Together Mar 12 by Mario-Design

T gether

Paul Williams: "You Know You’re an Alcoholic When You Misplace a Decade" Page 11

A voice f or health a n d rec overy

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Inside A Sober St. Pat's Day? In New York?

Fight Your Fight or Flight Impulse.......8 Shortcuts to Daily Bliss............................12

"Something So Perfect" Page 4

Sometimes an addiction isn’t the only problem

By Terry A. Kirkpatrick

nthony had always suffered a vague anxiety that would spill over into frustration, constant worry and anger at his wife and children. Despite it he became a successful Wall Street executive. Alcohol made him feel better, and he started drinking more and more, even though in hindsight he now realizes that alcohol made his anxiety worse. Eventually he joined AA and got sober, but two years into sobriety his anxiety returned with a vengeance. Someone mentioned a therapist, and in therapy Anthony was able to get a clear picture of what he had experienced and what he was now feeling. A doctor prescribed non-addictive medication that helped him deal with the anxiety, and he felt serene and at peace for the first time in his life. The therapy and the prescription, he believes, make it less likely that he will return to alcohol to medicate his uneasiness. Things did not work out that way for Margaret, a mother of three and chronic abuser of alco-

Mood

ANXIETY

ION ICT ADD

hol. She suffered depression and the trauma of verbal abuse by her husband. She was in and out of treatment centers, withdrawing when her husband stopped paying. On a gray day at some friends’ weekend home on the Jersey Shore, Margaret took a kayak out into the surf and was never seen again. The police interviewed her friends and family and suspected suicide, but they will never know for sure. Anthony and Margaret (whose identities have been disguised) had co-occurring disorders: a mental condition combined with substance abuse. Co-occurring disorders – sometimes referred to as dual diagnoses or comorbidity -- are very common, and anyone who wants to be sober needs to consider that he or she might suffer one. Otherwise attempts at recovery from substance abuse are more likely to fail. Likewise, treating mental health problems will be difficult if not impossible, because substance addiction will contribute to the mental condition. “One of the biggest causes of relapse is an underlying mental disorder that is not being treated,” says Keith Arnold, vice president of operations for Elements Behavioral Health and Promises Treatment

Beginning the Ascent to Recovery The family ties itself together and looks to its Sherpa to lead off

March/April 2012

What Else Is Wrong With Me?

Page 10

An All-Purpose Miracle Medicine.................6

New York Edition

By Janice Blair

t a recent intervention, the “intervenee” called me the Blair Witch Project. It’s hard not to take that personally. At my age I don’t immediately go to Sabrina or even Samantha Stevens. Rather, that horrible, green-faced, wartnosed, black hat-wearing “I’ll get you, my pretty, and your little dog, too!” nightmare came to mind and sent me debriefing to my most supportive colleagues. Like any good group of therapists, we processed until someone cognitively reframed the comment with a quote from a witch expert of sorts. According to Gerina Dunwich, “to be a witch is to live one’s life in tune with the earth and the cycles of nature. It is reclaiming old ways, viewing the world and everything in it as magickal, and working with the mystical energies of (nature) to create positive changes within and without.” In tune with nature to create positive changes -- it sounded more like alchemy than witchcraft, but I wasn’t going to quibble because either way I felt better. I began to wonder if this wasn’t, in fact, the best of what I bring to the intervention process. There was a time in my life when this was a foreign, and not altogether appealing, notion. It went against everything I was taught --

if something isn’t working, I was told, try harder, work longer, push on. I can do that and I’m quite good at it. Which is likely why it took me so long to grasp the recovery concepts that would ultimately save my life.

Going with the flow Healing, growth, and restoring the true self required a way of thinking and a set of skills I did not have at the time I hit my own bottom with alcohol. In AA, I was advised that I should find a guide and follow directions. That turned out to be harder than it sounded, despite my sponsor’s constant reminders that he could teach a lab chimp the 12 steps. I used to tell him not if the chimp was a middle child. I still had my dignity. I would come to understand the need for being “in tune with,” for surrender and acceptance; I would learn how to listen, to slow down and to go with the flow. This flow idea intrigued me from the very start, and I recall spending a good portion of my first year in a befuddled attempt to find it. “Enough of inventories

(Continued on page 16)

(Continued on page 20)

EDITOR'S•DESK

Ask a Lot of Questions

t is generally accepted today that we must be “advocates” for ourselves in the medical “system” – which, as one cynic put it, wasn’t designed as a “system” and doesn’t operate as one. I do not take as gospel everything every doctor says. I have gotten second opinions in fields as far ranging as urology and pediatric ophthalmology. I discovered on my own the new respect given Vitamin D and began taking it even though my doctor never recommended it. My first blood test for Vitamin D was ordered by a urologist. It’s necessary for all of us to be aware and to be responsible for our own health. These thoughts came to mind as I was preparing this issue. As I researched the lead article on co-occurring disorders I realized that a layman faces a bewildering array of choices when seeking professional help with recovery. Some doctors, psychiatrists and therapists are trained in addiction, some aren’t. Some treatment centers are good at addiction, but aren’t equipped to deal with mental disorders. And as with all other fields of medicine, this one is always changing. And more than just the addiction and the mind need to be checked out. One psychiatrist I talked to said that physical ailments can cause mental symptoms – a deficiency of Vitamin B12, for instance. Well, how many doctors check for that? The best solution, as I explain in the article, is to ask a lot of questions – about professional certification and, more importantly, experience.

Physical activity, we are discovering, is one of the most important things we can do for our health, as we see in “An All-Purpose Medicine” on page 6. This piece refers to the work of Professor Steven Blair. “I wager that the typical physician is 10-50 times more likely to measure cholesterol, blood pressure, and BMI than to measure fitness,” he writes in an article in the British Journal of Sports Medicine. Even though the data show that fitness – walking 30 minutes five times a week – is the most important thing you can do! How we treat our bodies, of course, affects our minds. Simply paying attention to our breathing – literally feeling our breaths – can reduce the stress in our heads, as a teacher of yoga explains on page 8. Oh, and you don’t have to practice or even like yoga to reap the benefits. I take moderate, recommended amounts of vitamins, and I always tell a doctor what I’m taking. I don’t pretend to be a doctor, but I read health articles online, print them out, and show them to one. I try to walk 30 minutes every day. I go to a yoga class twice a week – and, no, I can’t do half of it, including balancing on one foot and pretending to be a tree. My doctor approves. “Yoga,” he told me once, “is good for balance.” Right.

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GUEST•COLUMNIST

From Victim to Volunteer Helping others allows those who suffer to redefine themselves

By Peter H. Fleiss

he charity I manage, Corporate Angel Network, arranges for thousands of cancer patients to travel to specialized treatment every year in the unused seats of corporate jet aircraft. The patients, who often need to fly cross-country for the proper treatment, usually cannot make the trip without needing to go through crowded airports, which many must avoid for fear of infection. They pay nothing for our help. The diligent folks on our staff of six remain with us year after year and they’re very proud of what they do. But their loyalty certainly can’t be based on the modest salaries we can pay. I’m sure it’s because the rewards are never-ending in terms of personal satisfaction. After all, they’re often saving lives. We get hundreds of letters and cards of appreciation and we eat way too many cookies that have been sent by gracious patients we have helped. Frequently we get a heart-warming phone call or a personal visit from a patient we’ve never met, and that makes our work very real. But my thoughts dwell regularly on the 35 other people at Corporate Angel who do not get paid by us, even modestly. These are the volunteers who come into our office regularly, man our telephones and computers, and work with cancer patients, physicians, corporate flight departments, and cancer treatment centers to match the medical travel needs of the patients with the flight activity of our 500-plus participating companies. I’d like you to meet several of them.

ing bouts with treatment. I would think the process of recovery from the ravages of cancer would be similar in many ways to what I’ve learned about the arduous path followed by those recovering from drug or alcohol addiction. As with many cancer patients, Alex tried to keep his spirits up hanging out with other cancer patients, joining a support group, and discussing his progress with family. This was a good thing in one respect, but it kept the cancer always at the front of Alex’s mind.

Pleasure of productive work In his weekly visits to Corporate Angel, Alex was alert and enthusiastic. He did his research work thoughtfully. And when one day another volunteer thanked Alex warmly for cultivating a connection that helped us build a new relationship with one of the big hospitals, things seemed to leap forward for him. Alex began coming in twice a week, explaining that he needed more time to get a grip on this significant task of his. The pleasure of productive work seemed to be replacing his focus on his own problems. After Alex’s tenure at Corporate Angel Network had stretched beyond one year, we had a chat in our lunchroom over coffee. I didn’t learn, or seek to learn, much about Alex’s status. Small hints about his struggle had crept into our conversations over the months, and additional information was his to share, not mine to pursue. But here’s what I did discover that day. The mentoring clergyman had seen value in pursuing a self-treatment program for Alex that would give him an important identity and a very real sense of satisfaction and self-worth, and that was clearly helping him. Many who are recovering from cancer find value in plunging back into the work environment, letting their jobs absorb their thoughts. But Alex had no intention of becoming an employee again. It’s true that he played golf and loved the theater, but occasional exposure to these did little to renew his vigor and occupy his mind. I guess coach and patient felt that as Alex pursued compelling and responsible volunteer work, he would be increasingly looked upon as a contributor, not a victim. I imagine the same is also true for those recovering from an addiction. Alex has not been around lately. I haven’t heard from him for a while, which is unusual in our organization. But I’m sure things will turn out well over time because he is basically a very solid citizen. I think he redefined himself here at Corporate Angel Network. The ways in which reward systems work in humans can be immensely complicated. But the fundamentals pertain, and while some rewards can be fulfilling, others often turn out to be less effective and even irrelevant over time. This know-how helps as I structure the right kind of satisfaction to a group of capable and conscientious volunteers who could just as easily be spending their time elsewhere.

Service to others is a big part of recovery, because it is a way to get outside of oneself and the associated problems of living.

Stir my emotions Susan came here because she needed something “that would stir my emotions.” Although she had a little extra time in her life, she said that arranging flights was not exactly what she had in mind when she joined us five years ago. “But I couldn’t be more fulfilled,” she said. “It’s the wonderful chance to help people with serious problems that stands out with me.” Wally has been scheduling flights with us for 22 years. He’s an oral surgeon and he is 90. “I have always marveled at how personally satisfying it is to be helpful to others, particularly in the field of medicine. Folks who have spent their entire lives in hum-drum jobs without much feedback can come into our place and suddenly feel incredibly good about themselves.” When Betty set out 18 years ago to find the “best place” to volunteer she quickly discovered that working in a hospital coffee shop “was not my cup of tea.” The mother of two says that “helping children was my highest priority.” She says that the work she’s doing now scheduling kids and their families for travel to treatment “fills my heart.” Dick, who was an award-winning investigative reporter on one of the largest American newspapers more than 50 years ago, edits our newsletter. “The deadlines are not as tight as when I was covering politics and crime,” he says. “But in a very real sense the stories are just as important to our readers. Doing something like this on a regular basis gives me a good grip on my feelings of self-worth.” Quartered among these fine people and many others like them, I spend much of my time supervising staff work and promoting the organization to donors and corporations who contribute seats on their aircraft. But in my drives home from work, I often marvel at the giving nature of our volunteers. Some of them are mature housewives who do not have

Together - A Voice for Health & Recovery

regular jobs and who come from homes filled with comfort and memories. A few are former business executives accustomed to impressive offices and many helpers. Others have traveled extensively, written important books or raised impressive families. All have been touched by cancer through their work with patients here and, in many cases, personally or among family members. Yet they spend long periods of time with us, hanging out in crowded surroundings, sitting on secretarial chairs at drab metal desks working on shared computers that are affected by the “slows.”

Satisfaction in giving Why do they do this? The answer is not hard to figure. We know that eating, sex and even hard work can produce feelings of significant pleasure. I have learned here and in other places that giving also offers huge satisfaction and that this is demonstrated by the donations of so many people to important and worthwhile causes. When I was asked to write a column for a recovery magazine, I didn’t at first see the connection with the cancer community. But cancer patients, almost universally, want to be known for what they do and who they are, and not for their disease. I understand that service to others is a big part of recovery from addiction as well, because it is a way to get outside of oneself and the associated problems of living. The people who volunteer here aren’t in recovery from addiction, but they clearly know how healthy public service can be. Not long ago I spent time with one of our volunteers who reinforced for me how this works and who gave me an interesting perspective on how responsibility and useful activity can play a very positive role in their battle. For about a year, Alex helped us by maintaining contact with the operations of about 50 of the largest cancer treatment centers in the United States. (Alex is a made-up name for this wonderful person who asked that I keep his confidence.) Alex had been retired for only 11 months when cancer was found, but the disease was heading toward remission when he first walked in our front door. He came to us on the insistence of a minister – his life coach if you will -- who felt strongly that Alex needed something meaningful and productive to do after his soul-deflat-

Peter Fleiss is the founder of two successful companies, and was president of a third, in the marine instrument field. He also has served as a sales and marketing consultant to a pioneering aviation technology firm. Fleiss was a technical advisor in three America’s Cup campaigns and was Race Controller for the 110-foot speedboat, Gentry Eagle, which broke the Trans-Atlantic world speed record. He has managed the work of Corporate Angel Network for seven years.

IN•THE•NEWS

Headliners • • • • • •

Drunk on the set The actor Daniel Radcliffe has admitted that he was drunk while filming some scenes for the “Harry Potter” movies during a period in his life where he was drinking “nightly,” Reuters reported. “I have a very addictive personality. It was a problem. People with problems like that are very adept at hiding it. It was bad. I don’t want to go into details, but I drank a lot and it was daily -- I mean nightly,” Radcliffe told British celebrity news magazine “Heat.” “I can honestly say I never drank at work on ‘Harry Potter.’ I went into work still drunk, but I never drank at work. I can point to many scenes where I’m just gone. Dead behind the eyes,” the 22-year-old actor said. • • • • • •

Understanding his relapse Josh Hamilton is undergoing counseling individually and with his wife in the aftermath of his alcohol relapse, and the Texas Rangers slugger said he is “doing things

right a day at a time,” The Associated Press reported. In an interview, Hamilton said he knows his addiction is a serious issue. The interview came just over than two weeks after Hamilton had several drinks during dinner in Dallas in January and continued drinking later that night. It was the second known relapse with alcohol in the past three years for the recovering drug addict. “We’re taking this as, obviously it’s a serious issue,” Hamilton said. “I had a slip-up in `09 and moving past that, it was, OK, I’m fine. OK, it was just one night, everything’s over and we didn’t really move back towards well, what caused some slip-up? So this time, it’s not just, `OK, it happened, we’ll move past it and maybe it won’t happen again,”’ he said. “We want to find out why it continues to happen.” • • • • • •

High on the mound Former Red Sox pitcher Dennis “Oil Can” Boyd admitted that two-thirds of the time he was on the mound, he was under the influence of cocaine. He played from 1982 to 1991. “Oh yeah, at every ballpark. There wasn’t one ballpark that I probably didn’t stay up all night, until four or five in the morning, and the same thing is still in your system,” Boyd told WBZ NewsRadio in Fort Myers, Fla. “It’s not like you have time to go do it while in the game.”

