Recovery...as this drunk sees it #6

 

Get help or else. (Change)

It is necessary to understand that no one is going to do

anything to help cure the drunk, because there is no cure,

there is only recovery.

The therapist, the judge, the friend, the family or the
sponsor may suggest a change,

but only the drunk can make the change.

Cured is a state of being in the mind of the alcoholic/addict
that when the physical compulsion and the mental
obsession to drink and use has been lifted and they now understand how their recovery was manifested.
That understanding only comes when they realize who or
what gave them the courage and strength to change.

"We will suddenly realize that God is doing for us what we

could not do for ourselves."  BB    pp84

If the drunk is not willing to change, nothing will change.

Change, be it for the better or for the worse, just change, usually because anything is better than what
we were subjected to when the drunk was drinking, the addict was using.

Treatment and recovery usually means that we are trying to restore the alcoholic/addict to sanity.
Sometimes the restoration becomes lost in the fog of who is that person, really. Sometimes we
remember vividly who that person was; the smiling, confident, caring and loving child, spouse, sibling,
friend, co-worker, that we remember from when. Many times we wonder if there ever was any
sanity, the drunk has been drunk for so long that all we remember is the misery and torment of
broken promises and broken dreams.

At this point in his/her recovery the list of bad habits, the defects of character have been made and
the alcoholic/addict has said they are willing to change those bad habits and questionable
characteristics to resemble sane behaviors.

Stopping the drinking and drugging is not the only goal of recovery. Many a person has stopped
drinking and drugging on their own. Without changing their emotional make up those people are
just miserable dry drunks who no longer drink or drug. Their behaviors remain just as destructive
to the family structure as were the drunken sprees.

The change that a treatment program seeks is the maturation of an immature ego that has been
stunted in its growth by drugs and alcohol. Rather than face reality or learn from previous bad
experiences the addict/alcoholic who is in their active addiction use drugs and alcohol to numb
them into unmanageability and virtually ignore any feelings towards anything. The word
consequence means little or nothing to the addict/alcoholic. Many a drunk knows no fear and
they believe that they are invincible, bullet proof, above the law, beyond needing to comply with
rules and regulations.What else would explain why the drunk would drink and drive again, knowing
that if apprehended one more time they could face consequences that could include jail time,
the loss of a career, the loss of loved ones and  possible financial ruin for the family.

The functional alcoholic is capable of maintaining a career and routine responsibilities, however,
their capability to show emotions, feel guilt, shame or remorse, has been totally destroyed.
At some time during the progression of the disease of addiction and alcoholism the ability to
function at a level that can maintain a career or act responsibly is usually ruined. The inability
to have true feelings, other than anger or rage, is what leads the addict/alcoholic to destroy
relationships and eventually to a destroyed self image. The functional alcoholic/addict that
still has his material world under control but stubbornly refuses to examine the emotional
consequences of his bad habits is usually the most difficult of cases to enter the rehabilitation facilities.

 It is this emotional side of their recovery that is the most difficult to have the addict/alcoholic identify
and change. Early in treatment or recovery the alcoholic/addict will be flooded with feelings, some for
the first time in their lives, some for the first time in many years. This flood of emotions makes the addict/alcoholic very uncomfortable and vulnerable to relapse.  Fight or flight is often the most
immediate response by the client to avoid the sense of being overwhelmed by feelings. As noted
previously, the family of a person in treatment should be warned that the telephone call may be
forthcoming, “Get me out of here, these people are crazy, “with the motivation of the client being,
"I can’t stand having these feelings."

Those treatment centers that believe in a cure say that a changed self will is sufficient.

Those religious treatment centers believe that their God can cure anyone.

Those who are proponents of AA believe that a combination of physical, emotional and
spiritual changes will help a person achieve sobriety.

All theories work for some of the people some of the time.

Reality is that the success rate, the number of treated people who are restored to sanity,

among all forms of treatment is very low.

