Oct14 issue by The Sober World,LLC

THE DEATH OF ROBIN WILLIAMS – A WAKE UP CALL THE FOUR LEVELS OF TRANSFORMATION DEATH OF A FAMILY STAY CLOSE: A MOTHER’S STORY OF HER SON’S ADDICTION SOLO-MOMS AND TROUBLED SONS AFTERCARE A MUST IN ADDICTION RECOVERY RELAPSE PREVENTION THERAPY: AN OVERVIEW THE ANSWER IS THE EMOTIONAL SELF – RELIANCE THE GIFT OF EMOTIONAL TRANSPARENCY FOR CHILDREN

THE SILENT ASSAULT ON AMERICANS WITH ADDICTIONS - NOW IS OUR TIME IN ADVERSITY LIES OPPORTUNITY EFFECTIVE PSYCHOSOCIAL APPROACHES FOR ADOLESCENT SUBSTANCE USE CHOOSE YOUR WORDS WISELY, THEY REALLY MATTER! MY LIFE AS AN ADDICTLIFE ISN’T ALL IT’S CRACKED UP TO BE A SUCCESS STORY NO WILLPOWER NEEDED: WE MUST TREAT THE DEEPER MIND!

A LETTER FROM THE PUBLISHER Dear Readers, I welcome you to The Sober World magazine. The Sober World is an informative magazine that’s designed to help parents and families who have loved ones struggling with addiction. We are a printed publication in South Florida, as well as an online e-magazine reaching people globally in their search for information about Drug and Alcohol Abuse. We directly mail our printed magazine each month to whoever has been arrested for drugs or alcohol in Palm Beach County as well as distributing locally to the schools, colleges, drug court, coffee houses, meeting halls, doctor offices and more throughout Palm Beach and Broward County. We also directly mail to many rehabs throughout the state and country. Our monthly magazine is available for free on our website at www.thesoberworld.com. If you would like to receive an E-version monthly of the magazine, please send your e-mail address to patricia@thesoberworld.com Drug addiction has reached epidemic proportions throughout the country and is steadily increasing. It is being described as “the biggest man-made epidemic” in the United States. More people are dying from drug overdoses than from any other cause of injury death, including traffic accidents, falls or guns. Many Petty thefts are drug related, as the addicts need for drugs causes them to take desperate measures in order to have the ability to buy their drugs. The availability of prescription narcotics is overwhelming; as parents our hands are tied. Purdue Pharma, the company that manufactures Oxycontin generated $3.1 BILLION in revenue in 2010? Scary isn’t it? Addiction is a disease but there is a terrible stigma attached to it. As family members affected by this disease, we are often too ashamed to speak to anyone about our loved ones addiction, feeling that we will be judged. We try to pass it off as a passing phase in their lives, and some people hide their head in the sand until it becomes very apparent such as through an arrest, getting thrown out of school or even worse an overdose, that we realize the true extent of their addiction. I know that many of you who are reading this now are frantic that their loved one has been arrested. No parent ever wants to see his or her child arrested or put in jail, but this may be your opportunity to save your child or loved one’s life. They are more apt to listen to you now than they were before, when whatever you said may have fallen on deaf ears. This is the point where you know your loved one needs help, but you don’t know where to begin. I have compiled this informative magazine to try to take that fear and anxiety away from you and let you know there are many options to choose from. There are Psychologists and Psychiatrists that specialize in treating people with addictions. There are Education Consultants that will work with you to figure out what your loved ones needs are and come up with the best plan for them. There are Interventionists who will hold an intervention and try to convince your loved one that they need help. There are detox centers that provide medical supervision to help them through the withdrawal process,

sen. There are long term Residential Programs (sometimes a year and longer) as well as short term programs (30-90 days), there are Therapeutic Boarding Schools, Wilderness programs, Extended Living and there are Sober Living Housing where they can work, go to meetings and be accountable for staying clean. Many times a Criminal Attorney will try to work out a deal with the court to allow your child or loved one to seek treatment as an alternative to jail. I know how overwhelming this period can be for you and I urge every parent or relative of an addict to get some help for yourself. There are many groups that can help you. There is Al-Anon, Alateen (for teenagers), Families Anonymous, Nar-Anon and more. This is a disease that affects the whole family, not just the parents. These groups allow you to share your thoughts and feelings. As anonymous groups, your anonymity is protected. Anything said within those walls are not shared with anyone outside the room. You share only your first name, not your last name. This is a wonderful way for you to be able to openly convey what has been happening in your life as well as hearing other people share their stories. You will find that the faces are different but the stories are all too similar. You will also be quite surprised to see how many families are affected by drug and alcohol addiction. Addiction knows no race or religion; it affects the wealthy as well as the poor, the highly educated, old, young-IT MAKES NO DIFFERENCE. This magazine is dedicated to my son Steven who graduated with top honors from University of Central Florida. He graduated with a degree in Psychology, and was going for his Masters in Applied Behavioral Therapy. He was a highly intelligent, sensitive young man who helped many people get their lives on the right course. He could have accomplished whatever he set his mind out to do. Unfortunately, after graduating from college he tried a drug that was offered to him not realizing how addictive it was and the power it would have over him. My son was 7 months clean when he relapsed and died of a drug overdose. I hope this magazine helps you find the right treatment for your loved one. They have a disease and like all diseases, you try to find the best care suited for their needs. They need help. Deaths from prescription drug overdose have been called the “silent epidemic” for years. There is approximately one American dying every 17 minutes from an accidental prescription drug overdose. Please don’t allow your loved one to become a statistic. I hope you have found this magazine helpful. You may also visit us on the web at www.thesoberworld.com. We are on Face Book at www.facebook.com/pages/The-SoberWorld/445857548800036 or Steven Sober-World, Twitter at www.twitter. com/thesoberworld, and LinkedIn at www.linkedin.com/pub/patriciarosen/51/210/955/. Sincerely,

Patricia

Publisher Patricia@TheSoberWorld.com

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THE DEATH OF ROBIN WILLIAMS – A WAKE UP CALL By Fred Von Stieff, MD, AAFP, ABAM, CSAM, ASAM

The shocking tragedy of Robin Williams’ death has left many with questions. Why did this comic genius suffer such severe depression that he was moved to take his own life? What possible role did his past struggles with drug and alcohol addiction play in this decision? Could a change in common treatment practices have prevented this from happening? These questions, and many more like them, have been brought to my attention after weighing heavily on the minds of patients I treat for depression and chemical dependency. As an addictionologist and family medical practitioner, I only wish I had had the opportunity to meet and treat him before it was too late. Robin Williams’ life shows that drug and alcohol addiction and depression have nothing to do with one’s intelligence or artistic talents. Rather, it is all in the neurotransmitters. Often at the source of severe depression and substance abuse, there lies a genetic neurochemical imbalance. Each individual’s genetics contain the code that builds the nervous system, including the neurotransmitters our brain needs to function properly. Many of us are born with deficiencies in one or more of these neurotransmitter systems. People with depression often have genetic imbalances within their serotonin, dopamine, and/or noradrenaline neurotransmitter systems. People struggling with these imbalances are more inclined to become addicted to certain kinds of substances. Cocaine, for example, is one of the most powerful dopamine stimulants out there. High doses of alcohol result in a highly euphoric dopamine release that is commonly achieved right before a person blacks out. Hence, it is easy to see why people who suffer from depression due to a deficiency in their dopamine neurotransmitters so easily become addicted to alcohol and other dopamine stimulants. Recent findings reveal that the culprit behind countless cases of alcoholism, drug abuse, and depression is a dopamine neurotransmitter deficiency. In fact, the driving force behind heavy drinking, methamphetamine and cocaine abuse is almost always cravings for the stimulation that only high dopamine release can provide. But the dopamine neurotransmitter system is not an isolated entity. Understanding the connections that exist among the eight neurotransmitter systems involved in chemical dependency is absolutely vital to finding solutions to most chemical dependency problems that exist in our society. Even certain cases of opiate addiction have been found to result from the addictive dopamine release that comes from opiate neurotransmitter stimulation. Why does this knowledge matter in cases like that of Robin Williams, and millions of others who suffer from depression and alcoholism or perhaps cocaine addiction? Because once doctors know the source of the problem, they can then prescribe the best-suited medication. Typically when a patient comes to a psychiatrist with depression, the doctor will go through every drug in their armamentarium, trying to find the right combination of neurotransmitter-stimulating medications, usually trying those that stimulate the various subtypes of serotonin first. (Serotonin adjusters do work well for many kinds of depression, but usually not for the more severe cases.) Meanwhile, during the weeks or even months of trying medications that don’t work for their particular kind of depression, the slippery slope of suicidal depression can overcome the patient, leading to catastrophic decisions. On the other hand, if psychiatrists or medical doctors look into patients’ past substance abuse and find cocaine use, high dose alcohol use, or even opiate abuse, they can guess the person has a dopamine deficiency. They can then proceed to prescribe the best corrective medication the first time, pulling them out of their deep depression. Robin Williams’ history of cocaine use and heavy drinking are strong indicators of a dopamine deficiency. Cocaine is one of the most powerful dopamine drugs out there. Additionally, a dopamine

release occurs only after extended heavy drinking. It appears he chased after the dopamine high. Studies with rats show tracks that excite the nucleus accumbens to release dopamine and cause an imbalance that’s formed in the brain with even just one dose of cocaine, meaning the brain immediately gets ready for the next dose. Once those tracks have been placed and the imbalance created, individuals crave more drugs to help stay one level above depression. It can be an endless cycle. Unfortunately, there are not many medications that increase dopamine production, aside from Wellbutrin, Abilify, and some benzodiazepines like Xanax (which carries its own addictive dangers). It would be of great help if pharmaceutical companies could come out with other safe dopamine stimulant medications. Finding the right dopamine medication can do wonders. I have seen lives completely turned around due to finding the right medication that provided patients with the correct neurotransmitter stimulation required to feel normal, escaping the pit of depression. Aside from the right corrective medications, intense therapy is a vital component to treatment. My job as an addictionologist is much like being a mechanic, using the tools of the mind, adjusting neurotransmitters until that ideal balance is attained, where thoughts are clear and cravings are eliminated. If more psychiatrists and other doctors focused on the vast influence that neurotransmitters have in behavioral and mental health, there would be a lot more successful detoxifications and treatments, with fewer relapses and more lives saved. The death of Robin Williams deeply affected many in this nation because many of us saw a little of ourselves in this extraordinary man. One out of ten Americans struggle with some form of substance abuse and many more suffer from depression. Robin Williams suffered from depression and had bouts with alcohol and drug addiction, yet he was known for his phenomenal career, candid approach to life, and outstanding acts of kindness with his charity work. Robin Williams’ life reminded us to not let our struggles define us, but rather continue to overcome them and strive to be something better. Let his passing remind us of the necessity to seek help and reach out to those in need of our support. Addictionologist, Dr. Fred Von Stieff is one of the most sought-after doctors in California due to his discoveries surrounding imbalances within the neurochemicals of the brain, and his pioneering methods of preventing relapse. His research proves there is more behind addiction than previously realized. Genetic neurochemical imbalances are the culprits behind countless cases of alcoholism, substance abuse, depression, bipolar, and other psychological disorders. Pinpointing the exact sources of these mental health issues takes away from the guesswork previously inherent to chemical dependency treatment, making possible administering effectual treatment the first time. You can learn more about Dr. Von Stieff’s highly effective methods in his book, Brain in Balance: Understanding the Genetics and Neurochemistry behind Addiction and Sobriety, available at: www.BrainInBalanceBook.com.

