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.
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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:

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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…

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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.

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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.

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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

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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.

 

 

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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…

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[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/

 

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.

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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.

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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.
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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.

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

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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!

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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!

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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.

FSDP Co-founder Carol Katz Beyer Represents the Family Voice at Rutgers University School of Law

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FSDP was privileged to have co-founder Carol Katz Beyer invited to participate on an international panel of experts at the Rutgers University School of Law on October 31, 2018. Randy Thompson, founder of Help Not Handcuffs hosted the discussion on “Drug Decriminalization: The Triumph of Human Rights and Health over the Drug War”45144582_2393306420685983_7391489221489328128_n

Randy Thompson, founder of Help Not Handcuffs, in conjunction with The Open Society Foundations (OSF), The Rutgers Criminal Law Society and the Rutgers Public Interest Law Student Association, coordinated the event featuring Dr.João Goulão, the Portuguese Drug Czar, Kasia Malinowska, Director of the Global Drug Policy Program at OSF, Tess Borden, Staff Attorney for the ACLU-NJ and Carol Katz Beyer of FSDP as speakers.

What was detailed was nothing short of amazing! Portugal, which decriminalized all drugs has almost non-existent overdose deaths. In Portugal, harm reduction is so well developed that it is significantly reduced overdose deaths and the spread of HIV/AIDS and HepC; and they provide superior treatment on demand for those who want it, at less than 1/10th of the cost to taxpayers compared to the New Jersey system

Kasia engaged Dr. Goulão in a conversation and he brilliantly articulated the history of how the Portugal model came to be. He illustrated that change is possible when the goal is to elevate society through the lens of public health with strategies and solutions rooted in compassion and science.

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Panel, from left: Dr. João Goulão, Kasia Malinowska, Tess Borden, Carol Katz Beyer

Tess detailed the egregious human rights violations that the US policies of prohibition and criminalization are inflicting on families.

Carol eloquently elucidated the issues and harms that our families needlessly suffer as a consequence of the war on drugs as well as recommended public health solutions. Carol said, “I cannot express enough how privileged I felt to be present in the company of Dr. João Goulão who articulated so poignantly what transformative solutions in drug policy reform look like”.

Immense appreciation and thanks go to Randy, who did a tremendous job organizing this important event and skillfully moderating. There was a robust Q and A afterwards as audience members representing Rutgers law students, healthcare professionals, and community members.

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Host/Moderator Help Not Handcuffs founder Randy Thompson

I cannot express enough how privileged I felt to be present in the company of Dr. João Goulão who articulated so poignantly what transformative solutions in drug policy reform look like–FSDP co-founder Carol Katz Beyer.

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Attendees included FSDP co-founder Barry Lessin and FSDP members Anne Earle and Lisa Raphael

Because of your ongoing support, we are bringing our communities together, empowering families, restoring health and saving lives!

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FSDP at The 12th National Harm Reduction Conference in New Orleans, LA

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Thanks to the generosity and support of our friends and stakeholders Team FSDP attended the 12th National Harm Reduction Conference #harmred18 in New Orleans, LA, October 18-21, representing a growing number of families who are adversely impacted by the unprecedented public health crisis surrounding substance use.

This biennial event brought together some of the most creative minds from the US and abroad to address a myriad of complex issues facing the harm reduction movement. A diverse community of people who use drugs, social justice activists, service providers, healthcare workers, researchers, policymakers, public health officials, and law enforcement gathering together determined to put an end to the harms and injustices caused by the War on Drugs.

FSDP is dedicated to serving the needs of our families and our participation in this conference is a heartfelt expression to honor our loved ones who have been lost to overdose and to save the lives of those who remain at risk.

 

FSDP co-founders Carol Katz Beyer and Barry Lessin were privileged to be invited to join harm reduction pioneer and visionary Patt Denning, Ph.D. on her panel: “Loving Someone Who Loves Drugs and Alcohol.”

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Patt outlined specific strategies for family members and friends based on guiding principles of harm reduction including “there are no rules except the ones you make”, “establish your absolute limits”, affirm your values, “identify what’s most important for you” and “tough love is neither, and it feels bad to all”.

The packed meeting room was inspired by Carol sharing how her lived experience inspired her to advocate for impacted families by creating a space to powerfully speak the truth to the powers that be in the broken treatment-industrial complex.

Barry gave an overview of the work of FSDP and shared how family and friends can become empowered by being open to reality-based harm reduction information and sharing it with peers, planting seeds of hope in their communities.

