Families Matter/Family Matters February 2020 Blog Dee-Dee Stout, MA

Families Matter/Family Matters February 2020 Edition!

Welcome to the February 2020 edition of Family Matters – Families Matter, our new blog authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout.

Capture

Good enough.  I don’t know about all of you, but I stopped making New Year’s resolutions years ago.  For me at least, they seemed just another way that I was saying to myself, “you’re not good enough”.  And of course, we know how poor the outcomes are for those resolutions: according to one survey, only 8% of us follow through and successfully complete out resolutions[1]. Ouch!  However, this doesn’t mean I don’t have goals, or as I’m calling them now “a direction I’m headed right now.”  Yes, it’s more cumbersome but it lands better on me.  So what direction am I headed in 2020?  The Land of Good Enough.  And I’m not talking only in actions but mostly about getting OK with being “good enough” in all areas of my life.  This may not sound very challenging but it sure is to me – and apparently also to several others with whom I’ve mentioned this topic.  And why is that?  Well, that’s part of what we’re going to explore in this New Decade’s Family Matters/Families Matter blog.

2020 is perched on a precipice of many important as well as disastrous moments in our lives:  climate crises (now occurring horribly in Australia as I write this); elections including the Presidential this fall; racial & faith killings; further drug use crises & legalizations of (more) psychedelics; the coronavirus outbreak, and more.  So how does this concept of “good enough” help us through these and other challenges?  Let’s find out together.

I can’t recall when or where I first heard the phrase “good enough” but I’m pretty certain it was in something I was reading related to parenting.  The general idea was that we are all unable to be perfect parents so perhaps embracing the concept of simply being “good enough” would be a positive move.  Think of this as “harm reduction parenting”! Somehow, the author seemed to be saying, we need to let go of the need to be perfect parents as this is utterly unattainable anyhow.  So what if we looked at that in relation to other areas of or lives too?  Perhaps it’s due to my age now but I’m exhausted from trying to please everyone else:  parents, children, students, even clients sometimes.  And I don’t mean to suggest that embracing “good enough” means I am giving up on gaining new skills or learning.  Not at all.  To me, accepting I am “good enough” is the only way to make change.  It was the brilliant psychotherapist and theorist Carl Rogers who said, “The curious paradox is that when I accept myself just as I am, then I can change.[2]

This is true of us in recovery especially.  If I can only see what needs to change, I will get overwhelmed at the huge task in front of me.  That will likely lead me to feel more stressed out which will likely lead me to increase my use of those old habits/behaviors that are causing me & others pain.  It’s a vicious cycle.  Where I think we get terribly confused is in the word “acceptance”.  We seem to think that if we accept where we or someone else is, it means I agree with the behavior, that somehow I’m saying, “sure keep on doing what you’re doing; it’s ok with me!”  Nothing could be further from the truth.  The truth is we humans aren’t terribly adept at holding two competing ideas at the same time, what some consider to be the definition of “critical thinking.”

The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function. – F. Scott Fitzgerald

heart

I’m working with a family right now (the parents and the son) who’s oldest son has struggled with chaotic drug use for some time.  After hundreds of thousands of dollars spent, numerous types of treatment (some truly terrible, they now understand) and countless hours with me, things seemed to be in a pretty good place.  Then the bottom fell out:  he overdosed.  Thanks to Narcan, he is alive. Things went well again for a brief period and then again, his drug use got out of control.

In another family, the son did well this semester only to suddenly drop out this semester.  The had tried a new therapy and was really hopeful even after more trials of medications than either of us can count in the past 5 years.  But now, with yet another “failed” attempt, his depression has returned.

These are familiar stories to most of the families I work with and hear from, but also from their loved ones chaotically using substances.  It’s tempting to get angry and frustrated, or to even want to quit trying (me too as I’m also human!).  But what we really all need to focus more deeply on in scenarios such as these is that we’re all doing the best we can in some pretty awful circumstances.  And we definitely need to have more compassion for each other, along with some ‘radical acceptance’ of the reality of all our unique circumstances.

“Believing that something is wrong with us is a deep and tenacious suffering,” according to the book jacket of Tara Brach’s remarkable book, “Radical Acceptance.”  She goes on to discuss the trap of our habits that often occurs, calling it “the trance of unworthiness.” I love that idea:  I’m in a trance and that’s why I’m having such a hard time making a change!  And after all, if I’m not worthy of change, why should I bother?  I know that’s how I felt during my 2 decades of troubled drug use.  And I had lots of people around me in their own trance unable to see me as anything but a damn drug addict.   It wasn’t until I had people who deeply believed in me and my ability to make change – and managed to get my own tiny amount of acceptance of where I was – that I was able to begin to recover from a lifetime of pain.  It wasn’t quick nor without pain but I wasn’t alone and I had purpose in my life again.  So how do we start this practice of self-acceptance?  There are several ways of course and I encourage you to seek one or more that feels good to you.  One that I’ve just become aware of and use myself as well as with clients is something fairly new called “Mindful Self-Compassion.[3]

“Mindful Self-Compassion” is a way to “[learn] to embrace yourself and your imperfections [and] gives you the resilience needed to thrive.”[4]  Why do so many of us have such a difficult time loving ourselves?  I suspect much of this comes from our false belief that loving oneself means thinking we’re perfect or better than others.  Or perhaps it comes from the seemingly nearly universal idea that if we’re loving ourselves, we’re self-centered or selfish.  Nothing could be further from the truth!  Self-compassion, according to Neff & Germer, has none of these traits.  And in fact, they argue that if we can’t learn to love ourselves compassionately, we also can’t do so for others.  It’s also just good for us: “Individuals who are more self-compassionate tend to have greater happiness, life satisfaction, and motivation, better relationships and physical health, and less anxiety and depression.  They also have the resilience needed to cope with stressful life events such as divorce, health crises, academic failure, even combat trauma.”[5]  We don’t have the research yet but I’d say it’s safe to assume that cultivating mindful self-compassion would also lead to better parenting and possibly even reduce the need for medicating ourselves so much (for me the term “medication” includes prescription drugs as well as illegal substances used problematically).

breathe

So how does this translate in relationships to others?  Neff & Germer believe that there are “2 types of relational pain:  connection, when…people we love are suffering, and disconnection, when we experience loss of rejection and feel hurt, angry or alone.”[6]  They believe that we are each responsible in part for each other’s emotional states, which they call “emotional contagion.”  This of course flies right in the face of those of us taught that we are ONLY responsible for our own emotions and NEVER for others (they are responsible for their own feelings).  Perhaps we got that one wrong?  In the meantime, let me share with you my favorite brief meditation that I’ve used for more than 20 years.  It is in the lovingkindness tradition so fits with our discussion of Mindful Self-Compassion and can be used as way to take a “Self-Compassion Break”[7] the next time you find yourself upset with someone, including yourself:

With your eyes open or closed, in any position you are in though sitting is generally thought best (but I use this walking & even while driving).  Repeat the phrase below 3 times and between those repetitions, breathe deeply in through your nose (holding briefly) and exhale through your mouth.

[8]May I be filled with lovingkindness

May I be well

May I be peaceful and at ease

May I be happy*

(*A suggested substitution here if you find “happy” to be too uncomfortable or challenging right now, use the word “kind to myself.”)

lovewhoyouare

Now I’m not going to suggest that these ideas of radical acceptance and mindful self-compassion are easy for most of us to attain.  I’m constantly practicing these concepts.  But I do best when I’m able to accept where I am and appreciate that I’m doing the best I can right now:  sometimes that’s great and other times, I struggle frankly.  What I’ve learned in my 6-decades plus of life is that I’m not alone and if I keep actively working on these notions of mindfulness and self-acceptance/compassion, I am able to feel like I really am “good enough” some days.  And that’s definitely a positive change.  That also seems like a “good enough” place to begin for this New Decade.  Join me.

 

Happy 2020!

DD

deedeestoutconsutling@gmail.com

www.deedeestoutconsulting.com

 

 

All images courtesy of unsplash.com

[1] https://finance.yahoo.com/news/many-people-actually-stick-resolutions-214812821.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAIQ_LjZjZKDh5IS6cLk99vcJy7ccHqZ-nekHQEYlSjWWoodJzCrPYCVy7agi8zV5u3IVgQg5iPY6qFzA1hSTjukhnAktz9jeKj0oyFWxWJfYMsEuBzoxmTPGK-BcMOcyR-AkIAEtkDnCed8TB99shKGMRrvI94ZXibZZpXhG20n8.  Accessed 1.23.2020.

[2] From “Radical Acceptance” by Tara Brach. Bantam Dell, 2003. P24.

[3] “The Mindful Self-Compassion Workbook”.  Kristin Neff, PhD & Christopher Germer, PhD.  The Guilford Press, NY.  2018.

[4] Ibid. p1.

[5] Ibid.

[6] Ibid. p130.

[7] Ibid. p34.

