Canada Drug Rehab

Geoff Thompson, MA, CCC

Geoff Thompson, Program Director for Sunshine Coast Health Centre, discusses Aaron Antonovsky’s “Sense of Coherence” study and why those with a higher “S.O.C.” score are more likely to succeed in their recovery.

Geoff Thompson, MA, CCC

Geoff Thompson, Program Director for Sunshine Coast Health Centre, talks about the difficulty of defining what spirituality really is.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services at Sunshine Coast Health Centre, talks about the label of “codependency.”

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services, discusses “PAWS” or Post-Accute Withdrawal Syndrome and the key points in an individual’s recovery where there may be a higher chance of relapse.

Geoff Thompson, MA, CCC

Geoff Thompson, Program Director for Sunshine Coast Health Centre, talks about Ernest Hemingway’s catch phrase, “… grace under pressure” and facing struggles in life heroically rather than as a victim.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services for Sunshine Coast Health Centre, discusses what you should be concerned about if your loved one feels they could handle drinking again after addiction treatment.

By Geoff Thompson
Program Director
Sunshine Coast Health Center

Spirituality is a hot topic today. Bookstores are filled with works on ‘Mindfulness’, ‘Purpose-driven life’, Ekert Tolle’s and Wayne Dyer’s bestsellers, and so on. In this blog article, we’ll examine a little more in depth the nature of spirituality.

There is good reason to spend some time thinking about spirituality. If you are involved in the 12-step program, then you know that Bill Wilson considered alcoholism a “spiritual” disorder, which required a “spiritual” solution. If you are a fan of psychology, then you know that cutting-edge research has concluded that good recovery is linked with ‘spirituality’—and poor recovery with a lack of ‘spirituality’.

So, everyone agrees that ‘spirituality’ is very important to live a great life in recovery. The problem is that nobody seems to be able to tell us what exactly this ‘spirituality’ thing is.

In a previous article, we looked at two ideas that seem to have something to do with ‘spirituality’. Alumni talked about their experiences with coincidences that seemed to be more than just accidental (synchronicity), and Joseph Campbell said that when you live the life that is true to you, then you will feel as if “hidden hands” are helping you along. We also chose three common things about ‘spirituality’ that just about everyone agrees with: spirituality is a good thing, it inspires hope for the future, it is a way of living.

In this article, we’ll look at the idea that the power of spirituality is that it allows people to live a personally meaningful life. This won’t surprise alumni who were at Sunshine Coast when we put the new program in place, which emphasizes the importance of meaning and purpose in life.

The new treatment model is called ‘meaning-centered therapy’, developed by Dr. Paul Wong. Wong believes that spirituality can provide a way to live meaningfully. And he’s not alone. As one example, the Association of American Medical Colleges Consensus Conference for Spirituality and Health defined spirituality as “every person’s inherent search for ultimate meaning and purpose in life.” So even the medical doctors are on board with this.

Here’s the basic idea: There is ‘something’ going on in the world beyond what you and I see in everyday life, some sort of benevolent force that provides order to life. If you discover this ‘something’, then you realize very quickly that there is a lot more to life than the limited, narrow-minded view many have in active addiction. By joining with this Force, we find a sense of belonging. We realize that life is valuable and worthwhile. Being spiritual means that we join with the Force.

Suffering as Part of Spirituality

If spirituality is acceptance that there is something ‘bigger’ happening in life, then even the suffering in life must have some sort of meaning. There must be some sort of logic in the experience of suffering.

Psychologist Ken Hart has just completed a very interesting research project on addiction and spirituality. Part of the study was to test Viktor Frankl’s idea that happiness depends on finding meaning in suffering. And Hart’s research data indicated that Frankl was right. Those who found meaning in their drug-induced suffering had a better quality of life than did those who dismissed their suffering as merely a place of pain and misery—that is, suffering was of no value and had no purpose.

