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Joan Opyr wrote:<br>
<br>
"What I wonder, and what I'd like to ask you about, is what you think
can be done in terms of treating not the symptoms of addiction, the
drinking and the drugging, but the underlying psychological causes? My
father was a sociopath and a narcissist; my grandfather was an
untreated (and, until late in life, undiagnosed) manic-depressive.
Neither AA nor NA nor detox can or did deal with these psychological
problems. Shit, Dr. Freud himself would have been sorely-pressed. I'd
be interested in hearing your thoughts, Dave -- or anyone else's -- on
therapy as a means of treatment. How do treat each addict as an
individual? How do you build self-esteem in the addicts who lack it,
and treat narcissim and borderline personality disorder in addicts who
suffer from these disorders? How do you get manic-depressive illness
under control? Can you? Do you? How do you ensure that an entire
family's life isn't governed by one family member's addiction? Is that
even possible? It's not, in my experience, and that haunts me. It's
also why I absolutely hate 12-step programs. "<br>
<br>
You know Joan, these are tough questions and I assure you I don't have
many answers. I cleaned up by myself ("white knuckled it" as the 12
steppers would say.) Then, about two years in, I brought a relative
here to detox from heroin - never a dull moment. It was he who
introduced me to the rooms of NA. I found a few things that were
helpful in the program mostly about how to deal with the constant mind
racing and self doubt so I can make it through the day. I also found
that making amends had a huge benefit. I cannot speak for others. My
experience is that many addicts are simply just plain a-holes. They
were that way before they became addicted and they remain that way in
recovery. Many need years of therapy to uncover the termites in their
attics that drove them to the narcissistic behavior in the first place,
but few will ever admit it. The most difficult question is how to deal
with loved ones. Your father or brother might be a schmuck, but they
are still family, and no matter how much you love them you can't stand
them.<br>
<br>
One of my best friends is a psychiatrist who practices a form of
treatment called ortho-molecular medicine. He contends that much
behavior is from organic physiology. This tracks with the common
protocol of using SSRI's for post detox management. Anyhow, he feeds
his addict patients full of omega 3 fatty acids (fish oil) to regulate
serotonin and then provides basic counseling to address mood, energy,
etc. I've got to say, the fish oil thing has helped me a lot.
Strange, isn't it?<br>
<br>
The problem is that addicts are not suffering form a homogenous
malady. Each, I think, needs a separate program to address their
issues. The medical community does not yet understand the "disease"
(I'm not convinced it is a disease as yet, but I use it as in the
common nomenclature.) I think that one-on-one head shrinking is the
best place to start,
but that may be difficult to get a self-centered, narcissistic a-hole
to
begin. Root causes are all different. We can't begin to count the
ways that people can get screwed up in life; overbearing parents with
unachievable expectations, sexual and physical abuse, chemical
imbalances and just pain vanilla learned hedonism ad nausium. Who
knows?<br>
<br>
So as for how to deal with family? I hate to sound like a hard ass,
but you have to be willing to give these people permission to destroy
themselves in order to save yourself. Leave or give 'em the boot. Like
with my relative, the first time he fell off the wagon I showed him the
door. It worked for a while, and only when he went back to the comforts
of family did he relapse again. I'm speaking about relapse here, not
intervention. I would propose
that getting someone to detox the first time is a good endeavor, but
3, 4, 5 times? How much punishment can one take? Short of that, send
them to a meeting, cross your fingers and get out of the way. After
detox they at least have a shot at making some good decisions.<br>
<br>
I haven't attended a meeting in quite some time, but I still make time
to tour the detox facility. These people don't need to be scowled at by
family or preached to about how they ruin other peoples lives at this
point. Most are painfully aware of the pathetic state of their lives.
They need someone to say that the pain will end and there is hope.
That's all, just a schnitzel of hope. But I don't discount 12 step
programs. They have worked for some and for others, like me, they can
provide a couple of good tools. And I think any program is better than
no program for someone looking for help. <br>
<br>
As I said, I have very few answers. I do, however, have a broad
understanding of options and approaches. I'm glad to share my
experience with anyone who has someone they are worried about
(including themslves.) <br>
<br>
To paraphrase an old cliché, a journey of a thousand miles begins with
a single oy.<br>
<br>
db<br>
<br>
<blockquote type="cite"
cite="midBAY10-DAV2775B9E156787BD25BDCF0C5630@phx.gbl">
<div>Dear Dave:</div>
<div> </div>
<div>Okay, I'm not coming to Montana to kick your ass. My Suburban,
AKA The Beast, only gets 12 mpg, and besides, we're now in complete
accord. (Probably on that Pat Buckley being hot thing, too, though you
haven't had time to respond to that yet.)</div>
<div> </div>
<div>I agree with you that dealing with addiction on the federal
level makes no sense, with the exception (as you note below) of perhaps
diverting some DEA funding to the states to pay instead for treatment.
