LoveFirstBlog

Forming new habits – David Brooks, NYT

David Brooks

David Brooks - New York Times

David Brooks has a fabulous article in the New York Times about how we form new habits. More than that, he talks about the way we have thought about this culturally from the 19th century to the present. The Machiavellian Temptation – NYTimes.com.

 

I don’t want to be a spoiler, but the last paragraph is really terrific, so make sure you read the whole thing through to the end.

 

What’s so great about this article is that Brooks gets below the surface and points to some of the deeper reasons we make changes and learn how to stick to them.

 

-Jeff Jay
 

In Memoriam: George Mann, M.D.

George Mann, M.D.One of the giants in the addiction recovery field, Dr. George Mann, has passed away. A memorial service will be held at The Retreat, in Wayzata, Minnesota at 7 p.m. Feb. 29, 2012. He was one of the original pioneers of modern treatment, having played a key role of the development of the “Minnesota Model.” He continued to innovate all his life, inspiring new leaders and helping thousands of people to heal from their addictions.

 

“What was so unique about George was his gift of seeing all individuals as spiritual beings,” said John Curtiss, president of The Retreat, “that at the core of recovery lies a spiritual transformation.”

 

“Don’t forget the love!”

Those were George Mann’s final words to me when we met last Spring, and I think they sum up his teaching to colleagues, friends and family. For Dr. Mann, addiction and recovery were not just medical matters, but matters of the heart and matters of the spirit. Even though he brought a physician’s insight to the illness and its treatment, George was always on a higher plane, unleashed from convention and unwilling to compromise with mediocrity. He was a visionary both in what he would produce and what he would cut away, just as a master gardner creates beauty both by planting and by pruning.

 

George Mann also played an important role in the development of the Minnesota Model, the world-famous method that would transform the field of addiction treatment from the early 1970’s to the present. This model was based on the notion of a multi-disciplinary team working with patients in a holistic manner –addressing mind, body and spirit– to treat their illness and bring them into a life-long program of recovery. Of course, ‘holistic’ was an unknown descriptor in 1970, but that was just like George to begin doing things before they were discovered or named by others. He had no interest in taking credit.

His most important contribution to the addiction recovery field was the founding of The Retreat, a residential program that eschewed therapizing in favor of  total immersion in the 12 steps of Alcoholics Anonymous. In an era of ever-expanding diagnoses and medications, The Retreat led the way back to basics and to a clinical reliance on the power of the recovering community. This approach, in different guises, is now all the rage from coast to coast, but you’ll rarely hear George Mann’s name come up in policy discussion. He didn’t fly below the radar, but rather soared so far above it as to be all but invisible.

Last Spring, my wife Debra and I came to talk to George about our plans for a professional training. George was enthusiastic, as usual, and he gave us a lot of good advice. But his last words to me were especially meaningful. I can still see his eyes sparkling as he said, as though it were a last request: “Don’t forget the love!”

 

Now, Debra and I are the authors of a book called “Love First,” so it might seem odd that he would make this point so emphatically. But in the whirlwind of planning and logistics and curriculum, it’s easy to get lost in the details and forget the big picture. George was always focused the big picture and that meant LOVE. This cardinal virtue illuminated all his actions from the inside out, whether it was washing dishes or endowing a foundation.

 

He was a happy warrior, battling bureaucracy, hierarchies and psycho-jargon with an informed passion. He was Buddha-like in his belief in simplicity and his faith in the recovery process. His mantra was consistent, and it was put into action on a daily basis in his family and professional lives.

 

What he was trying to tell me was to keep the power of love first and foremost, to guard against the avalanche rules and regulations that can bury the spirit alive. There is no greater power in the universe, and George Mann was it’s champion, quietly toiling in unknown wards and meeting rooms, with a smile for a balm and an easy laugh to enliven shattered souls and rekindle that most essential element: belief.

 

–Jeff Jay

Ex-super-agent Leigh Steinberg addresses his alcoholism

Leigh Steinberg from USA Today – By Christopher Blumenshine, Getty Images for Mercedes Benz

Really great article in USA Today about the famous agent (and real-life Jerry McGuire) who has battled alcoholism for many years. Ex-super-agent Leigh Steinberg addresses his alcoholism, bankruptcy – USATODAY.com.

 

Although he is still shy of 2 years sober, as of this writing, his story is compelling. Money is the fuel of addiction and in the heady world of professional sports there’s plenty of fuel. For many people, wealth becomes a buttress against intervention, treatment and recovery. But this doesn’t have to be the case. If the most important people in the addicted person’s life will make common cause and set aside their own financial interests, intervention and treatment becomes possible. In this case, it appears that all the fuel had to be exhausted.

 

We wish Leigh well in his journey of recovery.

 

––Jeff Jay

60 Minutes on antidepressants

Take the time to watch this great segment on 60 Minutes. New research shows that antidepressant medication is only marginally better than placebo, especially for mild to moderate depression.