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“Am I Good Enough?” Excerpts from Kevin Costner’s eulogy at the funeral of Whitney Houston:

t the height of her fame as a singer I asked her to be my co-star in a movie called ‘The Bodyguard.’ I thought she was the perfect choice, but the red flags came out immediately. I was reminded that this would be her first acting role. “That was a lot for the studio to accept, and to their credit, they did, but not without a screen test. Whitney would have to earn it. That was the first time I saw the doubt. The doubt creep into her that she would not be handed the part. She would have to be great. The day the test came and I went into her trailer after the hair and makeup people were done, Whitney was scared. Arguably, the biggest pop star in the world wasn’t sure if she was good enough. “She didn’t think she looked right. There were a thousand things to her that seemed wrong. I held her hand and told her that she looked beautiful. I told her that I would be with her every step of the way, that everyone there wanted her to succeed, but I could still feel the doubt. I wanted to tell her that the game was rigged. That I didn’t care how the test went, that she could fall down and start speaking in tongues, that somehow I would find a way to explain it as an extraordinary acting choice. And we could expect more to follow, and gee, weren’t we lucky to have her? “She took it all in and asked me if she could have a few minutes by herself and would meet me on the set. I was sure she was praying. After about 20 minutes later she came out. We hadn’t said four lines when we had to stop. The lights were turned off, and I walked Whitney off the set and back to her room. She wanted to know what was wrong, and I needed to know what she’d done during those 20 minutes. She said, ‘Nothing,’ in only the way she could, ‘Nothing.’ “So I turned her around so that she could see herself in the mirror and she gasped. All of the makeup on Whitney’s face was running. It was streaking down her face and she was devastated. She didn’t feel like the makeup we put on her was enough so she’d wiped it off and put on the makeup that she was used to wearing in her music videos. It was much thicker and the hot lights had melted it! She asked if anyone had seen. I said I didn’t think so. It happened so quick.

“She seemed so small and sad at that moment, and I asked her why she did it. She said, ‘I just wanted to look my best.’ It’s a tree we can all hang from. Unexplainable burden that comes with fame, call it doubt, call it fear. I’ve had mine. I asked her to trust me, and she said she would. A half hour later, she went back in to do her screen test, and the studio fell in love with her. The Whitney I knew, despite her success and worldwide fame, still wondered, ‘Am I good enough? Am I pretty enough? Will they like me?’ It was the burden that made her great, and the part that caused her to stumble in the end. “Whitney, if you could hear me now, I would tell you, you weren’t just good enough, you were great. You made the picture what it was. “You weren’t just pretty, you were as beautiful as a woman could be. You set the bar so high that professional singers, your own colleagues, don’t want to sing that little country song. What would be the point? Now, the only ones who sing your songs are young girls like you, who are dreaming of being you some day. “And to all those young girls who are dreaming that dream, that maybe are thinking, are they good enough, I think Whitney would tell you, ‘Guard your bodies, guard the precious miracle of your own life, and then sing your hearts out,’ knowing that there’s a lady in heaven who is making God himself wonder how he created something so perfect.”

Whitney Houston 1963-2012

www.together.us.com | March / April 2012

IN•THE•NEWS

YourHealth • • • • • •

Eating to reduce stress Stress, the hormones it unleashes, and the effects of high-fat, sugary “comfort foods” push people toward overeating, the Harvard HEALTHbeat newsletter reports. In the short term, stress can shut down appetite. A structure in the brain called the hypothalamus releases corticotropin-releasing hormone, which suppresses appetite. The brain also sends messages to the adrenal glands atop the kidneys to pump out the hormone epinephrine (also known as adrenaline). Epinephrine helps trigger the body’s fight-orflight response, a revved-up physiological state that temporarily puts eating on hold. But if stress persists — or is perceived as persisting — it’s a different story, HEALTHbeat says. The adrenal glands release another hormone called cortisol, and cortisol increases appetite and may also ramp up motivation in general, including the motivation to eat. Once a stressful episode is over, cortisol levels should fall, but if the stress doesn’t go away — or if a person’s stress response gets stuck in the “on” position — cortisol may stay elevated. Once ingested, fat- and sugar-filled foods seem to have a feedback effect that inhibits activity in the parts of the brain that produce and process stress and related emotions. So part of our stress-induced craving for those foods may be that they counteract stress. • • • • • •

The addicted brain Drug addicts have inherited abnormalities in some parts of the brain that interfere with impulse control, according to a British study. Previous research has pointed to these differences, but it was unclear if they resulted from the ravages of addiction or if they were there beforehand to predispose a person to drug abuse. Scientists at the University of Cambridge compared the brains of addicts to their nonaddicted siblings as well as to healthy, unrelated volunteers and found that the siblings shared many of the same weaknesses in their brains. That indicates that the brain vulnerabilities had a family origin, though somehow the siblings of addicts -- either due to environmental factors or other differences in brain structure -- were able to resist addiction. • • • • • •

Shake and bake meth A crude new method of making methamphetamine poses a risk even to Americans who never get anywhere near the drug: It is filling hospitals with thousands of uninsured burn

patients requiring millions of dollars in advanced treatment -- a burden so costly that it’s contributing to the closure of some burn units, The Associated Press reports. So-called shake-and-bake meth is produced by combining raw, unstable ingredients in a two-liter soda bottle, The AP reports. But if the person mixing the noxious brew makes the slightest error, such as removing the cap too soon or accidentally perforating the plastic, the concoction can explode, searing flesh and causing permanent disfigurement, blindness or even death. An Associated Press survey of key hospitals in the nation’s most active meth states showed that up to a third of patients in some burn units were hurt while making meth, and most were uninsured. The average treatment costs $6,000 per day. And the average meth patient’s hospital stay costs $130,000 -- 60 percent more than other burn patients, according to a study by doctors at a burn center in Kalamazoo, Mich. Burn experts agree the annual cost to taxpayers is well into the tens if not hundreds of millions of dollars, although it is impossible to determine a more accurate number because so many meth users lie about the cause of their burns.

Addiction Shatters Lives We can help.

• • • • • •

Smart kids, dumb habits Smart children, especially girls, may be more likely to experiment with drugs when they grow up, according to a report in the Journal of Epidemiology and Community Health. In the study of 8,000 people, those who had high IQs when they were aged 5 and 10 were more likely to use certain illicit drugs at age 16 and at age 30. Why having a high IQ may encourage future drug use is not fully understood. But researchers have a theory. “People with a high IQ have also been found to be more open to new experiences,” study researcher James White, PhD, said in an email to WebMD. The research has been mixed on how a high childhood IQ affects behavior in adulthood, White says. “Previous studies have found high childhood IQ is associated with mostly healthy behaviors in adult life, such as having a healthy diet, being physically active, and not smoking,” he says. “However, other studies have found high childhood IQ is linked to excess alcohol intake and alcohol dependency in adult life.” In the study, women with high IQ scores at age 5 were more than twice as likely to have used marijuana and cocaine by age 30 than those with lower IQs at age 5. Men with high IQ scores at age 5 were about 50% more likely to have used speed (amphetamines), 65% more likely to have used ecstasy, and 57% more likely to have used multiple illicit drugs by age 30, compared with those who did not perform as well on IQ tests at age 5. The findings held when IQ was measured at age 10. Parents’ social status, psychological distress during adolescence, and their adult socioeconomic status did not affect risk of illicit drug use.

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BODY•MIND•SPIRIT

An All-Purpose Miracle Medicine – And It’s Free The secret: one day at a time, think about 30 minutes have a big interest in preventive medicine, which can mean a lot of things, from cancer screening to eating more fiber, to having a good social network -- and I mean that in the old sense of the word -- weighing less, drinking less, smoking less, controlling your blood pressure and cholesterol, and so on. All of these things are incredibly important, and I wouldn’t want you to minimize your efforts in any one category. But I wanted to know what comes first, what has the biggest impact, what has the biggest return on investment, what makes the biggest difference to your health? So I did my research and I found an answer. It’s tricky, because all these things are sort of overlapping. But I picked up this intervention because of its breadth -- it worked for so many different health problems -- and that’s what I found so cool about it. Just to walk you through a quick list: • This intervention in patients with knee arthritis who received one hour of treatment three times a week reduced their rates of pain and disability by 47 percent. • In older patients it reduced progression to dementia and Alzheimer´s by around 50 percent. • For patients at high risk of diabetes, when coupled with other lifestyle interventions, it reduced

Attributable Fractions (%)

By Michael Evans, M.D.

18 16 14 12 10 8 6 4 2 0

Men Women

Low CRF Obesity Smoker Hyper- High Diabetes tension Colesterol

Low cardiorespiratory fitness (CFR) accounts for about 16% of all deaths in both women and men, and this is substantially more, with the exception of hypertension in men, than the other risk factors. Reproduced from the British Journal of Sports Medicine, Blair SN, 43:1-2 (2009) with permission from BMJ Publishing Group Ltd.

progression to frank diabetes by 58 percent. • Post-menopausal women who had four hours a week of the treatment had a 41 percent reduction in the risk of hip fracture. • It reduced anxiety by 48 percent. In a big meta analysis of patients suffering from depression, 30 percent were relieved with a low dose and that bumped up to 47 percent as we increased the dose. • In a study following over 10,000 Harvard alumni for over 12 years, those who had the intervention had a 23 percent lower risk of death than those who didn’t get the treatment. • It’s the number one treatment for fatigue. • My favorite outcome is quality of life, which is really all of the above, and really about making your life better, and this treatment has been shown again and again to improve quality of life. So the question is, what’s the medicine? And what is 23 1/2 hours? The medicine is exercise, mostly walking. Let me put it in a different way. What I’m asking you to do is think about your typical day. There are 24 hours, and so you might spend most of your day couch surfing, sitting at work, obviously sleeping. What the evidence I’m about to show you tells me is the best thing you can do for your health is to spend half an hour being active, maybe an hour, and that if you can do that you can realize all the benefits I have described.

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BODY•MIND•SPIRIT

"Walking" by Ben Gancsos

anything to doing something, and after that the return is more granular. If we take the well-known nurses' health study, women who went from zero activity to just one hour a week reduced their heart disease rates by almost half. You can break it down so its just 10 minutes here, 10 minutes there and 10 minutes at another time if you want to do 30 minutes of exercise and you want it broken into three parts. It looks like higher intensity is equivalent to less time than lower intensity. But I think the clinical pearl is mostly thinking about your style and habits, such as couples who take a half hour walk every morning or in the evening. A dog is a great walking coach. The data show that 67 percent of dog walkers achieve 158 minutes a week just with the dog walking. Or consider your commute: getting off the train one stop early, talking the stairs, and so on.

The data show that 67 percent A cure for of dog walkers achieve 158 Sitting Disease Let me walk you through minutes of this medicine a week some of the literature. The first one comes from just with the dog walking. Japan. In the 1990s Japan reBiggest risk of death Let’s take a quick walk through some of the literature. Steven Blair, a professor at the Arnold School of Public Health at the University of South Carolina, looked at this in what is called the Aerobic Center Longitudinal Study, which followed over 50,000 men and women over time. The study looked at all the risks – smoking, hypertension, and so on – and found that the biggest risk of death is low fitness. This is important, because most the studies we see are funded by pharmaceutical or other companies, because they have a drug for high cholesterol or diabetes, but we rarely see fitness thrown into the mix, so it's nice to see a trial that is not so siloed. Blair also did another trial looking at obesity, and what he found is that obesity and no exercise is a very bad combination, and that´s where we saw many of the negative consequences of obesity from a health point of view. But if the obese person was active, even if they didn’t experience weight loss, but were just active and obese, the exercise ameliorated many of the negative consequences of obesity. So if exercise is the medicine, what’s the dose? And when I think of dose, I mean, how long? how often? and how intense? I´m going to give you a slightly mixed message. Essentially, more activity is better, but I must say that the rate of return seems to decline after 20 to 30 minutes a day. So that means you need to be active 150 minutes a week, or more if you´re a kid, an hour a day if you’re a kid. The literature draws a very broad brush, and so we see big differences when somebody goes from not doing

quired all employers to conduct health screens for their employees. A large gas company in Japan called Osaka answered this question. People who walked to work reduced their high blood pressure. What they found: under 10 minute walk, no difference; 11 minute to 20 minute walk, 12% reduction in rates of high blood pressure or hypertension; and over 21 minute walk, a 29% reduction in rates in high blood pressure. So the study authors calculate that with every 10-minute increase in your walk to work, there’s a 12% reduction in your likelihood of getting high blood pressure. The second exhibit is looking at stents. This is something we commonly do in medicine when an artery is blocked. A vascular surgeon puts in a balloon to open the artery and then a stent to keep it open, which makes great sense. A German doctor and researcher named Rainer Hambrecht looked at this with about 100 cardiac patients. He got the group to exercise 20 minutes a day on an exercise bicycle and once a week in a 60-minute aerobics class. The other half got the high tech stent and just did their normal activity. After one year 88 percent of the exercise group were complication free, compared to 70 percent of the people who got a stent. So both worked, but I find it incredible that the low tech made a bigger difference, and you have to remember that the stent fixes only one part of the heart. The next way of thinking about it is the reverse, so what I call Sitting Disease. We know that being sedentary is bad for your health. A researcher named Lennert Veerman wanted to quantify this, and he did so down in Australia. In a big study they found that, compared to persons who watch

Together - A Voice for Health & Recovery

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no TV, those who spent an average of six hours a day watching TV can expect to live about five years less. That’s incredible! And I think, who watches six hours a day of TV? It turns out the average adult in the USA spends about five hours a day watching TV. I find this fascinating that we never think of the TV as something that’s bad for our health, but clearly it’s as powerful as many other risk factors for chronic disease. I’m going to leave you with two quotes, one by Jerry Garcia, the lead singer for the Grateful Dead. He said, “Somebody has to do something; it’s just incredibly pathetic that it has to be us.” I think that’s true, that in some ways it has to be us. And Hippocrates said, “Walking is man’s best medicine.” I’m going to finish by asking you a question. This may have some personal challenges for you if you’re very busy with work, or kids, or both, or maybe you’re in pain. But my question for you is: Can you limit your sitting and sleeping to just 23 1/2 hours a day? Something to think about. Dr. Mike Evans is founder of the Health Design Lab at the Li Ka Shing Knowledge Institute, an Associate Professor of Family Medicine and Public Health at the University of Toronto, and a staff physician at St. Michael’s Hospital. This article is adapted from a video entitled “23 and 1/2 hours: What is the single best thing we can do for our health?” available on YouTube at http:// youtu.be/aUaInS6HIGo.

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BODY•MIND•SPIRIT

How to Fight Your Fight or Flight Response In a few minutes you can coax your mind and body into a relaxed state

By Patricia Keane

n route to a recent appointment, I encountered an everyday annoyance: traffic. My initial response was to denounce God, the universe, and all the other drivers. Where are all these people going? Then I began the bargaining: please open up. Just this one time, give me a break. As it became clear that it would not be sorted out anytime soon, my emotions veered from bad to worse. I’m angry, I’m desperate, I’m going to lose it! With my shoulders up around my ears and my hands tightly gripping the steering wheel, I embodied those thoughts physically as well. My sympathetic nervous system came into dominance, releasing noradrenaline into my body, and the result was dilated pupils, sweating, an increased heart rate and higher blood pressure. My body was experiencing the well-known “fight or flight” response, the holdover from earlier times when threats were real tigers coming out of the jungle -- not simply being late for an appointment. In our day and time, however, it’s hard to avoid these perceived “threats.” We experience thousands of thoughts and emo-

tions every day. The ideas that pass through our minds can be chaotic and disjointed, or repetitive and obsessive. These thought patterns can produce a continuous menu of stressors, placing us in a perpetual state of high alert. Daily life conspires to keep us there, with its endless barrage of anxieties, deadlines, financial worries, relationship problems, employment issues, sleep deprivation – and, of course, traffic congestion. Left unaddressed, this uncomfortable, anxious frame of mind takes a dramatic toll. We become physically and emotionally accustomed to chronic stress, resulting in anxiety, depression, sleep disturbances, and elevated blood pressure and triglycerides. Is it any wonder that these conditions are practically at epidemic levels? Thankfully, each of us is equipped with a powerful tool to combat the negative effects of stress: our minds. Stress is produced either internally from thought, or externally from an event. We have the potential to manage our response to what lies in our inner landscape and in our everyday lives. Sometimes all we need is a simple change in our internal dialogue, and an

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BODY•MIND•SPIRIT

The Power of Mojo We who aspire to bring healing power to others might consider that how we walk may be more valuable than how we talk

By Jeffrey C. Friedman

n 1911 the pioneering psychoanalyst Carl Jung wrote, “All neurosis is a substitute for genuine suffering.” Jung’s insight of a century ago may have some value for us today, since the conditions from which the readers of Together recover – disorders like alcoholism, other chemical and behavioral addictions, depression, anxiety and trauma – are all neuroses. This category of disorders includes ways the nervous system can respond to stress and trauma, as well as the myriad of maladaptive behaviors we resort to in our attempt avoid the pain of living. So often the ways we choose to escape our inescapable suffering end up creating an avalanche of trouble – an avalanche that can sweep away careers, families, even lives. Sooner or later, many of us realize that our self-generated pain has reached an existential watershed. We see that our ego-generated suffering finally outweighs the suffering of accepting the unavoidable pain of being human. This is the crossroads many of us find ourselves at as we take our first tentative steps in recovery. And if we are fully able to engage in the recovery process, and if we are gifted with a little grace, our suffering may be transmuted into a spiritual and emotional awakening. Such a transformation can occur in the context of treatment, a religious or spiritual experience, or by the more mundane and gradual two-steps-forward-onestep-back trudge familiar to members of the 12step groups.

