Categories
Alcoholism Mental Health Recovery Treatment

Wet House, Wet Drunk

What do they do with the hopeless, late-stage alcoholics in Minnesota? They sometimes send them to the St. Anthony Residence, which is one of five “wet-houses” in the Twin Cities area. Wet houses are residential facilities where sobriety and recovery aren’t expected. They use a “harm-reduction” model, which employs a set of strategies meant to reduce the negative effects of alcohol (homelessness, panhandling, jail, etc.). These wet houses also provide shelter, meals, and medical attention for late-stage alcoholics. Often, their modality of thought is, “It’s safer and cheaper to have these guys drinking in a controlled environment than out on the cold Minnesota streets.”  And expense certainly does motivate:  Rather than the state spending inordinate amounts of money on jails, detox, et cetera, they now share the $18,000 per year costs for room and board with Catholic Charities. Residents receive $89 a month for expenses (most of which is spent on alcohol). This is a clear savings for the state. In fact, research done regarding a similar program in Seattle and published in the American Medical Association in 2009, showed striking savings in their public spending:

“The year prior to the opening of the wet house, its 95 participants had cost the government nearly $8.2 million in policing, jail, detox and other medical spending, an average of $4,066 per person per month. But after moving into the wet house, costs were reduced to $1,492 per person monthly after six months, and to $958 after 12 months.”

Still, according to Bill Hockenberger, a recovering alcoholic who manages St. Anthony’s, three to five percent of the residents stop drinking. But I wonder if cost is really a good reason to give up on the 12-step model that has been clearly shown to work.

As I watched these interviews with some of these men today, I was struck by the textbook depiction of their addiction to alcohol. Deluded into thinking that all they’ll ever be is an alcoholic, they’ve literally thrown in the towel and succumbed to the disease. One resident says, “There’s no hope for a scoundrel like me.” Their descriptions of drinking and their corresponding alcoholism mirror the way it’s described in the “Doctor’s Opinion”: “The sensation is so elusive that, while they admit it is injurious, they cannot after a time differentiate the true from the false. To them, their alcoholic life seems the only normal one.” Many of these men were homeless and had been in and out of detox facilities and treatment centers–all resulting in relapse. Their “failure” at sobriety ultimately led them to their residency in a wet-house either via county recommendation or by a self-appointed application. Residing in a wet house may mean retaining the last shred of one’s dignity, and it also may represent the end of the line for the hopeless and often-times dying: the “unfortunates” as the Big Book describes them, those “constitutionally incapable of being honest with themselves.”

St. Anthony’s takes men who would otherwise be homeless and panhandling and provides them with a safe place to lay their heads…and to drink. Perhaps placing an active, low-bottom drunk in an environment which actively shows them what drinking does will bring about an awareness of the disease. There are certainly those who stay in these wet houses and choose not to drink. In fact, some even get sober and leave, though I believe those to be in the minority. Even though counseling is made available, and drinking is only allowed in one area, I’m just not convinced that sobriety is attainable when recovery is looked upon with such complacency.  Just because the alcoholic is hopeless doesn’t mean we have to become hopeless in our approach.

Related articles:

A safe place to drink, or just giving up? (cnn.com)

You Are Here: The ‘Wet House’ Where Alcoholics Can Keep Drinking (nytimes.com)

At St. Paul ‘wet house,’ liquor can be their life – and death (twincities.com)

‘Wet Houses’: Letting Alcoholics Drink, with Surprising Results (healthland.time.com)

 

Categories
Addiction Feelings Mental Health Mindfulness Recovery Self-Care Spirituality

Resiliance

Resilience: That’s something an addict/alcoholic discovers in their back pocket when they overcome a difficult situation. It’s the ability to bounce back after the multitude of knocks we’re sure to get just by being alive.

In the using days, problems often seemed unsurmountable, so the only way to “deal with it” was to drink or use. In sobriety, that’s no longer an option. Instead, we sometimes try to “deal with it” by shopping, gambling, sex, video games, food, exercise, you name it. In the end, those behaviors don’t really correct the problem.

