Wednesday, December 31, 2008

Self Blame

It is hard to be cheerful or happy when you’re scared to death. This holiday season many of us are feeling stressed and fearful about our futures. In addition we are feeling angry and resentful. We may be in fear of, or have lost our job or lost significant amounts of money in our retirement accounts. In some extreme cases we may be losing our homes.

For the addict/alcoholic we have a tendency to beat up on and blame ourselves for our unfortunate circumstances. We spend a great deal of time beating up on ourselves for perceived mistakes that may lead to losing money, job or home. The other feeling is, I’m defective and I deserve this.

Self blame is a useless exercise and only serves to distract us from sober thinking and paralyze us so we are unable to take any action. It enables us to feel shame and guilt and does not do anything to effect a change in our circumstances. It is not uncommon for the alcoholic/addict to have a tendency to take on more responsibility for a situation than is realistic. Often when we find our self in a difficult or unhappy circumstance we do have some responsibility for it. The alcohol/addict tends to take all the responsibility for the situation. It is important to recognize that the need to be completely responsible is directly related to our need to control. “If it is my fault I can fix it.” The feeling that we somehow deserve life’s negative outcome serves to reinforce our tendency to be a victim.

It is an important component of the recovery process to honestly take responsibility for our actions and make amends wherever possible. It is equally important to be willing to let go of events that are not our responsibility and outside of our control. Navigating this delicate balance is essential to maintaining a sober mind. The shame associated with being a victim deserving of bad things leads to anger, resentment, depression, isolation and loss of the ability to ask for help. The result is loss of mental sobriety and in many cases physical sobriety.

Whatever has been lost in the current economic crisis it is critical to protect both our mental and physical sobriety. It is important to acknowledge what actions created the problem and to not lose the lesson. I have heard it said at meetings that there are no victims only volunteers. It is important to keep our head where our feet are and use the tools of the twelve step program to not fall in to despair; to stay in the day and enjoy our life and our holidays.

As the end of 2008 approaches it is my hope that we all have a better 2009.

Monday, September 29, 2008

Anxiety and Worry

Worry seems to be an inherent human condition. Most of us worry about things we cannot control and many of us attempt to anticipate all eventualities. Those of us that grow up in alcoholic/addictive families learn to worry well and often from a very early age. We live in a continuously stressful environment where the only certainty is uncertainty. The alcoholic/addictive parent is unpredictable and as young children we spend a great deal of time attempting to avoid and control their uncertain behavior. We are doomed to failure and the result is frustration, shame and guilt. The belief that we have somehow caused the unhappiness of the alcoholic/addict leads us to the conclusion that we do not deserve to be happy. We spend a great deal of time trying to find a solution and create a happy life. We are anxious and worry all the time and as a result we often are irritable and angry. Anxiety and the worry that result from it are punishing and deprive us of happiness. Many of us seek happiness through alcohol, drugs, food, sex, work and other addictive, self defeating behaviors.

The sad news is that there is not enough alcohol, drugs, food, sex and money in the world to relieve the anxiety and worry. Many of us loose control of these behaviors which ultimately serves to increase our frustration, shame and guilt. They handicap and diminish us, obstruct our thinking and distort our reality. The result is our anxiety and worries become exaggerated.

Anxiety and worry can make it difficult or in some instances impossible to function. We can become overwhelmed and often paralyzed with fear over some insignificant or misinterpreted incident. We begin to question our own ability and judgment which can lead to an inability to act in our own behalf or to self- sabotage. We become vulnerable to manipulation. A good example is the current financial situation that permeates the news recently. We are being bombarded with doom and gloom. It is entirely possible that many of us will experience some financial problems. If we allow our anxiety to cause us to react we may not make the right decision for our self. This is a time to follow my basic rules: keep your head where your feet are; for today you probably have what you need. Do what is right for you; don’t make decisions while you are anxious, make sure you think before you act. Finally stay away from people that don’t make you feel good about yourself. People are afraid and fear can be contagious, try to avoid conversations that are full of someone else’s anxiety. Talk to people who are knowledgeable and sensible.