[8] From “A Path with Heart” by Jack Kornfield. Bantam Books, 1993. Jack Kornfield is the co-founder of Spirit Rock in Marin County, CA. www.spiritrock.org.

Repping the Family Voice at DPA’s Reform Conference!

What:  Repping the Family Voice at DPA’s Reform Conference!

When: November 6-9, 2019
Where: St. Louis, MO
http://www.reformconference.org/
Screen Shot 2019-10-31 at 3.14.35 PM
Why: Families for Sensible Drug Policy will be repping the family voice at Drug Policy Alliance’s Reform conference! Carol Katz Beyer and FSDP Secretary-Treasurer Rory Fleming will both be present to speak to harm reduction advocates across the nation and world about our innovative programs like Family Drug Support! We will also be attending to meet with other Open Society Foundations grantees for an upcoming push in New Jersey to replace tough love approaches with evidence-based public health endeavors and compassionate policies.

From Conflict to Conversation

Welcome to the Fall 2019 Back To School edition of Family Matters – Families Matter, authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout.

Close up of red autumn leavesFall. Thoughts of crisp autumn nights and drinking apple cider come up for me, of my youth spent in the Midwest. It also reminds me of “back-to-school” time which can cause some concern for many parents, as well as their new students heading off to University. I’ve been working with a couple of sets of parents with college-aged kids who are all nervous that these young folks aren’t prepared for the new challenges, new people, and new temptations both healthy and less so. Perhaps there’s been problematic drug use or some other challenging behavior/mental health concern which is also interfering with their child’s ability to prepare better for these new experiences. So, what’s a family to do? While we might not be able to prepare our kids for every new experience, we can definitely work on listening better to what they say they need/want – and what they don’t want/need from us – which I think is at the core of improving all family relationships. Plus, these same communication skills will be used for the rest of all our lives: with our family members, friends, colleagues, everyone. And yet, these are skills that are rarely taught, which leaves us to learn them through trial and error or with the help of books, coaches, counselors, podcasts, and more. So, how can we learn to listen more and talk less, no matter what’s getting in the way?

While there is no magic answer to doing this, it really is the simple answer to better communication. And boy, it’s really easier said than done! With my own fractured family, I see just how hard this is to do. But there are ways we can get better. Here are a couple of ways to improve conversations within families and begin to get a bit better at “listening more and talking less,” especially with our adult kids using drugs problematically. The first, from the Australian online group Family Drug Support (FDS), founded by Tony Trimingham, (look for FSDP’s launch of our own FDS USA soon!) are these basic ideas: 1) Choose your moment – e.g. not when someone is under the influence of drink/drugs. This first step to better conversations is also discussed in many other books and trainings on Family Coaching including Robert Meyers’ Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening and The Parent’s 20 Minute Guide1.

Another strategy I have adopted from The Parent’s 20 Minute Guide is to think of conversations as if there are traffic lights in a thought bubble above the other person(s) head. For example, a green light means someone is engaged and listening (though perhaps not about the subject you’d like to discuss!); a yellow/caution light means we may be headed into dangerous territory (think “danger, danger Will Robinson”, to borrow a phrase): actions such as voices starting to be raised or someone changing subjects defensively; and a red light means the conversation has gone off into unwanted topics, leaving our loved one and/or us threatening, screaming, swearing, or falling silent and retreating. Not a lot of listening going on when we see these behaviors so experts suggest we stop trying to have a conversation then and simply step away. Remember, these “lights” refer to all family members not just the person(s) using drugs problematically. That’s really important. In fact, one of the parents I work with calls these “caution” signs “relapse warning signs for the whole family.” Here’s an example of how a conversation might look using all the lights:

Beginning statement from you: “I’m really concerned about your grades this semester.”
Your child: “OK I know I’ve slipped a bit but can we discuss this later please?”
Your response: “OK I understand this isn’t a good time. When can we talk about this please?” (green)
Your child: “Stop interfering in my life! I’m an adult now and you can’t tell me what to do!!”
Your response: “You’re right you are an adult. We’re just concerned and want to help if we can.” (red)
Your child (voice raising): “I know, I know! But I’ve had a lot of hard classes and it’s been a lot more work than I thought! Can’t you just get off my back?”
Your response: “You sound pretty stressed out right now. Let’s talk about this over the weekend when we’re both calmer.” (yellow/caution)

Another strategy toward better listening – or what clients sometimes call “not taking the bait” in conversations – comes from Motivational Interviewing or MI. In MI, there’s a strategy we teach called “key questions” which I think are brilliant. These are statements I make when it either feels like I’m wanting to take charge of a situation or it seems that someone expects me to have answers for them. These are a way to respond that shows my interest in the conversation while not taking the bait of thinking I need to come up with answers/take charge. Here’s an example:

You: “I’m really concerned about your grades this semester.”
Your child: “Well what am I supposed to do? It’s really stressful…and these classes are much harder than in high school!”
Your response: “Things are definitely harder than you expected (this is called a reflection). What do you think would be helpful to make things easier right now (key question)?”

See how this parent has let go and not taken the bait? Instead of saying something like, “well you know what you need to do is…” and trying to solve this problem for them – in MI we call this “the expert trap,” which means we’re assuming we HAVE the right answers for someone else, like we’re experts in other people’s lives which of course we’re not – this parent gives the solution back to their child. This also helps the child learn to figure out what’s best for them and not to rely on us parents. By the way, this doesn’t mean we can’t ever offer advice or have an idea. But again, borrowing from MI, when we do so, the third tip for better conversations is to ask for permission before offering any ideas. Yes, you heard me: ASK FOR PERMISSION. It’s simple thing to do and it shows respect to the other person.2

Along these same lines, something I learned to use with my now adult son while he was in college was to ask at the beginning of a call, “do you want me to listen with the goal of giving advice or with the goal of just listening?” That simple phrase helped me a lot. It was important for me to set that goal up front and it also seemed to help my son communicate to me more fully and honestly. Of course, the REAL trick is to keep quiet when you hear things that make you want to scream, “NOOOO!!!” But I learned that my son – like most of our kids – was pretty darned good at making generally healthy decisions for himself – and the couple of times that he wanted advice, he was able to ask for that since I’d respected his desire and not given unwanted advice the other times he called. Come to think of it, he might’ve even called home a bit more than he would have.

The more we understand that much (most?) of someone’s drug use is a direct result of medicating trauma, anxiety, depression and more, the more we also see that improving conversations with our loved ones is crucial to keeping our families listening and attached rather than talking at each other and detached. And that’s always the goal, huh?

Navigating conversations in families is always challenging let alone when someone is using drugs problematically! I get it. And I can definitely say that this way of deeply listening to each other takes work, commitment, and practice. And a willingness to make a lot of mistakes. To help reduce mistakes, one of the parents I work with likes to make “flashcards” of bytes of responses they could make when their adult child begins to unravel or becomes demanding (and old pattern of push/pull that they’ve all become expert on). I am immensely impressed with these families and their collective loved ones for their efforts to change these imbedded patterns!

Being a part of a family takes real effort, like all relationships, with more listening than talking at the core. Dr. William Miller, who co-wrote the book Motivational Interviewing, has a new book out called Listening Well: The Art of Empathetic Understanding that I often use with families if they’re interested. It’s an easy read, less than 100 pages, with exercises at the end of most chapters (some of which are three pages long) that can be done in session with a professional as well as at home for practice. In it, Dr. Miller discusses the idea that one of the main ingredients to “listening well” is to have compassion and empathy toward one another: this means all family members, drug users and non-drug users alike. To me this concept is also at the core of an idea that I first learned from an early mentor of mine, Jane Peller, LCSW, co-author of Recreating Brief Therapy and retired professor of Social Work, Northeastern University: think of this as “Appreciation.” Jane taught me that if I were to be successful with a client, I needed to find something to appreciate in each of them – and if I can’t then I need to refer them on to someone else who might be able to help. Well, I say if we’re going to be successful in conversation with someone using substances, we need to appreciate what those substances are doing for that loved one that nothing else seems to help. I also need to find something in my loved one to appreciate about them as they are today, not as I remember them or wish they were (again this applies to all members of the family). I even go so far as to explain to everyone I work with that someone’s drug use (or other problematic behaviors) makes perfect sense if we understand that drug use is a symptom of something and not a pathology. After all, all behaviors provide us with some reward – or we’d stop engaging in them (even if the reward is negative by the way).

This is where listening deeply comes into play. We need to be able to hear – and possibly without words – the reasons that our loved ones are using drugs or are engaged in other less healthy behaviors. To those using drugs problematically I will often say that they too need to find a way to appreciate the drugs they’ve been using (I realize that may sound strange but hang with me). Why? Because it’s likely that those drugs kept them alive to get to this place – of considering change. And then I typically follow up that remark with, “And isn’t it interesting that the very behavior that helped you cope/stay alive is now killing you/putting the things and people you love at risk?” Finally, I’ll ask something like this (here comes the key question): “So, what do you think you’d like to do now?” This is what I like to call an INVITATION to make a change – or to think about making a change or consider what would need to happen to be ready to consider a change, or anything that speaks to talking about any positive change.

