Opening Up To Fear

Maybe I’m just more aware of it since Halloween is fast approaching, but I have noticed a lot of friends and clients dealing with fear and anxiety. It’s no secret that many people with substance abuse disorders struggle with anxiety, using drugs and alcohol to quiet their overactive nervous system which has sometimes been rewired due to various forms of trauma they have experienced. Often times family members of those struggling with addiction are the most affected by fear, as the threat of death or incarceration for a loved ones is a very real possibility. And unfortunately, sometimes the worst fears about addiction are realized. Obviously, fear is not reserved only for people or families facing addiction, it is a reality for all sentient beings. Realizing this allows me to have compassion for all who I come in contact with on a daily basis.

In my experience it is helpful to separate legitimate fear, which is calling us to action, from mind-generated fear which is causing us worry and stress,

William James, one of the father’s of modern psychiatry, said that most fear and stress is the result of a faulty belief system. To overcome fear we must be willing to change our belief system. In working with clients, some of our time together often involves the deconstructing of family beliefs around money, success, relationships, and family expectations. If there is addiction in the family system, the entire family tree may be rooted in generational fear that results from dysfunction, abuse, prejudice, secrets, and rage. We unpack these beliefs and see if they still serve a purpose or if they have become a hindrance to whatever goals they are trying to achieve.

When I got sober, I had a clear realization that the philosophy upon which I tried to build my adulthood needed to be completely obliterated before I could begin moving away from the horrifying fear of my last few years drinking. In my teens and twenties I had adopted a nihilistic view of the world that supported my addiction. If life is meaningless, I thought, then it only makes sense to pursue pleasure and self-gratification above all else. This worked fine when intoxicated, but when sober I was possessed by a paralyzing fear that I couldn’t shake without the help of alcohol. When the emotional pain of my failing life was severe enough, I became willing to let go of beliefs and opinions that no longer served me and adopt those of people who seemed to be able to face life with courage in the face of fear.

Along with a new belief system that included the view of a benign universe, I began learning meditation and was able to observe the mind’s fearful nature. Once I saw the brain as an organ and not myself, I was able to detach from fearful, mind-generated anxieties. These things, along with the ability to feel and express emotions, dramatically reduced my fears and allowed me to be at ease in my body for most of the hours in a given day.  Just verbalizing to someone when I’m afraid tells the brain and nervous system that it can relax because the fear has been acknowledged.

Here are a few of my favorite quotes about fear that I’ve heard or read about over the years. I share in the hopes that you live in more faith and less fear.

Thanks for reading. Happy Halloween.

1.) Fear is paper-thin. It takes one courageous step to walk through it.

2.) A ship in harbor is safe, but that is not what ships are built for. – JOHN A. SHEDD

3.) Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. The fearful are caught as often as the bold. Faith alone defends. Life is either a daring adventure or nothing. -HELEN KELLER

4.) Behold the birds of the sky, that they neither sow nor reap, neither do they gather into barns, and your Father who is in Heaven sustains them; behold, are you not better than they? But who of you is able to add a foot to his stature through worry? And why are you taking pains about clothing? Consider the lilies of the field, how they grow without laboring or weaving. But I say to you, not even Solomon in all his glory was clothed like one of these. But if God so clothes the grass of the field that is today and will fall into the oven tomorrow, does he not multiply more to you, Oh ye of little faith? .-BOOK OF MATTHEW

5.) Siding only with those who agree with me is greed. Opposing those who don’t agree with me and wishing they would go away is hatred and fear. Not being able to see this mechanism is ignorance.- GUO GU, ZEN TEACHER

 

 

 

 

Advice and Optimism Regarding the Opiate Crisis

In light of National Overdose Awareness Day, which took place over the weekend, I wanted to write about some of the things I have observed and been told over the years that seem to be effective in preventing opiate and opioid deaths. I counted over fifteen clients on my caseload that have over a year in recovery from opiates, most of whom were IV heroin users. A couple of weeks ago I began asking some of them what they thought were some important pieces of their recovery, and how they have gone from being another sad statistic to happy, productive members of their families and communities.