Our dedicated team was on hand to welcome attendees at our exhibit table continuing the conversation, networking and providing conference attendees with educational materials, tutorials and resources.

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Thank you Juan Fernandez Ochoa for sending us the Support Don’t Punish t-shirts. They were a big hit!

The 2018 Harm Reduction Conference comes at a time when harm reduction, health care, and drug policy reform have entered a dynamic and critical phase. The prescription opioid and heroin overdose epidemic has captured national attention, with renewed focus on transmission of HIV and Hep C among people who use drugs. These trends are reshaping the policy and public health landscapes, making harm reduction more urgent and relevant than ever before.

Because of your ongoing support, we are bringing our communities together, empowering families, restoring health and saving lives!HandDonate

Welcome Family Drug Support USA This Giving Tuesday!


GT Tony
GivingTuesday is a global day of giving fueled by the power of social media and collaboration.

Celebrated on the Tuesday following Thanksgiving, (November 27 in the U.S.) and the widely recognized shopping events Black Friday and Cyber Monday,

FSDP is excited to announce that starting at 5am PST on November 27, Facebook and PayPal will contribute a total of $7M to partner with our stakeholders and match any donation to your designated nonprofit of choice! Giving Tuesday is a not to be missed opportunity to help us support more families by bringing Family Drug Support USA to communities across the nation. Our Facebook friends can also have their gifts matched by using the fundraising for nonprofits option on Facebook for which includes birthday fundraisers and the donate button feature

As a mother, Carol Katz Beyer, who has been personally impacted by the devastating loss of her two children Bryan and Alex, was inspired to co-found Families for Sensible Drug Policy with Barry Lessin to regain control of our families’ health by collaborating with our stakeholders to implement a new paradigm of care and support based on compassion, science, public health and human rights.

Please read this heartfelt message from Tony Trimingham to learn more about Family Drug Support:


“When someone dies as a result of illicit drugs, it is estimated that on average they lose 35 years of their lives (compared to 5 years for nicotine and 15 years for alcohol). Not only does this rob the person of a chunk of their life, it has a massive impact on their family. When my 23-year-old son died from a heroin overdose, not only did I experience profound grief and shock, there was excruciating pain and a massive impact on me, and all my family. If I could get to sleep (which was rare) I would dream of him being alive, then I would wake up to the nightmare. I found myself breaking down on an almost daily basis, and simple everyday tasks became difficult.

 My wife and friends who were suffering their own grief had to cope with my not coping. I would hear his voice in public places and thought I saw him walking along the street. For the first 6 years after he died this level of pain continued and it took a long time before I was able to smile again and enjoy the normal things in life. It is now 21 years and while the pain has subsided and is not as acute, there isn’t a day go by where I don’t feel sad, and miss my son. I have missed out on conversation with him, possible grandchildren, and seeing him progress through life. I have had similar conversation and reflections with hundreds of other families who have lost people, and suffer the same anguish. For this reason, Family Drug Support believes that keeping people alive and safe is the first priority when it comes to dealing with problematic drug use.

In my work with Family Drug Support, I have spoken to more bereaved families in the last six months than I have in the last six years. This is because of the increase in the use of legal opiates, and also because street heroin is back on the radar. The truly sad fact is that these deaths, along with those at music festivals from taking pills, are completely preventable.”

Family Drug Support Training is an opportunity to work directly with Tony Trimingham 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. People that successfully complete the training will be able to bring this peer to peer support to their communities.

Please click here for more information about Family Drug Support USA

Meet Tony Trimingham in this video describing the workshop.

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Our families desperately need your help and we urge you to join us as part of a long term solution that will keep our loved ones safe, connected and plugged in to the services that will keep them alive. A watershed moment reflecting our nation’s most significant public health disaster, requires that we as a nation embrace a multi-tiered and realistic approach towards prevention, education and access to healthcare services.

Your donation no matter how big or small helps save lives by forwarding our mission to deliver the message of harm reduction to communities around the world. Please help us reduce overdoses and empower families by educating and advocating for progressive solutions for family support based on science, compassion, public health and human rights.HandDonate

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Sign up HERE to receive our newsletter stay informed on the latest news and events.

Thanks so much being a valued friend to our community. Your generosity and support is  really appreciated and will help make our family voice be heard.