Last year, we asked alumni at Sunshine Coast Health Center to tell us their thoughts on their personal experience of hitting bottom. The answers were remarkable. Those who avoided thinking about their suffering or who dismissed the drug days were all struggling in their recovery. But those who told us that they realized that hitting bottom was a necessary step on their journey to happiness were all doing well.

Knowing this, Sunshine Coast counsellors are concerned when they hear a client say: ‘I don’t want to think about the old days; I’m starting a new life’. We worry because psychology tells us that their lives will actually improve if they reflect on their old way of life and make some sense of it.

Here are three ways our alumni have made sense of the old days in active addiction. Some see it as a gift: “I would never have known how amazing life could be if I didn’t hit bottom.” This is the idea that you have to go to Hell to find Heaven. Some see it as part of a meaningful life: “I should have been dead a hundred times; there must be some reason why I’m still on this Earth.” Some see it as a necessary step to wake up to life: “When I hit bottom, I realized that I’d better get on with living.”

At Sunshine Coast, we remind clients that this was what happened to actor Christopher Reeve when he broke his spine, to Viktor Frankl at Auschwitz concentration camp, to many people when they were diagnosed with cancer or HIV, and so on. These people were not victims of their biology or circumstances because they “tapped into their spiritual core,” as Frankl put it.

Those people who have no ‘bigger’ picture of their lives believe that suffering is 100 percent pain. Self-proclaimed spiritual people, such as Frankl, are able to find meaning in suffering—in other words, because of spirituality, suffering is much more than just pain.

Spirituality is Attitude, Experience, Creativity

Frankl helped us understand some of the concrete, daily activities that are part of ‘spirituality’. If it’s true that the essential component of spirituality is that it provides meaning in life, then there are specific things you can do to achieve this. According to Frankl, you need three things: develop a positive attitude, experience what life has to offer, make the world a little better place to live. 

You need a positive attitude. Silly as it may sound, we need to see the cup half-full, not half-empty. We ask our alumni to think back to their time at Sunshine Coast. They may remember all the remarkable people they met, or they may still cringe at all the irritating stuff such as people not doing chores, showing up late, pushing their buttons, and so on. There is no scientific reason why we should choose the good over the bad, but Frankl says that remembering the good stuff is necessary for happiness.

Secondly, we need to experience life. In active addiction, we find that our clients often wandered through the universe with blinders on. The things they paid attention to revolved around the drug: how to get it, how to avoid feeling guilty about using, how keep out of trouble at work and home over the drug use, and so on. It’s really quite a pathetic life when you think about it.

According to Frankl, you have to start taking things from the world. Watching a child smile, going to a football game, listening to their favorite songs, watching a good movie, watching a sunset, etc, are all ways of taking something from the world. We are not the child smiling or the one playing professional football or the musician or the movie director or the sunset. But our lives are enriched by paying attention to these blessings.

Thirdly, we have to give something to the world. If we find a cure for cancer, that’s great. But for most of us this means being a good father, friend, employer/employee, lover, neighbor, citizen, member of a congregation, etc. These are what Frankl called acts of creativity.

If we can put these three things together in a way that is personal, then, according to Frankl, we will be living a personally meaningful life. And the byproduct of this life is happiness. Perhaps attitude, experience, and creativity are three components of what it means to be ‘spiritual’.

Spirituality is Living for more than Yourself

Spirituality is often interpreted as recognizing that all of us are in this thing called ‘life’ together. If we believe in a religious God, then we recognize that everyone is created in His image. In 12-step programs, a common saying is, “God doesn’t make mistakes.” If spirituality is based on some idea of Nature, then we may recognize that we are part of nature. In other words, spirituality offers a sense of belonging to a greater whole. 

If we recognize that we belong to a greater reality, then we might follow psychologist Paul Wong’s advice and “not live life just for ourselves.” Dr. Wong believes that happiness is a result of positive relationships with others. He’s a great believer that happiness depends on living life not only for yourself but for others.

