Together Sept 11

T gether

Rep. Mary Bono Mack: No Child Should Be Buried in a Prom Dress Page 3 A voice f or health a n d rec overy

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What If The One I Love Is An Addict?

Inside Brad Lamm: Conquering food addiction

How to survive: what to do, what not to do

Page 13

By Janice Blair

A scientist looks at prayer................................10 How to overcome fear....................... 9 Have a healthy power trip............................15 If you need help..................18 Amy Winehouse:

It's too late.

She's gone

Page 7

September/October 2011

Y

ou’d have to have ice running through your veins if you didn’t cry when Leonardo DiCaprio died in Kate Winslet’s arms at the end of Titanic.

I curse screenwriter James Cameron for what he did to them. Every time I watch it, I secretly pray that this time Jack and Rose somehow survive and we all get the happy ending that was coming to us.

I want you to imagine that things did go a different way after disaster struck. The Titanic does not sink but is teetering on the crest of the iceberg, ready to go down at any moment. Jack, Rose and her family make it safely to the lifeboat. Rose, despite her impassioned love for Jack, is inexplicably drawn to the ill-fated ship and, amidst heart-wrenching pleas from her family, leaps back onto the promenade deck and begins to set up camp.

Jack and the family plunge into a painstaking operation to get her back, attempting everything from woebegone laments to logic to threats and intimidation. They can’t help but sympathize

with her grievances about the dire conditions aboard the ship, so they execute a water-bailing strategy and send up blankets, medical supplies and their own personal food rations, all the while tirelessly pleading with her to come to her senses.

Jack leads a number of attempts to take her by force, a few times even succeeding in getting her into the lifeboat, only to have his hopes dashed as she finds her way back to the ship. As exhaustion and resentment mount aboard the lifeboat, Rose plots to split the family to more easily target the most self-sacrificing member. This escalates the fighting and finger pointing among the family members as they become increasingly depleted from neglecting their own needs. The wear and tear is too much for some, and they shut Rose out completely. The others pick up the slack and soldier on.

(Continued on page 16)

The Ancient Secret In My Treasure Box A Japanese master showed this young punk a path higher than the mean streets of Brooklyn

H

By Richard E.

ey, Dad, do you want this? Mom says I can have it if you don’t want it.”

I shuddered. This was a new ploy on my wife’s part. Every year, as she put the house through its spring metamorphosis, bringing summer clothes out of hibernation and dragging winter coats and ski boots down to the basement, she sought to coerce me into giving up some beloved old things. In the past, her approach has been more direct.

She’d appeal to my sense of responsibility for the poor and the victims of earthquakes, floods and revolutions. We both knew, of course, the real reason she wanted me to relinquish my favorite old clothes was to afford her more shelves for her favorite new clothes of the future. But who among us can face down another’s pretense of social righteousness with weak accusations concerning their ultimate selfishness? No one who wishes to escape with his lucky pants intact.

So I’d whine and paw through the selected “donations” and

make myself feel better by knowing I’d at least managed to save my treasure box, as she calls it, for another year.

Inside the treasure box are old shirts from my stint with the U.S. Marine Corps, yellowed, aging pictures of buddies whose names I’ve forgotten, a few medals and my Judo Book.

Now there stood my daughter, eyeing me excitedly, holding my Judo Book. To what new lows could my wife sink? She was using my kid!

I took the precious old book into my lap. As I began to look through its brittle pages, I told Katie to let me think about it.

Memories flowed through me so powerfully that they produced physical sensations. I was transported back thirty years to a small island in the Pacific Ocean. I could smell the salt and feel the air and see the beauty of Okinawa. What became most vivid, though, were the smile and grace and love I saw on my old teacher’s face.

In the intense glare of one morning after, when I was par-

(Continued on page 11)

EDITOR'S•DESK

My Flower Power

I

go for a walk along a quiet road every morning for my physical health, and to amuse myself I carry a garden spade to liberate wild flowers from town mowers.

Yellow, red, blue, maroon, they stand defiantly before the powerful tractors. What most consider weeds, I see as The Artist’s clock: each appears in its own timing through the summer for its brief sojourn in the sun. At home I plant them, and many of them survive.

I, too, have power over these diminutive creatures, but I can’t control them. They will decide if the spot I’ve chosen for them is satisfactory – if it’s not, they just die. And only they can decide how long they will bloom.

Off and on over the years, I’ve studied aikido, said to be the most spiritual of the martial arts. Under my first sensei, or teacher, the only spirituality was prayer for enough breath to endure sheer exhaustion. Sensei had worked as a bounty hunter, and occasionally he would tell us stories of the streets and how real life differed from the dojo. “If you can walk away from a confrontation, do it,” he said. “If you need to, run.”

He is a big, thick guy, and I’ve watched him throw 240-pound men through the air, but that was his experience of what works.

What is true power, then? As I discovered with the wild flowers, power is not control. Trying to control flowers, beyond loosening the soil and watering, leads only to frustration. It’s the same with people.

Janice Blair makes this point in her front-page piece on enabling. “You don’t plant a tree and then watch it around the clock, micro-manage its growth, try to talk some sense into it, plead

with it or nag it if it’s not growing fast enough,” she writes. “Most of us don’t use force on our flowers. We care for the soil with water and fertilizer, make sure the sunshine is plentiful and it’s protected from the stresses of the environment while it develops its root system. We have the power to influence and mediate its growth, but we don’t have control.”

Steve Hauptman reinforces the point in his piece on control on page 15. Power, he writes, cannot be had by controlling others: “Start by shifting your focus from outside — people, places and things — to inside — your own needs, thoughts and feelings. Happiness is an inside job, and most of the answers you need are there.”

Richard, a good friend, completes the circle with his page one story of his own sensei, who counseled him as mine did me. Transferring that lesson to the mean streets of Brooklyn, however, was much harder than executing a neck lock on the next thug to wander along.

I began with my daily walk, and I’ll end there. When I was a kid, the teenager next door, a basketball and tennis star at the high school, coached me and my pals in whatever sport was in season. He grew up to be a nationally-ranked tennis coach, college professor, author of many books and an authority on sports medicine. So I asked Jim Brown how we who aren’t particularly fond of sweat can get ourselves out and moving — without, you know, too much sweat. What we’ve all heard, he writes on page 8, is true. Walking nourishes the body, but also the mind and the spirit.

Turns out that it’s not so hard, especially if you love wild flowers.

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Together Welcomes Together AZ GUEST•COLUMNIST

No Child Should Be Buried in a Prom Dress

their daughters. If a mom places a huge quite peaceful after doing so. Of course, stress on physical appearance in her what she doesn’t realize is such serenity own life, this can easily be passed on to is the result of endorphins flooding her her daughter. Sometimes, a daughter’s bloodstream — the body’s attempt to obsession with calorie counting and soothe itself after vomiting. The next time Marysize Bono hasofseen the danger she feels high anxiety, she copes by eating clothing is a Mack reflection her mother’s of prescription drugs Fathers first hand her late her favorite foods, without fear of gaining attitudes and behavior. are –also husband, Sonny Bono, her son and her important because they are a daughter’s step- weight. This is often how it starts, and just daughter were abusers. Today, from her seat first, and often most significant, male as with anorexia, she becomes addicted to in the U.S. Congress, she is fighting back. relationship. It cannot be stressed enough the behavior. Because after all, it works. how critical it is for fathers to focus on a What people rarely realize at the outset daughter’sBgood instead of her of any eating disorder is how much it will y Repqualities, . Mary Bono Mack physical appearance. What a profound eventually control their lives. In the case t started out as aiftypically quiet day of bulimia, a great deal of effort inevitably difference it would make girls could inup Medford, New York.

But at 10:20 goes into acquiring the food, planning the just grow confident in the knowledge a.m. on June 19 this Father’s Day, binge, ensuring the immediate environment that what really mattered inyear, life was a man walked into the Haven who you are, not what you looked like. Drugs is safe to not only eat all this food, but pharmacy and murdered four people perform the ritualistic vomiting. It is all for 11,000 tablets of hydrocodone – an opioid BULIMIA used toNERVOSA manufacture a long list of narcotic consuming. You see, bulimics don’t engage in this unhealthy behavior just occasionally; All eating disorders hold one thing in pain killers, including Vicodin. common: Butgunned whereas anorexia One offood. those down was a cus- it is not unusual for the person to binge dozen or more times a day. istomer, defined by restriction, bulimia is who was and 33-year-old Jamie Taccetta, ery purge single aday. engaged to be married. and Instead, she was That’s a lot of food even national more planning. characterized by bingeing purging.

According to aand recent survey, buried in bulimia her wedding dress.

A pharmacy When some laxative 7 millionabuse people age 12 oraolder reguis involved, whole Those with consume enormous employee, 17-year-old drugs, and enters there are new dimension amounts of food, often Jennifer Mejia, was larly abuse prescription also killedof and laterinburied in her prom approximately 7,000 abusers thenew equation.

Itevery is notday thousands calories, a experts believe dressperiod along of with herThey high school Most diploma. – many of them teenagers and young adults. uncommon for a person short time.

This senseless tragedy is thethe latest and Thatmedia alarming trend is taking a huge toll on American to steal both food and eat much more than would most horrific example of a growing wave of society. due to the – esbedrug considered reasonable store robberies by prescription Today, prescription drugs plays adrug key role in the thisabuse oflaxatives, cost involved.

Another and far beyond the point of addicts. pecially painkillers, stimulants and depresaspect that drug a bulimic comfort.

When But it’s also they part simply of a larger,problem rapidly escaby consistently sants – is the fastest-growing problem rarelywho recognizes cannot any lating consume struggle nationwide against prescrip- in America. As someone has been deeply rewhich ectingis our tion they drugpurge abusethe and addiction, at the of the more, food, andsociety’s personally affected byoutset this issue, I believe expected to claim the about disorderawakening is the profound usually by vomiting.

In lives of tens of thou- there needs to be a national obsession with sands of they Americans this year alone. thethinness. threat this alarming shame,epidemic guilt andposes to addition, often abuse Why is it happening? tell us our families and ourembarrassment communities. she will laxatives, ingesting up to Scientists The message is if a girl that childhood trauma, genetics, mental ultimately experience.

200 laxatives a day. These disorders, depression, stress, anxiety, thrill lose enough can just The absolute truth behaviors are extremely seeking, peer pressure, severe pain from inis thattono — notjob of hard onand the illnesses body. Theand even theweight, juries horrors ofshe can, and we need For starters, doone a better even an individual medical combatconsequences all contributeofto prescription drug monitoring and limiting access to prescripwill,andhavetionit all. completely engaged in bulimia include injury to lead to tragic addictions, which can drugs containing controlled-release avoidable deaths. bulimia —including can defend,the the esophagus, stomach oxycodone hydrochloride, what’s even more insidious is the way popular painkiller OxyContin. or even really explain, andBut intestines as well these powerfully addictive narcotic preOriginally, OxyContin was intended her behavior.

They to be as damage to the heart, scription drugs quickly people without often prescribed for severe a way to isolate,only becoming morepain andas more lungs, kidneys and teeth.turn Although the any real emotional or physical problems help patients dealing with late-stage cancer alone, and dependent on, the disorder. mortality rate is not as high as anorexia, into desperate people suddenly facing life- and other severe illnesses. Today, however, anorexics, who often like the way those withstruggles. bulimia can diethings from are medical or-death Few more de- Unlike more and more people across America are they look and are proud of their complications related to their disorder. structive. being prescribed OxyContin, asdiscipline, well as othis quite common for bulimics.

Why would anyone According to the willingly Centers for Disease self-loathing er generic oxycodone drugs, for less severe Anorexia and bulimia areasextremely subject themselves to suchisathe highsecond lead- reasons Control, drug overdose – clinically known moderate pain ing cause of of accidental death in the United complex People who have never consumption food in tandem with – greatlydisorders. expanding the availability and poStates – in large part behavior? due to prescription had tential for abuse of these an eating disorder are powerfully-addicusually baffled the subsequent purging drug abuse.

And the problem is growing tive thenarcotics. very idea of them. Yet, those who Here’s why: bulimia, like many eating ev- by are engaged in these behaviors absolutely disorders, is not about food, it’s about know why they do them. What’s more, feelings. Those who engage in bulimia do even if these individuals look terrible and so as a form of emotional regulation, in feel even worse, they may find it nearly effect, as a way to cope with unpleasant impossible to give the disorder up. This emotions. Consider this example: a young is why professional help is frequently woman goes away to college, leaving home required, especially if the disorder has for the first time. Nothing is familiar, been going on for a long period of time. âœş everything is foreign — a whole new environment, academics, etc. She Lifeskills friends, South Florida is a private, residential, wantsextended so desperately well, to make Cabrera, Psy.D., is a licensed careto do treatment program Dena for a success of her life.

Her anxiety level is psychologist and has been on staff at adults with co-occurring and/or psychiatric very high. She is homesick and scared. She Remuda Ranch Treatment Centers for disorders. We individualize all treatment notices that her stress level diminishes 10 years. Dr. Cabrera is an expert in the offering such comfort, abstinence and whileplans eating; the food provides psychodiagnostic assessment and treatment evidenced modalities of treatment like an old friend.based She consumes more than ofaseating disorders. She presents to national normal and worries about weight gain. She audiences on state-of-the-art treatments of self-help participation, Cognitive Behavioral has heard talk around the dormitory that Therapy, eating disorders and difďŹ cult mental health Therapy, Dialectical Behavioral many students vomit after they eat to stay problems. Dr. Cabrera has written numerous Mentalizing and Motivational Interviewing. thin. She tries it and it works. Although articles in journals and magazines and she feels a certain amount of repugnance has appeared in several national media 800-749-7149 by the act ofwww.lifeskillssouthflorida.com throwing up, she actually feels interviews.

Teenagers and Treatment

on happiness, relationships, fun, pursuit of passions and helping others. It was obvious that their positive energy is infectious.

(Continued from page 12) Recovery is a powerful thing to witness.