The good news is that we do deserve to be happy and while we may be powerless we are not helpless. We worry because we want to avoid pain by preventing or resisting some undesirable outcome. While it is not possible to avoid life’s realities we can relieve anxiety by taking responsibility for ourselves and being aware of our anxiety triggers. It is important to be aware that many of the things we project happening are usually unrealistic. Life events are mostly random and that it is a waste our precious time to try to control the outcome. Additionally, if we focus on managing our anxiety and worry when there is a crisis will be better able to cope.

When we are feeling anxious it helps to take action. Probably the most important thing to remember is to breathe. When we are anxious we tend to breathe short shallow breaths. Taking a few minutes to do some deep breathing it will help the anxious feeling. Some people use exercise, yoga or meditation to relieve stress and anxiety. It can be helpful to listen to music, read a good book or do some other activity that will distract us from the focus of our anxiety. Twelve step meetings and professional counseling can help us to learn tools and exercises to cope with stress and anxiety.

Remember: Worry never robs tomorrow of its sorrow, it only saps today of its joy. ~Leo Buscaglia

Monday, June 2, 2008

Detachment

The concept of detachment can be very difficult to grasp, especially for those of us who have grown up in alcoholic/addicted families. Living in an alcoholic/addicted family can be a very painful, frightening and frustrating experience. We are often witness to our loved ones repeated, self destructive behavior. Many of us determine to live a very different life which gives rise to our compulsion to control the people around us. We come to believe in a sense of power and responsibility; power that we have control over the behavior and feelings of others and that it is our responsibility to do so.

Many of us harbor the delusional belief that we are in control of every aspect of our lives and the lives of our loved ones. That it is our responsibility to order the lives of our parents, our partners, our children, our friends and anyone else that is in our world. We are oblivious to our own pain. We are happiest when every thing goes according to our perception of correct, and miserable and angry when it deviates from our plan. Many of us believe that control is our job and consequently we are out of control. The need for power and control leads to distorted and irrational thinking.

Father Martin said, “The only one sicker than the alcoholic is the alcoholic spouse”. That statement touches a nerve with many of us, our spouse is sick, but we have no idea how sick we have become. We believe we are powerful and in control. This type of distorted thinking leads to frustration and a deep sense of failure when we can’t control our loved ones’ behavior. Detachment requires that we do not interfere with the consequences of anothers actions. The goal is to recognize that it is our fear, guilt and outside pressure that manipulate us to intervene and prevent some terrible fate that might befall a loved one.

Learning to detach can be difficult and when we are in an alcoholic/addictive relationship it requires support. Twelve step recovery programs and professional counseling are usually necessary. Detachment is non judgmental and requires compassion for the alcoholic/addict; it means learning never do for someone what they can and must do for themselves; to allow others to be who they are not who we want them to be; to let go and establish emotional boundaries; to allow learning through natural consequences and resist the urge to rescue.

It is important to learn we are not responsible for anyone but our self. As long as we focus on someone else’s problems we are distracted and don’t have to take personal responsibility for our own behavior. The key to detachment is learning "love of self" and maintaining our own mental sobriety. We can find the wisdom to know the difference between what we can and cannot change if we focus on our own needs and problems, only then will we achieve mental sobriety.

Thursday, May 8, 2008

Mother's Day

Mother’s Day may be the most emotionally charged holiday on the calendar. In the days and weeks leading up to Mother’s Day we are surrounded by advertisements designed to elicit emotional spending on gifts and cards for Mom. The ads describe this perfect person that is sweet and kind; a woman who has sacrificed for her children and loved them unconditionally. A mother that is a person that deserves to be honored.

Mother’s who are, alcoholic/addicts or codependent with the alcoholic/addict may not fit that picture of motherhood. They often have a very limited ability to provide the love and nurturing children need. Mother’s Day can be a painful reminder of broken promises and disappointments for their children. It is probably true that Mom did the best she could. She allowed us to use her body as the vehicle to enter the living world. That is an act that deserves to be honored.

The twelve step programs teach us that no one can be all things to all people, even mothers. People don’t let us down; it is our expectations that let us down. It is important to learn self acceptance, self trust and self love. We need to make sure not to break promises or to disappoint our selves. The fact that we managed to survive our childhood is evidence that we have the capacity to take care of and love our selves; that we have the courage and tenacity to overcome our distorted perception of love and the inability to trust.

