Counselor - June 2016 Issue Preview

INTERVIEW: ONDCP DIRECTOR

INSIDE BOOKS

BECOMING A SAGE

MICHAEL BOTTICELLI

By William White

Pg. 48

By Sharon Wegscheider-Cruse

June 2016 Vol. 17 | No. 3, $6.95

Pg. 72

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When Addiction Threatens To Derail Their Future

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CONTENTS

32

Letter from the Editor

By Gary Seidler Consulting Executive Editor

Counseling African Americans with Substance Use Disorders

CCAPP

Tobacco-Free Treatment

By Mark Sanders, LCSW, CADC

9

10

By Jennifer Carvalho

Discusses barriers to building trust with African Americans in counseling and explains aftercare considerations for this population.

NACOA

Our Stories Count Too!

12

By Sis Wenger

38 Substance Use and the Asian Client

By Serena Wadhwa, PsyD, and Kulsum Siddiqui Examines protective factors in the Asian American community, presents information on adolescents, and provides a case example.

Cultural Trends

America’s First Mass Murderer, Part I

By Maxim W. Furek, MA, CADC, ICADC

Opinion

Lesbian Love Addiction

A Spiritual Revolution

The Partnership: Facilitating Recovery in Hispanic/Latino Communities

By Mark Sanders, LCSW, CADC, and Jose Tovar Jr. Describes recovery-oriented systems of care in Hispanic/ Latino communities and provides recommendations for successfully treating this population.

18

By Lauren D. Costine, PhD

From Leo’s Desk

44

14

20

By Rev. Leo Booth

Wellness

Let Your Healthy Self Take the Lead

22

By John Newport, PhD

The Integrative Piece New Growth of Spring

24

By Sheri Laine, LAc, Dipl. Ac

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3

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Director of Editorial Communications STEPHEN COOKE Phone: (800) 851-9100 ext. 222 E-mail: stephen.cooke@usjt.com Conferences & Continuing Education LORRIE KEIP Phone: (800) 851-9100 ext. 220 Fax: (954) 360-0034 E-mail: Lorriek@hcibooks.com Website: www.usjt.com Advisory Board ROBERT J. ACKERMAN, PHD, CHAIRMAN JOAN BORYSENKO, PHD RALPH CARSON, PHD TIAN DAYTON, PHD BOBBY FERGUSON DAVID MEE-LEE. MD DON MEICHENBAUM, PHD PETE NIELSEN, CADC-II CARDWELL C. NUCKOLS, PHD MEL POHL, MD MARK SANDERS, LCSW DAVID E. SMITH, MD

CONTENTS Topics in Behavioral Health Care

26

The Thirteen P’s: A Comprehensive Approach to Addiction and Recovery, Part II

Recovery and National Drug Policy: An Interview with ONDCP Director Michael Botticelli

By Dennis C. Daley, PhD

Counselor Concerns Addiction Treatment: Then and Now

28

By Toni Galardi, PhD

Inside Books

By William L. White, MA Discusses Michael Botticelli’s early career, his involvement with the Office of National Drug Control Policy, and his thoughts on the current state of recovery advocacy.

By Gerald Shulman, MA, MAC, FACATA

Ask the LifeQuake Doctor

48

30 72

Becoming a Sage

From the Journal of Substance Abuse Treatment

Meeting the Needs of Lesbian, Gay, and Bisexual Clients in Substance Abuse Treatment

By Sharon Wegscheider-Cruse Reviewed by Leah Honarbakhsh

ALSO IN THIS ISSUE Ad Index

68

CE Quiz

70

By Annesa Flentje, PhD, Nicholas A. Livingston, MA, and James L. Sorensen, PhD Describes a study identifying differences between LGB clients and heterosexual clients in treatment and provides recommendations for care.

60 Key Competencies for Working with LGBTQ Clients

By Julie Ebin, EdM, and Nathan Belyeu, BS Describes how to better serve LGBTQ clients in substance abuse settings, and provides resources for clinicians.

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Counselor · June 2016

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LETTER FROM THE EDITOR

One Size Does Not Fit All

A

s the nation scrambles to combat the unprecedented opioid epidemic—now claiming more lives daily than fatal traffic accidents or death by gunshots—several progressive initiatives underscore just how far some of our long-held beliefs about treating addiction have changed in what seems like a blink of the eye.

Consider the following:

• Who could have predicted even a short time ago that traditional addiction and recovery programs— the majority of whom believe fervently in AA’s and NA’s abstinence-only approach—could ever endorse, let alone promote medication-assisted treatment.

• Who would have imagined that our field would ever be open to even the possibility that those of us who struggle with alcohol addiction could ever return to moderate or social drinking, or take medications to control their craving. And, although harm reduction is still a dirty word in some quarters, the fact is that most of us have come to understand and accept that one size does not fit all when it comes to addiction treatment.

• The $35 billion per year treatment industry has proved resistant to integrate the new drug or behavioral approach, but in the wake of the unprecedented deaths from overdose, the tide has turned.

• Last month, President Obama proposed $1.1 billion in new federal spending to fight the growing epidemic of heroin and prescription opioid addiction. His 2017 proposed budget designates $920 million for states to expand access to drugassisted treatment over the next two years. It also calls for more prescription drug monitoring programs and increasing the use of naloxone.

• In another hugely important happening, addiction medicine has been recognized not only as a preventable and treatable disease, but as a new medical subspecialty which will provide a new career option for medical students, residents, and physicians interested in specializing in the treatment of addiction.

The question of effective treatment for alcohol and substance use disorders is more pressing than ever. According to a recent article in The New England Journal of Medicine, the number of Americans admitted to treatment programs for prescription opioids more than quadrupled from 2002 to 2012 (Compton, Jones, & Baldwin, 2016). Deaths from heroin overdoses nearly quadrupled from 2002 to 2013, the Centers for Disease Control and Prevention reported (2015).

In addition, an estimated eighteen million Americans have alcohol use disorders, according to the NIAAA (n.d.),

and a study published in the Journal of the American Medical Association last year found that the number of Americans who drank to excess was rising (Grant et al., 2015).