These miracles are happening every day one time had very little hope of a successfor and so real muchprogress of it starts notyoung goingpeople, to make any until ful adult life were truly happy, exchanging we limit access so to simple these powerful with something and oftennarcotic given sober war stories, laughing and having a drugs and ensureinthat only patients in setoo little priority treatment and recovery: great time with long-term friends they had vere pain can obtain them. Today, I have FUN! âœş sobered up with. They had been there for legislation pending in Congress to accomone another throughout their lives. plish this goal.

Josh LISAC, of CAC II, is the Owner How wonderful it is that having dealt TheAzevedo, pervasiveness prescription drug and Director headlines at The Pathway with their alcohol and drug use early on abuseProgram made national recently Program. when federal, state and local law enforcethey were able to focus their young lives ment agencies, led by the Drug Enforcement Administration, cracked down on so-called “pill mills� in Florida, resulting in dozens of arrests – including five doctors.

Congress needs to make it much more difficult for these rogue pain clinics to operate, and we should treat offenders like any other street drug dealer. By better coordinating the efforts of local, state and national agencies – How serious is the problem today? Well, and by reducing the supply of highly addica recent report by the National Institute on tive opioid painkillers – I am convinced that Drug Abuse found that nearly 1 in 20 high we can eventually save thousands of lives school seniors have reported abuse of Oxy- and spare millions of American families in the Hamptons from the heartache of addiction.

Contin.

No child should ever be buried in a prom For people all across America, prescripAlcohol & Substance Abuse Treatment tion drug abuse is a day-to-day struggle. dress because we ignored the problem.

Where the healing begins.....

Over time, it can destroy families and wreak Rep. Mary Bono Mack, R-CA, is Chairhavoc on communities.

Someone with a

man of the House Subcommittee on Comtoothache or a sore back should not be premerce, Manufacturing Adults -painkiller.

Adolescents - Family - Men & Women and Trade and serves scribed a potentially addictive as Honorary Chairman of Mothers Against Clearly, expanded public education plays 1-800-448-4808 Prescription Drug Abuse (MAPDA). a role in addressing this problem, but we’re

Prescription pills are killing our kids. We need a national awakening about this epidemic.

I

SEAFIELD

Day to day struggle

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

Together

Addiction Specialists

15

3

IN•THE•NEWS

To

YourHealth • • • • • • Talk to your doctor about these news items to see if they apply to you.

Crazy? Or just sick?

More than 100 medical disorders can masquerade as psychological conditions, Harvard psychiatrist Barbara Schildkrout writes in her new book, Unmasking Psychological Symptoms.

Studies have suggested that medical conditions may cause mental-health issues in as many as 25% of psychiatric patients and contribute to them in more than 75%.

In a review of the book, The Wall Street Journal reports that common culprits include under- or over-active thyroid glands, which can cause depression and anxiety, respectively. Deficiencies of vitamins D, B-12 and folate, as well as hormonal changes and sleep disorders have also been linked to depression.

Diabetes, lupus and Lyme disease can have a variety of psychiatric symptoms, as can mercury and lead poisoning and sexually transmitted diseases, the Journal reports.

Many medications also list mood changes among their side effects, and substance abuse is notorious for causing psychiatric problems.

Telltale signs of underlying medical problems include significant changes in energy, weight, appetite or sleep, which could be due to an endocrine disorder, the Journal reports. Experts say mental-health counselors should ask patients about their medical histories as well as emotional issues, and make sure they’ve had a recent physical exam.

Seeing double Do you take more than one medication to treat your mood disorder? If you do, you're not alone. A recent study finds that the number of adults being prescribed a combination of psychiatric medications is growing, and it may not be for the best.

Johns Hopkins researchers analyzed trends in psychotropic polypharmacy (the use of more than one psychiatric medication) by looking at drugs prescribed during 13,079 psychiatrist visits.

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From 1996-1997 to 2005-2006, the percentage of visits at which two or more medications were prescribed increased from 43 to 60 percent, and the percentage of visits at which three or more medications were prescribed increased from 17 to 33 percent.

While the efficacy of some combinations is supported by research, many are untested, according to Johns Hopkins researchers.

And while combining medications may be beneficial for some, growing evidence suggests they can have negative side effects, such as weight gain and high cholesterol levels.

If your doctor prescribes more than one psychotropic drug for you, ask if this is best and for a careful explanation of each drug’s role, the researchers advise. If you’re concerned about your treatment, consider getting a second opinion.

The danger of anorexia Anorexia is the most lethal psychiatric disorder, carrying a six fold increased risk of death — four times the death risk from major depression, WebMD reports.

The odds are even worse for people first diagnosed with anorexia in their 20s. They have 18 times the death risk of healthy people their age, according to an analysis of the medical literature by Jon Arcelus, MD, PhD, of the University of Leicester, England, and colleagues.

The study found anorexia to carry twice the death risk of schizophrenia and three times the death risk of bipolar disorder, WebMD reports. Although anorexia is by far the deadliest eating disorder, death rates are also higher than normal in people with bulimia and “eating disorder not otherwise specified” (EDNOS, a common diagnosis for people with a mixture of atypical anorexia and atypical bulimia), according to WebMD. “Mortality rates in individuals with eating disorders are high not only for those with anorexia but also for those with EDNOS and bulimia, which highlights the seriousness of these conditions,” Arcelus and colleagues conclude in the July issue of Archives of General Psychiatry.

A cocaine blocker A common beta-blocker, propranolol, currently used to treat hypertension and anxiety, has shown to be effective in preventing the brain from retrieving memories associated with cocaine use in animal-addiction models.

Currently, “exposure therapy” is used to help recovering addicts suppress their drugseeking behavior. In this therapy, the patient is repeatedly exposed to stimuli that provoke cravings but do not satisfy them. Done repeatedly over time, the patient experiences less craving when presented with those stimuli.

The success of exposure therapy, however, is limited. Combining therapy with the use of propranolol would boost the effectiveness of the treatment, researchers at the University of Wisconsin-Milwaukee say.

W it

To

"The only way to keep your health is to eat what you don't want, drink what you don't like, and do what you'd rather not."

– Mark Twain

www.together.us.com | September / October 2011

Together Welcomes Together AZ IN•THE•NEWS

Serving Patients, Saving Families®

growth of the Internet and pornography Addicts (COSA), and Recovering Couples Anonymous (RCA). Recovery will also industry will likely be accompanied by explosive growth in sexual preoccupation and include finding a sponsor and accountability addiction among youth, teens and adults. group. Pursuing spiritual recovery is crucial. And for many, therapy will be an Recovery from addiction starts by asking for help. Many individuals may have to important component of healing. ✺ “hit a bottom” in order to be desperate and mal brain cell growth adolescence, willing enough to seek treatment. Finding Kay Butler-Lueking, MC, during LPC, specializes in particularly in these brain regions, connection with a self-help organization is counseling services relatedfrontal to substance abuse/ People who begin drinking at a young which could interfere with teens’ ability to vital. age Self-help groups include: Sexaholics anxiety and depression, trauma, also may drink heavily during stressful addiction, perform in school and sports, and could Anonymous (SA), Sex Addicts Anonymous self-esteem and relationship events later in life, the National Institute have long-lasting effects,issues. even months after (SAA), and Love Addicts AnonymousResults Forthe more information visit: onSex Alcohol Abuse and Alcoholism. teen uses.”

(SLAA), S-anon orstudy Co-dependents of Sex from a recent found an interaction be- www.pcsearle.com and www.sexhelp.com tween an early age of first drink and drinking patterns later in adulthood.

Results showed stress doesn’t necessarily For kids who are at risk for drinking, cause people to drink more often, but it does smoking, using drugs, and delinquent because them to drink larger quantities when we havior, a higher-performing open the attending valve to let some water out so (Continued from page proved 11) they do drink. Daily hassles to be un- theschool be burst. protective, according to the heater may doesn’t Similarly the griever ness of the grieving process while providing related to drinking behavior.

National Institute on Alcohol Abuse and to let the feelings out. We alcoholics Alidentification for the the reader. of these is had a needs In addition, ageOne of first drink coholism. are study, notorious for repressing “Sanity and Grace” by the singer Judy significant influence on both theCollins. number of and addicts A recent published in theour March come out sideways. recomdrinking days total amount of al- feelings Several years ago sheand lost the her 30-year-old 2011 until issuethey of Prevention Science, Ievaluated consumed in the last month. People mend after initialenvironment grieving period, son tocohol suicide.

Her experience as a recovering the that effect ofthe school on kids with an earlier age ability of firsttodrink had more when thepublic family schools and friends are no low-income, longer in 61 in urban, person proved key in her cope with frequentI have andrecommended higher consumption ethnic/minority areasallows in Chicago that the griever him or between herself that tragedy. this book levels available, than people who began drinking at an older a specific 2002 and 2005. period of time each day to sit quietly to many recovering people who have similar age.

The study found students at schools with their feelings.

Thisthat allows us to gradually losses. Another title that is helpful is “The Year with “value-added education,” a measure accommodate and return focus to the business of Magical Thinking” by Joan Didion. Clients showing higher than expected academic of life.

Above all else we need to be kind ourwho have lost spouses have been able to relate achievement and better attendance to records selves and recognize that we have a right and Binge drinking may have lasting effects Ms. Didion’s experience to their own. given the profile of the student body, were the still-developing brains of teenagers, a need to grieve our losses.

Unpleasant events much less likely than kids attending simiForon younger grievers, including adolescents WebMD reports. but poorer-performing drink, andlar, feelings are part of life. Ourschools primarytoreand young adults, the book “Green Angel” A new study shows that, long after the sponsibility smoke, use drugs, or have is toillegal not pick up a drink or abehavior drug

by Alice Hoffman has been helpful. Several hangover wears off, binge drinking impairs problems. no matter what. ✺ yearsthe ago spatial I introduced this book to Cottonworking memory of teenagers. wood’s Sweetwater Program for adolescentto these Girls appear especially vulnerable females.

One of our young patients returned effects.

Dan Stone, MSW, LCSW, LISAC, CT, is a Spatial memory is the ability to social worker and counselor who specializes to a session withworking notes she had taken detailing perceive thewith space you, remember, in addictions and grief. Dan is a counselor at her identification thearound main character’s A growing number of universities are and work with this information to perform mourning process.

Tucson, a recovery co-occurring disorders creating so-called communities, a task, such as using a map, playing sports, Cottonwood I often describe grief as similar to an old treatment facility for adults and clubhouses, adolescent which often feature on-campus or driving a car. water heater a safety recreational opportunities, academic sup“Our with study foundvalve. thatPeriodically female teenage girls. heavy drinkers had less brain activation in port and recovery courses, The Wall Street several regions than female non-drinking Journal reports.

To promote the spread of the concept, teens when doing the same spatial task,” about 20 colleges this summer formed the says researcher Susan F. Tapert, acting chief recovery.

In addition to referencing relapse as of psychology at the VA San Diego Health- Association for Recovery in Higher Educaa metaphor, using dreams thefounding late stagememof (Continued from page 13) tion.

On the campus ofin one care System. “These differences in brain also reference the attitudes and ber —can Georgia’s Kennesaw State University activity were linked to worse performance recovery haviors that excite and stimulate recovery — the community of 50 recovering that made significant changestudents poson other measures of attention and working behaviors values. is in upthefrom when the program sible earlythree stage of recovery.

In this re-was memory ability.”

Finally, counselors are interested in physi- gard, launched in dream 2008. is a call back to the basic “Even thoughwho adolescents might the using Two Big Ten giants, the University of Michhelping clients determine thetheir meaning and cally appear grown up, brains are con- principles of recovery, though it’s understood igan and Penn State University, are launching significantly develop and mature, valuetinuing of usingtodreams will need to account for therecovery current need is to apply these principles to programs that they expect eventualparticularly in frontal brain that are the stage of recovery each client is regions in. Research problems other than substance use. ✺ ly to serve hundreds of students, not only adassociated with higher-level thoughts, demonstrates that using dreams differ in func-like dicts but also the adult children and siblings planning and organization,” Tapert says. tion as clients move from early recovery to late of substance abusers.

Brown, S. (1985). “Treating the alco“Heavy alcohol use could interrupt nor- References: recovery (Flowers, L. and Zweben, J., 1998). holic” John Wiley and Sons: New York, New York.

As a general rule, clients in early recovery can Choi, S. (1973). “Dreams as a prognostic factor in expect using dreams to relate literally to their alcoholism.” American Journal of Psychiatry, 130: 699-702. Flowers, L. and Zweben, J. (1998). “The substance abuse problem. Counselors can changing role of ‘using’ dreams in addiction recovdirect clients to discuss and react to the using ery.” Journal of Substance Abuse Treatment, Vol. 15 dream as if it related specifically to the addic(3). Reid, S. and Simeon, D. (2001). “Progression of tive process.

Dreams of crack cocaine abusers as a predictor of However, clients in late recovery can expect treatment outcome.” Journal of Mental and Nervous the using dream to function differently, no Diseases, Vol. 198 (12). longer necessarily relating to actual substance use. The using dream begins to act as an unAddiction affects and friends all over the city. conscious altering system for clients in thefamily late Charles Gillispie, MFA, LISAC has published a stage of recovery. TheseHow dreams can be viewed do you reach them?

Advertise indescribing Togetherhis use of creative number of articles as serious warnings that alert the dreamer writing as an adjunct to cognitive-behavioral to major life stressors, difficult emotional Tap into the country’s number market!include Addiction therapy.

Hisone publications experiences, or life transitions independent Join the conversation about addiction, recovery andofhealthy lifestyles Professional, Journal Poetry Therapy, and of substance abuse. Counselors can direct Therapeutic Recreation Journal. Charles is a these clients to examine life events that may counselor at Cottonwood Tucson, a co-occurring Together make a difference. have triggered a using dream, and help we themcan disorders treatment facility for adults and apply principlesCall of growth comparable to early 917-370-2173 for advertising adolescent girls. information.

Is Your Child at Risk?

Early drinking, later effects

Sober and Grieving

Better schools help

Brain on a binge

Colleges are providing havens

Relapse Dreams

T gether New Yorkers suffer with addictions.

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

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IN•THE•NEWS Together Welcomes Together AZ

InPassing

Sober and Grieving • • • • • •

I

Betty Ford Delivered the Punch Line

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

By Kate A. Scannell, MD patients’ lives, it appeared that their substance use spiked — sometimes dramatically.