And, yes, let's try a wide variety of treatments. I'm sadly familiar
with the drug cocktails of detox; I'm also sadly familiar with
Alcoholics Anonymous and Narcotics Anonymous. I'm familiar with these
treatments from the family member/Al-Anon side -- and what both do is
substitute one addiction for another. This is my criticism of 12-step
programs: <u><strong>when</strong></u> they work, they work because
they fill a vacuum in the addict's life that used to be filled with
booze or drugs. The addict gets off his numbing agent of choice and
gets hooked instead on Jesus, or Scientology, or the 12-step program
itself, but he's still an addict. He still has a vacuum, a big hole at
his center, a hole that he's going to pack with whatever is handy --
and the bulk of that stuffing is you, his family. There you are,
filling the hole with your time and effort and energy and the weight of
your being; you're always, always, always helping the addict to stuff
that void. And you and the addict are going to keep stuffing and
stuffing, but that hole isn't just big, it's black, and so it will
never be full. </div>
<div> </div>
<div>Some family members (my grandmother, for example) jump into the
hole, and slowly but surely, they get sucked dry. Others -- though
this is much more rare -- completely disengage. They back away from
the edge; they move out from the center and onto the fringe. They
abandon the relationship and declare independence. This is not an easy
path in any family, but it was my path. I moved out at 17, and it
saved my life, or at least my sanity. (Although I suppose this latter
conclusion is debatable.)</div>
<div> </div>
<div>Unfortunately, in my experience, once treatment commences, very
little changes in terms of family dynamics. My family life used to
revolve around my father's and grandfather's addictions; when they were
in AA/NA, family life revolved around ensuring that they attended their
meetings and that we supported their recovery. And here I'll repeat my
rude/cynical observation of about three posts ago: an active drunk
is lower maintenance than a dry drunk. "One day at a time" isn't a
promise or a source of hope for me; it's a threat. It's a constant
reminder that the addict in your life could start drinking/drugging
again at any moment, and that you'd better watch your step or you might
"drive" him to it. This, I think you'll agree, Dave, is no way to live.</div>
<div> </div>
<div>If I seem to be blathering on, dear Visionaries, I apologize.
In fact, I should probably button up as what I'm doing is giving away
the entire plot of my second book, <strong>Don't Mind If I Do</strong>,
and that's not good for sales. (My agent says I'm a crappy
businesswoman, and she's right. Thank God she's not on this list --
she'd probably hit me with a stick.)</div>
<div> </div>
<div>I do congratulate you on your sobriety, Dave. Seven years clean
and counting is quite an accomplishment. What I wonder, and what I'd
like to ask you about, is what you think can be done in terms
of treating not the symptoms of addiction, the drinking and the
drugging, but the underlying psychological causes? My father was a
sociopath and a narcissist; my grandfather was an untreated (and, until
late in life, undiagnosed) manic-depressive. Neither AA nor NA
nor detox can or did deal with these psychological problems. Shit, Dr.
Freud himself would have been sorely-pressed. I'd be interested in
hearing your thoughts, Dave -- or anyone else's -- on therapy as a
means of treatment. How do treat each addict as an individual? How do
you build self-esteem in the addicts who lack it, and treat narcissim
and borderline personality disorder in addicts who suffer from these
disorders? How do you get manic-depressive illness under control? Can
you? Do you? How do you ensure that an entire family's life isn't
governed by one family member's addiction? Is that even possible?