Without question, medication-assisted t r e at m e nt ( M AT ) i s at the forefront of the latest options being championed for addiction treatment and perspectives are dramatically changing in Twelve Step programs.

No one represents our shift in perspective better than Michael Botticelli, President Obama’s “Drug Czar,” who is featured in Bill White’s interview in this issue. In Twelve Step recovery himself, Botticelli recognizes that we’ve come a long way as a recovery community, knowing that there are multiple paths to recovery and that medications for many people are an important part of their path.

Indeed, the times they are a-changin’.

Gary Seidler

Consulting Executive Editor Counselor, The Magazine for Addiction & Behavioral Health Professionals, A Health Communications, Inc. Publication

References: Centers for Disease Control and Prevention (CDC). (2015). Today’s heroin epidemic. Retrieved from http://www.cdc.gov/vitalsigns/heroin/ Compton, W. M., Jones, C. M., & Baldwin, G. T. (2016). Relationship between nonmedical prescription opioid use and heroin use.

The New England Journal of Medicine, 374(2), 154–63.

Grant, B. F., Goldstein, R. B., Saha, T. D., Chou, P., Jung, J., Zhang, H., . . . Hasin, D. S. (2015). Epidemiology of DSM-5 alcohol use disorder: Results from the national epidemiologic survey on alcohol and related conditions III. JAMA Psychiatry, 72(8), 757–66.

Lavitt, J. (2015). Interview with Michael Botticelli, Obama’s “recovery czar.” Retrieved from https://www.thefix.com/obama-drug-czarmichael-botticelli-now-recovery-czar?page=all The National Institute on Alcohol Abuse and Alcoholism (NIAAA). (n.d.). Alcohol use disorder. Retrieved from http://www.niaaa.nih.gov/alcohol-health/ overview-alcohol-consumption/alcohol-use-disorders

www.counselormagazine.com

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CCAPP

Tobacco-Free Treatment Jennifer Carvalho

A

s 2016 stretches before us, I am filled with anticipation and dread—anticipation of unlimited opportunities to provide treatment to those seeking a new way of life, and dread because way back in 2012, Skyway House committed to a five-year plan culminating in tobacco-free provision of services. That means no tobacco at any of our facilities!

What seemed a long-term plan is now a short-term action item. As we draw nearer to 2017, my thoughts are turning to the challenges and rewards of tobacco-free treatment.

The research is clear; substance-addicted and mentally ill populations have higher rates of tobacco-related illnesses than the general population. And further, smoking cessation during treatment has been shown to enhance recovery and abstinence rates. It is heartbreaking to hear of folks who quit drinking and drugs just to die of tobacco-related illnesses later in recovery, and it is certainly a compelling argument for going tobacco free. Our leadership team agreed that it was important enough for us to focus on cessation resources for our staff, new policies supporting a tobacco-free environment, and protocols assisting clients in cessation if they chose.

Our first step was to restrict client and staff smoking together. That was fairly straightforward and everyone agreed it was a good idea. We also relegated smoking areas to a part of the facility that limits the effects of secondhand smoke on the other clients and staff, as well as the neighbors. The 10

Counselor · June 2016

next step was to offer cessation resources for staff and clients who chose to quit. We offer the patch and a phone support network for staff. We also encouraged a weekly Nicotine Anonymous group on our campus and lower health care rates for tobacco-free employees. While there was general engagement at first, as can be the way with resolutions, the interest waned rather quickly. And of course we have staff who steadfastly cling to their right to smoke.

We continue to offer clients assistance if they want to opt for a tobacco-free experience. 1-800-QUIT-NOW has been helpful for connecting clients with cessation resources. However, there is evidence that the tendency of staff to encourage smoking cessation among clients is directly related to their own smoking status. For example, current smokers are less likely to recommend clients consider cessation (Ratschen, Britton, Doody, LeonardiBee, & McNeill, 2009). So, our challenge lies in educating and supporting our staff. As I contemplate a tobacco-free agency, I can’t help but wonder, “If we do it, will they come?” When I was seeking treatment myself, my only qualifier was that I had to be able to smoke! How then, if I was seeking that freedom of choice years ago, can I create an environment where others won’t have it today? And the answer is, resoundingly, that I know better now. I know that tobacco limits our freedom and allows us to remain embedded in the disease of addiction far longer than we

CCAPP have to. But “Can I smoke there?” remains a qualifier for many when choosing treatment.

The state of New Jersey has been successful in adopting the person-centered programming that utilizes craving management through counseling and medication in tobacco cessation. In 1999 that state passed licensure standards that required residential addiction treatment providers to assess and treat patients for tobacco dependence and maintain tobacco-free grounds at all residential treatment sites. There was a phased implementation and ultimately funding available for training, free nicotine replacement therapy (NRT), and implementation of the new standards.

While I don’t seek state oversight in this area, program unity in our approach would be transformational. We as treatment leaders have been slow to address nicotine dependence despite evidence that while smoking has decreased in the general population, people with mental health and behavioral health issues are 70 percent more likely to smoke than their general counterparts and show little change over time (Weir, 2013).

As an industry how long will we tolerate tobacco use? As we transition to mainstream health care, will our tolerance level change? Will we treat tobacco as hospitals do, with a tobacco-free campus, no-evidence employee usage, and cessation resources available to all who request them?

Will we support clients in their effort to be truly free of all substances?

And finally, as treatment leaders, should we not be having these conversations? Should we not be charting a new way forward for our clients? I welcome the discussion

of health equity at our CCAPP conferences and hope to find partners willing to contemplate the impact of tobacco on SUD treatment.

2017 and its tobacco-free initiative looms large for our agency, but not nearly as large as the challenge facing our clients as they battle tobacco-related illnesses. In my own recovery journey, nicotine was the hardest drug to quit and the one I am most proud to remain free of, despite my counselor in treatment telling me that I’d never make it! C Jennifer Carvalho is the CEO of Skyway House Recovery.