 


 

Getting Lost in the Underlying Cause?

courtesy of photostock

Families always ask me, “Why is my son an alcoholic?” This is a sticky subject. The answer is easy. He has an inherited disease and at one point the genetic switch was flipped. Folks don’t want to hear that answer. They will tell me that their son is depressed, that their daughter experienced a horrific trauma, their mother is always full of anxiety. If the question is being addressed during an intervention training then I reiterate that this is an inherited disease and that everything else is academic in the present. They can explore the believed causes of the addiction at treatment with professionals who understand the disease of addiction. I know that the treatment centers that we use provide the most up to date and accurate education for our clients. So it is better not to get sidetracked during a training and focus on what is important in the present and near future; getting their loved one into treatment.

 

If I am asked about underlying causes in my psychotherapy practice at Love First I am afforded the time to explain the disease of addiction to my clients. It is key that all family members understand that addiction is an inherited genetic disease. Debra Jay writes in No More Letting Go that although the disease is inherited, addicts are morally obligated to get help and manage their disease. Families are also obligated to learn and understand their role in supporting life time recovery. One area is not to intertwine other issues such as trauma or perceived mental health issues with the addiction. This may be counter to what families hear from other helping professionals, well minded friends, the media, and even some addiction treatment programs. I educate family members that their loved one may use to ease the pain of a trauma, but at some point, the genetic switch is tossed. It is no longer about the trauma. As an EMDR therapist I can help clients resolve the trauma. However with an addict who lives with trauma all I have done is fix one problem. The client is still an addict, now they use without the pain of trauma.

 

I have had many clients tell me, “I just wish I was crazy. Then there is a pill to fix me.” We know that when clients are off of ALL drugs that most symptoms related to mental health issues disappear. A pill will not fix an addict.

 

I do not want to minimize the existence of co-occurring mental health issues. Clients do experience anxiety, depression, bi-polar disorder, etc. These are real issues paralyzing millions of Americans. I want to stress that we cannot correctly assess the severity of the co-occurring issue until the alcoholic is clean or dried out for a significant amount of time. Then the appropriate therapies and treatments can be used to address those symptoms.

 

Treating addiction does not need to be messy and complicated. There exists a rich tradition of successful treatment that includes the 12 step fellowships. Families should work with interventionists and treatment facilities that talk about treating the disease of addiction. Follow their suggestions. During the aftercare process identify psychotherapists in your community who have a firm understanding of addiction. Make sure they are licensed professionals and hold certifications in addiction training. If they are at least master’s level clinicians then they have a strong foundation in mental health counseling. These clinicians understand the disease of addiction and the process of recovery.
 

Best colleges to avoid excess partying

The real title to this article is unfortunate, but still worth looking at: The 10 Best Colleges for Teetotalers. What you’ll find is a list of top schools with a party life that eschews getting schwaisted (i.e.: hammered). While it might not be a surprise to see Brigham Young on the list, Georgetown and Vassar also make the list. Interestingly, the schools that have dedicated “sober dorms” aren’t mentioned.

 

Thanks to Buddy T. at alcoholism.about.com for the heads-up.
 

Eye on Addiction

Jeff Jay and Love FirstJeff Jay was a guest on the Eye on Addiction radio show, with host Joe Herzanek. The show was titled: “How do I intervene?” Jeff talked about the power of intervention, different methods for intervening and the ways family can plan and prepare for a successful intervention. He also discussed what to do when the addict finds out about the intervention in advance. The answer may surprise you.

 

To listen to this one-hour show, including questions from listeners, visit the Eye on Addiction website and check the show archives.

Eye on Addiction – listen now
 

Relapse Prevention

image by photostock

Dear Jeff and Debra,

 

My wife is just returning from a month of inpatient addiction treatment. She had a terrible problem with pain medication, which started of innocently enough when she had a skiing accident two years ago. After the problem spiraled out of control, we had a family intervention and got her into treatment. We were all relieved she accepted help, but now that she’s coming home, a whole new set of fears have taken hold. What can I do to help prevent a relapse?

 

A Concerned Husband

 

 

Dear Concerned,

 

As you know, treatment is a launching pad for recovery, not a cure for addiction. Treatment is vitally important, but it’s not a panacea. In treatment your wife learned how to work a program of recovery. You can’t work her recovery program for her any more than you could work an exercise program for her.

 

But that doesn’t mean that you don’t have an important role to play. First of all, you can scour the house to make sure there are no narcotic painkillers, muscle relaxants, tranquilizers or other suspicious prescriptions anywhere in the house. She doesn’t need to find some forgotten bottle oxycodone in the medicine cabinet.

 

Next, we would recommend that you remove all alcohol from the household. Although you have only reported your wife’s problem with prescription pain medication, the shortest road to relapse for her is probably through a social glass of wine. The phenomenon of cross-addiction is unappreciated and underestimated by most people, and it’s the cause of many preventable relapses.  She will have learned in treatment that she cannot safely drink alcohol from this point forward, and you can play a major role in making that fact easier to bear.

 

In social situations, join her in not drinking alcohol. It’s not such a big deal in our modern era, as many people decline alcohol for a variety of health and personal reasons. It’s easy enough to have a glass of juice or a soft drink at a party, and most people will never know or care. She’ll appreciate your solidarity with her and it will help quell her concerns about what other people might think. The fact is, when a person makes a fuss about another person not drinking, it says more about the drinker than the abstainer.