Sobriety presents us with an opportunity to learn how to live without the crutches of drugs and alcohol. Instead of infusing ineffective “solutions” to mounting troubles, we now have a toolbox equipped with the 12 steps. One by one, step by step, viable solutions will unfold. Before we know it, the hard work pays off, and our proverbial tool box gets filled with a variety of options. Mine has, anyway.

When I come across an aversive situation, I now have choices. I start with the foundation: the 12 steps, remembering I can approach difficulty one breath at time if need be. Or I might  engage the tools of a meditation practice, asking myself, “Am I breathing?”  Try it. You might even discover that you’ve been holding your breath!  Other times, I might engage the tools garnered from my yoga practice, asking myself,  “Am I present?” The majority of the time, however, it’s a combination of all three, allowing me to season my responses/reactions accordingly.

Recovery teaches us to face adversity with an open heart and a present state of mind. It teaches us that our previous acts of avoidance merely created a diversion to feeling better. The wreckage of our past proves when we walk around the issue, the solution feels and often is unattainable.  Here, in sobriety, we learn to “uncover, discover, and discard,” rather than to “run, hide, and duck for cover.”  So, if/when you find yourself faced with adversity, ask yourself this: “Is my reaction helpful or harmful?” If nothing else, you’ve provided yourself with a break and an opportunity to do the right thing.

Related articles:

Kevin Griffin: A Buddhist Approach to Recovery: Step Four — Searching and Fearless (huffingtonpost.com)

Categories
Body Image Eating Disorders Mental Health Recovery Therapy

Starving at 8

image © sarit photography

I know an 8-year-old who’s been known to choose an outfit specifically because it makes her “look thin.” This same 8-year-old often doesn’t finish meals because she thinks she’s fat. She’s the same 8-year-old that has begun to develop food rituals, often leaving the table with a reorganized plate full of uneaten food. Simply put, she already has an irrational fear of getting fat.
It’s hard being a girl. It’s hard to find a way to look at your unique self without comparing it with images of Barbie or Bratz. It’s hard to accept that  the beauty standard set by Cinderella or Sleeping Beauty isn’t actually real. But children, whose minds are filled with wonderful imagination and fantasy, aren’t going to cognitively recognize images that are potentially harmful. Instead, many will attempt to achieve the pink, thin, fluffiness of a Disney princess, or the skinny sass of a Bratz doll. Often times, even when parents are encouraging a healthy body image, the education on the school yard has a dramatically different lesson plan than the one from home. I’ve overheard conversations on the school yard that have made me pause – -it’s clear that body-image issues are in abundance and the pressure to look thin and svelte is invasive and intense.

So what can parents do? Start with eliminating the shame game. This might mean letting your daughter dump that maple syrup on her pancakes or having a cupcake at a birthday party. It’s a treat, not a vehicle for punishment!  Encourage healthy eating, but can you do it with compassion rather than the mallet of criticism?  Eliminate “fat talk”: your kids don’t need to hear it and frankly, it’s not good for you either. Stop trying to control what those around you eat. It’s not your job!  I’ve seen dads controlling the food intake of their wives and daughters to the point of devastating eating disorders (my dad was one!); and I’ve seen moms spewing “fat talk” or signing up for any and every diet fad while their daughters learn to eat in secret or restrict because they’re terrified of the incendiary reaction of their parental food monitors. These behaviors certainly don’t encourage self-love. If anything, they sow the seeds of self-destruction.

If you’re worried that your son or daughter might be developing an eating disorder (note: boys are not immune to this!), look out for some of these signs.