People in pain

ence that is at the core of the possessor’s being. This medicine, this potency, cannot be taught. It’s a quality that a person either has or does not have. Real potency, like real medicine, is very difficult to fake. It is true evidence of one’s authenticity and wisdom and emblematic of a life lived with courage and commitment. Many believe that a person’s potency is a direct expression of their willingness to sit presently with their own personal suffering. Those who are willing to directly confront their existential pain can bring great power to the work of caring for others. It seems as if their ability to suffer courageously empowers their effort to ease others who suffer. Conversely, those eager to help but who are unable to summon resolve sufficient to be fully present with their own pain too often offer their support to others in a way that can come off as superficial and nervously cheerful. They fill the conversation with psychobabble, pseudo-therapeutic vagaries and forced, well-meaning platitudes. This manner of carrying the message of recovery rarely goes over well with a recipient who comes to the helping dialogue with any degree of grounding or self-awareness. And a helping effort can go awkwardly awry when it is eventually revealed that the helpee’s medicine is more powerful than the helper’s. Someone like the Apache warrior Geronimo, a man whose medicine was the stuff of legend, if subjected to such a weak approach, would certainly be nonplussed. But if Geronimo was not one to suffer fools, he was known to suffer well. Growing to manhood in a harsh and unforgiving desert environment, Geronimo bore great difficulties in a way that embodied the highest of Apache values – perseverance, selflessness and a willingness to endure intense suffering. This brave and rigorous walk hardened Geronimo’s body and imbued his soul with a kind of potency and presence that is, even today, admired by all who are familiar with his story. Born Goyathay in 1829 in what would one day become Arizona, Geronimo earned his nom de guerre in a remarkable display of bravery and determination. While leading an attack against a superior force of Mexican soldiers who had just days before murdered his wife and three children, Goyathay seized a knife and ignored a hail of concentrated musket fire to make repeated attacks against panicked soldiers who went down screaming desperate pleas to their heavenly patron, St. Jerome (Geronimo!). Getting one’s moniker from the dying utterances of one’s enemies, I think, imparts a certain gravitas to a person. Considering how Geronimo’s displays of selflessness and courage brought potent medicine to the battlefield, we who aspire to bring a special healing power to our work with others might do well to consider a cogent fact: how we walk may be more central to that effort than how we talk. Our ability to live a mindful, measured and courageous life, rather than what we think we might know about recovery, might be the thing that empowers any message of hope we might carry. For those of us who are called to help others, the extent to which we are able to sit presently and courageously with our own suffering might be the deepest measure of our ability.

Our ability to live a mindful, measured and courageous life, rather than what we think we might know about recovery, might be the thing that empowers any message of hope we might carry.

Readers of Together may think that a commentary on suffering is an unusual offering for a publication whose focus is hope and whose motto is “a voice for health and recovery.” But suffering is a subject to which my mind often turns. I suspect that the reason I think about suffering so much is that I am a member of the recovering community and have regular contact with people who are in pain – and, as a recovering person I am drawn to help these suffering others find ways to suffer less. If there is a single skill that expresses the most artful practice of helping others, it may be the ability to help them find within themselves the flexibility, acceptance and courage to be with their suffering more presently and mindfully, and by taking this brave path, to hurt less. Those few who have a special genius for helping others this way are especially blessed. Now, as a helper, I am decent but not a great. I know this because I walk among with some truly gifted natural healers and every day I see them doing something that I can never quite pull off. With their words, their silences, their gestures and their stillness, but ultimately by their wise, calm and powerful presence, these truly skillful ones create healing insight and heart’s ease in those with whom they work. After years of studying the qualities of wise and powerful healers, I have come to a conclusion about what makes people like these so singular. It is something called potency. All great healers have it and a rare few have it in spades.

Native American medicine In the realm of recovery the term potency is often used to describe a vital quality that Native Americans have for millennia known as medicine. Medicine, sometimes referred to as mojo, is a kind of intrinsically powerful resolve, an innate wisdom and pres-

Together - A Voice for Health & Recovery

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The Apache warrior Geronimo emobidied perseverance, selflessness, and a willingness to endure intense suffering.

EVENTS

A Sober St. Patrick’s Day? Is such a thing possible? In New York City?

By Suzanne Riss

om O’Leary used to feel embarrassed on St. Patrick’s Day. Sure, he drank most days, but privately, at home, and all alone. He didn’t make a public spectacle of himself like so many of his fellow Irishmen. “St. Patrick’s Day didn’t make me feel good,” O’Leary says, remembering that he’d steer clear of the parade in New York City. “The Irish seemed to be the only nationality to celebrate their stereotype with wild, crazy, drunken, mindless displays in the streets.” This year, O’Leary, who has been sober for 17 years, is excited about the chance to celebrate his recovery and his cultural heritage in a different way, with the first annual Sober St. Patrick’s Day party. “This is about a group of people getting together to celebrate sobriety,” O’Leary says of the party that will include live Irish music, step dancing and comedy. “It’s a

chance to connect with your cultural pride and spirituality.” Sober St. Patrick’s Day will focus on good news. “More than 20 million family members are living amazing lives in recovery,” says Robert Lindsey, president of the National Council on Alcoholism and Drug Dependence. Sober St. Patrick’s Day will be a reminder that people can and do recover from alcoholism—and they can still have a great time. “Many people who are living with active alcoholism or in the early stages of their recovery are terrified that if the drinking stops, they won’t have fun any more, that life would be totally boring.” In fact, quite the opposite is true, Lindsey says. “What you hear instead is that life as result of recovery is beyond people’s wildest dreams.”

Reclaiming the day The event is the brainchild of William Spencer Reilly, who hopes to reclaim the true

spirit of the day. “St. Patrick’s Day has long been hijacked by people getting blotto in the streets,” says Reilly, who is Irish on both sides of his family. “I wondered what would happen if we held a party to show what the day is really about and to celebrate the best in Irish culture.” He hopes the party will become an annual celebration in New York City and roll out to other cities so that people in recovery can have a sober, celebratory venue on this holiday. It’s a welcome alternative because St. Patrick’s Day can be a trigger for many people in recovery. “It’s a day when it’s OK to get plastered because, seemingly, everyone else is,” says Todd Whitmer, regional vice president of Caron, the alcohol and drug addiction treatment center. “Pretty much everywhere you look, alcohol is being pushed and promoted.” Whitmer hopes that the Sober St. Patrick’s Day party will dent the perception that the Irish are more prone to alcoholism than others. He believes that some people laugh at the Irish drinking as a way to excuse their own drinking. “It’s similar to the ‘comparing out’ that many people do when they first come to an AA meeting,” Whitmer says. “They tell themselves, ‘Wow, I’m not that bad! So I can keep doing what I have been doing.’” All family members will be welcome at the celebration in recognition of the fact that alcoholism is a family disease. Indeed, one in four children live in a family with alcohol abuse or alcoholism, says Sis Wenger, president and CEO of The National Association for Children of Alcoholics. “It’s important that this party includes the whole family, not just the addicted person,“ she says. “It brings attention to the fact that when one person in a house is an alcoholic, every person in that

house suffers from the disease. Recovery is individual for each member of the family down to little kids.” Children who grow up in an alcoholic home need to get information about the disease from a caring adult in their lives, she says. “Kids need to know that what goes on in their family isn’t their fault,” Wenger says. “They need to be told: ‘You don’t need to fix it. You can still have a good life even if your parents never get better.’” She notes that in many alcoholic families, the disease is never mentioned. “We need to educate health care providers and teachers to never shy away from naming it when they see it,” she says. “An alcoholic family is a dishonest system that sustains the active use of alcohol. If everybody was honest, it couldn’t keep going on.” Children can suffer from chronic emotional stress from the unpredictable nature of their homes, she adds. Wenger sees the Sober St. Patrick’s Day party as a chance for families in recovery to celebrate the day sober, while also celebrating their Irish heritage. Information about alcoholism and recovery will be on hand at the event. “There’s a way to enjoy St. Patrick’s Day without alcohol,” says Lindsey of NCADD. “This is a chance to help the public understand that as much as we talk about the problem of alcoholism, we need to talk about solution--recovery for individuals and families.”

“St. Patrick’s Day has long been hijacked by people getting blotto in the streets.”

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 first book, The Working Mom Survival Guide, was published by Weldon Owen in October.

Sober St. Patrick’s Day at a Glance WHEN: Saturday, March 17 (3 p.m. to 7 p.m.) WHERE: The Regis High School, 84th Street between Park and Madison Avenues in New York City. WHO: Families and children of all ages are welcome. WHAT: Live music, dance and comedy. Finger food and alcohol-free beverages. Open AA and Al-Anon meetings on site. HOW: Tickets are $12 per person. To reserve a ticket go to soberstpatricksday. org. Reservations are required.

www.together.us.com | March / April 2012

TOGETHER•INTERVIEW A conversation with

Paul Williams

“You Know You’re an Alcoholic When You Misplace a Decade” An interview with Grammy Award Winning Songwriter Paul Williams I’ve tried to fill it in many, many ways. One of them was that relationship that was going to fix everything. I’d left my wife and kids for a 22-year-old psych major who refused to watch me slowly die of my addictions. To keep her with me I went to treatment. Of course I slipped after seven months and eventually she left me to my drugs and booze. In 1989, in a blackout, I called a doctor and said I was finished. I changed my date to March 15th, 1990, over a valium and have been clean and sober since. It’s the single greatest gift I’ve ever been given.

By Barbara Nicholson-Brown

Together: Your resume spans music and acting; when did you know that your career would be on the stage? Paul Williams: I was one of those kids who showed up in the Midwest at talent shows singing “Danny Boy.” My dad used to get me up in the middle of the night to sing for him. He was a construction project manager and we moved all over the Midwest … nine schools in nine years. He died in an alcohol related onecar crash when I was 13. I pretty much quit singing then. I was shipped off to live with an aunt in Long Beach, California. I was 30 miles from Hollywood and a big movie buff. It wasn’t long before I knew I wanted to act. So, I started out as an actor. Did a couple of films in the 60’s but the career fizzled. So “no” has always been a gift in my life. The acting didn’t work. I got depressed and started to write songs for my own amusement, kind of home musical therapy. One door closes, another opens. We put those sayings on bumper stickers because they’re true!

You have a brother who is also a credited songwriter. Was yours a musical family? What was it like growing up in the Williams household? Not really. We moved around a lot and we sang in the car. My brother started singing in bars when he was still in high school. When I stumbled into a songwriting career we suddenly had music in common. He’s a terrific writer and “Drift Away” is one of the great rock and roll anthems ever written I think.

What was your first encounter with alcohol? We were raised in a household where alcohol was the reward for a hard day’s work. It was always around. In a dry state my dad would hit the bootlegger’s house on Sundays and pick up a bottle. He was a sweet man but an alcoholic who never sought treatment or even recognized his addiction. He died at 59 in 1954. I drank with my buddies in high school. It was a rite of passage. The thing I remember was not so much enjoying the alcohol as the feeling of being one of the guys. Looking back it was a temporary cure for feeling different! Something I hear again and again from other recovering alcoholics.

You have said, “You know you’re an alcoholic when you misplace a decade.” Does this sentiment reflect a direct experience that you had during your life? It does. I don’t know when I crossed the line from use to abuse to addiction, but I’m pretty sure it was around the end of the 70’s. That decade was an amazing span of accomplishment, productivity and discipline. It’s also the decade when I went from different to special. I’m talking about the amazing power of celebrity, a condition I believe

Together - A Voice for Health & Recovery

You have been sober for over 21 years. What keeps you on the path of recovery?

“We self-medicate our feelings away, and the awakening that comes with sobriety has a lot of information in it that slipped by during the storm. I had no idea I’d survived such a terrible childhood until I was many years sober.” is as addicting for some as any chemical substance invented. I had huge success as a songwriter and entertainer and in a sense I became better at showing off than showing up. I loved feeling like I belonged and the alcohol and drugs that celebrated the achievement soon became the substance I needed to look like I could handle it all. Or perhaps what I needed to not feel what was really going on, which had to be a lot of fear. It’s interesting that we self-medicate our feelings away, and the awakening that comes with sobriety has a lot of information in it that slipped by during the storm. I had no idea I’d survived such a terrible childhood until I was many years sober. To answer your question, the 80’s I refer to as the “Ishtar” years. I began to hide out, not taking job offers and avoiding appointments. The party was over? No, it wasn’t a party at all by then. It was isolation. Hiding in my bedroom looking out the venetian blinds … looking for the tree police I knew had come to get me. Psychosis began to creep into my psyche.

When did you seek help? Did anyone encourage or assist you in finding the initial help to stop using? I went for treatment twice. Once for “her.” “The ‘One!” I have a God-shaped hole in the middle of my soul and

Principles and traditions that will keep me from naming the association that has given me a home, a group that meets all over the world and for which I am eternally grateful. Gratitude is high on my priorities. I think gratitude is the fuel that drives us to that new freedom and a new happiness! The spiritual life is not a theory. We have to live it. So I start my day with a quick word to the Big Amigo. “Surprise me God!” It implies complete trust. Here are the reins to my life. “Lead me where you need me!” is another Paulie Prayer.

Parental interaction can be crucial in the prevention of substance abuse in teenagers. When your children were younger, how did you approach this subject with them? When I got sober my kids were pretty small. My daughter was six and my son was nine. I shared basic information about my disease. I talked about the spirit of my recovery and the result was my daughter at five was saying things like, “I think Cole (her brother) is beginning to get in touch with his feelings.” Or, “He has anger issues Dad!” My kids sounded like John Bradshaw at times, and it was a gift of the kind of open conversation we had about my new way of living.

What encouraged you to become a Certified Drug Rehabilitation Counselor? I was friends with a musician who described himself as “the oldest living Jewish junkie.” Buddy Arnold was a great jazz musician, a saxophone player who got sober and went to work in recovery. He wound up at Brotman Hospital in Los Angeles as program director, second in command as I recall, and decided that musicians are generally over medicated and under insured. He decided to start an organization called The Musicians Assistance Program, aka MAP. He said I should take UCLA‘s drug and alcohol counseling study program and get certified. I spent a year in school two nights a week and began working every morning at Brotman. I traded my services (as a fundraiser for the program as well as facilitator) for a bed that we could put muzoids in.