Here’s an example we hear from Sunshine Coast alumni. Those who are thriving in their recovery have figured out how to live for more then themselves. Some are now little-league coaches, some have used their jobs as an opportunity to help their community by setting up Eco projects, some have volunteered at the SPCA or seniors’ home, some have become involved in 12-step volunteer activities, and so on.

A warning. Some alumni seem to have lived their lives only for others. This is also not a good idea. We talk to our alumni who tell us that they are craving drugs again because their family is on their case. Attempting to control the family, they choose their words careful so as not to “give my wife an excuse” to criticize, they go to meetings to “keep the family off my back,” etc. In other words, they give up being true to themselves to appease others. This is definitely not what Dr. Wong means when he says to live life beyond yourself.

Most alumni who are struggling in recovery are usually living life only for themselves. They have pursued a job because it would give them lots of money. Others sit in the house hoping that the phone will ring, others are so wrapped up in a blanket of their own depression or anger that they have little interaction with others, others are too afraid to take risks of setting boundaries or take risks even to challenge their fears.

Spirituality is Making Sense of Life

Aaron Antonovsky recognized that some people are much better able to cope with stress and challenges better than others. Those who did not seem to be resilient often fell ill to disease and suffering. But those who had resilience had fewer health problems and more happiness in life. So he studied what it was about people that made them better able to cope with life’s problems.

He concluded that the key was ‘meaning’. They were able to make sense of their lives in a way that worked for them. Those who were not able to make sense of their lives fell victim to stress and challenge. He called this a Sense of Coherence or SOC. If someone believes his life is predictable, manageable, and worth emotional investment, then Antonovsky says the person has a high SOC. On the other hand, if he finds his life confusing, unpredictable, unmanageable, and not really worth an effort to save it, then Antonovsky says he has a low SOC.

He even developed a test to measure SOC. Interestingly, researchers discovered that SOC and spirituality were closely related. Those who scored high on SOC tests also scored high on spirituality. Those who scored low on SOC tests also scored low on spirituality.

Based on this research it seems reasonable to say that someone who is ‘spiritual’ also makes sense of his life in a way that leads to happiness. He finds life predictable, manageable, and worth living and fighting for.

It should be no surprise that the SOC test has been used extensively in recovery, and research has shown that those who score high on SOC also do well in recovery. Go figure, eh…

By Daniel Jordan
General Manager
Sunshine Coast Health Center

In one of my web surfing sessions I happened to come across a YouTube video showing an interview with Carl Gustav Jung, the famous Swiss psychiatrist. Not only is this a rare glimpse into the world of a master therapist it is, to me, an account of the ‘inner void’ that seems to lie at the core of addiction. 

For those that prefer not to watch the entire video, the key section of the video (2:22 - 7:54) has been transcribed as follows:

Background

Jung: A case where there was an intelligent, young woman, she was a student of philosophy, very good mind; where one would expect easily that she would see that I am not the parental authority but she was utterly unable to get out of this delusion. And, in such a case, one always has recourse to dreams: it was just as if one would ask the unconscious “now what do you say to such a condition?” You see, she says in her conscious “of course I know you are not my father but I just feel like that; it is like that: I depend on you …”

The Therapy Session

Jung: Now let’s see what the unconscious says. Now the unconscious produced dreams in which I really assume the very curious role … she was the little infant, she was sitting on my knees; I held her in my arms. I was really tender father to the little girl. And, more and more, the dreams became empathic in that respect; namely that I was a sort of giant; and she a very little, very human, thing you know like a little girl in the hands of an enormous being; and the last dream of that series was … I cannot tell you all the dreams; was I was out in nature, I stood in a field of wheat that was ripe for harvest and I was a giant and I held her in my arms like a baby and the wind was blowing that field of wheat. Now you know when the wind is blowing over a wheat field there is waves; and with these waves I swayed as if putting her to sleep and she felt as if being in the arms of a god; of the godhead.