Previously she was the executive director after serving many years as a board member for Skyway House. She is a graduate of California State University, Chico. Jennifer is a board member of California Consortium of Addiction Programs and Professionals (CCAPP), a member of the Butte County Behavioral Health Mental Health Services Act Advisory Committee, and a board member of Chico Sunrise Rotary Club.

References

Ratschen, E., Britton, J., Doody, G. A., Leonardi-Bee, J., & McNeill, A. (2009). Tobacco dependence, treatment, and smoke-free policies: A survey of mental health professionals’ knowledge and attitudes. General Hospital Psychiatry, 31(6), 576–82.

Weir, K. (2013). Smoking and mental illness. Monitor on Psychology, 44(6), 36.

www.counselormagazine.com

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Our Stories Count Too!

s Wenger NACOA

Our Stories Count

“Great rides ave been ade in ringing he Sis Wenger hame of ddiction ut of the shadows and getting America and the world to believe in recovery. However, the biggest little secret remains the countless kids wh e being hurtilently each and suffering every day by the whomillions, don’t get talked development about, funded, of its children—children donated to or brought parents out of who theare shadows “yesterday’s nearly children,” enough. Those childre hose lives are children hamstrung of alcoholic by having and/or one parent drug- struggling who are lost withinbeing the painful an addict confusion and the other still trapped parent struggling in the silence with where managing healthy that addict wh living ever addicted at the precipice parents need of self-destruction.” and deserve –and Tianfear Dayton, this disease PhD generates. All emotional development cannot live. ilently suffering better efforts by the from millions, society children to protect, of alcoholic need age-appropriate and/or drug-addicted recovery parents support, need and Sodeserve long as better we waitefforts for thefrom children society of to protect, sup port, and support, empower andthem empower to come them outtoofcome the shadows. and most They will need nottoget hear it, even the stories though of other addicted children parents andtofamilies developbeing behavioral set free from the pa nd confusion out ofofthe theshadows. family system, They need and to take hear the first the steps effects toof freedom parental in their addiction own personal on health recovery—through problems before we Alateen, intervene Al-Anon, we Nar-Anon ructured the family stories therapy of other and children recovery andsupport. families children can lead to hopelessness, as perpetuate the silence and encourage being set free from the pain and con- the people they love and depend on for the familial transmission of the disease.

The 2016fusion themeofisthe “Join family the Voices system, of Recovery: and take Our safety Families, and support Our Stories, are theOur same Recovery.” people There That silence is a growing is ingrained and increasingly in our society powerful recover ovementthe in our firstcountry, steps to freedom supported in and theiroften own driven who frighten by the stories them. The of people familyin silence, long-term and recovery, has been butdeafening its focus is foralmost too long.

100 percent on th ddicted family personal member recovery—through and supportingAlateen, that person’s driven recovery. by theYet, disease, when addiction is ingrained slips in in and There takes are public over aawareness family, allcampaigns— are hurt by this maddenin sease and Al-Anon, a persistent Nar-Anon and or debilitating structuredsilence family overwhelms, the family and trapping spills over eachinto family society. member COA in itAwareness and creating Week a fertile in February, field for chaos. therapy and recovery support.

It enables the immediate damage that Alcohol Awareness Month in April, and A chaotic or The trauma-engendering 2016 theme is “Joinfamily the Voices can make regularly it difficult assaults to create the child a sense and, of safety too Children’s and cooperation.

Mental Health Children Week inin that May— environment lear hey cannot of communicate Recovery: Our their Families, needs Our and Stories, desires to frequently, the people leads they to adepend lifetimeupon of negative for theirand veryall survival. are opportunities They feel left for breaking out in the cold, as if the ere floating Ourabove Recovery.” the heads There of those is a growing to whom they health yearn andto relationship be connected. consequences.