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PRACTICUM

My Shortcuts to Daily Bliss It’s not hard to get your day going right By Meryl Davids Landau

and, equally important, they expand my mind. My favorite micro session when I can’t do a full class: A boat pose (aka Superman), a full forward bend, and a half spinal twist. (If I’m at my desk: raising my arms and arching backward and holding a minute, folding forward down to my ankles for another, then twisting around to the right side, then the left.)

ure, the ancient yogis found inner bliss by stretching in their yoga poses and sitting on their cushions for hours on end. But we live in the real world -- frequently too busy treading water to spare that kind of time. Fortunately, after digesting tons of spiritual books and attending myriad workshops, then experimenting with what works for me, I’ve created my own Reader’s Digest-ish shortcuts to daily bliss. To connect to my elevated interior, I try to sprinkle these simple steps throughout my day.

5. Sit on my rump.

1. Sing in the shower.

One thing the ancient yogis were right about: Set a good tone first thing in the morning and you float through the day. But I can’t drag myself out of bed early enough to meditate, so my solution is to sing in the shower. Rather than fixate on problems and to-do' s, I send my thoughts skyward via song. I learned this technique from a healthy and joyful 99-year-old man, who I’m convinced got that way because he belts out “Oh What A Beautiful Morning” with every shampoo. (I prefer Natasha Bedingfield’s “Unwritten.”)

2. Listen for the bird chirp (or the dog bark). Several years ago, I

read the old Aldous Huxley novel, Island, in which the Mynah birds on his utopian Pala constantly shout, “Attention, attention,” to remind the natives that here-and-now is most important. I decided to use the occasional chirping of the birds outside my South Florida window as my own prompt to pause. I stop and take a long, deep breath, and am immediately pulled into the present moment -- the only place we can access our higher selves. If you don’t have regularly cacophonous fowls, any vocal animal, or even a neighbor’s crying baby, is an equally wonderful cue.

3. Stop whining. The biggest problem with chronic complaints: They keep my mind

fixated on what’s going wrong, rather than on the higher-vibration, fabulous things that are working. When I’m ready to criticize or complain, I stop and ask, “What is this unhappy situation making me desire?” Then I turn my whole focus to that.

4. Stretch my arms up.

As a longtime, big-time fan of yoga, I know the value of sneaking even a couple of poses into the day. The stretches make me feel great physically,

"Up" by Rosalie Bischof

I’m not talking about all those hours I spend on the computer. I’m talking about meditation. Not necessarily the 15 to 30 minutes twice daily that experts recommend. (I definitely do that when I can. But I’m talking shortcuts here.) Ten, or even five, minutes once or twice anytime in the day can be sufficient. By focusing my mind on one thing (a word like “peace,” a sound like “om,” the flicker of a candle), I’m training it to release the worries about the past or fears over the future that keep me from fully experiencing the present. I adore my 10-minute minimeds, and, more important, the way they spill into the rest of my day.

6. Fantasize. I fantasize about what I want for my life. The teachings about the law of attraction by Esther and Jerry Hicks make clear that you get what you think about. I used to spend much of my day pondering things as they were (what the Hicks’ call “tell-it-like-it-isitis”). But if our thoughts create, it behooves us to shift to those that make our hearts sing: the desired job, financial state, health status, dream trip, romantic partner, and/or situation in the world. I ponder my desires in great detail, until I feel enthusiasm stirring.

7. Kiss my pillow. Before going to bed each night, I think about five people, events,

and/or objects I appreciate. I begin with the easiest: items right in my delicious bed (including your scrumptious pillow). How better to end my day than by connecting to my highest self -- which, as pure love, always appreciates? I drift off with ease, and, more important, set a glorious vibration to wake up to in the morning. Meryl Davids Landau is the author of the spiritual women’s novel, Downward Dog, Upward Fog, which ForeWord Reviews touts as “an inspirational gem that will appeal to introspective, evolving women.” She has also written for many national magazines -- including Reader’s Digest, Whole Living, Self, O-The Oprah magazine and more. For more information about Meryl please visit: www.downwarddogupwardfog.com.

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Together Welcomes Together AZ PRACTICUM

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and typical scenarios they will be confronted with in waking life after leaving treatment. In these cases, the importance is not placed on ean, a patient in treatment for the individual dream but the manner in which substance abuse, came to my group dream content shifts over time. If clients like disturbed about the following Jean continue to dream about using substancâ&#x20AC;&#x153;usingâ&#x20AC;? dream she had the night before: By Alan Cohen and youshould will find â&#x20AC;&#x153;just rightâ&#x20AC;? tribe.their es, they be your encouraged to record â&#x20AC;&#x153;I dreamed I was in the cafeteria teaching Regardless of apparent chaos, a grand dedreams and note any shift in content. other patients here howintoThe chop lines of young sign is unfolding. Upheaval is theThis turning n a classic scene Graduate, process may instruct clients and counselors cocaineBen andissnort them.â&#x20AC;? Though she laughed at his college graduation party over of the ground in preparation for planting about significant triggers that need to be adat the dream when abecause friend of of its hisridiculous parents takes him new seeds. The winter may have been harsh dressed, clients to examine and cold,while but challenging the spring will soften the soil. aside and earnestly whispers, â&#x20AC;&#x153;Plastics.â&#x20AC;? plot, Jean also wondered what it might their readiness to change. industry willher be recovery. the next rage, the The ego resists change because it has a vested mean, That if anything, about One particularly usefulthe study of drug-using in maintaining status quo, even if fellow hints, and if Ben is smart heâ&#x20AC;&#x2122;ll get in on interest the status quo is dysfunctional. Yet the higher the ground floor. dreams demonstrates that a clientâ&#x20AC;&#x2122; s personal THEFast VALUE OF DREAMS or inner spirit recognizes that anything forward to 2012. A young acupunctur- mind response to the dream is more important than Thephones purposemy of this to briefly outline away is replaced by something greater. ist Hayarticle Houseis Radio show, â&#x20AC;&#x153;Get taken dream content when it comes to predicting some ofand theconfesses clinical research s been Real,â&#x20AC;? her fearthatâ&#x20AC;&#x2122; that she will not As Rabindranath Tagore noted, â&#x20AC;&#x153;Faith is the a positive treatment outcome (Brown, 1985). conducted aboutenough the occurrence, meaning be able to earn money to provideand for bird that feels the light and sings when the The study finds that clients who dream about dawn is still dark.â&#x20AC;? her family, including her little child. I whisper value of drug-using dreams. It is my intention using substances fall into two main categories: to her, â&#x20AC;&#x153;Transformational services,â&#x20AC;? andcan leave to demonstrate that drug-using dreams be one group experiences frustration that their auseful pregnant pause for the message to sink in. in counseling when clients and clinicians my passion? I go on to tell the woman that in the years Whereâ&#x20AC;&#x2122;s dream isnâ&#x20AC;&#x2122;t real and the second group experiarecome informed about theincreasing possible function to we will see change,this disTo clarify your rolethat in their the coming world, ences relief dream isnâ&#x20AC;&#x2122;t type of dreamand serves. orientation, turmoil as many social sys- ask yourself, â&#x20AC;&#x153;Where does my passion call real. The first group is described as Oneand study, a classic inwill thelikely field ofdisintegrate. subtems institutions me? How can I serve others in the highest having relapse-pending dreams. This They be treatment, replaced by new systems rooted way possible? stancewill abuse demonstrates What tools can I offer that group to peace re-experience intoxiin truth, vision, and service rather than fear, will bring them longs greater and aliveness? that alcoholics who dream about drinkcation and feels triggered toward greed, and illusion. As people are pushed out Regardless of what I was told about how the ing during the course of treatment tend substance use.isThe second group of old comfort zones of and world supposed to work, to achieve longer periods sobriety lifestyles they will be hungry what as dohaving I know, from inside is described recovery(Choi, 1973). relief, This finding suggests that for answers, and skills out,dreams. about This howgroup life wakes really affirming clients Jean whoauthentic dream about the to shiftlike into more works?â&#x20AC;? up disturbed by their dreams and substances they are attempting and rewarding careers, re- to abDuring this crucial shift feels repulsed from actual substance lationships, and situ- in the stain from may beliving more engaged we are taking back the power use. Clients like Jean clearly belong ations. At process such athan timethose any-patients we have vested in external treatment to this second group and often need one connected to spiritual institutions. The only real who donâ&#x20AC;&#x2122;t report drugprinciples and tools will be help perceiving their authority resides in the wisusing dreams. In other in high demand and of great dom andusing power within dreams as ayou. rewords, these clients take service. As you trust your heart and covery-affirming protheir struggle sub- healIf you are awith teacher, vision more andit cess.than Theydogma may find stance abusetherapist, seriously coach, er, massage dictates, you will have all the helpful to inventory speaker, or counenough tominister, dream about guidance you need and the theirall motivations for selor offering services to uplift individuals ability to help others access the guidance it at night. As Freud recovery and review or groups, the universe has a job for you. In they need. observed, only matters the world as we have known it, where many their actionâ&#x20AC;&#x153;May plan. you The A Chinese blessing suggests, of greatest importance people are clinging to methods and systems live during interesting times.â&#x20AC;? That can we be do. using dream are permitted to disturb based on shallow values and false security, In many ways our timesharnessed seem unstable and as a â&#x20AC;&#x153;wake our sleep. you may In notthis beregard, sought out, acknowledged, worrisome, but they are also rife with the posup callâ&#x20AC;? challenging Jeanâ&#x20AC;&#x2122; s drug dream or paid wellusing for your work. But in the coming sibility of change for the better. A Course in clients like Jean to epoch which people is good.â&#x20AC;? may bein understood as a need integrity more Miracles tells us, â&#x20AC;&#x153;All change re-examine theirDay than hype, they will be happy to pay you to In another classic film, Ferris Buellerâ&#x20AC;&#x2122;s positive sign, dreamed assumptions about soothe their journey and accelerate their evoOff, Ferris phones his friend Cameron to ask by a person who is seriThe using dream can be lution. him if he wants to skip school and go out and recovery. ously concerned about play. When Cameron complains that heâ&#x20AC;&#x2122;s too the consequences of harnessed as a sick â&#x20AC;&#x153;wake upoutcallâ&#x20AC;? to get of bed, Ferris tells Cameron It takes faith relapse. DREAMSâ&#x20AC;&#x2122; RELEVANT that he just canâ&#x20AC;&#x2122;t think of anything worth getchallenging to reA morethe recent studyconsciousness MESSAGES ting up for. Until deeper is estab- clients If the world or your life seems sickrelapseor tired, lished, is addicts required. The old has died of crackfaith cocaine Clients with examine their assumptions we have accepted away, or is about dying,drug and the new has not yet it may be only becausepending who dream dreams will a world that doesnâ&#x20AC;&#x2122;t offer us anything to get come to replace it. Imagine you are at a party use demonstrates that also need help in up about recovery. where you have grown tired, bored, or disillu- for. But if we recognize that something new the content of using regard to receiving a sioned with the people and conversations in and wonderful is calling to us, we will find the dreams is also relevant message from what we would the room. Youimportant step out of the room in search energy and means to create in predicting treatment the reactions they have of new friends and peers who match your val- choose rather than what has been cast upon outcomes (Reid, S. and Simeon, D., 2001).inter- us. to their using dreams. Counselors can direct ues and offer stimulating, empowering Transformational services. Toolsthat to awaken. actions. In the corridor canwho faintly hear these Over a ninety-day period, you clients report clients back to interventions address connectionstage andofexpanded aliveness. people in another room, but youcocaine cannottosee Deeper their dreams changing from using the contemplation change. These cliGet in on theof ground floor. them. you transition between rooms you The activelyAs refusing cocaine tend to achieve longer entsnew mayplastics. benefit from a review the costs and may feel alone, insecure, or frightened. You periods of abstinence. This finding suggests consequences of their substance use. Alan Cohen is the author of many popular might be tempted to turn back â&#x20AC;&#x201D; but you that readiness change reflected The relapse-pending dream maythe bring books, including just-recouldnâ&#x20AC;&#x2122;t even for if you tried.is The genieinisdream out of inspirational content andSo that dream-life clients leased to lightEnough their impoverished view of sobriety. Already: The Power of Radical the bottle. you have to can justprovide keep moving with antrusting opportunity rehearse change. These Counselors canVisit challenge these impoverishedor www.alancohen.com ahead, thattoyou are on your way to Contentment. info@alancohen.com. higher The trail become to wider email dreamsground. provide clients withwill an exposure views and direct clients toward new becravings, interactions with â&#x20AC;&#x153;using friendsâ&#x20AC;? (Continued on page 17) iLLESpiE

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Together - A Voice for Health & Recovery May/June 2011 | www.together.us.com