“Now the harvest is ripe, and I must tell her. And I told her, “what you want and what you project into me - because you are not conscious of it - that is, you have the idea of a deity you don’t possess. Therefore you see it in me. That clicked.”

“She suddenly became aware of an entirely heathenish image that comes fresh from the archetype. She had no idea of a Christian God or an Old Testament Yahweh. It was a heathenish God, a God of nature, of vegetation, he was the wheat himself, the spirit of the wind; and was in the arms of that numen.” *

(*) Numen - a god or spirit believed to inhabit a place or being.

Jung’s Interpretation

Jung: That is the living experience of an archetype. That made a tremendous impression upon that girl and instantly clicked. She saw what she really was missing; that missing value, which was in the form of a projection in myself and made myself indispensible to her. She saw he’s [Jung] not indispensible; because it as the dream says, it is in the arms of that archetype … idea. That is a numinous experience. And that is the thing people are looking for: an archetypal experience, that gives them an incorruptible value. They depend upon other conditions, they depend upon their desires; their ambitions; they depend upon other people because they have no value in themselves. They have nothing in themselves. They are only rational, they are not in possession of a treasure that would make them independent.

“But when that girl can hold that experience then she doesn’t depend any more; she cannot depend any more; because that value is in herself, and that is a sort of liberation.”

“And that, of course, makes her complete. Inasmuch she can realize such a luminous experience, she is able to continue her path, her way, her individuation.”

WHY THE FASCINATION WITH THIS VIDEO

Despite it’s title, neither transference * nor archetypes is central to my interest in this video. Furthermore, dream analysis is typically not a technique we utilize at Sunshine Coast Health Center. ** So why, you may ask, the fascination with this video? For me, it’s the “numinous experience” described by Dr. Jung as the moment when his client, the philosophy student, was able to free herself from her unhealthy fixation on Dr. Jung.

Obviously, Dr. Jung is not some sort of drug but, according to Dr. Jung himself, his client was “dependent” on him as a father figure. From my personal experience with our chemically dependent clients, there seems to be an inner void (clients often call it their ‘donut hole’) that finds them grasping for anything external: drugs, alcohol, cigarettes, sex, gambling, anarchy, etc. Those clients that complete addiction treatment and go on to live happy lives seem to discover an inner “treasure” that, as Dr. Jung points out, makes them independent, complete, liberated.

(*) Transference: the emotional bond that develops on the client towards his analyst/therapist.

(**) Note: Sunshine Coast Health Center does, however, use depth psychology, which is related to archetypal psychology in that they both employ the model of the unconscious mind as the source of healing and development in the individual.

BILL WILSON’S ‘WHITE LIGHT EXPERIENCE’

For Bill Wilson, a similar moment of transformation was the beginning of long-term recovery for the famous founder of Alcoholics Anonymous. During Wilson’s fourth admittance to Towns Hospital in 1934, Bill Wilson recalls his ‘white light’ experience: “Suddenly the room lit up with a great white light. I was caught up into an ecstasy which there are no words to describe. It seemed to me, in the mind’s eye, that I was on a mountain and that a wind not of air but of spirit was blowing. And then it burst upon me that I was a free man.” *

Source: Kurtz, Ernest (1979) Not-God: A History of Alcoholics Anonymous, pgs. 19-20.

CONCLUSION

I will be the first to admit that these peak experiences are rare and that holds true for the clients at our alcohol and drug rehab program. For them, addiction recovery is more gradual, with repeated advances and retreats. Regardless of how long it takes, however, the objective of personal transformation remains valid.

Oftentimes, it’s a difference in language. For example, what Dr. Jung calls a “luminous” or “archetypal” experience, we at Sunshine Coast Health Center call “personal transformation.” The end result of such an experience, what Dr. Jung calls “incorruptible value,” we call “meaning and purpose.” However, this video, if anything, further reinforces my sense that our current approach to treatment is heading in the right direction.