September is Recovery Month: Reinventing Recovery

 

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

In the first of a series of our Fall 2018 blogs, since September is Recovery Month for SAMHSA, this seemed the perfect time to write about the word, or concept of, “recovery” specifically as it’s typically applied in substance use disorder (or “addiction”) treatment.

September is also the traditional “back to school” month and many of us have kids who are returning to school or perhaps young adults transitioning to college. This is a good time to to review constructive ways to talk to our kids about alcohol and other drugs, and also to take a new look at treatment, drug policy, binge drinking. and how to negotiate the holidays  Therefore, for the remainder of 2018, our blogs will take a look at those topics and more. See you next month! #recoverywithoutabstinence #stopthestigma #familiesmatter

And now our 2018 “Recovery Month” edition:

Reinventing Recovery

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Photo by Toa Heftiba from unsplash.com

Usually when we hear (or often use) the term “recovery”, it has a very specific meaning: nearly always 12-Step oriented, abstinence-only based, and says to us this is a disease you’ll have forever. I want to definitively make the case for a new kind of recovery in the world of addiction(s): an “inclusive v exclusive” recovery that does not require the elements we’re used to – including abstinence – but whose definition can certainly contain it …and so much more. 

Recovery. It’s a truly loaded word (pun intended). Let’s go on a bit of a journey to see how and from where our concept(s) of recovery stems as it’s a word that comes with a lot of baggage, both positive and less than positive.

According to etymonline.com, the origin/first use of the word “recovery” comes in the mid-14th century and meant “return to health.” “Recovery” originates from the Anglo-French word “recoverie” meaning “remedy or cure.” The additional meaning of an “act of righting oneself after a blunder, mishap, etc.” is from the 1520’s. Could this also be at the root of the word having such moral implications?

In his July 2014 article for Psychology Today, well-known addiction expert, author and former Harvard Medical School professor, psychiatrist Dr. Lance Dodes discusses some of the problems we have with the word “recovery.”[1] In part, he sees the word as acceptable in the context of “recovering from a medical illness”, meaning that 1) relapse/lapse is normal, and that 2) one is headed toward a cure or an ending of the condition/illness. Quoting from the article, Dr. Dodes says, “In most of life, ‘being in recovery’ means a person is making progress even though s/he isn’t ‘cured.’” This is far different than how we too often hear the word used in addiction treatment circles or our greater culture. In both places, “recovery” typically means that one is abstinent and attending a 12-Step group – “working the program” to use the language of AA for example. This is meant to establish an “us vs. them” quality: you’re either attending meetings, working the Steps, and have a sponsor so you’re “in recovery” or you’re not and therefore you’re not in recovery. Black or white; right or wrong. Plus, the implication is that anything short of a 12-Step traditional recovery means you’re not doing recovery “right.” A lot of people – including many professionals – believe this is what the word means and ONLY what it means. I, too, believed this for a long time.

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photo by Danielle MacInnes for unsplash.com

I went to residential treatment here in Oakland, CA, in the late 1980’s. These were the “salad days” for residential treatment, coming on the heels of First Lady Betty Ford openly discussing her addiction to alcohol and pain medications.[2] No one of her stature had ever talked about their alcohol and other drug problems in the US and her “coming out” can’t be understated; it was also a huge step in reducing the stigma/shame for others to seek help for their substance misuse/problems. Finally, this event was also partly responsible for opening the doors of treatment to become the Big Business it is today (more on that in another piece).

In treatment, we were taught that addiction is a 3-fold disease: bio-psycho-social (some also added “spiritual”). It was like a, sleeping tiger, always waiting to pounce on you unless you were constantly vigilant in your recovery (meaning abstinence, attending meetings regularly, and “working a good program.”). We were taught phrases such as, “Your mind is like a dangerous neighborhood: don’t go in it alone” and “Avoid old people, places and things to stay sober.” In other words, 1) don’t trust your own thinking because you’re an addict/alcoholic and “your best thinking got you here”, 2) you’re never fully recovered, and 3) you must cut off all your old friends as they were only using friends and therefore not interested in your well-being; your relationships were only based on drug use. I remember someone saying that everything I had done up to the point of my entering treatment/recovery didn’t count – but now my life could really begin: “Today is the first day of the rest of your life”[3] was up on a wall somewhere. Scary stuff. And I was scared straight.