Late afternoon sun shining on water through trees“The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function.” F. Scott Fitzgerald

Please don’t hear that I’m suggesting for one minute that you must agree with or like your loved one’s drug use or any other behaviors (nor do they need to like yours). Not at all. In fact, that’s the “trick”: “How do I appreciate/try to understand this thing you’re doing/using that may be helpful & deadly to you and that I really hate because it may kill you?” Well, I’d argue that this is our job as family, as loved ones, and definitely as parents: we recognize that your behavior shows just how much pain our family and our beloved family member is in.3

Gabor Mate and others in the trauma world have spoken about the rates of trauma in folks with problematic drug use/other coping behaviors; for women, it’s up to 99% of those seeking treatment for substances (Najavits, 2002)! Trauma is a main factor in drug use because of the fact that so many drugs work well to alleviate the anxiety, fear, and uncomfortable, overwhelming feelings that often arise with trauma (as someone with a diagnosis of non-combat PTSD, I can attest to how well various illicit and licit drugs can work – and how they can become problematic without treatment to address the trauma): “Up to 59% of young people with PTSD subsequently develop substance abuse problems. This seems to be an especially strong relationship in girls,” according to recent information from our National Institute of Health or NIH. But let me be clear here: not all trauma rises to the level of PTSD. Nor does all problematic drug use stem from trauma. However, the rates of trauma symptoms are increasing along with the rates of anxiety in teens of today causing some to see anxiety and trauma as the next health crisis in the making.

At the end of the day, only you and your family can decide what’s important to you all, what values you hold as a family, and how you’re going to respond to a loved one’s substance use, problematic or otherwise. Whatever you decide, I invite you to consider that as your child moves into adulthood and leaves home, it may be time to reevaluate your relationship with them and make a goal to HAVE a longlasting relationship with your child no matter what they do/decisions they make. To lose your family support is about the most damaging thing we know of when looking at any number of health-related problems. We also know that family support is a major reason for successful treatment for substance use disorders, and that being connected is the best way to support mental illness as well.4

While we may not be pleased with all the decisions our children make – nor they of all of ours – perhaps we could all do a bit better to act with compassion, empathy, and most of all, with unconditional LOVE toward each other. I know that I would never have made the Herculean effort to change my own drug-related behaviors/improved my mental health if it weren’t for the love of my son and my former husband. I certainly had no self-compassion and therefore no reason to stop – and my family of origin had mostly written me off. It’s been a lot of hard work – the same hard work I am honored to witness in the families and individuals I work with today. And while drugs hold little interest for me anymore, it doesn’t mean I have a life of ease or that my relationship with my adult son perfect. But I don’t look for perfection anymore – not in me and never in my clients. After all we’re human and therefore we will screw up. Doing better is good enough for me now. I hope it can be for you, too.

Dee-Dee Stout, MA
Author, Coming to Harm Reduction Kicking and Screaming
www.deedeestoutconsulting.com

All photos courtesy of unsplash.com

1By the Center for Motivation and Change, 2nd edition (2016).
2These are all conversational suggestions. There are a LOT of ways to have better conversations and plenty of materials out there to help us. I have listed only a few here. -D.S.
3Paraphrased from Gabor Mate’s conversation with the author Chris Grosso in Dead Set on Living (2018), Gallery Books.
4Hari (2018)

 

Spring and the Cycles of Change!

Welcome to the Spring 2019 edition of Family Matters – Families Matter, our new blog authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout.
IMG_6574

I have been a Star Trek geek for as long as I can remember.  This infatuation even rubbed off on my son who designed the current World Tour stage for the multi-award- winning mega-band Muse to be shaped like a Klingon Bird of Prey[1].  I never quite understood my fascination with all things alien, watching the new Star Trek Discovery series week after week in tears.  Really??  Crying over a TV show, and a sci-fi show no less??    Well, after some 50 years of dedication and fanaticism, I think I figured it out:

startrek

To borrow a phrase:  it’s the future, stupid.  The past is finished, complete, even if I do mine it reasonably often, still attempting to understand things as they unfolded oh so long ago. There is wisdom that has come from that exercise as well as some futility.  But it’s the future that really does it for me, makes me weak-in-the-knees excited & emotional all at once, like the old roller coaster The Big Dipper in Santa Cruz does every time I ride her.  And the relationships, the dedication, the incredible sacrifice and love emanating through every episode brings my heart into my throat with regularity.  That all makes me desire to keep going – which some days is a monumental feat I will admit briefly – as I see real possibility for us all, the Human Race.  And besides, if a Vulcan can ask for forgiveness (Sarek, in Part 1 of the second season’s finale) who am I to not give such a gift to myself and my families:  both the one of chance and the one of choice?  It appears this is the work of my future, the work of ‘Change to Come’.

And so we’re onto Change for this month’s blog.  And here’s where I’ll begin…

change

Change is about leaving what we know behind, jumping into the abyss of the unknown just as a starship jumps into warp drive.  Never knowing what’s on the other side should be exhilarating for me (Remember? Rollercoaster lover?) and yet it’s always filled me with fear & uneasiness.  I’m still here though, alive – as are many others who shouldn’t be – and that’s all due to this thing called Change and those who have ridden this wave with us all.

“Most people never get a chance to learn what’s in their own hearts.  If we figure it out it’s often not what we expected, or even what we would have chosen for ourselves.” 

—Capt. Christopher Pike, 2019; Star Trek Discovery, episode 13

What’s in my heart?  I wondered when hearing this line of dialogue.  As so many others have too, I have studied several religions at various points in my life. My first exposure was as a child when I was baptized in the Congregational church of my maternal grandparents, and then as a grade school-age youngster in my family’s home (in Midland, MI) at the United Church of Christ (UCC) which they helped to build.  I am proud of the heritage of the UCC as a church of social justice and inclusivity.  Even at the height of my drug use, my minister refused my mother’s request that I not be allowed to attend nor teach at the church.  He believed in me and the idea that Change could only happen in a place of love & inclusion.  He also preached that God was not something outside of ourselves but rather inside of each and every living thing.  Finally, he told us that our church was about ‘accepting the unacceptable’ of society (that belief is partly what drew me early on to helping problem drug users ironically).  I also recall as a teen wishing to become Catholic as I saw many of my drug using friends able to attend confession each week which they believed absolved them of their “bad behavior” as well as allowed them to repeat it the following week.  To me, it simply appeared that Change for them was easy[2] – and I was jealous.

flowers

In the pagan Wiccan traditions, every season brings Change of a new variety.  As we leave April and head into May, the Wiccan calendar moves to celebrate the festival of Beltane.  This date is also known more commonly as May Day.  It is a time for birth and renewal:  pastel colored eggs to signify fertility; a Maypole around which songs are sung while long ribbons twirl while celebrants dance around the phallic symbol of the pole, and rituals around fertility, crop blessings, and romance abound.  After a long hard Winter, Spring brought promise to our ancient people’s here; a promise from someone, somewhere, that they had not been abandoned nor forgotten.

I see Change as a promise to us too:  a promise that no matter what, nothing will ever remain the same; all will be well; don’t worry, be happy!  Within addiction, this is ultimately the challenge as there often seems little to be happy about when things turn bad.  When I was using drugs problematically, I see now that a good part of my reasoning was to keep things the same, status quo.  That provided me with ritual, some strange stability, and again ironically, a sense that I always knew what to expect.  As a person with a history of trauma, I yearned for something to keep me centered, something expected.  It’s also what kept me in violent/abusive relationships.  I recall saying out loud finally that I understood that “to know something – even something violent – was better than leaping into the unknown.”  Some people believe that those of us who remain in these violent relationships do so because they’re comfortable, that we become comfortable with the abuse.  I disagree. I say we become familiar with it and that’s the point:  it is better to stay with what we know v be so terrified that Change could be worse.  That’s how frightened we often are of Change.  IT is the enemy.  It is the same with addiction:  fear of Change can keep us from trying something new.

peter

And this leads me to the topic of families and the people they love who problematically use drugs.  We all resist change to some degree.  To some degree we would rather stay in the status quo, in the familiar, than take a risk into the unknown – “to go where no one has gone before” – or perhaps we’d simply prefer that someone else makes the Change and not us.  But this isn’t how Change works!

Recently a post from my dear friend and colleague Andrew Tatarsky[3] (Board member at FSDP) came through my Facebook feed, which Andy had reposted from a colleague apparently having a conversation with Dr. Gabor Mate, the renowned trauma & addiction expert and author.  Much like my beloved Star Trek it, too, has left me in tears each time I read it.  I hesitate to repost this dialogue here for fear of offending people reading this blog.  But I am going to take that chance and hope you will hear the hope and joy and see the “Way Out” – as our Brit neighbors wittily call an exit – as I unexpectedly did after reading it. Bring the hankies.  Here goes:

“We weren’t quite finished yet. I wanted to know about family members who are dealing with addiction. What can they do for a loved one who’s caught in the grips of active addiction? Because when people are that deep in addiction, they’ve lost themselves—they’re gone in a way. I know I was. I know there was nothing my family could have done no matter how much they wanted to.”

