Ask Jeff and Debra

The Myth of Hitting Bottom

A letter from one of our readers…

Dear Jeff and Debra,

My daughter is an alcoholic, and she refuses to get help. People tell me there’s nothing I can do until she hits bottom, but she has two small children, and I just can’t bear to watch this go on much longer. Is hitting bottom the only way?

Worried Mother

 

Dear Worried,

Why not raise the bottom to right now? You don’t have to wait for a drunk driving or a medical problem or an accident with the children. You don’t have to wait for something terrible to happen. You can take action right now, without waiting for her to hit bottom (whatever that means).

 

The idea of hitting bottom is difficult to define, when you examine it closely. What does it take for an alcoholic to realize they’re sick and accept help? For some people it might be the loss of a job or a marriage, but many people will keep drinking anyway. For other people, it might be a medical or legal problem that opens their eyes, but many people will keep drinking anyway.

 

So, what is hitting bottom? What will cause a person to hit bottom, and realize they’re an alcoholic? How can we define “bottom?”

 

Simply put, an alcoholic’s bottom is a moment of clarity, and a moment of action. At the bottom, an alcoholic will admit that they can’t go on drinking and they don’t know how to stop (and stay stopped).

 

Dr. Vern Johnson, an episcopal priest and a recovering alcoholic, realized in the 1980’s that there had to be a better way than merely letting a person free-fall to their bottom. He developed the first popular intervention technique to help bring about this moment of clarity, without the dire consequences.

 

Over time, the technique was evolved to truly harness the power of love and concern, so family and friends could break through the wall of alcoholic denial and help the alcoholic accept help. Using a love-first approach, we have learned how to raise the bottom to right now, and begin the recovery process before it’s too late. Remember, for some people, the classical bottom has no bounce. They simply die of their disease.

 

This post originally appeared in the Grosse Pointe News

 

You may also want to read this excerpt from No More Letting Go: http://lovefirst.net/no-more-letting-go/hitting-bottom-a-family-affair/

The Silent Treatment

A letter from one of our readers…

Dear Jeff and Debra,

My little brother is successful in business, but his life is being ruined by alcohol. He’s already lost his marriage because of his drinking and verbal abuse, but he’s still playing a blame game. Some of his friends and I tried to talk to him about his drinking, but he wouldn’t listen. Some people say I should cut him out of my life until he accepts help. Should I stop talking to him?

Big Sister

Dear Sister,

Just the opposite. When a person doesn’t accept help for an obvious problem, it’s usually more effective to increase communication. Alcoholics usually want to isolate themselves from concerned family members and friends. They do not want to talk about their drinking. When forced to talk about it, they will reframe the issue and blame others for their dilemma.

 

Your informal intervention didn’t have the desired effect because it wasn’t well planned. When we do a good, structured family intervention, we spend a lot of time in training and rehearsal. There are three keys to a successful intervention: Plan, Plan, Plan. We need to use the power of love and concern in a very specific and organized way, so we can break through the natural denial and defenses of the alcoholic, and bring them to a moment of clarity where they will say Yes.

 

If we can’t reach an agreement for treatment, the family members and friends should promise to continue the conversation at every opportunity. They should no longer avoid the issue. If the person we’re concerned about was avoiding treatment for any other life-threatening illness, we wouldn’t walk away. Why should we do it with addiction?

 

Mental health and addiction problems thrive in the dark. They grow in islolation, and snowball with other negative emotions. When we continue to bring the issues into the light with care and compassion, we make it more and more difficult for the alcoholic to refuse help.

 

Rather than give your brother the silent treatment, you should consider a better-planned approach and keep the conversation going. We don’t recommend nagging him, but we do recommend a family commitment to recovery.

 

This post originally appeared in the Grosse Pointe News

 

 

Holiday Drinking Guide

A letter from one of our readers…

Dear Jeff and Debra,

We now have two family members recovering from alcoholism (and a few more who probably should be). We always host a large family party over the holidays, and we wonder if we can offer something besides soft drinks and coffee for the non-drinkers?

Holiday Hosts

 

Dear Hosts,

Thoughtful people like you embody the spirit of the holidays. Family parties should be a time for celebration, but for newly-recovering alcoholics, they can be stressful and dangerous. Having some interesting alternatives to alcohol will not only make their lives easier, these “great pretender” drinks can also encourage others to stay within their limits.

 

For many years, AAA Michigan published “Great Pretenders” drink recipes for just this reason. Although it hasn’t been published this year, you can find a previous edition here: http://bit.ly/2heHguW .

 

We also found a tasty drink called Golden Glow Punch at drinkmixer.com

6 oz orange juice concentrate 6 oz lemonade concentrate
1 qt chilled apple juice
2 qt chilled ginger ale

1 pint lemon sherbet or ice ring

Pour the concentrates and the apple juice into the punch bowl. Stir the ginger ale into the bowl. Spoon in sherbet or add an ice ring. Serve immediately.

 

To make ice ring, arrange thin citrus slices in a 6-cup ring mold. Pour water into mold to partially cover fruit. Freeze. When frozen, add water to fill mold 3/4 full. Freeze. Unmold and float fruit side up in punch bowl.