In what’s known in 12-Step circles as the Big Book (Alcoholics Anonymous 3rd edition), there are several references to the word “recovery” and “recovering” (somewhere around 15) but also references (about 10) to the word “recovered” which is akin to blasphemy today in most 12-Step circles.[4] This is another point of contention for many of us. Can we ever say we’re “recovered” or even “cured?” I say, “yes we can,” to borrow a phrase. And that we should. Why? Because to those outside of traditional treatment/recovery, I hear folks constantly say, “Apparently treatment doesn’t work because you people are never recovered!” I had never thought of the phrase “recovering” as potentially responsible for this perception. I personally say that after over 30 years of continuous abstinence, I am completely comfortable declaring that I’m “recovered;” the problems I have today have nothing to do with illicit drug and/or alcohol use (sometimes that would be simpler, frankly). The first paragraph in Chapter 2 of the 3rd edition of the Big Book titled, “There is a Solution,” also appears to see an end state to addiction. It states: “We, of Alcoholics Anonymous, (italics theirs) know thousands of men and women who were once just as hopeless as Bill. Nearly all have recovered (emphasis mine). They have solved the drink problem.”[5] This passage certainly seems to imply that one can indeed recover. But then what exactly does it mean to recover? And how do we achieve this state of being?

Mindfulness + Connectedness + Inner Growth

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Photo by Austin Chan for unsplash.com

 

A Phrase is Born. While working for the large American HMO Kaiser in the 1990’s, I was charged with developing and leading a relapse prevention track for patients in our Chemical Dependency Recovery Program (CDRP). These were folks for whom the course of treatment we offered (intensive outpatient program or IOP) didn’t work – or, as we phrased things back then, patients who didn’t try hard enough, were in denial of their “disease,” or simply relapsed back into drug/alcohol use due to inattention to “people, place, and things.” During one of our evening groups we were working on a definition for “recovery” and decided to see what we could come up ourselves. After all, we surmised, how can one relapse if you don’t have a clear idea of recovery?

Mindfulness, connectedness, and inner growth was the phrase we all agreed described the basic ingredients for recovery. It wasn’t until later that someone noticed we neglected to include anything about abstinence/sobriety, 12-Step attendance, or the other usual things we associate(d) with recovery. I remember that night well because a gigantic light bulb didn’t just light up, it blew up in my head! This was the moment I began to wrap my head around the idea that perhaps alcohol and other drug use itself – and abstinence specifically – really had nothing to do with one’s healing or recovery; recovery wasn’t in fact begun with stopping drug use first (which is what we always told folks). What was at the core of the concept of true recovery of one’s life we decided were these 3 elements defined here – which may or may not include an end to one’s drug use:

Mindfulness: paying attention – to what you’re doing, who you’re with, what you’re putting in your mouth/arm/throat/etc., really everything that’s happening as well as you humanly can, plain and simple.

Connectedness: this means getting reacquainted with yourself, a vertical connection, we called it – your body, your mind, your spirit – and fully trusting them. This also spoke to the idea that your mind is connected to your body (yes, no matter what Descartes[6] said, they’re attached; it’s called a neck!). This vertical connection could also be to a higher power or great spirit of some kind. Connectedness includes a horizontal connection, too, or connection with others.[7]

Inner growth: this was a bit more difficult to flesh out at the time but we settled on it meaning whatever an individual does that leads to their seeking out new information and new ideas, being a part of the world at large. This could be going to school, walking in the park, dating, making new friends, a yoga practice, meditation, attending synagogue/mosque/church/temple/circle, or even reading. Or anything else that “feeds” a human’s curiosity and need for knowledge.

And that was it. Drug use, abstinence, continued using or something in between, wasn’t mentioned. Why? Because we realized that in any other bio-psycho-social illness (which nearly all are), one did not have to recover perfectly. In fact, in my definition humans cannot do this – at least not all the time. And we realized that it wasn’t the alcohol or other drugs that were at the core of the problems we had: they were but a symptom. [8]

Therefore, one could indeed be in recovery and use drugs. Not problematically because then you’re not connected or mindful or growing. But we agreed (again to our collective surprise) that yes, one could be using alcohol or other drugs – having a healthy relationship with them – and be mindful, connected, and growing internally: in recovery. And we also agreed that for some folks, to have these 3 elements in their lives could require abstinence: total, partial, forever or for a while, we made no comment on those notions. That would remain up to the individual (which also fits within AA/12-Step guidelines of no one being able to tell another that they are an “alcoholic or addict.”). In fact, we realized that having healthy relationships of all kinds could be achieved through these three elements. What a jolt to the brain this was to us all!