Together

13 13

Together Welcomes Together AZ BODY•MIND•SPIRIT

TheFight Forbidden Addiction or Flight Each of us is equipped

using sex or romantic intensity to tolerate also emphasize the importance of learning colorwhen of thein sand, andabout whether is completely bare or dotted difficult experiences or emotions; anditdeveloping healthy self-esteem, with beautiful seashells. Takeintimacy, in the shape the clouds and A key a relationship, being detached or unhappy; healthy and of healthy sexuality. the color of the sky. Add whatever wildlife wouldand perfect your when out of a relationship, feeling desperate focus will include marital family therapy vision -- such as dolphins or seagulls. Inhabit this internal from page 8) some people dispute whether this type of and alone; inability to leave unhealthy since the partnership and family members BY KAY B(Continued UTLEr-LUEKing vacation for as long as you wish, riding the waves with your extreme sexuality can actually be considered relationships despite repeatedbreath. promises are so intricately involved. Honesty, empathy, elevated awareness and evaluation of our responses. addiction. Since no chemical or substance is to self or others; returning to previously and disclosure should also be key aspects of For example, when we are angry at someone oran something, involved physical symptoms such as tolerance unmanageable or painful relationships Dealing with boundaries he taboo to topic of sex addiction is Touch your breath. Thistreatment. will involve several hand it is common think or say, "I'm mad." Even the use of the positions; your intention will be three or more patient statement "I am" implies state of existence emoandthe withdrawal are not measurable. However, despite promises to self or others; and shame will beslow, included since plastered all over theamedia these days. -- that back withwith yoursex knees bent live tion is actual who Or, are indicates we that sex addiction follows mistaking sexual experiencesbreaths and for each one. Lie on your most people addiction So,our what is sexidentity. Is addiction "mad" and why is we are?research yourshadow head with a blanket or simply feelingcontroversy angry? When you re-state an similaraspatterns and affects the brain similarly romantic intensity for love. and feet flat on the floor. Support in the of shame. Learning there so much surrounding it? the emotion pillow. Leaving your elbows on the floor, place your left hand experience you are having rather than a state of being, it to other addictions. Although it is not currently The Earles state that other warning to control the addictive behavior Noted expert, Dr. Patrick Carnes defines sex opens the door to evaluation and choice. Instead of being the Be aware of your breath. Sit comfortably in a chair, allow- on your navel and your right hand just below it, on your lower included in the Diagnostic and Statistical signs to watch for include: out of be a as major Establishing addiction as a recurrent behavioral pattern moves you goal. breathe in and negative emotion, we are able to observe it and take the time ing the curve in your lower back to be present and lengthening belly. Notice the way your bodywill Manual for Mental Health Disorders (DSMcontrol behavior, time lapses, severe a healthy recovery support system which includes inability out through your nose. to decide how the to react. to resist engaging upwards from your navel to your sternum. Relax your shoulIV), efforts include underand soften After a few breaths, begin toismove theThe lower hand toprocess rest consequences to sexual crucial. treatment in extreme behaviors. Sex addiction “Direct sexual your attention inward,” the popular spiritual writerare underway der bladesto down youritback your belly. due Allow your behavior, just above the other, stopping may at each newCognitive-Behavioral hand placement Eckart Tolle has “Have a look inside What the title of Hypersexuality in the edition. inability to stopClose despite adverse include can also be seen aswritten. the use or dependence on yourself. head to bow very2012 slightly, almost imperceptibly. your for aoffew cycles of breath. Observe the spreading of your ribs,and kindsexpression of thoughtstoisdeal yourwith mind producing? do you feel? eyes and through your nose. As the breath fillspursuit a diagnosis of inhale Sexual slowly Disorder, consequences, persistent therapy, Experiential therapy, sexual life’s stressors. What Currently, the lifting of your belly, and thearising of your chest. Once you For IfLike youother keepaddictions, your attention in the body as much Not as possible, lungs, feelexist. your ribs expand inself-destructive all directions. or Hold that Otherwise your Specifi ed does high risk behaviors, solid relapse prevention plan. sex addiction usually you will be anchored in the Now. Thoughts and emotions, full breath to a count of two, and then slowly exhale through reach the top of your torso, place your left hand lightly on ongoing desire or some individuals, follows several distinct and predictable fears and desires may still be there to some extent, but they your nose. Notice the sensation of air moving through your your throat and rest your right palm on your forehead. After effort to limit sexual medications to deal patterns. When a pattern is continually WHAT ARE SOME SPECIFIC EXAMPLES won’t take you over.” nostrils, and of your ribs dropping back towards your center. a few breaths, lay your hands on the bones that protect your behavior, using sexual with obsessions repeated despite consequences, it SEX ADDICTION? eyes, blocking the light for several moments. Then return Twelve years negative ago, during a very stressful timeWHICH in myMIGHT life, INDICATE Wait two counts before you begin your next breath. Repeat your hands to your sides and relax for a few more obsession and fantasy mayminutes. be prescribed can be considered anIaddiction. cycleexpected Compulsive of pornography and or a friend suggested try a yogaThe class. I to do a few usethis five or more times. and feel out. At the end of class self-gratifi I wondered as a primary coping as part of the ofposes addiction alsostretched predicts the addicted cation, numerous affairs or sexual I was able to recover from my traffic nightmare how Iwill hadexperience lived for sothe long without yoga, and why everyone Takeuse a of virtual You may want to set amood timer so strategy, severe treatmentusing process. person onset of cravings partners, compulsive phonevacation. or computer even the planet doing it. The asanas -- or poses areofan you won’t about falling asleep! Lie onaround your back with these breath awareness practices when I got home. Yes, changes sexual Sexual addiction toon continue the wasn’t behavior, intense pleasure sex,--use prostitutes, andworry violent sex would integral part of a yoga practice, but there is so much more legs outstretched and arms at your sides. For comfort, you though I teach these everyday I still need them myself. In activity, and neglect is viewed by Dr. and relief in planning and acting out all be examples of possible sex addiction. to it. “To me yoga in its broadest sense is learning to observe might add a pillow under your head and a rolled up blan- fact, I began breathing slowly and deeply in the car, because of important social, Ralphmy Earle as a rituals, followed by a period of withdrawal According to experts, Drs. Ralph and state and dis-identify with one’s thoughts,” the renowned physical ket under your knees. Take a few breaths in and out through I knew what was happening. I was able to observe st occupational, or sign of an “intimacy and onset ofand cravings once again. Marcus Earle ofyour Psychological Counseling of mind and acknowledge my oh-so-human response to a 21 therapist yoga teacher Judith Lasater has said. “To have nose, observing the sensations of breath moving in and activities. disability.” The basic Engagingand in risky behaviors and distorted Services, who are thoughts beliefs is so human; to get caught up in themLtd. is (PCS), out ofindividuals your body. Now, imagine thatrecreational you are lying on a beach. Century tiger. so human; to learn observe them is to practice concerned yoga.” about Imagine leaving of thesex deepest impression you cannote in the They also thatsand, building blocks to thinking patterns alsotooften go hand-in-hand the possibility or Patricia Keane is aform Hatha Yoga Instructor, specializing in don’t have to practice yoga, or even like it, addiction to ben- can allowing your to become heavy and relaxed. Feel the might other compulsive behaviors be involved intimate relationships are incomplete. withBut sexyou addiction. Examples of distorted love look for thebody following restorative and therapeutic applications. She offers group and efit from its teachings. following simple yet powerful as it fills the curves under yoursuch body. sound of eating your disorders, asThe work, drugs, and Therefore, the road to healing will be based thinking patterns include: The obsessions, warning signs: sand Constantly seeking a sexual practices will coax your body into a more relaxed state, help- breaths echoes the sound of the waves. Feel the sun on your private adult classes in Northern Westchester County, New perfectionism — what Dr. Patrick Carnes calls on learning to trust, to rebuild relationships rationalizing, justifying and denial. partner, new romance or significant other; ing you to reconnect to the inner voice that acknowledges skin, the warm breeze grazing your face. Smell the salt air. York, at the Yoga Loft at the Bedford Post Inn, Union Hall in addiction interaction disorder. Signifi cant with one’s with oneself, The controversy surrounding the subject inability or diffi culty being alone; using sex, sites. ForHigher schedulePower, information contact emotion rather than embodies it and that observes thoughts In your mind’s eye, paint a picture of the perfect beach scene. North Salem, and other changes in sexual behavior may be evidenced. and with others. Their healing process ofrather sex addiction maytostem from seduction and intrigue to hold onto a partner; her at PKeaneYoga@gmail.com. than reacts them. the fact that You are the artist, the architect ofTogether this experience. Notice the Q pg CH 10/27/11 4:20 PM Page 1 Intimacy may be decreased due to the intimacy promotes interdependence on a Higher disability through the acting out behaviors. Power, self, and others. They underscore the importance of learning to tolerate WHO IS AT RISK FOR DEVELOPING SEX ADDICTION? conflict, ambiguity and imperfection; being willing to self-disclose and to answer Many professional therapists in the field of “Why am I afraid to tell you who I am?” sexual addiction believe these behaviors are The Earles highlight the importance of traceable to early childhood development. supporting the family members of persons Individuals who grew up without sexual sexual particularly information and education as children may Wewith We Have to Get Away Before Can Beaddiction, Fully Pre sent the Inter-care is dedicated to providing high quality individualized outpatient spouse or partner. According to the Earles, be at risk. Individuals who encountered treatment to individuals and families impacted by substance use disorders the devastating impact of behaviors which early sexual experiences or were neglected directly impact their partners include: in childhood are at risk. Childhood the betrayal of lying and living a “double shame affects a person’s entire identity. life,” objectifying and sexualizing other Shame at a young age, coupled with other Services people; time taken from the relationship compulsive behaviors puts individuals at Substance Use Evaluations and work due to sexual binge pursuits; and risk for developing sexual addiction. Motivational and Early Intervention Services rapid and unpredictable mood changes. The stigma surrounding this type of Intensive Outpatient Program (IOP) Perhaps more than with any other addiction may be tied to the shame associated Early and Advanced Recovery Programs addiction, the self-esteem of the partner with it. Unlike other addictions, this type Executive and Professionals Programs is battered; they feel they must be lacking of behavior is characterized by the deepest Dialectical Behavioral Therapy (DBT) Groups something. It is vitally important for the kind of boundary violation — to one’s self Dual Diagnosis Program partners to learn they did not choose and his or her loved ones. Dr. Marcus Earle DWI/DUI Programs their addiction and there is a way out. describes this type of addiction as tied to one’s Drug and Alcohol Testing very essence and who they are at the core. Individual Counseling and Psychotherapy Like other addictions, sex addiction WHAT CAN WE EXPECT IN THE FUTURE? Gender Specific Counseling does not discriminate. Individuals With the extreme advances in technology, Gay Men’s Groups affected come from all socioeconomic experts predict that we can expect accelerated Other Addictions Group backgrounds. The stereotypical image sexually-related issues with not only adults Relapse Prevention most people hold of sex addiction is not but particularly with youth and teens. For Drug and Alcohol Education accurate. Individuals struggling with sex example, Dr. Carnes notes that combining Family Program and Codependency Treatment addiction can be found in both professional sexuality and technology will increase IMAGO Therapy for Couples and blue collar environments. unhealthy sexual experimentation among 12-Step Recovery Groups teens and youth as well as adults. Both Alcohol & Drug Treatment Center Drs. Ralph and Marcus Earle report that WHAT IS THE TREATMENT? Alumni Association since more adults are exposed to Internet An initial goal will be education and 24-Hour Hotline Support 201-600-2665 • 800-646-9998 technology than ever before, more adults are “carefronting” as Dr. Ralph Earle calls it. Non-Profit Nashville,engaging TN • Founded 19 66 in sexually-related activities who According to theAEarles, mostFoundation individuals• with 51 East 25th Street, New York, NY 10010 (between Park Avenue and Madison Avenue) might otherwise never have. The news media sex addiction don’t know or can’t admit they cumberlandheights.org Phone: 212.532.0303 Fax: 212.532.9225 www.inter-care.com is reporting an increase in cyber sex and sexual are addicted, so it is important to help them texting or sexting among youth. The explosive admit and accept they have a problem. They

with a powerful tool to combat the negative effects of stress: our minds

Sometimes

CUMBERLAND HEIGHTS

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BODY•MIND•SPIRIT

Mojo (Continued from page 9) A psychiatrist can help patients through the artful prescribing of mood-regulating medicine. But we can’t prescribe pills. We either bring our own mojo to the caring relationship or we arrive empty handed. If a person cannot become an effective helper in an environment of ease and comfort, and if we each must find our medicine in the way we manage our own suffering, then those of us who share the miracle of recovery with others can scarcely avoid the idea that we too must suffer well if we aspire to do good. But, sadly, suffering does not always perfect the sufferer. We all know people who, overcome by their own pain, have turned only meaner and more irritable as a result of their suffering. To achieve therapeutic potency, must those of us who choose to help others run the risk of being scorched by our own pain? If the answer to this question is yes and I think it might be – then it may behoove anyone whose mission is to help others to approach their own suffering mindfully and skillfully, and informed by a spiritual practice in which they have faith.

When the heart breaks But for those who prefer a more vivid answer, the closest thing I have so far found came on an evening a few years ago when I was vegging in front of the TV, not really paying attention. I was jolted into presence when I heard a guy speak a simple declarative sentence; but it is one that I will take to my grave.

A San Francisco AIDS worker who had endured the worst years of that city’s HIV epidemic was being interviewed on the news. He had spent over a decade working 20-hour days providing palliative care to hundreds of dying AIDS patients. He was soft spoken and slight, and I had to lean in a bit to catch his words. When the interviewer, with a tone of respect rare to news shows, asked the guy from what magic place he summoned the strength to sacrifice so much to attend to the final physical and emotional needs of terminally ill young men and women, he paused thoughtfully before saying in a calm and even voice, “Sometimes, when the heart breaks, it breaks open.” I would love it if I could truly wrap my brain around that kind of spirit, that brand of bravery, selflessness and modesty. But I’m limited by my own shortcomings. The old Apache would have gotten it though. Separated by a century and a thousand miles, one warrior surely would have recognized another. Geronimo knew strong medicine when he saw it. Jeffrey C. Friedman, MHS, LISAC is a primary therapist at Cottonwood Tucson, a 50bed inpatient behavioral health treatment center in Tucson, Arizona. He is a summa cum laude graduate of The School of Human Services of Lincoln University (PA). Jeff ’s work at Cottonwood includes treating chemically dependent and disordered gambling patients, lecturing on the neurobiology of addictive and mood disorders, and presenting workshops on a range of behavioral health issues at counseling conferences throughout the Unites States, Europe and Asia. His articles have appeared in Together AZ, Counselor Magazine and Addiction Professional.

In F act:

The consequences of drinking for 18 to 24-year-old college students each year: • 1,825 die from alcohol-related injuries, including motor vehicle crashes • 599,000 are injured • 696,000 are assaulted by another student who has been drinking • 97,000 are victims of alcohol-related sexual assault or date rape • 25 percent report missing class, falling behind, and receiving lower grades • More than 150,000 develop an alcohol-related health problem • 10,000 are arrested

-- The National Institute on Alcohol Abuse and Alcoholism

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COVER•STORY

Ascent to Recovery (Continued from page 1) and service work,” I would complain, “where is the flow?” Twenty-five years later I remain intrigued and also humbled that I am just as often out of the flow as in it. My personal journey has me standing at a very empathetic vantage point as I watch family after well-meaning family trying so hard to affect some change, any change in the addict. Most of the time, I notice, they are working much harder than the addict. I watch them exhaust themselves and each

Much like mountain climbing, intervention offers up the best of times and the worst of times. other with some very rational and innovative approaches that do not budge the problem. Intervention, like recovery and life itself, is about trying easier -- living in tune with the reality of this disease, its treatment and each 7.45 x 9.1 other. I don’t know much about mountain climbing, but I can’t help but be in awe of those

who do it and, as an observer, I am fascinated by the process and its similarities to intervention. Frankly, I have been involved in my share of interventions where I would have preferred being on the north face of Everest, at least for the moment. I recently watched “As Far As the Eye Can See,” a gripping documentary of Eric Wei-

henmeyer’s unfathomable trek to the top of Mt. Everest. Weihenmeyer lost his sight completely when he was a young child so it was difficult to imagine how he was to accomplish such an impossible goal. In my head, it was so impossible that I likely would not have believed it had the camera not captured him stepping onto the top of the world. In light of the bleak survival statistics of alcoholics and addicts, have we anything to learn from such people about achieving the long shot? I watched the film a few more times taking mental notes of the components integral to his success. Weihenmeyer began by picturing himself already there and then summoning the will to turn the improbable into the inevitable. He surrounded himself with close friends and family -- those who would stand by him. He handpicked trained professionals and took direction. He learned everything there was to know about climbing and about his mountain. He was exhaustive in his preparation for uncontrollable events like weather and accidents. He trained himself to view and interpret obstacles as challenges that may slow him down but would not stop him. He conformed his expectations to the formidable task at hand and did not expect that it would go seamlessly. He committed that he would not yield to despair but would practice tolerating the nerve-wracking moments. He hired Sherpas who had been up and down the mountain under every sort of condition and took their direction. His team stayed together, continually checking in with and encouraging each other. He stopped and recharged as needed. He did not stop at the first base camp and call it the summit.

Where’s my epidural?

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Much like mountain climbing, intervention offers up the best of times and the worst of times. The coming together of the family, the healing of relationships, the synchronicities and personal epiphanies, the letting go’s, the ups and downs of a worthy journey taken with those most cherished and, ultimately, the passing forward of all that -- the very best. The worst, while typically dwarfed by comparison, can be daunting enough to stop all but the most courageous in their tracks. Perhaps it’s a bit like childbirth; the labor phase -- very painful. In the midst of it, you feel as if it will go on forever but of course it doesn’t because it’s a phase. It paves the way for the birth of a new being -- a being pushing to be free, to evolve into the higher life form it was meant to be. It finds itself in a bigger world with bigger choices and, hopefully, in a family that knows how to support all that. Equally painful and challenging phases can be found during the intervention process; yet they are phases that we must pass through in the service of growing and evolving to a higher, better life. The labor pales in comparison. All are part of the miracle. How many interventionists does it take to change a light bulb? Only one, but it really has to want to change. Despite all evidence to the contrary, this remains the most enduring myth associated with addiction and is one of the main reasons why so many continue to suffer and die from a very treatable disease. Those of us who work in this field know that “you can’t help an alcoholic until he’s ready for help” is simply not true and the implication -- “therefore there is nothing I can do except stay out of the way until he wakes up” -- is a tragic misconception. The

www.together.us.com | March / April 2012

COVER•STORY wake-up call is all-too-often a crash of sorts that is irreparable and is precisely what the intervention is designed to avoid. Addiction is progressive and fatal, if not treated. It does not get better on its own. Intervention, while necessarily creating certain discomfort and chaos in the addict’s world, is planned to control for many of the potentially destructive variables. This misconception also adds to the confusion and suffering of friends, family and even employers who typically commit themselves to one of two equally futile camps: either so totally immersed in the problem that their own lives are in chaos, or ignoring the problem to the extent that they aren’t allowing themselves to be part of the solution. It is not uncommon to switch camps when frustration sets in. To effectively address addiction is to simultaneously feed the solution and starve the problem. Tricky business. It is true that deep changes occur only once the addict is internally motivated to get well but, more often than not, it takes the treatment process to get them to that stage and some form of outside intervention to get them to treatment. The team approach is critical to the successful intervention -- the group is simply stronger than the individual. Fritz Perls called this the Gestalt concept and developed a whole branch of psychology based on “the whole is greater than the sum of its parts.” From “The Wizard of Oz” to “Seabiscuit,” life and literature are rife with stories of downand-outers achieving great things when they hook up and support each other. The simple act of teaming up seems to create hope while bringing out the best in people, scarecrows and horses alike. Dale Earnhardt described it as “a crew emerging into a single force that is unstoppable.” There is any number of ways to move forward and all can be effective if done by an informed, committed and professionally guided team. Far from helpless, the addict’s circle of people have, in fact, a great deal of influence (this is different from control). While we cannot control addicts, we can change their environment so as to make it as easy as possible for them to say yes to treatment and as uncomfortable as possible to remain in the problem.