Gabor didn’t agree with me. “You don’t know that. What you do know is what they tried didn’t work, but you don’t know that there’s nothing they could have done. In one sense, you are 100 percent right: There’s nothing they can directly do to change your mind. There’s nothing they can directly do to change your mental status. There’s no way that they can talk to you, advise you, control you, beg you, accuse you. That does not mean there’s nothing they could have done. Imagine if your family had come and said, ‘Chris, here’s how it is. We recognize that your addiction is not your primary problem. Your primary problem is that you’re in a lot of pain. And that pain is not yours alone. That pain has been carried in our family for generations. And we’re as much a part of that pain as you are. You’re just the one who’s soothing it with that behavior. In fact, you’re the one whose behavior shows us how much pain there is in our family. Thank you for showing that to us. So we’re going to start working on you, because we realize that we’re as much a part of it as you are. We’re going to take on the task of healing ourselves. We invite you to be there if you feel like it. And if you’re not ready, sweetheart, then just do what you need to do right now.”

“Families also have to decide, can I have this person in my life, or can I not? If I want them in my life, there must be certain rules, like they can’t steal from me and so on, but if I can have them in my life, I must accept them exactly as they are, exactly where they’re at, and 100 percent accept that right now they’re using because they feel they need to. I’m not going to nag them, cajole them, advise them. I’m not going to say a thing that they didn’t ask me about. I’m just going to accept that this is who they are and I’m just going to love them. That’s a rational decision to make. It’s equally rational to say, ‘You know what? It’s too painful for me. I can’t handle it. I can’t stand to see you do this to yourself. It’s too stressful. I can’t be with that, so I’m sorry, I love you very much, but I can’t be with you.’ That’s legitimate, too.”

“What is completely nonsensical—and unfortunately the pitfall for most families—is to try to be in the addict’s life and try to change them all the time. That’s the one thing you cannot do. So either accept or lovingly distance yourself, but don’t try to stay in there with the intent of altering the other person. To the addict, that signals only one thing: ‘They don’t love me the way I am.’ That’s my advice to families. I do believe that addiction in a person can be a healthy wake-up call for them and for everyone in their lives.” — Dr. Gabor Maté, Dead Set On Living

desert

Change, especially when we look at addiction(s), sure isn’t linear; not even close.  In fact, even the theorists behind the Stages of Change[4] now use a spiral model[5] rather than their traditional wheel.  Me?  I’ve always seen Change more like a pinball machine, and I’m no wizard:  you know, one minute you’re over here, the next down there, and a moment later, ding, ding, ding!  It’s unknowable, it’s exciting, and it’s scary as hell.  That’s the Change I know…and I am finally just beginning to like Change rather than fear and respect it like an overbearing & abusive parent.  Bottom line:  it always happens whether I like it or not!

If I may, this seems like a good point to insert briefly the 7 Stages of Change[6] (SOC) as they apply to any Change you might want to make, and of course I will provide you with references for more on them if you wish (apologies to anyone in the know here.  Feel free to skip this next part):  precontemplation, contemplation, preparation or determination, action, maintenance, termination & relapse/recycle.  In a nutshell, here’s the definition and task of each stage (please keep in mind that these stages aren’t linear; remember – pinball!!)

Precontemplation:  When my behavior is in this stage it means I can’t see it as a problem so I’m unlikely to see a need for change (think the old idea of denial).  Perhaps my family, friends, or employer is seeing a problem in my behavior.  So here the main task is to increase my awareness of the need to change – to help me/someone recognize that the cons of not changing are greater than the pros of change.

Contemplation:  This is the stage of thinking (insert Rodin’s The Thinker).  I see my behavior as being a possible problem but I’m not ready to commit to making a change.  Ambivalence lives here.  Think of this stage as “well, maybe I should make this change but…”

Preparation or Determination:  When my behavior is in preparation, you’ll know because I’m planning out the needed resources, discussing how and maybe even why I want to make this change.  I might even begin to take baby steps toward my healthier self.

Action:  In action, I’ve moved forward and state my intentions to keep on that path toward healthier living.  Any positive change[7] is the key here.

Maintenance:  Since I plan to maintain my change in this stage, I will need to work on recognizing obstacles and other speed bumps to my continued Change path.

Termination:  For the researchers, this stage was noted by the problem behavior being eliminated for at least 6 months.  This stage is often left out of behavioral health programs (including rehabs) however as many don’t believe this stage is reachable.  I believe this concept deserves review, and that “termination” should be viewed personally and individually.  For myself, I do believe my former addictive behaviors with alcohol and other drugs is done, finis, over with, hasta la bye bye.  I have all sorts of other problem behaviors to continue to work on but not those.  Others will likely feel more comfortable with termination being left out of the Spiral of Change.

Recycle/Relapse:  The researchers decided that the term relapse wasn’t good enough as it isn’t accurate for most people making Change.  This is because to relapse means to go back to the beginning, in this case to precontemplation. And while some people will indeed return to precontemplation, most will instead recycle back into one of the other pre-action stages.

 

 

change

Spring appears to have finally come to the Bay area.  While we are all grateful to not have to endure yet another year of horrendous drought, we are equally grateful to get a respite from the torrents of rain that have devastated communities throughout our Golden State recently.  Even as I write this, we are being warned of a touch more showers coming tomorrow, hopefully the last spurts for the wettest April I recall in my 40 years here.  Spring is a natural time to think of change:  flowers blossom; mice mate and dogs give birth; the seasons shift as our little Blue Marble of a planet tilts on its axis once again.  Like the seasons, Change is both predictable and unpredictable at the same time: the only thing we can be sure of is that nothing will remain the same and that Change happens, constantly and without permission.  I can accept that or not but like the moonrise, it will happen everyday in spite of my feelings about it.  So will my Change.  I will continue to change and grow because to do otherwise will be more painful. This I now know for sure.  So, I will make room for the Change in the same way as the philosophical cat Garfield says so brilliantly: “Everything I’ve ever let go of has claw marks all over it!”  No one said I have to Change gracefully.  And I will wait to cry one more time at Part 2 of the final episode of this Star Trek series season to begin my long winter of wait for the next season to begin.  And the next season, and the next Change, will come gratefully – both for my beloved Star Trek and for all of us, if we can just hang on to each other a bit longer.  Let the adventure continue…

adventure

[1] The 2019 Simulation Theory World Tour (www.muse.mu).  The simulation hypothesis or simulation theory proposes that all of reality, including the Earth and the universe, is in fact an artificial simulation, most likely a computer simulation, leading to the 1990s-influenced stage and costume designs. (Wikipedia, accessed 4.14.19; 2019 personal communication with Muse Creative Designer Jesse Lee Stout).

[2] Please do not interpret my comments here as a negative stance on the Catholic church.  This is merely how I saw things as a teen, quite simplistically.

[3] Andrew Tatarsky, PhD is the author of “Harm Reduction Psychotherapy” (Guilford Press) and the founding Director of The Center for Optimal Living in NYC.  He can be reached at http://centerforoptimalliving.com/.

[4] The Transtheoretical Model (TTM) of Change was developed by the Drs. James Prochaska, Carlo DiClemente and John Norcross.  For more, please see their academic websites:  https://web.uri.edu/psychology/meet/james-prochaska/;   https://psychology.umbc.edu/people/corefaculty/diclemente/; https://www.scranton.edu/faculty/norcross/

[5] See “Changing for Good” by Prochaska, DiClemente & Norcross.

[6] There are a lot of good sources for SOC materials.  Here are a few standouts: https://www.lifehack.org/676832/stages-of-change-model; “Changeology” by John Norcross; “Changing for Good” by Prochaska, DiClemente & Norcross; “Changing to Thrive” by Drs. Prochaska.

[7] Thanks to my friend, the late Dan Bigg, founder of the Chicago Recovery Alliance (CRA) for this simple phrase. For more on CRA, go to https://anypositivechange.org/

 

Let’s Honor International Family Drug Support Day on February 24!

Welcome to the February 2019 edition of Family Matters – Families Matter, our new blog authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout.

IMG_6574

This month, Dee Dee, with her exuberance and energy, explains why International Family Drug Support Day means so much to so many of us… 

Join us in honoring International Family Support Day on February 24, 2019!! Please follow us on Facebook and check out our website at fsdp.org for more information.

Hello everyone and happy 2019!!