It's not, in my experience, and that haunts me. It's also why I
absolutely hate 12-step programs. (Whoops -- giving away book plot
again. Slapping self on wrist very hard.)</div>
<div> </div>
<div>BTW, I'm willing to take this conversation off-list if we're
boring the rest of the Vision 2020 world, but addiction is such a
problem -- and so very common -- that perhaps the lucky few around
these parts who can afford to be disinterested could just hit the
delete key?</div>
<div> </div>
<div>Joan Opyr/Auntie Establishment</div>
<div> </div>
<div>[<strong>Note to Pat Kraut</strong>: Jesus might have saved
George Bush, but as my grandfather used to say, "God is a son of a
bitch!" Lucky George Bush; unlucky Ranny Watkins. The issue here
isn't whether or not drunks can get sober or whether or not we should
continue to hold a man's past against him long after he's been
"redeemed." The question, originally, was what has Mr. Bush done with
his story of personal salvation and redemption from addiction? How has
he used his experience and his power as President to make the world a
better place for addicts and their families? Has he used what he's
learned to press for more kindness and understanding for other
addicts? Or has he used his life's story to sell himself to
fundamentalist Christians while simultaneously continuing to push the
wretched War on Drugs? I'm afraid all evidence points to the latter
conclusion, and that is why I deem him a hypocrite.] </div>
<div> </div>
<blockquote
style="border-left: 2px solid rgb(0, 0, 0); padding-right: 0px; padding-left: 5px; margin-left: 5px; margin-right: 0px;">
<div
style="font-family: Arial; font-style: normal; font-variant: normal; font-weight: normal; font-size: 10pt; line-height: normal; font-stretch: normal; font-size-adjust: none;">-----
Original Message -----</div>
<div
style="background: rgb(228, 228, 228) none repeat scroll 0%; -moz-background-clip: initial; -moz-background-inline-policy: initial; -moz-background-origin: initial; font-family: Arial; font-style: normal; font-variant: normal; font-weight: normal; font-size: 10pt; line-height: normal; font-stretch: normal; font-size-adjust: none; color: black;"><b>From:</b>
David M. Budge</div>
<div
style="font-family: Arial; font-style: normal; font-variant: normal; font-weight: normal; font-size: 10pt; line-height: normal; font-stretch: normal; font-size-adjust: none;"><b>Sent:</b>
Tuesday, February 22, 2005 9:11 PM</div>
<div
style="font-family: Arial; font-style: normal; font-variant: normal; font-weight: normal; font-size: 10pt; line-height: normal; font-stretch: normal; font-size-adjust: none;"><b>To:</b>
David M. Budge</div>
<div
style="font-family: Arial; font-style: normal; font-variant: normal; font-weight: normal; font-size: 10pt; line-height: normal; font-stretch: normal; font-size-adjust: none;"><b>Cc:</b>
Vision2020 Moscow; Joan Opyr</div>
<div
style="font-family: Arial; font-style: normal; font-variant: normal; font-weight: normal; font-size: 10pt; line-height: normal; font-stretch: normal; font-size-adjust: none;"><b>Subject:</b>
Re: [Vision2020] Drunks, drugs, and the empathy factor</div>
<div> </div>
Joan, oops, I misread your last post. (it's that damn dyslexia thing)
My apologies. Generally we are in accord on the subject with one
caveat. <br>
<br>
The vast majority of clinical programs are built on the 12 step model
for long term recovery, hence their effectiveness compares directly
with that model. The AMA and the American Hospital Association both
have dogmatic views of treatment, charge large fees, and are building
an industry with poor outcomes. The vast majority of people who stop
drinking or taking drugs do so with no clinical help. Additionally,
the medical protocol for detox and maintenance is a cocktail of SSRI
drugs (like Prozac) with a diazepam chaser to ward off the
anti-depressant jitters. Accordingly, the medical community is
substituting one addiction for another, the efficacy of which shows
little or no clinical promise from an outcome based review of the
literature. <br>
<br>
It makes little sense to spend great deals of public funds on
conventional rehabilitation. One thing that may make sense on a trial
basis, is to provide vocational and social rehabilitation within the
context of drug rehab. The root causes of addiction usually come from
a need for a larger sense of self. Many, although not all, addicts
lack basic social skills and have few marketable skills. Thus,
addiction becomes a vicious cycle of failing then self-medicating to
achieve a sense of well-being. As I said in a previous post: most
addicts only stop when they want to stop. If there is a potential
positive outcome it may come in the form of providing an environment
for personal productivity. <br>
<br>
I don't know if this program would work, but I think that the
literature provides enough evidence to give it a shot. Also, I'm not
sure if the federal government is the answer here. Like Justice
Brandeis hypotheses that "each state is a laboratory of democracy" I
think a multitude of experimentation at the state level would produce
positive outcomes faster.<br>
<br>
Diverting federal funds from the DEA to the medical industry would
surely be less costly than the current system. We need to ensure that
special interest groups don't co-opt treatment however. It seems this
would be throwing good money after bad regardless of the magnitude if
we don't insist on performance accountability.<br>
<br>
My name is Dave, and I'm an addict. I have 2617 days clean.<br>
<br>
ps. Anyone who wants to talk about anything or anyone regarding this
issue should feel free to contact me off list.<br>
</blockquote>
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