(Please note, certain behaviors are warning signs, but in combination and over time, they can become quite serious):

Behaviors specific to anorexia:

  • Major weight loss (weighs 85% of normal weight for height or less)
  • Skips meals, always has an excuse for not eating (ill, just ate with a friend, stressed-out, not hungry).
  • Refuses to eat in front of others
  • Selects only low fat items with low nutrient levels, such as lettuce, tomatoes, and sprouts.
  • Reads food labels religiously; worried about calories and fat grams in foods.
  • Eats very small portions of foods
  • Becomes revolted by former favorite foods, such as desserts, red meats, potatoes
  • May help with meal shopping and preparation, but doesn’t eat with family
  • Eats in ritualistic ways, such as cutting food into small pieces or pushing food around plate
  • Lies about how much food was eaten
  • Has fears about weight gain and obesity, obsesses about clothing size. Complains about being fat, when in truth it is not so
  • Inspects image in mirror frequently, weighs self frequently
  • Exercises excessively and compulsively
  • May wear baggy clothing or many layers of clothing to hide weight loss and to stay warm
  • May become moody and irritable or have trouble concentrating. Denies that anything is wrong
  • May harm self with cutting or burning
  • Evidence of discarded packaging for diet pills, laxatives, or diuretics (water pills)
  • Stops menstruating
  • Has dry skin and hair, may have a growth of fine hair over body
  • May faint or feel dizzy frequently

Behaviors specific to bulimia

  • Preoccupation or anxiety about weight and shape
  • Disappearance of large quantities of food
  • Excuses self to go to the bathroom immediately after meals
  • Evidence of discarded packaging for laxatives, diuretics, enemas
  • May exercise compulsively
  • May skip meals at times
  • Teeth may develop cavities or enamel erosion
  • Broken blood vessels in the eyes from self-induced vomiting
  • Swollen salivary glands (swelling under the chin)
  • Calluses across the joints of the fingers from self-induced vomiting
  • May be evidence of alcohol or drug abuse, including steroid use
  • Possible self-harm behaviors, including cutting and burning

If you notice even one of these, it’s time to address it. Talk to your daughter or son, talk to your doctor. If necessary, elicit the help of a treatment facility. In other words: Get help. Showing our kids that we care and are willing to stop our own negative behaviors in order to help them is invaluable. It’s a family problem, not an individual one.

Some helpful links:

NEDA
WebMD
Voice in Recovery
Peggy Orenstein
maudsleyparents.org
Also, check out “Brave Girl Eating: A Family’s Struggle With Anorexia” By Harriet Brown

Categories
Addiction Alcohol Alcoholism Holidays Mental Health Recovery

New Beginnings

Image via Wikipedia

It’s Passover, and you know what that means? It’s that time of year where it’s customary to drink four glasses of wine through dinner as part of the Passover story! It means giant family gatherings, with the myriad of wacky personalities. It also may mean some anxiety for the newcomer (or even someone with time, you never know!) For some, it’s this Passover week, for others, it might be the upcoming Easter Sunday. Either way, self-care is key. Ask for help if you need it, and have an exit plan–better to have one and not need it than to need it and not have it!

This particular holiday reminds me of my early introduction to alcohol. My family didn’t drink that often; holidays were the exception. Still, I have distinct memories of sitting at the family Passover table, with my thimble full of Manischewitz wine, thinking I was the coolest kid in the world. I remember the warmth in my belly, and the slight fuzz in my head (I would get sneaky and steal sips from other folk’s glasses). I remember thinking I was a part of the adult world, and a real part of my family. It was a childhood delusion, of course, but the memory stuck.

Wine has deep roots in some religions, for example, in Christianity it represents the blood of Christ, and in Judaism, the fruit of the vine. It’s an accepted, expected, ritualistic piece of the religious meal. But as we get sober and learn to participate in the rituals of our varying cultures, we must learn to make adjustments. No one wants to see you drunkenly opening the door for Elijah! We drink grape juice instead of wine, and we learn to adapt the rituals and meals to our sober, clean lives.

Passover is about freedom from slavery and tyranny; and like Easter, it’s reflective of Spring and new beginnings. What apropos likeness to our recovery! Here, we are offered an opportunity to begin to view our sobriety as freedom from the tyranny of drugs and alcohol. Our recovery is our new beginning and our new life. Remember what Chuck C. said: “You cannot think your way into a new way of acting, but you can act your way into a new way of thinking.” Have a safe, sober, and joyous holiday week.