Infoot somein etty Ford never actually set cases the loss downward of mytriggered medicalaclinic.

But I spiral sometimes using and depression that ultimately resulted felt that she was there, accompanyin admissioning into treatment. was drawn to to patients who Iwere motivated seek care how because ofaddiction her. learning more about grief, and I was aaffect medical in 1978 was recovery eachstudent other and how Iwhen couldithelp widely reported that Betty Ford had amore probnewly sober people negotiate their grief lem with “addiction” to a variety prescribed adaptively.

I came to believe that ifoflife losses pills and alcohol.

The news was shocking were not adequately addressed in treatment, in that pre-Amy-Winehouse era when nobody the neglect of this would be a contributing facspoke — let alone sang — about addiction and tor in potential relapse. My own experience of “rehab.” loss reinforced emerging viewpoint.

Inalso fact, had youmy told someone back then Myyou father died in February of 1986, a time that were “going to rehab,” they may well when, sadly, I was not yet sober.

My response have assumed you were planning to renovate to that loss was that I used more of the subyour kitchen. stances I was then addicted the Our medical school had to. anThroughout extended campus inmourning Grand Rapids, the hometown initial ritualsMich. of my— religion, I was of Betty and her husband, Geraldchecked Ford, who physically present but emotionally out served as president between 1974 and 1977. and unavailable.

Many of us Michiganders prideand in the In November of 1987 I hitshared my bottom local celebrated successand andhope. their unbegancouple’s a new journey of recovery abashed display of earthy Midwestern sensiAs my body and mind healed, an interesting bilities. phenomena occurred when I had about three

B

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• Mood/Bipolar Disorder • Chemical Dependency • Depression • Anxiety • PTSD • Grief and Loss • Anger and Rage • Compulsive Gambling • Sexual Addiction • ADD/ADHD • Eating Disorders • Obsessive Compulsive Disorder

• Substance Abuse/Dependence • Depression • Anxiety • Self-Harm Behavior • Trauma • Eating Disorders • Family Conflict • Grief and Loss • Low Self-Esteem

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It was a knockout blow to our obliviousness about a soaring addiction problem While in the White House, “Betty” had become famous in her own right for speaking her mind on sensitive cultural issues. For example, she sent public shockwaves across the country when she voiced her support for legal abortion. When she rallied for passage of the Equal Rights Amendment for women. When months sobriety.

I was nowwith remembershe saidofshe’d be sleeping her husband ing mysame dreams as my sleep bed. pattern began in the White House When shetopubnormalize. licly spoke about birth control and speculated One night I dreamthaving that I was in a Newsex.

York about her daughter premarital City subway car. The car was empty with the exception of someone sitting next to me. That person’s role in the dream was to listen to me a certain ageexperiencmay not apas IPeople spoke ofunder the new hope I was preciate how radical it corner was inofthe ing in recovery.

In the far the‘70s car afor a woman — let alone a First Lady — to share person was reading a newspaper. The paper such opinions so directly, forcefully, and was shielding their face. unapologetically with the public. Today we As I spoke of my new life, the person in thethat point accusing fingers at some countries corner put down the newspaper and stood flagrantly suppress women’s self-expression, up. was mythat father but not as I happen remembered as It though would never in our him.

He was not the eighty-two year own backyard. But that would beold anwho error, had recentlywhat died from pancreatic Hehad forgetting generations of cancer. women looked likeinhethis didcountry. in photos I had seen of him endured So twenties, when many of usrobust heardwith the dark newshair about in his healthy, straight-talking “addiction” to pills, — the prizefighter Betty’s he had been in his youth.

I we paid attention — even if we said, “Dad!respectful What are you doing here?

You’re were somewhat about there being dead!”

He replied,confused “I just wanted to tell “a problem.”

In fact, you to keep doing what over you’relunch, doing. one It’s of my perplexed medical school classmates scoffed, going to be O.K.” “Are we supposed to think of her pill-popping woke up with running down asI some kind of atears ‘disease’ now?” myIface.

Shortly afterwards I went to understood his bewildered indignation. his grave thewas cemetery.

Standing After all,at it the ‘70s, and by recreational his tombstone wept asaI mundane spoke to him drug use had Ibecome recreationabout myfor life.many I walked backAmericans. to my car Besides, al sport young it was relieved also a time doctors feeling — aswhen if a weight hadhanded out powerful as though they were been lifted tranquilizers from my shoulders. candy.

Indeed, “Mother’s little helper” — a Over the next ten years I continued witty nickname for Valium — sedated and my pursuit of recovery and eventually anesthetized an entire generation entered my current profession as a of besieged housewives and careworn mothers. Its use therapist. In 1988 my mother died of a stroke became so widespread among corporate at the age of 81. I left Tucson to go to her crowds that it also became known as “Execubedside as she lay in a coma. During a seventive Excedrin.” dayU.S. deathNews vigil, I& stayed in touch with recounted my World Report recovery support system received support that in 1978 “nearly 2.3and billion of the tablets from new friends I met at 12-step in stamped with the trademark ‘V’meetings were ingestFlorida.

When mybecome mother fi nally died, I was ed.” Valium had the most commonly prescribed between 1969toand there to holddrug her hand and talk her 1982, in her and “everyone seemed to reach” for one on oclast moments. casion.

The Rolling Stonesmesang aboutthat it in My mother’s death helped to realize a an 1967 song tellingly “Mother’s as alcoholic working atitled, spiritual programLittle I Helper.”

The ubiquity of the drug was reflectwas able to cope with adversity differently than ed in American novels and movies. Comedian when I was using substances. I was supported Milton Berle joked: “The definition of a Valievery step ofisthe way and I found I could um addict a patient who takesthat more Valium be there for my family as well as for myself. than his doctor.”

This was a realiscontrast to the when I The point that, with hertime family’s support, lost my father and was self-medicated and Betty ultimately “got the joke” — and she

The radical 70s

Together

took it seriously. It was not funny that huge segments of our population were becoming dulled and lulled by drugs, and that American medicine and pharmaceutical marketing were normalizing and profiting from it.

In fact, Betty gave the joke a much stronger punch line: a forceful knockout blow against our country’s obliviousness to its soaring addiction problem. When she publicly announced that she was an addict seeking help, she once again broke ranks with the status quo. Her candor shattered another deadening silence, motivating many people — and doctors — to rethink their casual attitudes about drug and alcohol dependencies and to obtain assistance.

Shortly after getting help, she joined others in 1982oftothe establish Betty Ford Center thoughtless needs ofthe others.

— the first licensed addiction hospital in the In grief, recovering people experience the world. More than 90,000 people have been same struggle as “normies.” We too are faced treated there since. By the mid-’80s, it had with the tasks of acceptingin themedical reality ofcircles the to become commonplace loss, experiencing our feelings, coping without shorthand a recommendation for substance the loved one we have lost and accommodatabuse treatment as “prescribing a trip to Beting a world that has changed. admitted needty to Ford.”

Patients sometimes ing help by claiming that they might benefit from “some time at Betty Ford’s.”

THE RITUALS Participating in mourning rituals often involve interactions with family members. Many cultures celebrate the passing of a loved one impact culture of withBetty wakes,Ford’s funerals and theon like.the Participating health care extended even further, inAmerican these ceremonies can often be problematic beyond raising national consciousness about for those new in recovery. To be thrust into addictions and women’s reproductive health. aNotably, situationshe where might be alsofamily brokemembers the deafening silence drinking is difficancer cult enough.

When is about breast in 1974 afterthis undergoing compounded with unresolved confl ictsasa radical mastectomy only family months after and mistrust theofrecovering person, the suming the of role First Lady. chances of relapse increase.

Even are At the time, there were nowhen pinkwe ribbons or celebrity spokespersons cancer. mindful of this risk,for we breast often feel an Public discussions about “the word” were obligation to attend andCsomehow hushed and rare, fiand some doctors bewe must nd aeven way to cope. lieved it was humane andaddicts ethically Many recovering andcorrect to withhold cancercome diagnoses from patients. alcoholics to the realization But as Betty later grieving explained, while hospitalthat their process had been ized during her mastectomy, she looked out delayed or postponed until their the window and saw throngs of international recovery began.onThis I think, media trying to report herfact, condition. is evident in my story and also in the That experience made her appreciate of many clientschange I have and power ofthe herstories position to create worked As a grief counselor I improve the liveswith. of others.

When she consehave adopted the position that I am quently decided to disclose her diagnosis and speak openly about her treatment, thousands “companioning” people in the first werejourney instantly inspired fiof tfulwomen steps of their through grief.to By seek breast cancerthem screening. accompanying on the first stage of their Bettythrough Ford died on July 8 in IPalm Springs journey the grief process, am able at 93 years of age.

She was liberated and to help them to narrate the story of their loss liberating, a smart and unpretentious woman without judgment. This task is of paramount who knew how to speak truth to silence. Her importance successfully negotiating the many refreshing inpersonal honesty inspired grief process.

Addicts and alcoholics often exwomen, and her unflinching and compasperience grief as ahuman result ofcondition their sionate complicated view of our tattered self-perceived failures lapses in being a helped to save manyand lives. “good” child, parent, partner, sibling or friend.

It isKate common to hearMD, statements Scannell, is an beginning internist and rheumatologist, who has beenhave…” a syndicated with “If only I had…” or “I should medical opinion withanseveral Bay Sometimes peoplecolumnist will have had ambiguArea newspapers, including ous relationship with the deceased.The TheOakland fact Tribune, in which thismember article first appeared. that the deceased family might have Her books include the Good struggled with his or “Death her ownofissues and Doctor — Lessons from the Heart of the AIDS Epiinappropriate behavior can also complicate demic” and “Flood Stage.”

Far-reaching influence

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

IN•THE•NEWS

Amy Winehouse: It’s too late. She’s gone.

The pop singer tried to get clean over the years, but in the end addiction claimed her timeless talent “They tried to make me go to rehab, I said, ‘No, no, no.’”

– Amy Winehouse, “Rehab”

T

hose lyrics in the award-winning song Amy Winehouse co-wrote may have been prophetic. Her father attributed her death on July 23 to withdrawal from alcohol, a risky process often managed by rehab facilities because of the dangers.

In his eulogy, Mitch Winehouse, the father of the Grammy-winning pop singer, discounted reports that she had been on a 72-hour bender. “He wanted everyone to know that he, her boyfriend and her manager believed it was actually the complete opposite,” a family source told The Sun. “He said doctors had told Amy to gradually reduce her intake of alcohol and to avoid binging at all costs. Amy told him she couldn’t do that. It was all or nothing and she gave up completely. Mitch said the shock of giving up, after everything she had been through over a bad few years, was just too much for her to take.”

A final determination of the cause of death may take some time, but it should be taken as a warning of the risks of unsupervised withdrawal. The U.S. National Institutes of Health says that, “Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition.

Symptoms such as sleep changes, rapid changes in mood, and fatigue may last for months. Most people who go through alcohol withdrawal make a full recovery. However, death is possible, especially if delirium tremens occurs.”

Talent came early The 27-year-old British singer was the winner of five Grammys for her 2006 album “Back to Black.” In that year she also won the Ivor Novello Award for “Rehab.” Her talent had early roots: as she grew up in North London, her father would sing Frank Sinatra songs to her, and her teachers said she sang so often in class that they had trouble keeping her quiet.

Russell Brand, the English comedian, actor and singer, was a good friend. After her death he wrote of seeing her perform. “From her oddly dainty presence that voice, a voice that seemed not to come from her but from somewhere beyond even Billie and Ella, from the font of all greatness. A voice that was filled with such power and pain that it was at once entirely human yet laced with the divine. My ears, my mouth, my heart and mind all instantly opened. Winehouse.

Winehouse? Winehouse! That twerp, all eyeliner and lager dithering up Chalk Farm Road under a back-combed barnet, the lips that I’d only seen clenching a fishwife fag

and dribbling curses now a portal for this holy sound. So now I knew. She wasn’t just some hapless wannabe, yet another pissed up nit who was never gonna make it, nor was she even a ten-a-penny-chanteuse enjoying her fifteen minutes. She was a genius.”

In 2007 she married Blake Fielder-Civil, a former video production assistant. Theirs was a tumultuous relationship, with tabloid headlines of physical abuse on her part.

Winehouse told Britain’s News of the World that the marriage, “was based on drugs.”

They eventually were divorced.

Addictions plagued her. She admitted to problems with self-harm, depression and eating disorders. In 1997 she was hospitalized with what was reported as an overdose of heroin, ecstasy, cocaine, ketamine and alcohol. In the next few years, however, the newspapers reported several incidents of heavy drinking and rowdy behavior. She was arrested for assault and disorderly conduct.

Despite her protestations in the lyrics of “Rehab,” Winehouse reportedly entered a two-week treatment program in early 2008, but just months later her manager and father sought help in having her involuntarily committed again. And the next year her father reported that she was in yet another drug rehab program. Then in 2010 she announced that she had been drug-free for three years. “I literally woke up one day and was like, ‘I don’t want to do this anymore.’”

However, this past June, a month before her death, Winehouse’s European tour was cut short after reports surfaced of a performance in Belgrade, Serbia, in which Winehouse struggled to remember her own songs.

others whose unnecessary deaths have been retrospectively romanticized, at 27 years old. Whether this tragedy was preventable or not is now irrelevant. It is not preventable today. We have lost a beautiful and talented woman to this disease. Not all of us know someone with the incredible talent that Amy had, but we all know drunks and junkies and they all need help and the help is out there. All they have to do is pick up the phone and make the call. Or not. Either way, there will be a phone call.

“When you love someone who suffers from the disease of addiction, you await the phone call. There will be a phone call. The sincere hope is that the call will be from the addict themselves, telling you they’ve had enough, that they’re ready to stop, ready to try something new. Of course though, you fear the other call, the sad nocturnal chime from a friend or relative telling you it’s too late, she’s gone.”

The night before death The singer had lunch with her mother, Janis, the day before she died. Winehouse was “out of it,” her mother told The Sun. That night, her father said, she had a routine doctor’s appointment, then went home and sang and played the drums into the early hours. The next afternoon her security guard found her dead in her North London home.