It is my belief that human beings do not so much need to be loved as to loving. We need to learn to love our selves as we can not give what we don’t have. The wisdom of the twelve steps of the addiction recovery programs provides a roadmap to achieve trust and self love; by participating in the recovery process and reaching out to those individuals that have the ability to meet our needs it is possible to develop realistic expectations of others and of our selves.

On this Mother’s Day honor you mother for the role she played in giving you life; honor all the people in your life that may have served as a surrogate mother and helped you mother you; honor you as the true source of your ability to love and make it a Happy Mother’s Day.

Monday, March 31, 2008

Gossip

Gossip – we’ve all done it, and while it may seem like a harmless pastime, we need to resist the urge to engage in it, if we want to maintain a sober mind.

Gossip is damaging and degrading to the person that gossips, the person that listens to the gossip and the person gossiped about. The wisdom of anonymity in the twelve step recovery programs goes far beyond just guarding the identity of the addict. It emphasizes the importance of an atmosphere of trust and confidentiality.

There are many kinds of gossip and many reasons to gossip. We all want to feel that we are important, that we matter and that we are a part of something. To establish a sense of intimacy with friends and acquaintances we'll talk about the details of other people's lives. Many of us use gossip to have something to say in social situations; to appear informed; to be understood or to impress others.

What is gossip? I think of gossip as talking about someone when they are not present. It can be “positive”, like “my husband stopped drinking”, or it can be negative, like “guess whose husband got a DWI”?

In the addictive/alcoholic family system gossip can sometimes be the only form of communication. Often the family is so enmeshed that what goes on in one family member’s life is the business of everyone else, particularly if they’re in crisis. They’ll talk about each other instead of to each other because they fear being direct and confrontational, or because they’re addicted to chaos and excitement. Confiding is not gossip - there are times when we need to talk about someone for our well being, or for theirs. In that situation it is necessary to seek the help of a counselor and/or a trusted twelve step program friend.

To break away from the gossip habit requires awareness, courage and self disciple. Avoiding gossip is very difficult and anxiety producing. We don’t want to be left out and we may feel that if we don’t engage in gossip someone might get angry and reject us.

When we gossip about someone we reinforce and perpetuate a reality about them that may or may not be true, and once that reality is created it’s difficult to change it. The image of that reality can be an obstacle to recovery for the alcoholic/addict. Even in sobriety addicts are stuck with an image of themselves that interferes with healing many of the hurts incurred during their active time.

We justify gossip by saying “everyone does it” or, “we are only talking out of concern for the person." In dealing with someone suffering from addiction, gossip can prevent us from focusing on ourselves and it can reinforce our victim role. It can lead to dishonesty and can damage our relationships with friends and family.

My #1 Rule for a Sober Mind is "Do what is right for you". Talking about other people doesn't serve us or others in a positive way. Instead, we can put that same energy into better use by figuring out our own lives, and pursuing our passions.

Thursday, March 20, 2008

Welcome Spring!

This morning at precisely 1:48 A.M. EDT the sun crossed over the Earth’s equator (Vernal Equinox) and for the northern hemisphere marks the first day of spring. Winter is a very difficult time of year for many of us. Spring brings the promise of enduring life and for many of us renewed hope. It also reinforces our powerlessness over all but our own mental sobriety.

"Sit quietly, doing nothing, spring comes, and the grass grows by itself."
Zen saying

Sunday, March 9, 2008

Courage

Without fear there would be no need for courage. Being afraid does not mean we don’t have courage. Fear is a genetic instinct necessary for human survival. Courage is a learned behavior - there is no such thing as a born coward. It is possible to teach ourselves to have courage. The kind of courage it takes to achieve and maintain a sober mind is very conscious. It isn’t a knee jerk reaction. It is the ability to confront a situation and ask yourself, “If I take this action or decide to do nothing at all, what is the worst possible outcome, and can I live with it? To accept that I am not responsible for nor can I control the outcome once I have made the decision, I just need to have courage.