By Daniel Jordan
General Manager
Sunshine Coast Health Center

Earlier this week, I had a thoroughly enjoyable discussion with Paul Murray, a private-practice psychologist based out of West Vancouver, British Columbia. Our discussion covered a lot of ground but one topic that I found particularly engaging was the notion of powerlessness. Both Paul and I marvelled at how two people declaring powerlessness over their addiction may have two very different treatment outcomes based on fundamentally opposing underlying intentions: one may reflect a preference for the status quo while the other could be ready to turn over a new leaf.

How Powerlessness Became Synonomous with Addiction

Obviously, this idea of powerlessness is not something that Paul and I invented. As friends of Bill W. will tell you, powerlessness lies at the heart of the 12 Steps of Alcoholics Anonymous and it’s first step: We admitted we were powerless over our addiction - that our lives had become unmanageable. Al-Anon has also consoled family members for years by telling them that they, too, are powerless over alcohol.

Over the years, however, Alcoholics Anonymous and other 12 Step programs have had their fair share of critics with powerlessness frequently at the heart of the dispute. For example, SOS, has created an alternative self-help group for “… those people who find that the ideas of reliance on a Higher Power or God, “powerlessness” and the emphasis on character defects to be an obstacle to recovery.”

The addiction treatment community has long since argued for and against the notion that individuals with addictions are ’powerless’. Powerlessness proponents tend to be traditional 12 Step treatment programs, physicians, and psychiatrists while those opposed tend to be psychologists, scholars, and mental health practitioners. The ongoing debate between these opposing camps has only hampered efforts by moderates to find common ground.

Furthermore, the debate over powerlessness and addiction is more than just a trivial concern judging by the vitriol one hears expressed on talk-back radio programs.

Defining Powerlessness

Let’s consider five different ways that powerlessness is understood in relation to addiction:

1) Powerlessness is a Choice

Recently, a book by Harvard psychologist Gene M. Heyman (*), Addiction: A Disorder of Choice, has suggested that individuals choose to be powerless. Dr. Heyman argues that addiction is voluntary rather than compulsory, and that addicts respond to incentives just like most other people. According to Dr. Heyman, interviews with drug users in recovery shows that quitting was preceded by such factors such as finances, family, career, and health.

People who suffer from diseases such as Alzheimer’s or schizophrenia, however, will rarely find improvement in their condition due to good intentions, even when followed by concrete steps. In other words, human beings are only truly powerless when faced with ‘real’ diseases.

One important difference between Dr. Heyman and other opponents to the concept of powerlessness, however, is that while Dr. Heyman believes that to remain powerless over an addiction is a choice, noone chooses to become an addict. As our Program Director, Geoff Thompson, often reminds our clients, children rarely tell their parents ”when I grow up, I want to be a drug addict.”

(*) Note: For more information, see Interview with Gene M. Heyman.

2) Powerlessness is a Lack of Willpower

Society often believes that, with a little bit of willpower, people can simply stop using drugs or alcohol or reduce their consumption to socially acceptable levels. This mistaken belief, however, is actually a failure to distinguish between the separate, progressive stages of compulsive use of chemicals or processes: abuse and addiction. As Carlton K. Erickson points out in his book, The Science of Addiction: From Neurobiology to Treatment, addiction is a failure to stop using in spite of negative consequences. Abusers of alcohol or drugs, most notably college students, will often stop excessive consumption when they are in a new environment where getting high or drunk is no longer encouraged, or when they experience negative consequences. For individuals with addictions, however, drinking or drug use will continue even after job loss, divorce, or illness.

Even for people who don’t struggle with addiction, however,  it is arguable whether simply trying harder is an effective method for attaining any worthy goal. Most who have tried to lose weight or have implored their children to improve their grades know that trying harder may work, but only temporarily. Without an effective strategy and implementation plan, willpower is not enough.