They feel unseen the silence. and misunderstood, All provide tools to and help this start experience, whe peated over andand increasingly over and over powerful again,recovery can morph into Children cumulative stand trauma. scaredItand becomes braced the learning the conversation place thatatchildren the dinner build table, upon and carry in l their interactions. movement in our country, supported for danger in those moments, prepared over lunch, in faith communities, in the and often driven by the stories of people by eons of evolution, ready to flee classroom—from first grade to graduate These are in the long-term forgotten recovery, victimsbut of its thefocus substance is for usesafety disorders or stand devastating and fight. millions Theyof families school—and and profoundly in the clinician’s impacting office.the emotional an rain development almost 100 of itspercent children—children on the addicted who aresimultaneously lost in the painful yearn confusion for connection and fear this disease Any society generates. thatAll considers need age-appropriate itself recove upport, and family mostmember will not and get it, supporting even though that the effects and toof beparental seen and addiction understood. on children The civilized can leadtakes to hopelessness, care of its mostasvulnerable the people they love an epend onperson’s for safety recovery. and support Yet, when are the addiction same people resultwho is that frighten theythem. become Theconfused family silence, children. driven Children by theofdisease, alcoholics is ingrained live in a in the fami nd spills over slips into in and society. takes It over enables a family, the all immediate are and damage lose heart. that Isolation regularlyisassaults a common the child world and, thattoo does frequently, not take care leads of them—a to a lifetime of negativ ealth andhurt relationship by this maddening consequences. disease and feature of both trauma and depression silent world of fear and confusion where a persistent and debilitating silence and it is no wonder why. If they cannot the people who should nurture and Childrenoverwhelms, stand scared trapping and braced each for danger family in those keep themselves moments, prepared feeling safe, by if eons escape of evolution, supportready them toare fleethe for safety ones that or stand are and fight. The multaneously member yearn in itfor and connection creating aand fertile to be field seenseems and understood. impossible The because result isthey that are they become hurtingconfused them. What and would lose heart. happen Isolation if is a commo ature of both for chaos. trauma and depression and it is no children wonder why. growing If they upcannot trappedkeep by their themselves the Best feeling Interest safe, Principle if escape seems of the impossible UN becaus hey are children A chaotic growing or trauma-engendering up trapped by their ownown size size andand dependency dependency within within pain-engendering pain- Convention families, on the then Rights something of the Child inside them freeze st gettingfamily through, can just make surviving it difficult the toexperience create a engendering becomes paramount. families, then Theysomething can grow up were in other turned areas, into forreality? example intellectually, and rema ery closedsense and of immature safety andincooperation. their capacity Children for intimate insideconnection. them freezes. Just getting through, What would happen if you, the reader in that environment learn they cannot just surviving the experience becomes of Counselor, started the conversation This chronic communicate emotional theirtrauma needs and impacting desires to the family paramount. creates They a vulnerability can grow up intoother adolescent with depression, your clients who anxiety are parents disorders, andand early use bacco, alcohol, the people and they otherdepend drugs. upon Thesefor children their genetically areas, for example are the most intellectually, at risk for substance and helped usethem disorders, to talkand to their for continuing children in athe generation ansmission veryofsurvival. both theThey family feel trauma left outand in the the family remain disease. very closed Shouldand they immature not get caught in constructive in the jawsand of addiction, supportivewithout way about help they will sti row up tocold, be parents as if they who were arefloating “yesterday’s abovechildren,” the theirstill capacity trapped for in intimate the silence connection. where healthy the truth emotional of addiction development in their families cannot live. heads of those to whom they yearn to This chronic emotional trauma through the generations? C There are becountless connected. untold Theyfamily feel unseen recovery and stories impacting lurking in the theshadows. family creates They musta come out into the light to break the vicious generation ycle of shame, misunderstood, embarrassment, and this andexperience, abandonmentvulnerability that will plague to adolescent its victimsdepression, for a lifetime if we do not step up, name the reality, and take actio ar too many when adult repeated parentsover in recovery and overthemselves and over see anxiety their history disorders, repeating and early in their use children. of We know it doesn’t have to be that way, that childre ho participate again,incan recovery morph support into cumulative programs in treatment tobacco,centers alcohol, or in and student otherassistance drugs. Sis Wenger is NACoA’s programs in th hools can trauma. go on to It becomes lead balanced, the learning productive placelives, These even children if theirgenetically parents doare notthe recover. most president and CEO. that children build upon and carry into at risk for substance use disorders, So longall astheir we wait interactions. for the children of addictedand parents for continuing to developthe behavioral generational health problems befo e intervene we These perpetuate are the forgotten the silence victims and encourage of the transmission the familialof transmission both the family of the trauma disease.

That silence grained substance in our society useand disorders has been devastating deafening for andtoo the long. family There disease. are public Should awareness they campaigns—CO warenessmillions Week inofFebruary, families Alcohol and profoundly Awarenessnot Month get caught in April, in the and jaws Children’s of addiction, Mental Health Week i ay—and impacting all are opportunities the emotional for breaking and brain the silence. withoutAll help provide they will tools stillto grow helpupstart to bethe conversation he dinner table, over lunch, in faith communities, in the classroom—from first grade to graduate school—and in the clinician’s office.

S

S

12

Counselor · June 2016

These awareness campaigns crack open the door to start the conversation that can free these invisible and trapped victims. But unless w

Too!

NACOA

“Great strides have been made in bringing the shame of addiction out of the shadows and getting America and the world to believe in recovery. However, the biggest little secret remains the countless kids who are being hurt each and every day who don’t get talked about, funded, donated to or brought out of the shadows nearly enough. Those children whose lives are hamstrung by having one parent struggling with being an addict and the other parent struggling with managing that addict who is living ever at the precipice of self-destruction.”

– Tian Dayton, PhD

www.counselormagazine.com

13

CULTURAL TRENDS

America’s First Mass Murderer Part I

Maxim W. Furek, MA, CADC, ICADC

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Counselor · June 2016

CULTURAL TRENDS

“It Just Wasn’t Their Night.”

–Richard Speck

T

he very public transformation of Bruce Jenner to Caitlyn Jenner initiated a fierce global debate. Viewed as an important milestone for the transgender community, it also presented an opportunity for increased understanding and awareness. Just as former Olympic champion Bruce Jenner had appeared across America on the cover of Wheaties, Caitlyn debuted on the July 2015 cover of Vanity Fair wearing a custom-made, silk, strapless bodysuit (Bissinger, 2015).

That single event unleashed immediate controversy, triggering a circus-like atmosphere on the garish pages of supermarket tabloids. People were angry, and “over ten thousand people signed a petition calling for the International Olympic Committee (IOC) to revoke the sixtyfive-year-old former Olympian’s medal” (“Caitlyn Jenner allowed,” 2015). Jenner had competed in the 1976 Olympic Games as Bruce Jenner and won the coveted decathlon.

Demonstrating courage and common sense, the IOC stood its ground, allowing Caitlyn Jenner to retain her medal.

Still, the media continued to pursue the story. Interviewed

by ABC’s Diane Sawyer, Jenner addressed her decision by saying, “I’m me. I’m a person. This is who I am. I’m not stuck in anybody’s body. My brain is much more female than male. For all intents and purposes, I am a woman” (Kornowski, 2015).

The public has witnessed this intense scrutiny before.

Richard Raskind, a successful ophthalmologist and internationally known amateur tennis player, underwent a sex change operation in 1975. At age forty, the 6’2” tall Raskind became Renee Richards.

Initially treated as a curiosity, she created heated media frenzy. Richards sued the United States Tennis Association for banning her from playing at the US Open as a transsexual.

Richards won that verdict and was viewed as a pioneer for transsexual rights (Goldsmith, 2007). She played tennis professionally until 1981.

Later her appeal and stature diminished, as she became yesterday’s news. Both of her memoirs, including No Way Renee (2008), disclosed a deep-rooted sadness. The book touched upon emotional abuse from her sister and mother and the use of female hormones. Richards did not regret having the sex change operation, but revealed that she still felt incomplete. She said, “Better to be an intact man functioning with 100 percent capacity for everything than to be a transsexual woman who is an imperfect woman” (Wadler, 2007).