The best thinking of the drunk is not of the best.

Michael_e

Recovery...as this drunk sees it #5

Assuming the client is still in rehab, has physically detoxed,

and has admitted to having a small problem with alcohol

 it is now time to start a treatment plan.

At this juncture every rehab in the world diverges.

The extreme left does not believe in the disease concept

and they use voodoo tactics to have the alcoholic cured.

The extreme right use traditional religion and faith to cure

the alcoholic. The middle of the road uses a combination of physical, mental and spiritual understandings to allow the alcoholic to recover.

Every alcoholic is different and only if the alcoholic wants to change will there be any chance of cure or recovery.

All forms of treatment agree on the most significant point of rehabilitation being that the client must change, willingly.

At this time the client is often ask to answer a detailed questionnaire or just to write about or make a list of people, places and things associated with their drinking behaviors.

This list of people, places and things becomes the foundation of the treatment program.

Some of the items on the list are obvious bad habits which need to be changed. The client can no longer continue going to the local bar or package store and buy more alcohol.

Hiding the booze all over the house so the spouse cannot find it must stop. The spouse who has returned home is advised to search the house thoroughly and remove all bottles.  If the spouse likes to drink and is adverse to dismantling the family bar there may be a long uphill battle for the development of a treatment program that will achieve the intended result of total abstinence for the client. If the client cannot go fishing, go to a ball game, go to his buddies’ garage, or go shopping with the girls without having a few social drinks with some friends, those people, places and things may have to (must) be changed.

The list of bad habits, the people, places and things are the easiest part of the clients drinking behaviors to be identified. The more difficult part of treatment is the emotional part of the clients’ reasons for drinking. The alcoholic drinks because they have a physical addiction to the alcohol and also a mental compulsion to believe that they have a reason to drink poison. The physical addiction can be held in remission by complete abstinence. The emotional reasons for drinking are as varied as there are individual drinkers and the treatment programs must identify the uniqueness of that individual.

My parents did not love me, I could not live up to the standards set by my older brother/sister, my boss is a real stinker, my wife ignores me, I was abused by the priest /sister, I am just having fun with my friends, I belong to the club to advance my career, if you worked as hard as I do, you would enjoy having one too, my team lost, my team won, it’s raining, the sun is shining and the reasons go on into the millions. For as many drinks that were consumed today, there are as many reasons to justify each one of them. The emotional reasons that the addict/alcoholic fabricate to justify their actions may also be deep rooted, sub-conscious misperceptions that may require many months or years of treatment to be exposed and identified for change.

The development of a treatment plan that addresses the emotional disparities suffered by most alcoholics/addicts may be started during the inpatient rehabilitation stay and are then transferred to an extended care treatment program.

During inpatient treatment the patient and the therapist review the list of habits and behaviors identified by the patient. If the alcoholic/addict is not in a treatment program and they are using the self help program of AA, they are doing the Fourth of the Twelve Steps of Alcoholics Anonymous when the make their list, and they are doing the Fifth Step when they share their list with another person.

Another successful tool to identify habits and misconceived reasons to justify alcoholic drinking behaviors is the small group therapy session. Guided by a trained counselor or therapist, the small group helps its members to identify inappropriate behaviors and may even make suggestion as to how these behaviors can be corrected. The sexual makeup of the group, all one sex, or mixed, is usually determined by the philosophy of the treatment facility. This idea of one alcoholic helping another and the idea of suggested methods to correct bad habits is also the foundation of Alcoholics Anonymous. This practice of discussing behaviors with others is the basic training for the alcoholic to learn how to reach out for help. A part of the disease of Alcoholism is the emotional mindset that the drinker is a loner, they do not fit in, they want to isolate, they want to push away anyone who loves them and they want to kill themselves. Asking for help is not a reasonable concept or a normal activity for the problem drinker or the addict. The support group that many recovered alcoholics use to keep sober in their life after the rehab is a carry over from the small group that was used as a part of their inpatient treatment. The newcomer to AA is greeted at the first meeting and given a list of telephone numbers that can be used to start a support group. In AA it is strongly suggested that the men stick with the men and the women with the women.