3) Powerlessness is the Same as Helplessness

Helplessness can be understood as the tendency for some addicted individuals to assign blame to external forces and avoid taking personal responsibility. So, when someone says “I am powerless to stop my addiction” they could be actually saying, for example, “my drinking wouldn’t be a problem if only my wife would get off my case.” This lack of accountability is typically obvious to everyone but the individual with the addiction, including those of us working in the field.

However, while it may be easy to spot helplessness in another person, determining the root cause of why someone is so incapable of taking action is far more challenging. For example, helplessness could be a response to childhood trauma, a phobia or depression. Taped recordings of AA Founder Bill Wilson suggest that he understood the link between helplessness and addiction. Following the sudden death of his childhood sweetheart, Bertha Banford, Bill Wilson concluded that “He knew now …. His need, his loving, didn’t matter a good goddam. His wanting, his hunger and desire, meant nothing to the terrible ongoing forces of creation and he would never forget this truth which he saw and accepted that night.” * Helplessness, as illustrated by Bill Wilson’s recollection, may not simply be a result of laziness but a reflexive survival mechanism in respsponse to painful past experience.

(*) Source: Thomsen, Robert (1975) Bill W.

4) Powerlessness is a Symptom of a Disease

The disease concept of addiction found an early advocate in the recovery movement with Dr. William Duncan Southworth, physician to AA founder Bill Wilson. By providing a physiological explanation for why alcoholics are powerless over their use of alcohol and through his close affiliation with Bill Wilson, Dr. Southworth helped shift the balance of power in addiction from organized religion to medicine. 

Dr. Southworth’s observation that alcoholism cycles between mental obsession and physical lack of control (or powerlessness) has stood the test of time. Defined this way, powerlessness is a common criterion used in the assessment of addiction. For example, Sunshine Coast Health Center recommends an addiction test, called the 3 Cs of Addiction: compulsion, control, and consequences. * What the 3 Cs test calls compulsion and control, Dr. Southworth calls, respectively, mental obsession and physical allergy. While the term ‘allergy’ may be arguable, alcoholics do appear to be physically powerless to stop drinking once the obsession to drink overpowers their decision not to drink.

(*) Note: see the Helplessness section above for information on the 3rd C - consequences.

5) Accepting Powerlessness is Critical to Lasting Recovery

First of all we had to quit playing God.
~ Alcoholics Anonymous, p. 62

This last example of powerlessness has been intentionally left to last since, unlike the first four definitions, this last definition will conclude this blog article on a hopeful note. Fortunately, many individuals have successfully come to terms with their addiction and have gone on to lead fulfilling lives in recovery. At Sunshine Coast Health Center, clients learn spiritual principles that often prove helpful as basic action guidelines in recovery. One spiritual principle, acceptance, seems particularly effective and is closely tied to the notion of powerlessness.

In his book, Not-God: A History of Alcoholics Anonymous, Ernest Kurtz suggests that “from the alcoholic’s acceptance of personal limitation [read powerlessness] - arises the beginning of healing and wholeness.” Furthermore, this message of “not-God” is, for Ernest Kurtz, an “affirmation of one’s connectedness with other alcoholics.” At Sunshine Coast Health Center, we wholly endorse the notion of connectedness, however, would extend it further to include family members, co-workers, and friends.

Conclusion

In the early days of Sunshine Coast Health Center, I will always remember how insistent one of our first clinicians was on the importance of making sure clients understand, at a gut level, Step One . As far as he was concerned, without a firm understanding of powerlessness, it is difficult, if not impossible, to properly work the remaining 11 Steps. However, I have learned over the years that words can often have multiple meanings and can trigger certain emotions depending on the perspective of the listener. By avoiding rigid absolutes, Sunshine Coast Health Center believes that it’s integrated approach allows clients to embrace multiple perspectives and, therefore, to appreciate the complexity that is inherent in any meaningful discussion on addiction.

Geoff Thompson, MA, RCC

Geoff Thompson, Program Director for Sunshine Coast Health Centre, discusses why it is important not only to live in the present, but to keep an eye on the future.