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THE FOUR LEVELS OF TRANSFORMATION By Larry Smith, CAS III

Few of us recognize or appreciate the true power of the human mind; it’s unusual for humans to be fully aware of its effect on our daily lives. However, the laws of cause and effect are always present during transformation. The cause of conflict in the human mind is fear. The effect of conflict is our misconception that we are alone in this world and powerless over our thoughts and actions. We must realize that the mind is always active, even when we are sleeping. The mind creates thoughts based on the filtered or unfiltered perceptions that we allow into our consciousness. There are no idle thoughts; each one produces some form of emotion. If our thoughts go unchecked we continually play the same loop of negative filtering, which becomes ingrained into our psyche. Often, we mention the two basic emotions, love and fear. Fear is derived from the lack of love; the only real remedy for fear is perfect love. The reality of perfect love comes directly from the Spirit, and the misconception of fear, is conceived from the notion that we have little to no control over our thoughts. We will now venture through the process of transformation with awareness that, at every juncture, love should, and eventually will override fear. We always have the choice to choose love over fear, peace over chaos, faith over doubt, and eternity over death. There is a level beyond the God-Consciousness of a Spiritual Awakening. There is an unconscious state of competence that equates to being on autopilot in God’s world. This degree of vigilance requires a willingness to relinquish everything except God’s will; this takes a great amount of effort – until it takes no effort at all. The word unconscious in the context of this writing means awake, but not aware. Step 1 of the 12-Steps uses the phrase “… and our lives have become unmanageable.” The words competence and incompetence equate to manageability and unmanageability over one’s life. The four psychological stages associated with learning a new skill were developed to demonstrate actual phases that occur when learning a new job, an athletic sport or any new behavior that is not intrinsically inherent to human beings. Here we apply the same principles to the levels of transformation that take place in recovery from addiction. Not just recovery from chemical addiction, but also recovery from the self-sabotaging thoughts and behaviors associated with obsessive and negative thinking. The Four Levels of Transformation 1: Unconscious Incompetence 2: Conscious Incompetence 3: Conscious Competence 4: Unconscious Competence Level 1: Unconscious Incompetence Unconscious incompetence is the human state in which there is something woefully wrong with our thinking and behaviors and either we don’t recognize it, or we believe we are not the one with the problem. This is denial in its truest form. Untreated addicts and alcoholics in the midst of chaos fall into this category. Denial acts as the brain’s defense mechanism, preventing us from feeling the pain associated with reality and truth. Consequently, when asked if alcohol or drugs affect the quality of life, someone in denial will most likely answer “no,” and follow up with statements such as, ”It’s my spouse who has a problem,” or “My job sucks – that’s the real problem.” Some forms of denial related to level 1 unconscious incompetence are: • Avoidance: There is nothing wrong

• • • • •

Deflection: Blame others Reflection: Blame the accuser Minimizing: I’m not that bad Rationalization: If you were me… Uniqueness: I am different

Eventually, the consequences of denial or unconscious incompetence become too devastating and the problem transfers into conscious awareness. Moments of clarity often propel people into the next level. These moments are usually preceded by events such as a spouse moving out, an accident, being fired from a job, an arrest or the death of a loved one. They may not be ready to take action, but they are no longer oblivious to the fact that they have a problem. Level 2: Conscious Incompetence We now have that initial conscious awareness that some facets of life have become unmanageable. Not yet possessing true clarity, the person still behaves incompetently. It is like being lost in the woods without a clue about which direction to walk. The negative consequences of ones behaviors start to surface here, often like a domino effect. Health issues arise and selfesteem and integrity plummet. The downward slide seems to pick up momentum once a person boards the elevator going down. Ground Floor: Extreme lows and highs The ego speaks first and speaks loudest. Planning the next high or cleaning up the wreckage of the last intoxicating event takes priority over living in the present. 1st Floor Down: Family – addiction is the elephant in the room 2nd Floor Down: Friends – we seek lower companionship 3rd Floor Down: Finances – Addiction is expensive 4th Floor Down: Legal – Another blow to self-esteem 5th Floor Down: Career – The threat of losing a job is many times the bottom 6th Floor Down: Jails and institutions – sober up or locked up 7th Floor Down: – Death – covered up My personal bout with conscious incompetence brought me to believe I was hopeless and I was simply going to die an addict. My blind uniqueness told me that no rehab would work for me and that AA was for quitters. I totally relate to an addict or alcoholic who truly believes that they just can’t stop. Many die rather than move on to the next phase. Level 3: Conscious Competence Becoming aware that we have a choice to actually heal is instrumental in reaching conscious competence. We recognize the

Continued on page 42

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DEATH OF A FAMILY By Dr.Galen Morgan Cooper, Ph.D.

An older woman with red rimmed empty eyes sat by the bed of the 40-year-old patient in 14B. I knew those eyes. I have had those eyes, those mother’s eyes, sitting by my son, in another hospital on the other side of the country. Lowering her grieving eyes, the woman quickly left her son’s room. My position at a major metropolitan hospital was to conduct addiction medicine consults on patients admitted for diagnoses that could potentially be brought on, or exacerbated by, drug and/or alcohol use. Using the evidenced based practice of Motivational Interviewing (MI); I approached patients with respect, exploring ambivalences in order to potentially facilitate change in destructive behaviors. When a patient is in a hospital bed with the probable cause stemming from substance use and/or abuse, change is often sought. Mr. 14B reported that he currently lived with his 72 years old mother, his father left his mother 6 years ago and his only sibling, three years younger than he, was an attorney. “I moved in with mom after I lost my last job. ‘Bout 6 months ago. She said I could stay ‘til I get another job but I’m trying to get on disability.” “What’s your disability?” “I’m bipolar.” Mr. 14B reported that he had “figured out” his diagnosis on line and that he was trying to find a doctor to do the paper work so he could “get SSI.” The Internet can be a helpful tool, but it can be extremely dangerous in the hands and minds of the psychologically untrained. “What do you use?” I asked. “Oh, when I was younger I used the usual--crystal, crack, a little heroin. Mostly I just drink now, use a little coke, some benzos when I can get ‘em.” “So the crystal or crack hype you up and the heroin or benzos or alcohol bring you down, is that how it works?” (In the field of addiction, Benzodiazepines--Xanax, Klonopin, Ativan, etc.--are considered alcohol in a pill). “Pretty much.” Bipolar disorder mimics this type of drug use. The patient is up, then down. He may be irritable in either phase, talk too fast, experience changes in sleep or eating patterns and may be suicidal. These can also be symptoms of drug and alcohol abuse. If properly diagnosed by a trained professional, bipolar disorder can be treated with medication and behavioral therapy. “Tell me about your father. Does he drink? And your mother, sister?” I asked, seeking a possible biological link to the patient’s substance dependence in the Biological-Psychological-Sociological Model of Addiction. “Only a little, all of ‘em. My dad just thinks I’m a loser. He told my mom that she’s crazy and left her. He always wanted to kick me out and mom was afraid I’d die. My sister’s the good kid, I’m the loser.” When a child dies, an estimated 80-90% of the parents divorce. The pain is too personal, too unbearable, often driving a wedge between the parents. Death is the one way to lose a child. Losing a child to addiction is another. Friction in the family centers on how to pay for treatment and what type of rehab to seek. There are heated debates over what treatment really works and how much emotional support and involvement the family should give the addicted member. Then of course there is the blame game—who’s fault is it that an offspring has become an addict? The “other child” often tries to be the perfect one, attempting to make up for the trouble and heartache caused by the addicted sibling--trying to make up for the hole in the family where the addict once dwelled. She may be terrified, fearful for her sibling’s life but also tired of

repeated relapses and broken promises. Searching the streets, the beaches, the fields for their runaway brother or sister can create a seething anger as well. Some experts believe family members of an addict may actually suffer from Post Traumatic Stress Syndrome from the repeated assaults on their sense of safety and the enormous, mostly self induced but still very real, pressure to make up for what the parents lost by having an addicted child, or the helplessness that comes with loving an addict. “I know you guys love me, I can see it in every move you make. But I’ll never be everything because the bottom line is, there’re two kids and one of them is missing,” my daughter said of her heroin addicted brother. When I left my position at the hospital, I became a certified personal coach, believing that the coaching model works well in families as opposed to the disease model that can leave family members feeling as though they suffer from a psychological disorder. In addition, coaching the addict on his road to recovery can be beneficial in any follow up treatment plan. With my background in clinical psychology if I detect pathology, clients are referred to appropriate professionals. In my practice, I often see “scapegoating” the one who is dependent on drugs, making the addict feel he is to blame for all the problems in the family. This may or may not have any merit, but it does become an easy copout for other family members who do not want to face their own possible dysfunctions. In the example of Mr. 14B’s family, he may be the scapegoat for the family dysfunction. Triangulation is another symptom I often see in families of addiction. The term triangulation is most closely associated with the work of Murray Bowen who theorized that a two-person emotionally unstable system forms into a three-person system or triangle under stress. (Bowen, Murray (1985). Family and Therapy in Clinical Practice. p. 478.) For example in Mr. 14B’s family, the father may have substituted his daughter to communicate dissatisfaction with the mother and discuss how to solve her brother’s addiction. The daughter is thrust into the role of a third party, even a “surrogate spouse,” thus triangulating the relationship with the mother. Aligning with her father may serve to solve the daughter’s ambivalence towards her brother however; it may alienate her from her mother. Death is sadly the outcome in the life of those with substance dependence. The secondary death is often the family unit, destroyed in the firestorm of a loved one’s addiction. Galen Morgan Cooper, Ph.D., is a specialist in addiction psychology. As a certified coach, Dr. Cooper helps families navigate their lives when addiction strikes as well as helping those with addictive behaviors focus on their goals. Dr. Cooper is the author of the book, A Turmoil Called Home: My Family’s Journey into the Hell of Addiction and a play of the same title, based on her memoir. Dr. Cooper speaks at community venues and universities, appears as an expert on television, and presents her play nationally and internationally to raise awareness on addiction.

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STAY CLOSE: A MOTHER’S STORY OF HER SON’S ADDICTION By Dr. Libby Cataldi

This is my story, our story: my son is a heroin addict. He wasn’t born this way, or maybe he was and the addiction was there, hiding, all through his childhood years. That’s the thing with addiction, no one knows the cause. I have spent a lot of time trying to ferret out the answer to why one son is an addict and the other isn’t, but I’ve given that up. I now spend my time learning about how best to support my son through his recovery. My son is twenty-nine years old, and he is good today, sober and productive after fourteen years of addiction. This story is about addiction, but more importantly, it is about hope. Addiction isn’t going away. At one of my son’s first rehab centers, a place in Maryland, the counselors told me that for every one addict at least four other people are affected. Addiction attacks the family first, then moves outward, affecting extended family and close friends: a cousin, a husband, a sister, a coworker, none of their lives will ever be the same. In our home, addiction took on the characteristics of another living member, demanded attention, caused trauma, concealed itself, never went away and never will go away. My son will always be an addict. There is no finish line. Every addict has a mom and dad. We parents suffer as we see our children dying a little at a time. We want to save them, jump into the fire, grab them, and bring them to safety, but we can’t. Tell that to a parent, that he or she can’t save her child -- the pain is incomprehensible. But as Jeff said, “I know the writing of the book was hard, Momma, but the living of it was harder.” When I first started attending Al-Anon Meetings more than ten years ago, I sat in on three different meetings before I found a group where there were other parents of addicted children. At that time, we were in the minority; we were only four parents out of more than twenty people. These days, when I attend meetings, I find that most members of the group are parents. It seems as if the number of young people who are addicted to drugs has increased greatly. Words like heroin, crack, and crystal meth are common. Sadly, Jeff’s story is not the exception. Many experts claim that “an addict has to hit his bottom,” but I could never gauge where Jeff was on his descent. Alcoholics Anonymous defines addiction as a progressive and fatal illness, and I saw that Jeff’s bottoms got continually worse. Each time he fell lower and faster until I feared he would die. With every new low, I would rush in thinking, “This is the time. This is his bottom. Go, Lib.” The recovery centers, the psychologists, Jeff’s arrests, and all his many interventions must have made a difference, but I don’t know how much of one. Jeff was in rehab programs, jails, and institutions of many kinds. He lived on the streets and the beach. He stole, had things stolen, and ultimately he pawned almost everything he owned. He lost friends and destroyed his veins. At times, my articulate, ambitious son could hardly put two words together. I banished him from the house. I threatened, cajoled, pleaded, wept, and wrung my hands. I punished, screamed, fought, ached, had nightmares, stuffed my emotions into my belly and suffered in silence. His father and I followed the advice of experts and friends and even people who knew nothing. We wrote intervention letters, paid for psychologists, recovery centers, and medicines. His father, brother, and I were like a starving family, ready to latch onto anything that might alleviate our pain and Jeff’s hunger for drugs. I would have sold my soul for his recovery, made a bargain with the Devil himself - but all this was to no avail. Addicts live a tortured existence. Jeff has told me that he was filled with shame, regret, self-blame, and self-loathing. He says that addicts, even those who can’t mouth these words, hate themselves for what they are doing, despise the destruction they are causing, but they can’t imagine a life without drugs. About the final days of Jeff’s last descent, he wrote, I chalked death up to an unfortunate repercussion, not a deterrent. I couldn’t imagine my life without drugs in it. I didn’t want to die, but I didn’t want to stop using. They say that addicts aren’t afraid to die, they’re afraid to live without drugs.