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Photo by Ron Smith for unsplash.com

YOU GOTTA GIVE THEM HOPE”, Harvey Milk[9]

These days, I have come to realize that it appears these elements or ingredients of recovery also build on one another: for example, you first need to improve or have some mindfulness about what you’re doing before you can truly connect with others and yourself, and that action can lead to growing internally. And again, we made the argument then which I’ll repeat here, drugs and drug use (including alcohol of course) don’t necessarily impede one’s ability to recover or regain health from having problems with them – or being “addicted.” The problem is in one’s relationship with substances or behaviors that have become problematic or compulsive, and that we continue to engage in despite negative consequences – what we call “addiction.” So here’s the Big Question: what if we as a collective culture decided to work on these 3 ingredients and the issues that get in one’s way of achieving them? What if we decided to help those in need to uncover why they – or collectively, why so many of us in the wealthiest nation in the galaxy – need to use substances in order to cope? Hmmm…

It’s time to reinvent the word recovery to mean this: “I have recovered my life and my health. with or without abstinence. I am mindful, connected, and growing.” Now that’s real recovery!

One of the ways to address these issues of the lack of mindfulness, connectedness, and inner growth is with what the Canadian author, physician, and addiction expert Dr. Gabor Mate calls “compassionate inquiry.”[10] Dr. Mate makes the case for needing people in our lives who can/will listen deeply, compassionately to those of us involved in using substances/behaviors that are causing pain in our lives. Another advocate of doing things differently in treatment is Stanton Peele, PhD, JD. In his newest book on addiction, Recover! Stop Thinking Like an Addict and Reclaim Your Life with The Perfect Program,[11] Dr. Peele discusses these issues at length, as he has for over 50 years. As an early adopter of harm reduction principles, he has tried to get us all – but especially we Americans – to see that the way we have come to view addiction is all wrong: 1) it’s not a disease, 2) most people quit on their own (so how can it be a disease), and 3) not all people are susceptible to becoming addicted. In fact, by viewing addiction as a disease, our society has actually increased the possibility of relapse[12]. It reminds me a bit of Charlton Heston’s famous line at the end of the film, The Planet of the Apes, when he realizes where he really is – back on Earth: “You finally really did it. You maniacs! …God damn you. God damn you all!” In looking for the reasons for addiction, we have to consider that perhaps, unintentionally, we have done much of the damage ourselves with our racist policies, unscientific treatments/interventions, and blaming of the people who use drugs (and often their families as well). It sure is easier to blame a drug(s). It’s much harder to look within, compassionately and deeply, for the reasons so many of us are in pain (of all kinds) and need relief to cope with living.

I see September’s Recovery Month as a great time to take a look at what we’ve done with addiction treatment and recovery. And to take a hard look in the Mirror of Truth about our society and its complicity in addiction(s). It’s time to stop the unscientifically-tested treatment of this “medical-and-more” complicated condition. It’s time to demand professionals who are highly trained and compassionate – always. It’s time to radically change how we view people with substance problems – and their loved ones – regardless of whether you believe this is a condition of their making or not.

It’s time to reinvent the word recovery to mean this: “I have recovered my life and my health. with or without abstinence. I am mindful, connected, and growing.” Now that’s real recovery!

DON’T MISS NEXT MONTH’s EDITION: 

COMMUNICATING WITH LOVE ABOUT DRUGS WITH SOMEONE YOU LOVE. 

[1] https://www.psychologytoday.com/us/blog/the-heart-addiction/201407/what-does-it-mean-be-in-recovery

[2] A Johnson Institute-style intervention was held in 1978 for Mrs. Ford leading her to seek treatment for her substance use. In 1982, she founded The Betty Ford Center which is now part of the Hazelden family of programs.

[3] As discussed in our last piece on “tough love,” the originator of this phrase is the founder of Synanon, Chuck Dederich.

[4] “A Reference Guide to the Big Book of Alcoholics Anonymous” by Stewart C.; (1986). Recovery Press, Seattle, WA.

[5] p17. Note: The “Bill” that is referenced here refers to the co-founder of AA, Bill Wilson.

[6] Rene Descartes was a 16th c. French philosophermathematician, and scientist; dubbed the father of modern Western philosophy who famously argued that the human body and mind were separate. Wikipedia.com

[7] Remember that church I mentioned in my first blog, the United Church of Christ or UCC? There we were taught that God was within each person and living thing on Earth and that we were all connected. Very Deepak Chopra. Hmmm…

[8] Interestingly enough, a similar idea can be found in AA’s Big Book on p85, in this line: “What we really have is a daily reprieve contingent on the maintenance of our spiritual condition.” And I was taught that “spiritual” merely meant connected.

