Together July 11

T gether

Ben Cheever: Dear Reader, I Hate You. – Page 3

A voice f or health a n d rec overy

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Inside

Not happy?

There's an Answer........16 Guess I'm Not an Alcoholic.....................19 You Are Not a Fraud..... 11 If You Need Help...........18 Being Spiritual...............12 Are You in Denial?.........15

New York Edition

This is Your Brain in a Blackout long years after the night of the stabbings because he had disclosed his involvement in the crimes at a meeting of Alcoholics Anonymous.

At his trial, Paul’s freedom depended on his lawyers’ assertion of two key points: One, that his blackout on the night of the crimes constituted a state of temporary insanity that prevented him from appreciating the wrongness of his actions. And two, that, since Paul’s confession occurred in the context of an A.A. meeting, his statements should be considered privileged in the same way a disclosure to a priest or psychiatrist is. Because communication within an Alcoholics Anonymous meeting was privileged, his lawyers argued, any utterances Paul made to other members of A. A. were inadmissible in court.

It was bad news for Paul when the trial judge ruled against him on both of these points. The even worse news was that the state’s attorney’s case against Paul was of the slam-dunk variety.

By Jeffrey C. Friedman

P

aul Cox is a man of quiet reserve who in casual conversation gives the impression of a business executive just entering his peak earning years, rather than the hard working carpenter he was in his youth. But today, at 43, Paul has no career—unless you count the prison job he toils at each day in the New York penitentiary, where he is serving double life for the 1988 murders of a couple he had never met. On the night before New Years Eve in 1988, in an alcohol-induced blackout, Paul stabbed them to death.

You might remember the case of Paul Cox, but not for the fact that he had committed an unspeakably brutal crime while in an alcoholic blackout—crimes committed in alcohol-fueled blackouts are way too common to make the front pages of newspapers. His case made headlines for an entirely different reason. Paul was arrested and charged with two counts of second-degree murder four

(Continued on page 8)

Seeing Ourselves in TV’s Female Addicts Smart, accomplished and imperfect, these women strike a chord with viewers

By Suzanne Riss

W

July /August 2011

omen are providing some of the most complex and provocative portrayals of addiction on television, helping broaden awareness and understanding.

Unlike Mad Men that glamorizes addiction or Celebrity Rehab and My Strange Addiction that portray it as a circus sideshow, several television shows are offering more nuanced portrayals. Junk-food obsessed L.A.P.D. Deputy Chief Brenda Leigh Johnson on The Closer, pill-popping Jackie Peyton on Nurse Jackie, and recovering alcoholic Abby Lockhart on ER depict various stages of addiction and recovery that experts say can help educate viewers and jump start conversations.

On The Closer, Brenda doesn’t yet experience the negative impact of her obsession with sweets. She’s in the early stages of something that may or may not develop into a full-blown addiction, experts say. For Nurse Jackie, marriage, work, and kids take a back seat

to her craving for opiates. Figuring out how to keep a steady supply of Adderall, Vicodin, Percocet and Oxycontin at her fingertips informs her every move and thought. And while she probably wouldn’t admit it, she stands to lose everything. With Abby Lockhart on ER, we had the unusual experience of following a woman in recovery over the character’s 10 years on the show, seeing her two steps forward, one step backward journey that ultimately ended on a hopeful note.

“ER stands out because it showed Abby living and working as a recovering alcoholic,” says Robert Thompson, professor of popular culture at Syracuse University. “Following a woman in recovery over such a long period of time and in such depth is something we didn’t show on TV before.”

High stakes Smart, accomplished and imperfect, these three women strike a chord with viewers. “Whether addiction touches your family or not, the topic

(Continued on page 13)

Triggering Food and Substance Abuse

B

renda, Jackie and Abby have more in common than a spiritual longing and something in their lives over which they lack control. Research published in April identifies a common thread in substance dependence and compulsive eating. Both have similar patterns of brain activity, according to a study from the Rudd Center for Food Policy and Obesity at Yale University. Ashley Gearhardt, clinical psychology doctoral student

(Continued on page 13)

EDITOR'S•DESK

From the Editor

E

• • • • • •

arly on a recent Saturday I found myself in the basement watching water leak out of my furnace.

I’d just bought a piece of black rubber for the thing -- $400. Now the guy was telling me I’d need a copper coil, most certainly a whole lot more.

Time for a whole new furnace, I figured. So I’ll just mow the yard. Except the lawnmower, into which I’d just poured more than $100 to make it ready for the season, wouldn’t go.

Fine. I’ll mend the little stonewall by the drive. Just need to put this heavy granite rock into place. Except my index finger happened to be in that place, and I got what is known as the “granite kiss.” The pain only intensified during the evening.

Was I supposed to be happy? Cicero apparently thought that one could be happy even on the torture rack. Oh? I doubt he had an oil-fired furnace.

A special focus of this issue is “the pursuit of happiness.” I pursued it when I went out and bought me a brand spanking new, jet black, really boss lawn mower. But is that all there is to happiness?

I’m happy depending on how my lawn mower is running?

Epictetus, the Greek philosopher who lived 2,000 years ago, would say no. “The essence of philosophy,” he wrote, “is that a man should so live that his happiness shall depend as little as possible on external things.”

Those who have thought and written about happiness through the ages seem to agree on two things. One, true happiness is not found in things and events, most of which we can’t do anything about. It is more likely found in something greater than ourselves.

“True happiness,” the writer Henry James noted, “consists in getting out of one’s self, but the point is not only to get out, you must stay out; and to stay out you must have some absorbing errand.”

Dennis McMahon, an historian, traces the history of thinking about happiness in his article on page 17 and concludes that “we

2

might focus less on our own personal happiness and instead on the happiness of those around us, for relentless focus on one’s own happiness has the potential to be selfdefeating.”

Acceptance of what life gives us is a critical part of it, as John Dyben suggests on page 16. Going with the flow, he says, is how we keep broken furnaces and fingernails in perspective.

Ah. To not have my peace of mind dictated by external events, even if I have to type this with a band-aid on my finger. To be grateful that I have a house that needs a furnace, when many don’t. Grateful for the rain this year that has made me need a lawnmower. Grateful even for the fact that pain means I’m alive.

I now regard “the pursuit of happiness” as the wrong goal. “The pursuit of happiness is a most ridiculous phrase,” the novelist C.P. Snow wrote, “If you pursue happiness you’ll never find it.”

Where was he when we were selecting a focus for the issue?

• • • • • •

Published by

Contact Together: General information: info@together.us.com

Letters to the editor: letters@together.us.com

Editorial submissions: editorial@together.us.com

As I assume the editor’s seat with this issue, I am grateful as well for those who have gone before me. Nancy O’Hara and her team launched and sustained Together through its first year, leaving me a legacy of excellence.

Barbara Nicholson-Brown, who, with her late husband, Bill, launched Together Arizona 20 years ago, has become a solid advisor. Rosalie Bischof, who looked at that paper and asked, “Why can’t we do this in New York?” has been a constant source of ideas and inspiration. Richard Horton, our publisher, has become a good friend in just weeks. And Maggie Keough, our Web Director, is my new confidant in all matters editorial.

I am grateful to the writers who put their hearts into this issue.

And especially to you for reading. As the word Together suggests, we want your ideas in our pages. Write to us!

And if anyone needs an old lawnmower …

General correspondence: news@together.us.com advertising@together.us.com distribution@together.us.com subscriptions@together.us.com

Editor-in-Chief | Terry A. Kirkpatrick Contributing Editor | Barbara Nicholson-Brown Contributing Editor | Suzanne Riss Design Director | Mario J. Recupido Web Director | Maggie Keogh Publisher | Richard Horton Marketing Director | Rosalie Bischof

Terry A. Kirkpatrick

www.together.us.com | July / August 2011

Cover Story GUEST•COLUMN

Changing Your Mind

Dear Reader,

(Continued from page 14) Imaging has also shown that the amygdala, where stress and upset occur, often develops a thicker wall through meditation, and becomes less active. (Prior to imaging technology, autopsies of chronic drinkers and long-time drug abusers were found to have smaller and more damaged amygdalae than in non-abusers).

I Hate You ...

In those days an adult male who didn’t get pie eyed at least once a week, was considered eccentric. You needed to get a note from a doctor that said you had an ulcer, and even then, your FBI file was flagged.

where to MeDitAte

TAddicted to chocolate?

drinking and dark chocolate.

My fathertowas an of actual alcohere are many different styles of meditation and a myriad of choices those us lucky andallI’m anplaces actualtolongenough to live in New York. Our home, the subway and theholic, bus are great hate out to let a meditate, but if you want a place away from home and thedistance crowdedrunner. streets, Icheck day pass without running five some of these centers to find the group that fits your style. miles There the is nosame orderway of preference he hated to this list and it is not exhaustive, so do some exploring, ask your friends and start to have one passtransforming without a your brain and your moods. fifth of Gilbey’s gin. Although he never backed over a dog of anyget breed.

But he diddiff some centers that offer much more than meditation where you can a taste of many erent wild things. Nor -- before AA spiritual practices and teachers: -- would you haveand wanted to – the Jcc in Manhattan offers free daily meditation Monday – Friday 7:30-8:30am Monday get between that man and his Thursday 5:45-6:45pm and many other classes and workshops. jccmanhattan.org bottle. the open center (of Holistic Learning and World Culture) also offers erent kindsaddicts. of classes Somany we diff were both throughout the year. opencenter.org What else have we got in sivananda Yoga Vedanta center offers a classical Indian style ofcommon meditating, as well as yoga classes, though?

Something and courses for spiritual development. sivananda.org/newyork we’ve got in common with you well. We’ve always needed tibet center has lectures, evening and weekend workshops andas conferences. tibethouse.org to the have somebody pay attenthe omega center in rhinebeck is perfect for a weekend in country of meditation and tion. He was famous, won the relaxation; they also offer some programs in the city. eomega.orgPulitzer Prize and the Nation-

Addicted to running?

Addicted to words?

Saying I love you

other benefits of meditation are impressive: Nowadays all you have to Got your attention? Good,

By Ben Cheever 1. Lowers the consumption of oxygen. because that’s what I want: do is say, “My name is Ben and It’s what you I’m an alcoholic.” Presto-chan2. Reduces anxiety or panic attacks.attention. want too. Pundits bewail go, you’re an alcoholic. Or the oil shortage, the job not. But I know about those 3. Increases mental focus. tool, especially for the antsy, uncomrooms, and there’s something shortage andspiritual the ethics going on there that’s magic. fortable, racing minds of the newly clean and shortage, of these 4. Increases blood flow and slows the heart but none People often pay attention to compare to the attention sober.

It’s interesting that, in the America of rate. one another.

But you have to shortage. the 1930s, Bill Wilson recommended medibe an alcoholic. You have to 5. Helps maintain a more constant and That’s whytation dogsin the are Eleventh Step of AA, although suddenly such a phenom- say you’re an alcoholic before deeper level of relaxation. he would likely you havecan hadfeel a more traditional al Book Award, which doesn’t the love.

Love. enon. If you have a Milk A few Buddhist & Zen places that we like: Judeo-Christian kind of meditation in mind; mean that anyone’s paying at6. Slows respiratory rate.

Now there’s a word that’s had Bone, you can get a dog’s the interdependence project, 302 Bowery, theidproject.org tention to you. Odd how that not necessarily a cushion a zendo the taron beaten out ofinit.

I love attention. Doesn’t work sitting 7. Increases cardio exercise tolerance in heart works. Celebrities complain ordinary Mind Zendo, 107 West 74th St., Apt. BR, ordinarymind.com ashram. with people.or I’ve tried my wife. I love my new compatients. of ny.shambhala.org it, and I believe them. If Milk Bones. I’ve also tried puter. I love when it snows. shambhala Meditation center of new York, 118 West 22nd St., you’re unimportant enough, I almost never say goodbye Twinkies.

Do you suppose still Mind Zendo, 37 West 17th St., stillmindzendo.org BELIEVE YOUR EYES 8. Can reduce high blood pressure.cash might work? nobody will see you. If you’re to anybody in my immediate Village Zendo, 588 Broadway, villagezendo.org There is something slightly absurd about And when it comes to at- family without adding, “I love you,” a couple of times, as if I too important, they stop seeing you again. You can be well 9. Builds confidence and produces creative Zen center of new York city,known 500 State Brooklyn, mro.org/fi relotus “proving” scientifically the benefits of mediandStreet, lonely.

For years my father counted most on an old tention, dear reader, you’re getting the short end of the stick were salting popcorn. thinking. tation and yoga practice, which have existed Black Labrador who reminded him of his mother.

Here’s the point where a professional columnist might conhere. Because you can read what I’m saying, while I can’t hear for thousands of years ancient cultures I don’t know you, and so I don’t know your needs, but I’ve demn thisinintellectual sloppiness, and give you all a scolding. youReduces talking back.

You can goSyndrome. to my web site and write to me.

10.

Pre-Menstrual a serious But I’mWe oneinofthe themodernized worst offenders.know you are in the presencemade of someone ex-study of my own. And Arthur Miller was right throughout Convince me that you’re real, and think I’m real as well, andthe world.

1 1. to relieve and emotional in that playcalm, of his, when has Linda Loman us all thatin It is with genuine bitterness I have concluded thatwho the exudes I’ll Helps write you back. mental The web site’s at Benjaminhcheever.com. traordinary, even holy, light, west like proof obtained in laboratory studies, that Lesleyhe Logan has worked fortell many years language is not blame.

I have humor troubleand mastering I’mstress. not suggesting you do so. I don’t want you feeling grace. the lan- “attention must be paid.” but ifcheated, in your travels you have evertocome across book and magazine publishing in all Addicted to running? Addicted to chocolate? Addicted to guage and this life because I have an inadequate brain. The though.

So, as the saying goes in meditation circles: capacities. She is also the author of many guide sunnyasin or BudMeditation’s healing power has become a true yogi, bodhisattva, computer that runs this self didn’t come with enough RAM words? Addicted to vodka? We’re all in this boat together.

I wish I could write a column -I wish I could write a book-MO7035.

Makom Print AD Resize 6/9/10 4:00 PM Page 1 decades of daily practice, you don’t just do something, sit there. books.much more alike than we are willaccepted as a potent psychological as well as dhist monk withinstalled.

And✺I believe that we’re that would sit still and listen to the people who bought it. I’d ing to admit.

