Treatment and Recovery disconnection

January 18, 2014 by

Saturday is time to revisit my favourite old blogs from the website. Here’s one of the most viewed from last year.

‘William White describes how somewhere in the process of the professionalisation of addiction treatment in the US, treatment got disconnected from the larger more enduring process of long-term recovery.

He points out that we are recycling large numbers of people through repeated episodes of treatment. Their problems are so severe and recovery capital so low, there is little hope that brief episodes of treatment will be successful. We end up blaming them for failing to overcome their problems.

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‘The crisis of modernity’ by Phil Hanlon

January 14, 2014 by

Recently, I introduced you to Professor Philip Hanlon. Mark Gilman had told me about Phil and his work and I am excited by what he and his colleagues are doing. Over the coming weeks, I’m going to show a series of film clips which describe Phil’s Afternow project.

On the relevant webpage, Phil says:

‘Modernity has brought many benefits (including technological improvements, material comfort, longer life expectancy and improved health), but the downside includes the emergence of new problems which stem from the way we live our lives and structure our society.

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‘Unraveling the Mystery of Personal and Family Recovery: An Interview with Stephanie Brown, PhD’ by Bill White (Part 3)

January 7, 2014 by

Unknown-4‘Bill White: In 1999, you published a book with Virginia Lewis that virtually transformed my own understanding about family recovery from alcoholism. Could you share with our readers how the book came to be written and some of its major conclusions?

Stephanie Brown: The book came at the end of a ten-year research project that Virginia and I undertook in 1990 to study the process of recovery for the family. I had always wanted to know what happens to the whole family when the drinking of one or both parents stops.

We asked the same main question I had asked previously: is the process of recovery for the family similar to the process for the individual, and do the stages of active addiction and recovery I identified for the individual hold true for the family? We discovered pretty quickly that these stages do hold true and that they are a good guideline for understanding what happens with recovery growth following abstinence.

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Silent recovery boards – Introduction, ‘Towards Recovery’ Conference

January 4, 2014 by

Last month, I showed a film clip of Mark Gilman talking at the ‘Towards Recovery’ conference. We’ll have more from this conference, but for now I show the opening:

‘Silent recovery boards – conference delegates simply showing “where they were” and “where they are now”. A powerful way to start the day. Towards Recovery Conference, 23 Nov 2013, held in Henley, UK.

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‘Mental illness, addiction & most chronic physical illness is the result of childhood loss & trauma’ by Monica Cassani

December 31, 2013 by

UnknownI love Gabor Maté. He’s one of my favourite people working in the recovery field and you can find a number of blogs referring to his work on this website. And I’m not the only person who loves his work. Here’s the latest blog (slightly modified) from Monica at Beyond Meds.

‘Here, Gabor Mate tells us the medical profession are the most difficult to speak to about what he’s learned in his work because they don’t recognize that so-called mental illness and most physical chronic illness is the result of childhood loss and trauma.

We don’t need anymore research he says. We know the cause of these issues.

He points out that the barrier to the health professionals is that they’ve not cared for their own trauma. This is clearly true. Many professionals are afraid of their own darkness. This makes it impossible for them to correctly recognize issues in their patients and clients.

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‘The Masks of Addiction and Recovery’ by Bill White

December 29, 2013 by

Masks of RecoveryThere is a discrepancy for each of us between the internal self and the personas we project to others.  Personal health, wholeness and integrity hinge in great measure on the degree to which these private and public selves can be brought into harmony.  That reconciliation is potentially life-saving for persons seeking the metamorphosis from active addiction to long-term recovery.

It is a unique medical disorder whose effective management requires living as authentically and honestly as possible, and yet it is that precise aspect that leaves many people viewing addiction recovery as a priceless gift that far transcends freedom from destructive drug use.

What makes this journey towards authenticity so much more hazardous within addiction recovery compared to the parallel journey for others is the degree of duplicity at the very heart of the addiction experience.  Addiction hollows one out, leaving only the mask of the moment.  With every repetition of use, the drug becomes more powerful and the self becomes weaker, its boundaries and internal substance fading, leaving only accumulating secrets in its wake.

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‘Personal Failure or System Failure’ by William White

December 17, 2013 by

System Failure‘In my writings to people seeking recovery from addiction, I have advocated a stance of total personal responsibility:  Recovery by any means necessary under any circumstances. That position does not alleviate the accountabilities of addiction treatment as a system of care. Each year, more than 13,000 specialized addiction treatment programs in the United States serve between 1.8 and 2.3 million individuals, many of whom are seeking help under external duress.  Those who are the source of such pressure are, as they see it, giving the individual a chance – with potentially grave consequences hanging in the balance.

Accepting the mantra that “Treatment Works,” families, varied treatment referral sources and the treatment industry itself believe that responsibility for any resumption of alcohol and other drug use following service completion rests on the shoulders of the individual and not with the treatment program. 

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‘Talking to the Dalai Lama about addiction’ by Marc Lewis

November 14, 2013 by

rsz_dalai_lamaCan you imagine it, talking to the Dalai Lama about addiction? Well, it happened to some lucky people in the field recently, including Marc Lewis. I suggest that you read Marc’s blog directly, since you can see some photos and comments.