[9] Quote from slain San Francisco Supervisor Harvey Milk, one of the country’s first openly gay politicians. This is from a tape recording (1977-11-18) to be played in the event of his assassination, quoted in Randy Shilts book, The Mayor of Castro Street: The Life and Times of Harvey Milk. (1982), p. 277. Wikipedia.com; personal communications.

[10] From Dr. Mate’s website, drgabormate.com: “Through Compassionate Inquiry, the client can recognize the unconscious dynamics that run their lives and how to liberate themselves from them.”

[11] For more information, view the results of the NESARC study and more, discussed in Dr. Peele’s book, p36-42. (2014), Da Capo Press.

[12] Miller et al; “What predicts relapse? Prospective testing of antecedent models.” https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1360-0443.91.12s1.7.x

“Love Has No Labels: The Rise and (hopeful) Fall of Tough Love in America?” — Part 2

Welcome to the August 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. To learn more about how your family can join our growing community of enlightened friends and advocates sign up here now.tyler-nix-525388-unsplash

Last month we started our discussion of “tough love” and its origins. This month we’ll continue this look at this well-known and used concept to see if it really works and is the most effective strategy for families who love someone who misuses drugs.

We’ve discussed Synanon and its use of harsh confrontation and “tough love” in treating drug use problems. We’ve looked at Al-Anon and its concept of “letting go with love” and seen that what that often looks like is anything but love – though setting limits is important, too. Also, we’ve discussed how this concept of “tough love” isn’t just bad for helping drug users make changes but also bad for loving family members. We also talked about the difference between gaining or giving approval versus love. Finally, we looked at what more pain does for drug users: encourages them to use more, not less. So, let’s pick up the conversation here, starting with more on harsh confrontation.

You may have questions by now and I’m going to try to guess what some of them are and provide answers here. 1) Is tough love the same as harsh confrontation? The answer is yes! 2) I thought treatment is supposed to break through the denial of a person addicted to substances? The answer is no, that’s actually more likely to harm clients especially those with other underlying mental illnesses including trauma. 3) Don’t people who use drugs problematically need to be shown what a mess their lives are and how they’ve hurt others, such as their families? Again, the answer is no, they’re fully aware already and are usually extremely ashamed of their lives and behaviors even though families may not see this.

By the way, these are all reasonable questions to ask. Let me suggest, as many experts in the field do, that we look at how we treat other chronic medical conditions. Let’s take diabetes for example: when one has diabetes and is reliant on medication, do we complain that they are “addicted” to insulin? Of course not. We’re happy that there is a medication that can help them live a more full and healthy life. But with medication-assisted treatments (MAT) we hear negative comments (Narcotics Anonymous (NA) has made their views clear in their official pamphlet on MAT) such as how folks are just trading one drug for another; that they aren’t really “clean”. Here in California, our Department of Health Care Services has informed treatment providers that they expect us not to ask clients to engage in activities that we wouldn’t ask of those with other chronic health conditions such as diabetes. So, for instance, would we ask someone with diabetes to list their character defects that may have led to their illness? Of course not. Would we ask them to hold hands in prayer around a circle? No again (while any individual may find this helpful, we wouldn’t consider this professional treatment). We certainly wouldn’t put a toilet seat around their necks and tell loved ones to throw them out of the house for eating less healthy foods! But these are all deemed reasonable treatment approaches to addiction to many in our profession even today. (This calls for a lengthier discussion on addiction that I’ll do in another installment)

As I often do, I got out the dictionary to view some definitions of these 2 words as I prepared to write. Using the online version of Merriam-Webster’s (M-W) dictionary, I found “tough” means durable, strong, resilient, sturdy, rugged, solid, stout (I couldn’t resist!), long-lasting, heavy-duty, industrial-strength, well built, made to last. And what of love? “Love” is defined by M-W as “unselfish, loyal and benevolent; concern for the good of another.” Love is further defined as “an assurance of affection.” An assurance of affection. Wow. In my experience with “tough love”, there was absolutely none of that. In fact, withholding affection/love is at the crux of “tough love.”