We’re all fumbling around in a darkened cellar, Mark Twain wrote that, “The difference between the perfect certainly buy my own copy. Until, then, though, all I can be is word and the next best word is the difference between light- looking for understanding and operating with an intelligence honest. Honest and precise. Others have succeeded. ning and the lightning bug. “ I spend a lot of time reaching programmed for survival and reproduction. Operating with a around in that hamper of 250,000 words and coming up with brain that can’t easily tell one Peter from another. Those other creatures we sense and touch are frightening and sometimes the next best one. even grotesque. It’s dreadful, but at least we’re not alone.

I buy a lot of books. Sometimes Iwith feel that these books are Meditation at The JCC in Manhattan We can use language. We can write and read as honestly as paying attention to me. Not because the writer knows where we know how. Sometimes you’ll get the lightning, sometimes I am, but because he’s expressed where he is, or where she Join our gifted teachers for our FREENor drop is in this meditation practice most obvious flaw. When it comes the bug. Sometimes you’ll like what you hear, sometimes my processor’s is, and done so with such candor and force that I am there Mon—Fri, 7:30—8:30 am and Mon—Thu, 5:45—6:45 pm. too. The light shone has illuminated us both. It’s a good trick, to filing names, I’ve got the sort of secretary (administrative you’ll hate it. That’s not what’s most important. The contact is assistant?) in my cranium that I’d have fired, if I still had an what’s important, the authenticity. The attention being paid. though, and not everyone can do it. Words tricky. on Slippery.

For moreare information ongoing evening classes, introductory classes a secretary to fire. All Peters, for instance, she’s It was Rollo May who told us that the opposite of love is not mini-retreats visit jccmanhattan.org/makom call 646.505.5726.

The Oxford English Dictionary listsand 250,000 distinct words, office joborand but clearly that’s not enough. Because we’re always grabbing got in a single hanging Pendaflex file. Peter O’Toole, Peter hate. The opposite of love is indifference. the ones we have and squeezing them into different mean- Canning, Peter Boyer and Peter Herbst. Even Peter Lorre’s Benjamin H. Cheever has published four novels (The PlaMakom addict, Meditationaat in there, though I never met the man, nor am I certain what ings. Just take the word “addict.” You can be a heroin movies he was in. They’re all named after the same Apostle, giarist, The Partisan, Famous After Death, The Good Nanny).

JCC can in Manhattan chocolate addict, or a sex addict. Or -- as in my caseThe -- you The Samuel Priest Rose Building but otherwise they have nothing to do with one another. Of- He’s also written two works of nonfiction (Selling Ben Cheevbe addicted to distance running.

334alcoAmsterdamten Ave.as atnot, 76th St. though, I reach for one man and retrieve somebody er and Strides). He edited The Letters of John Cheever. He’s Or take the word “alcoholic.” In 1950, you weren’t an taught at The New School for Social Research, and the Benholic until you’d ruined at least two perfectly good careers and else.

If all those Peters can go in the same folder, then long- nington M.F.A. program. He hosts a TV show called “About backed the family station wagon over the family poodle, killing Find Makom on distance running can hang in the addicted file along with Writing,” which can be seen at PCTV76.org. her.

Addicted to vodka?

We’re all in this boat together.

Addicted to running

Relax. Release. Renew.

a beneficiary of UJA-Federation

Please pay attention

Get Together.

Online.

Together we can make a difference.

16Together - A Voice for Health & Recovery

Together

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To and Treatment Teenagers

YourHealth (Continued from page 12)

IN•THE•NEWS enhanced feeling of stimulation and high on happiness, relationships, fun, pursuit of impulsivity levels.â€? passions and helping others. It was obvi“The findings from this study provide ous that their positiveevidence energy isthat infectious. concrete laboratory the mixRecovery is a powerful thing to witness. ture of energy drinks with alcohol is riskier These miracles are happening every day“Colthan alcohol alone,â€? said Marczinski. for people, soaware muchof ofthe it starts legeyoung students needand to be risks of thesesomething beverages.soMoreover, who with simple andclinicians often given are little working within risky drinkers will need to too priority treatment and recovery: try andâœşsteer their clients away from these FUN! beverages.â€? [http://www.eurekalert.org/pub_releasJosh Azevedo, LISAC, CAC II, is the Owner es/2011-04/ace-deb040911.php] and Program Director at The Pathway Program.

one time had very • •little • •hope • of• a successful adult life were truly happy, exchanging sober war stories, laughing and having a great time with long-term friends they had sobered up with. They had been there for one another throughout their lives.

The wonderful combination impaired impulse How it isof that having dealt control enhanced with theirand alcohol and drugstimulation use early on may makewere energy drinks they able to focuscombined their youngwith livesalcohol riskier than alcohol alone, a new study shows. “Young people are now drinking alcohol in different ways than they have in the past,�

Alcohol dependence is four times more said Cecile A. Marczinski, assistant profes- likely to occur among adults with mental illsor of psychology at Northern Kentucky ness than among adults with no mental illUniversity and first author of the study. ness (9.6-percent versus 2.2-percent), a sur“Classic mixed drinks such as rum and coke vey shows. have been replaced with mixed drinks that The rate of alcohol dependency increases use energy drinks instead, such as yager- as the severity of the mental illness increasbombs and Red Bull™ and vodka. es, according to the nationwide survey conThe study was designed to demonstrate ducted by the Substance Abuse and Mental that alcohol/energy drinks are pharmaco- Health Services Administration (SAMHSA). logically distinct from alcohol alone and are For example, while 7.9 percent of those with in the Hamptons adding to the risks of drinking. mild mental illness were alcohol dependent, Alcohol Abuse Treatment “A consumer of alcohol, with&orSubstance without 10 percent of those with moderate mental illthe energy drink, acts impulsively comness and 13.2-percent of those with serious Where the healing begins..... pared to when they had not consumed al- mental illness were alcohol dependent.

cohol,� Marczinski said. “However, the con“Mental and substance use disorders often sumer of the alcohol/energy felt more Adultsdrink - Adolescents - Family - Menin&hand,�

Womensaid SAMHSA Adminisgo hand stimulated compared to an alcohol-alone trator Pamela S. Hyde, J.D. “Co-occurring 1-800-448-4808 consumer. Therefore, consumption of an mental illness and substance use disorders

energy drink combined with alcohol sets up are to be expected, not considered the excepa risky scenario for the drinker due to this tion. Unfortunately, signs and symptoms of

Bad vibes from energy drinks

Alcoholism tied to mental health

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these behavioral health conditions are often missed by individuals, their friends and family members and unnoticed by health professionals. The results can be devastating and costly to our society.� [http://www.samhsa.gov/newsroom/advisories/1106021725.aspx]

Relationships reduce amphetamine abuse Long-term relationships make the commonly abused drug amphetamine less appealing, according to a new animal study in the June 1 issue of The Journal of Neuroscience. The findings suggest that social bonds formed during adulthood lead to changes in the brain that may protect against drug abuse.

Zuoxin Wang, PhD, of Florida State University studied prairie voles, which form lifelong bonds with mating partners, to understand how bonding affects the brain’s use of dopamine when amphetamines are used. “Our results indicate that the pair bonding experience may alter the neurobiological response to drugs of abuse, which in turn may diminish the rewarding effects of the drug itself,� Wang said. “Understanding the neurobiology of how social bonds protect against the rewarding aspects of drug abuse may ultimately inform novel therapies for addiction,� said Larry Young, PhD, an expert in social behavior at Emory University, who was unaffiliated with the study.

The research was supported by the National Institute on Drug Abuse and the National Institute of Mental Health. [http://www.eurekalert.org/pub_releases/2011-05/sfn-srr052711.php]

Fish don’t get drunk

d in end, ain,

Omega 3 fatty acids may be beneficial for more than just the heart. Research at the Indiana University School of Medicine disclosed at a molecular level a potential therapeutic benefit between these dietary supplements, alcohol abuse and psychiatric disorders.

Omega 3 fatty acids were given to mice with bipolar disorder. The fatty acid DHA, one of the main active ingredients in fish oil, “normalized their behavior,� according to Alexander B. Nicolas, MD, PhD, associate professor of psychiatry and the lead author of the study. “The mice that were given DHA normalized their behavior, they are not depressed and when subjected to stress they do not become manic,� said Dr. Niculescu. “When we looked into their brains, using comprehensive gene expression studies, we were surprised to see that genes that are known targets of psychiatric medications were modulated and normalized by DHA.�

An unexpected finding of the research was the discovery that the mice given DHA also showed a reduced desire for alcohol. “These bipolar mice, like some bipolar patients, love alcohol. The mice on DHA drank much less; it curtailed their alcohol abusive behavior,� Niculescu said. To verify this finding, the researchers studied another wellestablished animal model of alcoholism and obtained similar results. “We believe a diet rich in omega 3 fatty acids may help the treatment and prevention

Addiction Specialists

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of bipolar disorder, and may help with alcoholism as well,� he said.  [http://communications.medicine. iu.edu/newsroom/stories/2011/fish-oilmay-have-positive-effects-on-mood-alcoholcraving-new-s/]

What beer does to the belly Whether it’s called a beer belly, a spare tire, the apple shape, or the middle-age spread, abdominal obesity is the shape of risk. Abdominal obesity is a health hazard, increasing the risk of heart attack, stroke, diabetes, erectile dysfunction, and other woes. Risk begins to mount at a waist size above 37 inches for men, and a measurement above 40 inches would put you in the danger zone. For women, the corresponding waist sizes are 31½ and 35 inches, respectively.

Despite the name, beer is not specifically responsible for the beer belly. Research from the Czech Republic tells the tale. In a study of nearly 2,000 adults, beer consumption was not related to girth.

If it’s not beer, what is to blame? The culprit is calories; if you take in more calories with food and drink than you burn up with exercise, you’ll store the excess energy in fat cells. And unfortunately for men, their abdominal fat cells seem to enlarge more readily than the abdominal fat cells in women But although beer is not a special problem, it can add to abdominal obesity by contributing calories. In round numbers, a standard 12-ounce beer contains about 150 calories; a light beer, about 110 calories.

For comparison, a 5½-ounce glass of wine or a 1½-ounce shot of hard liquor provides about 100 calories. Since all these beverages contain approximately the same amount of alcohol, you can see that regular beer does have extra calories over other adult beverages — unless you count the mixers and olives. — Harvey B. Simon, M.D. Editor, Harvard Men’s Health Watch [ h t t p : / /w w w . h e a l t h . h a r v a r d . e d u / healthbeat/6-simple-steps-to-keep-yourmind-sharp-at-any-age]

Like father, like son When parents have alcohol use disorders, their children are more likely to inherit the same issue and need alcoholism treatment at some point down the line, according to a recent study from The University of Copenhagen.

The study showed that this genetic relationship was isolated from other factors contributing to alcoholism, such as social status and gender. The study showed that this association was even more common amongst female children of parents with alcohol issues.

During The University of Copenhagen study, data was analyzed from more than 7000 parents who are currently an average of 60 years old. The study benefited from the fact that Danish citizens have personal identification numbers, making it easier to follow them for decades. This new study confirmed other recent research that has shown a genetic link between parents and children with alcohol use problems. [http://www.prweb.com/releases/2011/5/ prweb8405411.htm]

www.together.us.com | July / August 2011

The controversy surrounding the subject of sex addiction may stem from the fact that

inability or difficulty being alone; using sex, seduction and intrigue to hold onto a partner;

IN•THE•NEWS

Headliners • • • • • •

"I had it all" Network news anchor Laurie Dhue revealed in March that she had been a closet alcoholic for a decade.

“When people look at me they say, ‘You don’t look like an alcoholic. How could you have these types of problems?’ But outward appearances are deceiving and they certainly were in my case,” she told CBN News. “From the outside, I had it all. I had a great job at Fox News. I had more friends than I can count. A loving family. None of that mattered.

“Because inside I was a shell of a person.

I had low self-esteem. That’s why I turned to alcohol. It seemed to make me happier.

But as the years went on and my problem didn’t get better, it actually got worse. I had to look at myself and see what it was that I felt so bad about that I had to cover with alcohol.”

“I drank to “I got sick and make myself tired of being more interesting sick and tired." to other people,” she continued.

“And I drank to make other people more interesting to me. When the truth of the matter is, I was very interesting the way I was, and alcohol wasn’t doing me any favors. When I realized that, I was ready to get sober, because I was sick and tired of being sick and tired.

And I got down on my knees and begged God for help on the morning of March 14, 2007. I said, ‘I cannot do this. God help me,' and that’s when I knew the fight was over.

“My faith played an enormous role in my sobriety. I would not be where I am, which is four years sober -- four years without a drink -- without God’s help.”

• • • • • •

The party’s over The singer Whitney Houston, 47, who has struggled with substance abuse in the past, entered an outpatient treatment program, it was reported in May. “Whitney Houston is currently in an outpatient rehab program for drug and alco-

hol treatment,” her rep said in a statement.

“Whitney voluntarily entered the program to support her long-standing recovery process.”

Houston first entered rehab in 2004, telling ABC News interviewer Diane Sawyer at the time: “I partied a lot. Trust me: I partied my tail off.” But, the singer also admitted, “You get to a point where you know the party’s over.”

• • • • • •

Fighting to change The celebrated and controversial fighter Mike Tyson is fighting now to change his life.

When he was at the top of his game, Bill Whitaker reported in a CBS Sunday Morning profile, Tyson was at the top of the world: vanquishing contenders, flouting convention, living the high life on his terms, earning, by some estimates, as much as $400-million — more than enough to feed all his appetites.

His first marriage dissolved amid charges of spouse abuse, Whitaker reported. He was convicted and served time for rape.

And he perpetrated one of the most infamous acts in modern sports history: In a 1997 comeback match, he bit Evander Holyfield’s ears and tore off a piece of one.

Tyson really never came back from that.

Staying on the straight and narrow has had its ups and downs, Whitaker recounts.

He’s had recent brushes with the law: a cocaine conviction in 2007; arrested for scuffling with a photographer in 2009. But he’s been to rehab and is now 2 ½ “Right now years sober. He supercedes all knows skeptics 16 that liquor, all will think this new Mike Tyson that dope.” is just another act. He wonders if he’s fooling himself. From his suburban enclave he can see Las Vegas shimmering in the distance, where he once was up in lights. Resisting the pull of the past is the hardest fight of his life.

“This is pretty interesting,” Tyson said of his quiet life with his third wife and two small children. “I like this life right now.”

“When in your life has been the best time?” Whitaker asks.