Power, not force The intervention process is off and running when the team begins to shift its focus from the problem to the solution; time and again this has proven to be a most empowering and inspiring first step. We have Einstein to thank for that. I hope he would forgive my ignorance of his equations and theorems when I say that, for me, one of his fundamental laws boils down to “when a thing is energized or given attention, it expands.” Most people unwittingly but relentlessly throw their energy at the addict’s problems and then become exasperated as those problems expand. Having developed a finely-tuned, low-threshold Trouble Radar that detects and even anticipates problems, these wellintentioned folks have things solved before

they are even a blip on the screen of the addict’s own radar (which is typically set to a much higher threshold). Problems caused by the addict are symptoms, and a quieted symptom will soon be replaced by another, louder symptom. It’s nature’s way of calling attention to the source of the problem. This vicious cycle has the problem-solver and the addict choreographing a dance that eventually spins everyone out of control and right off the dance floor. Einstein would say, “I told you so.”

thing like the Sopranos’ ill-fated attempt to get Cousin Christopher to change his drugdealing ways. There is no strong-arming, no bounty hunting and no circling of the wagons. It is a very empowering process once the family stops dancing long enough to recognize where the power is. There is tremendous power in knowledge, in numbers, in love, in kindness, in taking responsibility and in doing the right thing. There is power in the solution-focused approach. The earth doesn’t force the moon into its orbit. It’s sim-

The family may well be aiding and abetting in myriad ways that maintain the addictive cycle. Understandably caught up in the cycle, families need help making the leap from being reactive to being proactive. While the family is by no means the cause of their loved one’s addiction, they may well be aiding and abetting in myriad ways that maintain the addictive cycle. It is not at all uncommon for the addict’s environment -- family, friends, workplace, trust funds, etc. -- to inadvertently clear the way for the addict to forge ahead in relative comfort, save for occasional lectures, threats or silent treatments.

Enabling the addict The addiction field refers to this as “enabling.” Enabling the problem to continue is really disabling or handicapping the addict and robs him of the opportunity to grow. If you are doing something for the addict that he should be able to do for himself, you are enabling the problem. If you are not standing true to your own intuition, your feelings and your inner wisdom, deferring instead to the addict, you are enabling. If you are not confronting the problem (confronting is more than noticing), you are enabling. If you are covering up, excusing, minimizing, accepting half-truths and shallow promises, or allowing yourself to be moved off your own integrity, you are enabling. During the intervention process, we look at all of this in a very sympathetic light. It is all absolutely understandable within the context of addiction, and it’s important in life to know when to cut yourself slack. We do not play a blame game, but we do take an honest and courageous look at the contributing factors that will end up sabotaging your goal and, ultimately the life of the addict. Rather than putting out one fire after another, then, we begin to focus on what we can control by replacing enabling behaviors with healthy behaviors that do not support the problem. It is important here to underscore that all team members will need the collective support and compassion of the others where this is concerned. Oftentimes, we don’t see our own enabling so we’re lucky to have loving family members to readily point them out. This may not feel lucky at the time. Power, not force. Intervention is not Gary Cooper in “High Noon,” nor does it look any-

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ply attracted to us, and who can blame it? The laws of gravity are similarly at work during the intervention process: the intervention team reaches a critical mass of solution and positive energy so as to attract smaller, weaker objects around us; i.e., the addict. “Addiction isn’t a spectator sport. Eventually the whole family gets to play,” Joyce Rebeta-Burditt has said. All families have spoken and unspoken rules that provide the foundation for all the rest. The rules in an alcoholic family evolve to preserve the pathology of drinking or using drugs. “Don’t talk; don’t feel; don’t trust” are typically the three foundational rules in any dysfunctional family. The first phase of intervention involves breaking them all, effectively collapsing the existing family structure. The intervention team members pool their experiences and

information; they share their feelings (the most accurate source of information); they begin to trust each other and trust the process. The collapse is not a pleasant phase for anyone in the family. We’ve all seen news footage of buildings imploding. The implosion literally demolishes the old structure to make way for something more stable and safe. Much easier to watch on CNN than to experience first-hand within our own families. And, while we all agree that this collapse makes good theoretical sense, we are not buildings; we are very human and, as such, we love and are drawn to the familiar much as we are to an old pair of slippers. The known is our default, our autopilot and our comfort zone and it beats the unknown even if it stinks. Change, therefore, will take a collective commitment to trust the process and practice replacement behaviors for a long enough period of time for them to become familiar. The family needs to step outside the unhealthy system to get the help they need and to learn and appreciate healthy family rules. The underlying goal of the intervention process is to get the family out of the destructive cycle and into healing. Intervention includes, but is not restricted to, getting and maintaining help for the addict. Until the last few years, we have been unable to explain the behavior of addicts except in pejorative terms with lots of colorful expletives. I recall sitting in a laundromat in Edmonton, Canada, for hours one harsh winter night, stealing a quarter here and a quarter there until I had enough to buy a small bottle

(Continued on page 18)

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COVER•STORY

Ascent to Recovery (Continued from page 17) of bad Scotch. I was 24, broke, unemployed, unemployable, divorced, disliked and/or disowned by despairing family and friends, just out of the ER with lacerations and black eyes of unknown origin, and looking every bit the pitiful alcoholic. I had grown up in a very loving and safe family, and was given a wonderful education and every opportunity. I did not have a bad personality, bad morals or bad parenting. Yet there I was, barely able to see out of swollen eyes, running to make it to the liquor store before it closed. My thoughts were of my family and what they would be doing, two weeks before Christmas. Standing in line with my quarters and my scotch, I had a moment of lucidity and questioned what had happened that brought me here; it seemed completely inconceivable and quite insane, and yet I also recall with absolute clarity that it did not feel like a choice. Today, we have hard facts and very good neurophysiologic explanations for my feeling and my behavior that night. It has taken science a long time to put some of the pieces in this puzzle because the brain is so difficult to study. Many brain-based disorders are at a distinct disadvantage because they cannot be measured or proven with an X-ray or a blood test. Hence, it will likely be a long time to come before people stop debating the disease concept of addiction. Functional MRIs and the like, mouse experiments and correlational studies, however, are finally shedding enough light on the brain to explain why alcoholics continue to drink despite egregious consequences, why addicts crave and lose control of drugs and why they will step over everything that is most meaningful to them to get to the drug. We now know that this is a disease of the cerebral cortex versus the midbrain. The cortex is the most highly developed part of the brain and is responsible for its highest functions -- our thinking and interpreting, our sense of self, our personality, our values, our purpose and meaning, our spiritual connections, how we choose our friends, how we treat others. It sees the big picture. Drugs, it turns out, actually work in a much more primitive part of the brain -- the midbrain or limbic system. This is the survival brain, in charge of the most basic, survival-related information: eat, drink, have sex, kill a thing if it threatens your survival. It sees the next 60 seconds. Found here are highly potent

feel-good chemicals like dopamine, which tell us to do something again and again if it is perceived as good for our survival. The highly reinforcing properties of the midbrain play the critical role in addiction because the addicted brain directs the addict to use the drug repeatedly in order to survive. Before addiction took hold, my thoughts about alcohol were at the level of “I want to take the drink.” Once I crossed the addiction line into what I call the “Hotel California” phase (you can check in anytime you want, but you can never leave), my thoughts became “I have to take the drink.” Empirical and clinical data have established that the addict will use drugs to the exclusion of all other survival imperatives and even to the point of death. In other words, the drug of choice is more rewarding to the addict than life itself; it is the trump card and becomes synonymous with survival. Under normal circumstances, the thinking, rational cortex overrides the power of the

A marathon, not a sprint Treatment involves waking up the prefrontal cortex and turning the volume down in the reptilian midbrain. Sobriety allows the brain to re-set its neurochemistry, optimizing the body’s innate healing properties. Addicts are given tools to manage stress and reduce craving. They dump baggage, help others and take a long, courageous look in the mirror, perhaps even catching a glimpse of who they really are. They are helped by counselors and peers to find that one thing that is more important and powerful to them than the drug -- in AA, this thing is referred to as their “higher power.” Doing good causes feeling good, and they begin to rediscover dignity and pride. They find hope and they begin to trust the recovery process. Recovery is a developmental, lifelong process, not a singular event. As with all chronic diseases, addiction cannot effectively be treated as if it were acute. It does not get fixed

Recovery is a developmental, lifelong process, not a singular event. As with all chronic diseases, addiction cannot effectively be treated as if it were acute. midbrain. In a disease state, the cortex shuts off -- it has no voice -- it is fair to think of the addict as a prisoner inside his own body. This is why the family’s attempts to appeal to common sense, rationale, family ties or his sense of right and wrong appear to be falling on deaf ears. You might as well be talking to the dog. In the grips of the disease, the addict does not have access to his better judgment or the depth of his family connections or anything else that means anything to him. It is critical that families, addicts and health professionals (not to mention politicians and insurance companies) understand the biological nature of this disease. Its power should not be underestimated. Addiction does not play by the same rules as any other psychiatric or physical disorder. It is like the playground bully that way. During an intervention last summer, a particularly insightful group of siblings responded to their sister’s demand to “leave me alone” by pointing out that they didn’t leave her alone in sixth grade when she was being bullied by Tommy Holloway and they weren’t going to back down now.

in an office visit, a moment of revelation, or 28 days. While those things can begin the recovery process, possibly even stabilize the addict, it is a common and deadly mistake to think of stabilization as anything but the first phase of recovery. It is the first base camp. Likewise, abstinence does not equal recovery. We know that it takes an average of three to five years for the new family structure to gel, and five to seven years for the addict to achieve the solid, deep changes that predict future success in recovery. Just as important as coming together to extend a lifeline to the addict, is staying together as the recovery process takes root. The whole group should reconvene after treatment to discuss and clarify the recovery plan and the relapse plan. Each person has the potential to fall back into old, self-defeating behaviors (relapse) so each person should have a plan. Everyone must understand the reliable predictors of successful recovery and how to quickly and effectively respond when they have concerns. I have found that the single most important determinant for success is the addict’s willingness to follow the directions of professionals to the letter until

ongoing recovery is demonstrated over a significant period of time. Demonstrating ongoing recovery, however, is not easy for the family to recognize, verify or agree upon. Nor is it particularly useful to go by the addict’s idea of what this means. Best to rely on your Sherpa all the way up and down the mountain. “Within every problem,” Einstein said, “lies hidden an opportunity so powerful that it literally dwarfs the problem.” This concept is the most valuable tool in my personal toolbox, and I pester every person involved in an intervention process to search fearlessly for the opportunity to grow, to learn and to give.

Amazing grace One of the life lessons I count among my most precious came to me through an article I read a few years ago. It was a brief report on what I recall was an event at the Special Olympics, an athletic competition for children with intellectual disabilities and mental challenges. Little boys and girls, at the starting line of a running event, eagerly await the flag that will set them off on their dash toward the finish line. They must have made for quite a scene, their excitement far outweighing their personal challenges. At the halfway point, one little guy fell and began to cry in frustration as he struggled to get back up. Just as suddenly as the fall, the contestants, every one of them, turned back in unison to pick up their opponent and, linking arms, stumbled and laughed their way over the finish line (sometimes I wonder about how we psychologists define mental disability). Little witch-alchemists viewing the world as magical, living in tune with what is, creating positive change. Showing the rest of us family at its best. No one gets left behind. Their oath: Let me win. But if I cannot win, let me be brave in the attempt. Janice Blair received her Ph.D. in Clinical Psychology at Arizona State University and is trained in the treatment of psychiatric disorders, with an expertise in addiction. She completed internships in neuropsy-chological assessment, pediatric trauma, depression and ADD, forensic assessment, chemical dependency, and assessment/treatment of the Seriously Mentally Ill. She received post-doc training at the Betty Ford Center. Dr. Blair has a private practice in Scottsdale, Arizona, where she offers individual, couples, family and group counseling. She is a preferred interventionist for several leading treatment centers. Visit www.janiceblairphd.com or call 480-323-5209.

Lifeskills South Florida is a private, residential, extended care treatment program for adults with co-occurring and/or psychiatric disorders. We individualize all treatment plans offering such abstinence and evidenced based modalities of treatment as self-help participation, Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Mentalizing and Motivational Interviewing. 800-749-7149 www.lifeskillssouthflorida.com

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TOGETHER•INTERVIEW

Paul Williams (Continued from page 11)

Later Buddy moved to CPS Westwood and I worked briefly in dual diagnosis. I never got my CADAC. I worked as a volunteer for several years at MAP running a group with a wonderful woman named Mary Turner. She’s still at it I think. Buddy died a few years ago and MAP became a part of MUSICARES, the NARAS (National Academy of Recording Arts and Sciences) program that has now helped thousands and thousands of musicians in crisis for a multitude of problems. MAP remains the treatment wing of their work. It’s a great living tribute to the work Buddy began. It kept me sober and made me feel a part of something bigger than my problems. I refer to it as the “Paulie Lama” period of my life.

Having worked in the music industry since the 1970s, what trends have you seen in substance abuse among celebrities/musicians? The choice of drugs has changed, but it seems the results are the same. Lives devastated by abuse and addiction. There is a much greater awareness of the disease these days and I know that’s good. Drug courts around the country are doing wonderful work giving people in all walks of life a chance to recover rather than tossing them in jail. I think people need to be reminded that there’s no real difference between a rock & roll star shooting drugs and a bored housewife in Ohio drinking Listerine. They’re both caught in the clutches of their addiction and neither lifestyle should be glamorized. The whole “news at 6 o’clock’ latest celebrity in rehab” gives me pause. I also am not convinced that a using addict or a wet drunk should be given the option of signing a piece of paper that puts him on national television while he’s in rehab. The public awareness reward is great for the larger community, but I don’t think it’s fair to the individual. We’re people, not lab rats. I enjoyed my privacy as I worked on rebuilding my life. Everyone deserves that opportunity. I shouldn’t get into the rehab on TV story. There’s a great line I heard once. “Lord walk with me as I learn to live this way. Keep your arm over my shoulder and your hand over my mouth.”

Today you are still very much active as a composer and as President and Chairman of the Board of The American Society of Composers, Authors and Publishers. Are there internal discussions within the scene to help fellow artists/musicians find recovery? For example we recently lost singer Amy Winehouse and although the cause of death was not directly related to drug use, Winehouse was

known for her addictions. Is there a way to help someone like this whose addiction was plastered all over the media? There’s a way to help all of us. But, it’s a difficult task at any age. I think for the young addict in the midst of their addiction and the peak of their success at the same time the challenges are biblical in proportion. We’re ready when we’re ready. I think intervention is key. The statistics support successful recovery no matter the way we’re introduced to the life-giving process. People who are intervened upon and reluctantly go to treatment have about the same percentage of recovery as people who have an awakening on their own. Do whatever you can to get the identified patient and his family into treatment. The chances of choosing a life of abstinence are pretty slim when you have your favorite chemicals and booze in your system. But properly detoxed there’s a light that goes on and with clear vision you can choose life. I pray for Amy … and for all the Amy’s who are suffering around the world. Let’s remind people that while she may have appeared to be a self-indulgent drug addict the fact is she suffered from a disease. The Jelnick study proved that in the 60s and the AMA adopted their findings as fact.