So if these 2 words are polar opposites, how did they come to occupy the same space in our heads and in our common lexicon? As stated previously,    the phrase “tough love” was originally used by therapeutic community programs such as the former Walden House in San Francisco and DayTop Village and Phoenix House in NYC and continues to be used frequently today (just Google it to see for yourself). Using this concept of tough love, parents were encouraged to check their troubled teens into wilderness camps and behavior modification programs to deal with their kids increasingly frustrating and sometimes dangerous behaviors. And parents absolutely mean/t well; they were at a loss as to how to control their “out of control” teens. Plus they were listening to the so-called experts tell them, “you have to stop coddling your kids; you need to get tough with them – show them who’s boss.”

My own parents tried to do this with me when I was 15 or 16 (It backfired. I filed for legal emancipation and won. However, my relationship with my parents and siblings was forever damaged, as was I). It would seem that the concept of tough love is really about control. And when did control become synonymous with loving?

“Tough love” is also often associated with criminal activity or with children. In other words, if you’re a person who uses drugs problematically – or a criminal or a child – our society says using tough love is acceptable. The thinking is that in any of these three instances the person you’re using “tough love” with is incapable of learning any other way; their behavior must be controlled for their own good. In fact, the definition according to an old book we used to use in addiction treatment and studies called “Addictionary” (by Judy and Jan Wilson, 1992; Hazelden) “tough love is a phrase that describes behavior to stop enabling addiction. When you refuse to cover up for an addict, to rescue them, or to prevent them from experiencing consequences of their addiction, that is tough love. It is loving of the person but tough on the disease.” But is this true? And is this the most effective treatment modality? Perhaps the best question is who does the concept of tough love harm? I’d argue that tough love harms everyone involved – and that often once used, it damages relationships beyond repair.

But it works sometimes, right? I guess that depends on your definition of “works.” Can you get your loved one to behave or not behave in a way that’s acceptable to you? Probably, with enough threatening and coercion. But again, that’s not love. And it usually isn’t helpful for those of us diagnosed with a mental illness or substance use disorder (or chronic pain condition). In fact, Johann Hari, in his book “Lost Connections” argues that disconnecting from loved ones (as parents and partners are often told to do) who are “misbehaving” is typically the worst thing a parent or partner can do; losing connections to love – friendships, enjoyable activities such as sports, pets, and more — is often the exact scenario that is ripe for addictive behavior and other mental illnesses to thrive in, to fill the void left by the withholding of love and affectional bonds. I know I can definitely relate to this.

Now let’s be clear here: I’m not saying that limit setting is unnecessary. Of course, it’s necessary. Limit setting is part of being a responsible parent and, sometimes, a loving partner. But the most important piece is that when you set limits with someone, you do so with unconditional love and appreciation for the other person.

You listen to their ideas, negotiate, and you have this conversation–this is crucial–when you’re not emotional. Once again, the time for limit setting is BEFORE the undesired behavior occurs, not afterwards (when limit setting is done after the behavior occurs, it’s called ‘punishment’). There are exceptions, which again each family must work out for themselves (this is the work of family or couples treatment/therapy). Bottom line, when dealing with the problematic drug-use of a loved one, yelling, screaming, throwing out their alcohol or other drugs, etc, isn’t helpful to anyone.   And it certainly isn’t loving behavior.

Now let’s be clear here: I’m not saying that limit setting is unnecessary. Of course, it’s necessary. Limit setting is part of being a responsible parent and, sometimes, a loving partner. But the most important piece is that when you set limits with someone, you do so with unconditional love and appreciation for the other person.

OK so what about the idea that “addicts” must be shown what a mess their lives are and take responsibility? Well, I can tell you that I was aware every moment that my life was a mess when I had a substance use disorder as we now term the condition. There was no need to show me how bad things were. In fact, whenever I got a glimpse of the mess that was my life, I wound up using more to cover the pain and the shame. This is a typical response we see in many problem drug users. Lastly, let’s look at how tough love confronts personal responsibility. The tough love that my family of origin gave me did two things: 1) made me more ashamed and reluctant to try to change (if it’s my fault and I’m such a fuck up, why bother trying to change?); and 2) ruined any chance of a healthy family system because my family couldn’t look at what they may have contributed to my life of addiction (no I don’t blame them). Most of the “mess” or “unmanageability” as 12-Step would describe it, are problem behaviors of illicit drug users due to the illegality of most drugs of misuse. When drugs are illegal, drug users must go to places to get drugs where they are likely to be put in danger, risking rape and other physical harms, as well as jeopardizing their freedom by being caught by police with the results often being arrest/jail/prison, especially if you happen to be black or brown. Plus, drug users tend to use more in these circumstances than they would in safer locations, and they overdose more often. More on this in future segments.