“Now!” Tyson says. “Now! Right now supercedes all those championship belts, all that money, all that liquor, all that dope.

Right now.”

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for two years. One of the assignments that patients at that time presented in primary group was a timeline in which the patient depicted

ing to a world that has changed. person’s role in the dream was to listen to me as I spoke of the new hope I was experiencTHE RITUALS ing in recovery. In the far corner of the car a Participating in mourning rituals often involve person was reading a newspaper. The paper interactions with family members. Many was shielding their face. cultures celebrate the passing of a loved one As I spoke of my new life, the person in the with wakes, funerals and the like. Participating corner put down the newspaper and stood in these ceremonies can often be problematic up. It was my father but not as I remembered For over 20 years, Cottonwood's beautiful, 35-acres setting for those new in recovery. To be thrust into him. He was not the eighty-two year old who has been the perfect place to begin the process of recovery. a situation where family members might be had recently died from pancreatic cancer. He dollars. Roosevelt’s wife, Eleabuilding, furdrinking istheir difficult enough.watching When this their is looked like he did in photos I had seen of him nor, took a dimmer view, refusing niture being hauled out ( just as compounded with unresolved family confl icts in his twenties, healthy, robust with dark hair throughout her husband’s terms Jack Lemmon and Lee Remick of the recovering person, the — the prizefighter he had been in his youth. I • • • and • •mistrust • relapse in office to serve alcohol at White do 30 years later we in are “Days chances of would increase.

Even when said, “Dad! What are you doing here? You’re House dinners. It may not surof Wine and Roses”).

In his empty mindful of this risk, we often feel an dead!” He replied, “I just wanted to tell prise you to learn that her father apartment hasand a brief moment obligation to he attend somehow you to keep doing what you’re doing. It’s was an alcoholic. of clarity from a sacred music rewe must find a way to cope. going to be O.K.” cording played on a neighbor’s (Continued from page 19) Hockey player Derek Boogaard, 28, of the New York Rangers died in Many recovering addicts and I woke up with tears running down radio;ofit’s his one brush with reliMinneaplis from an accidental overdose the drug oxycodone mixed alcoholics come to the realization my face. Shortly afterwards I went to with alcohol, the New York Times reported.

The medicaltake. examiner atgion, andgrieving it doesn’t Soon equal voting rights, began to exercise equal wo years earlier, the that their process had beenhe’s his grave at the cemetery. Standing by SWEETWATER ADOLESCENT tributed the cause of death to “mixed alcohol and pennies oxycodonewhile toxicity” panhandling drinking rights.

Ironically, one of the last legendary director D.W. ADULT PROGRAM or postponed until their his his tombstone I wept as I spoke to him GIRLS and said the death was an accident. delayed daughter sellsThis apples a street staunch defenders of Prohibition was the Griffi th PROGRAM made his last began. fact, Ion about my life. I walked back my caracknowledged that herecovery Histo family was battling addiction atthink, the time corner.

Ku Klux Klan. film, “The Struggle,” in a Bronx is evident in my story and also in Oxyfeeling relieved — as if a weight had Cottonwood's 90-day residential Cottonwood's intensive Adult Program with of his death and had played in pain for Thanks years, the Times reported. to hisclients child’s unwaverWhen the stock market crashed in 1929, studio and partly on New York the stories of many I have been lifted from my shoulders.

Sweetwater Program for girls 13-17 places individualized treatment plans includes a codone is a powerful and addictive painkiller. In a time-release form, the drug is known as ing love and loyalty, “The most efforts to enforce Prohibition virtu- streets. Written by Anita Loos with.

As the aacute grief counselor a strong emphasis on scholastics as well as Over the next ten years solid base of medical management.

OxyContin.

Mixing anyI continued form of oxycodone with alcoholworked can increase danger of a Ibad Struggle” has a happy ending — ally ceased. Popular support dwindled away. (“Gentlemen Prefer Blondes”) and a therapeutic curriculum. have adopted the position that I am reaction. a substance abuse rehabilitation program. my pursuitBoogaard of recoverywas andin eventually Jimmie quits and is reEven though overall drinking • Mood/Bipolar Disorder declined by adapted from a short story by the The Boston University School braindrinking wouldin bethe examined “companioning” people first entered my current profession as a of Medicine said that Boogaard’s stored to health, to his family and 30% during the 1920s, drinking to excess French author Emile Zola, it’s the Hal Skelly struggling with the drink.

• Chemical Dependency for signs In of 1988 a degenerative head trauma.

While • Substance Abuse/Dependence tfulathletes steps of who their sustain journey through grief. By therapist. my mother disease died of aoften strokefoundfiin to his it jobwas in the steel mill. This was rose sharply along with cirrhosis deaths and first feature-length • Depression there is no evidence that this was the case with Boogaard, with a former N.H.L. • Depression (93 minutes) accompanying them on the first stage of their at the age of 81. I left Tucson to go to her vows abstinence.

For a time Jimmie stays the beginning of Hollywood’s long reliance alcoholic•psychoses.

New York City boasted American movie about an alcoholic and is player, as Bob who died of aheart failure journey at 45 last year. Probert had a history of drug Anxiety • Anxiety through the grief process, I am able bedside sheProbert, lay in a coma.

During sevensober, sipping sarsaparilla at the donated bar withafter onhis thedeath, family as the major instigator of re30,000 speakeasies.

Chicago mob boss Al worth considering. and alcohol and his brain, signs of • PTSD • Self-Harm Behavior to help them to showed narrate the story ofdamage their lossfrom day death vigil,abuse, I stayed in touch with my concussions, researchers a distinctly white-collar crowd at heBoston longs University coveries said. from alcoholism, all the way up to Capone summed up well: “When I sell Jimmie (Hal Skelly, a Broadway pro repeated • Grief anditLoss • Trauma without judgment. This task is of paramount recovery support system and received support liquor it’s• Anger bootlegging. and Disorders Florrie (Zita Johann, who to join. The couple’s first-born daugh- “I’ll Cry Tomorrow” in 1954. “The Struggle” and Rage When my patrons of the era) • Eating importance in successfully negotiating the from new friends I met at 12-step meetings in • • • • • a commercial • aCompulsive Gambling failure, probably beserve it on silver tray on Lake Shore Drive, would partner Karloff in “The Mum- ter grows into a little girl in their modest • was • FamilyBoris Conflict grief process. Addicts and alcoholics often exFlorida. When my mother finally died, I was • Sexual Addiction it’s hospitality.” my”) are• Grief initially pictured as a pleasant one-bedroom, but one night, mostly on cause it came at a time when America was and Loss perience complicated grief as a result of their there to hold her hand and talk to her in her • ADD/ADHD • Low Self-Esteem In the spring of young couple being impulse, Jimmie yields to the cajoling of no longer hiding its bottles or its drinking. self-perceived failures and lapses in being a last moments.

Eating Disorders 'When I sell liquor it’s 1933, •Prohibition swept along in the fri- his hard-drinking pals and takes a glass of American movie audiences, as we’ve seen “good” child, parent, partner, sibling syncopated or friend.

My mother’s death helped to realize that Gil me Scott-Heron, the poet and recording artist whose • Obsessive Compulsive Disorder and another. from Daniel Okrent’s meticulously dewas repealed, with volity and open social whiskey. And another spoken styleprogram and mordant oftopolitics, racism and mass meItcritiques is common hear statements beginning as an alcoholic working a spiritual I bootlegging.

When my Once Jimmie begins drinking heavily,voice tailed history, wereculture just beginning to view President Franklin drinking of the wandia made him a notable of black protest in the 1970s and was able to cope with adversity differently than with “If only I had…” or “I should have…”

“The Struggle” picks interest.early He influence loses alcohol once again a newfound and alRoosevelt declaring patrons serve it on a silver ing years of Prohibi- when an up important on hip-hop, diedwill inashave Manhattan, The New Sometimes people had an ambiguI was using substances.

I was supported celebration, and most legal friend. ✺ that the legalization tion. Florrie’s wary of his job, wrecks a family tucson York Times reported. ous relationship with the deceased. The fact every step of the way and I found that I could tray on Lake • Shore Drive, insurance pol-of the Last Poets, a group of black nationalist of beer alone would Jimmie’s drinking and cashes in his wife’s $4,000 the work that the deceased family member might have 1-800-877-4520 Tucson, Arizona be there for my family asAlong well aswith for myself. performance poetsliquor who emerged alongside him in the late 1960s and schemer’s fake increase federal tax agrees to marry this icy to back a blonde Kurt Brokaw is Associate Teaching Professor struggled with his or her own issues and This was a real contrast to the time when I —Al Capone it’s hospitality.'

Scott-Heron the New attitude and the stylistic haul. ’70s, WithMr. no job or incomeestablished to support much his of revenues by hunblue-collar steel work- early at The School and senior film vocabulary critic of The inappropriate can also lost my fathercharacterize and was self-medicated and would thesidewalk socially conscious of earlybehavior rap groups likecomplicate Public Enemy family, he stands on the outside work dreds of millions of er/supervisor only if he that Independent (Independent-Magazine.org).

As my body and mind healed, an interesting phenomena occurred when I had about three

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I N Welcomes • T H E • NTogether E W S AZ Together I thenAnd ask them to determine distance the grieving process.Productions, Clients sometimes need reported. and Boogie Down the Times he has remained what part of the DNA of hip-hop by being sampled by stars like Kanye West. the chairs is comfortable. The client between encouragement to talk about their painful In later years, struggled publicly Since 2001, Mr. Scott-Heron then begins to read the letter.

At the conclu-had experiences so thathe healing, forgiveness andwith addiction. been convicted twice forbe cocaine possession, a sentence Rikers Island sionhe of served the reading I will askatthe questions to in acceptance can ultimately achieved.

Work- and New York for parole violation. assist the client in getting further in touch with ing with a counselor who understands the His friends were horrified by his descent, The Times reported. In interviews Mr. Scottgrief process can help the griever address these their feelings. If I feel it is appropriate, I will Heron often dodged questions about drugs, but the writer of a New Yorker profile reported ask them to so speak in the voice of the deceased, issues so thatMr. resentment and shame aresmoking not witnessing Scott-Heron’s crack and being troubled by his own ravaged telling the client what they need to hear suppressed for fear of being disrespectful to physical appearance that he avoided mirrors. “Ten to 15 minutes of this, I don’t havefrom pain,” their lovedcrack one. We conclude the exercise by the dead.

Mr. Scott-Heron said in the article, as he lighted a glass pipe.

That Times report seemed to contrastwhat tragically with Mr.Clients Scott-Heron’s processing has happened. often In myimage, work atThe Cottonwood and insaid, my prilegacy as someone had once so trenchantly mocked therelieved psychology of addiction.

“You report feeling as a consequence of dovate practice, I beginwho any grief counseling with keep sayin’ kick it, quit kicks need it quit it!” saidthis in exercise. his 1971 song “Home Is Where the a consultation to assess theit,client’ and to he ing Hatred Is.”their “God, did you ever try to turn soul inside out so that group the world could Activities in a grief-specific setting are fully hear story.

Developing a strong andyour sick watch you die?” also helpful in assisting clients in addressing trusting therapeutic relationship with a client • • • • • • their losses. One exercise involves identifying is essential to a successful outcome. In some a person’s greatest pain by giving it a name, cases the death is a sentinel event that has shape, color and sound. After sharing their profoundly disrupted the life of a client. Prior descriptions of pain, areatthen to the loss the client mayAlthough have enjoyed a fairly the actor Jeff Conaway, who died clients in May the asked age ofto60, often spoke of worldhis longtimegive battle alcohol theirwith paindrug a newand shape, color,addiction, sound and he contented life. Understandably, their “was a terribly complex with chronic pain, addiction name.

I encourage them opiate to use this as a tooland view assumed that their children would outlive case trauma,” Dr. Drew Pinsky, who had in reducing the intensity of theworked feelingswith whenthe them, that they wouldsevere enjoy achildhood long life with actor over the past few years, told People Magazine. overwhelmed. their partner and that their parents would live “One of the deeply moving aspects of Jeff ’s case was the profound Sometimes during the mourning process to a ripe old age. Death results in the bursting trauma he suffered during childhood,” Pinsky said. one deal with as well-wishers who someof“Only these expectations.

Suddenly the world is no in retrospect did he become aware that hehas wastoexploited part of a child pornogtimes make statements that are thoughtless longer as safe and predictable a place as it had raphy ring and suffered ritualistic abuse by the older children in his neighborhood,” Pinsky inappropriate.

Anpain example of this might earlier We are intosevere a strange told theseemed. magazine.

“Aspropelled with many traumaand survivors, chronic is a frequent manifestation.” be, “Don’t cry. Everything will be okay.” Anand terrifying landscape. Nothing is the same painremark often might amplifies whenare opiates or opiother be, “They in a better asRecently, before. “in the setting of addiction, chronic oids are used,” Pinsky explained. “That is called hyperalgesia, andgriever it haschooses been well docuplace.”

It’s okay if the to believe TOOLS AND mented andSUPPORT I certainly see it frequently in addicts. is not as though thisofalways occurs, but this.ItSometimes, this kind thoughtless statefor addicts thereI have is a very high likelihood.

One of the tools found to be helpful forCertainly this was the case with Jeff.” ment is just a sign of the well-wisher’s anxiety Pinsky urged Conawayreality to seek “I begged him repeatedly to try something clients whose presumptive hasalternatives. been experiencing the griefdown of others. else,” he says. told him dozens times thatinshould he continue that path, I was shattered is an “I exercise called a Loss of CharacRecovering people need to give themselves convinced he would die.