I’ve had a remarkably busy start to the New Year as perhaps some of you have as well, meaning there was no blog for January.  My apologies!  As the Lunar/Chinese New Year just passed, it seems a good time to discuss the new partnership between FSDP and Family Drug Support Australia.  Having attended the engaging and insightful training in NYC with Tony Trimingham (www.fds.org.au) at Dr. Andrew Tatarsky’s Center for Optimal Living site, I want to speak about the work of both these organizations as we prepare to commemorate International Family Drug Support Day (2/24).  This date is important to Tony personally as this is the date his own son, Damien, died of a drug-related overdose in 1997 (see https://vimeo.com/249347700 for more from Tony).  Each year Tony and his team have chosen a topic on which to focus.  This year it’s #SUPPORTTHEFAMILYIMPROVETHE OUTCOME.

31 years ago when I began my journey into traditional recovery, there was family support built into the rehab I entered.  There was even a program for my young son, Jesse, though that program was an additional fee.  But the Family Program, which met every Saturday during my treatment stay, was vibrant!  In those days, the family was too often seen as part of the problem however (think “enabler” and “codependent”, labels I would never use today though many professionals still do).  Today we know that family[1] support is crucial to long-lasting change to happen for those with problem alcohol and other drug use.

Families have lacked support in their struggles and in daily living with those they love with problems using drugs (including alcohol).  International Family Support Day is one way to highlight the need for families like outs at FSDP to not only be recognized and heard but also supported and encourage to speak out regarding their concerns and their needs, including the needs of their loved ones with problematic drug use.  One saying that I love is this: “If my family member had died of cancer or heart disease or a car accident, neighbors would be bringing me a casserole.  Not so with addiction.”  We at FSDP say we want to see casseroles!

One of the biggest and fastest growing areas of family work in addictions is the notion that abstinence doesn’t have to be the final goal.  In my world, I call this Harm Reduction Recovery™ (HRR).  Recovery without abstinence is entirely possible but it does require thinking out of the norm!  HRR can be a goal to itself or perhaps it’s a stepping stone on one’s path to abstinence – or something in between.  Families see that the most important first goal is keeping their loved one(s) alive.  That means for many families, requiring that they throw their loved one out when they exhibit the very symptoms we want them to seek treatment for is no longer an option.  As my aunt (who’s taught me a ton about families, addiction, and harm reduction) said, “He’s my child.  I’m not going to be able to sleep at night worried that he’s not only using drugs but now he’s alone on the streets.  I don’t need more to worry about; I need less.”  More and more families are speaking out against easy “solutions” like exiting their loved ones.  They’ve come to the realization that my aunt did:  throwing your loved one out may not be the best solution.  In fact it may increase your own stress and add more trauma to all involved which doesn’t lead to a reduction of drug use.  In fact, it often leads to an increase.  We have learned that the opposite of recovery isn’t harm reduction but rather zero tolerance (and tough love).  And we will NOT enable these concepts to rule us anymore.

Speaking of tough love, refusing to participate in this concept is another area of growth in family addictions work.  We’ve learned through research that many problem drug users are using alcohol and other drugs to soothe trauma(s) they have experienced in life.  Addiction is definitely enabled by, if not always directly caused by, trauma(s).  We also know that having a trauma history can be a barrier to seeking help (lack of trust; fear of others’ judgments; lack of confidence; distrust of healthcare professionals, and more).  Therefore again, if we want our loved ones to seek help, we must be willing to reduce/do away with as many barriers as possible.  Demanding abstinence can be a huge barrier; insisting that problem drug users “hit bottom” is a re-traumatization which also increases barriers.  Families are converging and demanding better for their dollars from rehab providers and other professionals.  We at FSDP are behind them all the way!

Families for Sensible Drug Policy (or FSDP) was founded by Barry Lessin, a therapist working in the addictions field, and Carol Katz Beyer, a mom who lost 2 of her 3 young adult sons to drug-related overdoses.  She knows a thing or two about what it’s like to change your approach to drug treatment/rehab and drug users!  As we head into International Family Drug Support Day (IFDSD), here are a few things Carol and the gang at FSDP want you to know about this special day:

The objectives of IFDSD are to:

  • Reduce stigma and discrimination for families and drug users (bring on the casseroles!)
  • Promote family drug support services for families and friends (all treatment needs to include all players)
  • Promote harm reduction strategies for families and friends (no more tough love or zero tolerance)

In addition, the following issues will be highlighted around the world by all participating in this event:

  • Establishing the important role of FDS and FSDP volunteers in providing family support in the US, Australia, and the world
  • Reducing fatal and non­fatal overdoses from drugs including pharmaceuticals
  • Promoting the widespread availability of naloxone
  • Promoting greater inclusion of family members in the decision-making process for families experiencing problematic drug use
  • Promoting greater support and resources for treatment services for those who want it and need it – and appropriate alternatives for those not yet ready

For more on what you can do in your area – or if you have an idea of your own – please contact Carol Katz Beyer at carol@fsdp.org.

The take-away:  please join us this year on February 24 to honor International Family Drug  Support Day in any way that feels right to you.  I’ll be lighting my candle that night for all those using drugs problematically and their families of chance and/or choice, as well as those lost to this complicated condition we call “addiction”.  I’ll also be saying a “thank you” to my son, Jesse Lee, my late former husband (Bob) and my late in-laws (Rhett & Faren) for their constant, unconditional love and support while I developed a path to recover me.  I’m also lighting my candle for my friends who were with me in the beginning and those who are with me now and those who will be with me in the future.  Without them all, I would not be here and for that, I will always be grateful and will continue to work for the voice of all in addiction to be heard and honored. Support the Family, Change the Outcome.  It’s a recovery revolution and the time is now.

[1] Let me define “family” here:  One type is the family you’re born into which I call your “family of chance.”  The other is the one you create which I call your “family of choice.”  Sometimes they are the same of course.  The important point is that you need not have a “family of chance” present, but you must have a family of choice then.  All humans need community in some form as we are social beings.  How much and what kind is up to the individual.

HandDonate

PLEASE SUPPORT OUR FAMILIES!

A Milestone for FSDP: Family Drug Support USA, a Step Forward for Families Impacted by Substance Use.

E9EBF66E-DF9E-4FAE-A784-24EFD7AB8B2AA long-awaited milestone for Families for Sensible Drug Policy of bringing a new paradigm of support for families impacted by substance use occurred last month when Tony Trimingham, founder of Australia’s Family Drug Support, came to the United States and trained our first group of family members and professionals from across the United States at a sold-out workshop in Family Drug Support USA.

Family Drug Support USA, co-hosted by our friends at the Center for Optimal Living in New York City, is a program of innovative non-judgmental, peer-led support groups with solutions and strategies that encourage self-empowerment by recognizing each family as unique. It will provide our families with an opportunity to access much needed community support and connection based on what families need, expect and experience. This model of support helps families better understand and strengthen the connection between ourselves and loved ones who use substances.

We were humbled by the interest of the attendees in learning the model and impressed with their passion and brilliance in their shared experiences. Family members and advocates from diverse communities attended the training to bring the groups home, planting seeds of harm reduction and hope.  It was a remarkable weekend, tangible evidence of our mission to bring communities together to embrace enlightened drug policy–empowering families, restoring health and saving lives.

The workshop was in two parts: On Friday night was “Support The Family Improve The Outcome”, an introduction to the Family Drug Support model providing an in-depth overview including harm reduction tools and coping strategies. Saturday and Sunday was a two-day intensive training, which afforded participants an opportunity to work directly with Tony in an experiential workshop learning specific skills using harm reduction principles and the psychological approach of motivational interviewing to deliver support to those in need.

Families have a vital role in the development and resolution of how substance use impacts their home—for far too long our families have not been afforded the opportunity to engage as active participants and problem-solvers.

IFDSD 2018 main image-page-001

Our commitment to making the family voice heard will continue on February 24 as we bring communities together to commemorate International Family Drug Support Day, (IFDSD) a global event which aims to highlight the need for families impacted by substance use to not only be recognized and heard, but to be supported and encouraged to speak about their concerns and needs in drug policy.

To learn more about what you can do for IFDSD, please…

FSDP Brings Australia’s Family Drug Support Model to the United States

Our families have a vital role in the development and resolution of how substance use impacts their home—for far too long our families have not been afforded the opportunity to engage as active participants and problem-solvers.50556292_2514971128519511_2200632244790362112_o

Last weekend, January 11 to 13, 2019, presented an exciting opportunity for Families for Sensible Drug Policy and the Center for Optimal Living to embrace a new paradigm of support for families impacted by substance use when we welcomed the founder of Australia’s Family Drug Support Tony Trimingham, who led a sold-out weekend workshop training for attendees from across the US in the Family Drug Support model. Family Drug Support USA brings  innovative non-judgmental, peer-led support groups with solutions and strategies that encourage self-empowerment by recognizing each family as unique.