First Mass Murder

Decades earlier, under different circumstances, another individual had initiated a sex change procedure. But this individual represented something far more sinister. Richard Speck, labeled as our nation’s first mass murderer, assumed a notoriety reserved only for the most depraved and soulless www.counselormagazine.com

15

CULTURAL TRENDS of criminals.

Like many social outcasts, Richard Speck had a difficult childhood. He was born on December 6, 1941 in Kirkwood, Illinois, the seventh of eight children.

His father died when Speck was six. The siblings were raised by their mother and abided under “strict religious rules,” including abstinence from tobacco and alcohol (Montaldo, 2014).

A f ter his mother married an insurance salesman, Carl Lindbergh, in 1950, the family relocated from Illinois to Dallas, Texas. That event traumatized the family as Lindbergh was prone to violent drunken episodes. Young Richard Speck became victimized by his stepfather’s physical and emotional abuse. He became a “poor student and juvenile delinquent prone to violent behavior” (Montaldo, 2014). He carried a switchblade knife and demonstrated a lack of interest and aptitude for academic studies. He quit school in the ninth grade and left his family.

Additionally, at age twenty he married fifteen-year-old Shirley Malone. Theirs was a relationship filled with violence and devoid of love. Speck regularly abused both his wife and mother. He violated his wife sexually at knifepoint, reportedly several times a day.

Speck, a tall, pock-faced man with a southern drawl, proudly displayed a “Born to Raise Hell” tattoo on his forearm. It was a symbolic message.

By the age of twenty-five he had over twenty arrests, including burglary and assault. He was an angry alcoholic, a petty criminal, and a predator. Most of his life was spent on the other side of the law. His rap sheet included thirtysix arrests in Dallas and two stays in prison. After attempting to rob a woman at knifepoint, Speck was sentenced to fifteen months in jail. Upon release, he became an invisible transient. He relocated from his sister’s Chicago home to low-rent hotels and skid row bars, periodically working on cargo boats traveling the Great Lakes (“A mass murderer,” 2013).

Organic Brain Syndrome

On a steamy, nondescript July evening, around 11:00 PM, Speck knocked on the door of a nursing 16

Counselor · June 2016

student’s dormitory. The eight students who resided there all worked at nearby South Chicago Community Hospital.

The townhouse was located in a neat middle-class neighborhood on Chicago’s Southeast Side. Intruding into the dormitory, Speck tied up nine women, and then systematically tortured, raped, and murdered eight of them. The one survivor hid under a bed, and Speck missed her during his homicidal rampage (Noe, 2006).

A massive manhunt ensued. With the dragnet tightening, Speck attempted suicide. He was captured several days later, arrested, and charged with the murder of eight nurses.

W h i le aw a it i ng t r ia l, Sp e ck participated in twice-weekly sessions with Dr. Marvin Ziporyn, a parttime Cook County Jail psychiatrist.

Ziporyn’s discharge summary identified depression, anxiety, guilt, and shame among Speck’s emotions, but also a deep love for his family. It went on to note an obsessive-compulsive personality and a “Madonna-prostitute” attitude towards women. Ziporyn maintained Speck viewed women as saintly until he felt betrayed by them, after which hostility developed. He also diagnosed organic brain syndrome resulting from the cerebral injuries suffered earlier in Speck’s life.

The psychiatrist concluded Speck was competent to stand trial but was insane at the time of the crime due to the effects of alcohol and drug use on his organic brain syndrome. This conflicted with an impartial panel of five psychiatrists and one general surgeon who determined that Speck had not been insane at the time of the murders (Breo & Martin, 1993).

Speck’s psychiatric assessment documented a “long history of trying to deal with his inner turmoil by a chronic, repetitive pattern of drinking, drug abuse, and fighting; by chronic self-destructive acts, including auto accidents, falling from trees (once he was knocked unconscious for several minutes), running into poles (again knocked unconscious), picking up gonorrhea five separate times, as well as syphilis, and his attempted suicide on July 16, 1966” (Breo, 1986).

Cheated Death

It appears that Richard Speck cheated death. On June 5, 1967 he was sentenced to die in the electric chair, but, several weeks later, the US Supreme Court (citing their June 3, 1968 decision in Witherspoon v.

Illinois) upheld Speck’s conviction but reversed his death sentence. According to Encyclopædia Brittanica, “When the Supreme Court declared capital punishment unconstitutional in 1972, Speck’s sentence was changed to eight consecutive terms of fifty to 150 years” (Doorey, 2015).

Incarceration was the next phase of his criminal timeline and Speck easily adapted to life at the Stateville Correction Institute. He listened to music, collected stamps, and was allowed to keep a pair of sparrows.

His nickname was “Birdman.” Speck seemed to be having the time of his life.

It was later disclosed that he reveled in bootleg alcohol, drugs, and clandestine sexual encounters while behind bars.

Although Speck typically refused all media requests, he granted one prison interview to Bob Greene after reading Greene’s column in the Chicago Tribune.

In this 1978 interview, Speck publicly confessed to the murders for the first time. Speck believed he would get out of prison “between now and the year 2000,” at which time he hoped to run his own grocery store business. He told Greene one of his pleasures in prison was “getting high” (Greene, 1984).

When Greene asked him if he compared himself to celebrity killers like John Dillinger, Speck replied, “Me, I’m not like Dillinger or anybody else.

I’m freakish” (Greene, 1984). Speck said when he killed the nurses he “had no feelings,” but things had changed: “I had no feelings at all that night. They said there was blood all over the place.

I can’t remember. It felt like nothing . . . I’m sorry as hell. For those girls, and for their families, and for me. If I had to do it over again, it would be a simple house burglary” (Greene, 1984).

Speck served nineteen years of his sentence. He died on December 5, 1991 from a massive heart attack. The autopsy revealed an enlarged heart and occluded arteries. His 220-pound body

CULTURAL TRENDS was bloated and his face covered with pockmarks. No one claimed the body.

His cremated ashes were discarded in an unknown location.

Speck’s wicked story should have ended there, in cold, unspoken silence.