In spite of telling him repeatedly his addiction would kill him, I terization. The Loss Characterization is basicould not pull him from the clutches of the painpermission meds.” to cry if they need to. For so long cally a character sketch the client composes we medicated our feelings. Some of us were about him or herself that is written in relation raised in environments where crying was conto a loss. The client writes this in the third sidered unmanly or childish. Many of us have person from the perspective of a close and heard the expression “Pull yourself up by your loving personal friend who knows the client inbootstraps.” When the world is full of sorrow, timately. When the assignment is completed I statements like these can be cruel and insensiask that they share it with me. Together we can tive. What I found to be helpful is the presence explore what meaning the author perceives of of people who care. Support is always available their experience of loss. at 12-step meetings. Sometimes the words of In one recent session a client had expecomfort are not needed but the hugs are. rienced the death of a teenage son. At the conclusion of sharing the loss characterization DISCOVERING TRIGGERS with me she expressed anger at God for takIn recovery we learn to identify triggers that ing her child from her. As she was a religious could lead us to relapse. Grief has its own woman, the thought of anger toward God was triggers. They can arrive without warning, a difficult one for her to express. She felt inreminding us of our pain. Photos, films, tensely guilty about being disrespectful toward articles, songs and anniversaries can prompt God. I gently encouraged her to dialogue with thoughts of our pain. At these times the pain God using the technique of an empty chair brought on by these reminders of our loss can gestalt. After some initial reluctance, she was elicit thoughts of using substances. In relapse able to go with it. Along with expressing her prevention workshops that I have facilitated anger, she was able to ask questions like, “Why we address the grief-related risk factors that did you do this to me?” and, “When will you can precipitate a return to using substances. give me the strength to go on?” Concluding Among these are difficult emotions, conflict this exercise the client reported feeling comwith others and testing control. forted and relieved. In fact, she reported that There are ways for alcoholics and addicts afterwards she felt that her relationship with to cope with loss so that the experience can her Higher Power was healing. be meaningful. We have learned to value a On several occasions I have suggested relationship with our higher power. Turning that my grieving clients write a letter to their to the God of our understanding can provide deceased. I provide these clients with a format comfort even when our prayers express only that cues them to write about what is missed, anger and confusion. Journaling has proven what is not missed, regrets, and appreciation. I to be beneficial. Writing can be therapeutic on encourage clients to write what feels appropriboth a physical and emotional level. After the ate and authentic. When the letter has been death of my mother I returned to the twelve completed, I ask my clients to share it with me. steps. Completing a fourth step inventory and This is also a time when I have used the empty sharing it with a sponsor proved helpful. chair technique with positive results. I begin There are many books related to bereavethe gestalt by asking the client to describe the ment. Some may seem to reinforce the idea physical appearance of the deceased including that grief is a predictable process. I tend to their posture, clothing and expression. Somesuggest other books that recognize the uniquetimes a photograph is available and we use it.

(Continued on page 17)

Jeff Conaway, 60

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7 11

COVER•STORY

This is Your Brain

over the crime scene. Short months later, Paul was looking at the world through the bars of the upstate New York prison where he will likely spend the rest of his life.

(Continued from page 1)

Anatomy of a blackout

Strange state of oblivion At trial, the story told by the prosecutor about Paul’s actions on that night in December 1988 is one guaranteed to send a chill down the spine of anyone who has ever suffered an alcoholic blackout. After an evening of heavy drinking at a Larchmont, N.Y. bar, Paul was driving home with two drinking buddies. His last memory of that night was trying to negotiate a tight curve and one of his friends warning, “You’re not going to make it.” Then nothing.

The alcohol Paul had consumed that night had triggered a biological reaction deep within his forebrain that temporarily but effectively prevented it from forming new memories.

Not even knowing it, Paul entered the strange oblivion of an alcoholic blackout.

But somehow he made it home that night, and too early the next morning a bleary-eyed and befuddled Paul was roused by a phone call from the local police, who were pointedly interested in why they had found his damaged but drivable car abandoned along a Westchester County highway. Paul stammered through a weak and implausible explanation, but in reality he had no clue. In fact, prior to hearing from the police, he had assumed the car was parked in its usual spot in his driveway. Eventually, one of his drinking buddies told Paul that he had hit a guardrail, and, even though the car was still operable, he had abandoned it and his bewildered friends and calmly walked off down the road.

The same morning he spoke to the police, Paul first heard an ominous buzz circulating in the neighborhood about a husband and wife, both prominent local doctors, who had been stabbed to death the night before while asleep in their Dutch colonial home at 36 Lincoln St.—the same house in which the Coxes had lived when Paul was a child.

Detectives mounted a vigorous investigation of the murders, but before long, despite the money and man-hours they put into the case, they hit a dead end. They hadn’t found any viable suspects, they had no promising leads, and they lacked even a plausible motive for the crime. At the same time that the Larchmont police were scratching their heads over the murders, Paul began to feel a haunting unease and an inexplicable but increasingly intense sense of guilt whenever anyone talked about the crime. He also began to experience fragmented but persistent dream-like recollections of stabbing his own parents in their old family home.

These frightful quasi-memories combined with other alcohol-related life problems, and eventually Paul sought recovery in Alcoholics Anonymous. Two years after joining A. A., and in the clarity of sobriety, Paul was beginning to connect the dots of that horrible night. Ultimately he shared his fears and recollections about the stabbings at an A. A. meeting. Another person at the meeting informed the police about what he had disclosed, and detectives soon matched Paul’s fingerprints with those left in the victims’ blood all

Paul Cox’s journey to prison began in an alcoholic blackout—a phenomenon known to anyone with a working knowledge of alcohol and alcoholism. Actually, an alcoholic blackout is a peculiar form of anterograde amnesia caused by the presence of a sufficient amount of alcohol in a drinker’s bloodstream. The term “anterograde amnesia” refers to memory loss in which the affected person is unable to form new memories after an actuating event (in this case, alcohol intoxication) but can remember everything, including procedural or how-to memory, known before the onset of the amnesia.

Anterograde amnesia is distinct from another kind of memory loss called retrograde amnesia. In retrograde amnesia, a person can remember present and ongoing events but cannot recall anything that happened prior to the actuating event (typically a traumatic brain injury) that triggered the amnesia.

Alcohol can produce measurable impairments in memory after only 2-3 drinks. A drinker who is in the netherworld of an alcoholic blackout can appear fairly normal; they are usually able to carry on conversations and even negotiate their way through difficult or complex tasks. There are even documented cases of pilots flying airplanes, surgeons performing complex operations and lawyers trying cases—all the while in full-blown alcoholic blackouts. Both men and women drinkers seem to experience blackouts in about equal numbers and, surprisingly, blackouts are as common among social drinkers as they are in alcoholics.

Some drinkers, particularly those with a history of blackouts, are at a higher risk for blacking out whenever they drink heavily. There might also be a link between prenatal exposure to alcohol and a vulnerability toward blackouts.

Some researchers believe there may even be a specific genetic predisposition to having blackouts.

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Together Welcomes Together AZ COVER•STORY

Relapse Dreams A hidden Message?

J

MarkerBYfor alcoholism chArLES giLLESpiE

The noted alcoholism researcher E. M. Jellinek ean, studied alcoholic blackouts a patient in treatment for in the 1940s bysubstance surveying recovering abuse, came tomembers my group of Alcoholics Anonymous. Because of the high disturbed about the following prevalence of blackouts in the drinking his“using� dream had the night before: tories of A. A.she members, Jellinek concluded “I dreamed I was in the cafeteria teaching that alcohol-induced blackouts, especially other patients here howearly to chop lines ofdrinking blackouts occurring in one’s career, were an accurate biological cocaine and snort them.� Though shemarker laughedof alcoholism. at the dream because of its ridiculous InJean 1969, on interviews with 100 plot, alsobased wondered what it might hospitalized alcoholics, Goodwin and his colmean, if anything, about her recovery. leagues concluded that there were two distinct forms of alcoholic blackout: en bloc and THE VALUE OF DREAMS fragmentary.

According to Goodwin, an en The of is this is toloss briefly outline blocpurpose blackout a article complete of memory, characterized by anresearch inability -- sdespite some of the clinical that’ been all efforts by the drinker or others tomeaning cue recall conducted about the occurrence, and-to remember any events that occurred while value of drug-using dreams. It is my intention intoxicated. Fragmentary blackouts, as the to demonstrate that drug-using dreams can be term implies, involve only a partial inability useful in counseling when and clinicians to remember events.

In clients fragmentary blackare informed about the possible function thisreouts, forgotten events can sometimes be type of with dream serves. cueing. called persistent These dataa classic and their clinical One study, in the field ofimplications subwere the result of careful observations of stance abuse treatment, demonstrates blackout drinkers.

Alcoholism researchers that alcoholics who dream about drinkhad to be content with this kind of observed ing during the course of treatment tend clinical data, because they lacked the kind to longer periods of sobriety of achieve neuroimaging technology that would al(Choi, 1973).toThis finding suggests low them look deeply into that the brains of blacked-out subjects. thethe late 1960s clients like Jean who dreamIn about though, innovative neuroimaging substances they are attempting to ab- systems allowed new be generation of brain scientists stain froma may more engaged in the to unravel the neurobiological intricacies of treatment process than those patients the alcoholic blackout. who don’t report drugusing dreams. In other words, these clients take their struggle with substance abuse seriously To make sense of how alcohol can disenough to dream about rupt the brain’s ability to make memories, it at night.

Asfirst Freud researchers had to identify a model of observed, only mattersthat could be used as a memory formation of greatest importance contextual reference for the process of remembering, also one that was adaptable are permittedand to disturb to the rigors of neuroscientific investigation. our sleep.

In this regard, A number of thedream early studies into the neuJean’ s drug using robiology of alcoholic blackouts used a paramay be understood as a digm of memory formation first described by positive sign, Atkinson anddreamed Shiffrin and called the Modal by a person who is seriModel of Memory. ously concerned In the Modal about Model of Memory the formationconsequences of memoriesofinvolves a number of disthe tinct but coordinated actions that begin with relapse. sensory A moreinput recentforming study an immediate, or sensory, memory (the kind of memory that lasts of crack cocaine addicts only a few seconds). If a person attends to the who dream about drug sensory memory and if information encoded use demonstrates that is important enough in the sensory memory the of using related to the memory is or ifcontent the information rehearsed, theimportant immediate memory may then dreams is also proceed to long-term in predicting treatmentstorage—a place where it can be retrieved whenever it D., is needed. outcomes (Reid, S. and Simeon, 2001).

Each of these processes is handled by a Over a ninety-day period, clients who report different part of the brain; the most critical their dreams changing from using to of which is the hippocampus, a cocaine chili pepper actively cocaine toforebrain. achieve longer shaped refusing structure deep tend in the The periods of abstinence.

Thisisfinding suggests the job of the hippocampus to coordinate process of memory formation by routing raw that readiness for change is reflected in dream sensoryand data from a variety sites clients in the content that dream-life canof provide neocortex (the outer, wrinkledchange. surfaceThese layer with an opportunity to rehearse of the brain) and sorting this often-jumbled dreams provide clients with an exposure to cravings, interactions with “using friends�

The neurobiology of a blackout

information into a coherent autobiographical memory. The hippocampus then sends the memory on—via tiny structures on its surface called pyramidal cells—to the brain’s frontal cortex, where it can be used to reason, plan and guide behavior.

In sufficient amounts, alcohol can prevent memory formation by disrupting the normal and typical they will be confronted function ofscenarios the hippocampus and paralyzing withpyramidal in waking life after leaving treatment.

In the cells.

When affected by alcothesethe cases, the importance notability placedto onsort hol hippocampus losesisits the individual random sensory sent to it byinvarious dream data but the manner which areas the neocortex.

Hippocampal dreamofcontent shifts over time. If clientsimpairlike ment is then compounded byusing alcohol-soaked Jean continue to dream about substancpyramidal cells that are now incapable of es, they should be encouraged to record their sending memories, jumbled or otherwise, to dreams and cortex. note anyBy shift in content.

This the frontal causing a dysfunction process may instruct clients and counselors in the hippocampus and pyramidal cells, alabout significant triggers need to be adcohol ensures that the that drinker’s brain cannot formwhile new challenging usable memories. person in dressed, clients toAexamine an alcoholic lives only in the prestheir readinessblackout to change. ent, lacking any kind of study immediate or recent One particularly useful of drug-using memory to guide their speech or actions. dreams demonstrates that a client’s personal Memory loss is why intoxicated people often responsethemselves to the dreaminis more important than repeat conversation—going dreamthe content it comes to predicting over samewhen conversational ground again a positive and again.treatment outcome (Brown, 1985).

Some candream increase the The studydrinking finds thatbehaviors clients who about risk triggeringfall aninto alcohol-induced blackusingofsubstances two main categories: out.

Thereexperiences is persuasive data that one group frustration thatsuggests their that gulping drinks can heighten one’s risk dream isn’t real and the second group experiof blacking out. Drinkers who suffer alcoences relief their holic blackouts oftenthat drink toodream much isn’t and too real.rapidity The firstofgroup is described as quickly. The rise in blood alcohol having This level (BAL) mayrelapse-pending be as importantdreams. in triggering a blackout a high BAL itself. Alcohol groupas longs to re-experience intoxican also interact with other drugs,toward several of cation and feels triggered which even when taken alone, aregroup capable substance use. The second of producing dysregulation in hippocampal is described as produced having recoveryfunction similar to that by alcohol. affirming dreams.

This group wakes Benzodiazepines like ValiumÂŽ and XanaxÂŽ disturbed by their dreams can causeupmemory impairment evenand when taken alone and in amounts only substance minimally feels repulsed from actual higher than large like therapeutic dose.

And use.aClients Jean clearly belong when alcohol and benzodiazepines are need taken to this second group and often in combination, the effect almost guarhelpisperceiving their anteed to result in a blackout. Recent data using dreams as a reclearly show that using alcohol and maricovery-affirming projuana together results in greater memory They may find it impairment than would cess. result if either drug were taken alone. helpful to inventory Over the past twenty years adtheirtremendous motivations for vances have been made inrecovery our understanding and review of alcohol-related memory loss. In the near their action plan. The future, a new generation of electrophysiologiusing dreamthat can be cal recording devices—instruments will harnessed as allow scientists to gather data froma “wake many up call� challenging parts of the brain simultaneously--will likely yield new and more detailed information clients like Jean toand possibly a more nuanced understanding re-examine their of how alcohol can impact aassumptions wide range of brain about functioning, including memory formation. recovery.

But these new insights may end up being of more interest to the neuroscientific community than to the typical DREAMS’ problem RELEVANT drinker.

Most problem drinkers are already familMESSAGES iar with a much more cogent reality: Horrible Clients with relapsethings can happen to people when alcohol will shuts down their brain’spending ability dreams to remember. also need help in Just ask Paul Cox. regard to receiving a Jeffrey C. Friedman is a licensed substance relevant message from abuse therapist at Cottonwood Tucson, bethe reactions theyahave havioral health treatment centercan indirect Tucson, to their using dreams.

Counselors Arizona. His work includes treating chemithese clients back to interventions that address cally dependent and disordered gambling the contemplation change.