Many individuals in recovery were raised is very unstable homes. We spent a great deal of time feeling afraid. Often we were afraid for our physical safety or we experienced severe financial insecurity. Many of us feared disapproval and rejection from our parents or caregivers. These early childhood fears become a crippling force in our lives. As adults we are afraid of being alone, of rejection, of humiliation, of failure, of not having enough money, to mention a few. We have become skillful at avoiding what we fear, but by doing that we become its prisoner.

A courageous act may involve being honest and not agreeing with a friend or loved one and risking rejection; it may involve practicing being alone for short periods of time each day; it may involve trying something new and taking a risk. Courage doesn’t always require a heroic act. Sometimes it takes more courage to sit there and do nothing, like when we resist the impulse to enable a loved one. To watch someone we care for suffer the consequences of their own actions can require all the strength we can muster.

It is possible to acquire courage and overcome our fears; especially the one I believe is the greatest of all, the fear of asking for help. Participation in a twelve step program and/or psychotherapy can help us to identify our fears and develop skills for facing them courageously. Sharing our fears with someone we trust is an act of courage. Each little act of courage can build on itself and gradually liberate us from the immobility of fear.
Fear is not our enemy; we are born with the ability to fear in order to survive. We can use fear as an opportunity to grow and to develop courage, and to empower us to live a sober life.

"Courage is resistance to fear, mastery of fear - not absence of fear."- Mark Twain

Wednesday, February 27, 2008

The only true love is self love

One of my readers recently commented on my Valentine’s Day post, asking me to expand on the meaning of self love, a topic that’s important for anyone recovering from addiction.

Individuals can spend a lifetime looking for someone to love. Others remain in toxic, unhealthy relationships as adults because they do not love themselves. In order to keep the relationship afloat, they distort who they are and they deny their own needs. But the reality is that, until we accept, honor and truly love ourselves, it is very difficult to establish a loving relationship with another person.

Often times the concept of self-love is confused with selfishness and narcissism. Many of us were raised with the idea that love requires denying our own needs for the good of others. We have this false belief that in order to prove that we love someone, we must do what they want or need. This creates an obstacle to self discovery and self honesty. It is fertile ground for guilt and shame to be the prime motivators in our lives.

In a sense we are taught from early childhood to be dishonest and to deny who we are. If we feel resentment toward our loved ones we have to deny that feeling because we believe it is not loving. The resentment creates feelings of guilt and shame, so we try to cover it up by lying to ourselves and acting as if everything is “ok”. This behavior becomes second nature – just another automatic response that we engage in without thinking.

Love is something we share; it is a gift we give to others. When we give love away we often do it at our own expense. In order to achieve a measure of self love, an individual must believe that their needs are just as important as anyone else’s. Not more important, but certainly not less. If we don’t believe we are worthy of our own love, what value does that love have to others? How do we allow others to love us?

There is a difference between sharing love and giving it away. It’s impossible to share love or anything else unless we have enough for ourselves, and for that we must nurture ourselves and keep our love “reserves” full.

It is no easy task to practice self love. It requires that we be kind and gentle with ourselves and that we put forth the effort to learn who we are and what we need. We can start by identifying things that make us feel good about ourselves, like finally getting to read that book that’s been sitting on our night table, or embarking on that exotic vacation we’ve been dreaming about for years. Paying careful attention to the way we talk to ourselves and eliminating the negative voices in our head is another way we can be caring. Most of us are quick to criticize, but we forget to compliment, so we need to practice positive affirmations and compliment ourselves often.

Learning to love ourselves requires courage, self knowledge and self honesty. Working a twelve step program and/or talking to a qualified, dedicated professional are good ways to find out who we are and what our needs are. For this we need a willingness to get better, and an open mind to ask for help, two traits that will lead us on the path to a Sober Mind.

“You, yourself, as much as anybody in the entire universe, deserve your love and affection.” --Buddha

Saturday, February 16, 2008

Can celebrities recover on camera? I don't think so.

I’m not a big fan of movies or television but recently many of my patients have encouraged me to watch Dr. Drew’s show, Celebrity Rehab. Recovery is a serious and personal process and I have strong objections to programs that sensationalize an individual’s life-and-death struggle. Perhaps I am just out of the loop and behind the times but I don’t understand what if any potential benefit there is in commercializing a life-threatening illness.