Russell Brand had his own problems with addiction. “In the public perception this ephemeral tittle-tattle replaced her timeless talent,” he wrote of Amy’s public persona.

“This and her manner in our occasional meetings brought home to me the severity of her condition. Addiction is a serious disease; it will end with jail, mental institutions or death. I was 27 years old when through the friendship and help of Chip Somers of the treatment center Focus 12, I found recovery. Through Focus I was introduced to support fellowships for alcoholics and drug addicts which are very easy to find and open to anybody with a desire to stop drinking and without which I would not be alive.

“Now Amy Winehouse is dead, like many

Together - A Voice for Health & Recovery

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Take a Hike It's good for your body — and your mind Easy Start Walking Program

By Jim Brown

T

Week

Slow/Warm-up

Brisk Walk

Slow/Cool Down

Total Time

here are two prob 1 5 min.

5 min.

5 min.

15 min. lems with the no 2 5 min.

7 min.

5 min.

17 min. tion that exercise

3 5 min.

9 min.

5 min.

19 min. might improve a person’s temporary 4 5 min.

11 min.

5 min.

21 min. mood or even one’s overall 5 5 min.

13 min.

5 min.

23 min. emotional health.

6 5 min.

15 min.

5 min.

25 min.

The first is acknowledg 7 5 min.

18 min.

5 min.

28 min. ing the idea that exercise and 5 min.

20 min.

5 min.

30 min. mood are related. Take a walk 8 to feel better emotionally? Re- 9 5 min.

23 min.

5 min.

33 min. ally? Some people just don’t 10 5 min.

26 min.

5 min.

36 min. buy it. “Physical activity can’t 5 min.

28 min.

5 min.

38 min. do a thing that will take away 11 5 min.

30 min.

5 min.

40 min. the problems I’m dealing with,” 12+ a thoughtful person might say. [from Exercise and Your Heart, National Heart, Lung, and Blood Institute/ But even if you can connect American Heart Association, NIH Publication No. 93-1677] the dots between exercise and emotional health, how do you get started? gradually — and work up to a level of activJoin a health club? Lift weights? Enter a 10K ity that will produce physical, mental, and race? Just the thought of it can be depressing. emotional benefits. Forget, for the moment, Okay, bad choice of words. “Overwhelming” health clubs, gyms, weights, expensive sneakmight be more appropriate. The last thing ers, treadmills, anything that costs money. some people who are emotionally down want For now, make walking your exercise of to do is move around unnecessarily. choice.

If you are totally sedentary, try these baby steps first: Walk to the mailbox, if it’s outside, once a day. Walk to the corner and back once The scientific evidence that a link exists or twice a day. If you’re having a good day, between exercise and mood (or emotional walk around the block. health, mental health, depression, anxiety, Want more of a challenge? Walk 15 minstress) is compelling, if not indisputable. utes a day. If that’s too easy, walk the same Practically every major medical institute in distance, but pick up the pace. Your longthe United States has published a study, re- term goal is to walk at least 30 minutes a day, port or article confirming that exercise has a five days a week. Make it part of your schedpositive effect on various aspects of emotion- ule. al health. Here are just six examples of the Keep a chart of your walking routine. Note hundreds that could be cited. the time of day, duration, and approximate • “Exercise has been shown to release en- distance. Occasionally make a brief note dorphins — substances that help you feel bet- about the way you feel before your walk or ter and maintain a positive attitude.” — The the rest of the day after a walk.

Cleveland Clinic, 2011 One of the most practical walking pro• “Research has repeatedly shown that ex- grams, shown above, comes from the Naercise has significant mood-boosting effects tional Institutes of Health and the American in those suffering from depression and can Heart Association. It gives you a simple, 12be an important part of treatment.” – Johns week, progressive schedule for warming up, Hopkins Health Alert, May 2011 walking, and cooling down. Concentrate on • “Exercise training reduces anxiety symp- pace and time walked, not distance. toms among sedentary patients who have a There is no money-back guarantee that chronic illness.” – Archives of Internal Medi- walking or any other form of exercise will elcine, February, 2010 evate your mood or improve your emotional • “High levels of physical activity show a health. But there is a proven exercise/mood strong association with health, fitness, and connection. Why not see if that connection mood in older adults.” – American College of will make a difference in your life? Your probSports Medicine, June, 2010. lems won’t go away, but your mind may be a • “Depression symptoms often improve little clearer to deal with them. with exercise.” – The Mayo Clinic, 2011 • “A 30-minute walk around the track three Jim Brown, PhD, a former university protimes a week may be just as effective in re- fessor, is executive editor of the Steadmanlieving the symptoms of depression as anti- Philippon Research Institute News. He fordepressant medications.” – Duke University merly served as executive editor of the Penn Medical Center, 2005 State and Georgia Tech Sports Medicine Let’s assume that you have now been con- Newsletters, and for Healthy Years, a monthly vinced by evidence-based, peer-reviewed, publication of the UCLA School of Medicine. internationally published research. That He has represented the United States Tenwas easy. The hardest part is getting started. nis Association, the American Alliance for What should you do?

Health, Physical Education, Recreation, and Dance, and the President’s Council on Physical Fitness and Sports in clinics throughout the United States and Mexico. Dr. Brown has The answer is to start gradually — very authored or edited 14 books.

Consider the evidence

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Baby steps

8

www.together.us.com | September / October 2011

B O D YWelcomes • M I N D •Together SPIRIT Together AZ

Don’t Be Afraid of Fear

I then ask them to determine what distance the grieving process. Clients sometimes need between the chairs is comfortable. The client encouragement to talk about their painful then begins to read the letter. At the concluexperiences so that healing, forgiveness and sion of the reading I will ask the questions to acceptance can ultimately be achieved. Workassist the client in getting further in touch with ing with a counselor who understands the grief process can help the griever address these their feelings. If I feel it is appropriate, I will ask them to speak in the voice of the deceased, issues so that resentment and shame are not telling the client what they need to hear from suppressed for fear of being disrespectful to their loved one. We conclude the exercise by the dead. processing what has happened. Clients often In my work at Cottonwood and in my prireport feeling relieved as a consequence of dovate practice, I begin any grief counseling with a consultation to assess the client’s need and to ing this exercise.

Activities in a grief-specific group setting are fully hear their story. Developing a strong and also helpful in assisting clients in addressing trusting therapeutic relationship with a client their losses. One exercise involves identifying is essential to a successful outcome. In some a person’s greatest pain by giving it a name, cases the death is a sentinel event that has shape, color and sound. After sharing their profoundly disrupted the life of a client. Prior descriptions of pain, clients arewisdom, then asked to the loss B the client may have enjoyed a fairly your core self, your inner or to your y Tara Sophia Mohr dreams.

Naming voice of fear, give their pain a newthe shape, color, soundvisualizand contented life. Understandably, their worlding it Ias a character observing it helps ’ve watched hundreds of brilliant wom- name. encourage themand to use this as a tool view assumed that their children would outlive you get back charge.of the feelings when en and notenjoy do what they meant in reducing theinintensity them, that theymen would a long lifeare with 2. Follow the fear through to the end to do in — not would share their overwhelmed. their partner andthis thatworld their parents live voices, not ask for what they deserve, game. Fear holds us hostage, making Sometimes during the mourning process to a ripe old age. Death results in the bursting threats that if you do not take the who some-outof these expectations.

X, a disastrous risks involved in cre-Suddenly the world is no one has to deal with well-wishers times make statements that are thoughtless longer as safe and predictable a place as it had come will occur. The ating their knock-theof is this earlier seemed. We are propelled into a strange and inappropriate. An example remedy tomight imagine ball-out-of-the-park handle life — becauselandscape. of fear. Nothing is the same be, “Don’t cry. Everythinghow will beyou’d okay.” Anand terrifying that are outcome, all need fearother remark might be, “They in a better and asWe before. evaluate just bad slayers, tools that place.” It’s okay if the griever chooses to how believe TOOLS us AND quiet SUPPORTand really statebe. help this. Sometimes, this kinditofwould thoughtless This involves askovercome our Ifears.

One of the tools have found to be helpful for ment is just a sign of the well-wisher’s anxiety ing “so what?” again Here fivepresumptive of my clientsare whose reality has been in experiencing the grief of others. and again. If, for exfavorites: shattered is an exercise called a Loss CharacRecovering people needample, to give themselves you’re afraid 1.

Create a charterization. The Loss Characterization is basipermission to cry if they need Forrequest so long for that to. your acter. Create a charcally a character sketch the client composes a raise turned acter that symbolizes we medicated our feelings.

Some will of usbe were about himoforfear herself that is written in relation down, askwas yourself, the voice withraised in environments where crying conto ayou. loss. The clientshe’s writes this in the third “So Many if I of am turned in Maybe sidered unmanly or childish. us have the perspective of a close and so up what?

Then aperson frail from recluse or an heard the expression “Pulldown, yourself by your what?” eight-year-old bullywho knows the client inloving personal friend bootstraps.” When the world is full of sorrow, You’ll probably or a fire-breathing timately.

When the assignment is completed I statements like these canhear be cruel and insensiyourself thinkdragon.

Maybe ask that they share itit’s with me. Together we can tive. What I found to be helpful is the presence ing something like, the lion from “The explore what meaning the author perceives of of people who care. Support is always available “Well, I’d be disapWizard of Oz” or the their experience of loss. pointed, and of I’d Wicked Witch or the at 12-step meetings. Sometimes the words In onehimself. recent session think about Wizard Pick a client had expecomfort are not needed but the hugs are.whether the death of a teenage son. At the that means I need to arienced character that illusconclusion sharing DISCOVERING TRIGGERS change jobs. I guess trates howofthe voicethe loss characterization it wouldn’t bethat the end of fear in you,anger at God for takwith me feels she expressed In recovery we learn to identify triggers of thelead world.” great deal and name you hear could ing her childyour fromcharacter. her. As she When was a religious us to You’ve relapse.just Grieftaken has itsaown of powerThey away from your fear. warning, the voicethe of thought fear, greet it: “Oh, Cruella, I see triggers. woman, of anger toward God was can arrive without Or, you us might this outcome you’ve come Hello.” a difficult onetoforvisit. her to express. She felt inreminding of ourfind pain.

Photos, films,still feels Why does this work? Creating a charac- super scary, and your answer to the question tensely guilty being disrespectful toward anniversaries can prompt is, “I’dsongs feel and horribly embarrassed around ter helps youabout separate the real you from the articles, God. I gently encouraged her to dialogue with thoughts of our pain.

At these times the pain ask the part of you that’s afraid. Your fears come my boss every time I saw her!” Then God using the techniquepart of anofempty chair that brought on by these reminders of our loss can from that instinctual the brain gestalt.toAfter some reluctance, of using substances.

In relapse seeks avoid riskinitial at any cost — she notwas from elicit thoughts (Continued on page 18) able to go with it. Along with expressing her prevention workshops that I have facilitated anger, she was able to ask questions like, “Why we address the grief-related risk factors that did you do this to me?” and, “When will you can precipitate a return to using substances.

Upto go for give me Sign the strength on?”Emails Concluding Among these are difficult emotions, conflict this exercise the client reported feeling comwith others and testing control. forted and relieved. In fact, she reported that There are ways for alcoholics and addicts afterwards she felt that her relationship with to cope with loss so that the experience can her Higher Power was healing. be meaningful. We have learned to value a 50 people who sign up forTurning our On several occasions I have suggested The first relationship with our higher power. that my grieving clients write a letterE-mail to their Newsletter to the God of our get understanding provide will a FREE can one-year deceased. I provide these clients with a format even when express only print comfort subscription toour theprayers magazine! that cues them to write about what is missed, anger and confusion. Journaling has proven what is not missed, regrets, and appreciation. I to be beneficial. Writing can be on It's easy.

Gotherapeutic to encourage clients to write what feels appropriboth a physical and emotional level. After the www.together.us.com ate and authentic. When the letter has been death of my mother I returned to the twelve enter completed, I ask my clients to share it with me. steps. Completingand a fourth stepyour inventory and e-mailproved address.

This is also a time when I have used the empty sharing it with a sponsor helpful. chair technique with positive results. I begin There are many books related to bereaveNothing lose; toidea win! the gestalt by asking the client to describe the ment.

Some to may seemeverything to reinforce the physical appearance of the deceased including that grief is starts a predictable process. tend to Contest September 1, 2011, 12Ia.m.

EST their posture, clothing and expression. Somesuggest other books that recognize the uniquetimes a photograph is available and we use it.

(Continued on page 17)

Greet it, name it, look at it, and you become its master

I

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BODY•MIND•SPIRIT

Can Prayer Improve Your Marriage?

A psychologist applies the rigors of scientific research and comes up with a not so surprising answer

By Frank D. Fincham

“Properly understood and applied, prayer is the most potent instrument of action.”

— Mahatma Gandhi

M

ost people of faith, and that includes the majority of the world’s population, would likely agree with the above statement. But when confronted by the skeptic, can this belief be justified by more than personal experience?

In other words, what does science offer to support the power of prayer? Nothing it seems ... up to now. But that is changing.

Noting that prayer is a form of spiritual activity common to all the “Abrahamic” traditions (i.e., Judaism, Christianity, and Islam) with strong parallels in most other religious traditions (e.g., Buddhism, Hinduism, Shinto), my colleague Steve Beach and I were surprised to find so little scientific research on prayer.

And what we did find was disappointing. To the extent that there was any research on prayer it was almost exclusively focused on testing whether prayer for the physically afflicted leads to better health outcomes. The mechanism implicitly studied in this work is divine intervention. Not surprisingly, studies have yielded contradictory findings that are likely due to the scientifically (and perhaps theologically) problematic nature of this work.

We do not discount divine intervention but recognize that it is not an acceptable explanation in the realm of scientific research. Our work therefore started with a framework for understanding the impact of prayer that is informed by and grounded in an analysis of psychological and interpersonal processes. Our work investigates colloquial, petitionary prayer, a form of prayer that invokes God’s help in response to specific needs, using the individual’s own language rather than a set prayer.