50767670_2514977328518891_849438153398812672_o

The workshop was in two parts: On Friday night was “Support The Family Improve The Outcome”, an introduction to the Family Drug Support model providing an in-depth overview including harm reduction tools and coping strategies.Saturday and Sunday was a two-day intensive training, which afforded participants an opportunity to work directly with Tony in an experiential workshop learning specific skills using harm reduction principles and the psychological approach of motivational interviewing to deliver support to those in need.
50463165_2514972238519400_1803922097232150528_o

This long awaited milestone for FSDP will provide our families with an opportunity to  access much needed community support and connection based on what families need, expect and experience. This model of support helps families better understand and strengthen the connection between ourselves and loved ones who use substances. The peer-led support groups present viable alternatives for families to explore potential solutions and coping strategies.

Our commitment to making the family voice heard will continue on February 24 as we bring communities together to commemorate International FamilyDrug Support Day,  a global event which aims to highlight the need for families impacted by substance use to not only be recognized and heard, but to be supported and encouraged to speak about their concerns and needs in drug policy.

50303827_2514978361852121_8070260557254492160_o

Holy Holidays, Batman!…Or Ten Ways to Get Through the Holidays

HandDonate

PLEASE SUPPORT OUR FAMILIES!

Welcome to our Holiday Special Blog, the December 2018 edition of Family Matters – Families Matter, our new blog authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout.

This month, Dee Dee, in her own inimitable style, shares some essential tips to navigate the holiday season in empowering ways…

To join our growing community of enlightened friends and advocates sign up here now.

Hello all! Here we are at the end of 2018 – and of my blogs for this year! Thank you all for your support and your readership! I have truly appreciated all the comments and shares over these past few months. And I’ve discovered just how much I love to do research on these topics!

In the past five months we’ve talked about the dangers and origins of Tough Love; recovering the word “recovery;” and Harm Reduction strategies for families. I know I promised 12 “Ways to Get Through the Holidays” but you know, I found myself doing only 10, perfect for counting on both hands! I hope you won’t be too disappointed. Most importantly, remember our 2018 take away for all families and their loved ones through this sometimes treacherous time:

It really is all about the love – and love is never tough!

love tree

So, who knows what the new year will bring. I know I’m eager to see 2019 and I haven’t felt that way in a long time. For the New Year, what ideas and suggestions do you have for new topics and conversations? Please write to me at deedeestoutconsulting@gmail.com and let me know. See you all next year!

Holy Holidays, Batman!

element5-digital-462736-unsplash

Xmas trees

Holidays. I love them and hate them.

And regardless of which camp you fall into – or perhaps you’re in the “in between” camp – the winter holidays can be a challenge to navigate, especially when there’s added drug use (yes, I mean that tasty eggnog or rum punch too) by many involved. As I sit here with all my research and ideas in front of me, it occurs to me that I can’t think of anything to add to an incredible list of “do’s and don’ts” already available all over the internet and social media.

But that said, perhaps it’s worth revisiting some ideas with a “reduction-of-harm-to-all” bent – and so here goes (OK to sing your fave holiday tune along to these 10 tips, too. Ho ho ho!).

1. Eat light

One of the best tips we can use is to save those heavy conversations for another time. Sure, there will be exceptions to this, but the holidays are already such a heavy meal in so many ways that experts suggest benching the Big Convos until after things have settled down, including our stomachs. So what’s one thing we can do to lighten the mood?

Perhaps we can simply focus on the positives this season and save the less positives for later. That’s a tip for all seasons according to CMC’s 20 Minute Guides for Parents & Partners. What do we mean by this? Think of finding positive things – called “reinforcers” – to say to your loved ones – family, friends, and those using drugs problematically. And here’s why: “The value in reinforcing positive behavior…is that it can start to compete with the reinforcing effects of drugs and alcohol. In essence, your [loved one] can learn to “feel good” in other ways rather than using drugs/alcohol.”[1]

John Gottman, the famous couples therapist, has stated that we need a “magic ratio” of 5 positive statements for every 1 that we make to someone. Dr. Gottman and his team successfully predicted divorce with 94% accuracy in 700 couples 10 years after scoring their negative-to-positive responses in one 15-minute conversation.[2] That’s pretty darned “magic” indeed. We see similar results in workplace conversations as well. So lighten up on the negatives and accentuate the positive statements this holiday season. You might see a greater gift than you ever expected

2. Hang out in the bathroom

This is something I suggest to those trying to reduce or eliminate their drug use as a place to be alone and use a quick meditation. (side note:  I realize that for some this can also be a triggering place for both families and their loved ones using drugs so like all good suggestions, please use your discretion as to whether any of these are right for you). But this is also a terrific exercise for anyone to use for a quick fix. This exercise is known as “The Ball and Triangle.”[3] I learned it from the developer, Terry Gorski, back in the 90’s. And it can be done anywhere, with your eyes open or closed. Here it is:

To start, take a deep breath in through your nose and out through your mouth, like a big sigh. Now imagine there’s an equal-sided triangle floating in space in front of you. In one corner of the triangle there’s a small ball, just sitting. On your next inhale, move the ball up the side of the triangle. On your exhale, allow the ball to fall back into its original place. Do this until you feel as relaxed as you desire.

There are many ways to get creative with this brief meditation too so feel free to experiment; make it your own.

3. Just like real estate: it’s all about location, location, location

One thing that I hear from families and their loved ones is that the location of the festivities is important. Some places encourage nostalgia though may also bring up tension. It may be helpful to discuss the location of events with the whole family. See how everyone feels. I have found with my own family that eating out at a local restaurant can be wonderful: a) everyone’s food intolerances can be honored; b) most folks will be on their best behavior when in public and finally c) no one has to do the dishes! Perhaps grandma’s or dad’s special chocolate pecan pie at Aunt Cristina’s house can be an alternative.

4. BYOB: Bring your own bottles

Even if you’re not the one with the drinking/other drug problem, it might be a good idea to limit your intake. The very best way to do this is to first, bring your own fave beverage. I’m a big fan of Pellegrino so typically carry a couple of bottles with me (I even bring a baggie of lime slices). That way I know what will be served. If you’re moderating your drinking especially, it’s really important not to get dehydrated which is easy to do in a heated room with booze. So experts suggest drinking water between alcoholic beverages. Again, an easy way to reduce your intake – and possible help stave off a nasty hangover too. Be sure to eat something as drinking on an empty stomach is never advised. Also food will help to absorb some of the alcohol which will keep your overall blood alcohol levels down. Finally since alcohol is known as a “social lubricant” for good reason, you might consider who you’d like to be in charge of your emotional state during this event (see # on Lizard Brain). But if you want to indulge more than usual, remember the previous tips and to call Lyft this holiday season. It’s so easy not to drive while intoxicated now – and expensive to get caught.

pup and mistletoe

5. Find support where you can

Hug your pet. See old friends. Go to a meeting at a support group, or a service at your local synagogue, church, temple, or mosque. Volunteer and make new friends. Lots of ways today to stay in touch with others even if only through social media. Visit someone in a nursing home or senior housing. Take a plate of cookies to a neighbor you’ve never met because you’re working all the time (no, they don’t have to be homemade).

6. Like a good photograph, mind your exposure.

If you’re spending time with those that irritate you, do so gently. It’s OK to limit the time you’re with those you love. This is your holiday, too.

7. Rest when you can

For many of us, the holidays are an expenditure of more energy. Sometimes more than we can muster! So resting and sleeping well are crucial to having the outcomes we want. You can think of rest as our body’s need to regenerate its resources to allow us to think before we eat, act, or wind up somewhere we didn’t want to go. I’ve learned that I can’t engage my mind when it’s running on empty, which leaves me with Lizard Brain[4] in control. Now I’m OK with old Lizard Brain having some fun once in a while but not all the time and especially not when I’m going to be in an emotionally challenging situation

8. Cravings aren’t just for drug users

Yes, you heard me right! I like to think of cravings as the body’s way to say “Holy crap, Batman, I need something – help!” The difference for families is that there aren’t any medications for your cravings (and yes I know there aren’t meds for all chemical cravings too but let’s ignore that for now). You may have physical or emotional cravings for all sorts of things from food to the latest mystery to taking a ski weekend in Banff. Whatever it is, it’s just possible that your body/mind is trying to tell you something. We want to learn from our emotions and not be afraid of them or ignore them. We all know the holidays are overfilled with stress so perhaps we can take a page from relapse prevention for drug users and learn to “urge surf”. Here’s how to do it[5]. And you can keep your eyes open or closed them as you find most comfortable:

First, think of something in your real life that’s challenging for you, something that actually triggers some strong emotions (be gentle with yourself here though. Nothing too tender please!). As you think about this challenging behavior or event, imagine that you’re NOT reacting in the moment with that usual strong emotion (you’ll be responding to the situation soon). As you’re thinking about this event, be mindful of where you’re sitting: how does it feel? Are you comfortable? Plant your feet gently and firmly on the floor if you’re sitting. Let your breath gently come in and out of your nose and notice the rising and falling of your chest/lungs. Now once again, think about the triggering circumstance. Really see yourself there at the moment and bring yourself right up to the moment that you’d typically lose your temper, or be overcome with sadness, or even use a drug/take a drink. Here we might think it’s a good idea to push away these strong emotions or swing the opposite way and give in to the emotion/behavior. Instead, I’m going to ask you to just be curious about this emotion and event without reaction. Ask yourself these questions: 1) what does the feeling really “feel” like? Where is it located in your body? 2) what about this situation/feeling feels intolerable? Can you stay with it and relax into it rather than get overwhelmed by the situation/feeling? 3) what is it you really need right now?