My family knows well the Hell of addiction, but we know only our own Hell. Those who love addicts suffer. The addict suffers. No one is immune. In our family, we each handled our grief differently. Jeremy, the younger brother by twenty months, held things inside, caught in that gap between loving his brother and hiding the truth and loving his brother and telling the truth. How does a brother handle these conflicted loyalties? Tim and I suffered and responded in our own divergent ways. He became quiet, withdrawn; his absence spoke for him. I whirled into action, trying anything that I thought would help, running from one possible solution to another. Grandparents, uncles, aunts, cousins, friends, no one knew what to do. During one Christmas, when neither son came home for our large Italian family gatherings, my brothers didn’t know what to say. They didn’t even know whether to invite me to the festivities. The cousins were confused; could they ask about Jeff or would it be kinder to leave him out of the conversation? It is time to bring addiction out of the shadows and into a place of healing. There is great shame associated with this illness, I know. However, I also know that when I was young, we didn’t talk about topics like breast cancer or homosexuality. Today we talk openly about these things. We name the issues and try to face them. Jeff, Jeremy and I are committed to carrying the message of hope and compassion, of reaching out a hand to help another family, another parent, maybe even another brother. Jeff says this is his Twelfth Step: Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics (and addicts), and to practice these principles in all our affairs. Every day we’re grateful. Every day, in the very marrow of our bones, we give thanks that today Jeff is okay, that he is alive and productive, that he has good hope of creating a better future. But we know that we only have today. Jeff once asked me, “Never quit believing, OK, Momma?” I won’t quit believing, Jeff. Never. Dr. Libby Cataldi holds a doctorate in education from the University of Pittsburgh and has been an educator all her life. For seventeen years (1987 – 2004) she was head of The Calverton School, an independent day school in MD. STAY CLOSE was published in May 2009 by St. Martin’s Press (NY) and is currently at work on her second book. She lives part of the year in Florence, Italy, where she is a proud member of the Florence Dragon Boat Ladies, a rowing team of breast cancer survivors. She also serves on the Board of the International School of Florence and is a member of the American International League of Women. Dr. Cataldi has appeared on National Public Radio (NPR), Good Morning Maryland, Fox News Washington, and radio stations, Dr. Cataldi and her son Jeff spoke to groups about drug addiction. For more information, visit www.libbycataldi.com or contact her representative – judymacwilliams@comcast.net

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SOLO-MOMS AND TROUBLED SONS By Noel Neu, MS, LMHC

It is a trend that has been occurring with increasing frequency over the past thirty years - Mothers raising their sons by themselves or with an emotionally absent father. Bringing up a child alone is not an easy task to handle. When the child is of opposite gender it can be especially challenging. This is caused by not having the benefit of knowing from a boy’s viewpoint what your son is going through as he develops and matures, and not having his father’s built-in knowledge as a guide. Of course the same can be said for a dad raising his daughter, which I completely understand now that I have the wonderful blessing of my young daughter and my loving wife to help me as my guide. However, moms alone with their sons is a situation that is near and dear to my heart as I was raised by my mother alone, and I have made it a personal mission to help mothers recover a healthy connection with their sons. In my practice over the years, I have been fortunate to be able to assist many single mothers and their sons with building solutions to help make their lives better and heal their emotional wounds. In addition, I have had many mothers in my practice who were still married to their husbands, but due to a variety of factors (the main one being the husband’s unwillingness to make his son one of his primary priorities in his life) were solely responsible for the raising of their son. The dynamic between the single mom and the mom married but fully responsible for their boy’s development by themselves is so similar that I have coined a category called the “Solo-Mom.” The determination of the Solo-Mom is fierce as she tries to work through the trials and tribulations of a developing boy becoming a man while balancing her own life needs by herself. The love between a mother and her son is very deep. The dayto-day struggles of making sure your son’s needs are being met without emotional or financial support from his father can be overwhelming. Not to mention the innate need to help him become a good person as he grows up being consistently challenged by his developing personality that appears to come in and out like a distant radio frequency. When the son becomes especially troubled, an undercurrent develops between the Solo-Mom and her son who is laboring to understand himself. This undercurrent comes to culmination as traits that are developed from the methods in which mom and son communicate (or a lack of communication) with each other. More often than not, a reactionary relationship is established which eventually becomes a power struggle. How this struggle plays out is based on the personality type along with the communication methods of both the mom and her son. To qualify the different types of Solo-Mom and troubled-son power-struggle relationships, I uncovered four distinct classifications for each. Let’s start with the classifications of the different types of troubledsons. Using a spectrum for both the personality type and the basic communication style that your son tends to utilize, a manner in which he acts and reacts starts to take shape. Taking a measurement of each spectrum will lead to the individual classifications. The spectrum of the troubled-son’s personality type ranges from Shutting Down (introverted) to Acting Out (extroverted), and the range of communication style that the troubled-son uses moves from Detached to Engaged. The classifications of troubled-sons that arise from these measurements are the Mini-Man, Mama’s Boy, Solitary Son, and Rebel. For the sake of brevity, a brief description of each troubled-son type is made here: The Mini-Man son combines extroversion with engaged communication which results in qualities such as being very personable, passive-aggressive, demanding, low frustrationtolerance, and a genuine concern for others. The Mama’sBoy is engaged in his communication style along with being introverted and exhibits characteristics such as being composed, manipulative, concern for others, passive, and avoidant. The Solitary son is introverted and detached which results in traits such as being withdrawn, angry, indifferent, passive-aggressive, and disconnected from others. The Rebel son mixes extroversion with

SOLO-MOMS

ENERGETIC WAVERING DECISIVE RESTRAINED

TROUBLED-SONS ACTING-OUT DETACHED ENGAGED SHUTTING-DOWN

being detached and displays mannerisms that include hyperactivity, anger, aggression, confrontation, and disillusionment. Now for the different types of Solo-Moms, the spectrum of the Solo-Mom’s personality type ranges from Restrained (introverted) to Energetic (extroverted), and the range of communication style that the Solo-Mom tends to utilize moves from Wavering to Decisive. The classifications of Solo-Moms are the Captain mom, Masculine mom, Friend mom, and Distressed mom. The first quality all of the following Solo-Moms possess is caring. They all care in one form or another. The difficulty is getting the sense of care across to the troubled-son on the other end. In addition to genuine care and concern each type displays certain characteristics. The Captain mom is both energetic and decisive uncovering qualities such as being direct, controlling, influential, intense involvement, and assertive-aggressive. The Masculine mom combines being restrained and decisive and is logical, analytical, shrewd, direct, and has low frustration-tolerance. The Friend mom is restrained in personality and wavering in communication style and presents traits of being indirect, passive, indecisive, ameliorating, and avoidant. The Distressed mom has an energetic personality style with wavering communication and has attributes of being passive-aggressive, dramatic in displaying emotion, involved, hyper-verbal, and persuasive. Negative characterizations aside, the traits as listed above are used to determine a broad picture of the impact personality and communication has on relationships. The negative behaviors of the son and the difficulties the Solo-Mom has communicating with him are intensified when not in full awareness. The awareness creates ownership, and once we can own our behaviors, we can change them. Knowledge is power and becoming aware of your son’s behavioral patterns as well as your own can make you empowered. My focus is to help Solo-Moms connect emotionally, mentally, and spiritually with their sons, who are hurting, troubled, angry, and acting out. Through improving understanding of the dynamic that develops when a mother raises her son alone, and communicating more effectively between mother and son, a miracle occurs. The miracle of connection between two emotionally injured people who love each other is healthfully restored. Please don’t give up before the miracle happens. Noel Neu, MS, LMHC is the CEO and clinical director of Empathic Recovery (www.empathicrecovery.com). Mr. Neu has been a clinician in private practice for over ten years and has developed programs for “Assertive Awareness” training, “Living your Truth” to build self-esteem, and helping families with addictions heal.

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AFTERCARE A MUST IN ADDICTION RECOVERY By Marlene Passell

It is tempting for those who have made it through an addiction treatment program to conclude that their problems are over. Getting help for an addiction is a great achievement, but it is not the end of the story. National statistics show that up to 50% of those who make it through an addiction treatment program will later relapse. This is a depressing fact, but the good news is that relapse is preventable. The highest risk of relapse is during the first 60 days following discharge from a rehab. This risk remains high for the first five years of recovery, according to national experts.

needs to occur during normal everyday living. As the person in recovery is faced with new problems, they will be encouraged to find new solutions. Those who return to substance abuse tend to follow a certain pattern called the relapse process. This begins with becoming stuck in recovery. This process leading to relapse can be stopped at any time and aftercare is the most effective way of doing this. Those who continue to receive support are far more aware of relapse triggers. They are also more likely to spot the warning signs that they are moving towards a relapse.

Staying off alcohol or drugs is harder in the outside world then it is in a residential treatment facility. There is a lot of support in rehab and the individual is protected from temptation. A return to normalcy can come as a shock. The individual is once again surrounded by temptation and they now lack the support found in rehab. It can be a real struggle not to be drawn back to familiar behavior.

Types of Aftercare

Those who receive some type of aftercare are less likely to relapse and more likely to live longer, according to the National Recovery Center. This aftercare can keep the individual motivated and provide support when things get difficult. The individual who goes through a treatment facility will pick up a lot of knowledge and skills, but most of the learning needs to occur during normal everyday living.

Dual diagnosis support is required when an individual has another mental health problem as well as their addiction. A lot of addicts can also suffer from depression or other types of mental problems that need addressing. Failure to treat a dual diagnosis will mean that life in recovery is unsatisfactory and can easily lead to relapse.

The Causes of Relapse When the individual leaves a treatment facility they will usually be highly motivated and confident about the future. They have made it through physical withdrawals and a can now see how a life without substance abuse is possible. Their self-efficacy is high. They should rightly feel proud of their achievement. Once they return to normal living though, they can find that recovery is more of a challenge. Staying off alcohol or drugs is harder in the outside world. There is a lot of support in rehab and the individual is protected from temptation. A return to normalcy can come as a shock. The individual is once again surrounded by temptation and can lack the support found in rehab. It can be a real struggle not to be drawn back to familiar behavior. Coping Strategies Needed in Recovery There are a number of reasons why people relapse after a period of recovery. Motivation can wane if there is not a concerted effort to keep focused on living free of alcohol and drugs. The individual can begin to feel that their problems are behind them and that no special effort is required to stay sober. They then forget the reasons that drove them into recovery in the first place. Another reason why people relapse is that they fail to pick up the necessary coping strategies needed to live comfortably in recovery. Life will always have ups and downs and the individual needs to be able to handle both. If the individual just gets sober without developing new ways of coping, they will continue to struggle and may relapse. The Importance of Aftercare Those who receive some type of aftercare are less likely to relapse and more likely to live longer. This aftercare can keep the individual motivated and provide support when things get difficult. The individual who goes through a treatment facility will pick up a lot of knowledge and skills, but most of the learning

Twelve Step Groups are the most well-known of all the aftercare options. The members are encouraged to attend regularly for the rest of their lives. Depending on the degree of need, some treatment centers offer outpatient and intensive outpatient programs. These sessions will have the effect of renewing the individualâ&#x20AC;&#x2122;s motivation and reducing the risk of relapse.