Specifically, we sought to examine the impact of prayer for a partner in a relationship. Our initial work showed that prayer predicted relationship satisfaction (both concurrently and over time) over and beyond positive and negative behavior in the relationship.

Just pray normally Encouraged by these findings, we next turned to experimental research designs. Thus we began to randomly assign study participants to pray for a partner or to comparison conditions such as describing a partner to a parent or meditating on the partner’s positive qualities. In some studies we have even used as a comparison condition undirected prayer (“just pray as you normally would each day for the next four weeks”). We have consistently documented that petitionary prayer for the partner has a greater impact on the relationship than any of the comparison conditions. Here is an example of the instructions we use in our studies and a sample prayer.

“Please read the example prayer below to get an idea of the type of prayer we would like you to pray on behalf of your partner: Dear Lord, Thank you for all the things that are going well in my life and in my relationship. Please continue to protect and guide my partner, providing strength and direction every day. I know you are the source of all good things. Please bring those good things to my partner and make me a blessing in my partner’s life. Amen.

Now, please generate your own prayer in your own words on behalf of the well-being of your romantic partner and in the space below write a short description about what you prayed for.”

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These instructions illustrate those used when participants come to the laboratory and engage in a single prayer session.

A bit artificial? Yes, it is! And that is why we always replicate what we find in the laboratory using longer term, diary studies in which participants are asked to pray each day for a month.

We ask participants to make online reports twice a week during the month. That way we can be confident that they are following study instructions.

One set of studies showed what most people of faith intuitively know, that prayer increases willingness to forgive a transgression by the partner. This is important because in relationships such as marriage one will certainly be hurt by one’s partner, and that hurt is all the more poignant as we make ourselves vulnerable in such relationships. It is little wonder then that it has been said that a happy marriage is the union of two good forgivers.

In these studies we documented that prayer led to high levels of agape or selfless love and that this love led to greater willingness to forgive. But, our critics justifiably argue, this is merely self-report. That is why we have now shown that prayer following a partner transgression influences actual behavior in response to the transgression. Participants were exposed to a partner transgression in the lab. Then after praying (or engaging in a control activity) participants were given the chance to cooperate with or antagonize their partner in a computer game. Those who prayed were more cooperative than control participants. Furthermore, in another study we tested whether partners of participants who prayed over the course of four weeks would report the participants as more forgiving. Apparently prayer has a strong enough effect on participants’ forgiving behavior to be perceived by the partners.

Better mental health But the impact of prayer is not limited to forgiveness. In another set of studies initiated by Nate Lambert we also documented that petitionary prayer for the partner leads to greater gratitude. This is important as being grateful in life is associated with better mental health, which is, in turn, related to healthy marriage. In a third series of studies Nate was able to demonstrate that prayer influences satisfaction with sacrificing for the relationship.

In this series of studies we videotaped participants after the month long intervention. Specifically, they were asked to,

“Please describe something you have given up, or would be willing to give up, for your partner or for your relationship.”

Objective coding of the videotapes showed that those randomly assigned to the prayer condition were rated as more satisfied with sacrifice than those who had daily recalled positive partner characteristics but had not been asked to pray. Clearly such findings show that prayer has a protective effect on relationships. but does it also help when it comes to risk factors?

The answer to this question was serendipitous. As some of the research has been conducted with university students in romantic relationships, data on substance use is routinely collected, given the prevalence of substance abuse among undergraduates. I thought it was a mistake when one of my students told me that prayer for the partner had decreased alcohol intake by 50 percent. So we did the study again to make sure, and we obtained the same result almost to the same decimal point!

This finding is important, as we have documented that drinking increases the likelihood of casual sex among undergraduates, especially women.

A critical risk factor for a relationship is cheating or infidelity. In the general population 2-4% of spouses are unfaithful each year, with wives and husbands now cheating in equal numbers (and extramarital affairs are the leading cause of divorce across 160 cultures) and among students in committed relationships rates are even higher (up to 65% of couples by one estimate).

In a recent set of studies we were able to show that colloquial, petitionary prayer for the partner also decreased infidelity.

Moreover, “sanctification of the relationship,” or the process by which secular aspects of life (in this case their relationship) become perceived as having spiritual significance and character, was shown to mediate this effect. Those who had prayed for four weeks were rated as more committed to the relationship, which helps explain why there was less cheating during this period even when taking into account baseline rates of cheating.

Pray together, stay together It has commonly been said that, “couples that pray together, stay together,” and in another study we assessed the effect of praying for a partner’s well being together with that partner.

Participants who prayed with a partner for four weeks reported a greater level of unity and trust with that partner, compared to participants assigned to a positive interaction condition. Unity mediated the relationship between praying and the increased level of trust.

And what does all this mean for families? Steve Beach and I have also just finished a randomized clinical trial with 393 African-American married couples in which we added prayer to a well researched preventive program (Prevention and Relationship Education Program) to see if it increased the effectiveness of the program. As anticipated, there were no differences immediately at program completion but differences did emerge 6 and 12 months later. Those in the prayer supplemented intervention showed great intervention gains over time.

Critics of our prayer research point out, and rightly so, that praying is not like working a candy machine. We agree. When prayer reflects selfish concerns and focuses on changing the partner, we believe that it is likely to exacerbate relationship difficulties rather than improve them. Some practical advice: in your own words ask for your partner to be blessed in different ways and for discernment in how you might be a vehicle of God’s love for your partner Frank D. Fincham, PhD, is Eminent Scholar and Director at the Florida State University Family Institute. A former Rhodes Scholar, he received his doctorate in social psychology from the University of Oxford. He has been listed among the top 25 psychologists in the world.

www.together.us.com | September / October 2011

Together Welcomes Together AZ COVER•STORY

Relapse Dreams Treasure ...

(Continued from page 1)

A hidden Message? ticularly suffering the effects of the night before, a friend had said, “You can’t be enjoying yourself staggering in every night. It hurts just watching Whyg don’t you join me at BY cyou. hArLES iLLESpiE the judo school in town today? Just check it out.� ean, a patient in treatment for His suggestion appealed to me. A major substance abuse, came to mytaken groupup part of my life in the Marines was disturbed about the following at local joints, drinking. Drinking often led “using� dream she the night before: to arguments, andhad they led to fights.

More efficient fighting a great goalteaching for a street“I dreamed I waswas in the cafeteria smartpatients Brooklyn guy.

I accepted. other here how to chop lines of That day I met my teacher,she Ikolaughed Onaga, cocaine and snort them.� Though who instructed us to at the dream because of its ridiculous call him “Sensei,� the plot, Jeanword also wondered ancient mean- what it might mean, if anything,teachabout her recovery. ing “venerable er.� He looked so small andVALUE unassuming that THE OF DREAMS therepurpose was no wayarticle on is to briefly outline The of this earth I could have some of the clinical research that’s been foreseen that this man conducted the occurrence, meaning and would alterabout the rest of value of drug-using dreams. It is my intention my life. to demonstrate dreams can be He began that to drug-using exuseful in counseling plain that judo was when an clients and clinicians art informed and that about its name are the possible function this meant the serves. “gentle type of dream way.� told us that, OneHe study, a classic in the field of sub“If a robber approachstance abuse treatment, es and demands your demonstrates that alcoholics whoitdream money, you give to about drinking during of treatment tend him.�

No the onecourse of us was ever tolonger use judo to of sobriety to achieve periods hurt anyone else finding — or suggests that (Choi, 1973). This he’d belike banished from clients Jean who dream about the Onaga’s dojo. I remember thinking, “How’s he substances they are attempting to abgonna know?� stain fromweeks may be more in the A few went by,engaged and I was surprised treatment process than those patients to find myself looking forward to every day’s who don’t report drug-aspect wasn’t lost on me, lesson.

The practical for I was saving a bundle going to judo class using dreams.

In other in the evenings, rather words, these clients takethan to the bars. I was morestruggle excited,with though, their sub- by what I was actually learning and doing, how my body was feelstance abuse seriously ing, and how much I was beginning to admire enough Onaga. to dream about it atOur night.

As Freud grew into something I’d relationship observed, only matters never experienced with another. We weren’t friends, forimportance that would imply an equality we’d of greatest never have. He was my teacher, my mentor, are permitted to disturb my sleep. leader.InI this wasregard, his student and I’d have folour lowed him down whatever course he led me. I Jean’s drug using dream loved him and I felt his love for me, too. may understood as a with Onaga to the I be remember walking positive sign, dreamed dojo and from there to the public bath. He by a person is serididn’t walk who as much as he seemed to float in a sereneconcerned dance, the steps of which only he knew. ously about Hisconsequences head was always the of high and never bobbed with his steps. His shoulders were square, relapse. his back straight. His eyes lovingly took in all A more recent study around him. He was self-confident without a of crack cocaine addicts hint of cockiness, and he always had a smile who dream about on his round face drug under a helmet of steel-grey use thatOnaga without executing hair.demonstrates No one passed a deep bow.of using the content In the beginning, the strangest aspect of dreams is also important these walks treatment with my teacher was that he in predicting held my hand along the way. Now, my crowd outcomes (Reid, S. and Simeon, D., 2001). in Brooklyn did not hold hands — not with Over a ninety-day period, report A anyone and certainly notclients amongwho ourselves. their dreams changing using cocaine to kid who reached out from for another guy’s hand actively refusing tend to achieve longer had better knowcocaine at least judo, for he’d have been setofupon, pummeled and left for dead. periods abstinence.

This finding suggests But readiness holding Onaga’s hand became so natural that for change is reflected in dream and always me with a can warmth that I felt content andfilled that dream-life provide clients sure it radiated directly from within him. I with an opportunity to rehearse change. These dreams provide clients with an exposure to cravings, interactions with “using friends�

J

was proud to walk with him, pleased to hold his hand, and I was on my way to becoming a different man than my seventeen years in Brooklyn had destined.

On my first visit to his home in the farming village of Agena, I passed rice paddies and neat little houses on postage stamp sized plots, and I saw old people delicately balancing honey and typical they willIbe confronted buckets on scenarios their shoulders. was astonished with waking life after leaving In at theinchildren who would runtreatment. away, screamtheseincases, is not ing terrorthe atimportance my approach.

I placed realizedonthat their only experience Americans was the individual dream butwith the manner in which when wouldover wander dreamsoldiers content shifts time. through If clients drunk like and was embarrassed andsubstancashamed.

Jeanabusive. continueI to dream about using After the locals had seen me with Onaga, I bees, they should be encouraged to record their came a friend. The respect they accorded him dreams and notetoo. anyOn shiftmy in last content. was mine now, visit This there, as may clientsthat and counselors Iprocess crossed theinstruct little bridge led out of the about significant triggersvillage, that needthose to be adsame children came to say dressed, while challenging clients to examine their readiness to change.good-bye with bows waves.

I cried beOne particularly usefuland study of drug-using cause I knew I’d never dreams demonstrates that a client’s personal return — never again response to the dream isto more than seeimportant that beautiful dream content when it comes predicting place tothat had bea positive treatment outcome come(Brown, home to1985). me. cried, too, because The study finds that clientsIwho dream about wasmain leaving behind using substances fall intoI two categories: the man who’d taught one group experiences frustration that their me that strength was dream isn’t real and the second experifound group in gentleness ences relief that their dream and that love isn’t and rereal. The first group described as spect iswere far supehaving relapse-pending dreams.

This rior to fear and bragroup longs tovado. re-experience intoxiI’m stilltoward intimate cation and feels triggered with substance use.enough The second groupthat young man making is described ashis having recoveryjourney home to affirming dreams.

This be awaregroup thatwakes these up disturbed their dreams and realizations were onlyby vague impressions.

He was aware that thefrom life he’d and the feels repulsed actualled substance glimpse he’d allowed of clearly a trulybelong new viuse.been Clients like Jean sion for the future would beand tested back to this second group often needin New York. He wasn’t accustomed to their passhelp perceiving ing tests using this new vision. No one who using dreams as athey rechallenged him would understand that covery-affirming prolost if he were to walk away from them. He cess. may in find it himself had wrestled with thisThey concept the surroundings ruled over by Sensei.

How could helpful to inventory he triumph in Brooklyn on streets lined with their motivations for rough bars, tattoo parlors and punks whose recovery and review only vision was the primitive insight of surtheir action plan. The vival? These were streets whose rulers could using dream be sense indecision as though it werecanblood harnessed as a “wake streaming from a wounded animal. Again, the up call� challenging question, “How’s he gonna know?� occurred to him — and then he was home. clients like Jean to And so he took on thosere-examine who daredtheir him. He fought often and to kill assumptions and it became clear about to him that he had acquired a deadly weaprecovery. on. He fought to hurt others, to fit back in and to prove himself to primitives. His body wrenched in the middleDREAMS’ of a fightRELEVANT with the old anger raging against the serenity of Sensei.

MESSAGES But the congratulations from others, the free Clients with relapsedrinks, the hilarity following a confrontation dreams grew less exhilarating pending and, finally, leftwill him also need help in empty and sad. His body and mind ached. regard to receiving Sensei knew. Truth recognizes itself. a After months of struggling recedefrom into relevantto message the old skin, the youngtheman relaxed inhave the reactions they truth and thedreams. new growth took hold.

He aged to their using Counselors can direct and acquired the insight needed to fully apthese clients back to interventions that address preciate what Sensei had toiled to convey. The the contemplation stagepart of change. cligentle way was made of himThese and influents may enced thebenefit whole.from a review of the costs and consequences their substance use.

Years later ofthe not-so-young man would learn that Onaga-sandream had denied him the The relapse-pending may bring to light their impoverished view of sobriety.

(Continued onthese page 12) Counselors can challenge impoverished views and direct clients toward new be(Continued on page 17)

He was self-confident without a hint of cockiness, and he always had a smile on his round face under a helmet of steel-grey hair. No one passed Onaga without executing a deep bow.

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Photo courtesy of Jim Garner, Seattle, WA

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

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Gosnold on Cape Cod

Since 1972, a bridge back...

To hope, to life, to recovery

Quality, Affordable Treatment for the Life of Your Recovery

COVER•STORY

Treasure ...

(Continued from page 11) rank of shodan, or black belt, which he had earned with his physical skill because he failed to accept that at its heart judo is spiritual.