Each of my clients who are in recovery from opiates have been admitted to at least one inpatient treatment center, most of whom required at least two or three admissions before finally becoming sober for good. They speak of relapse as sometimes being part of the process in order to realize the severity of their addiction, pointing to the financial sacrifice of their families who understood that relapsing is often part of the recovery process. Many of them also relate that staying in a treatment center for an extended period of time (usually 2-3 months) was key to finally turning the corner and beginning to see progress. The reason long term treatment is so key is that it gives the brain time to heal, allowing for better executive functioning instead of being enslaved by the addicted brain which operates from a primitive level of craving and immediacy.

Nearly all of those who are abstinent spent a period of time in a good recovery house after they discharged from treatment. The recovery house serves many purposes, but some of the most important are accountability, structure, and a living environment where the use of alcohol and drugs is prohibited. Yes, sometimes people do relapse in recovery homes, but if the ownership of the house implements a zero tolerance policy  those who relapse are quickly identified and either asked to leave or readmitted to a treatment center or detox ward. There is also the Tennessee Alliance of Recovery Homes  that sets standards and practices that ensure that supportive housing is implementing best practices.

All of my clients utilize or have utilized 12 step recovery. Some no longer attend meetings, but most do. 12 Step recovery is not the only method for sustained or early recovery, but in my experience it is the most effective for overcoming the incessant pull of addiction and teaching the recovering person how to navigate the world without the use of consciousness blunting substances. I have worked with many clients who have a strong aversion to AA or NA meetings, some who have felt they encountered a heavy-handed approach to spirituality. Most of the time these clients can work through their resistance, encouraged to find meetings that are less rigid and open to many different approaches in regard to finding a healthy way to interact with the principles of the 12 steps. Buddhist recovery groups have become widely available in the last ten years, and there is also Celebrate Recovery, which caters to those who wish to have their recovery focused around their Christian faith.

The efficacy of opiate antagonists such as Naltrexone and Vivitrol have been well documented. I have had clients tell me that these medications have been “a game-changer” in regard to reducing the cravings and obsessive thoughts associated with addiction. In the last year I have recommended these treatments to almost all clients who meet criteria for severe opiate and alcohol use disorders. Additionally, medication assisted therapies such as Suboxone can also be implemented, especially for clients who have had repeated overdoses and who have not responded to abstinence based treatment.

Finally, I will advocate for the implementing of a licensed alcohol and drug counselor or addiction trained therapist to assist in the recovery process. The importance of helping a client cultivate their strengths, reduce anxiety, and guide them to needed resources cannot be understated. UTILIZING A GOOD THERAPIST OR COUNSELOR IS AS IMPORTANT FOR FAMILY MEMBERS AS IT IS FOR THOSE WHO ARE FIGHTING THEIR ADDICTION.

In my experience, a realistic, optimistic, holistic, medically appropriate approach will eventually solve the addiction crisis that has decimated this country for not just the past ten years, but since its inception. The lethality of drugs such as heroin, fentanyl, and opioids have raised the stakes, forcing ourselves and our families to stop ignoring how our culture glorifies and glamorizes the use of alcohol and drugs.

EXORCISING ADDICTION

Not long after I got sober in October 2000, they re-released the movie “The Exorcist” in theaters. Looking for things to do in my early sobriety, I went to see the movie with several friends I had made while in treatment for my addiction, a couple of whom were ultimately killed by their disease. Though I had seen the movie in the past, the plot of a young girl possessed by something destructive and evil seemed to take on new meaning for me, even though I still wasn’t convinced that things like demons or evil existed. However, coming out of nearly fourteen years of active alcoholism, I was convinced that something outside of myself had taken over my body and personality, turning myself into a creature that only vaguely resembled my old self.