Categories
Anxiety Depression Mental Health Recovery Self-Harm

Cutting: Beyond YouTube

Cutting is back in the spotlight after a study by TheJournal of the American Academy of Pediatrics brought attention to the high numbers of YouTube videos showing teens and young adults exhibiting self-harming behaviors. By simply typing “self-harm” and “self-injury” into YouTube’s search engine, Dr. Steven P. Lewis, et al, discovered numerousvideos showing various levels of self-harming behavior.After extensive review and documentation, these were the findings:

“The top 100 videos analyzed were viewed over 2 million times, and most (80%) were accessible to a general audience. Viewers rated the videos positively (M = 4.61; SD: 0.61 out of 5.0) and selected videos as a favorite over 12 000 times. The videos’ tones were largely factual or educational (53%) or melancholic (51%). Explicit imagery of self-injury was common. Specifically, 90% of noncharacter videos had nonsuicidal self-injury photographs, whereas 28% of character videos had in-action nonsuicidal self-injury. For both, cutting was the most common method. Many videos (58%) do not warn about this content.”

Researchers worry that these videos might lead to a normative view of cutting and self-harming. As one who self-harmed for years (even into my sobriety), my concern isn’t whether or not this will be viewed as normal, but rather, is anyone taking action and listening to this loud cry for help?
It’s not fun to self-harm. It isn’t a source of pride. It’s not something you share with those around you. It’s not something you do to feel “a part of” or to be “cool.” For me, it was something I did to actually feel because I was so numbed out. In the flash of the adrenaline rush, I felt alive and present when I self-harmed. I felt like it was the only way to feel “real” in my otherwise surreal life. I also felt immediate and devastating shame. It was scary. It was embarrassing. Having to explain abhorent injuries to the curious when the perpetrator is you is nightmarish.
Getting help took an act of bravery on my part. I had to tell someone. I had to talk about it…openly. I had to face my shame and fear so I could transform it into something positive. I had to do some deep, spiritual work in order to learn how to turn self-harm into self-care. I continue to do this work, so I can  revel in self-care and be of service to others. I had to build a fellowship of support that would be there if I slipped back. I empathize for the kids on YouTube. I hope someone reaches out the hand of recovery and lets them know they don’t have to hurt like that anymore.

Categories
Mental Health Recovery Spirituality

Acts of Kindness

I came across a beautiful article written by Ed and Deb Shapiro, authors of “Be the Change” in which they call for a “Revolution in Kindness.” Their article expressed the need for compassion and kindness and asks us to change our actions. It really made me think about recovery and how we so often come into the rooms bereft of problem-solving skills, angry, and hurting, and lashing out.

Most of us come in as the antithesis of kind. The change we experience in recovery is profound as we learn to transform our programmed responses to people, places, and things. Truly, these new actions do require a sort of metamorphosis. As we begin the recovery process, we are choosing to cease fighting. We admit we’re wrong, we admit powerlessness, and slowly, we begin to learn how to function gently and with clarity.

It’s tough to admit we’re wrong, especially when we are attached to the context of the situation itself, and even more so when we’ve invested so much energy in our anger and its corresponding story. But wouldn’t it be liberating NOT to fight–to admit that you are (gasp) wrong?! Sounds crazy, I’m sure, but think about it: so much of our conflict is created because our egos command us to prove we’re right (even when we’re not!). We often fight to the point of ending friendships, both personal and professional, but in the end, our fight means nothing at all.