Change now becomes paramount in the recovery of the addict/alcoholic.

Every day the world changes and normal people accept changes as growth, maturation, aging, what is expected of life. The alcoholics/addicts do not know how to change, it is stated that when the first drink or drug is used to stuff the feelings the emptional growth of the individual stops. The recovering individual who is honest will identify the emotional age at which they stopped growing and what they are now doing daily to learn to accept life on the terms of their Higher Power.

For extended treatment the professionals may recommend additional professional one on one treatment, small group therapy treatment, more intense behavioral modification treatment, AA, or a combination of any of the recommendations, and the emphasis of all treatment is "change."

Michael_e

Recovery...as this drunk sees it #4

   We are now going to assume that the individual presented to treatment or assigned to a self help group has successfully detoxified and it appears that they are not crazy.

At this stage of treatment detoxification still has two important influences on treatment.

Younger, more resilient bodies clean up in a hurry,

look great, feel great, what is the problem??,

I’m O.K. and I think I can go home now.

The patient has just awakened from a relatively long drug and alcohol induced stupor

and the guilt and shame

that is felt once they realize where they are is

too much to handle, time to leave.

   Most treatment facilities enforce a blackout of five to seven days after the patient has been committed to prevent the patient from trying to arrange transportation to “Get me out of Here.”  The excuses to leave are as varied and as creative as there are clients in every rehab center.  Most alcoholics have been rightly accused of lying once or twice in their lives and trying to flee rehab is a suitable challenge to any alcoholics creative story telling.

   The second thing that must be understood is that the entire cleansing of the body and mind usually takes a whole year and many times up to two years. Many recovered alcoholics will describe the experience of total detoxification as an event where at a given moment, a year or two after drinking has stopped, there is a feeling that a fog has lifted from their brain.

Now begins the most critical process of recovery treatment.

   Through the use of personal interviews and introduction into small group therapy sessions the counselor and the client must agree to be honest, trusting and to agree to thoroughly examine why the client is in treatment.

Self realization is the key to recovery.

There is very little emphasis on how much or what kind of alcohol was consumed, when the alcohol was consumed or where the alcohol was consumed. The emphasis is on the consequences of the drinking.

Most alcoholics agree that they rarely had trouble every time they drank, but when there was trouble it was usually because of drinking. The emphasis of the self education is to have the client understand, in their own words, what control the alcohol had over their actions.

As an example: I had only two drinks three nights ago, because I said I was only going to have two. I had only two drinks two nights ago, because I said I was only going to have two. Last night I said I was only going to have two, but I lost count.

Group therapy is one of the strongest forms of assisting the client to begin self realization. In the normal 28 day, 4 week treatment program, there are two clients who have three weeks exposure, two who have two weeks, two who have one week and two who are just out of detox, recently admitted. By sharing experiences and learning to identify with someone who has the same apparent problems, the client is guided to self realization. A peer group admonishment is not as damaging to the fragile ego as a direct condemnation from family or other authority figures. A good therapist asks questions and allows the group to provide an answer or explanation. Are you being honest?

Many of the best, one on one, client therapist discussions end with the therapist recommending the client take the issue to their group session. Most clients who do not like their groups are incapable of being honest and are having trouble facing reality.

The group does not like them either.

Admitting that there is a problem with alcohol is the springboard to the next step of the treatment program.

If the alcoholic is trying to sober up using the twelve steps of Alcoholics Anonymous, they have just completed step 1.

“We admitted we were powerless over alcohol, that our lives had become unmanageable”.

Happiness is helping someone help themselves.

Michael_e

..

Recovery...as this drunk sees it #3

Alcohol is a poison.

Detoxification of the alcoholic can be fatal.