So here we are at the end of this discussion on “tough love”. And I hope I’ve shown that tough love doesn’t look much like love at all. Instead the concept appears to be all “tough” with “control” at its core. Think of it this way: with positive reinforcement (think B.F. Skinner and others), I reward you for positive behavior (coming home on time) by giving you something you want (perhaps an extended curfew on one night) and set limits regarding less positive behaviors (think staying out after curfew) but I do this BEFORE you are late. And I do this when I’m not emotionally raw. If I wait and give you “consequences” for your undesired behavior, then I’ve punished you. That does not lead to positive behavior change. It leads to controlling with fear. Also, too often we fail to couple “consequences” with any kind of reward for the positive behavior. And when that consequence is withholding love and affection, well, can you see where this could lead to increased drug use? Not what anyone wants. But now we’re “woke” and can see while it isn’t what I wanted, it is expected. This denial of love and affection leads more people to have a (another?) traumatic experience and we know trauma and addiction – and other mental illnesses – tend to feed off each other. I am sure that this is not the outcome that any parent – or partner or loved one – wants for their child/partner/loved one.

So what have I learned – and what do I hope I’ve shared with you all here on this topic of “tough love?” Here are my Top Four “Take Aways” from this discussion:

1) Perhaps the most important take away is this: I hope I’ve made the case that we as a culture need to stop treating the concept of “tough love” as something positive and healthy. I’m optimistic that I’ve shown how inaccurate and horribly damaging to individuals and families tough love actually is, too;

2) That the concept of tough love really means that this concept is tough on all of us: drug users and loved ones/families alike. Like my own unrepaired family of origin, I have seen so many that will never recover from this so called “treatment intervention/sign of love.” Nothing could be further from the truth;

3) That what we really need instead is a concept let’s call “love AND limits,” meaning there is no limit on our love – ever – and (not “but”) we human beings have limits, too: on our time, our resources, our finances, and more. That’s called life and should always be negotiable and honest.

4) We can no longer afford to use a tired, inaccurate, corrosive concept such as “tough love” to (hang in here with me ok?) “excuse” us from the task having difficult conversations about hard topics with people that we love, what I’m calling “Compassionate Conversations.” What do I mean by this? I mean we must begin the work of having conversations that are about deep, profound, empathetic listening to one another, conversations that seek to really understand.

Today it seems that the conversations we typically have with loved ones – especially with drug users – are ones with agendas to get them to stop using. So, what’s the worst that could happen if we could truly let go of our old agendas and just listened? And just for the record, I’m not suggesting that we should agree with how our loved ones view something or how they behave right now, but rather I’m suggesting that our conversational goals change from getting-them-to-do-something-I/we-want to one of astonishing appreciation: of their views, their perspectives, their reasons for using/behaving in less than healthy ways. Let us decide that gaining compassion will be our attending agendas in these conversations.

Our world today is filled with rhetoric (with few real conversations) that is siloed and dishonest, cut off from reality, and full of prejudgments and predetermined agendas. Sadly, when we act from these values, we do so from fear–fear of losing power, fear of not being accepted, fear of losing our place in the world, fear of losing our loved ones to drug use and more. But when we push forward incorporating these fears rather than fighting them and force ourselves to see what is and become “woke” as the modern vernacular states, we have opportunities galore to change our relationships to ourselves, to our loved ones, and to the world. We learn how to say things like, “I love you more than anything AND I’m uncomfortable/unhappy/it’s difficult being around you when you’re loaded/high/under the influence. But when you’ve come down/sobered up/are able to moderate, let’s have lunch/dinner/go to that movie we’ve talked about.” Or how about, “I really love spending time with you when you’re emotionally available to me/us/the family/yourself.” I realize these “compassionate conversations” aren’t dramatic so they won’t make for good “reality” television, however they do make for good, healthy, strong relationships in real life. Plus research shows us these types of conversations are also more likely to help encourage positive changes toward healthier behaviors for everyone.

So, let’s tip “tough love” into the collective trashcan and from our collective vocabulary. Instead let’s work towards an agenda/belief of “love and limits” through “compassionate conversations.” Frankly, after all the pain caused to us all from using “tough love”, just how much harder can this new way of being really be?

#stopthestigma #recoverywithoutabstinence

In honor of September being Recovery Month, don’t miss next month’s edition: Reinventing Recovery