But there was more to be revealed. In May 1996, Speck was seemingly raised from the dead. Bill Curtis, news anchor at CBS in Chicago, received a videotape shot in Statesville Correctional Institute.

It showed a bizarre, boastful Speck with women’s breasts—obviously from some hormone treatment—wearing blue silk panties and having sex with an inmate. Before the sexual exploit, he casually tells an off camera interviewer about the murders (“Richard Speck biography,” 2013).

State legislators sat in a packed hearing room to view the two-hour tape of Speck cavorting with his prison lover.

Purportedly filmed in 1988, three years before Speck’s death, the tape shows the two inmates snorting cocaine, rolling marijuana joints, brandishing a roll of $100 bills, and engaging in oral sex. “If they only knew how much fun I was having,” Speck deadpans to the camera, “they would turn me loose” (“Nary a speck,” 1996).

An off-camera voice questioned why he killed the women. Speck responded, “It just wasn’t their night.” He was asked how he felt about the killings, to which he replied, “Like I always feel. Had no feelings” (“Nary a speck,” 1996). He added he did not feel sorry. Throughout the video, he ingested and smoked drugs with bravado. He described in detail how it felt to strangle someone: “It’s not like TV . . . it takes over three minutes and you have to have a lot of strength.”

The twenty-four-year-old sailor committed one of the most shocking crimes in American history. Speck’s horrific mass killing of eight innocent nurses remains his legacy. It gripped the city of Chicago and the nation in a state of fear. He is believed to have killed at least eight other women prior to the nursing student massacre. Speck was an alcoholic and predatory sociopath, but his title of “first mass murderer” is the one that people will always remember. C

Maxim W. Furek, MA, CADC, ICADC, is an avid researcher and lecturer on contemporary drug trends. His rich background includes aspects of psychology, addictions, mental health, and music journalism. His latest book, Sheppton: The Myth, Miracle, & Music, explores the psychological trauma of being trapped underground and is available at Amazon.com.

References

“1966: A mass murderer leaves eight women dead.”

(2013). Retrieved from http://www.history.com/this-dayin-history/a-mass-murderer-leaves-eight-women-dead Breo, D. L. (1986). July 14, 1966. Chicago Tribune. Retrieved from http://articles. chicagotribune.com/1986-07-06/ features/8602180461_1_susie-lives-younger-sister Breo, D. L., & Martin, W. J. (1993). The crime of the century: Richard Speck and the murder of eight student nurses. New York, NY: Bantam Books.

Bissinger, B. (2015). Caitlyn Jenner: The full story. Vanity Fair. Retrieved from http:// www.vanityfair.com/hollywood/2015/06/ caitlyn-jenner-bruce-cover-annie-leibovitz “Caitlyn Jenner allowed to keep 1976 Olympic gold medal.” (2015). Retrieved from http://www. rediff.com/sports/report/caitlyn-jenner-allowed-tokeep-1976-olympic-gold-medal/20150605.htm

Doorey, M. (2015). Richard Speck: American murderer. Retrieved from http://www. britannica.com/biography/Richard-Speck Goldsmith, B. (2007). Transsexual pioneer Renee Richards regrets fame. Retrieved from http://www.reuters.com/ article/2007/02/18/us-richards-idUSN1619986120070218 Greene, B. (1984). American beat (pp.

58–62). New York, NY: Penguin.

Kornowski, L. (2015). Celebrities react to Bruce Jenner coming out as transgender. The Huffington Post. Retrieved from http://www.huffingtonpost. com/2015/04/24/bruce-jenner-celebrity-reactionsto-diane-sawyer-interview_n_7108826.html Montaldo, C. (2014) Richard Speck, born to raise hell. Retrieved from http://crime. about.com/od/serial/p/speck.htm “Nary a speck of decency. A mass murderer’s video puts the lie to hard time.” (1996). Time. Retrieved from http://content.time.com/time/magazine/ article/0,9171,984604,00.html#ixzz2jdWqKZb8 Noe, D. (2006). “Supermale” in blue panties: The woman-murderer self-womanized. Retrieved from http://www.karisable.com/speck.htm “Richard Speck biography: Murderer (1941–1991).” (n.d.). Retrieved from http://www.biography. com/people/richard-speck-11730438 Richards, R. (2008). No way Renee: The second half of my notorious life. New York, NY: Simon & Schuster.

Wadler, J. (2007). The lady regrets. The New York Times.

Retrieved from http://www.nytimes.com/2007/02/01/ garden/01renee.html?_r=0&pagewanted=print

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OPINION

Lesbian Love

Addiction Lauren D. Costine, PhD

H

ave you heard the joke about the lesbian and the U-Haul? It goes like this: What does a lesbian bring on a second date? The punch line, an in-joke about the potent emotional entwinement that happens quickly in lesbian relationships, is “a U-Haul.” Two dates and it’s a move-in. This harmless enigma makes nearly everyone laugh.

Even straight people seem to appreciate the psychology and intensity of lesbian relationships.

Lesbians have long considered the U-Haul joke to be a complex, cute, funny, and sometimes embarrassing component of our unique lesbian lifestyles. It’s sweet, yet intense. You see, we’re close; we know how to bond and we’re not afraid of intimacy. This is one of the things lesbians have to offer the world, the seemingly innate ability to attach to one another and to commit almost effortlessly. It can be mesmerizing. We also know from a psychological perspective that the U-Haul metaphor does have a dark side. Far from being something ideal, this instant merging often points to a deeper problem: lesbian love addiction, a very common phenomenon with real consequences that millions of lesbians are adversely affected by. Like countless other addictions that have claimed our psyches, love addiction has, for lesbians, become the insidious superglue that offers a quick-fix solution that hides and prevents the real underlying, unmet needs inherent in our addiction to love, women, relationships, and fantasy.

There is a happier, less conflicted way of coupling—a relationship style that is less harmful to the individual self—but it takes awareness of the issues that complicate lesbian relationships for this healthier state to become the new norm.