Marlene Passell is the marketing & communications manager for Wayside House in Delray Beach, FL, a residential program for women with addictions. www.waysidehouse.net

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RELAPSE PREVENTION THERAPY: AN OVERVIEW By Terence T. Gorski MA, MAC, NCAC II, Florida CAP

Relapse usually does not occur suddenly, nor does it start with the first use of an addictive substance or behavior. Many times, relapse-prone individuals experience progressive warning signs that eventually make substance use seem like a good idea. People don’t consciously plan their return to addictive substance use. From the client’s point of view, it just seems to happen without warning. But there are always indictors that trouble is brewing. Once patients learn to identify relapse-warning signs, they can begin to manage them. This concept is the core of Relapse Prevention Therapy (RPT). Cunning, Baffling, Powerful Early students of addiction—the members of Alcoholics Anonymous—noticed a paradox: people with substance use disorders often act in ways inconsistent with their conscious intentions. The Big Book contains a vignette about Jim, a salesman, who stopped at a restaurant for lunch. Although he wasn’t thinking about alcohol or relapse: Suddenly the thought crossed my mind that if I were to put an ounce of whiskey in my milk it couldn’t hurt me on a full stomach. I ordered a whiskey and poured it into the milk. I vaguely sensed I was not being any too smart, but felt reassured as I was taking the milk on a full stomach. Decades later, some vulnerabilities and mechanisms for relapse have been identified. Environmental factors include high-risk situations where cues to use substances are present. These cues are generally described as “people, places and things” that have been associated with prior drug use. In Jim’s case, for example, relapse occurred in a restaurant that he had visited many times prior. The restaurant was likely full of drug-using cues that shaped his cognitions and behavior. Relapse Prevention Therapy The Gorski-CENAPS model, one form of RPT, has been evolving since the early 1970s (Gorski TT, J Chem Depend Treat 1989;2(2):153–169; Gorski TT, J Psychoactive Drugs 1990;22(2):125– 33; Gorski TT, The CENAPS Model of Relapse Prevention Therapy. In: Approaches to Drug Abuse Counseling. Bethesda, MD: National Institute on Drug Abuse, 2000, p. 23–38). As currently delivered, there are nine principles and associated counseling procedures. Principle 1 involves self-regulating thinking, feeling, memory, judgment and behavior. The primary procedure entails breaking the addiction cycle, often through formal substance abuse treatment, and stabilizing physically, psychologically and socially. The key metric for success at this stage is the client’s ability to perform basic activities of living. Principle 2 involves integration, or developing a conscious understanding and acceptance of the situations and events that led to prior relapses. The primary procedure is self-assessment through the use of a personal life history and addiction history and listing the problems that caused the person to enter treatment. The goal is to discover what the client wanted substances to do for them (positive expectancies) and what happened once they started acting out their addiction again. Principle 3 involves understanding the general factors that cause relapse. The primary procedure is relapse education. Principle 4 involves self-knowledge. The primary procedure is warning sign identification and management. Clients develop a long list of early warning signs and high-risk situations that may lead them back to substance use. Warning signs represent irrational thoughts, unmanageable feelings (negative affect, stress) and self-defeating behaviors that can prompt clients to seek out high-risk situations (e.g., old drug-using peers). High-risk situations, in turn, undermine recovery supports, expose clients to cues and reinforce cognitive distortions. Principle 5 involves coping skills. The primary procedure is recovery planning to increase clients’ self-efficacy. Techniques include mental rehearsal, role-playing and therapeutic assignments. Therapeutic work occurs in three domains. The first is situational-behavioral, where clients

are taught to avoid situations that trigger warning signs and to modify their behavioral responses should such situations arise. The second is cognitive-affective, where clients are taught to challenge irrational thoughts and deal with unmanageable feelings triggered by warning signs. The last domain deals with core issues where clients are taught to identify how their cognitions and emotions can generate warning signs in the first place. Principle 6 involves change. The primary procedure is recovery planning whereby clients develop a schedule of recovery activities and appropriate self-care. Principle 7 involves awareness. The primary procedure is inventory training consisting of a Morning Planning Inventory and Evening Review. The former entails getting up, reading something that focuses the mind on sober and responsible living, and planning out the day. The goal is to anticipate stressful problems, warning signs and unavoidable high-risk situations. During the Evening Review, the client examines their day and reflects on how they dealt with various challenges. If there are residual issues, the client then decides whether to tap into their support network before going to bed. Principle 8 involves significant others. The primary procedure is incorporating family into the relapse prevention plan. Evidence suggests that family involvement represents a protective factor that improves drug use outcomes. Principle 9 involves maintenance. The primary procedure is ongoing professional monitoring, which is sometimes described as Recovery Management Check-ups. Field studies have demonstrated that such protocols yield better results compared to non-intervention. At minimum, I recommend monthly visits for 3 months, quarterly visits for the next 2 years and then annual visits for at least the next 5 years. A detailed clinical manual describing the conduct of care is available (http://bit.ly/18NlGRi). Care Delivery RPT generally occurs in a group context. A typical RPT session is structured in the following way: 1) Introduction and pretest (15 minutes); 2) Educational presentation (30 minutes); 3) Interactive exercise conducted in pairs or small groups (15 minutes); 4) Large group processing (15 minutes); and 5) Posttest and wrap-up (15 minutes). The format can be condensed and modified when dealing with individual clients during shorter appointments. References available upon Requests Terence T. Gorski is the Founder and President, The CENAPS Corporation. Terence T. Gorski is an internationally recognized expert on substance abuse, mental health, violence, & crime. He is best known for his contributions to relapse prevention, managing chemically dependent offenders and developing community-based teams for managing the problems of alcohol, drugs, violence, and crime. He is a prolific author and has published numerous books and articles. Additional Resources Gorski’s Relapse Prevention Certification Workshop is being held in Ft. Lauderdale, Florida, November 10-14, 2014. Gorski-CENAPS’s Advanced Relapse Prevention training has been “a turning point” in both the professional and personal lives of many former participants. Upon completion of this training, participants will be able to develop comprehensive Relapse Prevention Plans for identifying and managing both high risk situations in early recovery and the core personality and lifestyle problems that lead to relapse in latter recovery, after initial stabilization. For information and Registration: Contact – The CENAPS Corporation or Tresa Watson at 1-352-596-8000 or tresa@cenaps.com.

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THE SILENT ASSAULT ON AMERICANS WITH ADDICTIONS NOW IS OUR TIME By John Giordano DHL, MAC

Archeologists have long suspected that addiction and substance abuse has been around longer than once thought. Scientists have found South American tribes’ paraphernalia used to prepare hallucinogenic drugs for sniffing, dating back to prehistoric times. Researchers have also confirmed that alcohol was brewed in China dating back to 7000–5600 BC, approximately the time when barley beer and grape wine were beginning to be made in the Middle East. Nearly 5000 years ago beer was the beverage of choice among Babylonians. The ill effects to public health and open drunkenness were tolerated by the ruling powers that be – as the major concern was fair commerce in alcohol. How far have we really come?

Governor Patrick was the first to permit first responders to carry and administer Naloxone, a drug that can reverse an opiate overdose instantly. The governor dedicated $20 million to enhance substance abuse treatment programs and he continues to fight for the ban of Zohydro – a dangerously addictive, pure hydrocodone painkiller 10 times stronger than Vicodin – in Massachusetts. Addiction and substance abuse have a long and storied history. Much has been learned about the disease and its treatment, but nothing more so than what has been revealed in the last thirty years. In the 80’s and early 90’s scientists and researchers were working at break neck speed to decode the genome. My good friend and colleague Dr Kenneth Blum was one of them. His discovery was a game changer that made headlines across the globe. Dr. Blum found the genetic link to addiction or in his terms ‘Reward Deficiency Syndrome.’ The study was published in the peer reviewed Journal of American Medical Association (JAMA) nearly twenty-five years ago and forever changed the way we in the field view and treat addiction. Dr. Blum made understanding addiction and developing new scientifically-proven, cutting-edge treatments his life’s work. To date, Dr. Blum has written over 400 papers on addiction and related disorders that have been published in peer reviewed scientific and medical journals. As I look at the breadth of Dr. Blum’s body of work and that of his peers – the quantum leaps they have made in science has led to a far greater understanding of addiction over the last twenty-five years – and I’m simply appalled that substance abuse has actually grown to the level that it has and the ineptitude associated with it. It is truly horrifying. How is it that with all this wealth of knowledge it could easily be argued that addiction is America’s most neglected disease? The rate of substance abuse has consistently remained high for decades, yet doctors are only required to have one hour of addiction education per year? Prescription opioid painkillers have taken over as the drug of choice among addicts. A person with a severe mental illness requiring hospital care in 1900 would be better looked after back then, than that same person would today. The realities are incongruent with the available science. The advancements have not translated into practice; but why? With all we’ve learned in the last 5000 years, have we, as a society, digressed so far as to become Neo-Babylonians? We live in an era where prescription drugs kill more people every year (16,000 plus) than cocaine and heroin combined; yet the

amount of prescribed opioid painkillers consistently increases every year. A time when 80% of the world’s production of opioid painkillers – legal heroin – is prescribed and consumed by less than 5% of the global population – us; when corporate owned and publicly traded methadone clinics are replacing state sponsored psychiatric centers closed under the guise of ‘budget cuts’ and treatment isn’t even a consideration. Over the last four years, pharmaceutical and health products spent 1 billion dollars on lobbyists and political campaign contributions intended to sway your congressman and senators vote their way. Has Big Pharma created an environment conducive to addiction? Let’s face the facts – addiction is a cash cow feeding money and blood into the coffers of Big Pharma – an $8 billion dollar industry. As Big Pharma grows, so does the number of deaths as a direct result of the products they sell. Is the fair trade of beer – or in this case prescription drugs and health care – more critical to our society than our public health? Welcome to Babylon twenty-fourteen. But all is not lost in our David verses Goliath battle – in fact quite the opposite. Our combined voice is being heard. Massachusetts Governor Deval Patrick has been very active in his pursuit of an effective drug policy. Patrick recently signed a bill reforming imprisonment of non-violent drug offenders. He said in a statement. “Those changes start to move us away from the expensive and ineffective policy of warehousing non-violent drug offenders towards a more reasonable, smarter supervision and substance abuse program.” Governor Patrick was the first to permit first responders to carry and administer Naloxone, a drug that can reverse an opiate overdose instantly. The governor dedicated $20 million to enhance substance abuse treatment programs and he continues to fight for the ban of Zohydro – a dangerously addictive, pure hydrocodone painkiller 10 times stronger than Vicodin – in Massachusetts. Governor Patrick’s administration has become a vanguard of sorts in the respect that many other governors are watching him closely so that they can implement their own drug policies.

Michael Botticelli, the new head of the Office of National Drug Control Policy – or more colloquially known as the ‘Drug Czar’ – is in recovery himself. What I find most encouraging is happening on a national level. Michael Botticelli, the new head of the Office of National Drug Control Policy – or more colloquially known as the ‘Drug Czar’ – is in recovery himself. Obviously his personal experiences give him an advantage over his predecessors. However it doesn’t end there. I happened to catch a media interview he did not long ago and I must say that I was thoroughly impressed. Botticelli was spot on and did not pull any punches. He was straight forward in identifying the lack of addiction education in medical schools and the role pharmaceutical companies play in the prescription painkiller epidemic we’re facing. He’s against legalizing marijuana, citing 1 in 9 people who use it regularly become addicted. As intriguing as the interview was, it is Botticelli’s plan that I found most encouraging. When asked about the over-prescribing of opioid painkillers he responded: “A prime goal of our office is to work with physicians. We actually want a balanced approach Continued on page 28

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THE ANSWER IS THE EMOTIONAL SELF – RELIANCE By Bajeerao Patil

According to the 2010 National Survey on Drug Use and Health, drug and alcohol abuse is the third leading cause of death in the United States. The study found that 23.6 million Americans aged twelve or older, roughly thirteen percent of the population, are dependent on a substance. Addiction and the subsequent healthcare costs— accidents, crime, incarceration, clinics—cost Americans over $484 billion every year. Not only is this epidemic increasing in scope, but also the employment of substance abuse and behavioral disorder counselors is expected to grow by 27 percent from 2010 to 2020. Drugs are big business. That’s clear. But even more daunting, most public agencies face serious obstacles as they struggle to find solutions. Throwing more money, more in-patient treatment, or more aggressive RECOVERY state intervention rarely addresses the underlying causes. Individuals addicted to mood altering chemicals need help, but they need more than “tough love.” Instead, they need an alternative to help them manage the have toughest obstacle all: Their Emotions. “Please don’t anything to doofwith this book, unless you want to

free from addiction.”