Some would argue that maturity, natural and always slow, had taken root.

Yet his contemporaries are occupying the same bar stools, fighting in the same arguments and drinking the same beer. He knows this so clearly because, much older and a family man now, he took his daughter on a tour of the neighborhood and learned of the lives lived by these perpetual boys with swollen bellies and old men’s faces. He felt some shame that day. It was all so obvious, so tangible. If only he could wrap up the lessons of thirty years and hand them to his little girl. Is it possible to tell her the truth and have her recognize it without the doubts, testing, failures and guilt that youth insists upon? Will

a child believe one who tells her that all she needs to know in life is held in her heart right now?

All this, and more, came back to me as I fingered my worn book. I called my daughter, and she came running from her rummaging in the basement.

“How about we share this book?” I said.

“It can belong to both of us. I’ll tell you about what it teaches and the old man who gave it to me.”

“Yes! I’ll tell Mom,” she replied. I held her shoulders, looked into her eyes and conspired with my new shareholder of treasures. “Tell Mom, too, that Daddy looks like he’s crying over his old book and that he’d like to tell you both a story tonight. O.K.?”

“O.K.!” and off she ran.

Two can play that game.

Richard E. is retired and living in the Green Mountains of Vermont. His daughter teaches autistic children and is studying for her Ph.D. degree.

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www.together.us.com | September / October 2011

TOGETHER•INTERVIEW

A conversation with

Brad Lamm

You Can’t Take the Butter Out of a Muffin Food addiction is the number one cause of death — if you include heart disease, stroke, hypertension and diabetes

W

By Courtenay Smith

hen Dr. Oz chose Brad Lamm’s book, Just 10 Pounds, to be the center of an anti-obesity initiative on his Dr. Oz Show, Lamm became one of the most famous interventionists openly talking about food addiction. As founder of the Change Institute, Lamm understands addiction in all of its forms. He recently toured the country, sharing his own story of bulimia, compulsive overeating, and drug and alcohol addiction. He urges people to break weight loss goals into manageable steps while addressing the emotions that drive overeating.

TOGETHER: Is food addiction responsible for obesity in America?

LAMM: No, that’s too easy an answer. Food addiction is a symptom of a culture that wants more. Our culture enables addiction in all different forms.

You just traveled around the country in support of your book, Just 10 Pounds, talking about food addiction. What has the reception been like?

The thing I was most nervous about turned out to be the most delicious part. I was at 12 high schools around the country talking about how food can get out of control and take away from the kind of life we want. After the talks, kids would cry and laugh and ask for help.

What were the kids crying about?

It was fat girls talking about being called “pig.” It was skinny girls talking about how their disease is the outgrowth of their mom’s eating disorder. It was kids that are heavy talking about how they’re not eating at home. Their meals are the crap that’s part of the school lunch program.

You have said that most food addicts will not identify themselves as food addicts. What do they call themselves?

They will say, “I’m addicted to sugar, I’m addicted to carbs,” but they won’t opt into being food addicts. So I try to couch the message in Just 10 Pounds as, first, starting with a love centered diet, and then, two, identifying the emotional triggers and the battleground beliefs that lead to binging and sideways eating behaviors.

Can you give me an example of an emotional trigger?

People will say, “I’m bored.” And “bored,” if you break it down, is a feeling of disconnect, a feeling of loneliness. We are all in some way emotional eaters. The most often heard complaint about why people overeat is that they are not mindful or they’re emotional. You can’t extract the feelings from the way we feed ourselves, just like you can’t take the butter out of a muffin.

Can food create a high similar to alcohol?

Oh my god, absolutely. I can think about a binge food right now — cherry pie, the buttery crust, the sugar in the berries, the thick sauce and my mouth is watering. Now, just thinking

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about it, I’m having a response. If I ate some I would have an incredible response — I would have a dopamine rush [a brain hormone that focuses attention] and it would make me feel different.

You’ve also said most food addicts will resist going to a 12-step program. Can they find another way to recover?

Absolutely. The people who say the only way is 12-step, I think that comes from a place of fear. I have clients who have broken all sorts of addictions on routes that do not include a 12-step program. If you look at the statistics, I hope it’s not the only answer because it sure isn’t very effective.

Where else should food addicts look for help?

A goal would be to expand their spiritual lives. If you look at health and recovery as an integrative path, then it naturally leads in my mind to a spiritual community. You could go to the Y, find a church, join a synagogue. It might be yoga, it might be a movement that is with other people, so that you’re noticed, and so your story is heard, so that you’re not alone.

What does hitting bottom look like for a food addict?

tion of abstinence is that I’m not purging. Now, if I’m not on my food plan, if I’m eating trigger foods, it is likely to lead to thoughts of binging and purging. Having sugar is not something that breaks my abstinence. If I binge and purge, I’m no longer abstinent.

If there is some room for sugar in your food plan, does that mean moderation works in treating food addiction?

I don’t think so. My plan is pretty rigid, actually. I’m careful about what I eat. For breakfast this morning, I had three eggs, two ounces of yogurt, and fruit. For lunch I had four ounces of fish, broccoli, baked sweet potato and whole wheat cous cous.

I have something similar almost every day. Most people would not consider that moderate.

Considering how most of America eats, you mean.

Yes. The truth is, I think sugar is a horror. If we didn’t eat it, we would be so much healthier and it would solve so many problems. I also think white flour is not healthy for us.

Food addiction treatment centers often lump bulimics and anorexics and compulsive overeaters together. Are they really all the same?

For some people it will be death. I once met a girl who weighed 75 pounds and was on a feeding tube. Then I think of my mom: I picture her in a bed, having had her life ruined due to strokes, a direct response to the way that she treated her body. She had food disorders for 40 years. But I believe we can help people create a bottom. The idea that we have to wait for them to hit bottom is nonsense.

I think that’s a treatment model that people have begrudgingly followed because of economics. In classic addiction terms, it’s the same problem. It’s the hole in the soul. But the hardest thing to treat is the compulsive overeater.

Complete this sentence: Alcoholics begin recovery by putting down alcohol. Food addicts begin recovery by …

Because when a client comes in who has 100 or even 80 pounds to lose, that physical transformation takes a year or more. Treatment creates a firewall between them and the food until the weight stabilizes. People aren’t going into treatment

Making a food plan and becoming abstinent. And abstinence means that they’re following the food plan. My defini-

Why?

(Continued on page 14)

13

T O G E T H E R • Imovies+books+theater+fitness+travel+more+ NTERVIEW

plus

Food ...Era: The Prohibition

People would rather be termed mentally ill than addicted

your head, but it’s part of a plan. Because if I’m deciding on their watching the spot with my tongue and mybuilding, nose and my senses, their and iffurmy niture being hauled out just as emotions are involved, then I’m unlikely to stay on the( beam.

Jack Lemmon and Lee Remick would do 30 person years later in “Days Do you need to find a like-minded to turn of Wine and Roses”). In his empty your food over to? apartment he 10 hasBuddy,” a briefsomebody moment I suggest in my book recruiting a “Just of clarity from a sacred music rewho is going to support you in the decision that you’re going cording played on adoesn’t neighbor’s to make changes 10 pounds at a time.

The person have it’s have his one withWhat relito be healthy themselves,radio; but they to bebrush hopeful. gion, and it doesn’t take. Soon he’s equal voting rights, began to exercise equal wo that years earlier, the you’re looking for is encouragement and inspiration. there be a diagnosable disorder that could be treated with And yet insurance has to pay the cost of all the heart panhandling pennies while his drinking rights. Ironically, one of the last director D.W. a pill, rather than an addiction, which implies a lifetime of disease treatments, diabetes mediations, the resultslegendary work to get on beam and stay on the beam. daughter apples on a street staunch defenders of Prohibition was the Griffi th made histhelast Should you expect the person tosells make comments of the extra weight caused by food addiction. corner.

Ku Klux Klan. film, “The Struggle,” in a Bronx about what you’re eating?

But they’re viewing it as a cost effective Where in the national conversation about Thanks to hissochild’s unwaverWhen the not stock market crashed in 1929,approach. studio and partly on are Newwe York First, share with them your food plan, in turning over food and where do you think we need to your food they become aning love and partner. acute loyalty, “The most efforts to enforce Prohibition virtu- streets. Written byaddiction, Anita Loos accountability If they know The addiction community accepts away. food addiction as Prefer go? Blondes”) and has athey happy ending — ally ceased.

Popular support dwindled (“Gentlemen your story, and you say, “IStruggle” had ice cream,” know whether aEven realthough disease, but do nutritionists and lossfrom a short story by the Jimmie quits drinking and is reoverall drinking declined byweight adapted that deserves a conversation.

The next couple of years are going to be huge. I’m co-hostprofessionals? stored to health, to his family and 30% during the 1920s, drinking to excess French author ing Emile Zola, it’s the Hal Skelly struggling the drink.about a lifestyle intervention conference in with September to his job in the steel mill. This was rose along with cirrhosis deaths feature-length (93 minutes) It’ssharply still a real conversation.

I just got and a letterfiarstcouple of food addiction. plans?

We’re just really starting to grapple with it in How do people find food vowsLiterally, abstinence.

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

New taking York City boasted American movie about anWe’re alcoholic days ago from a professor great offense that I’m using a new way. going and to getishonest. it’s the number I go back to this litmus test for what you put in yourself: is the word speakeasies. addiction withChicago food, saying food is not one cause of death — if you include heart disease, stroke, hy- at it sober, sipping sarsaparilla the bar with on the familyhave as the major of re30,000 mobthat boss Al addiction worth considering. loving and good?

It doesn’t to be freshinstigator – I love frozen scientifically proven, that I’m doingIpeople real ad-(Hal pertension, — that we really have a saywhite-collar in controlling.crowd a distinctly heItlongs coveries to Capone summed it and up well: “When sell withJimmie Skelly, adiabetes Broadway pro foods. doesn’t have to befrom fancy.alcoholism, I’m the kingallofthe the way friedup egg. dictions an injustice. liquor it’s bootlegging. When my patrons of the era) and Florrie (Zita Johann, who to join. The couple’s first-born daugh- “I’ll Cry Tomorrow” in 1954. “The Struggle” you thinkinfood orgrows just being into a little girl in their modest was a commercial failure, probably beserve it on a silver tray on Lake Shore Drive, would partner Do Boris Karloff “Theaddiction, Mum- ter Any final words?

Is word addiction offensive even to people overweight, number one cause of death? one-bedroom, but one night, mostly on cause it came at a time when America was it’sthe hospitality.” my”) who are initially pictured is as the a pleasant I think food is the hardest addiction to tackle, because we might be food addicts?

Will they say, call me other impulse, yields to cajoling of no longer hiding its bottles or its drinking.

In the spring of being If young there arecouple 72 million Americans who Jimmie are overweight or thehave to eat every day, and it’s a constant battle. One client’s ofthings, but don’t call me an addict?

'When I sell liquor it’s obese, hispercent hard-drinking pals and takes of one American movie audiences, we’vecookseen 1933, Prohibition swept along themaybe fri- 12 statistics sayinthat of them are classifice aisglass a horrible for a food addict.

There areasalways whiskey.

AndYou’ve another and from Daniel Okrent’s meticulously dewas repealed, with rather be termed mentally ill than they fied volity open social believe as foodand addicts.

I actually it’s half. still gotanother.

I think people would ies and cupcakes. She’s surrounded by her trigger foods. You bootlegging. When my hundreds of millions of years that you’re cutting short.

Jimmie begins drinking heavily,that tailed beginning President Franklin drinking of the wan-of livesOnce would an addict. can suggest she gethistory, anotherwere job, just but the reality istoa view perloses trigger alcohol again as to a newfound and alRoosevelt declaring son’sHe primary can once be really tough change. patrons serve it on a silver ing years of Prohibi- “The Struggle” picks up interest.

What does recovery look forjob, a food addict Do think that? his wrecks a family celebration, and most legal friend. ✺ thatyou thereally legalization tion.

Florrie’s wary of like tray on Lake Shore Drive, you’ve intervened? ofOh beer would Jimmie’s drinking and cashes in his wife’s $4,000 insurance polyes.alone Parents are my first callers, the biggest group of peo- after Courtenay Smith is a health journalist and a former editor icy to so back blondeturning schemer’satfake liquor More, increase federal tax agrees toa continuum marry this KurtFitness Brokaw is Woman's Associate Day. Teaching Professor ple who ring my help line. They are horrified that their child, I believe in of contact, thata means Prevention, and —Al Capone it’s hospitality.' haul.

With no job or income to support his revenues hun- child, is an addict. They would rather yourblue-collar steel workat The New School and senior film critic of The and it can bebyan adult food over to someone else. So it’s not happening just in dreds of millions of er/supervisor only if he family, he stands on the sidewalk outside Independent (Independent-Magazine.org). dollars. Roosevelt’s wife, Eleanor, took a dimmer view, refusing (Continued from page 13) throughout her husband’s terms in office to serve alcohol at White House dinners. It may not surfor that long, and insurance won’t pay for it. If prise you’reyou tiny,to learn that her father meaning anorexic or bulimic, generally medicalwas insurance an alcoholic. covers your treatment. If you’re big, it won’t. It’s a shame and (Continued from page 19) injustice.

When Drinking America Hid Its Bottles

T

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speci a l • f ocus

Have Yourself A Healthy Power Trip When you stop trying to control the world, you can find genuine power within yourself

I

to be yourself with another person, and to allow them to do the same with you. We call this intimacy, and it’s hard emotional work. It’s hard because it combines both detachment (letting go of control) and responsibility (noticing and expressing feelings), and demands we rise above our fear of both. But it also offers us our only chance to feel truly connected to and accepted by another human being.

Let’s be clear here. Recovery from control addiction isn’t easy. The people I know who commit to it — who decide to give up controlling and replace it with personal power — do so mainly because they’ve come to realize that being addicted is even harder.

By Steve Hauptman

f you love an addict, or live with one, or depend on one in some way, you are probably in, as the old saying goes, nine kinds of pain.

And I’m guessing that, whether or not you realize it, the very worst of these pains comes from being confused about the difference between power and control. No, they’re not the same. In some ways, they are opposites.