Let’s get a sense of what makes this lesbian love addiction issue so 18

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prevalent that it has turned an injoke into allegory. To understand love addiction, let’s look at the three types that commonly manifest in lesbians: the love addict, the love avoidant, and a combination of both, the love ambivalent.

Love Addicts

Love addicts fall in love easily and quickly without really knowing the other woman. They are addicted to the way falling in love makes them feel, more specifically to the feel-good chemicals such as dopamine and oxytocin, which are emitted in the beginning stages of romance. Many love addicts have a sudden need to spend all their time with their new love, and many women move in together within a couple of dates or months (hence the U-haul joke).

Love addicts have difficulty setting boundaries, losing their sense of self once they are in a relationship.

Some women even stop taking care of themselves to better fit into their new partner’s life. They lose touch with their own friends, family, self-care, and personal interests. Additionally, love addicts can have a pattern of falling for women who are perpetually unavailable physically and/or emotionally, and have their heart broken over and over again.

They can jump into one relationship after another to avoid being alone.

Love Avoidants

Love avoidants are addicted to the seducing and chasing—they get high from pursuing other women. Romeos and Casanovas aren’t gender-specific roles! Like love addicts, love avoidants are also addicted to the high of falling in love. However, they are afraid of authentic intimacy and consequently distance themselves emotionally once the honeymoon period ends. They can feel emotionally smothered by their partners once the glitter wears off.

They find fault, criticize, and blame in order to create the distance that makes them feel safe.

Love Ambivalent

Love ambivalents have love addict characteristics in one relationship and then love avoidant in the next. They

can also vacillate between love addict and love avoidant behaviors within a single relationship. Love ambivalents are either lightly or deeply ambivalent about their partner and doubt or fear their ability to commit. This is a pattern found in ever y relationship.

The Female Brain

As we now know, men and women don’t have the same exact brains as male researchers once assumed.

Recent discoveries indicate there are significant differences in communication modes and the connections made between the sexes.

For example, women are more wired to connect to others. It’s a biological strategy that helps human beings form groups and thus create community, which in turn improves our chances of surviving in hostile environments.

In other words, we crave relationships because our brains are wired to favor them. This explains, in part, why two women might be more inclined to connect more quickly than men traditionally do. This insight helps us understand how, following directions from the brain, lesbians suffering from love addiction slip into habitual patterns and roles that adversely shape their lives. We also omit oxytocin and

OPINION dopamine when falling in love—men do not in the same way—therefore when two women get together the “oxyfest” is beyond intoxicating. It can also lead to addictive tendencies for those who cannot get enough of how

these chemicals make them feel.

Withdrawals

Typically, addictive relationships don’t just fizzle out or finish with mutual understanding and a kiss goodbye.

Instead, they end as abruptly as they started. They come crashing down with the force that sudden withdrawal produces in someone coming off of alcohol or drugs. The body and central nervous system go into a state of duress from physical withdrawal. Science has shown that breaking up, at least when love is involved, creates a type of physiological withdrawal in the body. Humans are wired to dislike this kind of rejection or sudden change in connection. When we throw love addiction into the mix—when a person is not only attempting to heal from a broken heart, but the added wound of a toxic relationship—the withdrawal can feel like a death. Recovering from lesbian love addiction can produce this kind of all-consuming grief, but the

experience is essential to the healing process.

It is during this incredibly painful period that many women seek help through therapy or Sex and Love Addicts Anonymous (SLAA) or similar support groups. Without the support of others, many lesbians find it impossible to detach from their partner, to resist reaching out—calling and texting or visiting places they know they will see their ex. If they don’t get help and support at this time, the pull to end the pain by returning to the drug is too powerful. Symptoms often include: • Cravings to act out irrationally with love addicted behavior • Inexplicable aches and pains • Physical illness or exhaustion • Switching to new addictions • Changes in eating or sleeping patterns • Overwhelming self-doubt • Desperation and fear • Feeling crazy • Suicidal thoughts or impulses • Desire to isolate • Obsessive thinking or fantasizing about the partner • Sadness, despair or depression • Emotional highs and lows • Irritability, anger or rage The healing process from love addiction can prove to be one of the most difficult things a person will ever have to endure, but there is a light at the end of the tunnel. I tell my clients that one day withdrawing will be over and they’ll feel like a new person. In order to recover from love addiction, clients have to commit to the process of healing. This means experiencing the withdrawals and avoiding the urge to return to their partner. Once the psychological separation from toxic behaviors and ways of thinking is made, and the person who truly cares for herself and her needs emerges, a new person with a strong internal sense of liberation will step in. Allowing clients to go through (not around) the pain is the essential part of healing.

Avoidance leads to repetitive behaviors; true insight comes from the ability to stop, notice, and experience what is taking place, no matter how painful.

Help Clients Develop a Relationship with Themselves

For clients with love addiction, lea r n i ng how to re e st abl i sh a relationship with themselves after going through withdrawals isn’t easy.

It takes time and determination to get to know themselves outside continual love relationships with other women.

I advise my clients against jumping into dating again until they have a well-developed sense of who they are and why they became addicted to love, romance, sex, and fantasy. The reasons women suffer from this addiction become apparent once they can identify the root causes of their cravings, which are often deep-seated unmet needs.

In my experience, women who do the work continue to experience greater and greater freedom in their lives. They are better prepared for healthy intimate relationships after this process, and are more likely to attract partners who are ready for this, too.

In many ways, it’s simple. If clients spend all their time and attention focused on finding and maintaining girlfriends, partners or wives, they have less time for self-care. Ideally, they all make time in their lives for inner work such as therapy, SLAA, support groups, somatic healing work, experiential activities such as working with animals or at the very least, exercise, self-time, and mindfulness practice. The more clients see what stands in their way to a healthier self and what prevents them from creating healthier partnerships, the better they all become at healing the wounds. C

Lauren Costine, PhD, is a clinical psychologist, executive, educator, author, and activist. She received her MA in psychology at Antioch University Los Angeles and her PhD in clinical psychology from Pacifica Graduate Institute. She works with both individuals and couples and plays a key role in the feminist and LGBTQ community. Dr. Costine is currently chief clinician of Convalo Health, Inc. and the Founder of the LGBT-affirmative track of Convalo’s BLVD Treatment Centers.