‘I got back yesterday around noon. What a relief it was to be home! India is overwhelming in so many ways, with poverty and raw need topping the list. To get back to this calm, orderly place was a reprieve and a pleasure, tinged with guilt at leaving all that suffering behind.

For anyone just tuning in now, I was at a week-long “dialogue” with the Dalai Lama on the theme of “Desire, craving, and addiction.” I was one of eight presenters, each of whom gave a talk to His Holiness (as he is called) and to the surrounding experts, monks, movie stars and what have you. All the talks are posted here. My talk is here. I want to tell you about two of the talks I found most fascinating and most relevant for people struggling with addiction.

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The Roots of Addiction – Dr. Gabor Maté

November 7, 2013 by

‘It is critical to understand that although addiction is a problem it is also an attempt to solve a graver problem, that is, unbearable psychic pain. To understand addiction, we need to understand human pain and that takes us to focus on childhood experiences.

One of the outcomes of childhood distress is addiction and the more adversity an individual experiences in his or her childhood the higher their risk of resorting to addictive behaviour to sooth their pain, even temporarily. In other words addiction (alcohol, drugs, shopping, Internet, etc.) is an attempt to seek something from the outside that the individual is not able to generate from within.

What makes childhood experience significant is that the circuitry that modulates the brain’s reward chemicals is underdeveloped in traumatized children thus making them more susceptible to addictive behaviours and conduct disorders.

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What Works in Treatment?: Sapphire’s Story, Part 2

November 6, 2013 by

rsz_img_2115Last week, we looked at Sapphire’s Story, with the aim of showing the importance of person-centered treatment. Along Sapphire’s journey into and out of addiction, things went well when Sapphire was intimately involved in decisions about her treatment, but poorly when professionals took sole control.

We left Sapphire’s Story after the Community Drugs Treatment had reduced her prescribed methadone dose against her will and she started to use street drugs again. She eventually became addicted to crack. This drug took over Sapphire’s life, until the day she ended up in hospital: “I’m not sure what actually happened one particular day. I know that I had been up for about five days smoking crack and I think I had a fit and was taken to hospital.”

Sapphire was transferred to the drug and alcohol unit of the hospital and put on a high dose of methadone. When she left this unit, she did not go back to the controlling and abusive man she had been living with since she was 16 years old.  Her parents had found out about her drug-taking and became very supportive.

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‘Trauma Trails, Recreating Song Lines: The Transgenerational Effects of Trauma in Indigenous Australia’ by Judy Atkinson

November 4, 2013 by

rsz_41sanqzdhyl_bo2204203200_pisitb-sticker-arrow-clicktopright35-76_sx385_sy500_cr00385500_sh20_ou02_Every now and again, I read a book related to the recovery field which helps create a small shift in the way I work. A few months ago, I read a book that has opened my eyes to a problem I knew existed… but had little idea about. A big shift in the way I work is occurring.

Transgenerational, or historical trauma, is the transmission of trauma across generations arising from colonisation and its associated violence and control, seen in Australian Aboriginals and other indigenous populations, e.g. North American Native Indians, Maoris of New Zealand. This historical trauma influences individuals, families and communities.

Expressions of historical trauma in Aboriginal people can be seen in: adults who feel inadequate in their day-to-day functioning: the poor physical and psychological health and much lower life expectancy; the escalation in addiction to alcohol and other substances which are used as a coping mechanism; the increase in domestic violence across generations; the self-harm, suicide and risk-taking that occurs when people can find no meaning to their existence and have no sense of purpose for their day-to-day activities.

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‘Intergenerational Trauma & Healing, Parts 1-3’ by Joe Solanto

October 31, 2013 by

Yesterday, I posted a blog from Gabor Maté entitled Our Strange Indifference To Aboriginal Addiction. I highlighted the following about society’s – it’s not just Canada – response to the problems of addiction amongst Aboriginal people.

‘We seem to comfort ourselves with the belief that the endemic drug addiction and alcoholism are unfortunate realities for which we, as a society, bear no responsibility. From both scientific and historical perspectives, such a view is distorted and self-serving.’ Gabor Maté

I’ve heard many non-Aboriginal Australian people say in relation to Aboriginal people: “Why don’t they just get over it?” (Yeh, like non-Aboriginal people just get over diabetes, cancer or rape)

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‘Our Strange Indifference To Aboriginal Addiction’ by Gabor Maté

October 30, 2013 by

imagesHere’s an important blog from one of my favourite writers, Gabor Maté.

‘Marlene, a 46-year old native woman, sat in my office last week, slumped on her chair, blinking away her tears. I’d just shared the news that her most recent blood test confirmed she had “seroconverted” to HIV, become infected with the AIDS virus.

Although an injection drug user, Marlene had always been careful to use clean needles. Her route of infection was sexual contact – with the resigned naiveté characteristic of so many aboriginal women in Vancouver’s Downtown Eastside, she had trusted a man, himself a drug addict, who assured her that he was a safe partner.