The episodes of Celebrity Rehab that I watched were very confusing and distressing. It is not clear what treatment if any these patients are receiving. The environment appeared almost festive and chaotic. The casual nature of the intake did not communicate the seriousness of the illness. And taping the arrival of an addict to a rehab facility for a TV show can foster their sense of grandiosity, which is counterproductive to recovery.

Hollywood’s main purpose is to create fantasy, and success as an actor or performer requires being able to convince the audience of an altered reality. But in order to recover from addiction, a patient needs to begin to face his or her reality honestly, to acquire some sense of humility and to start to let go of their denial. It must be doubly hard for an artist be real and honest when they’re constantly praised for “putting on an act”. And then on top of that they’re being asked to show their vulnerabilities for the whole world to see.

There are a number of personality traits that are usually shared by persons suffering from addiction. Self importance, dishonesty, the love of drama and chaos are just a few. It is my professional judgment that these character flaws cannot be overcome in front of a camera on national television.

Addicts, whether they’re famous or not, need to be treated with the same dignity and respect as any other sick person. The recuperation process should be kept private and confidential, and should not be exploited for profit. At some point celebrities suffering from addiction need to be encouraged to be ordinary human beings, to be themselves, instead of the carefully crafted, false image that the industry wants them to fulfill. That’s how they get better, and that's how they can slowly attain a Sober Mind.

Wednesday, February 13, 2008

Happy Valentine's Day

On this day when many of us are feeling sad because we don't have that special Valentine, I would like to share one of my favortie quotes:

Pearl S. Buck:
"I love people. I love my family, my children . . . but inside myself is a place where I live all alone and that's where you renew your springs that never dry up."

The greatest love of all is the love you give to yourself.

Monday, February 11, 2008

Heath Ledger: A Preventable Tragedy

It is always unsettling to hear of a young person’s untimely death, especially when these deaths could have been prevented. This week the medical examiner confirmed that Heath Ledger died of an accidental drug overdose, but in my opinion, there is no such thing. His death was an accident in the sense that there is no way to know what was in Heath Ledger’s mind, and he may not have intended to kill himself. However, he clearly was not taking his medications as prescribed or this would not have occurred. Instead of trying to blur the problem, the media should focus on the reality. The man was not evil nor was he a hero - he was a sick person who suffered from at the very least substance abuse or at the most substance dependence. He was clearly unable to control his intake and as a result took more than required and died. Public awareness could be his legacy. Instead of trying to spin the reasons for Heath Ledger’s tragic death, we could use this opportunity to enlighten and inform the public about how to deal with the difficult issues that we face in life. The media should focus on how to save lives instead of trying to conceal the reality of his obvious suffering and subsequent death. Why did he have so many different prescriptions? What were they prescribed for? How could his problems been handled differently? These are the questions to be asked.

For more of my thoughts on this, listen to my podcast! I was interviewed this week regarding Heath Ledger by Take 12 Radio. To download the MP3 click here.

Thursday, January 31, 2008

Humility: Learning to Ask for Help

One characteristic of alcoholics/addicts is the need for perfection. One of the things we fear most is being wrong, or making a mistake, which makes it very difficult to ask for help. The notion that we should know things before anyone ever told us or taught us seems to be inherent in us. Often as children if we made a mistake we were cruelly criticized or ridiculed. This created a belief that we didn’t deserve help, and if we asked for it we were weak or stupid.

Many of us tend to put the needs of everyone else first. It is okay for others to need help but when it comes to us, often we believe that asking for help is an admission of failure. It is terrifying to be vulnerable and to expose our potential limitations. Putting the needs of others first and being the “go to” person helps us to feel powerful and in control.

In recovery we learn that we don't have to face life’s challenges on our own. Humility is about asking others for help with issues that trouble us. It should not be confused with humiliation; it is not a lack of self confidence or a weakness. To ask for help when we fear ridicule, to recognize that we have limitations and honestly reveal them, that is a testament to our strength and courage.