 

Third, you can begin working your own program of recovery, as a family member. We’ve written about Al-anon in this column many times, and there are also family programs specific to narcotics, though in our area we don’t find them to be as strong or well-developed (a pity really, as there is no shortage of prescription drug addicts —recovering and otherwise— in our community).

 

We hope that you attended the Family Program at the center where you wife was receiving treatment. The Family Program is your launching pad, and just like her treatment, it is only the beginning of the process. One of the best things you can do for your wife and yourself is to become very knowledgeable about the illness and about the recovery process, just as you would if she had contracted any other life-threatening chronic illness. Read all you can, attend open meetings of Alcoholics Anonymous in our community (there’s an eye opener!) and attend your own 12-Step meetings. This last point will serve two purposes: it will show camaraderie with your wife and it will give you greater insight into yourself. In particular, it will help you to see how you may have unwittingly enabled the problem to grow in the first place.

 

Finally, before your wife comes home from treatment, you should meet with her and her primary counselor to develop a Relapse Agreement. Its purpose is to spell out in black and white exactly what steps will be taken if there is a return to addictive behavior. Like the lines on a highway, a Relapse Agreement helps keep people on the road to recovery by making boundaries clear and consequences certain. It’s too late to set boundaries once the problem resurfaces.

 

Recovery from addiction is no different than any other chronic illness. There is no cure, per se, but the illness can be kept in remission indefinitely, one day at a time. No one ever has to relapse, and as long as your wife follows the directions she received in treatment, there’s no reason to think she ever will.
 

Rethinking Drinking

Here is a question we received that we answered in our regular newspaper article…

 

Dear Jeff and Debra,

I have a running argument with my spouse about my drinking and I want you to help settle it. I have one glass of wine every day and only one glass. Very occasionally, I will have another glass of wine when out to dinner with friends on the weekends. My spouse thinks I drink too much, but I think I’m very moderate. Do you think my drinking is too heavy?

Mr. Moderate

 

Dear Moderate,

One of the most important pieces of information we need to answer your question is missing, and it’s one of the most important reasons that people mistake “healthy” or moderate drinking for unhealthy or heavy drinking. The question is: What’s the size of a standard drink? Let’s look at the numbers supplied by the National Institute of Alcohol Abuse and Alcoholism (NIAAA).

 

The following drinks are considered equal in the volume of alcohol delivered to the human body. 12 oz of regular beer = 8-9 oz of malt liquor = 5 oz of table wine = 3-4 oz of fortified wine (such as sherry or port) = 2-3 oz of cordial, liqueur, or aperitif = 1.5 oz of brandy(a single jigger or shot) = 1.5 oz shot of 80-proof spirits (hard liquor).

 

In most social situations, alcoholic beverages aren’t carefully measured, so unless the drink comes in a single-serving container, like a can of beer, it may be unclear how many “drinks” are being served in a single glass. If you have a large goblet of wine and call it a single glass, it may easily contain two drinks, or 10 oz of wine.

For men, at-risk or heavy drinking is defined as more than 4 drinks on any day or 14 per week. So, if you exceed 4 drinks on a given day, you’ve crossed into heavy drinking. If you exceed 14 drinks in a single week, you have also crossed into heavy drinking, though you may never have had four drinks in a single day. For women, the numbers are smaller, both because women tend to weigh less than men and because they metabolize alcohol differently. For women, heavy drinking is defined as more than 3 drinks on any day or 7 per week.

 

The question for Mister Moderation is: How big is your glass? If you’re only having one 5 oz glass of wine per night, you’re not a heavy drinker. But, if you use a larger goblet, your drinking may put you at risk.

 

Some people say that light drinking may be good for your heart, but balance that potential benefit against the risks of heavy drinking. These risks include liver disease, heart disease, sleep disorders, depression, stroke, bleeding from the stomach, sexually transmitted infections from unsafe sex, and several types of cancer. Heavy drinkers may also have problems managing diabetes, high blood pressure, and other conditions. Birth defects are a risk with heavy drinking, as is the increased chance of injuries from a variety of accidents.

Quite a rouges gallery of risk for a potential benefit that can also be delivered by grape juice.

 

If you’d like to delve into this discussion more deeply, the NIAAA has developed a new website called Rethinking Drinking. It doesn’t focus on alcoholism, but rather the risks of heavy drinking. It will also show you how to assess your own drinking pattern. If needed, valuable tips are provided on cutting back, or on finding help if you can’t. http://rethinkingdrinking.niaaa.nih.gov/

 

Your question lacks a critical number, as we’ve explained, but it also contains an important piece of information that deserves a special comment. If your spouse believes that your drinking is problematic, listen to her. Whether or not she’s technically correct is beside the point. If the use of alcohol is damaging an important relationship, it’s already a problem. It’s often said among recovering alcoholics, “it’s not about how much you drink or how often you drink, it’s what happens to you when you drink.”

 

Perhaps you shouldn’t be counting drinks or measuring fluid ounces, at all. Instead, try asking yourself: “What’s so precious about this drink and what am I willing to sacrifice to have it?”