These cli- of patients, lecturingstage on ofthe neurobiology ents may benefit from disorders, a review of and the costs and addictive and mood presentconsequences their substancehealth use. issues at ing workshopsofon behavioral conferences throughoutdream the U.S., The relapse-pending mayEurope bring and Asia. information: to lightFor theirmore impoverished view ofwww.cottonsobriety. woodtucson.com.

Email these Jeff at jfriedman@ Counselors can challenge impoverished Cottonwoodtucson.com. views and direct clients toward new be(Continued on page 17)

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And, while the alcoholic blackout is something that has long been recognized by medical science, the neurobiological process by which alcohol robs the brain of its ability to remember has only more recently been discovered.

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The using dream can be harnessed as a “wake up call� challenging clients to reexamine their assumptions about recovery.

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May/June 2011 | www.together.us.com

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9 13

BODY•MIND•SPIRIT

How Chronic Pain Threatens Marriage It can become a disease in itself, creating tension between patient and caregiver

T

By Jim Brown, PhD

he unintended effects on a spouse or partner are familiar. Concern, support, and love are challenged by fatigue, frustration, and a sense of being overwhelmed.

Alcoholism? Substance abuse? Eating disorder? No, the problem is chronic pain — the kind that can last months or years. The kind that can threaten a marriage or a relationship, and the kind that is all too familiar to people who deal with dependency.

Studies show that those who suffer chronic pain often suffer anxiety and depression as well. Many sufferers turn to alcohol for relief, and some may be unaware that they are using alcohol as a pain medication. Unintended addiction to pain killers has made the headlines as well-known sufferers fall victim. The actor Jeff Conaway, who died this year, blamed his cocaine use and pain pill abuse in part on lingering pain from back surgery.

Although originally triggered by conditions such as arthritis, cancer, fibromyalgia, damaged spinal discs, osteoporosis, or shingles, chronic pain becomes a disease itself.

Pain signals continue to pummel the brain regardless of treatment, and sometimes the exact cause is not even known.

The number of Americans suffering from chronic pain reveals the scope of the problem.

More than 75 million adults — one in every six Americans — have reported long-term chronic pain, even though the condition is under-reported and under-treated. The number is higher among those 65 and over, and higher yet among cancer patients. And for every chronic pain patient, there is at least one person giving care whose life is also being changed dramatically. Chronic pain introduces tension to a marriage and increases the likelihood of divorce.

Reduce the stress. You and your spouse can reduce pain-related stress and protect your marriage. The first step is to be as well informed as possible. Support groups such as the American Chronic Pain Association and the American Pain Foundation (APF) are good resources. A monthly electronic newsletter titled Pain Monitor is free and full of practical information. (www.painfoundation.org/learn/publications/pain-monitorelectronic.html). Help is also available from

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family counselors, psychologists, and pain management physicians.

The caregiver has to acknowledge that chronic pain is real, it’s hard to manage, and it’s individual in nature. Wide variations exist in pain tolerance and how people respond to treatment. There will be good and bad days, so both partners should take advantage of the good ones.

Understand.

The patient has to understand 1) that the symptoms can often be controlled by complying with a doctor’s recommendation (for example, losing weight or exercising regularly), 2) that the condition places stress on both spouses, and 3) that there are limits to how much help one person can give.

Take a break The caregiver should take breaks — emotionally and physically — and the patient should encourage the spouse to take those breaks without feeling guilty. Scheduled breaks seem to work better than waiting for the right time. Help is often available from family members, friends, or support groups.

If someone volunteers to assist, have specific things in mind that person may be able to do (sit with the patient, run an errand, take the person to physical therapy or to a non-emergency doctor’s appointment).

Support without enabling The last suggestion might be the most difficult to implement, and you’ve heard it regarding dependency. If you are taking care of a person with chronic pain, help but don’t enable. It sounds harsh, but there are incentives for some patients not to get healthy. It might be to get more attention. It might satisfy their perceived need for more or stronger drugs. Pain, or exaggerated perception of pain, enables some patients to avoid household or family responsibilities.

Educating yourself and your spouse about the nature of chronic pain, complying with medical advice, scheduling breaks, and supporting without enabling may not only save a marriage, they might even make it stronger.

Jim Brown, PhD, Executive Editor at the Steadman Philippon Research Institute, is the author of Pain Management: Advances in Diagnosis and Treatment.

www.together.us.com | July / August 2011

BODY•MIND•SPIRIT

A Spell Cast Over Us Like hypnosis

By Alan Cohen

W

hile presenting a seminar in Japan, I asked for a volunteer to tell the group why he or she deserved to have good things. A woman named Sachi rose and explained in English that she is bilingual and bicultural.

Sachi had spent years living in America and had just returned to Japan. Sachi shared her “deserving” list in English, and then began to translate for the group members who spoke only Japanese. After a few sentences, Sachi stopped speaking and a pained look overtook her face. “That’s weird,” she commented. “In English I can easily explain why I deserve the things I want. In Japanese I feel ashamed and I can’t find the words.”

Sachi’s predicament represents not just the difference between cultures, but between two contradictory mindsets we all have. One mindset is big thinking, visionary, and deserving. The other is small, apologetic, unworthy, and prone to guilt and shame. When you are in the deserving mindset you know you can do it all and you can have it all. When you are in the worthless/useless mindset you feel like a nothing and a nobody. Each mindset feels real when you are in it. The question is, which reality are you speaking from? Who is home today?

This disparity takes on monumental implications when you consider the power of multiple personalities. Psychologists have documented contradictory manifestations in the lives of people who experience multiple personalities. One of the personalities is allergic to oranges and breaks out in severe physically observable hives if that person eats an orange. When that person is in a different personality, she can eat a dozen oranges without any adverse symptoms. Who is the person really? Do oranges cause hives, or is the belief in hives more powerful than oranges?

Ever feel like a fraud waiting to be found out?

“It’s the best possible time to be alive, when almost everything you thought you knew is wrong!”

Fraud guilt Many people experience a related issue called fraud guilt¸ the unspoken belief, “If you knew the truth about me, you would realize that I am a phony and you wouldn’t want me or love me.” The odd thing about fraud guilt is that most people have it, even if they are experts and huge successes in their field. When a group of Hollywood movie studio CEOs was asked, “What do you most fear?” the most common answer was, “I am afraid that people will find out that I don’t really know what I am doing.”

Ironically, these executives were extremely successful, turning out multi-million-dollar grossing blockbusters. Still, many of them felt like frauds.

All defenses do what they defend against. So the voice that tells you that you are a fraud is the fraud. The answer to the voice of fraud guilt is to simply keep on doing what you are doing as if you deserve to be doing it. Just do it anyway. “The dogs bark, and the caravan moves on.”

In all of my years working with people who experience fraud

That very feeling is evidence

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Fraud guilt is not inherent in the human psyche. It is entirely learned. Another name for fraud guilt is “competency hypnosis.”

I like this term because it indicates that a spell has been cast over you by people who were also hypnotized to believe in their smallness. A religion told you that you were a sinner before you were even born. A parent or teacher told you that you were stupid and incompetent. An elder sibling told you that you were ugly or annoying. At a young age you believed them, but you never stopped to question if they were correct.

you aren’t guilt, I have never met one person who is truly a fraud. People who are frauds generally do not stop to consider if they are fraudulent. Usually they are unconscious about their lack of integrity, or they rationalize it, and fraud guilt does not bother them. Only people of integrity worry about being a fraud. Yet the integrity that they demonstrate by asking the question is also the answer to the question.

Yet the time comes in every life when you begin to question the reality that was taught to you. If you are reading these words, that time has likely come for you. You and I have been told a few things about reality that are true, and a lot of things that are false. Now your job and mine is to figure out what is real and then live from that awareness. Tom Stoppard said, “It’s the best possible time to be alive, when almost everything you thought you knew is wrong!”

The next time you start to feel small, stupid, ugly, wrong, or incompetent, ask yourself, “Who is home right now?” Have I stepped into a hypnotized reality of emptiness, error, and evil, or by contrast can I claim a reality of wholeness, well-being, competence, and love? You can break the spell of smallness by consciously focusing on wholeness. Keep remembering why you are loveable, beautiful, and deserving.

That will be easier to remember than your adopted dark identity, because those noble attributes are your true nature. Over time you will become more comfortable in your worthiness than your smallness. Then, when someone asks you why you deserve to have what your heart desires, you will be able state your claim with dignity, clarity, and confidence.

Alan Cohen is the author of many popular inspirational books, including his newest book of uplifting messages, A Daily Dose of Sanity. Listen to Alan’s weekly radio show, Get Real, on Hay House Radio at www.hayhouseradio.com. For more information about Alan’s books, programs, or his free daily inspirational quotes via email, visit www.alancohen. com, email info@alancohen.com.

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elcomes Together AZ BODY•MIND•SPIRIT

Serving Patients, Saving Families®

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On Being Spiritual

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It’s a puzzle for some just entering sobriety. But practicing spirituality is not all that mysterious

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By Beth A.

once had the misfortune of being on a blind date. This was a double date, dinner with my friend Kate, her boyfriend, and Dan, the guy Kate thought was perfect for me. As I arrived at the table where the three of them were seated, I said to myself, Just be yourself, and just don’t drink.

Katie got the ball rolling.

“Beth here is very spiritual.”

“Really?”

Dan said.

“What does that mean?”

I took a deep breath and thought, It’s all downhill from here.

Well, what does it mean to me to be spiritual?

Being spiritual means making a place for the sacred, living my life on the highest level of consciousness possible. Being spiritual means doing things that nurture that part of me that I can’t see, that part of me that is timeless, eternal. Being spiritual means nourishing my soul and the spirit of those who cross my path.

is a alizes lor at orders escent

is the Coach. I try to pay attention. Everywhere around me someone or something is looking for acknowledgement, help or loving-kindness. I try to be ready to be of service, smile at the checkout lady, volunteer, send a friend an ecard for no reason, compliment a difficult person. Feed the birds.

“Make myself an instrument of God’s peace.”

5. Create something.

Anytime I make something that didn’t exist before, I am emulating God -- writing a song, baking brownies, making a bouquet, painting, writing in my journal.

6. Be quiet. If I’m making the noise, I stop. I listen. Listen to the birds, to the wind. I try to listen more than I talk.

7. Be humble. I accept that there is something more transcendent than my ego, and today it just might be God in the form of an ant. How do I put humility into action? For starters, I don’t think about my achievements, my possessions, my friends as if they belonged to me.

They don’t. They are on loan to me from the Divine.

8. Be teachable. I choose to perceive both pleasant and difficult/challenging people as a facilitators from the Divine who have been placed in my path to help me with my lessons on Earth. They are serving me.

9. Stop pursuing happiness as if it were a thing I could acquire if I only did such and such. When I am “in pursuit,” I am coming from a place of lack.

I try to enjoy the blessings of the material world without being possessed by them.

We are spiritual beings, living in a material world. Why do people think it’s spiritual to enjoy a sunset, a puppy but not a racy sports car or a beautiful designer dress? Being spiritual does not preclude material abundance.

10. Have unwavering faith. In all times, through all the vicissitudes of life regardless of what is happening, good or bad. If I feel I don’t or can’t have faith, I pretend I am a person with faith. I keep pretending until I don’t have to pretend any more.

To be spiritual means to honor the divine in everything. Honor yourself. Honor others. See yourself and those around you as a serene and gentle Buddha to Be. Each of us on this earth has chosen to suit up, show up and participate in the dance of Life. We are dancing with each other. It is the dance of the spirit in me honoring the spirit in you. It is the Dance of Namaste.

“The spiritual life isn’t a theory; we have to live it.”

– Alcoholics Anonymous

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How to live it?

Here are the steps I take.

1. I give unconditional thanks upon arising. Before I decide whether I have anything to be thankful for, I just give thanks. Thich Nhat Hanh says, “I breathe in, merci. I breathe out, merci.” The very first thing I do in the morning is thank the Divine for giving me this day; for giving me the opportunity to be an instrument of God’s peace. Before I have even a moment to decide whether I am dissatisfied with what I have, worried about what I might lose, fearful about what the future holds, I thank the Divine for this day and for this opportunity to co-operate with him.

2. I meditate on one line of a prayer I like each day and think of ways I will put it into practice for a week.

3. I tell others to practice the sacred rituals of their religion if they have one. If they don’t have one, I suggest they make up a ritual to honor the Divine and practice that.

“My religion is simple. My religion is loving-kindness,” says the Dalai Lama. Some people’s rituals involve walking their dog in the woods. Others chant. Cultivate rituals of reverence. Whether to the Divine, to animals, avatars or the “lilies of the field.”

4. Be ready: Life is a team sport and God

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COVER•STORY

TV's Female Addicts (Continued from page 1)

has inherent drama and high stakes,” Thompson says. “If we as humans are defined by our free will, then addiction is a force that throws a wrench into that freedom. A person in the grip of addiction is no longer free.”

Addiction touches most families: 69 percent of Americans report knowing someone who has a problem with drug or alcohol use, according to a Harvard School of Public Health and Robert Wood Johnson Foundation survey. Television is catching up to the fact that women struggle with addiction too, says Jill Talbot, author of Loaded: Women and Addiction, in which she chronicled her own addictions. “We used to think of men when we thought of addicts, and we’d think of substance abuse only,” says Talbot, an assistant professor of nonfiction writing at Saint Laurence University. “Now we’re seeing more women struggling with a wide variety of addictions. It can help us realize that we’re not alone.”

Like many women today, these three TV characters all experience stress as a result of high-powered careers. Today there are more women in the workforce in the U.S. than men for the first time, and more women dealing with unprecedented stress as a result. “About 15 years ago, women came in for help because their family fell apart,” says Cecelia Jayme, a program supervisor at the Women’s Recovery Center at Hazelden, in Center City, MN. “Today I see women come in because their career and job are suffering. They’re often the primary breadwinner in their family and they’re struggling with addiction.” Jayme would like to see Nurse Jackie and Deputy Chief Brenda Leigh discover a path to recovery. “It’s important to depict the hope that people do recover,” she says. “And that they live well in recovery.”

Junk food cravings On The Closer, (Mondays at 9 p.m. on TNT), Brenda’s career isn’t suffering from her junk food obsession. Though we see her hide junk food in drawers, purses and cupboards, she’s at the top of her game, making good use of her uncanny ability to extract confessions from subjects. “She’s a revision of the LA detective,” Talbot says. “Instead of a man at the desk, it’s a woman. Instead of a flask in the drawer, it’s candy.”