About half way through the movie there is a scene where the two exorcist priests have taken a break after hours of futility, failing to remove the demon from the young girl, witnessing her doing things that could only be described as sub-human. At one point, the younger priest turns to the older and begins asking questions about this evil, confused and terrified about the what he is witnessing.

He asks the older priest imploringly:

What is the point of this evil? Why this girl?

The older priest, answers his question with this statement:

I think the point is to have us despair, so that we see ourselves as animal and ugly and reject the idea that God could possible love us.”

When I heard those words in the theater, a cold chill ran up my spine. I had found the perfect description for what the disease of addiction had done to me for the past decade.

In the last years of my alcoholism it seemed as though I had been separated from all things good in this world. My capacity to love was gone. I couldn’t sleep or eat, the ability to receive joy was destroyed, and my creativity was no more. But the most damaging part of my addiction was the way in which it obliterated my  capacity to see the beauty of the world around me, both seen and unseen. The only way to experience the above pleasures was to continue to use the drug that was causing the problem in the first place. That is what they mean when they talk about powerlessness in 12 Step Meetings.

One of the reasons  I write this blog is to generate compassion for those suffering with addiction. After working in the field for nearly twenty years, I know for sure that most people who are struggling with addiction and mental health issues do not want to be the way that they are. This is difficult to see, because it looks like they are making the choice to live the way they live, destroying their bodies and families the way they do, but in my experience this is rarely the case. Science is beginning to recognize the truth of this statement, identifying deficiencies in the addicted brain that leave some people with little choice but to try to make themselves feel better by altering their neurochemistry. As I have said for years, all addicts and alcoholics are self-medicating.

In The Exorcist, both the priests and the child’s mother must look past the horrifying behaviors she is exhibiting while possessed, remembering that underneath all the hatred and ugliness, there is a little girl trapped within the evil. The ability to gaze deeply into the depths of human beings and see the divinity within is the greatest hope for healing addiction, and probably most of human evil we encounter everyday.

Good Grief

In my practice, I bear witness to a lot of different types of grief. Though it may be hard for some people to understand, there is a grieving period that is necessary to start the recovery process. For those dealing with substance abuse, alcohol and drugs have been a constant companion, even a best friend; always available, always reliable, and never judgmental. If you have never struggled with addiction, imagine someone walking up to you and telling you that you can no longer associate with someone you love, no matter how great the desire. Now imagine being full of shame for feeling this loss. That is something like addiction.

There are other aspects of grief that I see in my office on a regular basis. Due to the severity of the opiate crisis, many of my clients have lost friends and family to the disease of addiction. Last year, I counted eight deaths in one month related to overdose or suicide. Some were people I had known, some were friends or family of my clients. Each death represents a catastrophic loss for someone, a hole in the fabric of their universe that can never be filled.

Recently I have been observing my own grief, experienced due to the death of one of my dogs, Stella. I rescued her from the pound back in 2006, in part to help me through the loss of my father who had died the year before. She let me know very quickly that she only needed three things to be happy: Love, pillows, and treats. In a lot of ways, I don’t think human beings are much different, only we have forgotten the truth of simplicity.

Inherently, grief is the shadow of love. Without love there is no grief. When I am walking through a period of sadness, I always try to keep these thoughts with me and resist the urge to push away or repress the feelings associated with sensations of sadness and loss. As someone in recovery, I do not have the dubious luxury of numbing grief with a six pack of beer or a handful of Xanax, no matter how appealing this option might be. And today, I am grateful for the ability to feel my emotions, especially since I have seen how alcohol and drugs stifle the grieving process, lengthening the duration of mourning, often causing the mourner to become bitter, resentful, self-pitying, and spiritually confused.

In the 1940’s Thomas Merton wrote the following: “The more you try to avoid suffering, the more you suffer, because smaller and more insignificant things begin to torture you, in proportion to your fear of being hurt. The one who does the most to avoid suffering, is in the end the one who suffers the most.” As Merton noted, the only way to avoid grief is to reject and hide from love, an option in which I am no longer interested. So although I allow myself to feel the pain of losing my constant companion of the last thirteen years, I am also aware that there is a deep sense of joy and love just below the surface.