LIFELONG SOBRIETY

saveand youralcohol life. I highly recommend this23 book for the As a drug counselor for over years, I have worked and their ones.” with hundreds ofaddicted individuals who loved manage their emotions through omas L. Hay,chemicals. author of Th e Comeback the use of—Th mood altering Through myKid workshops and extensive institutional experience, I have witnessed those who seek help, relapse and begin to experience hopelessness again. Recovering individuals relapse not because they are incapable of recommend Bajeerao Patil’s book “Lifelong Sobriety.” living“Ilife without drugs or alcohol, but because they aren’t taught It how presents a practical guide in helping people overcome their alcohol to deal with their emotions. They haven’t learned how to and other substance abuse problems and learn how to live fulfi lling lives manage other critical aspects of their lives effectively.

Individuals withPolley, a drug and of alcohol disorder to find solutions —George author The Old Man andneed The Monkey to their issues, change their past behaviors, and learn how to manage their lives more effectively. As a drug and alcohol therapist, I have discovered that individuals with addiction issues allow their Bajeerao Patil possesses in depth knowledge addiction and the leads recovery to prolonged addiction. emotions to govern their oflives, which process. In his first book Insanity Beyond Undersatnding he answered the We all struggle with emotions. We all experience depression, questions on the minds of readers everywhere - Why were some individuals ablestress, to break the cycle of addiction while others were simply unable anxiety, anger, and frustration. Theor only difference is that unwilling to? these individuals rely on drugs to deal with their issues while most Nowof in us the pages of Lifelongin Sobriety explains how use ofways. illicit drugs or manage lesshedestructive alcohol impacts life adversely. The importance of taking care of emotional health and other significant aspects of life that have a direct bearing over sobriety. The use of Eastern philosophy and stories set this book apart from other recovery books.

Bajeerao Patil

Generally, people who don’t use drugs have clarity of thoughts. They are better equipped to deal with their emotions and other in intheir Whereas, individuals Mr.issues Patil was born India lives. and now lives in Media, Pennsylvania with hisaddicted to mood altering wifesubstances and three children.are He knows how to takeand care ofdon’t the present, not the to confused have right mindset or dwell in the past or worry about the future. skills to deal with their emotions. They resort to using drugs when overwhelmed with their emotions or faced against the odds. They quickly go from one extreme to the other. While in active addiction, self-love and respect go out the window. Even genuine complaints MEDIA PENNSYLVANIA are looked as cooked up stories. These individuals are always at ISBN: 978-0-9895698-1-1 the receiving end. In short, they are always at the mercy of others. Price $12.95 They are considered parasites.

Self-reliance is the answer. In order to recover, individuals addicted to mood altering chemicals must become emotionally self-reliant. They have to realize that depending on drugs or other people emotionally is unhealthy. They need to learn healthy coping skills to handle their emotions effectively without resorting to drugs or alcohol. We all make mistakes and learn from them. With these individuals, it’s different. They make mistakes and keep making them over and over, again and again. They need to stop the cycle by learning to see through the consequences of their action and implementing a proper action plan that should also include self-love and respect. The great secret to individuals who are still in active addiction but widely known by recovering individuals is recognizing when you need help and graciously accepting it. This is the first and most vital step on the road to recovery. Bajeerao Patil is an author of Insanity beyond Understanding, Lifelong Sobriety – How to Stop Drinking And / Or Using Drugs, and Anger Management Workbook. His books are available on Amazon.com, Barnes and Noble and http://www.bajeeraopatil.com

Bajeerao Patil possesses a wealth of knowledge on the subject of addiction from over 23 years of work as a dual diagnosed counselor. He specializes in human behavior. He has a Bachelors Degree in Social Work and a Masters in Human Resources from Mumbai University, India. He counsels dual diagnosed patients – patients using substances, and those who have severe mental health issues such as schizophrenia, bipolar disorder, ADHD, MDD, PTSD, and anxiety disorder. He also counsels patients who have an extensive criminal background and severe anger issues. His fascination with addictive behavior and his depth of knowledge encouraged him to write on the subject with the hopes of reaching readers with addiction issues in need.

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LIFELONG SOBRIETY How to Stop Drinking And / Or Using Drugs

Bajeerao Patil “A must read for anyone dealing with addiction who is committed to long-term sobriety.” —Steve Siebold, author of 177 Mental Toughness Secrets of the World Class “Please don’t have anything to do with this book, unless you want to save your life. I highly recommend this book for the addicted and their loved ones.” — Thomas L. Hay, author of The Comeback Kid “I recommend Bajeerao Patil’s book “Lifelong Sobriety.” It presents a practical guide in helping people overcome their alcohol and other substance abuse problems and learn how to live fulfilling lives free from addiction.” —George Polley, author of The Old Man and The Monkey

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WHAT IS A LEVEL 4 TRANSITIONAL CARE HOUSE? Sunset House is currently classified as a level 4 transitional care house, according to the Department of Children and Families criteria regarding such programs. This includes providing 24 hour paid staff coverage seven days per week, requires counseling staff to never have a caseload of more than 15 participating clients. Sunset House maintains this licensure by conducting three group therapy sessions per week as well as one individual counseling session per week with qualified staff. Sunset House provides all of the above mentioned services for $300.00 per week. This also includes a bi-monthly psychiatric session with Dr. William Romanos for medication management. Sunset House continues to be a leader in affordable long term care and has been providing exemplary treatment in the Palm Beach County community for over 18 years. As a Level 4 facility Sunset House is appropriate for persons who have completed other levels of residential treatment, particularly levels 2 and 3. This includes clients who have demonstrated problems in applying recovery skills, a lack of personal responsibility, or a lack of connection to the world of work, education, or family life. Although clinical services are provided, the main emphasis is on services that are low-intensity and typically emphasize a supportive environment. This would include services that would focus on recovery skills, preventing relapse, improving emotional functioning, promoting personal responsibility and reintegrating the individual into the world of work, education, and family life. In conjunction with DCF, Sunset House also maintains The American Society of Addiction Medicine or ASAM criteria. This professional society aims to promote the appropriate role of a facility or physician in the care of patients with a substance use disorder. ASAM was created in 1988 and is an approved and accepted model by The American Medical Association and looks to monitor placement criteria so that patients are not placed in a level of care that does not meet the needs of their specific diagnosis, in essence protecting the patients with the sole ethical aim to do no harm.

WHY IS THIS BOOK CALLED “OUT OF THE WOODS?” In Alcoholics Anonymous and other 12-step programs newcomers are often told, “It can take 3 to five years to get out of the woods.” But later, after many meetings and working the steps, many of us realize that it actually takes just that long just to get into the woods. Our lives get better and we continue on and longterm recovery begins to take hold. Gradually, there is a sensation of coming out of the woods: we see real changes and there is some stability and we are becoming new people. Of course we are not “fixed” and certainly not perfect, but in double-digit recovery another life begins. But as recovery continues it can take some turns. There is a shift in the pace and focus. This can be puzzling to those who have reached a ten-plus year milestone: What does it mean that I go to fewer meetings? Is it OK to spend more time on other projects? Is my commitment to a new relationship or a new career good or bad? Could I still relapse? What does it mean to be in double-digit recovery? In my long-term recovery I asked these questions too. I wondered what aging would be like, and new relationships and even retirement. I discovered surprises after ten and 20 and 30 years. “Out of the Woods” will make you laugh, and it will surprise you too. Join me on the path. 26

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THE GIFT OF EMOTIONAL TRANSPARENCY FOR CHILDREN By Debra Alessandra

Stress is rampant in our modern day world. From a long list of stressors in families, substance abuse often rises to the top. What strikes me most when this kind of stress invades a home and lingers is the impact on children. We often hear addiction is a family disease but fail to address the needs of children who are living in this kind of painful family system. The effects of addiction can impair a child’s psychological health and render emotional scars which may last for years.

children, we must first help ourselves. We must do the hard work of expanding our feelings vocabulary and speak openly and honestly with children when appropriate. We must show them how to manage and share their feelings. Some of us teach our children about feelings while we’re learning about them ourselves. No matter. What greater gift than allowing our children to witness our own growth and development in this area.

Due to the denial inherent in the disease of addiction, children may observe their parents becoming defensive and upset when attention turns to their addictive behavior. They learn to keep quiet and avoid the subject. The’ no talk’ rule blossoms under such conditions. The fear of creating more stress holds children in a state of anxiety.

Efforts to communicate better can be accomplished by attending a self-help group, working with a counselor, relying on a support group and/or journaling.

Our children’s need for frank authenticity and clear communication must be addressed. In order to improve family relations, we must learn to break the silent nature of addiction.

Conscious parenting requires us to move away from ‘automatic pilot’. We must find opportunities on a daily basis to slow down and connect with our children. Most of all, it means working on expressing ourselves so they can do the same.

Of course, I must mention the obvious. The healing process is generally gradual. This does not always jive with our quick-fix mentality, but must be understood and accepted in order to make steady progress and lasting improvements. Additionally, to be forthcoming about my position, I must express my truth. I believe children do not need ‘fixing’. Assistance, Yes. Support, Definitely. Modeling, Certainly- but ‘fixing’ implies some outside force will adjust and alter a child to our liking. I do not find this to be the kind of long-lasting help children need. We all realize the value of communication as a way to emotional health and healing. We claim we want our children to be comfortable with a broad range of feelings and be empowered to express themselves. One of the best ways to help children express their feelings is to practice and model this skill ourselves. If we want to help our

THE SILENT ASSAULT ON AMERICANS WITH ADDICTIONS NOW IS OUR TIME By John Giordano DHL, MAC

Continued from page 20

where Americans who suffer from pain get good treatment for their pain. But we also know that many people are getting these medications who don’t necessarily need them - that physicians don’t understand the history of someone. And making sure that they understand that there are risk factors attendant to these very powerful pain medications.” Now is our time. Michael Botticelli is doing a terrific job, but he is only one man who needs our help. Your voice has already made a difference in some areas of the country. Now it is our time to finish the job and save the lives of addicts who can’t do it for themselves. Please speak-out about your addictions, your successes and your failures, so that we can emerge from the epidemic and live life the way it was meant to be. John Giordano DHL, MAC is a counselor, President and Founder of the National Institute for Holistic Addiction Studies, Laser Therapy Spa and Wellness Center in Hallandale Beach and Chaplain of the North Miami Police Department. For the latest development in cutting-edge treatment check out his website: www.holisticaddictioninfo.com

Through these efforts we are better prepared to speak to our children about the challenging topic of addiction and recovery. We are able to engage in open exchanges and join in on-going conversations.

We are not perfect. What at first seems daunting, becomes easier over time. We come to cherish emotional transparency as an art form that makes our lives rich and rewarding. What greater service can we provide our children than to show them our own clear self-expression? What better place to practice our communication skills than in our own home? Debra Alessandra has a degree in Education and Sociology from Lycoming College. She is a life-long educator, former counselor, and the author of 12 Steps 12 Stories; an insightful and entertaining collection of stories for parents, grandparents, counselors and members of a 12 step recovery program. Debra is on a mission to help families navigate the path of recovery together. For further information, visit her website at www.12steps12stories.com or email her at debra@12steps12stories.com