Brenda’s love of junk food may be more of a quirky character flaw than something resembling an eating disorder, but experts say there’s a lot to learn about eating disorders from Brenda. “It’s helpful to show a professional woman struggling with food issues. It makes it less stigmatized,” says Lisa Claudia Briggs, MSW, LICSW, an eating disorder specialist for 25 years and founder of Intuitive Body. “It can help more women talk about what’s going on for them, especially when they’re feeling stress.”

For Brenda, eating candy appears to be a direct response to stress on the job. “Eating disorders often serve to reduce anxiety,” says Dina Zeckhausen, PhD, Founder, the Eating Disorders Information Network (www.MyEdin.org). “Carbohydrates are a mood altering drug; they produce endorphins in the brain. Brenda’s career may be a contributor, but probably her driven, perfectionist personality contributed to her choice of a high stress career in the first place.”

Some viewers question whether someone as thin as Brenda is believable as a person with an eating disorder. “Not all women struggling with an eating disorder carry excess weight,” says Brigg. “Some purge or use laxatives. What they do have in common is that they are often very high achieving.

They never see themselves as good enough. They’re people pleasers and caretakers.”

Actress Kyra Sedgwick, who portrays Brenda, has spoken of struggling with an eating disorder in her personal life many years ago, and has said that, “[Food] has never been easy for me.” Sedgwick has said she went to therapy to work on her food issues.

Brenda spent much of the premiere episode of the show secretly snacking on bags of candy. At one point we see her gaze become riveted by donuts sitting on a colleague’s desk. After solving a murder case, Brenda sat alone, and ate a Ring Ding.

We see her shove an éclair into her mouth as her expression changes from frustration to bliss and she relaxes. She winds up instituting a ban on processed sugar in the office.

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About 24 million people in the country have eating disorders, a figure that represents about 10 percent of the population, according to the National Eating Disorder Association (NEDA). Lynn Grefe, Pres of NEDA, says people with eating disorders share certain characteristics: “They have anxiety, depression or OCD. They’re often the best and the brightest.

They can have a fear of closeness and problems expressing anger.” Many people with eating disorders who are purging or using laxatives don’t realize how serious it is that they’re

not digesting their food, she says. “They can suffer heart failure, potassium deficiency,” Grefe explains. “Eating disorders can ravage your body and become life threatening.”

In her experience, women with eating disorders are unhappy about the amount of time the disorders take up and that it controls their life. “If food is your primary focus, something may be wrong,” she says. “Talk to somebody about what’s really bothering you. You can get better.” She recommends doing research to find a therapist and a dietician who specialize in eating disorders.

Secrets and lies While Brenda is in the early stages of what could develop into an eating disorder or addiction, Jackie is a full-blown addict that many say is one of the most consistently well told addiction stories on television. In Nurse Jackie (Showtime, Mondays, 10:30 p.m.) we have a compelling portrait of a woman whose life is overtaken by chaos and secrets. Jackie Peyton is a nurse at All Saints’ Hospital in New York City and the mother of two young girls, one of whom suffers from an

Food & Substance Abuse (Continued from page 1)

at Yale and lead author, says the findings support the theory that compulsive eating may be driven in part by an enhanced anticipation of food. As a result, food addicts are more likely to react to triggers the same way alcoholics do.

Similarities between food addiction and alcoholic addiction were at the heart of the research. “We got interested because we saw behavioral similarities between the two,” Gearhardt says, “like not being able to cut down even though they wanted to, using despite problems, spending a lot of time using and recovering from the consequences.”

The research looked at individuals who were food addicts, as opposed to people with eating disorders. “When we showed food addicts a picture of a milk

anxiety disorder. Though smarter than most of the doctors she works with, Jackie has a weakness for painkillers that she hasn’t admitted to anyone. Married to a loving man who runs a bar, she has an affair with the hospital pharmacist in exchange for Vicodin.

Slipping into the hospital ladies room during her shift, Jackie will crush an Adderall or Vicodin capsule before snorting it. Nurse Jackie stars Edie Falco, an actress who has admitted to her own addiction to alcohol. Falco has been in recovery for the past 20 years, admitting that at one point in her life, she was “drunk all the time” and hanging out with “scary people.” The actress was drawn to playing a character that she has described as “pulled to something that’s so bad for you.” The show was created

by Linda Wallem and Liz Brixius, both of whom have spoken about being in recovery and interested in putting their own life experiences to use in the story.

It’s not surprising that the show is universally praised for its gritty realism. “There are so many people out there like Nurse Jackie, working at jobs and functioning, who are addicts,” says Talbot, the author. “The program shows that despite having a good career, a devoted husband, great kids and a best friend, the most important relationship in her life is with pills. All of her other relationships suffer as a result.”

Melanie Olson, certified chemical dependency counselor at the Keystone Treatment Center in Canton, S.D., notes that Nurse Jackie does a good job of showing how an addiction can take on a life of its own. “I see women addicted to pain killers willing to go to great lengths to get them. They start going beyond the prescription, doctor shopping, and then they’re afraid of getting caught. They often didn’t realize the opiate was addictive until they tried to stop taking it. We work with people to help them understand that there will always will be stressors but you need to learn how to deal with life on life’s terms.”

About 2.3 million people use painkillers, stimulants and anti anxiety meds non-medically, according to the National institute on Drug Abuse (NIDA). And many are still able to do their jobs. “People develop a tolerance so it might not be apparent,” says Dr. Susan Weiss, Acting Director, Office of Science Policy and Communications for NIDA. “But if you’re addicted, you become focused on getting drugs and can go into withdrawal, craving it. This affects how well you can concentrate and function. You can have impaired judgment.”

She thinks it’s useful to help people recognize that abusing prescription meds can get them into patterns they never thought they’d be in. “Nobody can say it won’t happen to me because I have good job,” she says. “Hopefully this show can help people see a growing problem that has worsening consequences.”

Experts say Nurse Jackie embodies many of the charac-

(Continued on page 14) shake, we saw strong brain activity in areas such as craving and enhanced motivation,” she says. What happens with addicts, she explains, is that when exposed to their substance of choice, the brain region implicated in putting on the breaks--the lateral OFC (orbitofrontal cortex) involved in decision making--isn’t working so well.

“That’s why addicts will say they’ll only have one beer and then have 10, or that they’ll have one cookie and then eat the whole box,” Gearhardt says. “The substances they’re addicted to highjack their brain. And you can’t white knuckle it on a new diet. You need to seek professional help or 12-step groups.”

The research, she believes, can help us understand triggers, such as an alcoholic walking past a favorite bar, or a food addict seeing an advertisement for an ice cream sundae. “These triggers may be a core feature of addiction,” she says. “It’s less about how much you like it and more about how much you want it.”

13

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teristics of an addict, including a sense of invincibility, a belief that she’s in control, and a compulsion so great that no sacrifice is too great to feed her addiction. “We see many high functioning women with addictions,” says Jayme from Hazelden. “We see women with jobs and kids who abuse methamphetamines to get to work on time and drive the van full of kids to soccer. We see housewives who take them to control their weight and then get addicted. They look functional, until things start to spiral out of control.”

When Jackie’s husband and best friend stage an intervention, it doesn’t go well.

Jackie is an accomplished liar. Despite the chaos swirling around her life, she talked her way out of everything, at least for now.

Blacking out

Falmouth, MA 800-444-1554 www.gosnold.org

The long-running hit show ER (CBS, 1994-2009) included another high-functioning woman struggling with addiction, yet this time she was in recovery. Nurse Abby Lockhart was a recovering alcoholic who had been sober for five years when we first met her. During the course of the show, the nurse-turned medical student-turned doctor got married and had a son. Played by actress Maura Tierney, Abby was seen living in recovery: She had a sponsor, went to AA meetings and even became the sponsor of a

colleague, Dr. John Carter, whom she discovered shooting up pain killers.

We also saw Abby relapse. In one episode, she blacked out after drinking at a bar, and woke up in bed with the ER chief. When Abby had a particularly horrible birthday, she started drinking again, and then returned to her AA meetings.

Some addiction specialists wish this show discussed more about how relapsing happens. “I don’t see a lot of recovery information on TV. I’d like to see a TV show educate the public about the fact that relapse doesn’t come out of the blue. It’s a process,” says Olson of the Keyston Treatment Center. “If you’re going to meetings, people can help you recognize when you might be moving to a relapse. For Abby, showing the triggers, that she was starting to consider drinking again, that she was moving into a craving state, would have been helpful.”

At the end of the series, Abby told her co-workers about her alcohol addiction and sought help. It’s a hopeful portrayal, addiction specialists say, despite the setbacks. “It sends the message that recovery is not only possible but probable if you seek help,” says Jayme of Hazelden. “The addict keeps clean when she finds another way to fill her spiritual longing.”

Suzanne Riss is a writer and editor who specializes in women’s issues. Most recently she was Editor-in-Chief of Working Mother magazine. Her book, The Working Mom Survival Guide, will be published by Weldon Owen in October.

The road to recovery begins at Marworth When your loved one makes the decision to seek treatment for alcohol or drug dependency, help them make the best choice for their recovery. Marworth offers personalized programs based on the 12-step philosophy. We involve the family and our team has a proven record of success.

We offer residential and outpatient programs for adults as well as specialized programs for dual diagnosis, healthcare and uniformed professionals. We provide a serene setting in the beautiful mountains of Northeast Pennsylvania, where recovery is confidential and compassionate.

For more information, please call 1.800.442.7722 or visit www.marworth.org.

14

www.together.us.com | July / August 2011

INFORMED•OPINION

Are You in Denial?

P

Denial doesn’t go away

By Tian Dayton, PhD

When does denial become a quality of character? An unfortunate feature of both of these types of denial, conscious and unconscious, is that they do not necessarily disappear when the addict either sobers up or leaves the picture. When spouses, for example, spend years saying that there is no pink elephant in the middle of the living room, they all too often come to believe it themselves. Their habit of rewriting their gnawing and ever growing awareness that addiction is subsuming their once manageable lives gets generalized into rewriting any aspect of life that bothers them. Or threatens their sense of who they are. Or who they need to think they are, in order to feel safe. Or secure. Or not as insecure. Or superior. Or not as inferior.

These types of denial distort reality. They put family members in a terrible bind. They feel both hurt and envious, jealous because the denier seems to have such an easy time keeping his anxiety at bay and hurt because their sense of the truth is being insulted and, well, denied. Children, in their desperation to belong and assuage their anxiety, may wind up joining their parents in their distortion of reality, in order to remain close to them. At some level they know that they risk losing their parent’s approval and love by callings things as they see them. This kind of denial becomes a subtle force that divides families.

eople in recovery use the word "denial" to explain everything from having trouble accepting an addict’s drinking, drugging or sexual acting out to withdrawing into a shell of quasi oblivion in the face of addiction. It can also refer to an addict denying his or her own increasing use and its effect on his life and the lives of those around him. But are all forms of denial alike?

Let’s take a deeper look at the psychological and emotional forces that drive denial, and its more biological counterpart, shock and numbness.

Is denial always pathological?

Sometimes denial helps us, at least temporarily, to cope with a situation that seems to be more than we are ready to face. Denial can also be in service of preserving our sense of self, our stability and ability to cope without falling apart. Is the pathological denial that we talk about in recovery, in other words, a distortion of a natural, human trait?

When is denial not so bad? We know that we could die at any moment. No one has an ability not to die.

But we do sort of deny that ever present fact as we wander through our lives moment by moment, because we need to do things like plan for a future or invest in an IRA. Of course, there is always the possibility that the future might not come, but we keep that awareness at bay. And we deny, at least to some extent, that those we love could be taken from us in an instant, because being aware of that all the time could just be too overwhelming and immobilizing.

What about the death of a loved one? Is it denial that carries us through the first months when we still feel that the person who died isn’t really gone?

Is it spirituality and a sense of contact with a world beyond what we can see? Or is it emotional numbness, a natural reaction to trauma and a first stage of grief and loss? The stages of loss, according to Jonathon Bowlby, British psychoanalyst, are: numbness, yearning and searching, disorganization, anger, despair and reorganization.

The emotional numbness related to loss can mimic denial. Numbness is a natural, human response to extreme, emotional shock. We see this in its most extreme form in some WW II concentration camp victims, who became so pervasively numb that in certain cases it grew into a quality of personality that lasted a lifetime. We see this in lesser forms in the loss of loved ones, whether to death, divorce or addiction.

This kind of numbness or shock about what we are witnessing that doesn’t fit into our normal schema or sense of life is not the same as denial, as it does not involve a distortion of reality. It is a coping mechanism built into our human nature. It may contribute to a pathological form of denial if the loss is not eventually accepted. This numbness is in service of our survival. It can give us a chance to work through our overwhelming sense of grief towards accepting a loss and reorganizing our lives. This kind of numbness is also something we see in recovery as we work through the stages of grief associated with addiction and develop a new sense of self and life without the substance, addiction or behavior in the driver’s seat.

When does denial become pathological?

When it’s a rewrite of reality that is far enough from the truth that it makes us live a dishonest life on the inside or the outside.

When it forces others to join with us in living our lie.

When it alters reality to such an extent that we lose touch with “normal.”

When it alters reality to such an extent that it makes others feel crazy.

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A perfect storm

The faces of denial The most unconscious form of denial occurs when we block our awareness to such an extent that we don’t even take in something that’s happening. On Sept. 11th, for example, Susan called her boss over to witness what she was seeing from her window at work in New York City. The second hijacked plane had just flown into the second tower and destroyed it.

Her boss, who was standing right next to her, insisted that it was an optical illusion. He simply could not take in the reality of the situation. This kind of denial makes the people around it feel like banging their heads against the wall. They are essentially being told that what they are seeing right in front of them doesn’t exist. It’s crazy-making. It makes us doubt our sense of normal and question what we see in front of our eyes or feel in our guts to be true.

A more conscious form of denial is a distortion of reality in which we “rewrite” situations or behaviors that we find disturbing or don’t want to deal with. For example, the alcoholic in our lives isn’t drunk again; he simply has the flu, is over-worked, over-stressed or over-anxious and just trying to relax. What’s the big deal? We use a sort of twisted reasoning to make someone’s behavior more palatable or manageable than it feels. We don’t want to connect the addict’s increasing unmanageability, or our own chronic anxiety, to living with substance abuse. This kind of denial is complicated. It requires constant upkeep, because lots of little things that relate to what we’re denying keep cropping up in front of us, and we need to keep rewriting as we go. Again, it’s crazy-making.