When any alcohol abuser goes to treatment,
the first goal is to "Dry the person out."

It is not advisable to have a serious
problem drinker attempt to "dry out"
without the supervision of a Doctor
or trained clinician.

The mornings after sweaty shakes
are the first signs of withdrawal.

The alcoholic does not have his morning eye opener because he likes to drink; he has his first drink to make the pain and discomfort of the withdrawal symptoms go away. The dancing Pink Elephants are a scary hallucination for the alcoholic. If you are old enough to remember the classic Disney animated short of the Dancing Pink elephants, you can almost believe that the writers of that cartoon knew something about withdrawal from alcohol.
The following is an excerpt from an article published in the NIAAA (National Institute on Alcohol Abuse and Alcoholism) Journal in 1998.
 "Initial symptoms may include headache, tremor, sweating, agitation, anxiety and irritability, nausea and vomiting, heightened sensitivity to light and sound, disorientation, difficulty concentrating, and, in more serious cases, transient hallucinations. These initial symptoms of "Alcoholic Withdrawal" intensify and then diminish over 24 to 48 hours. Delirium Tremens (DT's), the most intense and serious syndrome associated with Alcoholic Withdrawal is characterized by severe agitation; tremor; disorientation; persistent hallucinations; and large increases in heart rate, breathing rate, pulse, and blood pressure. Delirium Tremens occur in approximately 5 percent of patients undergoing withdrawal and usually appear 2 to 4 days after the patient's last use of alcohol."

HUGH MYRICK, M.D., is an assistant professor of psychiatry and RAYMOND F.ANTON, M.D., is a professor of psychiatry at the Medical University of South Carolina, Department of Psychiatry, Center for Drug and Alcohol Programs, Charleston, S.C.

According to the statistics quoted in this article,75% of treated alcoholics have acute symptoms of alcoholic withdrawal when attempting to quit drinking.
A common error is to assume that an abuser, who has detoxed himself several times before without problems, can do it again. The disease of Alcoholism is progressive and personal histories as well as studies show that every detox is worse than the one before. The main reasons to have an alcohol abuser treated at a hospital or inpatient treatment Rehab center include constant and vigilant care as well as the patients’ removal from their normal environment and routine.
Another reason to seek treatment at a hospital/clinic is the availability of medications to reduce the fatal affects of withdrawal. According to the above article there are more than 150 medicines that have been used to lessen the physical affects of alcohol withdrawal. Unfortunately there has not been enough testing to recommend one drug over another, or even the proper dosage to use. Additional benefits to inpatient treatment include diet and exercise. A drunk usually ignores eating real food and when they show up for treatment, vitamin deficiencies and other health problems that have to do with a poor diet, only contribute to the affects of a bad or possibly fatal withdrawal. The next benefit of inpatient treatment is the clinical evaluation that is made in the first couple of hours or days of treatment. Is the alcoholic drunk or is he crazy? Until the withdrawal process is completed and the drunk has sobered up, it is difficult to proceed with the appropriate treatment until the mental evaluation is made. In the Rehab environment the addict/abuser also finds some solace with being among others who are having the same experience.
The aim of treatment in a rehabilitation center is to break the cycle of intoxication and withdrawal. This cycle varies among drinkers. In the early stages of alcohol dependency the cycle may be as far apart as once or twice a year. As the disease progresses the cycle may become once a month. Those who are in this cycle are usually referred to as binge drinkers. In the worst cases, the cycle becomes a daily routine. Many drinkers do not get drunk every time they drink. There are those who drink a certain amount every day to prevent withdrawal symptoms, and then binge once or twice a year, once a month, on weekends only, and eventually the binges take on a life of their own and the drinker has no control over when the drunks will happen.
Extended abstinence is required to restore the abusive drinker's health and well being.

http://pubs.niaaa.nih.gov/publications/arh22-1/38-43.pdf

Happiness is helping someone help themselves.       

Michael_e