Out From Under: Treating Your Own Addictions, Chapter 1

OUT FROM UNDER!
Treating Your Own Addictions

Chapter 1

NEARLY EVERYONE HAS AN ADDICTION

"Everybody's recovering from something." (Earl Cranamore)

Most of our addictions are acceptable to most of us. The vast majority of addictions involve socially acceptable behaviors and legal drugs. Our lives are so filled with harmful things and activities that nearly everyone needs recovery from something, be it a common addiction to a harmful substance, or continually choosing poor relationships, or consistently eating the wrong foods. There are so few exceptions that the abnormal appears as normal.

The local bar or pub is an addiction supermarket, "the place where everybody knows your name." And your addiction. Nearly all harmful substances are available there: alcohol, cigarettes. high-fat foods, sugar, coffee, and many combinations thereof. Sometimes illegal drugs are available too. Waitresses and bartenderesses, many chosen for their youthful figures, are utterly vigilant in filling your empty glass, always asking if you want another. The drink glasses are shaped and weighted to make you think you get more for your money. The cone-shaped martini glasses, for example, hold far less than you think. The snacks are salted and peppered to increase thirst. but the last thing they'll offer you is water, except when it is bottled and they can charge alcohol prices for it. Some pubs have video games, pool tables, etc., for informal gambling. At the bar are relationship addicts, love addicts, sex addicts, compulsive liars, sports addicts. sports-TV addicts, and "Whatever!"

There are many more addictions (for a list click: Appendix 7). Here are some less-obvious examples.

There are successful workaholics who seem to "have it all" until you ask their children if they or their parents are happy.
There is the "happy family" with a garage so full of goods that their cars stay out in the rain and much of their diminishing leisure time is spent cleaning and maintaining all the things they have.
Those who appear thin and "good looking" often do so with the help of harmful substances and by spending to much time worrying about their appearance.
There are children who watch television six hours per day.
There are legal and illegal drugs which are not used to heal but to make us "feel good."
The "Yellow Pages" abound with therapists of every kind, and thousands of doctors, lawyers and repair services.
Countless forms of passive spectator entertainment compete for our remaining "free" time, led by that great addictor: TV.

Click Wealth & Power: Assets or Addictions" for more about our addicted society.

Many of us are in denial:

"Oh well, I'd rather smoke than be fat."
"I'd rather be a workaholic than an addict."
"Well at least we're not addicted to drugs. But we are in trouble with our credit cards. Our kids aren't happy either. Do I need Shoppers Anonymous?"

These circumstances are not new. The great Benjamin Franklin wrote advice for better living and personal healing. Here are some examples from Poor Richard's Almanac (1754):

Deny Self for Self's Sake.
Success has ruined many a man.
The poor have little,―beggars none; the rich too much,―enough not one.
Drive thy business;―let not that drive thee.
Many estates were spent in the getting.
Eat to live, and live not to eat.
Wealth is not his that has it, but his that enjoys it.
Three good meals a day is bad living.
Who is strong? He that can conquer his bad habits.
9 men in 10 are suicides.

Alcohol the Drug

Drugs are at war with us. The goal: addict and destroy. This handbook contains strategies and tactics for a real life battle in which the lines are drawn and the sides identified. The spies are doing intelligence work, the underground movement is active. And there are no negotiations going on. This is global war at the individual level. Obviously these substances are harmful, and the total costs to the nation are great. But it is important that the reader realize that the evil army of cigarettes, alcohol, and abused prescription drugs causes far more death and harm than all the illegal drugs combined. While we sit on the couch watching the arrests of drug dealers on the nightly news, we die from the effects of cigarettes and alcohol.

There is a popular misconception that alcohol and cigarettes are used by more persons than the other drugs simply because they are so widely available. In fact, the reverse is true. These drugs are so widely available because they are the most addictive. Demand creates supply. Their chemical nature is such that they cause themselves to be the most habitually used. Their great availability is due to the fact that there is such great demand for them.