Is there a perfect storm, a confluence of responses to trauma that can contribute to pathological denial?

Living with addiction is a traumatizing experience. We freeze, like deer in the headlights, frightened or even terrified as a family member regularly morphs between a kindly Dr. Hyde into a monstrous Dr. Jekyll. And does this trauma send us into a kind of emotional and psychological shut down that mimics denial or in some way contributes to it?

A salient feature of trauma is that the prefrontal cortex temporarily shuts down when we’re traumatized. In this state we are not able to do our best thinking. However, our limbic system, where we process emotions and brace for fight or flight, goes into high alert, so we’re feeling a lot and thinking a little. Hence there is a sort of perfect storm. We are experiencing strong and disturbing feelings that we wish to explain to ourselves but our capacity to think is undermined because we’re in a high-stress, fear-based state. So we grab at what feels soothing and assuages our ever-growing anxiety that our lives may be spinning out of control. These forms of denial generally stay fairly unconscious, unless, through some process of therapy and recovery, they become translated into words and elevated to a conscious level where they can be shared, talked over, thought about and reflected upon.

Tian Dayton, who has a master’s degree in educational psychology and a PhD degree in clinical psychology, is a board certified trainer in psychodrama. She is the author of Emotional Sobriety, Trauma and Addiction, Forgiving and Moving On and several other titles. She is the director of The New York Psychodrama Training Institute, where she runs training groups in psychodrama, sociometry and experiential group therapy.

Dr. Dayton has launched RTR Relationship Trauma Repair this spring, an experiential, multi-sensory model for treating relationship trauma and PTSD for use in treatment centers, clinics and private practice. See www.relationshiptraumarepair.com.

15

SPECIAL•FOCUS

What Do You Want, Really?

You know how to make yourself happy. How’s that working for you?

T

By D. John Dyben

he man sitting before me in my office was 41 years old, a successful business executive, a family man with a wife and three children. His face was washed out. His eyes were red and showed fear and uncertainty.

We chatted about his trip to the rehab center and his decision to come, and then I asked, “What do you want?”

He looked puzzled. “You mean from you?

From this program?”

I did not answer.

“I guess I want to keep my wife and children. I want to keep my job. I may lose both because of my drinking. Is that what you mean?”

Again I did not respond. There was a pause.

“I just want to be happy.”

“You know how to do that,” I said. He looked at me quizzically.

“You can buy yourself a new car,” I explained. “You can watch your favorite TV show. You can mix yourself a martini.

These will make you happy.”

An epiphany This interview was unfolding just as hundreds of others have. The surprise on his face when I told him he knew how to be happy was the beginning of his epiphany.

His pursuit of happiness all his years had only gotten him a threat from his wife that she would leave and a warning from his doctor that his body was failing.

Each of us can be happy, understood as external pleasures, but there are two things wrong with this. This type of happiness is only temporary, and then we have to find something else. And when the events in our lives are not as we would like, we are unhappy.

The word “happiness” comes from the Old English word “hap,” which means luck.

My definition of happiness is feeling good based on my circumstances. Happiness is not a bad thing. If someone were to come into my office to tell me I had won a million dollars, I am going to be real happy, and there is nothing wrong with that. When I sing a song with my daughter, I feel really good, but it is feeling good because of external circumstances.

Happiness itself is not the problem. The problem comes when I live my life in the pursuit of happiness, believing that I must always feel good or avoid feeling bad. When it’s my life goal. How to pursue it is very simple: if it feels good, do it. Whatever you think will make you happy probably will.

And then you have to find the next thing and the next thing.

What the man sitting before me really wanted was peace. Peace means the primary goal in life is not feeling good or avoiding negative feelings. Peace is when I look you

16

in the eye and say there are things in my life right this moment about which I am not happy, but I am still okay. I am anchored.

I am solid.

Stormy weather Think about people living on two houseboats. One houseboat is called the pursuit of happiness; the other is the pursuit of peace.

The person living on the pursuit of happiness is always running away from any storm, always trying to find the perfect place where the sun will be beating down on him just right. He is always looking.

The person on the pursuit of peace also likes it better when it’s not stormy.

He still likes feeling good, but when the storm does come, he does not run, he stays anchored. He believes he can weather it. If you are living life in the pursuit of peace you can make it through the storms knowing they will go away. If an addict believes the most important thing in life is to feel good, he will almost always go back to drugs and alcohol. These are consistent with the pursuit of happiness.

I have never had trouble with alcohol or drugs, but I have had my own awakening about the pursuit of peace. Early in my career I was deeply troubled and unhappy.

I thought this might be burnout from long hours working as a minister with teenagers addicted to heroin. I was miserable, and I was making everyone around me miserable.

In this sense, I was not much different from the people I see whose symptom of unhappiness is the abuse of alcohol or drugs.

What I came to see was that I was validating myself with external things. I was pursuing happiness, and for me that meant yet one more degree or the next job. Each achievement made me happy – for a time, but then I needed some new credential.

At that time in my life I loved pushing my five-year-old daughter on the swing. There were times when I was completely enraptured, completely present with her in the moment. I think also of times when I was a million miles a way, going through all the worries, living in my problems, wondering how I was going to fix everything. This is the problem with the pursuit of happiness; it disconnects me from life rather than allowing me to be connected to life right here and now.

If it feels good The pursuit of happiness is easy -- do whatever feels good at the moment. The pursuit of peace is hard -- it requires developing a healthy spirituality. Think about physical fitness. Eating right and exercising does not make me happy. I like to eat. I do not like to exercise. But I want my body to be whole and healthy.

And that means discipline at the table and at exercise. Likewise, the pursuit of peace requires spiritual discipline and spiritual exercises.

This is good, because it means the spiritual life is attainable. It is not mysterious or magical.

It is something anyone can understand and do.

You do not go to the gym and tell a trainer you want a perfect body by the end of the week. You have to do the exercises regularly. Soon you will see a difference, although you will never reach perfection.

The most effective spiritual exercises I have ever found are in the 12 steps, the spiritual principles of acceptance, honesty, internal exploration, and sharing what I find about me with others, prayer, meditation, service, humility. These principles make me spiritually strong and whole. When I am daily exercising the spiritual principles in the 12 steps, I am pursuing peace.

Probably the most important spiritual principle is honesty with myself and others. When I am not honest I always have to move around. When I am dishonest I am desperately trying to avoid what is in front of me. If I am pursuing peace, I am dealing with what is in front of me.

Going with the flow Acceptance is another very important principle. Recently the center where I work merged with a larger one. The questions began: What would happen to me? Would I still have a job? Being honest with myself about what was happening and accepting it allowed me to be at peace, even though I had no idea what the outcome would be.

So these spiritual disciplines have practical application in the real world. It would be easier, however – if only for the moment – to deny and resist the inevitable change.

Think of a brick wall. If you strike it with a hammer, it will resist. That’s like happiness: when something I do not like comes

my way I have to resist it so that I do not become unhappy. A brick wall will resist, but because it resists it will eventually be chipped away and crumble.

Now think of a cork floating in water. You can hit it with all your might and it won’t resist at all, but then it will pop right back up. That is peace. Things I do not like are going to come into my life, but I am going to roll with them. Because I am able to roll with them, I’m going to pop right back up.

Peace is learning to go with the flow. One of the things that helped me when I left vocational church ministry was being able to look at all of philosophy and all of religion and all of the wisdom that has been blessed this planet over time. I found there are some systems that have a lot to teach that I missed by being in one specific religious mindset. I’m a Methodist, a Christian, but I am learning from all wisdom traditions.

For example, there’s an element of Taoism called Wu Wei. It means strength without resistance. Wu Wei is like a cork floating in water. It is going with the flow.

Wu Wei is key to the pursuit of peace above happiness. It fits Christianity and any other religion I have studied. From my own Christian tradition: Consider the birds of the air, the lilies of he field. They neither sow nor reap, but they’re okay. Wu Wei also fits recovery very well.

Learning to walk The man sitting in my office was beginning to relax. Here was something that made sense, even if he did not grasp it all.

He, too, had been caught up in changes at work and had tried to resist them by grabbing his Rolodex in panic and seeking some kind of external validation that everything would be okay. Just as I once did, he thought the goal of life was happiness, and the only thing he knew to do was sign up for one more management training seminar and add one more contact to his network and buy the newest model car, and then soothe the anxiety with a bottle. What he did not know, as I once did not know, is that there was another pursuit that could actually work.

In the coming days we would explore the other disciplines: gratitude, forgiveness, service to others. Like a child learning to walk, his first steps would be small and halting. And yet they would begin moving him toward his true goal.

“I cannot believe I have wanted the wrong thing my entire life,” he said.

“You,” I said, “are not alone.”

John Dyben, a board certified mental health and addictions professional, is clinical director at the Hanley Center in West Palm Beach, Florida. He supervises all residential and outpatient treatment, as well as Spiritual Care and Wellness programs.

www.together.us.com | July / August 2011

SPECIAL•FOCUS

What if I’m

Not Happy?

It is a modern ailment: the unhappiness of not being happy.

Maybe we’re looking in all the wrong places.

I

By Darrin McMahon, PhD

think it is probably fair to assume that most Americans today consider happiness not only something that would be nice to have, but something that we really ought to have—and, moreover, something that’s within our power to bring about, if only we set our minds to it. We can be happy, we tell ourselves, teeth gritted. We should be happy. We will be happy.

That is a modern article of faith. But it is also a relatively recent idea in the West that dates from the 17th and 18th centuries, a time that ushered in a dramatic shift in what human beings could legitimately hope to expect in and from their lives. People prior to the late 17th century thought happiness was a matter of luck or virtue or divine favor. Today we think of happiness as a right and a skill that can be developed.

This has been liberating, in some respects, because it asks us to strive to improve our lots in life, individually and collectively. But there have been downsides as well. It seems that when we want to be happy all of the time, we can forget that the pursuit of happiness can entail struggle, sacrifice, even pain.

trols our happenstance, and hence our happiness.

There were, of course, other ways of thinking about happiness. Those who have studied Greek or Roman philosophy will know that happiness—what the Greeks called, in one of several words, eudaimonia—was the goal of all Classical philosophy, beginning with Socrates and Plato, then taken up even more centrally by Aristotle, then featured prominently in all the major “schools” of Classical thought, including that of the Epicureans, Stoics, and so forth. In their view, happiness could be earned, a perspective that anticipates our modern one.

But there is a crucial difference between their ideas of happiness and ours.

For most of these Classical philosophers, happiness is never simply a function of good feeling—of what puts a smile on our face—but rather of living good lives, lives that will almost certainly include a good deal of pain. The most dramatic illustration of this is the Roman statesman and philosopher Cicero’s claim that the happy man will be happy even on the torture rack.

That sounds ludicrous to us today — and perhaps it is—but it very nicely captures the way the ancients thought of happiness, not as an emotional state but as an outcome of moral comportment. “Happiness is a life lived according to virtue,” Aristotle famously says. It is measured in lifetimes, not moments. And it has far more to do with how we order ourselves and our lives as a whole than anything that might happen individually to any one of us.

Given these presuppositions, the ancients tended to agree that very few would ever succeed in being happy, because happiness takes an incredible amount of work, discipline and devotion, and most people, in the end, are simply not up to the task. The happy are what Aristotle calls “happy few.” They are, if you like, the ethical elite. This is not a democratic conception of happiness.

After the Greek and Roman traditions, we have Jewish and Christian ideas about happiness. In the prevailing Christian understanding, happiness can occur in one of three circumstances. It can be found in the past in a lost Golden Age, in the Garden of Eden when Adam and Eve were perfectly content. It can be revealed in the future— the millennium when Christ will return and the Kingdom of God will genuinely be at hand. Or we can find happiness in heaven, when the saints shall know the “perfect felicity,” as Thomas Aquinas puts it, the pure bliss of union with God. Strictly speaking,

Happiness can

entail struggle,

sacrifice, even pain.

Roots of happiness Language reveals ancient definitions of happiness. It is a striking fact that in every Indo-European language, without exception, going all the way back to ancient Greek, the word for happiness is a cognate with the word for luck. Hap is the Old Norse and Old English root of happiness, and it just means luck or chance, as did the Old French heur, giving us bonheur, good fortune or happiness. German gives us the word Gluck, which to this day means both happiness and chance.

What does this linguistic pattern suggest?

For a good many ancient peoples—and for many others long after that—happiness was not something you could control. It was in the hands of the gods, dictated by Fate or Fortune, controlled by the stars, not something that you or I could really count upon or make for ourselves. Happiness, literally, was what happened to us, and that was ultimately out of our hands. As the monk in Chaucer’s Canterbury Tales declares: And thus does Fortune’s wheel turn treacherously And out of happiness bring men to sorrow.

In other words, the wheel of fortune con-

Together - A Voice for Health & Recovery

this is the happiness of death.

And so in the dominant Christian worldview, happiness is not something we can obtain in this life. It is not our natural state.

On the contrary, it is an exalted condition, reserved for the elect in a time outside of time, at the end of history.

This is the opposite of today’s egalitarian, feel-good-now conception of happiness.

Happiness revolution Enter the 17th and 18th centuries, when a revolution in human expectations overthrew these old ideas of happiness. It is in this time that the French Encyclopédie, the bible of the European Enlightenment, declares in its article on happiness that ev-

eryone has a right to be happy. It is in this time that Thomas Jefferson declares the pursuit of happiness to be a self-evident truth, while his colleague George Mason, in the Virginia Declaration of Rights, speaks of pursuing and obtaining happiness as a nat-

(Continued on page 18)

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17

A look at gambling

W

SPECIAL•FOCUS

by bobbe mcginLey

hen you read the words “gambling addict,� what is the first image that comes to mind? A mob type male, puffing on a cigar in a dark room playing poker with shady looking people as we often see depicted in crime movies? Or maybe it’s a woman in a bold dress that is too tight, with heavy makeup in the wee Together’s is to of serviceBecause to the extended community of individuals and families who are hours of themission morning inbe a casino? seeking information about relief from addiction-related issues and concerns in order to lead healthier ofand thehappier stigma lives. all addictions carry,list andofthe Here is a partial referrals with a more comprehensive list on together.us.com. fact that gambling so12-step well program or organization, although we do encourage them all.

Together is not affi addiction liated with is any One essential is knowing you don’t have to walk national alone. hidden, rarely of dorecovery we visualize someone problem gambling struggling with gambling addiction as an 12-step organizations Telephone Awareness Website week average looking person going about life. isadultchildren.org March 6-12, 2011.