 

Everyone will enjoy these festive drinks, and your thoughtfulness will be appreciated. Your sober friends and family members will notice the extra effort you’ve taken, and your holiday spirit will really shine.

 

This post originally appeared in the Grosse Pointe News

Rebuilding Trust

A letter from one of our readers…

Dear Jeff and Debra,

Our adult daughter’s life has been shattered by addiction, causing hurt and harm to everyone around her. She’s been through residential treatment twice, and is now living in a sober house, far from home. She asking us to trust her and allow her to come back to live with us, but we’re not sure what to do. How will we know when we can trust her?

Wary Parents

 

Dear Wary,

Your daughter is making a common mistake in asking you to trust her, and you are making a similar mistake in pondering the question. She is pulling at your heartstrings and asking for a favor. In most circumstances, her request might be reasonable, but in light of her addiction it could have life or death consequences.

 

Your daughter’s question shouldn’t be, “when are you going to trust me?” Her question should be, “What am I doing to become trustworthy?” As parents you are naturally wary based on your experience with her relapses. We can only imagine the havoc her addiction may have already caused in the life of the family. You are right to be cautious.

 

Like many things in life, recovery from addiction is the result of right actions maintained consistently over a sustained period of time. If someone has a broken leg, the bone must be set, the cast must be worn, physical therapy must take place, and so on. There is a natural healing process that must take place with a broken leg, and if the process is interrupted, the leg may be worse than it was before.

 

Similarly, your daughter must follow the recommendations of her treatment team. She must stay in a structured environment, continue her Twelve Step meetings, attend counseling sessions, and work an active program of recovery. It is up to her to rebuild trust by following the directions and achieving realistic goals. There’s work for you to do, as well. Follow the directions in the book, “It Takes a Family,” (Hazelden, 2014) and learn how you can support her progress. By building a culture of recovery in the family, trust can be rebuilt on both sides of the equation.

 

This post originally appeared in the Grosse Pointe News

College Drinking

A question from one of our readers…

Dear Jeff and Debra,

Our son has been having problems at college related to alcohol and pot. He used to be a good student, but his grades have plummeted. We know from reliable sources that he’s “partying” every day. We don’t want to interrupt his academic career (he’s a junior now), but college is expensive and we don’t know what to do.

Paralyzed Parents

 

Dear Paralyzed,

If you treat college like an entitlement program, you’re asking for trouble. Your son is fortunate to have parents who can pay for a good education, but that privilege brings responsibility.

 

As long as he’s living on the bank of mom and dad, there should be clear expectations for his behavior and performance.  He’ll face even greater expectations when he enters the workforce.

 

We don’t know if your son is addicted, but we do know it’s time for a serious talk, and probably a professional assessment. Don’t make the mistake of sending him to a counselor for a solo session. A thorough assessment will involve several family members and others with first-hand information. If he has developed a addiciton problem, it’s unlikely that he’ll be forthcoming about it, because denial is usually a hallmark of addiction.

 

If he doesn’t need addiction treatment, but needs to change his behavior, here are some tips for discussion. 1) Let him know that you’ve invested tens of thousands of dollars and countless hours in his education, but 2) it doesn’t look like he’s making the same level of commitment. 3) Tell him it’s OK to drop out of college and get a job if he’d rather party, but that 4) he can’t live at your home.

 

It won’t hurt him to get a taste of the real world, and reconsider the value of a college education. Early in adult life, most of us learn things the hard way. One last point: illegal activities are illegal. If you give any ground on that issue, you’re asking for trouble.

 

This post first appeared in the Grosse Pointe News

 

 

 

Why isn’t AA helping?

A letter from a reader…

Dear Jeff and Debra,

My wife has an alcohol problem, and she knows it. She’s admitted she’s an alcoholic. After trying to quit on her own, she tried going to a few AA meetings, but nothing seems to work. I don’t know how to help her. She’s tried everything. What do you suggest?

Bewildered Husband

 

Dear Bewildered,

If someone went to the gym a few times, but said it didn’t work for them, would you blame the gym or the treadmill? If someone tried various diets, but quickly gave up on them, would you blame the diets?

 

Alcoholics get frustrated when there’s no quick fix. They’re used to the instant gratification of alcohol or other substances, and they’re impatient with the idea of working a program of recovery. It requires honesty, open mindedness, and willingness.

 

It’s no coincidence that “one day at a time” is such a popular motto among recovering alcoholics (and their families). To avoid frustration, keep it simple, and take it day by day. Participate in a Twelve Step meeting today, call your sponsor today, read some recovery literature today. Most people find they can do almost anything for one day.

 

Before too long, there will be positive results. Crash diets don’t work because they’re not sustainable. But if we take a slow and steady approach, we can be successful. Our communities are filled with people who are ready to help (they’re at the meetings). Experience shows that if we keep doing the next right thing, years of sobriety can be achieved by taking it one day at a time.

 

 

 

This post was originally published in the Grosse Pointe News

Treatment Didn’t Work?