Is there a particular problem with performers being surrounded by people who enable them? Probably.

You have been very focused on providing resources to people in need, especially with the website Save Me A Dream, which houses several opportunities for people to find help with issues surrounding recovery, domestic violence, fetal alcohol syndrome and child abuse. What drives you to provide outreach such as this? The web site is the wonderful work of Sarah Edwards. She designed it and keeps it up and running on a daily basis. The idea was to do more than a fan site. If my work brought visitors to the site why not use it to provide resources for the people who are interested in recovery, child safety, and women’s issues. Speaking of which, my friend Michael Bolton has an amazing foundation that supports shelters for women and children leaving abusive relationships. If you’d like to contribute to a great organization, check out Michael’s work. Contributing Editor Barbara NicholsonBrown is publisher of the Together AZ and California Together newspapers and CEO and Founder of The Art of Recovery Expo in Phoenix AZ. She is dedicated to inspiring others on the road to recovery. For more information on Paul Williams visit www. paulwilliamsconnection.org.

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Develop interest in life as you see it; in people, things, literature, music - the world is so rich, simply throbbing with rich treasures, beautiful souls and interesting people. Forget yourself. -- Henry Miller

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COVER•STORY

Together Welcomes Together AZ

Sober and Grieving

Dual Diagnosis (Continued from page 1)

BY DAn STonE

t has been said that the only guarantees in life are death and taxes. This applies to everyone whether they are in recovery or not. Various aspects of the grieving process, however, hold special challenges for recovering alcoholics and addicts. Everyone grieves uniquely. In the past it was thought that there are predictable stages that grievers must go through to achieve acceptance of the loss. Twenty-three years of personal and professional experience tells me that, when it comes to the process of grieving, one size does not fit all. In my private practice and also at Cottonwood Tucson where I work as a grief counselor, I have conducted grief therapy with newly clean and sober clients, and found, time and again, that they respond to their losses differently. I have discovered that, in working with clients like these, the treatment of grief requires an individualized approach.

GRIEF, ADDICTION AND RECOVERY

In 1997 I had been working at Cottonwood for two years. One of the assignments that patients at that time presented in primary group was a timeline in which the patient depicted

significant life events and how these events impact on their lives in the present. Viewing these timelines, I often observed that directly after the occurrence of tragic life losses in these patients’ lives, it appeared that their substance use spiked — sometimes dramatically. In some cases the loss triggered a downward spiral of using and depression that ultimately resulted in admission into treatment. I was drawn to learning more about how grief, addiction and recovery affect each other and how I could help newly sober people negotiate their grief more adaptively. I came to believe that if life losses were not adequately addressed in treatment, the neglect of this would be a contributing factor in potential relapse. My own experience of loss also reinforced my emerging viewpoint. My father died in February of 1986, a time when, sadly, I was not yet sober. My response to that loss was that I used more of the substances I was then addicted to. Throughout the initial mourning rituals of my religion, I was physically present but emotionally checked out and unavailable. In November of 1987 I hit my bottom and began a new journey of recovery and hope. As my body and mind healed, an interesting phenomena occurred when I had about three

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Centers in California.“Take someone who is bipolar and addicted to alcohol and cocaine. They get out of treatment, they feel good, they’re going to a 12-step program, and they think, ‘I don’t need this bipolar medication anymore.’ Some of those people then will relapse and find themselves back in treatment. Some act out sexually. They are clean and sober, but they are not addressing underlying issues.”

A big risk The chance of two disorders existing simultaneously is quite high. “As many as six in ten substance abusers also have at least one other mental disorder,” says Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA). NIDA’s research shows that persons diagnosed with mood or anxiety disorders are about twice as likely to suffer also from a drug use disorder (abuse or dependence) compared with the general population. months of sobriety. now rememberThe same is trueI was for those diagnosed with ing dreams assyndrome, my sleep pattern began to anmy antisocial such as antisocial normalize. personality or conduct disorder. Similarly, persons diagnosed withI was drugindisorders One night I dreamt that a New Yorkare roughly twice as likely sufferwith also City subway car. The car wastoempty thefrom mood and anxiety disorders. exception of someone sitting next to me. That Many psychiatric disorders can to co-occur person’s role in the dream was to listen me with substance abuse, says David as I spoke of the new hope I was experienc-Sack, M.D., CEO at the Promises Treatment Cening in recovery. In the far corner of the car a ters in California. “The most common, if person was reading a newspaper. The paper you include personality disorders, would be was shielding their face. antisocial personality disorder, bipolar disAs I spoke of my new life, the persondisorders in the order, major depression, anxiety corner put down thegeneral newspaper and stood including panic, anxiety and social up. It was my not as Istress remembered phobias, andfather post but traumatic disorder.” him.Treatment He was notbecomes the eighty-two year old who a challenging chicken or egg problem. Sometimes the mental had recently died from pancreatic cancer. Hedisorder like leads to the substance abuse; somelooked he did in photos I had seen of him the drug leads robust to the mental problem. intimes his twenties, healthy, with dark hair times, thehe two unrelated. So sort—Other the prizefi ghter hadare been in his youth. I ing “Dad! it all out canare beyou difficult. said, What doing here? You’re dead!” He replied, “I just wanted to tell According to NIDA: you to keep can doingcause what you’re doing. • Drugs abusers to It’s experience going to be O.K.”of mental illness. The insymptoms I woke up risk withof tears runningindown creased psychosis some marijuamy face. Shortly afterwards I went toas evidence na abusers has been offered his grave at the cemetery. Standing by for this. tombstone (PsychosisI wept can occur from many drugs his as I spoke to him of my abuse e.g., cocaine, all car the amphetabout life. – I walked back to my amine-type many feeling relieved —stimulants as if a weightincluding had “party drugs” like Ecstasy, dextromethobeen lifted from my shoulders. rphan cough syrups), LSD, and Over the (in nextsome ten years I continued others.) my pursuit of recovery and eventually • Mental illnesses can lead to drug abuse. entered my current profession as a Individuals with overt, mild, or even therapist. In 1988mental my mother died ofmay a stroke subclinical disorders abuse at the age of 81. I left Tucson to go to her drugs as a form of self-medication. bedside she lay in and a coma. During a seven• Bothasdrug use other mental illnessdayes death I stayedby in touch with myfactors, canvigil, be caused overlapping recovery system and received support such support as underlying brain deficits, genetic vulnerabilities, or early exposure to stress from new friends I met at 12-step meetings in or trauma. Florida. When my mother finally died, I was there to hold her hand and talk to her in her rate of co-occurrence is pretty stalast “The moments. ble,” says Sigurd H.helped Ackerman, M.D.,that presiMy mother’s death me to realize dent and medical director of the Silver Hill as an alcoholic working a spiritual program I Hospital in New Canaan, Conn. “If you look was able to cope adversity at people who with are ill enoughdifferently to be in than a hoswhen I was using substances. I was supported pital for detox or mental illness, about two every step the way and I found that disorders. I could thirds ofof them have co-occurring be for my family as well as foradmitted myself. for. Itthere doesn’t matter what they’re This was a real contrast to the time when I lost my father and was self-medicated and

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If they’re admitted with a bipolar disorder or schizophrenia or depression, about twothirds will have a co-occurring substance problem. If they’re admitted for alcohol abuse, stimulant abuse (including cocaine) or opiate abuse, about two-thirds will have some diagnosable mental illness that should be treated. The numbers are a bit lower for the non-hospitalized population, but they’re still high.”

Sorting it out The term “co-occurring” suggests two disorders, but very often there are multiple issues. “It’s very common to see a woman who was abused and has an eating disorder and has depression and anxiety and is using cocaine and could have some borderline personality features as well,” Arnold says. “That’s a fairly typical client.” Adding to the difficulty of a diagnosis is that some physical conditions, such as a vitamin B12 deficiency or a thyroid problem, can cause mental problems, Ackerman says. As Margaret’s story attests, getting it right can be a matter of life or death. Sadly, her story is not unusual. According to the Centers for Disease Control, alcohol and drug thoughtless the needs of others. abuse areofsecond only to depression and In grief, recovering people other mood disorders asexperience the most the frequent same We too are faced riskstruggle factors as for“normies.” suicidal behavior. therapists long-timers in withMost the tasks of acceptingand the reality of the 12-step programs know of someone who loss, experiencing our feelings, coping without took hisone orwe herhave life.lost “I and know one individual the loved accommodatwho suicide,” Arnold says. “He ing to acommitted world that has changed. was clean and sober when he committed suicide, but he never discussed his depresTHE RITUALS sion; he wouldn’t take any medication and Participating in mourning rituals often involve he ended his life.” interactions family members.are Many “Peoplewith with addictions at a very cultures celebrate the passing a loved one high risk for suicide,” Dr. of Sack says. “About with funerals and the like.with Participating 10 wakes, to 15 percent of people alcohol or indrug these dependency ceremonies can often besuicide. problematic commit It’s the fornumber those new recovery. To be thrust intoaddicts oneincause of death of drug -- not drug overdoses, not liver failure a situation where family members might be – it’s suicide.is People serious drinking difficult with enough. Whenmental this is disorders are also a seriousfamily risk for compounded withatunresolved conflsuicide. icts If someone has both a psychiatric disorder and mistrust of the recovering person, the and also an addiction risks arewe not chances of relapse increase.the Even when arejust additive but exponential. They multiply one mindful of this risk, we often feel an another.” obligationa to attend and somehow Complicating diagnosis is that these cowedisorders must find ado way to cope. occurring not always happen Many recovering addicts simultaneously. “Adolescents, andand that’s my come tohave the realization specialty,alcoholics almost always an anxiety, detheir grieving process had been pressionthat or bipolar disorder predating their delayedbyorapostponed untiland theira half,” use of alcohol year or a year says Elizabeth Jorgensen, an adrecoveryDriscoll began. This fact, I think, diction therapist inmy Ridgefield, Conn., is evident in story and also in who lectures the at Harvard adolescent substance stories ofon many clients I have abuse. worked with. As a grief counselor I Among adults, thethepattern often have adopted positionisthat I amthe same. “If someone has a psychiatric diagno“companioning” people in the first sis -- panic, depression, PTSD -- when those fitful stepsdevelop of their journey By in people drug orthrough alcoholgrief. problems accompanying them on the fi rst stage of their the majority of cases – usually 60 to 70 perjourney the–grief I am able cent ofthrough the time theyprocess, have their psychiattoric help them to narrate theSack story says. of their loss they problems first,” Dr. “And without judgment. is of paramount have them five toThis tentask years before they have the drug or problem. importance in alcohol successfully negotiating the wayAddicts you look the vastoften majority grief“The process. andatalcoholics ex- of peoplecomplicated who have both diagnoperience griefaaspsychiatric a result of their sis and substance problems is that self-perceived failuresabuse and lapses in being a the psychiatric diagnosis has usually come first. “good” child, parent, partner, sibling or friend. Often by years. There is one exception: biIt is common to hear statements beginning polar disorder. If you look at people who are with “If only I had…” or “I should have…” diagnosed with bipolar disorder and alcohol Sometimes people ambigu- of dependency, whatwill youhave findhad in an a majority ous relationship withalcohol the deceased. The factcame cases is that the dependency that the deceased family member might have first.” struggled with his or her own issues and inappropriate behavior can also complicate

www.together.us.com | May/June www.together.us.com | March / April2011 2012

COVER•STORY

High Prevalence of Drug Abuse and Dependence Among Individuals With Mood and Anxiety Disorders 25

All respondents Any mood disorder Any anxiety disorder

Higher Prevalence of Mental Disorders Among Patients With Drug Use Disorders 50

All respondents Any drug use disorder

Any Drug

Opiods

Amphetamines

Cocaine

Marijuana

Mood Disorders

Anxiety Disorders

Data in graphs reprinted from the National Epidemiologic Survey on Alcohol and Related Conditions (Conway et al., 2006)

What to do? Recognize the potential danger. “People who are working with drug addicts or alcoholics need to be sensitive to the suicide risk,” Dr. Sack says. “Part of the challenge for relatives and friends is to realize that when people have an addiction they become at increased risk because their lives become unmanageable, but if you add a psychiatric disorder you add another level of hopelessness and worthlessness that exacerbates their despair and makes it more likely. “So when someone has these problems and a person says, I think I’m going to kill myself, people need to take that seriously. Most people are only suicidal for short periods of time. They may feel hopeless for longer periods but the phase of active suicidal thinking with a plan tends to be relatively short lived. It’s days or weeks or months, but it doesn’t go on for years. So there’s an opportunity to intervene and get them treatment, but you’ve got to get them into residential treatment.” Find the right professional treatment. Co-occurring disorders must be treated at the same time; otherwise, failure becomes likely. You will need someone who is experienced in both psychiatric issues and in addictions. Not every doctor or therapist is equipped to do both. In fact there are lingering biases in the professional community against one or the other of the disorders. “Until recently, maybe 25 or 30 years ago, addiction was of little interest to psychiatrists,” Ackerman says. “The treatment of heroin addiction, for example, was the province of social workers and counselors who ran therapeutic communities. The treatment of alcohol abuse was the province of AA. Psychiatrists had no interest. Not only that, but when psychiatric departments and

hospitals did offer programs for addicted patients, those programs excluded patients with mental illness. And programs for mental illness tended to exclude patients with addictive disorders. Actually the co-occurring disorders where there but people didn’t want to see them so they ignored them.” Ackerman experienced this some years ago when he was affiliated with St. Luke’s Roosevelt Hospital in New York City. The hospital did a study of two of its outpatient clinics – one for substance abuse only and one for mental disorders. “Both clinics,” we discovered, “had both patients. About twothirds of the patients in both had co-occurring disorders.” Brad, an advertising copywriter, experienced a series of traumatic events and began drinking heavily. Routine blood work for his annual physical revealed the excess, and he finally admitted to his family doctor that he couldn’t stop. His doctor wisely sent him to a psychiatrist “to first see if there’s anything wrong mentally.” But after listening to his story, the psychiatrist told him, “If you’ll stop drinking I’m sure we can find something wrong with you.” Brad’s doctor then sent him to an addiction therapist, who helped get him sober, but did not help with the deeper psychological issues. Brad eventually moved on to a psychiatrist who could identify and treat the addiction and co-occurring disorders and has remained sober. This duality in treatment still exists, according to NIDA: “Different treatment systems address drug use disorders and other mental illnesses separately. Physicians are most often the front line of treatment for mental disorders, whereas drug abuse

Together - A Voice for Health & Recovery

(Continued on page 22)

Will two weeks be enough time to influence the mind and spirit of a writer who could spend the rest of his life on San Francisco’s skid row?

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Available in hard cover and e-book format. 21

RESOURCES

Do You Need Help? Resources & Links

(Continued from page 21)

Together’s mission is to serve the extended community of individuals and families seeking information about relief from addiction-related issues to lead healthier and happier lives. Here is a partial list of referrals with a more comprehensive list on together.us.com. Together is not affiliated with any 12-step program or organization, although we do support them all. One essential of recovery is knowing you don’t have to walk alone.