For us to recover we need to dare to be ordinary and to make mistakes, instead of being perfect and correct at all times. Twelve-step programs provide the tools and the support for this important process. However, many of us may gain insight and awareness but still remain resistant, unable to accept our humanness. Our life history and experience may be too painful to tackle alone, and our perfectionism may be keeping us stuck, unable to move forward in our recovery. Private or group counseling may be necessary to get us to face and let go of our past and the first step toward the practice of humility.

True humility is an essential ingredient to A Sober Mind. It enables us to honestly see the reality of who we are. It reminds us of where we came from, where we are now and all that is possible in the future.

Friday, January 18, 2008

Secrets: The Chains That Bind Us

I have often heard at 12 step meetings we are only as sick as our secrets. Some of the secrets we keep are purposeful and we keep them to protect ourselves or our loved ones. Things like over drinking or drug abuse in us or others and the consequences, like loss of job, verbal, emotional, sexual or physical abuse to name a few.

Some secrets we don’t even know we are keeping, like our childhood experiences or the quality of our lives or our relationships. Many of us have no frame of reference and believe that we had a great childhood or the relationship we have with our parents, partners or children is a close and happy one, or at the very least adequate. If any thoughts of dissatisfaction come to mind we push them away and feel ashamed and guilty for having them. What kind of a child hates their parents? Or what kind of parent is not pleased with their child? What kind of a partner is angry and disappointed with their relationship? Our conflicted feelings cause a progressive distortion in our thinking and reality. Many of us deny our feelings because often it’s the very people we should be able to trust who are hurting and betraying us. Allowing those secrets into our consciousness is shameful and painful.

The important thing is to be able to share our secret concerns, fears and shameful feelings in a safe environment. Confiding in a trusted friend or counselor is the first step to freeing ourselves from the denial that enslaves us. In the 12 step programs we learn that protecting loved ones from exposure and keeping their secret is enabling them to remain in their disease and prevents them from realizing they need help. We perpetuate the illusion that their harmful behavior as a result of drinking or using drugs is okay. Keeping secrets cause us to be lonely, isolated and in our own self imposed prison. By finding a safe place or person to reveal our secrets we can start to become aware of those secrets we don’t know we are keeping.
Shedding light on our secrets requires a great deal of courage but it is an essential step toward a sober mind, and personal liberation.

Monday, January 7, 2008

Grief and Loss: Learning To Sing In the Shower

When most people think about grief and loss it is usually associated with the death of a loved one, the breakup of a relationship, or the termination of a job. But living with alcoholism or addiction can also cause significant loss. Unfulfilled hopes and dreams, and the reality of who we are or who our loved one is can cause great sadness. A significant number of alcoholics or addicts also come from alcoholic homes, and we start grieving losses as small children, even though we may not be aware of it. Then, as adults, life becomes a continuous series of losses and disappointments, which we tend to minimize and accept as the norm.

This constant state of grief and loss is very real and never goes away. The disease of addiction deprives us of our confidence and self worth. It makes it difficult to anticipate anything good in life or to believe we have the right to be happy or feel proud of our accomplishments. In dealing with loss, alcoholics/addicts often use a great deal of energy to try to fix the pain and distance themselves from it. Some of us strive for perfection in all aspects of our lives or bury ourselves in work or keep buying the next thing that will make us happy. We aim to be joyous and free but are continuously frustrated in our attempts. For some the disappointment and sense of failure of those frustrated attempts can lead to relapse.

Because this type of grief is stressful and persistent, we need to be continuously taking care of ourselves. The HALT acronym can help us with this. Asking ourselves, am I Hungry, Angry, Lonely, or Tired, will give us a quick handle on what needs attention. Eating healthy meals and getting enough rest, as well as participating in a twelve step and/or other support group or professional counseling to share your feelings is crucial to accepting, surviving and ultimately overcoming the effects of grief and loss.

The twelve step programs have taught me that serenity is not the absence of pain; it is the acceptance of pain. It is necessary to accept our losses as real and not to minimize them or dramatize them. We need to learn to use our energy to embrace reality and not try to change it. The pain of our loss is real and sufficient and we are entitled to experience it. In so doing we will be free to enjoy the simple things in life, like singing in the shower.