One difference: power is possible, but control is usually an illusion.

Another: seeking power can set you free, while seeking control can make you crazy.

Control, as I define it, means the ability to dictate reality. To get life itself — people, places and things — to meet your expectations. Power, on the other hand, means being able to get your needs met. To take care of yourself. To not just survive, but to heal, and grow, and be happy.

Here’s an example of the difference: Imagine your rich uncle dies and leaves you in control of his multinational corporation. So you wake up one morning the CEO of Big Bux, Inc. You go to your new job. You sit behind a huge desk. Four secretaries line up to do your bidding. You have tons of control. You can hire and fire people, buy things and sell things, build plants or close them, approve product lines and advertising campaigns, manage investments, bribe congressmen, you name it.

How do you feel? If you’re anything like me, you feel crippled by anxiety. Bewildered and overwhelmed by your new responsibilities. Disoriented. Panicked. Anything but in control.

You have lots of control but little power. You’re unable to take care of yourself.

Now imagine the Big Bux board of directors realizes you’re in over your head and fires you. “Here’s a severance package,” they say. “Go home and take a nap.” How do you feel now? I’d feel great. Sure, I no longer control the corporation, but my life is my own again. Giving up control has empowered me to take care of myself.

There are two other interesting differences between control and power.

Control looks outward, mainly at other people, places and things. Power looks inward, to your own feelings and needs.

So control-seeking pulls you away from yourself, away from self-awareness and self-care.

Control operates paradoxically. The more control you need, the less in control you feel. Which means if you depend on getting control to feel safe and happy, you don’t feel safe or happy most of the time. Chasing control is a lot like chasing a train you can never catch. Power, though — rooted in healthy, intelligent self-care — is a real possibility.

Addicted to control “Ideas we have, and don’t know we have, have us,” the psychologist James Hillman once wrote. Control is just such an idea.

Can you be addicted to control? I think we all are. I think it’s unavoidable. Who doesn’t hunger to be able to dictate reality?

Who doesn’t seek control constantly?

We do it in a gazillion ways, ranging from huge (starting wars) to tiny (changing channels), from mindful (driving a car) to unconscious (forming expectations), from creative (curing disease) to destructive (cutting down rain forests), and from innocuous (scratching an itch) to dangerous (beating a child).

However you explain this urge, it’s both an elemental part of human nature and the one that most clearly separates us from other animals, which pretty much have to take reality as it comes. So familiar we barely notice it, most of the controlling we do is habitual, automatic and unconscious. In fact, should we meet someone who is not automatically controlling (think: Dalai Lama) that person would probably strike us as, well, inhuman.

As a therapist I work with control addicts all the time. And

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Want to become more powerful?

I see their addiction as the root cause of most (maybe all) their emotional problems: anxiety, depression, substance abuse, bad relationship, bad parenting.

Control addicts act much like people who are addicted to substances. That’s because their behavior is driven by the same motive. The goal of any addiction is to manage feelings — i.e., to make uncomfortable feelings go away. Think about it. Whenever we seek control it’s because we’re convinced we’ll feel better with it than without it. We think dictating reality will allow us to avoid some sort of discomfort: pain, anxiety, boredom, anger, confusion, embarrassment, fear.

So control addicts use controlling behavior in essentially the same way that substance abusers use alcohol, drugs or food.

And like other addictions, theirs takes over their lives, and leaves them compulsive, narcissistic, self-defeating, largely unconscious, and damned hard to love or live with.

Try giving up control But what makes controlling an addiction as opposed to, say, just a bad habit? Several things, but here’s the most obvious: Addictions are famously difficult to give up.

Try giving up control for a day, and see how you feel. Try giving up control for ten minutes.

We tend to over control two things: our own feelings, and other people. Over controlling feelings makes us anxious, depressed and addicted. Over controlling other people ruins our relationships.

The antidote to over controlling relationships is being able

Here are seven ways to do it: 1. Detach. Let go of what you can’t control anyway. That may be a situation, or a person, or that person’s behavior. If it’s a person you love, you can detach with love, as they say in AlAnon. Detaching doesn’t mean you stop caring. It just means you acknowledge your limitations. And when you do that, an enormous relief often follows.

2. Refocus. Start by shifting your focus from outside — people, places and things — to inside — your own needs, thoughts and feelings. Happiness is an inside job, and most of the answers you need are there.

3. Take care of yourself. Stop over controlling yourself, and learn to listen to your body instead. Hungry? Eat. Tired? Sit. Rest. Maybe take a nap. (Naps are great.) Lonely? Seek out safe people. Angry? Scream (into a pillow, maybe, so you don’t scare the neighbors). Sad? Let yourself cry. It’s how the body naturally relieves tension, and it helps.

4. Educate yourself. You’re not crazy; your pain means something. Your job is to find out what it’s trying to tell you.

After his first Al-Anon meeting one of my clients told me, “It was like a light coming on in a dark room, and suddenly I could see all the furniture I’ve been tripping over.” Hey, why live in the dark if you don’t have to?

5. Get support. No one gets through life alone. Even if you could, why would you want to? Seriously consider checking out a self-help program, like A.A., Al-Anon or Nar-Anon or CODA. You’re probably scared of that first meeting. That’s okay; everyone is. Go anyway. It won’t kill you, and you can’t know beforehand what you’ll hear. A good meeting can save your life and your sanity.

6. Listen to feelings. This is a big one. Living with an addict usually requires hiding your feelings, sometimes even from yourself. But feelings are essential. You need to get them back again. Hang out with people who are trying to reclaim their feelings, and who can keep you company while you’re trying to reclaim yours.

7. Have faith. Develop your spiritual life. No, you don’t need to join a church. You don’t even need to believe in God. You do need to believe in something bigger than you, something you trust even when you don’t understand it. Call it Nature. Call it The Force. A.A. and Al-Anon call it Higher Power, but you can call it what you like.

I used to reject the idea of God, but I always believed in psychology. Then I heard Scott Peck suggest that it’s not unreasonable to replace the word God with the word unconscious.

That permanently reframed the idea of God for me. I realized there was some intelligence inside I could listen for, and which would guide me if I let it. I might doubt the existence of God, but who can doubt the existence of that voice? The part that Knows Better? So that gave me something to trust. Hey, we all need some invisible support.

Steve Hauptman, LCSW, is a therapist practicing in Mount Sinai, New York. A Gestaltist and leader of interactive therapy groups, he is coauthor — with his “inner monkey,” Bert — of the blog "Monkeytraps: A blog about control" (http://monkeytraps.com). He is also writing a book titled "The Illusion of Control." Steve can be reached at fritzfreud@aol.com.

15

COVER•STORY

What If ...

(Continued from page 1)

Sound familiar?

If you have an addict in your life, you no doubt recognize that the well-meaning family is “enabling” Rose. Enabling is, in a nutshell, helping. Jack and the family are enabling Rose to stay aboard the Titanic. I hope to shed some light on why they continue to do that as well as healthier and more effective alternatives.

In the addiction field, to enable means to help sustain the dysfunction in another, thereby encouraging and reinforcing the dysfunction. If you have done your share of bailing water, this will feel a bit pejorative, but the fact is we all do it and most of us do it unwittingly. So if you’re going to read on, you must be willing to cut yourself some serious slack. Recovery isn’t about blame; it is about throwing our energy and intelligence at the solution rather than the problem. It is our personal responsibility to examine whether we are adding fuel to the fire and take the necessary steps to stop it.

First and foremost: the lifeboat remains anchored next to the Titanic while there are people still on it. It is critical that the family gets – and remains – committed. The reason for this is simple although largely misunderstood: addiction is a brain disease that strips the addict of the ability to help himself. Recent advances in neuroscience have generated new understandings in the addiction field like nothing we’ve seen before. Neuroimaging is revealing the inside of the addict’s brain under all sorts of conditions, and what we see is tantamount to a neurophysiological pinball game that has left him with only a smattering of clear-thinking moments.

This makes it an absolute necessity for someone else to be in the driver’s seat if he is to survive. While this news is usually

16

very well received by the “Chief Enabler,” who immediately homes in on the driver’s seat like a heat-seeking missile, it is the trained addiction professional who should be relegated as both driver and navigator. The family will take the passenger seats, and if you can get the addict in the trunk for the time being, so much the better.

To buy into this seating arrangement you, the passengers, must know what you’re up against. You need to know what science knows about the changes that have occurred in the brain of the addict if you are to respond effectively.

We’ve come a long way from shock treatments and lobotomies when it comes to the brain. As a recovering alcoholic, I am deeply appreciative of the scientific explanations for what can only be described as unfathomable behavior during my drinking years. Take heart: everything you need to know about the addict’s brain can be summed up in one paragraph.

An addicted brain We know that different parts of the brain handle different functions. We know that two of them, the neocortex and the limbic system, account for most of the addict’s insanity.

Our neocortex, especially the prefrontal cortex, is the reasoning, moral, law-abiding, free will, good judgment part of the brain. This is the home of our personality, the things we dream about and love; there’s even a little section in charge of weighing future consequences against short-term gain.

Then there’s a much older, deeper part of the brain; the midbrain or limbic system – we call it the “reptilian” brain because it is so primal that all those beings from reptiles up the ladder rely on it for minute to minute survival. It is a very automatic, unconscious and instinctual part of the brain, the part that evokes the fight or flight response, for example.

In a healthy brain, the cortex listens to what the midbrain has to say, makes a split-second decision, and then tells the body what to do. In a healthy brain then, the reasoning cortex overrides the instinctual midbrain. However, an un-

fortunate roll of the genetic dice, coupled with early childhood stress added to adolescent risk factors and thrown into a pitcher of any mind-altering substance, will very likely produce a drug addict, irrespective of whether the drug is alcohol, prescription pills or crystal meth. And because all drugs work solely within the reward center of the limbic system, they “trick” the brain into misperceiving that the addict needs the drug to survive. I’m skipping heaps of research here to get you to the bottom line: addiction breaks the prefrontal cortex and the midbrain in such a way that the reasoning, moral brain is at the mercy of the primal, survival brain. The survival brain of the addict has become an omnipotent dictator whose singular mission is to keep taking drugs at any cost.

Animal Planet can always be counted on to provide the perfect metaphor. What happens to the brain of an addict is nicely illustrated by a species of parasite that lives in the stomach lining of the estuarine snail. For survival’s sake, these snails burrow into the ground so as not to stand out and make themselves easy prey. This living arrangement suits them both until it’s time for the parasite to reproduce.

It turns out that to reproduce the parasite requires an environment only found within the belly of a particular species of bird (Mother Nature is nothing if not quirky). When the parasite is ready to pass on its genetic material, then, it makes its way into the brain of the snail and “makes” the snail “feel like” coming out of the shadows and into the sun.

This is where nature really deals the snail a blow — once out in the open, the hapless snail sprouts orange antennae. In the bird world, this is tantamount to wearing a flashing light on top of your head; the bird eats the snail and the parasite is now in the belly of the bird ready to mix it up. My point: just as the parasite hijacks the brain of the snail, the biological effect of addiction hijacks the frontal cortex. We could blame the snail for being stupid and causing his own demise, but, to be fair, how much choice did he have once the parasite took over his brain?

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COVER•STORY Addiction is a parasite, a cunning predator that seeks to come up from behind and strike while you are facing the other way. This makes it vital for us to heed whatever wake-up call comes our way and stay mindful about our choices. Just as families and friends of the addict did not cause the addiction, there is nothing we can do to cure or even control it.

Nonetheless, the addictive family system is always a cocreation. Consciously or unconsciously, there is often much the family is doing to perpetuate the dysfunction, typically some form of caretaking or controlling. We lose way too many people due to a very understandable error: in an effort to do something, we focus on the short-term goal of putting out a fire or making the addict more comfortable instead of keeping our eyes on the long term goal of healthy recovery. It is very rare that an action achieves both. We cannot please the addict and move toward a healthy resolution at the same time. This is in keeping with the paradigm of operant conditioning that we know to be true: we should be rewarding only those behaviors that we want to see repeated. If we’re financing, rescuing, cleaning up after, accepting excuses or allowing ourselves to be bullied off our mark, we are reinforcing what they just did to get them into the trouble in the first place; what feels like helping has actually strengthened the addiction and the problem behavior. Notwithstanding our feelings of love, it is a mistake to think that letting addicts dictate the rules or preventing them from experiencing pain, hurt, frustration and even danger is an act of love. We can, as they say, kill them with kindness.

Along these lines, some of us are made to feel as though we’re in a court of law with the burden of proof on us. Addicts would make excellent litigators if only they would use their power for good. Let’s be clear about this because I hear it a lot: you are under no obligation to provide evidence when it comes to drinking or drug use. The fact is, close family members have the instincts of a nocturnal moth (the male nocturnal moth can tell at an astonishing distance whether another moth is female and the current phase of her cycle; this would be like Neil Armstrong standing on the moon intuiting where Mrs. Armstrong is and whether she is experiencing PMS). It is not all that unusual for an addict to fool a urine analysis; not once, however, have I seen an addict fool the instincts of a parent or spouse.

Why we do it See if these common reasons for enabling feel familiar.

We don’t see ourselves doing it. It is not uncommon to see one parent over-controlling the addict’s affairs while admonishing the other for over-caretaking. Enabling behaviors can feel right because they do solve the problem du jour and, in fact, they might well be appropriate if they weren’t being done for an addict.

We are protecting ourselves from our own feelings. Fear, sadness, grief and anxiety come with the territory so they should be felt, but we often attempt to outrun them with problem-solving, busy work and the illusion of control.

We are unwilling to deal with the addict’s reactions. And who can blame us? As an interventionist, I can attest to the fact that antagonizing an addict is on par with poking a hornet’s nest. This is particularly hard on conflict-avoiders.

We are uninformed. Historically, addiction has been steeped in commonplace misconceptions and fallacies that drive our actions and block any possibility of recovery: you can’t help an addict until they want help; there’s nothing we can do; if I just solve this one last problem things will be OK; it’s just a phase.