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7/10/14 12:52 PM

IN ADVERSITY LIES OPPORTUNITY By John Lehman

FARR was founded to enhance the quality of services offered by providers of peer supportive housing to those seeking freedom from the bondage of addiction. As an affiliate of the National Alliance for Recovery Residences (NARR), our board adopted a set of national standards developed through consensus by a group of NARR regional organizations spanning our nation from coast to coast. These forty-eight (48) standards, coupled with our Code of Ethics, are driven by four guiding principles to ensure FARR Certified Residences deliver on their promise to provide housing that remains: 1. Alcohol and drug free 2. Peer supportive 3. Safe, clean & dignified 4. A good neighbor and a responsible corporate citizen As FARR President, I’ve had the opportunity to witness both the best and worst this industry has to offer the citizens of Florida. I can attest from first-hand experience as to the selflessness of many operators whose primary motivation is to serve those willing to take the actions necessary to right their lives and escape the hopelessness of addiction. I can also attest to the rampant greed of those whose motivation for entering the space is to capitalize on revenue opportunities through the systematic abuse of health care insurers. While extreme examples can be found on either side of this spectrum, experience informs me that the vast majority of service providers seek to do the ‘right thing’ for those they serve while earning a reasonable return on their investments of time, energy and funds. However; several concurrent factors now frustrate this group from achieving the goal to deliver quality services that both support their clients and deliver reasonable ROIs. Recently, FARR was invited to attend a round table discussion presided over by US Representatives Lois Frankel and Ted Deutch. In addition to myself, FARR Board Members Michael Walsh, CEO/President of NAATP and George Jahn, owner of Sober Living in Delray, were listed under the heading “Advocates”. The remaining forty (40+) plus invitees were a combination of elected officials from state and local government and their supporters including city attorneys, Vice Mayors and representatives from various chapters of The Florida League of Cities. The focus of this round table discussion was specific: frustrated by FHAA and ADA barriers to enact and enforce discriminatory zoning ordinances that empower local governments to restrict the “proliferation of unregulated sober homes”, the assemblage sought support from representatives of US Congress to craft a joint statement to the Department of Housing and Urban Development (HUD) and the Department of Justice (DOJ) encouraging these two austere organizations to somehow restore municipal authority to discriminate against this protected class of disabled Americans. To be fair, not every official invited to participate in the discussion was fully on board with that proposed mission and we three ‘advocates’ exited the two hour dialog with the conviction that there is indeed an opportunity to capitalize on what US Congressman Deutch recommended - that state and local policy makers engage in further discussion with industry leaders on our shared intention; to better inform the process of arriving at equitable solutions that balance the rights of persons recovering from addiction with those of the communities in which that restoration process takes place. Senator Maria Sachs (Senate District 34) and Representative Bill Hager (Florida House District 89) expressed their willingness to continue the dialog. We truly hope this willingness proves genuine. For over two years now FARR has repeatedly reached out

to state officials in an attempt to address the real challenges facing the recovery residence and broader substance abuse treatment community. We’re prepared to recommend immediate remedies to heal much of what ails our community. Unfortunately; but for a few notable exceptions, we continually meet with disdain, inattention and a general unwillingness to discuss any question other than “how can you help us get these people out of our single family neighborhoods?” Surely, the irony is obvious: FHAA and ADA are clearly necessary federal protections against local and state government discrimination. As was evidenced by this most recent round table discussion, far too few elected representatives of the public interest are concerned with improving the quality of services rendered to the estimated million plus Floridians who currently meet the substance abuse treatment criteria established by the Substance Abuse and Mental Health Services Administration (SAMSHA). It is up the voters concerned with ensuring that their loved ones have access to quality substance abuse services to send a message to these politicians who regrettably hear only from their NIMBY constituents. Our voice matters and our vote counts. Ask representatives running for public positions what their stance is on funding for substance abuse treatment programs. Press them for details on their voting history in previous legislative sessions. Hold them accountable to become informed and to seek equitable solutions that protect both our communities and the rights of those afflicted with behavior health disorders. November 4th is fast approaching. Exercise your right to cast a vote for the candidates who demonstrate their commitment to issues that matter most to the quality of your life.

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7/15/14 9:14 AM

EFFECTIVE PSYCHOSOCIAL APPROACHES FOR ADOLESCENT SUBSTANCE USE By Fred Dyer, Ph.D., CADC

Research has shown that early onset substance use problems can predict continuing substance use problems in adulthood. Individuals who seek help at the earliest stages of drug use often experience more favorable outcomes, thus highlighting the importance of working with adolescents who are beginning their involvement with drugs. While several approaches to treating adolescent substance abuse have been evaluated, the majority of these approaches have little support for use with adolescents. Additionally, while therapy appears to help, little evidence is available to suggest that one therapy is more effective than another, and even less is known about what therapy works for different populations, including ethnic or cultural groups, adolescents with co-morbid disorders, and male versus females. Among outpatient treatment modalities, most include family therapy, 12-step/self-help, behavioral/cognitivebehavioral individual group, and motivational interventions. Family Therapy Family therapy is the most researched treatment modality for adolescent substance abuse. Several reviews conclude that family therapy is more effective than other forms of non-family outpatient treatment, including individual counseling, group therapy, and family drug education. Multisystemic therapy is an intensive (up to 60 hours) homebased intervention for families that addresses multiple systems, including schools, peers, groups, parenting skills, communication skills, family relations, and other cognitive behavioral changes. The therapy approach incorporates structural and strategic family therapy and cognitive behavioral therapy. Multidimensional family therapy (MDFT) is recognized as one of the most promising interventions for adolescent drug abuse. MDFT combines drug counseling with multiple systems assessment and intervention, both inside and outside the family. This approach is developmentally and ecologically oriented, considering the environmental and individual systems in which the adolescent resides. Brief strategic family therapy (BSFT) was developed and designed for Hispanic/Latino families with youth having behavioral problems. BSFT is structured to meet with the entire family once weekly for eight to twelve weeks and includes specialized engagement strategies, effectiveness of which has been evaluated and shown in several studies. The intervention is manualized and was recently reviewed. Few studies have compared family therapies with one another, and no evidence is available to suggest that one type of family therapy is superior to another. Indeed, family therapies may be more similar than different because they share the underlying conceptual framework that individual problems are best understood and addressed at the level of family interaction. More recently the field has seen an increase in integrative or combined interventions that include a combination of treatment contexts (individual and family therapy) or theoretical orientations (family systems theory combined with behavioral intervention). The family therapy field continues to evolve with process analysis that examines therapeutic alliance, changes in parenting practices, and underlying connections between changes in family functioning and specific adolescent problem behaviors. In summarizing, outcome research has provided support for the positive impact of family therapy on reducing alcohol and drug use, increasing engagement and retention in treatment, reducing internalizing and externalizing problems, improving family interaction, and increasing the adolescent’s involvement in school. 12-step Programs and Substance Using Youth Professional treatment approaches targeting adolescent substancerelated problems often incorporate the 12-step philosophy and practices of community mutual help organization, such as Alcoholics

Anonymous (AA) and Narcotic Anonymous (NA). In theory, community mutual help resources, such as AA and NA, possess certain elements that make them attractive as an adjunct to formal care. For instance, meetings are available in most communities several times a day, notably at times of high relapse-risk, such as evening and weekends. This provides a degree of flexibility that is not available in professional settings. Moreover, outside of regular meetings, sponsors and other fellowship members often make themselves available “on demand” (e.g., by phone) seven days a week at any time of day or night because a major precursor to adolescent relapse is association with pre-treatment substance using friends. The socially oriented organizational structure of AA and NA could serve as a useful antidote by providing access to a new recovery specific social network. Also of note is the fact that AA and NA groups can be attended free of charge for as long as an individual desires; thus, these organizations could be helpful for substance involved youth with an increasingly cost constricting managed care environment. Conversely, developmentally related differences between adolescents and adults suggest that 12-step fellowships may not be an ideal fit for all youth. For instance, compared to their older counterparts for whom AA was originally devised, adolescents on average possess less addiction severity and related sequelae and lower substance-related problem recognition and motivation for abstinence. They are also significantly younger relative to the majority of the other AA and NA members. Furthermore, some youth treated for substance use may feel uncomfortable with the degree of spiritual/religious emphasis in the AA/NA. Conceivably, such differences might signify a poor fit with 12-step fellowship’s unwavering emphasis on abstinence and spiritual growth. Treatment approaches vary because adolescents and their families, along with the adolescent substance use, enter in with other problems as well. Irrespective of the approach utilized, it is necessary for clinicians, youth advocates, program directors, and administrators to fully understand that, even though therapy approaches designate a certain amount of treatment time alone with the adolescent, one must never forget the clinical adage in adolescent work, “The way you help a kid is by helping the family.” References available upon Requests Fred Dyer, PhD., CADC, is an internationally recognized speaker, trainer, author and consultant who services juvenile justice/detention/residential programs, child welfare/foster care agencies, child and adolescent residential facilities, mental health facilities and adolescent substance abuse prevention programs in the areas of implementation and utilization of evidence-based, gender-responsive, culturally competent, and developmentally and age appropriate practices. He can be reached at dyertrains@aol.com.

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The Sober World is a free national E-Magazine as well as a print publication in South Florida for parents, families and those struggling with addiction. If you would like to receive our free E- version, please send your request to patricia@thesoberworld.com

FOR ADVERTISING OPPORTUNITIES IN OUR MAGAZINE OR ON OUR WEBSITE, PLEASE CONTACT PATRICIA AT 561-910-1943. We invite you to visit our website at www.thesoberworld.com You will find an abundance of helpful information from resources and services to important links, announcements, gifts, books and articles from contributors throughout the country. We welcome content and if you would like to submit an article for consideration in our magazine, please contact patricia@thesoberworld.com Please visit us on Face Book at www.facebook.com/pages/The-Sober-World/445857548800036 Again, I would like to thank all my advertisers that have made this magazine possible, and have given us the ability to reach people around the world that are affected by drug or alcohol abuse. I can’t tell you all the people that have reached out to thank us for providing this wonderful resource.

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CHOOSE YOUR WORDS WISELY, THEY REALLY MATTER! By Drs. Carrie Wilkens and Jeffrey Foote

Words matter. Our society’s beliefs about substance abuse and compulsive behavior problems—and the potential for change— are built into the words we use to speak about these issues. The way we use certain words reflects and conveys our deeply held beliefs and attitudes. Why does our word choice matter when it comes to talking about substance use problems? Because words are an attitude, a belief, and have an impact. Words can help us to motivate towards change or they can bring us down and keep us stuck in the situation we are in. Words matter, because they convey meaning and attitude, and they can set up barriers and roadblocks. Words like “addict,” “abuser,” and “alcoholic” are widely used indiscriminately to describe people who struggle with substance use issues and are laden with negative connotations for much of the culture. As psychologists who treat substance use disorders, we usually discourage clients and their families from using these words to describe themselves or their loved one. We do this for a variety of reasons. First, these words over-generalize and tend to whitewash important details about the people they describe. As they’re commonly used, they are labels that lump together an incredibly diverse group as if they were all the same. They completely blur the reality that people struggling with substance use problems have dramatically different levels of problems, have the problem for different reasons, have different prognoses, and will take a variety of paths with their relationship to substances moving forward. People who use substances are more diverse than they are similar. When you refer to someone struggling with a substance use disorder simply as an addict or alcoholic, you are at risk of losing sight of all the distinctions and variations that matter tremendously. Additionally, it is highly likely that your audience is making a variety of automatic assumptions based on what the words mean to them. While you may mean something very specific when you use the word, the person listening to you may have very different ideas (and you can almost always assume not good ones). You don’t have to dig very deep to hear the negative connotations attached to these words (e.g., lazy, weak-willed, failing moral compass, diseased). In fact, it is not uncommon for them to be used as an insult. The easiest way to confirm this for yourself is to listen to the tone of voice that most people use when they refer to someone as “an addict.” There is more often than not a tone freighted with toxicity, denigration, suspicion, and as a result stigma. Stigma is the second reason we ask people to be thoughtful about these words. Research has shown us that fear of stigma is one of the main reasons people resist seeking help. Studies have found that even professionals in the field are at risk for having the negative connotations associated with these words creep into their work. And stigma is conveyed by word choice. “I’m glad you’re here Mr. Smith, and it’s important that you’ve recognized you are an alcoholic” Ouch! “I thought I was just drinking too much in the evening! Maybe this isn’t the place for me...maybe they are going to view me a certain way...maybe I’ll do this on my own”. John Kelly, a psychologist at Massachusetts General Hospital and a leader in the addiction treatment field, conducted a survey of health professionals who were asked to answer questions about a hypothetical patient who was described as either a “substance abuser” or as “having a substance use disorder.” They found that referring to patients as a “substance abuser” resulted in more negative attitudes and assumptions about the patient. Specifically, the health professionals were more likely to agree that the client should be punished for not following a treatment plan and that their “character” was culpable. The study concluded that the choice of language was related to increased stigmatization. Similarly, studies have found that when treatment providers refer

to clients as “alcoholics,” they are at risk for making negative assumptions that potentially affect how they treat the people they are supposed to be caring for. Terrie Moyers, a psychologist at CASAA in New Mexico who is one of the leaders in motivational treatment approaches, conducted research with substance abuse counselors and examined attributes these counselors attached to the label “alcoholic.” She found that associated with this label were the beliefs that “alcoholics are liars,” “cannot make good decisions for themselves,” “have personality deficits that predate drinking,” have special “spiritual deficits,” and “need strong confrontation.” The final problem we have with using these labels to describe a person with a substance use problem is that people try to explain things through the use of these words. How many times have you heard people say “well, he’s an addict, what did you expect”? In my work, I often hear clients say “I’m an addict, that’s what we addicts do,” or “yeah, over the holidays I started to withdraw more… but that’s me being an alcoholic.” Typically, what people are describing in these discussions are behaviors that the rest of the non-substance abusing world is likely to share in as well (lying to avoid conflict, hiding out when overwhelmed). The difference is that non-substance users don’t explain their behavior by saying “I’m an addict.” Referring to someone else or one’s self as an “addict” seemingly explains a lot of behaviors neatly and under one heading. And the problem? When you explain things with false evidence, the real answers sneak out the back door. For example, “I’m an addict” is not a helpful explanation of why I lie a lot. Instead, I may have gotten into the habit of lying because I am ashamed or embarrassed or I got hit as a kid when I expressed myself. These are real reasons why the lying habit forms, not a reflection of an innate addict character trait. For this reason we DO stop clients from saying “I’m an addict” as an explanation for their behavior, because there is nothing to be learned from this labeling. While we point out all these “label” problems, we know that there are many people who find connection when self-identifying as an addict/alcoholic and find immense comfort in being part of a community who relates to these words. In the context of the 12step community, identifying as an addict or alcoholic can be a powerfully positive act. It is crucial to note however, that it is an act of choice. Calling oneself an addict is very different than being called an addict by someone else. Continued on page 36

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FOREVER ONE: Letters from God—You Are Perfect Love by Jerry Hirschfield, Ph.D. ISBN 978-09626597-3-7, Soft Cover, 8d” x 5d”, 288 pages

$17.50

A set of fifty-three letters (one for each week of the year—plus one to grow on) dictated by God/Spirit through an inner voice of Infinite Love and Compassion. The letters contain new, mindexpanding information regarding the creation of the universe, our infinitely loving, True Being, how we apparently imprisoned ourselves within our egos’ material creations, and how we can reclaim the original power, love, and freedom we were all given at creation.