A question from one of our readers:

 

Dear Jeff and Debra,

 

My husband went to treatment, but he started drinking again after he got home. He was only there nine days, but it didn’t seem to help at all.  What can we do? I’m so frustrated!

 

 

 

Dear Frustrated,

 

We feel your pain. Families are always shocked when they learn how little time a person gets in a residential treatment program. After waging a long battle to get their loved one to accept help, they expect the person will be away and in treatment for at least a month. Unfortunately, that’s not the case.

 

What your husband received is more properly called detoxification and stabilization, rather than treatment. Once a person has been medically stabilized, has received basic education, and has received a continuing care plan, they are discharged. The next phase is typically an IOP (intensive outpatient program), meeting at 3 to 5 times per week for 6 weeks. Not many patients comply.

 

When resources allow it, we recommend 30 to 90 days of residential treatment. The “gold standard” used for airline pilots and physicians who need treatment is 90 days—and that’s just the start.

 

Your husband’s focus has to be on Twelve Step meetings and outpatient services. Right now, the goal should be to consult with his doctor, keep it simple, and start over. The old prescription of “90 meetings in 90 days” is a good place to begin. He’s had a bad fall, but it’s time to get up and try again. There are many recovering alcoholics in our community who’ll be happy to help him.

 

 

This post was also published in the Grosse Pointe News

Helping Our Son

A letter from one of our readers…

Dear Jeff and Debra,

Our teenage son is on the road to recovery from problems with prescription pain killers. How can we learn how to be supportive, beyond the basics we learned from his treatment providers?

—Pensive Parents

Dear Pensive,

Your question is important, because most families (and most patients in treatment) underestimate what will be required to maintain long-term recovery. Treatment is just the beginning of the process, a launching padfor recovery. In treatment, the acute phase of the illness is arrested through detox and stabilization, followed by counseling and education, which lay  groundwork for the months and years of recovery ahead.

 

Most good treatment providers have family programs, but they are brief and don’t prepare parents for the difficulties that may lie ahead, especially the specter of relapse. Families can play an active and positive role in recovery, which is critical after treatment has concluded.

 

It Takes a Family, by Debra JayHazelden recently published “It Takes a Family: A Co-operative Approach to Lasting Sobriety,” by Debra Jay. This book lays out a year-long program for families and their addicted loved ones called Structured Family Recovery™ (SFR). The SFR system is based on weekly conferences, led by a trained SFR counselor, that promote recovery, prevent relapse, prioritize issues and provide a common language of recovery.

 

Togetherness creates transparency and positive accountability in a manner that prevents addiction from regaining control. In the past, families were often sidelined in the recovery process, but this new approach puts family members back in the picture, so relapse is avoided and the family is once again united.

 

This post originally appeared in the Grosse Pointe News

 

Success doesn’t come magically or accidentally. It is a result of what we do. The same can be said of failure. Usually it is a small change in one direction or the other that determines if we win or lose. Structured Family Recovery helps us make the correct choices and then steadily keeps us on course over time. ––Debra Jay, “It Takes a Family”

 

 

Modeling Adulthood

Girl-Imitating-AdultKids notice everything. As they move into their teen years they notice more of everything and with a more discerning eye. They’re constantly adapting themselves to the world around them and evaluating the actions of others. Young people want to grow up fast, so they pay special attention to adults.

 

If kids see that adult gatherings always include alcohol, it sends a message that will be received loud and clear. The message is: if I’m an adult interacting with other adults in a social setting, I should be drinking. Children are the only ones who aren’t allowed to drink. If I’m going to be one of the grown-ups, I need to drink.

 

When extended family and friends come over for a holiday celebration, an adult birthday or a special occasion, is alcohol always part of the program? If so, the point about adulthood equaling alcohol is being reinforced.

 

How about sending a richer and more nuanced message. Yes, adults may drink alcohol, but alcohol isn’t a requirement for adults to get together. Take some time to plan adult family activities that don’t include alcohol, where everyone is having fun together without drinking. This possibly strange behavior will be noted and if alcohol normally plays a big role in your family, the message will be puzzled over by your kids. That’s a good thing.

 

Be sure your kids see the different ways you have to relax and take time for yourself. Work out, read a book, work on a project. You won’t have the luxury of isolation because you live in a house with kids, but you can demonstrate the various ways that adults relax, without using substances.

 

If a problem does arise with substance abuse in your household, get some help. When you think about it, it’s the only sensible thing to do. If you had transmission problems with your car, you wouldn’t attempt to become a transmission specialist overnight. Why would you? You’d get professional help with the problem.

 

The brain of a young female will continue to develop until the age of 21 to 23. For males, brain development continues until the age of 22 to 24. The regular use of alcohol, marijuana and other drugs can impact the developmental process in a negative way. It may not be realistic to expect that your children will abstain from all substances until they complete their developmental process, but they should be made aware of the dangers. It also gives a reasonable and scientific basis for firm boundaries and expectations in the household.

 

Your kids will be exposed to alcohol and other drugs early in their teen years, if not earlier. Make sure you learn how to communicate with them before someone else does. And as always, actions speak louder than words.

 

– Jeff Jay

 

 

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.