In this light, the experience of grief is essentially good, but I sure do miss that little black dog.

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The First Thanksgiving

Had a lot of nice things said about this post, so thought I’d share it again.

Beginner's Mind, Writers Mind

The first Thanksgiving of my recovery, I was only one month out of treatment and living in a half-way house in East Nashville, back when that side of town was more avoided than desired. The house charged $85 per week for rent, an amount I struggled to come up with earning minimum wage flipping burgers at The Nashville Zoo. My mother and father would have given me money had I asked, and often they did. But I knew that I had burdened them financially by asking them to pay for my treatment twice in two years, so I learned how to make do with the bare minimum, realizing that things I viewed as necessities were actually luxuries. For the first time in my life, when I laid my head down on a pillow in a soft, warm bed, I felt a true sense of gratitude for what so many people…

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Remembering October

It’s a strange sensation when you know you’re dying. Stranger still, when you know that it is in some ways by your own hand. That was the only thing I knew for sure during the first week of October, 2000. I knew the disease of alcoholism was killing me and that if I took another drink I’d be dead before the age of 28.

I was in rehab again for the second time in three years, brought there by two friends and mentors I’d made during my first attempt at recovery. These two men traveled from Nashville to Indiana to pull me from my self-created hell and take me back to the treatment center I’d been admitted to two years earlier. Later they both told me that they weren’t exactly confident that I’d be able to get sober again, especially after they saw how I was living in my addiction. After my live in girlfriend moved out due to my drinking and insanity, I’d locked myself up in the apartment and began an episode of binge drinking and cocaine use, only leaving the apartment when I needed to replenish my reserves of poison. I was beginning to have both visual and auditory hallucinations, often pulling my bed from its box springs and placing it against the door because I believed that there were things outside the apartment that were stalking me.

Bill Wilson, the founder of Alcoholics Anonymous, writes that when alcoholics are toward the end of their disease, they will know a loneliness that few people ever experience. I knew what that loneliness was, a feeling that the world no longer wanted me in it, that I was incapable of functioning without the effects of consciousness blunting drugs, that the only choice was to either check-out or stay intoxicated round the clock until my body finally shut down. Once I got to treatment and was detoxed, the hopelessness became even worse, a false belief that I’d already tried recovery telling me that there was nothing they could offer me which could allow me any sense of peace or well-being.

In a way, I was right.

I’d grown up in a religious home, my mother was the secretary at the church and a deeply spiritual woman that tried to show me that there was more to the world than what I could perceive with my two eyes. But as I grew older and my addiction grew worse, my vision became more narrow, until I could only see the glaringly obvious intellectual and moral absurdities connected to many religious practices and sects. I’d become so cynical and angry that even the mention of the word ‘God’ would cause me to strike-out verbally against the one who uttered it.

On October 8, 2000, my fifth day in treatment, my despair became so deep, and the craving for alcohol so strong, I went back to my room and sat down on the bed and cried. I was considering leaving the treatment center and spending the last few dollars I had on a motel room and a bottle of rot-gut alcohol, just to silence the voices of my disease that wouldn’t relent with its whisperings of shame, self-hate and hopelessness. Then a second choice came into my mind, seemingly out of nowhere. With nothing left to lose, I called out to the Universe and begged divinity to help me.

In a flash, everything changed.

A deep feeling of peace enveloped me, a feeling that is beyond description, and I’m sure beyond belief for those who have not experienced it. Along with the feeling was a rush of insight about the nature of my problem: My entire life I’d been trying to achieve happiness by attempts to manipulate reality into what I thought it should be, instead of making the best out of the reality in front of me. I also realized that for most of my life I’d been a taker instead of a giver, and that this was the source of my existential angst. I saw that negative emotions and mental states preceded from my own consciousness, not from what other people had done to me. There were many other insights, some impossible to convey, but simply put, I had a deep and profound spiritual awakening that altered the entire course of my life. I’ve never had a drink or drug since.