US drug abuse statistics show that among persons aged 12 to 20 who had had any drink at all, fully 88% either binged (67%) or drank heavily (21%). From these data we may infer that alcohol causes anyone ho drinks it to want to drink again in considerable amounts. From that we may infer that alcohol addiction is caused by alcohol.

Alcohol is associated with various other health problems. In addition to increased risk for brain damage, alcohol use is linked to pancreatitis, cardiac myopathy (damage to the heart muscle), and blood abnormalities. Alcohol has long been associated with harm and death and yet each new generation seems surprised when it discovers this. This has been so since Biblical times! (Click: Appendix 15.)

There are reports that nearly 80 percent of those who commit suicide drink alcohol beforehand. One study reported that those who consume six or more drinks a day were twice as likely to die from suicide. Other studies have indicated that alcohol contributes significantly to birth defects, and one group of researchers suggests that maternal alcohol abuse during pregnancy is the most frequently occurring (but readily preventable) cause of mental retardation in the Western world!

The following was written in 1840:

This pestilent principle generally seeks for asylum where it may practice its deadliest deeds in some important and vital organ of the body. It sometimes makes the brain more particularly the seat of its venom, and victim of its cruelties. At another time, it hides itself in the inmost recess of the heart, or coils around it like a serpent; now it fixes upon the lungs; now upon the kidneys, upon the liver, the bladder, the pancreas, the intestines or the skin. It can agitate the heart until it throbs and bursts, or it can reduce pulsation until it becomes impalpable. It can distract the head until the brain sweats blood, and horrified reason flies away and leaves the man a manic or a madman. I never knew a person become insane who was not in the habit of taking a portion of alcohol daily.

Alcohol is linked with other addictions. As a "chaser drug" alcohol goes well with cocaine, amphetamines, nicotine, and marijuana, providing the nation with a substantial population of "dually dependent" persons. A surprising number report that alcohol addiction is the most difficult to "kick."

Nicotine the Drug

There remain about forty-five million smokers in this country. As addicted persons smokers are prime candidates to develop heart disease, chronic bronchitis, and emphysema. The Society cites smoking as the cause of 85% of the lung cancer among men, and 75% among women. Smoking is responsible for 30% of all cancer deaths and is the cause of cancers of the pancreas, bladder, esophagus, larynx, pharynx, and mouth.

Cigarette smoke contains an appalling assortment of poisons. Hydrogen cyanide, the gas used in execution chambers, is found in cigarette smoke at 160 times the level rated as safe! Other poisons include benzene, outlawed for paint thinners but not for smokers' lungs, nitrogen dioxide, which appears at fifty times the safe level, and tars, which form like road pavement on delicate lung tissue. The sad fact is that one thousand Americans die EVERY DAY from the effects of cigarette smoking. In addition, 53,000 nonsmokers die each year from the effects of other persons' smoking. (Click: Appendix 13.)

Normal Malnutrition

Malnutrition is so widespread in wealthy societies that it is overlooked. Our eating habits are such that we very rarely get all that we need. For example, ninety percent of us live on a diet that is deficient in chromium, a very important trace mineral which is an essential nutrient, not just an optional food additive. Chromium is needed in modern America because of our high sugar diets―it helps in the efficient digestion of sugar. Perhaps one third of us are hypoglycemic, that is, we are particularly inefficient in our digestion of sugar. This can result in chronic fatigue, depression, irritability, and simply not "feeling right." Chromium can be very helpful with hypoglycemia. Yet few of us take enough chromium. More on this later.

Then there are the normal side effects of eating the wrong foods, or too much or too little. Add to this the effects of stress, worry, or overwork. The list is long but the results are the same: too few of us feel as good as we would like or are as worry free as we could be.