The 12 steps ask us to give up our ego and self-centered behaviors. By demanding honesty in our inventories and actions, we are propelled to adopt a more altruistic approach to the world. We make amends for our actions, righting the wrongs we’ve caused, and we learn to stop the harming behaviors that got us here. This also means approaching our difficulties with kindness instead of closed fists. When we change our actions, we ultimately have a chance to end the incessant violence permeating our lives: the bullying, school shootings, hateful speech, drug and alcohol abuse.  Ed and Deb Shapiro said, “Kindness is completely revolutionary: it will change each one of us, it will change others, and it will definitely change the world.” What a wonderful reminder, then, to take responsibility for our actions and point less fingers at those around us. The world can be a sticky place, so why not begin to unstick it with small acts of kindness and compassion? Try it: One kind act, one day at a time.

Categories
Mental Health

Abuse and the Brain

                          (Image via Wikipedia)

    What is rudeness? We name it, become frustrated by it, react to it, sometimes even weave the behavior into our own lives. But why? Well, from a biological perspective, we are products of the environment we live in. As we move beyond the dyads of intimate conversation and expand into larger social groups, the societal mores can get watered down. If those stereotypical, expected polite behaviors cease (manners), stress increases and rudeness emerges. Dr. Douglas Fields, author of “The Other Brain” talks about environments where “strict respect and formal polite discourse” are more pronounced, saying that “these polite and formalized behaviors reduce stress in a stressful situation that arises from being an individual in complex society.”
    I am further intrigued by Fields’ information about children and the effects of stress in relation to their brain development. Dr. Douglas Fields says, “Stress is a neurotoxin, especially during the development of a child’s brain.”  It’s so important that we look at this, particularly from the lens of recovery. We are shown over and over again how psychological trauma in childhood leads to an increase in depression, anger, hostility, drug abuse, suicidal ideation, and loneliness. Studies also show us that abuse, be it physical, emotional, or sexual, negatively “undermine the normal wiring of brain circuits,” impacting the brain’s ability to connect the right and left sides through a “massive bundle of connections called the corpus callosum.” An impairment of that connection is directly associated with craving, drug abuse and dependence,as well as a decrease in one’s ability to make moral judgments.
    Researchers have also found that parental verbal abuse is more damaging to brain development than even physical abuse. Peers have an impact on our teens as well. In fact, according to a team of brain imaging scientists lead by Martin Teicher, MD, Ph.D, “The most sensitive period for verbal abuse from peers in impairing brain development was exposure during the middle school years. This is the period of life when these connections are developing in the human brain, and wiring of the human brain is greatly influenced by environmental experience.” 
    This information provides us with a wonderful opportunity to make a difference with our actions. So, what do we do? I’d start with being more aware of our actions, particularly regarding our speech. Before saying something, ask yourself  “Is what I am about to say helpful or harmful?” Taking a deep breath before speaking would also be useful. The process of maturing and brain development is rough for the kids as well as the adults. As parents, we simply need to remember to pause.

Categories
Mental Health Recovery

New Year Intentions

(Image by Christopher Chan via Flickr)

Round two of Holiday Madness is complete, and hopefully, we are on the other side in one piece. Now on the last stretch of the holiday road, we can now let go and get ready to celebrate the coming of the New Year.  For starters, many are ending this decade sober and stronger than they once were, optimistic in their desire for positive personal change in the year to come.  Some may be teetering on the edge of relapse, or may have already ventured down that path.  Hopefully, they make it back to the willing arms of recovery–remember, it just takes the willingness and desire to ask for help!

That said, all of us, sober or otherwise, look upon the burgeoning new year as a summons to better ourselves. We habitually make promises and set intentions to behave differently than we did the year before; we typically do pretty well in keeping those promises in the first month or so, and then, well, complacency begins to set in. The new membership to the gym starts to gather dust or we fall short in our attempts to deepen our spiritual practice, listening less to the call of our hearts and more to the chatter in our heads; at some point, we may even forget why we made these promises and intentions in the first place.