Finally, imagine that the feeling your experiencing is a wave on an ocean. You’re riding this wave like a surfer, using your breath as your surfboard. All you need to do right now is focus on your breath going in and out of your lungs and imagine that surfboard riding the waves like Bethany Hamilton! You’re able to keep your balance in spite of feeling a little frightened. Up and down, in and out, you’re riding your board; you’re not allowing the wave to push you off. This is “urge surfing”.

When you begin to feel relaxed and able to respond instead of reacting to a situation or feeling, you can let the board bring you home. Notice how you were able to ride the wave and not succumb to its power but rather allow it to be what it is: just a wave…and it will end. When you’re ready, come on back to the room while you let go of the triggering situation you were thinking of. Take a few deep cleansing breaths and know that you’ve got this! Bethany would be proud!free hugs

 

9. Ho, ho, ho!

I always encourage humor and lots of laughter during the winter holidays (actually I encourage it all the time!). Laugh till your face hurts. Be silly as often as possible. I read a piece recently on a family holding an “Ugly Christmas Sweater” contest with the winner getting a gift card to a favorite store. Wonderful idea! We humans are a pretty funny lot all in all and this is the perfect time of year to embrace that.

Movies are another great way to bring laughter into a room and there are some terrific old and newer holiday films that will make you pee your pants (in my family, it’s “A Christmas Story” hands down!).   Anything from “The Grinch” and “Charlie Brown Christmas” to “Bad Santa” and “Die Hard” are considered holiday fair game. Or perhaps you’re the sentimental type and look forward to watching your favorite heart-wrenching, tear-jerker each holiday. No problem! Those films are available as well (anyone for “It’s a Wonderful Life” or “White Christmas?”). Just be sure to temper those tears with some belly laughs

10 The holidays are a trip!

And they are literally for many of us! Traveling these days can be a trial-by-fire experience. Some quick tips: 1) Only use a carry-on bag 2) Bring something to read/watch/play and 3) slow down on imbibing early (planes really suck the moisture out of every part of us and alcohol makes it worse). For more excellent tips on everything “travel” this holiday season, check out Cheap Flights Survival Guide: www.cheapflights.com/news/holiday-season-travel-survival-guide

Bottom line for the season: Do your best, let go of the guilt/shame, and have as much fun as possible. That sounds like a pretty good recipe for 2019 to me, too. In fact, I think I’ve just found my 2019 New Year’s resolution. How about you?

chinese lanterns

[1] The Parent’s 20 Minute Guide by CMC: Center for Motivation & Change. (2016) Center for Motivation & Change. NY, NY. p93.

[2] https://www.ocde.us/PBIS/Documents/Articles/Positive+$!26+Negative+Ratio.pdf. Accessed 12.18.2018.

[3] https://terrygorski.com/2014/05/08/magic-triangle-relaxation-method/. Note: the Ball and Triangle exercise is now called the Magic Triangle Relaxation Method. Accessed 12.18.2018.

[4] The limbic system aka Lizard Brain is the seat of our emotions and the oldest known part of our brains.

[5] Bowen, S, Chawla, N. & Marlatt, G. (2011) Mindfulness-Based Relapse Prevention for Addictive Behaviors: A Clinician’s Guide. Guilford Press. NY, NY.

Introducing “FSDP Presents”: A Podcast Brought to You By Our New Partners at The Social Exchange!

HandDonate

PLEASE SUPPORT OUR FAMILIES!

FSPD is excited to announce our partnership with The Social Exchange, a brainchild of the brilliant Zach Rhoads and Aaron Ferguson.

26233524_10103289292747830_6908264666812993265_oThe Social Exchange interviews the world’s leading intellectuals about a variety of social topics: addiction, social science, philosophy, and many more.  Zach is a masterful interviewer and through their podcasts they offer listeners cutting-edge information about each topic.

What’s refreshing and unique is that there is no rule that the conversations are agreeable or comfortable. However, each conversation is guided by an honest, information-seeking style of dialectic. On The Social Exchange, ideas are challenged, people are respected.

As part of the partnership, FSDP will have the opportunity each month to select an FSDP community member to be interviewed on the podcast on a segment called” FSDP Presents”. We’re proud to have Glen Carner, Licensed Mental Health Counselor  from Hawaii as the inaugural podcast guest. Glen has a paradigm-shifting outpatient addiction counseling program, Family and Addiction Counseling LLC  that uses a collaborative harm reduction approach that coordinates care for his clients with relevant community supports whenever possible. As you’ll hear in the podcast, he blends his expertise with unbounding enthusiasm and a passion to work with individuals and families impacted by substance use.

You can hear the podcast here and learn more about Zach’s work with The Social Exchange on their Patreon page here.

NEXT UP ON “FSDP PRESENTS”: Kenneth Anderson, a pioneer of alcohol harm reduction and Founder of the HAMS Network: Harm Reduction, Abstinence, and Moderation Support.

Harm Reduction for Families: Communicating With Love

Adding to our Fall series, welcome to the November 2018 edition of Family Matters – Families Matter, our new blog authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout.

This month, Dee Dee shares her unique perspectives on harm reduction’s influence on family communication

To learn more about how your family can join our growing community of enlightened friends and advocates sign up here now.

image002

Communication.

This is a huge topic which I can only hope to touch on here. But I hope that I can offer some suggestions, look for some possible answers from you all (families) and see what we know in science now.

For more than fifty years, we professionals have made (still make??) terrible mistakes in our advice about communicating with loved ones who use drugs: DON’T BOTHER! We said things like, “All addicts are liars” and “They must hit bottom” and “You need to use tough love with addicts”. We called you all names: codependent, enabler, co-addict/alcoholic. Now don’t misread me here: we’re discussing a family which is a system.

To use the favored metaphor from famed American educator and author, John Bradshaw[1], “families are like mobiles: touch one side of a mobile and the entire piece shifts.” This means all family members must participate in changing in order for change(s) to actually happen. Bradshaw, [2] (who also coined the terms “dysfunctional family” and “inner child”, and some believe ushered in the self-help movement of the 1980’s) used to call the problem a “dis-EASE” with the world. I think that is still one of the best definitions of addiction we have. And it speaks to the trauma that all too often accompanies addiction/drug use. More on that in the future.

So, what does communication in a harm reduction world look like? Here’s an example from Patt Denning and Jeannie Little’s book, Over the Influence[3]:

“You can love your child and kick her out of the house. You can kick her out of the house and pay her rent somewhere else. In these ways you can continue to love and support her and limit the damage she can do to your marriage, your house, and your other kids. In other words, you can make changes in your relationship with your loved one way before you are completely worn out. In fact you should.”

A second example is from the Center for Motivation and Change’s (CMC) booklet, “The Parent’s 20 Minute Guide”[4] (they use the term “parent” to mean any caregiver). In the section titled “Helping with Understanding”, CMC makes the point that the behaviors your child is engaged in (i.e., using drugs) make sense and we parents need to appreciate that relationship that our loved ones have with substances even as we struggle to understand it. Wow, huh? This can be a tough request but here’s why it’s crucial to Communicating with Love:

“Feeling relaxed, exhilarated, less anxious, braver, funnier, and part of the group, are all potential benefits of using substances. If there were no benefits, there would be no use.” (emphasis mine)

This is enormously important for families to understand. Without this acknowledgement, little communication with love can happen. We need to remember that our loved ones’ actions have more to do with their personal reasons for using (the reinforcers) than us. This knowledge can help us to not take our loved ones’ actions so personally and to start to see the reasons for the substance use: loneliness, boredom, social/fitting in, anxiety, trauma, and more. The CMC 20 Minute Guide goes on to say,

“Understanding what your child gets from using can also lower your fear and anxiety, as it makes the behavior less random and more predictable. If he uses to fit in with other kids, then you know he’s more at risk when he’s out socializing than home with the family.”[5]

With this information in hand, strategies can be launched with your loved one and everyone can be invited to brainstorm options when your loved one is faced with potentially triggering social situations.

The Guide also has worksheets, such as the one titled, “Behaviors Make Sense”[6] which is designed for the parents to complete based on their understanding of their loved ones’ reasons for using drugs. I would suggest that these worksheets might be even more effective if completed with your loved one. That way you’re not left guessing about the relationship your loved one has with substances. It also allows for further exploratory conversations to better understand your loved ones substance use (it’s also possible that your loved one isn’t sure of all the reasons they use drugs; this openness to conversation could allow them time to consider why they use a substance(s)).