In a recent Glamour Magazine survey of 33,000 women, only 6 percent of the respondents were satisfied with the shape of their bodies, while 75 percent thought they were too fat. In fact, just 25 percent were overweight and 30 percent were underweight. Weight loss is a $10 billion industry in the U.S. Each year Americans spend $100 million on over-the-counter appetite suppressants, but ninety-eight percent of dieters gain back the weight they lost. Forty percent of teenage girls diet even though they are not overweight.

Effects on the Family

The addicted parents of the pre-addicted child battle continually during the child's developing years. There are constant angry encounters that the child witnesses. There is the pain of seeing the first two "gods" in one's life who, rather than complement each other, battle for control. Then the fatigue factor takes its toll on the children because they are smaller vessels. The child, rather than being assertive and outgoing withdraws from social encounters. He or she will interact in only the home environment, mostly to battle with his siblings. Drugs will later be the means whereby he can come out of his protective shell in social encounters. The initial stages of addiction are beginning to lay their foundations.

Then the parents mobilize the children into their own encounter. Addiction has thus begun to be ingrained into the child's development. The development of the child in these circumstances is slowly impeded in four iareas: spiritual, mental, emotional, and physical. Mental development is generally the first to be affected because the child learns how to function in an abnormal, but assumed normal way in the world. The internalized shame is buried deep in the constant mask the child wears. The son internalizes his anger at his mother whom he blames for letting this problem develop. With the daughters it is generally toward the father who is a poor role model. Both children will have developmental and relationship problems. with spouses and friends. The accumulating effects of all this cannot be changed by this time so that the relationships of male and female become distorted. Thus, as with the individual, the family unit declines physically, mentally, and spiritually because of broken ties and other relationship issues. At the very least, the children will become codependents, i.e., persons who do not use drugs but who have acquired the characteristics of the addict. In addition, they will manifest high rates of eating disorders and high rates of hospitalization.

Family Therapy

        In our work in treatment centers we have seen the "tough guys" who were afraid to confront their family, and who would even deny family difficulties were present. Yet, most were victims of dysfunctional family systems, and their problems are best dealt with in a family therapeutic setting. There are alternative approaches as well and these will be covered in the recovery chapters of this handbook, but for those for whom family therapy is an option, the following information is provided.

        During the 1960's therapists began to see that individual therapy based upon insight into "unconscious" contents or conflicts had a poor track record in fighting addiction, and we must assume that at the present time most types of psychotherapy are working very limitedly. These are recently being challenged by "combination therapies" or "shot gun" approaches. Other methods include general system theory, network communication, and theories of group dynamics that have opened new frontiers of therapeutic intervention.

        At the very same time, our nation is experiencing the appearance of new family structures that include not only the familiar hereditary family, but also the single-parent family, the remarried-parent family, the homosexual family, and other structural variations. Just as any organism adapts and mutates in order to survive, so does the addicted-system family.

Peter Minuchin, the founder of family therapy, described the family as a dynamic organic structural system in which repeated patterns of behavior become governing structures over time. Addictive behavior may be so deeply ingrained that the family unit maintains "addictive equilibrium." At first, treatment can appear to be threatening. The addicted person's family role must be changed by creating a new family structure so that there is genuine support for his or her recovery. Defeating the "old role" through daily effort will help build the personal strengths and inner values necessary to combat addiction.

A Big Side Effect: Lack of Trust

Persons who lack trust say "Don't expect reliability in relationships. Don't trust anyone and you will never be disappointed." Since the parents never got their dependency needs met as children, they cover up this insatiability with fantasy bonded illusions of self-sufficiency. As dependent persons, they can never trust in their own recovery because they never know when it will relapse. As a result, they cannot begin the process of trusting others because they are unable even to trust themselves. By acting either aloof and independent (walled boundaries) or needy and dependent (enmeshed boundaries), the dependent person feels emotionally cutoff and incomplete. The implication is clear: Trust may be the most important personal issue that needs to be addressed.