We want assurance that non-enabling will work before we relinquish our old ways. The risk feels too high; “what if ” paralyzes parents. There are no guarantees, because inherent in life is risk for ourselves or our children. There are, however, exhaustive clinical data documenting predictable outcomes for anything ever tried on the addict. For the most part, we know what does and doesn’t work.

We are acting on what we were taught to do as kids. Keep a peaceful and stable home and, if that’s no longer possible, keep up the image of a peaceful and stable home; put up a brave front; don’t air your dirty laundry in public; don’t let them see you cry.

We don’t grasp, or perhaps trust, that our ability to effect a solution is based entirely on those things we can control.

Rather than sticking to healthy boundaries and inspiring the addict to seek help, we wear ourselves out by focusing on what we cannot control and working harder than they at their life.

We are receiving some form of secondary gain. Conserving

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energy by taking the path of least resistance, feeling needed, gaining the acclaim of others who may see us as heroic, being in a perceived control position all reinforce our enabling.

We don’t know how to stop and/or we don’t have our own support system in place, which, in my experience, is a critical foundational piece.

Every recovering person will tell you the same thing:

I didn’t stop until the pain was big enough.

Sow, seed, water, wait If you are a gardener, you don’t plant a tree and then watch it around the clock, micro-manage its growth, try to talk some sense into it, plead with it or nag it if it’s not growing fast enough. Most of us don’t use force on our flowers. We care for the soil with water and fertilizer, make sure the sunshine is plentiful and it’s protected from the stresses of the environment while it develops its root system. We have the power to influence and mediate its growth, but we don’t have control.

A very unnerving paradox for the family is the more we try to control the addict’s behaviors, the less successful we are.

The following questions help us gauge whether our next action supports the lifeboat or the Titanic, and I encourage you to laminate the list and refer to it before doing anything for the addict (or anyone else for that matter). We’re aiming for what I think of as filtered help, a hand out not a handout. Professional guidance is instrumental in navigating the nuances and exceptions of this list because, and this one’s from the Dalai Lama who knew a thing or two about peaceful resistance, “one must learn the rules well in order to know how to break them properly.”

Was I asked? Many of us are adept at solving the addict’s problems before they even appear on his radar screen. Unless we are asked, particularly when it comes to advice giving, we are interfering and our motives can likely be traced back to our own fears and needs.

Am I suffering as a result? Is this taking time, money, energy that I don’t want to give? Is this taking away from my other relationships?

What are my feelings? Resentment, anger, feeling taken advantage of, victimized, unappreciated, used, over-extended or exhausted all indicate enabling. When you swallow these

feelings, you can count on seeing them again in the form of depression, anxiety and physical illness.

Is this something a (insert age)-year-old person should be able to do for himself? This is a “whose responsibility is it?” question. Even though we’re often asked to help, when we pick up after or take over for the addict they receive this message: “You can’t do this for yourself because you are lazy, irresponsible and/or incompetent and you can’t be trusted to run your own life.” The addict’s eroding self-worth goes from bad to worse, causing a physiological domino effect that mobilizes craving and compels the addict to drink/use. If you’re a parent, ask yourself whether you would do his homework for him.

Because that is an exact analogy. The class is Life 101.

Have similar responses on my part proven successful in the past? Look at the evidence: is the addict one inch closer to recovery or has it been one step forward, two back? If nothing changes, nothing changes.

Am I allowing the addict to fully experience all the consequences of his own choices? You are not causing a problem for the addict; you are simply not interrupting the natural effect of a problem they caused. Interrupting any natural or logical consequence includes any form of fixing, financing, solving a problem they made, helping to solve a problem they made, being overly-responsible, protecting them from reality and truth, trying to spare them suffering.

Despite the 28 years between me and my last drink, I recall with absolute clarity the heart-sinking laments of my family, the loss of job after job, my failed marriage, numerous emergency rooms, the inside of a jail cell and life at the Salvation Army homeless shelter. It all felt like a slap on the wrist compared to the searing agony of my cravings. Every recovering person will tell you the same thing: I didn’t stop until the pain was big enough. Only by experiencing hurt, frustration, loneliness and fear can the addict reach his personal “bottom,” which is essentially a pain threshold. Allowing addicts to take responsibility for themselves is not the same as blaming or punishing them.

There is a difference between fault and responsibility.

They’re bound to be disagreeable about this so I like to blame Isaac Newton and his First Law of Motion: for every action there is a re-action equal in magnitude but opposite in direction. If you rob them of their re-action, you are robbing them of the opportunity to grow. They don’t need lecturing, nagging, scolding or threatening. They do need to know: a) There is a problem. b) It’s MY problem. c) I can handle my problem. For the recovering addict, this is critical to the development of coping skills, strength and emotional maturity as well as self-confidence and self-worth (the operative word here is self, which implies that we don’t get these things when others step in for us).

Letting go, letting God The beauty of this age-old saying is that it doesn’t matter if my God is the Divine Rhythm of the Cosmos or a Benevolent Father or the Buddha or, a particular favorite of Star Wars fans, The Force. To let go does not mean to turn away or to stop caring or to cut myself off. It means I must make my peace with the reality that I can’t do it for someone else no matter how much I want to, and the outcome is not in my hands. Then it becomes a matter of trust between my God and me. It works best for me if I think of letting go in order to let God. How you address addiction in your family is just as important as doing it. I’m borrowing from a person who made it much higher on the evolutionary ladder than I. During an interview with a Phoenix radio station, Mother Teresa was asked by a caller, “What can I do to help others?” Her response has stayed with me over the years. “It is not a question of what – there are opportunities everywhere you look. “ How,” she said, “that is the trick.” I believe she meant that any hand extended must be extended in grace. As you make your way up to the summit of this, or any other, personal Everest, my hope is that you gain a deep knowing that anything is possible in the presence of grace. And a Sherpa.

Janice Blair received her PhD in clinical psychology from Arizona State University and is trained and experienced in the assessment and treatment of psychiatric disorders, with a specialty in addiction. She is in private practice in Scottsdale, Arizona, offering individual, family and group counseling as well as intervention services. For more details: visit www. drjaniceblair.com.

17

RESOURCES

Do You Need Help?

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.

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 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 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

Contact Together

High Stakes Addic Fear

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Resources & Links

12-step organizations

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adultchildren.org nycalanon.org nyintergroup.org chapter9couplesinrecovery.org canewyork.org codependentsnyc.org nycma.org danyc.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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question again: “So I’d feel embarrassed and awkward, then what?� Keep following the fear through to the endgame. You’ll find your resiliency and sense of perspective as you keep asking, “So what?�

3. Ask, by “Isbit true?� Whatever obbe mcg inLey the little voice of fear is saying, it’s probably not true.

The fearful part of us is irrational and overhen you read the words protective. It might be saying you are likely addict,� what is a risk, or to fall flat“gambling on your face if you take thewill firstlike image that comes that no one your ideas.

It might be tomoving mind? Ato mob typecity male, saying that a new could ruin puffing on a cigar a dark room your children, orinchoosing theplaying wrong job could havoc on your life. you poker wreck with shady looking people asWhen we hear ask yourself, “Is oftenfear-based see depictedthoughts, in crime movies?

Or what this is saying true?� or,that in author maybe it’s voice a woman in a bold dress is Byron Katie’s “CaninI the be absolutely too tight, withapproach, heavy makeup wee sure that this thought is true?� answer hours of the morning in a casino? The Because to these questions — especially the latter of the stigma all addictions carry, and the one — is most often “no.� fact gambling addiction is sothe wellvery cool 4.that Connect to love. Here’s hidden, rarely do we visualize someone thing about our human consciousness. We struggling gambling addiction as an can’t be inwith a state of fear and one of love average looking person going about life. Each at the same time.

They can’t coexist. gambling disoneLike blotsother out addictions, the other. When wedoesn’t are really connected to studies that mysterious energy 2%that criminate and show that between is3% love, weU.S. connect to a softness, safety, a of the population will have a gambling comfort, a healing. problem in any givenFear year,vanishes. thereby affecting So when you are stuck in fear, reconnect millions of people in the United States alone. to love.

Listening to a favorite song, Gambling addiction has devastating doing something you love, focusing on a picture effects on family and friends, destroyof a loved one, or connecting with nature ing lives as well as livelihoods, todaypeople are all good ways to do this.and Many gambling addiction is not only found in own find that a short meditation on their breathing or reaching out to a higher power in prayer reconnects them to love. Giving — time, money, a gift or a heartfelt compliment — to another person also connects us to love.

Use whatever process works for you. You’ll

know you’ve reconnected to love when you feel that sense of harmony and comfort and softness returning. If you aren’t sure what helps you easily and swiftly reconnect to love, start experimenting. All of us need a set of strategies for connecting to love when we get fearful, anxious, resentful or off balance.

5. Let fear be your traveling companion. Much of the time we can soften or even entirely lift our fears using the tools above, but sometimes, fear persists. Then it’s time for this tool: let fear be your traveling companion. Let it be there, but not in control.

Let it be there, but don’t take direction from it or stop moving forward because of it.

This is a skill. It’s a skill to learn to act in the face of fear, to allow it to be present but not to interfere.

You know when you are driving on the highway, and right next to you, one lane over, there’s some guy hanging out the window, keeping pace along side of you? He’s not in your way but he’s in your field of vision?

Think of fear that way: as the guy in the national gambling lane next to you.problem You are in the driver’s seat, Awareness week in your own lane, moving forward. He’s is March 6-12, 2011. next to you, not blocking you but just there, The goal of this week is to educate theThe somewhat irritating, palpably present. general health care ride would feel public more and enjoyable and free if he wasn’t there, about but you getting to your professionals theare warning signs of destination fine anyway. problemjust gambling and raise awareness Learn to the walk with this wayboth — as if about help thatfear is available it’s your uninvited traveling companion — locally and nationally. Please visit intrusive, but not in the way. http://www.NPGAW.org/ for ideas and more information.

Tara Sophia Mohr is a writer, coach and personal growth teacher in San Francisco.

She received her BA cum laude in English literature from Yale, where her studies focused on Shakespeare. She also received an MBA from Stanford University. Visit www. taramohr.com for more of her articles on personal growth and spirituality.

A look at gambling

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those have d Pat a prog the tra ing ab This le which proble unsucc lar eve For proble and m as spor stocks excitem applyi howev one th drugs, emotio contro If a bling p conseq best re a train

Correction:

SEAFIELD in theTheHamptons article “This Is Your Brain Alcohol & Substance Abuse In aTreatment Blackout� in our last issue incorrectly stated that Paul Cox Where the healing begins.....

had confessed at an A.A. meeting

to two murders. In fact, he con-

A.A. members who were Adults - Adolescents - Family - fessed Men &toWomen not in a meeting at the time.

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FINAL•WORD

"Geez, Mom, You’re a Drunkard ?"

I delayed telling the children that I am an alcoholic, and then one night my hand was forced

N

school friends came to an A.A. Big Book meeting I was leading at the school she and they attended during the day. It was an awkward moment … no kidding. When the meeting ended I secured half an hour's grace period from them so I could hurry over to where my daughter was swimming and tell her my deep dark secret. “I think it will really help her,” her friend said as I left the meeting.

So I told her. “Geez mom,” she said. “When you said you had to talk to me I thought someone had died!” Initial relief, however, turned into astonishment, or something close to it. For months afterward everything she said to my husband was divided into BMA (before mom’s announcement) and AMA (after mom’s announcement).

Finally, eventually, the news was integrated into everything else she was learning about the world, and became a sort of non-issue.

By Anne M.

ot long ago I was reading a book for work called The Essential Drucker. Written by a famous management guru, Peter Drucker, it contained his collective wisdom gathered over many decades and even reflected some of what I frequently heard in A.A. meetings.

One night, around nine-thirty, my middle son came in my room to kiss me good night. Having recently graduated from his fifth grade DARE (Drug Abuse Resistance Education) program, he became distraught when he saw what I was reading. “Why are you reading a book about being a drunkard?” he exclaimed, visibly shaken.

While the episode was humorous, the irony couldn’t be ignored. The truth is that for several years I was essentially just a drunkard. Fortunately he was just too young to remember it.

My children were 1, 3, and 6 years old when I came into AA. Over the years I had often pondered when the “appropriate” time would be to tell them my terrible secret of being an alcoholic. My husband, a “normie,” wasn’t much help. Various sponsors had had various ideas about the timing, and some friends in the program wondered why I hadn’t told them already.

Finally, in all of my wisdom, I decided 16 was the right age for them to be when I revealed my truth. For one thing, it was sufficiently distant in the future that I could forget all about it, a not inconsequential consideration.

The door is open

Choppy family waters The years passed, and our first-born, a daughter, turned 16. I knew she would be the toughest one to tell because she is most like me, displaying at an early age all of the “isms” I am so intimately familiar with. She already felt “different,” and claimed she must be adopted, since she felt no affinity with our family. I decided to wait to talk with her. Rocking the already tippy boat of our household, one that consistently seemed to be in moderately choppy waters already, felt unwise. Our late-in-life marriage, the quick addition of three children in five years, rampant ADHD with undertones of OCD in the father and children, and financial challenges galore were to be topped

What is the upshot? I’m not so sure I know, and I doubt the effect has ended yet. Like a pebble thrown into water, I believe the information continues to move outward. Certainly my daughter now sees me for the fallible human being I am, and that is good. When, as happens too regularly in our town, another drunken teenager wraps a car around a tree and dies, we can discuss it openly. She knows I am coming from an authentic place and not one of judgment or piety that few 18-year-olds can relate to. We can talk openly about addiction, and I can worry about her to her face rather than behind her back.

I wouldn’t say we are out of the woods yet. No parent of teenagers is. But we do have a shot at keeping an open door on our communication, and for that I am very grateful. I believe knowing what she knows will help her. If knowledge is power, as it surely is, she has the right to know about our propensity toward addiction, and I pray each day it will empower her in her struggle against this disease, which I believe she will surely have to fight.

And then, of course, there are still the other two children I must tell. Fortunately they are only 15 and 12 … and that means I can put it off, for at least a little while.

If knowledge is power, as it surely is, she has the right to know off by the revelation of my alcoholism? Maybe not just yet, I reasoned.

So it was that my daughter was 17 when my hand was forced. It happened because one evening two of her high

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