Denning and Little also provide some excellent guiding concepts for families to use, calling them “Harm Reduction Principles for Family and Friends:”[7]

  1. Promises only cause problems
  2. There are no rules except the ones you make
  3. You cannot enable drug use (unless you are supplying them)
  4. Base your actions on your values
  5. Base your actions on what you can manage
  6. You have triggers too
  7. Any limits you set are about you

I would add a couple of others:

8) Everyone’s doing the best they can so be kind/gentle with yourselves – and with your loved one (it may seem like your loved one cares more for drugs than for you right now but I doubt that’s really true)

9) You probably can’t solve this problem, but you can make it better or worse

10) For change to be successful for your loved one, you must also change

So perhaps now you’re thinking, “OK Dee-Dee, this is all great but is there some research to tell us how to communicate with love?” Yes there is!

CRAFT. Community Reinforcement Approach and Family Training[8], developed by Robert Meyers, PhD (Research Associate Professor Emeritus in Psychology at the University of New Mexico’s Center on Alcoholism, Substance Abuse and Addiction) is an answer. Bob Meyers (full disclosure: I have been trained by Dr. Meyers in CRAFT) came to the field of addiction through his own family’s problems with substance use. He became convinced that there could be a better way to interact with loved ones using substances and focused his research on finding some answers to this lifelong idea. Taking Dr. Nathan Azrin’s Community Reinforcement Approach (CRA) and combining it with his own brand of Family Training, Dr. Meyers developed CRAFT, now an evidence-based therapy.

CRAFT is unique in addiction counseling in many ways. One of the most important, in my opinion, is its focus on “catching people who use drugs doing something ‘right’”. In other words, instead of the main focus being on punishment for misbehavior, CRAFT encourages us to focus on the times when your loved one isn’t engaging in the ‘misbehavior.’ It also supports the idea that drug use (especially problem drug use) doesn’t happen in a vacuum: it happens within a system and all parts of the system must change.

Too often the drug user is seen as the Identified Patient (or Problem aka the IP) and taken off to treatment to make changes which we’re often led to believe will solve all the family problems. However, if the system she is in doesn’t also make changes, how do we expect her changes to be maintained? This is what’s called “magical thinking” (which has sadly been perpetuated too often in my profession); it’s also a set up for failure. All too often treatment does fail[9] too regardless of how much she wants to make a change(s).

Down under, Tony Trimingham, founder of Family Drug Support (FDS Australia), shares some similar ideas in his “Letter to Family and Friends.”:

“When we expect immediate changes and refuse to be with the person during the process we undermine the very goal we seek to accomplish.” [10]

I want to stop here for a moment to reflect on things that I’m suggesting families can do differently – I want to emphasize that I am NOT pointing these things out in order to lay blame. Never. Are there things we could’ve/should’ve done differently as families with loved ones who love drugs? Absolutely. Does that mean we are to blame/responsible for the drug use? Not likely. But we are part of the overall system – and therefore we must be willing to look at our part in the creation of that system of dis-ease we are all in squarely in the face.

After all, isn’t that what we ask people who use drugs to do in treatment? What I’m saying is that when there’s a complicated, possibly chronic condition in the family, it affects everyone, therefore, the solution(s) has to involve everyone. Gratefully we now have more options & suggestions for families than the old “let them hit bottom” and “stop enabling/being codependent.” We can now say, “don’t stop loving your family member!” and “when our loved ones are ill we need to hold them closer.” Learning how and when to “hold them closer” so change can be possible is the challenge. One way of helping us may be to learn more about change in general. How does it happen? How can we help or hinder change? Is it ever successful?image004

We’ve learned a great deal about how people make change(s) in their lives. The researchers James Prochaska, Carlo DiClemente, and John Norcross discovered how change happens back in the late 1970’s which they called the Transtheoretical Model (TTM) or Stages of Change for short.[11] We’ve learned that instead of looking at abstinence as the best or only way to recover or change, incremental positive change may be the best route: “Any positive change” is the slogan the late harm reductionist, Chicago Recovery Alliance founder Dan Bigg[12] who has used this slogan to describe how to view the small steps typically needed to move toward change.

Harm reduction for families at its core is about providing support to help families make decisions that fit their individuality: their values, their needs, their loved ones. It’s about helping families to see that abstinence is one possible outcome but doesn’t need to be the only one – nor is it always the best option for everyone.

For many people, the best way to make change is to go mindfully and slowly, small step by small step, moving closer and closer – with some setbacks – toward the big change you plan to make. Think of how many people quit smoking (side note: The Stages of Change were discovered when the developers/researchers looked at some 1500 smokers). Usually smokers quit on their own, either with or without the help of aids as nicotine replacement (Nicorette gum, inhalers, lozenges; anti-craving medications). Others just stop, cold turkey. But most professionals now will suggest – for those not wanting that “cold turkey” method – a “warm turkey”[13] approach is a good option especially for those who have a difficult achieving their goals with “cold turkey” methods.

The same can be true for abstinence or moderation goals in drug/alcohol use. Families can now Google terms such as “harm reduction for families” and find options that may be more in line with their values/goals and those of our loved ones using drugs. With cannabis legal in more and more states every day, many of us have found that we are looking to this substance to prove helpful in treating addictions (we already know about its usefulness – alone or in conjunction with cannabidiol CBD[14] – in treating anxiety, pain, depression and more for many people). Most families I work with now are more than delighted to have their former problematic drug-using loved one find relief and assistance in some form of cannabis.

Harm reduction for families at its core is about providing support to help families make decisions that fit their individuality: their values, their needs, their loved ones. It’s about helping families to see that abstinence is one possible outcome but doesn’t need to be the only one – nor is it always the best option for everyone. And by the way, one can definitely not be abstinent (defined as not taking any medication/drug) and still be “in recovery.[15]” More and more families are coming to see harm reduction as a better fit for them than the old “hit bottom/throw them out” model as they see the harm that is caused to them and their loved ones by such traditional, zero tolerance policies.

Families have also had enough of the old ways of thinking from my profession – the misinformation/scare tactics, the lack of nuance in treating them and their loved ones who use drugs, the one-size-fits-all approach – even the beloved American disease model of addiction has been challenged by many of the families I see![16] Family work in addictions is at a crossroads: in my opinion, it is the outcry from families that will be the reason new harm reduction policies will be adopted. It is your voices that are the loudest, strongest, and which will be best received since frankly, families are seen as victims of addiction unlike “addicts” (I’m not suggesting this view is accurate or not, simply that it is a reality in our culture). Bottom line: once again it’s about LOVE. LOVE which is the center of positive and healthy communication – and something we can all improve on demonstrating within our families this minute.

So grab one of these books – or perhaps you know of another one that fits your needs best – and start reading and practicing. It’s time for our Family Recovery movement. We must demand better, more from the professionals and other healthcare practitioners. And we must learn to improve our own communication with love.[17]image008

(Note: all photos are from unsplash.com)

Don’t miss next month’s edition:  “Holy Holidays, Batman!!  12 Tips for Enjoying the Holidays in Spite of Everything.”  

 

REFERENCES

[1] www.johnbradshaw.com.

[2] Ibid. Accessed on 9.26.18.

[3] Denning, P & Little, J. (2017). Over the Influence, 2nd Edition. Guilford Press. NY:NY. p221.

[4]https://the20minuteguide.com/. Accessed on 9.26.18. p11-12.

[5] Ibid

[6] Ibid. p13-14.

[7] Denning, P & Little, J. (2017). Over the Influence, 2nd Edition. Guilford Press. NY:NY. p221.

[8] www.robertjmeyersphd.com. Accessed on 9.26.18.

[9] Statistics for success re: professional treatment is difficult. 30% is the highest publicized rate yet this number generally reflects only those who completed treatment, not who improved longterm. AA’s rates are about 5%.

[10] https://www.fds.org.au/newsletters/letter-to-family-and-friends (accessed 10.22.2018)

[11] https://en.wikipedia.org/wiki/Transtheoretical_model (accessed 10.22.2018)

[12] Chicago Recovery Alliance (CRA): www.anypositivechange.org

[13] https://www.ncbi.nlm.nih.gov/pubmed/1787547

[14] https://www.projectcbd.org/about/what-cbd. Accessed on 10.25.2018.

[15] https://www.aa.org/assets/en_US/p-11_aamembersMedDrug.pdf

[16] See works by Marc Lewis, Maia Szalavitz, Stanton Peele, Jeff Foote, Denning & Little, Andrew Tatarsky, to name a few professionals in the field who do not ascribe to the traditional disease concept of addiction. Dr. Marc Lewis is a neuroscientist, researcher and former drug addict who has authored several books on this subject: http://www.memoirsofanaddictedbrain.com/authors-bio/

[17] Another book I suggest & use with families: William Miller’s (Motivational Interviewing) 2018 book titled, “Listening Well: The Art of Empathic Understanding.” It’s available at Amazon and beyond.