The authors in their work saw this problem of lack of trust over and over again. The dependent person's past experiences have made trusting a person, place, or thing highly unlikely. When this issue is not confronted and resolved, recovery is made much more difficult. The recovering person must learn to trust self and others; but, this difficult because of the random and unpredictable nature of addiction cycles.

Alcoholics Annonymous

Let us now look at the most popular type of recovery group: the anonymous twelve step support group most typified by Alcoholics Anonymous. We want to learn as much as we can about self-help groups in general in order to help ourselves recover.

Nothing speaks louder on the subject of Alcoholics Anonymous than the faces of men and women on their way to a meeting. Their wonderful humanity reveals itself both in their expectation of social contact with sober friends, and in their courage in battle. In the face of the worst enemy ever foisted on this planet (the chemical collection of cigarettes, alcohol, and all the other drugs) they march to war seeking serenity, living and letting live, and one day at a time. However, they are fighting chemical monsters who have actually enlisted the addict's own joy in the war against them.

A.A. is one of the best forms of treatment for chemical addiction, so one can hardly imagine any reason to critically examine its success. Yet, this must be a time for an iron attitude when it comes to analyzing our strategies and tactics. We must now look at healing and recovery organizations with a warrior's objective eye, and truthfully acknowledge the degree of actual success lest we ultimately lose the war because we have overestimated our weapons.

Just How Successful Are Addiction Treatment Programs?

A.A. is at the heart of most treatment programs. There is usually a solid dose of psychotherapy and education on addiction, but nearly all treatment plans require two or three meetings a week of A.A., or A.A. spinoffs, e.g., Narcotics Anonymous. (See Appendix 14a.) Many courts sentence drunk drivers to A.A. meetings. Private psycho- therapists and psychologists most often refer their dependent clients to A.A. Family members usually urge their dependent relatives to attend meetings, and A.A members themselves bring in over one third of new members.

Obviously A.A. has gained wide acceptance, possibly because the general public assumes that it "works," meaning that it helps most addicted persons to stop drinking.

        How well does A.A. work? A survey of many thousands of its members by the General Service Office of A.A. taken every three years reveals that 29% achieve 5 or more years of sobriety (continuous abstinence). This 29% is a collected group of all those sober 5, 7, 10, 15 years, etc. But 80% of those who first start going to meetings will relapse in their first month and 95% before completing their first year. This means that 95% of those who attend meetings regularly have gone through cycles of relapse before they achieve continuous abstinence. In addition, many have found that A.A. is not for them.

        It should be quickly noted here that, because of the prevailing belief that total abstinence is the only true recovery, periodic relapse is not properly understood as part of the recovery process. If the A.A. survey included those who are in the type of recovery defined by our Random Cycle Theory in Chapter 1, A.A. would be seen to have a much higher recovery rate. But just as many persons achieve healing and recovery through moderation as through total abstinence, and more recover without A.A. than with it.

        Two questions immediately arise: 1) do treatment programs that rely on A.A. "work" any better, and 2) why is the "success" rate so low? The answer to the first question will come from researchers investigating recovery, most notably Dr. George Vaillant. We take up the second question with an offer of a suggestion or two.

        Part of the problem might be the concept of powerlessness that appears both in the Twelve Steps and in the Serenity Prayer. The Prayer asks for the strength to accept the things that cannot be changed but offers no way of distinguishing them from the things that should be, other than by praying for the wisdom to be able to do so. The First Step speaks to powerlessness in the face of addiction. "Bill W.," one of the founders of A.A., spoke of 'surrendering one's life to an external higher power." This has been a sore point with various alternative recovery groups such as Rational Recovery Systems and Secular Organizations for Sobriety (click Appendix 14.)