THE TWELVE STEPS for EVERYONE . . . who really wants them by Jerry Hirschfield, Ph.D. ISBN 978-156838-047-6, Soft Cover, 8d" x 5d", 138 pages

$13.95*

A loving adaptation of the Twelve Steps of Alcoholics Anonymous for anyone confronting an emotional or living challenge. A classic Twelve Step book which will help you stabilize your emotions after becoming clean and sober so you may enjoy serenity and joy one day at a time. A favorite for all Twelve Step Programs and an excellent introduction for beginners. Over 500,000 copies in print Copyright by HI Productions, Published by Hazelden Educational Materials *Please order from Hazelden Educational Materials at http://www.hazelden.org/OA_HTML/ibeCCtpItmDspRte.jsp?item=1322&sitex=10020:22372:US or http://www.hazelden.org/OA_HTML/ibeCCtpItmDspRte.jsp?item=49108&sitex=10020:22372:US for ebook or Phone 1-800-328-9000

LOS DOCE PASOS HACIA LA LIBERACIÓN ESPIRITUAL** by Jerry Hirschfield ISBN 84-7640-635-5, Soft Cover, 8½" x 5½", 142 pages

$12.00

Este libro le enseña la aplicación práctica de los Doce Pasos de Alcohólicos Anónimos a toda persona que tenga algún problema con sus emociones, con su vida, o que está en la búsqueda de un camino que le lleve hacia la liberación espiritual y emocional. Este libro es tradución del exitoso, The Twelve Steps for Everyone . . . who really wants them, del que se han vendido más de medio millón de ejemplares en inglés. Los Doce Pasos... está escrito con compasión hacia el público en general como así también para el profesional. En los EE.UU., lo distribuye HI Productions.

Spanish translation of The Twelve Steps for Everyone. . . (see above) Distributed in the U.S. by HI Productions. ** Available only at HI Productions or www.hiconnections.com (Books and CD’s page) (Not available at amazon.com)

Order from HI PRODUCTIONS, 10211 Pines Blvd. #135 Pembroke Pines, Florida 33026 Phone: 954-537-3060 Fax: 954-443-7745 or at www.hiconnections.com or www.amazon.com

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MY LIFE AS AN ADDICT--LIFE ISN’T ALL IT’S CRACKED UP TO BE By Meg Henderson Wade

In October of 2005, my life was about to take a huge turn for the worse and I didn’t even know it. Gee, there should have been some sort of cosmic sign--“Don’t come this way to “Alice’s Restaurant”, or like in the WIZARD OF OZ, “I’d turn back if I were you.” wisely said by the Cowardly Lion. Ah, but life doesn’t spell itself out when we are in the middle of it. It flows along like a winding road and we don’t see the twists and turns and the road that we should obviously take. We just keep flowing along and destiny takes over. This karmic road is set in stone whether we realize it or not and sometimes we are helplessly propelled forward down the wrong road by one bad decision. I don’t believe in coincidences, I believe in “God Winks” and that things are meant to happen and if we pay attention to them, we will be on the right path. However, if we act on automatic pilot and ignore our inner moral compass we will always end up heading in the wrong direction.

crack cocaine addiction. Hey, if it can happen to this Southern Baby Boomer, it can happen to anyone.

All my life I had followed my own self-confident inner compass and marched to the beat of my own drummer, and somehow managed to always follow MY right path.

I smoked it once and became instantly addicted. And, if by being open and honest, I can make someone think twice and “JUST SAY NO”, then it’s an important thing for me to do.

Wow, what a life-changing mistake I made as I headed blindly down the road with my usual, Ready, Fire, Aim personality---jumping into something without thinking.

There is so much that I learned about the nine months of my life that I was a Crack Cocaine Addict. And being a normal human being with morals and a conscious, I feel ashamed that all of this crazy stuff happened to me. But as Narcotics Anonymous says, “You are only as sick as your deepest secrets.” And as I tell them they don’t have the power to hurt me anymore.

I should have paid attention to my inner voice. I knew it was such a stupid thing, yet I was trying to bond with my husband as I smoked the pipe he offered me. Drugs were what finally, sadly tore us apart and eventually ended his life. Don’t rain on my parade, don’t let the turkeys get you down, don’t smoke CRACK COCAINE. You would think these things would have been glaringly obvious to Moi. I definitely take responsibility for my own actions. I should not have naively, stupidly smoked whatever my husband gave me. I should have been true to myself. I should have JUST SAID NO TO DRUGS. It sounds trite and simple, yet I believe that this phrase means so much more and has become my mantra. I am on a crusade to educate the public about the dangers of crack cocaine and how easily, needlessly it can destroy your life. I guess the world needs to put a realistic face on addiction. So, I will be the new face of

So that’s my story and I’m sticking to it. I am going “Out on a Limb” like Shirley MacLaine and confessing my tales of crack addiction in order to motivate other addicts who need help--that’s me, The Southern Baby Boomer who was addicted to Crack Cocaine and found her way back to the right path that destiny had in mind for me all along... Meg Henderson Wade has been an author, actress and motivational speaker for over twenty years. She is the author of “Confessions of a Southern Baby Boomer” She has performed on Stage, Screen, Radio and TV as an actress, author and storyteller to bring her motivating messages to people throughout the United States, Canada and Japan. Meg’s company Bless Your Heart Productions produces TV & Radio shows and Fabs – Fabulous Author Book Signings where local authors have the opportunity to market their books and speak about why they wrote their story. www.meghendersonwade.com

CHOOSE YOUR WORDS WISELY, THEY REALLY MATTER! By Drs. Carrie Wilkens and Jeffrey Foote

Continued from page 34

The fortunate news is that words are hugely powerful mediators of positive change. Some of our most successful treatments (e.g. Motivational Interviewing) are predicated on use of language by the therapist that is non-confrontational, respectful, conveys a sense of collaboration, and demonstrates empathy and understanding of the other person… all with words! Additionally, this approach places a lot of emphasis on facilitating certain language from the client, called “change talk,” that has been demonstrated to predict positive change. So our language matters, and the language of the person we are trying to help matters.

about these words and may in fact relate to them deeply, it is important to not minimize the stigma they may carry for the person you are talking with. While the alternatives are awkward and far from a sound bite, phrases such as “substance user” and “person with a substance problem” are more accurate and less at risk for pushing a person away from change.

From the perspective of cultural ease, it is easy to understand the pull to find one-word explanations, especially in our current world of sound bites. But the reality is that labeling anyone with a substance problem as an “addict,” “alcoholic” or even “substance abuser” does stigmatize them in the real world, pushes too many people away from the help they need and want, and makes generic a problems that are profoundly complex. We cannot escape the reality that stigma is conveyed by word choice: once spoken, the genie cannot go back in the bottle. And while you may not feel anything negative

Drs. Carrie Wilkens and Jeffrey Foote are the co-founders of The Center for Motivation and Change and are co-authors of Beyond Addiction: How Science and Kindness Help People Change (www. beyondaddictionbook.com). Beyond Addiction is a compassionate and science-based family guide for navigating the addiction treatment world, understanding motivation, and training in the use of CRAFT (Community Reinforcement and Family Training) skills. To find out more about The Center for Motivation and Change or Beyond Addiction, you can visit them on the web at www.motivationandchange.com.

The scientific evidence is clear…words matter. They can open doors to change and expand our perspectives or they can set up barriers and roadblocks to understanding… we would like to keep them open.

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A SUCCESS STORY By Craig Lewis

I have lived an unconventional life as I lived in group homes from 1988-1991, for as they described it, being an “emotionally disturbed adolescent”. My life in the mental health system began when I was about 7 years old. My home life was quite dysfunctional and I learned some maladaptive coping skills due to experiencing my parents in action, as they lived with their own dysfunctional behaviors. I learned to yell and scream when I did not have things go the way that I wanted and I learned to yell and scream when I did not have my needs met, which throughout my life, caused me endless amounts of trouble, suffering and pain. I was put into a psychiatric hospital on April 13th, 1988. This is when hell really began for me. I was pulled from high school and never saw my classmates or friends again. I was told that I had a mental illness that would be with me for the rest of my life. I was put on heavy doses of psychotropic medication for schizophrenia, a condition I know now I never had. My parents would tell anyone and everyone who would listen, again and again, that their son was mentally ill. This helped sever or at least poison most of my familial relationships as well. After spending 4 months in this hospital, a hospital meant to keep people for about 7-10 days, and after being told that I could not go home, I was put into my first group home. It was terrible. At this point I was 15 years old and my life as I knew it was over. Life in this first group home was awful. I spent 15 months living there. During this time I continued to be prescribed medications for schizophrenia. My life in this group home was incredibly traumatizing as one could imagine. I was then released from the group home as I was deemed “cured”, and sent home to live with my parents. After 3 months living at home, things once again became out-of-control and I was put back in the same psychiatric hospital as before for another 3 months. Again I was told that I could not go home and I was put in a second group home for 12 months. Throughout all of these experiences I repeatedly asked the staff, therapists and psychiatrists why I was living there as I could not make any sense of my life. Once I turned 18 in May of 1991, I was put into a third group home for adults. There was a guy in this third group home that was very nice to me which was appreciated as I had no friends. He introduced me to alcohol as well as smoking pot, which was my first time ever getting high or drunk. Getting high was the greatest relief I had ever experienced in my life. I then spent many years living in different dysfunctional living situations and I smoked pot as much as possible. I made friends with people who were stoners and who were reliable in their ability to get me high. Smoking pot made me feel better and was the only reliable way for me to escape the raging pain that existed within me. For 10 years I got high as much as possible. I had become an emotional addict and could not survive my daily life without getting high. Some people may smirk at reading this; however, in my case there is no question that I was dependent. In 2001, as pot became more potent, I started to freak out more when I got high. This was a miserable experience and I knew that I had to stop. On May 20th I got high for the last time. It became easy for me to stop at this point because I knew that getting high inevitably meant that I would suffer immensely. This was the first step I had taken in my life, up to this point, that got me to where I am today. I finally hit rock bottom in 2004 and chose to try one last time to make my life better. Fatefully, after getting a new therapist, receiving educational training from the state, becoming a certified peer specialist, obtaining safe housing, volunteering at peer

recovery programs, earning my Associates degree in human services and graduating with a 3.88 GPA, finding a job I loveworking as a peer counselor (still there 4 years later), finding my soul mate and getting a new psychiatrist, life began to improve in ways that I never thought possible. My new psychiatrist suggested (after having the same one for 15 years), that I go off of the psychotropic medications that I had been taking since the 80’s. The results were I felt a million times better. While some people do benefit from these medications, in my case these medications along with the life of trauma that I have lived were the real causes of my dysfunction and suffering. Today I am a happy, healthy and satisfied person. I live with my soul mate and our two cat-sons. I have a good life. I don’t touch drugs or alcohol. I make decisions for myself to preserve my wellness, happiness and stability. All things considered, life is great. I do work hard every single day to manage my struggles and on some days I absolutely experience despair and this hurts terribly but I use my coping skills and I get through it- one day, one hour, one minute, one second and one split second at a time; for life is what you make of it. Sanity is a full-time job and I am happily employed. May you all have better days. Craig Lewis is a Certified Peer Specialist living and working in Massachusetts. He has struggled immensely with mental health issues, addiction and trauma throughout his life; however, he has successfully transformed this into a life of wellness. Craig is successfully working as part of an outreach team in Boston, Massachusetts. He also tours the country speaking about his lived experience, sharing his struggles and triumphs to help others. Craig has authored and published the Better Days – A Mental Health Recovery Workbook. Craig based the Better Days workbook on his personal life and recovery, and every page has been used successfully in peer group settings. Craig can be contacted at: betterdaysrecovery@gmail.com www.betterdaysrecovery.com www.punksinrecovery.com