12-step organizations

Adult Children of Alcoholics Al-Anon & Alateen Family Groups Alcoholics Anonymous Chapter 9 | Couples in Recovery Cocaine Anonymous Codependents Anonymous Crystal Meth Anonymous Debtors Anonymous Food Addicts in Recovery Anonymous Gam-Anon Gamblers Anonymous Marijuana Anonymous Narcotics Anonymous Overeaters Anonymous Sex & Love Addicts Anonymous Nicotine Anonymous

Telephone

562-595-7831 212-941-0094 212-647-1680 888-799-6463 212-262-2463 646-289-9954 212-642-5029 212-969-8111 781-932-6300 718-352-1671 888-424-3577 212-459-4423 212-929-6262 212-946-4599 212-946-5298 212-824-2526

National and institutional organizations Center for Alcohol and Substance Abuse Center for Substance Abuse Treatment National Association of Addiction Treatment Providers National Clearinghouse of Alcohol and Drug Information National Council on Alcoholism and Drug Dependence, Inc. National Eating Disorders Association National Institute on Drug Abuse National Institute on Alcohol Abuse and Alcoholism Partnership at DrugFree.org

Website

adultchildren.org nycalanon.org nyintergroup.org chapter9couplesinrecovery.org canewyork.org codependentsnyc.org nycma.org danyc.org foodaddicts.org gam-anon.org gamblersanonymous.org ma-newyork.org newyorkna.org oanyc.org slaany.org nicotine-anonymous.org

casacolumbia.org csat.samhsa.gov naatp.org health.org ncadd.org nationaleatingdisorders.org drugabuse.gov niaaa.nih.gov drugfree.org

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Dual Diagnosis treatment is provided in assorted venues by a mix of health care professionals with different backgrounds. Thus, neither system may have sufficiently broad expertise to address the full range of problems presented by patients.” Ask a lot of questions. In choosing a professional, the most important question to ask is how much experience he or she has in both addiction and psychiatric disorders. There are various certifications for both that can quickly become confusing to a lay person. But just as you would want to know how many operations a surgeon has done, so should you want to know a therapist’s experience. As Brad learned, not every psychiatrist deals with addiction. And many family doctors are not trained in addiction issues. Psychologists and therapists who do understand addiction can’t prescribe medicine for psychiatric disorders. It falls, then, to the individual and his family, as it did to Brad, to actively manage the recovery and find the right help. Know the warning signs. Because mental and addiction episodes can occur at different times in life, it’s important to document your history. Do any family members have mental problems? Have you ever been treated for a psychiatric disorder? Brad, for example, had been prescribed a medicine for anxiety many years before alcohol became a problem – a clear indicator. And once in recovery, how are you feeling? “The individual has to define what recovery is to them and how it’s working or not working in their life,” Arnold says. “How is it working? Sometimes we’re not our own best experts and that’s when we need to get advice. But it goes back to, ‘Am I sober, am I

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enjoying my life, am I happy? Am I contributing? If the answers are yes, your recovery is probably going pretty good. If you’re miserable and doing things because other people want you to, then you need to consider talking to a psychiatrist or therapist.” Dr. Sack says a person needs to assess his feelings early in recovery – even 60 or 90 days may be too long to prevent a psychological problem from reappearing and undermining recovery. Beware of biases against medical care. According to NIDA, “Lingering bias remains in some substance abuse treatment centers against using any medications, including those necessary to treat serious mental disorders such as depression. Additionally, many substance abuse treatment programs do not employ professionals qualified to prescribe, dispense, and monitor medications.” Bias against professional treatment can also exist in some 12-step groups, although this seems to be on the decline. “Historically the prejudice started in the 50s and 60s,” Jorgensen says. “Up until 1984, when Prozac was developed, most of the psychiatric medicines had some abuse potential – benzodiazepines such as Valium and Librium. Those were the only meds given for anxiety, and alcoholics would get addicted to them. Many medicines we have today don’t do that at the right doses. AA is overstepping its boundaries if it says people should not take medication, just as psychiatrists would be overstepping their boundaries by saying to a sober alcoholic you need to stop going to AA.” It happens, however, she says. “A woman who was sober for six years came to me for care. She was falling apart, severely depressed. She was going to three AA meetings a day. She did service work, did everything AA was telling her to do. But she was influenced by a pretty hard-core sponsor who said no meds, no meds. She was thinking of killing herself. I said, if your sponsor won’t agree to getting psychiatric care then you’ve got to get a new sponsor. She was white knuckling it. Today her symptoms are still there. None of that went away. “And she’s not thinking of killing herself anymore.”

“I have absolutely no pleasure in the stimulants in which I sometimes so madly indulge. It has not been in the pursuit of pleasure that I have periled life and reputation and reason. It has been the desperate attempt to escape from torturing memories, from a sense of insupportable loneliness and a dread of some strange impending doom.” – Edgar Allan Poe

www.together.us.com | March / April 2012

Together Welcomes Together AZ

FINALâ&#x20AC;˘WORD

The College Kid and the Graybeards

their daughters. If a mom places a huge stress on physical appearance in her own life, this can easily be passed on to her daughter. Sometimes, a daughterâ&#x20AC;&#x2122;s obsession with calorie counting and clothing size is a reflection of her motherâ&#x20AC;&#x2122;s attitudes and behavior. Fathers are also important because they are a daughterâ&#x20AC;&#x2122;s first, and often most significant, male relationship. It cannot be stressed enough how critical it is for fathers to focus on a daughterâ&#x20AC;&#x2122;s good qualities, instead of her physical appearance. What a profound difference it would make if girls could just grow up confident in the knowledge that what really mattered in life was who you are, not what you looked like.

quite peaceful after doing so. Of course, what she doesnâ&#x20AC;&#x2122;t realize is such serenity is the result of endorphins flooding her bloodstream â&#x20AC;&#x201D; the bodyâ&#x20AC;&#x2122;s attempt to soothe itself after vomiting. The next time she feels high anxiety, she copes by eating her favorite foods, without fear of gaining weight. This is often how it starts, and just as with anorexia, she becomes addicted to the behavior. Because after all, it works. What people rarely realize at the outset of any eating disorder is how much it will eventually control their lives. In the case of bulimia, a great deal of effort inevitably goes into acquiring the food, planning the binge, ensuring the immediate environment is safe to not only eat all this food, but perform the ritualistic vomiting. It is all consuming. You see, bulimics donâ&#x20AC;&#x2122;t engage BULIMIA NERVOSA Immediately ears just are occasionally; overwhelmed Byhold Johnone G. thing in in this unhealthy my behavior All eating disorders by all the voices shooting around the large it is not unusual for the person to binge common: food. But whereas anorexia he familiar smell of cigarettes space, and I can almost taste the coffee brewand purge a dozen or more times a day. is defined by restriction, bulimia is drifts to my nose the instant I ing in the tiny kitchen. The walls are bare, lot ofsome food prayers and even more planning. characterizedopen by bingeing aside afrom hanging here and the doorand of purging. the Jeep. The Thatâ&#x20AC;&#x2122;s When laxative abuse is involved, whole Those with bulimia consume enormous of the gray-haired driver peers at me there and a stone fireplace at theaback newofdimension amounts of food, Jesus overenters it. Rows fromoften over her bulky spectacles room with a painting the equation. is not thousands of calories, in a be back face the front, where aItlone table and informs me that sheâ&#x20AC;&#x2122;ll for meexperts in of chairs Most believe literature. for a person a little over of antime. hour.They I respond with a simple stands with stacks of uncommon short period around theretoare people fat, and skinny, smile and slight nod. I doubt sheâ&#x20AC;&#x2122;ll therememAmericanAllmedia steal bothâ&#x20AC;&#x201C;food eat much more than would tall, laxatives, short, white, â&#x20AC;&#x201C; she generally doesnâ&#x20AC;&#x2122;t â&#x20AC;&#x201C; due toblack, the old beber considered reasonable in my case, young. They butfar thatâ&#x20AC;&#x2122;s all right. The of walk plays a key role in this and,cost involved. Another and beyond the point all have at least 10 yearsâ&#x20AC;&#x2122; seback to campus never upsets aspect that a bulimic comfort. When they simply me, not after going where Iâ&#x20AC;&#x2122;m problem by consistentlyniority over me, but it never rarely recognizes cannot consume any ceases to amaze me that our headed. reďŹ&#x201A; ecting our societyâ&#x20AC;&#x2122;s at the outset of the the more, they purge the food, stories are essentially Following the smell, I disorder is the usually by vomiting. In stone same. An aura of love and stroll toward the great obsession with thinness. shame, guilt andprofound addition, abuse tranquility surrounds each building.they A often colossal golden in the room, we cross is ingesting suspendedupover embarrassment shefor will laxatives, to the The message is if a girl individual all know that what we canâ&#x20AC;&#x2122;t doors. The structure casts a ultimately experience. 200 laxatives a day. These can just lose enough do alone, we can do here, toshadow into the parking lot, The absolute truth behaviors are extremely gether. which covers me and two that no one â&#x20AC;&#x201D; not hard on the body. The weight, she can, and Aisfew months ago I was aged gentlemen who stand by even an individual medical consequences of snorting cocaine, a bottle of the doors, enjoying cigarettes will, have it all. cheap completely engaged bulimia include to On vodka in one handin and and each otherâ&#x20AC;&#x2122;sinjury company. bulimia â&#x20AC;&#x201D; can defend, the esophagus, stomach a blazing joint in the other, a cold, starry night like this, or even really explain, and intestines as well Eminemâ&#x20AC;&#x2122;s fuming rhymes there is no place Iâ&#x20AC;&#x2122;d rather be her behavior. They justiasgoing. damage to the heart, bursting from my stereo. I completely isolate, becoming more and fied and enjoyed my behavior at more the time. I lungs, kidneys andthe teeth. â&#x20AC;&#x153;Hey,â&#x20AC;? one of menAlthough says, his the unkempt often spent and nearly every night creeping along the beard bouncing as as hehigh speaks. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s the kid.â&#x20AC;? alone, dependent on, the disorder. mortality rate is not as anorexia, streets,anorexics, clothed in black, He takes deep drag themedical smoke trail Unlike who oftenstealing like thevaluables way those withabulimia canand dielets from fromlook anyone I could to of support my destrucoff, dissolvingrelated into nothingness. The man is they and are proud their discipline, complications to their disorder. tive patterns.isMy head becamefor sobulimics. twisted in probably in his late sixties, and though heâ&#x20AC;&#x2122;s self-loathing quite common Why would anyone willingly scruffy-looking I know from experience that such a short time; I saw jails, institutions and Anorexia and bulimia are extremely subject themselves to such a high the tears of loved ones, but nothing swayed his heart is in the right place. complex disorders. whoIhave never consumption of food in tandem with as I wasPeople concerned was not only The other laughs, his cheeks puffing up me. As far an eating disorder areI usually baffled the purginghere behavior? addicted to this lifestyle, was entitled to it. as subsequent he does. Everyone has deemed him had them. Yet, thosesome who who Hereâ&#x20AC;&#x2122;s why: and bulimia, like many eating Nowvery I sitidea in aof room with others, â&#x20AC;&#x153;Crazy Clyde,â&#x20AC;? itâ&#x20AC;&#x2122;s fitting; he rarely makes by the engaged in thesestolen, behaviors disorders, is not itâ&#x20AC;&#x2122;s about have lied, cheated, andabsolutely abused both sense when he about talks, food, and has an extensive are people andthey drugs I did, and some and ugly history alcoholism anddodrug know why do more them.than Whatâ&#x20AC;&#x2122;s more, feelings. Those who of engage in bulimia who were individuals lucky enough to terrible find thisand graceBut of Clyde is a dear friend, and even if these look soabuse. as a form emotional regulation, in ful place before they fell that far when he sees me he exclaims, â&#x20AC;&#x153;How feel even worse, they may find it nearly down effect, as a way to cope with unpleasant the rabbit hole. goes it, bud?â&#x20AC;? impossible to give the disorder up. This emotions. Consider this example: a young As I sip the coffee someone handed I extend my hand and shake his. is why professional help is frequently woman goes away to college, leaving home me I turn around and engage a middleâ&#x20AC;&#x153;Everythingâ&#x20AC;&#x2122;s just fine, my man,â&#x20AC;? I required, the disorder has for the with first atime. Nothing aged especially woman inifdelightful conversation. reply toothy grin. is familiar, been She going on for long period of time. everything is foreign â&#x20AC;&#x201D; a whole new â&#x153;ş spent thea majority of her life either The smell of burning tobacco environment, friends, academics, in prison or hiding from police as she taunts me. The addiction I haveetc. to She wants so desperately to do well, and to make Denafound Cabrera, Psy.D., is scrape a licensed disturbing ways to togethnicotine is unlike all others, I er enough heroin satisfy addicthe of peace smoking gave me,level but is amiss success her life. Her anxiety psychologist and has tobeen on her staff at tion. Ranch She is now blissful and knows for the people back campus have an She very high. Sheon is homesick and put scared. Remuda Treatment Centers sweetDr. tastes of freedom joy. in the abundance of faith in level me todiminishes make the notices that her stress 10 years. Cabrera is anand expert â&#x20AC;&#x153;You know,â&#x20AC;? she says, into righteating; decisions thecomfort, honwhile theand foodexhibit provides psychodiagnostic assessment andstaring treatment my eyes with her great emerald ones, esty and trustworthiness that comlike an old friend. She consumes more than of eating disorders. She presents to national â&#x20AC;&#x153;youâ&#x20AC;&#x2122;re lucky to be here at such a young ing here has given me. If that means normal and worries about weight gain. She audiences age.â&#x20AC;? on state-of-the-art treatments of I have to go without smoking, so be has heard talkthan around the either dormitory eating disorders difďŹ cult mental health â&#x20AC;&#x153;Yes,â&#x20AC;? I and say, slurping my coffee and it. So rather asking of mythat many students vomit after they eat to problems. Dr. Cabrera has written numerous feeling the serenity of the room envefriends for a cigarette, I tell them Iâ&#x20AC;&#x2122;llstay thin. She tries it and works. articles lope in journals and magazines and me. â&#x20AC;&#x153;I know.â&#x20AC;? see them inside and itI go in. Although she feels a certain amount of repugnance has appeared in several national media by the act of throwing up, she actually feels interviews.

He stood for a moment in the shadow of a cross and chatted with his new friends, the two old geezers

Teenagers and Treatment (Continued from page 12) 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. How wonderful it is that having dealt with their alcohol and drug use early on they were able to focus their young lives

They have at least 10 yearsâ&#x20AC;&#x2122; seniority over me, but our stories are essentially the same.

May/June www.together.us.com Together2011 - A| Voice for Health & Recovery

Together

on happiness, relationships, fun, pursuit of passions and helping others. It was obvious that their positive energy is infectious. Recovery is a powerful thing to witness. These miracles are happening every day for young people, and so much of it starts with something so simple and often given too little priority in treatment and recovery: FUN! â&#x153;ş Josh Azevedo, LISAC, CAC II, is the Owner and Program Director at The Pathway Program.

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15 23

A voice for health and recovery / NY EDITION

presents the 1st annual

NYC-IN-REC VERY

FILM FESTIVAL September 28-30 â&#x20AC;˘ New York City

30-hour Film Fest!

With distinguished actors, singers, writers, producers and directors

Featuring:

Top professionals from the recovery community, with opportunities for discussion after the showings.

FOUNDER

Aspiring Film Makers: Together New York is now accepting DVD submissions of narrative or documentary short films through June 1 (preferably under 20 minutes) on addictions, alcoholism, treatment or recovery. No fee for submission, and filmmakers whose shorts are chosen will be notified during the summer. Films will be chosen by Together New York committee.

Mail to: NYC-In-Recovery Film Fest, c/o Together New York, 51 East 25th St., Lower Level, New York, NY 10010

FOUNDING PARTNER

For Sponsorship Opportunties contact Rosalie Bischof, Marketing Director, at 917-370-2173 or via email at rbischof@together.us.com 24