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‘Social Actions to Control Addiction: Reviving Community Art’ by Bruce Alexander

October 13, 2013 by

rsz_slum_151210_fct951x585x28_t460In my humble opinion, one of the great thinkers in the addiction field is Bruce Alexander. In his excellent book, The Globalization of Addiction: A Study in Poverty of the Spirit, Bruce talks about addiction arising from people becoming disconnected (or dislocated) from the close ties to family, culture, and traditional spirituality that constituted the normal fabric of life in pre-modern times.

In the closing chapter of his book, Bruce describes some social actions to control addiction. What he describes are social actions that will NOT necessarily reduce addiction directly, but will help counter some of the adverse effects of our free market society and globalisation, factors that are leading to marked increases in addiction of all kinds.

In this blog, I’ll look at one of these suggested actions – Reviving Community Art – quoting directly from Bruce’s book:

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‘Addiction can’t always be cured so let’s focus on quality of life’ by David Best

October 10, 2013 by

rsz_3ycm9w7x-1380697705David Best has a new short article out in The Conversation. Would be great if you could sign up and comment. 

‘Alcohol and substance abuse costs the Australian economy A$24.5bn a year. The human toll from accidents, overdoses, chronic disease, violence, mental illness and family disruption, however, is immeasurable.

Modern, evidence-based policy responses to addiction focus on treatment, where patients aim to withdraw from drugs through therapy and medications. Harm-minimisation strategies such as the supply of clean needles and syringes and the prescribing of substitution medications are also key elements of Australia’s drug strategy.

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‘A Celebrity Death, Addiction, and the Media’ by Gabor Mate

October 9, 2013 by

rsz_1gabormateabout-330x330One of my favourite people in this field is Gabor Mate from Vancouver, whose book In The Realm of Hungry Ghosts is a classic. Here is the first posting on Gabor’s new blog, well worth a look.

‘It is always big news when a celebrity is stricken dead by a substance overdose. What never makes the news is why such tragedies happen.

The roster of drug- and alcohol-related show-business deaths is ever expanding: Janis Joplin, Jimi Hendrix, Elvis Presley, Keith Moon, Kurt Cobain; in the recent past, Heath Ledger, Michael Jackson, Amy Winehouse, Whitney Houston; and, most recently of all, Cory Monteith. A complete list would, of course, include many others.

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‘Narcotics Anonymous Comes of Age’ by Bill White

October 8, 2013 by

rsz_201307diamondjubileelogoBill White has recently written a blog and co-authored an article on the 60th Anniversary of NA.

‘Narcotics Anonymous (NA) is too often relegated to the status of stepchild of Alcoholics Anonymous (AA).  NA’s unique history, culture, and distinctiveness are routinely obscured within references to “AA and other Twelve Step programs.” 

For the past several years, Chris Budnick, Boyd Pickard and I have been conducting research on the history of NA, and we recently authored an article commemorating the 60th anniversary of NA’s founding.  In this article we identified and discussed 12 things we believed every addiction professional should know about NA.

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Happy One Year Birthday, Maddie!

September 29, 2013 by

rsz_851_bouquet_of_romance_products_largeOver a year ago, I met a special young lady from this side of the world, Well, let me clarify. We have never met physically, we started emailing each other. Maddie had blogged on Wired In To Recovery in the early stages of her own recovery, I had commented on the blog, and then we started emailing.

Maddie has talked about how she has been feeling on many days over the past year. It’s been very special (and an honour) to have followed her through this stage of her recovery. I have learnt so much. We’ve also been working on her Recovery Story, and boy-oh-boy, is that a Story! And Maddie has also helped me with a problem I had in my personal life.

Today is Maddie’s first year birthday. She’s been clean and sober one year! Isn’t that amazing, Maddie? One year today!

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‘Losing a Self: Lying to Yourself’ by Stephanie Brown

September 24, 2013 by

rsz_41a-shrpktl_bo2204203200_pisitb-sticker-arrow-clicktopright35-76_sx342_sy445_cr00342445_sh20_ou02_I’ve made reference to Stephanie Brown’s brilliant book A Place Called Self: Women, Sobriety, and Radical Transformation in past blogs. I’ve recommended this book to several women in early recovery and they have really like it.

Here, Stephanie describes how one’s self (or identity) changes in a negative manner during the process of addiction. She focuses on lying to oneself.

‘… addiction develops over time, and it involves changes in the way you behave but also changes in the way you think: the way you think about drinking, the way you think about yourself, and the way you think about life.

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‘Madness!’ By Maddie

September 20, 2013 by

Unknown-1‘So close to one year sobriety now and I’ve been reflecting a lot. The biggest thing for me at the moment is being so aware of the insanity and madness in which I used to live. I totally understand what insanity and madness mean now.

How insane to think it was a good idea to steal drugs from a dealer who was a biker and his girlfriend often had a black eye? How insane was it to think it was a good idea to have sex with strangers for money…

Towards the end of my using heavily, I would pick up my drugs from my dealer, go to work for the day (in the bathhouse), only to have to pay for more drugs on the way home. Insane! I was effectively making no money, as I was drugging away every single cent I earned!

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