Adult Children of Alcoholics 562-595-7831 Like other addictions, gambling doesn’t disThe goal of this week is to educate the Al-Anon & Alateen Family Groups 212-941-0094 nycalanon.org criminate and studies show that between 2%general public and health care Alcoholics Anonymous 212-647-1680 nyintergroup.org 3% of the U.S. population will have a gambling professionals about the warning signs of Chapter 9 | Couples in Recovery 888-799-6463 chapter9couplesinrecovery.org problem in any given year, thereby affecting problem gambling and raise awareness Cocaine Anonymous 212-262-2463 canewyork.org millions of people in the United States alone. about the help that is available both Codependents Anonymous 646-289-9954 codependentsnyc.org Gambling addiction has devastating locally and nationally. Please visit Crystal Meth Anonymous 212-642-5029 nycma.org effects on family and friends, destroyhttp://www.NPGAW.org/ Debtors Anonymous 212-969-8111 danyc.org ing lives as well as livelihoods, and today for ideas and more information.

Gam-Anon 718-352-1671 gam-anon.org gambling addiction is not only found in

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Resources & Links

Gamblers Anonymous Marijuana Anonymous Narcotics Anonymous Overeaters Anonymous Sex & Love Addicts Anonymous Nicotine Anonymous

888-424-3577 212-459-4423 212-929-6262 212-946-4599 212-946-5298 212-824-2526

gamblersanonymous.org ma-newyork.org newyorkna.org oanyc.org slaany.org nicotine-anonymous.org

National and institutional organizations

Center for Alcohol and Substance Abuse casacolumbia.org Center for Substance Abuse Treatment csat.samhsa.gov National Association of Addiction Treatment Providers naatp.org National Clearinghouse of Alcohol and Drug Information health.org in the Hamptons National Council on Alcoholism and Drug Dependence, Inc. ncadd.org National Eating Disorders Association& nationaleatingdisorders.org Alcohol Substance Abuse Treatment National Institute on Drug Abuse drugabuse.gov Where the healing begins..... niaaa.nih.gov National Institute on Alcohol Abuse and Alcoholism Partnership at

DrugFree.org drugfree.org

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Drugs Food Smoking Gambling Video Games Internet Sex Shopping Work

Addiction is too hard to go through alone.

Are you or someone you care about drinking too much?

Would you like to talk about it?

We would.

Together we can make a difference.

Call 212-532-1640 Monday – Friday, 10 am – 6 pm

If you are looking for answers for yourself or a loved one, The Together Warmline can help. It’s a free service staffed by addiction professionals and lay people who share their experience and knowledge about addictions. We are a non-emergency, non-crisis support and referral service not affiliated with any treatment program or service.

6

those over the age of 21; kids underage have discovered ways to gamble as well.

Pathological gambling is believed to be a progressive behavior disorder that has the trademarks of out of control thinking about gambling and urges to gamble.

This leads to gambling beyond limits, which in turn leads to more and more problem gambling, as the gambler tries unsuccessfully to get back that first dol(Continued from page 17) lar ever lost, and every dollar in between. many people gambling is not uralFor endowment and right. And it ais in this problem. natural risk takers, time that Gamblers the Frenchare revolutionary leader St. Just can stand during heightsuch of the and many begin up with simplethe activities Jacobin in France in 1794 and deas sportsrevolution betting, turning perhaps to trading clare: is a new ideaofinthe Europe.� stocks“Happiness and commodities because higher In many ways it was. excitement and the impression that they are When great the English philosopher and revoapplying skill. Pathological gambling, lutionary John Locke declared at the end of however, is described as an impulse disorder, the 17th century that the “business of man mimics he addiction alcohol and isone tothat be happy,� meanttothat we shouldn’t drugs, with most important traits being assume thatthe suffering is our natural lot, and emotional dependence that we shouldn’t haveontogambling, apologizeloss forofour control, and diffi culties with activities. pleasures here on earth.

Onnormal the contrary, we If a family suspects a gamshould work member to increase them.

It wasn’t a sin toproblem, enjoy our bodies, his contemporaries bling or has experienced the began to argue.

It wasn’tgambling, gluttony the and greed consequences of problem to work to improve standards best recourse is to seekour counseling withof living.

It wasn’tgambling a sign ofcounselor. luxury and a trained âœş depravity to pursue pleasures of the flesh, and whatever other kind as well. Pleasure was good. Pain was bad. We should maximize the one and minimize the other, yielding the greatest happiness for the greatest number.

This was a liberating perspective. Starting in Locke’s time, men and women in the West dared to think of happiness as something more than a divine gift, less fortuitous than fortune, less exalted than a millenarian dream. For the first time in human history, comparatively large numbers of people were exposed to the novel prospect that they might not have to suffer as an unfailing law of the universe, that they could—and should—expect happiness in the form of good feeling, and pleasure as a right of existence. This is a prospect that has gradually spread from the originally rather narrow universe of white men to include women, people of color, children—indeed, humanity as a whole.

This new orientation towards happiness was, as I say, liberating in many respects. I would argue that it continues to lie behind some of our most noble humanitarian sentiments—the belief that suffering is inherently wrong, and that all people, in all places, should have the opportunity, the right, to be happy.

Happiness

Unnatural happiness But there is a dark side to this vision of happiness as well, one that may help explain why so many of us are snapping up books about happiness and going to happiness conferences, searching for an emotion that we worry is absent from our lives.

For all its pleasures and benefits, this new perspective on happiness as a given right, tends to imagine happiness not as something won through moral cultivation, carried out over the course of a well-lived life, but as something “out there� that could be

Together

T

there's help

he National Council on Problem Gambling (ncpgambling.org) is a national advocate for problem gamblers and their families, with a 24-hour confidential national helpline (1-800-522-4700). In addition, Gamblers Anonymous (gamblersanonymous. org) is a 12-step program designed for problem gamblers and Gam-Anon (gam-anon.org) is a support group for family members and concerned persons affected by a gambler’s behavior.

So many of us are snapping up books about happiness and going to happiness conferences, In New York State, if you think you might have a gambling problem call the searching for an emotion 24-hour Helpline at 1-877-846-7369. that we worry is absent Bobbe McGinley MBA, CADAC, LISAC, fromMA, our lives.

NCGC II, is a nationally known speaker, author, presenter and trainer, consulting pursued, caught,industries and consumed.

Happiness many different about problem has increasingly been thought tocall be 602more gambling.

For more information about getting little infusions of pleasure, 569-4328 or visit www.actcounseling.com. about feeling good rather than being good, less about living the well-lived life than (Adapted from an article that appeared about experiencing the well-felt moment. in Together AZ Feb. 2011 edition) Don’t get me wrong; there is nothing bad about feeling good. But I would suggest that something of value may have been lost or forgotten in our transition to modern ideas of happiness. We can’t feel good all the time; nor, I think, should we want to. Nor should we assume that happiness can be had without a certain degree of effort, and possibly even sacrifice and pain. These are things that the older traditionsSpecialists knew—in the West Addiction and the East alike—and that we have forgotten.

Today, science is rediscovering the validity of ancient perspectives on happiness—that there are important connections between hope and happiness, for example, or between gratitude and forgiving and happiness, altruism and happiness. Science is often painted as being opposed to matters of the spirit, but new discoveries by researchers like Michael McCullough, Robert Emmons, and many others remind us how important non-materialistic, spiritual cultivation is to our happiness and well-being. It is all the more important to revive and cultivate this older wisdom today, given that so many of us assume that we ought to be happy as a matter of course, that this is our natural state.

Indeed, if you think about it, this idea of happiness as a natural state creates a curious problem. What if I’m not happy? Does that mean that I’m unnatural? Am I ill, or bad, or deficient? Is there something wrong with me? Is there something wrong with the society in which I live? These are all symptoms of a condition that I call the unhappiness of not being happy, and it is a peculiarly modern condition.

To cure this condition, we might focus less on our own personal happiness and instead on the happiness of those around us, for relentless focus on one’s own happiness has the potential to be self-defeating. The 19th century philosopher John Stuart Mill once said, “Ask yourself whether you are happy, and you cease to be so.� Whether that is really true or not, I don’t know. But given that we live in a world that asks this question of us every day, | March/April 2011 it iswww.together.us.com a paradox worth pondering.

Darrin M. McMahon, PhD, is a professor of history at Florida State University and the author of Happiness, A History. This piece is based on a talk he delivered at the 2008 “Happiness and Its Causes� conference in San Francisco, co-sponsored by the Greater Good Science Center. It originally appeared in Greater Good magazine, published by the Greater Good Science Center at UC Berkeley (http://greatergood.berkeley.edu).

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www.together.us.com | July / August 2011

FINAL•WORD

I Would Have to Say No A person of long-time sobriety takes a wry look back at the challenge of accepting that he was an alcoholic.

By Pat S.

W

e’ve all read them, sometimes as we struggle to understand why we can’t stop drinking despite countless vows to do so, wondering if perhaps we are, God forbid, alcoholics. Sometimes as we look back on our recovery, wondering what it was that finally pushed us across that imaginary chasm into grateful sobriety.

I speak of those 20 Questions that appear in the front of the meeting lists, on pamphlets in hospitals and doctors’ offices, and published beside articles on horrific traffic accidents caused by drunk drivers.

The questions are designed to appeal to our intellect. To highlight circumstances that, if examined honestly, would surely have us put the plug in the jug. The problem is that one of alcohol’s most immediate side effects is loss of judgment and objectivity. What is crystal clear to some is anything but to the alcoholic or his (or her) codependent co-conspirator.

I was clueless.

I recently had reason to examine my bottom after a healthy (but inconclusive) debate on why our bottoms are our bottoms, why it took so much to finally get to the point where I gave up alcohol and started going to meetings. I looked to the twenty questions for a clue.

• • • • • •

1. Do you lose time from work due to drinking?

No, I always reported to work bright and early. I rarely had hangovers, so I was able to get up and get going. Of course, there were the four-hour lunches. And the times we drank on the job. But I never called in sick.

Well, maybe once. Or twice.

2. Is drinking making your home life unhappy?

Absolutely not. My unhappy home life had nothing to do with my drinking.

My ex rarely said, “Don’t drink so much.” She wasn’t happy when I stayed out all hours, or when I failed my obligations as a husband (these were minor issues of honesty and reliability). But she rarely criticized my drinking. Everything else, yes. But rarely my drinking.

3. Do you drink because you are shy with other people?

8. Does your drinking make you careless of your family’s welfare?

Absolutely not. I have always loved my children. Most have never seen me drink. When I was drinking, I never put them in any more danger than I would put myself.

9. Has your ambition decreased since drinking?

Au contraire! I never had a vision of what I wanted to be as I grew up. Once I started drinking, I decided I wanted to be the US Ambassador to France.

A dream I haven’t yet fulfilled. In fact, I no longer aspire to that position.

10. Do you crave a drink at a definite time daily?

No. Anytime was fine.

11. Do you want a drink the next morning?

I would have to say no. I do remember the time I was commuting with my two alcoholic colleagues. They had picked me up from home at 8 a.m., and I shared that I had started my day with Irish Cream. They looked at me as if I were an alcoholic. Talk about the pot calling the kettle black!

12. Does drinking cause you to have difficulty in sleeping?

Absolutely not. Drinking usually knocked me out. I could stay up late, but I usually slept soundly after a night on the town.

13. Has your efficiency decreased since drinking?

No. I never took any efficiency measurements. Though I did lose a job or two, I don’t think it was efficiency related. More of a reliability issue.

14. Is drinking jeopardizing your job or business?

Negative. No, in my line of work, drinking is the norm, almost expected. We entertain clients and customers. One employer even said he liked it more when I was drinking.

15. Do you drink to escape from worries or troubles?

I would have to say no. That wasn’t the reason I drank. I admit that I worried less about everything while I was drinking. Of course, I worried more the next day. That’s not the point. I drank because I like to drink, not to escape.

I would say no. It is true that I was very shy, and that when I took my first drink my inhibitions melted away like magic. Though I made a fool of myself, I delighted in the alcoholdriven freedom from my years of self-consciousness. No, I drank because I loved the taste of beer and Scotch.

16. Do you ever drink alone?

4. Is drinking affecting your reputation?

I don’t remember. I do remember one time I thought I lost my memory when I couldn’t find my car after a night at the bar. But it turns out I had taken my motorcycle. My friend who had been drinking “borrowed” my car and forgot where he had taken it from. His issue, not mine.

I think not. I don’t know that I had a reputation before I drank. I was a shy and quiet student, whom few people noticed. Of course I had a reputation after I started drinking. But the answer to the question is that there was nothing to affect.

5. Have you ever felt remorse after drinking?

Absolutely not. This is irrelevant. I can feel remorse any time of the day. If I did feel remorse after drinking it was not because of the drinking. It was because of the things I did or didn’t do. But not because of drinking itself.

6. Have you often gotten into financial difficulties because of drinking?

I would have to say no. My financial troubles were due to poor investment calculations and a tendency to purchase things I couldn’t afford. And of course, it was the two divorces that really bankrupted me. The hundreds of dollars I would spend on alcohol each month were a mere drop in the bucket.

7. Do you turn to lower companions and an inferior environment when drinking?

No. I pride myself on having few prejudices. All men are created equal, whether on Wall Street or on the Bowery. I drank in four-star restaurants and dark, smelly bars throughout my drinking career. There was that knife fight one night, but that was the exception, rather than the rule.

Together - A Voice for Health & Recovery

What kind of question is that? Of course. I eat alone too. This question doesn’t count.

17. Have you ever had a loss of memory as a result of drinking?

18. Has your physician ever treated you for drinking?

No. I was generally physically healthy. So I didn’t have a doctor.

19. Do you drink to build up your self-confidence?

Heavens no. I like alcohol. Tastes great. Refreshing. I like the way it made me feel – so much that I drank a lot. No, I did not drink to build self-confidence.

20. Have you ever been to a hospital or institution on account of drinking?

No. It was only because I was miserable and didn’t like my life. My father was in rehab for his alcoholism, and I went for a weekend to participate in the “family program.” I stayed 28 days.

How am I supposed to interpret the results?

• If you have answered “yes” to any of these questions, there is a definite warning that you may be an alcoholic.

• If you answered “yes” to any two, the chances are that you are an alcoholic.

• If you answered “yes” to three or more, you are definitely an alcoholic.

Guess I’m not an alcoholic.

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www.together.us.com | July / August 2011