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NO WILLPOWER NEEDED: WE MUST TREAT THE DEEPER MIND! By Douglas Schooler, Ph.D

Where do our thoughts come from? Why do we feel the way we do? Why did we make that “choice”? Why did I have that dream? The answers are to be found in the deeper mind. Yet the deeper mind is a mystery; it’s the not-conscious, the subconscious, the unconscious, yet it affects us every second of every day, influencing our thoughts, feelings, and behavior in ways that we are often conscious of and frequently quite surprised by. Yet much mental health and substance abuse treatment ignores the deeper mind and instead targets the part of the mind most available and easiest to reach. A Mind Divided- A Mind United The human mind is the most complicated mind of any animal on the planet. This obvious fact has implications that are not always so obvious. The conscious mind has the power of logic and voluntary control. The deeper mind has the power of emotion and automatic control. They don’t always work together harmoniously. When someone enters a recovery treatment program they are essentially saying: My logical mind realizes drugs are bad for me, but my deeper mind keeps me using anyway.” A mind divided. No other animal would react or think this way. When a wolf sees a rabbit he doesn’t have to motivate himself to chase it. He takes action right away. When a crow sees another tree that has a better perch she flies there. Period. Simple. A mind united. Desire and behavior are linked directly. No guilt, no shame, no hesitation, no willpower needed. People come in to psychotherapy treatment because they want to think, feel, and/or act differently but they haven’t been able to get themselves to do it. Examples: I know I shouldn’t rage at my spouse but I can’t help myself and just lose it! I want to lose weight but I can’t get myself to stop eating muffins. I just can’t stop myself from thinking about my ex, even though I’m with someone else now. I can’t get myself to stop drinking even though I know it’s killing me. In each sentence it’s useful to realize that the “I” refers to the logical, conceptual, conscious mind and “myself” refers to the deeper, primitive, powerful, non-logical, emotional, and largely subconscious mind. The subconscious or deeper mind is in charge of automatic, involuntary behavior and what is addiction and habit but just that. Knowing this, the direction of treatment is clear. We must treat the deeper mind. If the mind of a person in recovery worked like the mind of a wolf, he might say: “Drugs have lost all appeal, I’m repulsed by the very thought of them, they’re poison and using is out of the question.” Mind united. Thought, emotion, and behavior connected and congruent. But we don’t often hear that. Instead we hear the opposite. “I know I need to stop but I don’t.” Treatment then is all about causing the mind to be united and congruent, so thought, emotion and behavior are on the same page. How does one accomplish that? The fields of psychotherapy, psychology, psychiatry, and drug treatment have evolved a whole host of approaches. Even though they claim to be scientific and “evidence based” (such a popular term lately) their prevailing view has been predominantly moralistic. Much of psychotherapy addresses the conscious mind, attempting to motivate and strengthen willpower. It is based on the notion that if one has insight into the origins and “causes” of his problems, willpower will be strengthened and motivated by guilt and regret, he will make better choices. And that has some limited value. Willpower can be trained and improved. But it is no match for the power of the deeper mind. So we need to do much more than that. The conventional paradigm has proven woefully ineffective. People often receive traditional psychotherapy for years with hardly anything to show for it – except for perhaps knowing that someone they look up to understands them and their suffering. That is not enough. We need to step back and rethink what we are really trying to do. We’re essentially trying to get our patient’s minds to work like

the mind of a wolf: See what’s of value and do it. No hesitation; a mind united. The human mind does have the capacity for unity of purpose. How much willpower do you need to stop you from eating a bowl of dirt? The new paradigm is based on advances in neuroscience. Recent discoveries have severely challenged the idea of free will and choice. The evidence shows that our minds are thinking for us, and that’s all happening below conscious awareness. Do a search for “free will” and you’ll find the details of research that shows that brain activity is occurring milliseconds or even seconds before a decision or choice is made. It seems as though our brains decide what’s next for us slightly before we are conscious of it. The new view is simply that the “subconscious mind” is running the show and it’s the therapists’ job to influence and adjust it. Not an easy task by any means, but that is where we must start. And we do have the beginnings of a technology to do that. Hypnosis in all its multitude of varieties, relaxation techniques, energy therapies, imagery and visualization, even behavioral approaches, all these have the potential to dramatically influence the subconscious mind. Even conversational speech, properly structured, can do so. Addiction professionals must at the outset of treatment target the subconscious mind, both on the clinical and program development levels. Yet we must not fall into the trap of telling our clients that they or (or their minds) are their own “worst enemy. “ We need to abandon all aspects of moralistic thinking and the labels and judgments that go with it. Making people feel bad in order to get them to do good has proven ineffective. Scientific thinking must replace moralistic. We must use the tools we already have (they work!) and develop new ones. We have to laser focus on our objective, which is to get the deeper, subconscious, primitive and emotional mind completely onboard. That is the job of the treatment provider. Keep that target clear in your vision and you have a good chance of hitting it. Dr. Doug Schooler is a Licensed Psychologist and Certified Master Practitioner of Rapid Resolution Therapy. He maintains an independent practice of psychology, The Center for Rapid Resolution Therapy, in Boca Raton, providing treatment to all ages since 1985 (www.DouglasSchooler.com). Before coming to Florida he taught psychology at Eastern Michigan University. He graduated from Queens College in 1964 and received his PhD in psychology from the University of Rhode Island in 1976.

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THE FOUR LEVELS OF TRANSFORMATION By Larry Smith, CAS III

Continued from page 8

need for change; we become consciously aware that we are not alone on life’s journey. We find satisfaction in helping others. We now take responsibility for our thoughts and actions. When we experience conscious competence we are not only aware of our addiction, we remind ourselves of it every day. People in recovery who have become honest, open-minded and willing are firmly planted in this stage. Level 3 is represented well in The Promises of Alcoholics Anonymous: These promises are integral to recognizing the actual results of our commitment to sobriety. However, there is still plenty of room for growth after the promises start coming true. I believe strongly in the 12-step process, nevertheless one of the complaints from mental health professionals about 12step programs is that after achieving long-term sobriety, many 12-steppers tend to still dwell on how sick they are. This criticism has some merit. Some people in recovery may be permanently stuck in this phase of their development. And that is not a totally bad thing – it beats living chemically addicted. An example of being stuck in this phase is when a person with more than 20 years of sobriety states that he or she is still powerless over alcohol. They are comfortable living in the problem. There is a tendency to place too much emphasis on drunk-a-logs and on how pitifully sick they are, as opposed to how well we can become by living in the solution. On the other hand, others continue to move forward in their recovery. They are able to gain self-esteem and still maintain humility. These people rarely use negative self-talk when sharing their experience, strength and hope. They have what I want. When personal growth slows down in level 3 conscious competence, recovery becomes more like work. By being satisfied with one’s personal growth, a recovering person will tend to move backward. Instead of an awareness of personal recovery, some believe they are still living in the throes of step 1. Some may argue that the first step implies that we never recover from being powerless. I address this issue when I discuss the first step. Maintaining one’s powerlessness is a defensive tactic. At this point in recovery, I prefer to be on the offense. I also choose to accept and experience all the grace that comes my way. At this phase of development, I suggest you hold your head high and aspire to live on a higher plane than people who have never sunk to the depth of addiction. There are many great teachers in 12-step programs; however, I am not drawn to those who claim they know the truths and all the answers. They tend to sit in meetings repeating the same stories over and over and continually preach to the newcomers. They are content to remain consciously competent. Instead, I am drawn to those who continue to seek knowledge and truth. The truth-seekers tend to read, learn, pray, meditate and journal. Whether they know it or not, they aspire to become unconsciously competent. Level 4: Unconscious Competence Every person achieving unconscious competence spent a great deal of time in the conscious competence phase. We can only find ourselves in level 4 by experiencing the repetition required in level 3 to maintain sobriety. Like miracles, unconscious competence comes to us – we don’t go to it. The level of competence equates to being self-actualized, the highest form of maturity in Maslow’s Hierarchy of Needs. When we live our lives in the flow of doing what is right without

consciously thinking about it, we experience unconscious competence. At this level, prayer, meditation and being of service are part of daily life. The reward is in the service. While living in level 4, we do not to take things personally, nor do we cave in under the weight of the ego. This is spiritual recovery in the highest form. Living life on this level may be the result of any of the following: 1) Having had a spiritual awakening as a result of the 12 steps 2) A profound spiritual experience such as a near-death incident 3) A massive shift in personal values 4) Spontaneous remission from a terminal disease When we have thoroughly experienced the 12 steps and have had the spiritual awakening referred to in step 12, we will most likely agree with these premises: 1) Today alcohol and drugs have no power in our lives. In fact, we rarely think about drinking or using. We have a God of our understanding, the fellowship of a 12-step program, and we work daily on the maintenance of our spiritual wellbeing. We are unconsciously competent about avoiding people, places and things that are not on our spiritual path. 2) We no longer allow our egos to successful challenge God’s will for us. We do this by utilizing only the quiet voice of the Spirit when making decisions. 3) We recognize that these steps are simplified ways for humans to digest God’s will slowly. God’s accomplishments are not gradual, nor do they ever change. With God, time is meaningless because God is eternal. 4) As half-measures avail us nothing when it comes to recovery from addiction, half-measures also avail us nothing when it comes to willingness to accepting God’s will. 5) Intuitively knowing how to handle situations that used to baffle us directly correlates to our state of unconscious competence. Here are some suggestions for maintaining unconscious competence. Upon awakening: 1) Read something of a spiritual nature. 2) Meditate on the lesson received from the spiritual reading. 3) Journal on the experience of the meditation. (Journalizing authentic feelings are easier after meditation) The time allotted for each step may vary each day. At times, I may only read one paragraph and other times I may read a chapter. Upon experiencing level 4 unconscious competence, our minds are free of the fear and anxiety created by our egos. It is at these times that we are fully in touch with our higher selves. We listen and follow the quiet voice of the spirit. We become oblivious to the chaos of the world and we accept that everything is exactly as it is supposed to be. Larry Smith is the founder and CEO of Get Real Recovery, Inc. He is a certified addiction counselor, lecturer, public speaker and author. He has published a goal setting and journaling book for people in recovery, Captain Larry Smith’s Daily Life Plan Journal. When Larry is not counseling, he flies 747s for a major international commercial airline. He is a retired Air Force Fighter Pilot and has accumulated over 20,000 hours of flying time. Larry is an Airline Pilots Association Rep and volunteers with his airline’s Employee Assistance Program. In that capacity, he works with the FAA and medical doctors to assist pilots with addiction problems through a rigorous re-certification process. Larry is also certified in EEG Neurofeedback. His presentations ‘Reclaiming Your Hijacked Brain’ and ‘Learning to Be Happy’ have been presented at state and national seminars. GetRealRecoveryInc.com

Banyan Treatment and Recovery Sober Living and Intensive Out Patient Program • Including 5 master level clinicians running our intensive out patient program • 24 hour admissions help line: 844-4Banyan (844-422-6926) • Tours for industry professionals Please contact Taylor Glenn, Director of Business Development

954-573-4978 www.BanyanTreatment.com 950 N. Federal Highway Pompano Beach, FL 33062

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