        Another part of the problem may be the "one-size-fits-all" aspect. This is possibly an unwanted side effect of the idea that addiction is a disease. When A.A. was founded during the Great Depression grc of the 1930's, the disease concept gained rec well deserved favor because it removed the mar stigmas attached to alcohol addiction. Notions that addiction was due to a moral defect, or to character defects, or to lower social status were popular at the hel time, and since disease can attack anyone everyone, it seemed natural that treatment for the "disease" would be the same for all. However, this makes the task of treatment appear too simple, and as a result does not meet the needs of those who need another "size" treatment.

        Another problem has been addiction to cigarettes. "Bill W." died from the effects of smoking, and too many drug-recovery meetings take place in a sleepy cloud of drug-smoke. Fortunately, the number of nonsmoking meetings is growing. Another problem, perhaps, is reliance on anonymity. This only plays into the stigmas previously mentioned. There is really no reason to be ashamed of addiction, and the more open our society is about it the better off we will all be.

You Are In Charge of Your Recovery: Try Many Paths

If you choose to go to a self-help group in order to enhance your chances for recovery, you have taken a step in the management of your recovery. If you decide that a treatment center is for you, you have taken a step in the management of your recovery. If you set up your own fun healing group, you are managing your recovery. Get the point? You are, and have always been, managing your recovery. Your purpose now is to get better at it by trying as many strategies as you can in order to find the ones that work for you. In our efforts we must consider every strategy and tactic no matter how funny or unusual it may seem.

The trend in the 21st Century is toward the eclectic or multifaceted shotgun approach. In opposition to the one-size-fits-all theory, the eclectic method creates and makes available many different forms of treatment so that the dependent d. person who tries them all may find some that "work." In addition, the established recovery groups need to become more flexible and welcome the new alternative groups. We need a unified front to win the war. The reader should consider trying several self-help methods instead of just one. TRY MANY PATHS. There is no one simple way to heal and recover. This handbook provides you with many strategies and tactics. If you try them all you will find some that work for you.

People Are Healing

        Millions of us have quit smoking, drinking, and many other activities. The ongoing twenty-five-year survey by the National Institute on Drug Abuse (NIDA) has shown a slow long-term decline in the use of every drug, from cigarettes and alcohol, to the exotic illicit drugs. Healing is not only possible, it is happening. However, we have only returned to an earlier level. After a peak in 1980, the total amount of drug addition has moved back down to where it was in 1970 or so. It was a bad situation then, so we have a long war ahead.

        Healing is only the first phase. Once there has been some repair of the damage caused by your addiction, you may need to change your circle of friends, your spiritual attitude, and your fun habits. This second phase begins true recovery.

        One last point. There has been for years a myth maintained that recovering addicts make the best addiction counselors because "they have been there." Actually, a good counselor need not have been addicted. What is needed is integrity and knowledge of recovery, and thanks to the integrity of Dr. George Vaillant and others in the field we have learned some very important things about recovery.

The Fun Factor

Among the subjects that this handbook covers is one that is missing from most healing plans. Many forms of recovery, personal or otherwise, involve too grim an approach. This is certainly understandable given the costs to the individual and to the nation as a whole. However, "normal ill health" persists. Something is missing from the picture.

Perhaps that "something" is FUN. Most persons who Use drugs for nonmedical purposes do so in order to have fun, at least at first. Alcohol, cigarette and coffee advertisers have long associated their substances with fun, or parties with beautiful bikinied women "coming alive" out of a magazine picture just after a long slow pour of beer. In reality healing must be the process of learning to have fun without chemical assistance or indulging compulsions.

In Conclusion

This introductory chapter has presented a summary of many sad truths about addiction. Obviously, this is a very serious matter. But this does not mean that the process of recovery must be all work and no play, and on the following pages the reader will find strategies and tactics both for fun and for the serious support of healing. Do not underestimate the power of fun and play.

This handbook was derived mostly from practice, but also from theory. Many of the strategies and tactics are those used by 1) persons with the same problems, 2) counselors, 3) many other recovery resources, and 4) scientific studies. The authors wish to convey their deepest conviction that healing and recovery are possible and their sincere commitment to yours.

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