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FROM LEO’S DESK

A Spiritual Revolution Rev. Leo Booth

I

n the political world we are seeing the conflicting ideas of “revolution” as opposed to the “establishment.” A similar battle is being played out between the orthodoxy of religion as opposed to the challenging revolution of spirituality. In my view religion is a prisoner of history, and although it is undoubtedly true that most religions have evolved over a period of time, this religious evolvement is slow and often produces conflicting denominations. Spirituality, on the other hand, seeks to reflect the now; it is a movement that has no problem affirming that we believe a thing until we don’t believe it anymore.

We often hear in recovery circles that God is doing for us what we cannot do for ourselves. What exactly does this mean? Is it suggesting that God, at times, breaks into our personal lives and does something, or makes something happen, that does not require our involvement or cooperation? Some Christians are still, today, receiving the message that they are nothing without God’s grace. Do we really believe this?

The theology of God’s grace has a history that involves 20

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the idea that mankind is “fallen,” and that we are inherently sinful creatures wholly incapable of doing anything good without God’s grace. This teaching was in part the result of Augustine of Hippo—also known as Saint Augustine—who famously said, “Give me what you command and command what you will” (2008/398 AD, p. 29).

Many religious people believe this. It is part of their religious tradition. It has also influenced the recovery literature and prayers in Alcoholics Anonymous suggesting that we ask God to make things happen and remove our defects of character.

Think of the Third Step Prayer: God, I offer myself to Thee—to build with me and to do with me as Thou wilt. Relieve me of the bondage of self, that I may better do Thy will. Take away my difficulties, that victory over them may bear witness to those I would help of Thy Power, Thy Love, and Thy Way of life. May I do

FROM LEO’S DESK Thy will always! (Alcoholics Anonymous World Services, 2001, p. 63).

Also the Seventh Step Prayer: My Creator, I am now willing that you should have all of me, good and bad. I pray that you now remove from me every single defect of character which stands in the way of my usefulness to you and my fellows. Grant me strength, as I go out from here, to do Your bidding (Alcoholics Anonymous World Services, 2001, p. 76).

Let me be clear, I do not believe this. I do not believe that God is manipulating our lives, as if we are puppets on a string; making things happen without our involvement and cooperation. Do I believe in God? Yes. Do I believe in God’s grace? Yes. But the real question is where do I believe that God and this grace exists? I believe that God and grace exist within each and every human being; just as I believe that God exists and is perceived within creation.

This not how I was raised. I was raised to believe that God is separate. That I had to go to Him, seek Him, and find Him. I do not believe this anymore. I am more inclined to the affirmation “Wherever I am, God is, and all is well.”

I do not ever want to miss me in the miracle of life. I am not a puppet, but a creative human being.

I have been influenced in this thinking by the writings of a British monk called Pelagius, who was born around 354 AD. In my challenging book, The Happy Heretic, I wrote the following about Pelagius: He was educated in both Greek and Latin, a monk but not a cleric; he was never an ordained priest. In his early years, he was admired by no less a person than Augustine of Hippo, who called him “a saintly man.” When he moved to Rome, he became concerned about the moral laxity in the city, believing it was partly the result of Augustine’s teachings concerning divine grace. Pelagius was concerned about the emphasis that Augustine placed upon God’s grace— the idea that since the Fall of Adam, every good thought

or action was dependent upon God. We could do nothing on our own. There was no teaching that affirmed the need for our response. There was little teaching concerning human responsibility; that we need to be accountable for our behavior. He was particularly disturbed by a famous quotation from Augustine, “Give me what you command and command what you will.”

Pelagius believed that this saying discounted free will, turning man into a mere automaton. He soon became a critic of Augustine, disagreeing with him concerning original sin and the working of God’s grace in perfecting salvation. Pelagius argued that if human beings could discipline themselves in the way exemplified by Jesus, then they could remain perfect. He believed that grace needed to be connected with human choice. Pelagius’s personal discipline made him extremely puritanical, teaching a strict regimen to his disciples in order to ensure moral purity.

Pelagius was politically sensitive to the church of his day, and yet he was gently rebelling, carefully challenging its teachings. He affirmed the divine power that existed within the church, but he also suggested a comprehensive spirituality that was reflected in every human being-even those who were born before the time of Jesus (2012, p. 7–8).

So this is what I believe today. Will I change my mind?

Maybe. But this idea of me partnering with God to create a better life and better world makes so much sense to me.

I’m not content with moving around in the box, I’m really thinking out of the box. Today I give myself permission to interpret recovery literature and prayers. I’m able to live alongside those who think differently and I’m ever open to a change in my thinking. I’ve embraced the spiritual revolution. C Reverend Leo Booth is a Unity minister and an internationally acclaimed author, lecturer, and trainer on all aspects of spirituality and recovery from depression, addiction, compulsive behaviors, and low self-esteem. He is also a recovering alcoholic. For more information about Leo Booth and his speaking engagements, visit www.fatherleo.com.

References Serving our community for over 20 years, we provide specialty care in the following areas: • • • • •

Chronic Pain and Medication Dependency Eating Disorders Chemical Dependency Adolescent Self Injury Mental Health Services Unique to Youth, Adults and Seniors

Alcoholics Anonymous World Services. (2001). Alcoholics anonymous (4th ed.). New York, NY: Author.

Booth, L. (2012). The happy heretic: Seven spiritual insights for healing religious codependency. Deerfield Beach, FL: Health Communications, Inc. Saint Augustine of Hippo. (2008/398 AD). Confessions of Saint Augustine. Minneapolis, MN: Filiquarian Publishing.

For more information or to make a referral, please call 909-558-9275 or visit us on the Web: llubmc.org

MANY STRENGTHS. ONE MISSION.

A Seventh-day Adventist Organization

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