Though my awakening gave me the hope I needed, there was a long road ahead of me. I’d spent fourteen years in my addiction, over a decade of making decisions based on what was easy instead of what was right. I spent eleven months in a recovery house, doing things like learning to make my bed and being where I said I was going to be. I worked jobs making minimum wage and learned that dignity comes from how you do your work, not from the work you do. And most importantly, I learned that the practice of spiritual principles in my life would enable me to deal with reality without the need for intoxicating substances.

Eighteen years later, the life I have is the life I want. I am still committed to helping those suffering with addiction in honor of all the family and friends who helped me along the way. As for the opioid and addiction crisis we are currently facing; it will be solved by individuals who heal, not governments that go to war.

Emotional Sobriety: Progress Not Perfection

Anyone who loves somebody in recovery from addiction, or is in recovery themselves, knows that the road to long-term sobriety doesn’t always follow a linear path. Many times before a person finally becomes abstinent from drugs and alcohol there are periods of setbacks, relapses, heartbreak, and financial struggles. For those fortunate enough to achieve remission from the disease process, it is a hard-fought battle, won with the help of parents, relatives, doctors, therapists, treatment centers, churches and support groups. Anyone who has witnessed someone pick up their anniversary chip or key tag in a 12 Step Meeting will attest to the fact that the journey to obtain lasting recovery is worth the effort.

But what happens when the initial rush of recovery wears off?

Since my first days in the world of recovery, I heard a disparaging phrase used to describe people who were abstinent from alcohol and drugs, but were still dealing with other issues which were affecting their quality of life. These so-called “dry-drunks” were sometimes banished to the fringes where many times they were forced to figure out their problems on their own. From the beginning, the term ‘dry-drunk’ left a bad taste in my mouth, probably because I know what harsh self-critics people in recovery are. And because after watching many friends die from the disease of addiction, I knew that if a person stayed sober, they at least had a chance to confront and conquer whatever demon was plaguing them. In active drug addiction there is no hope for self-correction. As I became seasoned as an alcohol and drug counselor, acquiring more knowledge about co-occurring mental disorders, process addictions, and the effects of trauma on the brain, I began to cultivate a deep sympathy for those struggling in their recovery, especially those with  years of abstinence.

As a result, I devote much of my practice to helping people move towards that elusive state of being that Bill Wilson, the founder of Alcoholics Anonymous, called emotional sobriety. What is emotional sobriety? It probably depends on who you ask; but to me emotional sobriety is when a person is no longer running from their addiction, but instead are moving towards their highest purpose. It is living a life free from constant anxiety and depression, not fettered to compulsive patterns of behavior and unfulfilling or abusive relationships. It is striving towards compassion for one’s self, one’s loved ones, and even one’s enemies. Emotionally sober people live in truth, not in shame; they are not perfectionistic, but they do not shy away from the challenge of making themselves better people. Emotionally sober people make mistakes, but they don’t make excuses. They understand that sickness, death, and unpleasant feelings don’t mean that life is going badly, it means that I am a human being, with human emotions, and human frailties.’

Lastly, and maybe most importantly, emotionally sober people know that if you haven’t struggled and suffered at some point in your sobriety, then you haven’t been sober very long. They deeply understand the old spiritual aphorism that “it is better to be a living dog than a dead lion.”  To have recovered from a disease that kills millions of people every year is no small accomplishment. That the addiction manifests in other areas is just the nature of the disorder. I am always deeply moved by the courage of people who are willing to sit in my office and admit that they still have some work to do on themselves. Their humility is to be admired. They are the ones who will break patterns of dysfunction that extend back through the generations. They will be the ones to map the final frontier of emotional sobriety.