Is anyone an "Anything?" I don't think so. Jane stands up in a meeting and identifies as a "Alcoholic" or "Addict", she is stating something essential about herself to people empathic and understanding, not calling herself a name. I tell little Johnny that he is the "Family Scapegoat", I have done nothing remotely helpful at all.
  • Enabling: Shocker: enabling is not intrinsically bad. If  I enable my kid to go to college, or my wife to open a studio, or my dog to go to a groomer, or my DVR to catch LOST, have I done something wrong. No, and neither have you. Enabling is recovery shorthand for behaviors that either facilitate an active addiction by financially subsidizing it, or by interfering with the logical consequences of addiction. That is about the extent to which you can generalize about enabling. Anything beyond that isn't much more than a name to call someone. Instead of helping someone to empower themselves, it gives them something to feel a little guilty and ashamed about.
I hope this gives an idea of what I'm trying to say. If Billy's mother has been paying his rent and car payment while he rocks out on OxyContin, she needs help and support to learn that she can risk the anxiety inherent in the situation to withdraw support for Billy's addiction, while actively increasing pressure for him to get into recovery. In other words, she begins to understand how an addiction is enabled. By doing this, she can begin to check out her actions, in advance, with friends, a counselor, an Al-Anon or Nar-Anon sponsor, to determine if what she is doing enables active addiction or enables Billy to begin a process of recovery.
She doesn't need to hear jargon; she needs to feel empowered to use her own intelligence and her own judgment, and not feel guilty for doing it.
I like to think Raymond Carver would approve.

The Shirtless Dancing Guy Theory of Leadership

Courtesy of my friend Jim Stiles. Real leadership made simple:

Silent Killers � Chaz’ journey back.

A must-read for Valentines day, from Chaz:

Thursday, February 11, 2010

Extra, extra, read all about it!

I have been snowed in.
That doesn't happen too often in Philadelphia. Here in the City of Brotherly Love & Cheesesteaks, we aren't exactly in the middle of the snow belt. We get a really good storm once in a while, but--well, look at it this way: the three snowstorms that we have had since last Friday have dropped as much snow on our little burg, as we have had in the whole last four years combined.
More than Buffalo, NY.
So, things have slowed down quite a bit. And as you can see if you scroll down a little, I have been traversing the blogosphere. There are so many good recovery-oriented blogs out there that you could take days and days just to get caught up. By no means are the selections below inclusive--quite the opposite! They only scratch the surface of the rich and deep treasure trove of discussion, disclosure, near-despair and spirituality, that are the every day reality of the addict and their families. Some, like An Addict In Our Son's Bedroom, and Fight Of Your Life, are so good that I get the Intervention families I am working with to read them in order to learn about enabling, addict behaviors, the values of faith and support, the disease of addiction and the importance of sharing. It works, too. They come back after spending some time with the blogs saying things like, "I never knew that anyone else had ever gone through anything like this," or "now I feel like I am not alone!"
So, read on, dear friend. I hope you find something that you like, or that makes you feel like you are not alone, or makes you uncomfortable in a good way.
Let me know what you think.

An Addict in our Son's Bedroom: Tempering Expectations

More from this excellent blog:

Big Changes In Store For Psychology's 'Bible' : NPR

A therapist friend used to call the DSM "1001 names to call your patients." From NPR:

Wednesday, February 3, 2010

The Lie

The first time we learn that we can consciously manipulate the truth for personal gain, we have no idea  what we are doing, what the consequences are and what negative, even evil, power has now entered our lives.
Children usually work at lying, they tell those obvious and broadly transparent fibs that do little to conceal the truth. The turned over cookie jar, spilled milk, messed pants or broken glass give it away pretty quickly. The lie, "I didn't do it!" Or even simply "Nothing!" are comical. Fortunate kids are corrected, and the reason is explained. Not so fortunate kids are stroked and even benignly encouraged. Kids from really dysfunctional families get both, and are left to try and figure it out.
The really dangerous lie is the one that is believed. That's when we learn to lie. Because the believed lie carries something terrific with it; the believed lie carries power.
I don't remember the exact year or grade, but I remember this: it was during Lent. Holy Week, to be specific. My class was in church for one of the solemn services traditional to the Catholic Chirch at that time of year. Some of the other boys and me, bored at the length of the service, began to clown around. We got loud. It distracted the priest, who said something from the altar. This was an unheard of rebuke in the late 50's and early 60's, and we knew that hell was coming as soon as the rite was over. You could see the nuns already shaking their heads and feel the tangible atmosphere of fear and doom that filled the church like the scent of incense..
We were instructed to stay after the service. The priest came out and asked "who was laughing?" No one spoke. He had someone bring out the crucifix, a big crucifix, with an agonized, bloody Christ on it. One by one the nuns brought the boys up to the crucifix and the priest asked "Were you laughing.?"
Everyone gave it up. They cried, they shook, they sweat and they admitted that they were laughing.
Everyone except me.
I hated to be kept after school, I hated detention and I especially hated boredom.
And, I had the idea in my head that as long as I didn't give in, they couldn't do anything to me. I mean, I knew that they could carry on and slap me around, which was common in those days, but they couldn't really do anything to me.
So I lied. When he asked if I was laughing, I said "No."
And they did holler and shake me and slap me. They made me kiss the cross and asked me again. My peers looked at me with hate in their eyes, and I lied. They took me around to all the grades, and  the crucifix, and asked me in front of all the other kids, and I lied.
And finally, they let me go.
Over the Easter break, every other boy had assignments to write (The Apostles Creed, 100x), convent basements to clean, parents to answer to (because they were called, of course.)
I read comics and played basketball.
I felt on top of the world.
I felt powerful.
I had lied, and was believed. I figured I had pretty much damned myself to hell, so what the heck. Might as well be out for me.
Obviously, this was not my last lie.
I lied about it the first time I drank alcohol, and I lied about it the first time I smoked pot and I probably lied about it when I popped my first pill or took my first hit of dope.
I lied to spouses, children, employers, landlords, friends and lovers.
It took me a dozen years to find my way to recovery and another forty years to find my way back to God.
I don't lie today. I don't lie because I really believe that my recovery and my connection to God can be easily severed, because both are truth and lying kills the truth.
Because every time I lied, I hurt someone. Starting with those kids writing the Apostles Creed who looked at me as a friend and then felt stupid and betrayed as a result of my actions.
Anyhow, a lot of my young clients seem to have the same disease I had, and we talk about it. They might say, well I don't know, I don't want to get clean and sober.
I say, then let's just work on telling the truth.

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