After countless years of failed “resolutions,” and a persistent sense of disappointment,  I decided to begin a new tradition, which is to no longer make promises I can’t keep, but rather, set intentions that allow me to get back up again if I should fall short. Intentions like being more committed to my life, my family, my sobriety, my spirituality. Or intentions to be kinder to myself and spend less time berating myself for things that are banal and insignificant, i.e., not making it to yoga one day or getting frustrated while I’m driving. In the grand scheme of things, one failed yoga class or a frustrated honk of the horn won’t eradicate the initial intentions that were set. Rather, those moments of forgetting allow me to ignite a practice of forgiveness, which allows me to forgive some of those shortcomings as I work so diligently to transform them.  Frankly, the real intention is our effort to change. “Progress not perfection,” right?

As long as we go forth one step, one breath, one day at a time, eventually, all the effort will pay off, leaving us with less dust, and more fervent joy.

Categories
Mental Health

A Yoga State of Mind

What is it about eating disorders that make us hate who we are and what we look like while inviting failure in our attempts at change?  Good question and one I’m not sure I’ll ever really know the answer to.

Image by myyogaonline via Flickr

    After a lifetime of intermittent starvation, exercise bulimia, and a passion for laxatives and anything that would purge that pesky bran muffin, etc., from my system, I decided to take the inward route and follow in the footsteps of the many eating disordered women I know: delve deeper into a yoga practice. For once, I wasn’t trying to lose my imaginary weight, but rather, I wanted to heal. I decided to approach this ancient practice with a beginner’s mind, rather than the one that has been dallying in yogic practice for over a decade. I chose not to pay attention to the pretzels and skinny bits in my classes, instead, focusing my gaze on my mat. What’s happened has not only been wonderful, but healing on a deep, cellular level. Does that mean I don’t get triggered? Nope, surely not, but it does mean I view my body in a healthier way: as powerful and strong, grounded in earth and sky, and present. With each breath and asana, I move toward a healing space, recognizing my limits, discovering my strengths and meeting them both with kind awareness.
    Body dysmorphia is a life-long disease. It loves to play games and trick you into thinking it’s correct in its delusions of grandeur. However, as we heal and grow in our sobriety and in our efforts to be kinder toward ourselves, our disordered perceptions of mind and body can begin to change. The beauty of a yoga practice is that it teaches us to recognize our limits, embrace our strength, all the while using the fluidity of our breath as an anchor to the present moment. It’s rather like a moving meditation, really. On the mat, I find myself forgetting how I “think” I look as I stay present and get out of the thinking mind. It makes staying present OFF the mat infinitely easier, and allows me to be kinder to myself about myself. What a wonderful gift!

Categories
Addiction ADHD Mental Health

ADHD and Addiction

There’s an interesting correlation between ADHD and substance abuse, with research showing children who have ADHD as being more likely to struggle with addiction issues as adults. According to the Journal of Nervous and Mental Disorders, “some studies show a higher rate of ADHD among substance abusers and that people with ADHD may develop substance abuse problems at an earlier age.”  The three main characteristics of ADHD are: inattention, hyperactivity, and impulsivity, which can lead to high levels of anxiety, restlessness, and stress. Attempting to manage these symptoms can be overwhelming, particularly if one is symptomatic yet untreated.
As researchers and medical professionals dig deeper into addiction issues and ADHD, they are finding proof that lower levels of dopamine is a key factor. Sufferers begin to self-medicate and will often find temporary relief when they smoke marijuana, for example. Why? Well, because THC temporarily triggers the brain to release dopamine and dopamine makes us feel better. The user doesn’t realize the damaging effects THC has to their brain cells and this type of self-medication can set the stage for substance abuse, particularly since the use of drugs and alcohol can provide a sense of calm, even if just for a minute. Also, with an inclination toward impulsivity and risk-taking, ADHD sufferers tend toward perilous behaviors, which can also allude to addiction issues.
It’s important then, as parents, and friends of those suffering from addiction to look at ADHD as a link. Taking a whole-body approach is necessary–one must treat the ADHD component in collusion with the addiction component. Twelve-step meetings or treatment are wonderful tools to combat and cope with one’s addiction and will allow one to better handle the prescription treatment involved with managing ADHD. They have to be undertaken together, however, or one will counteract the other.

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