Drug Rehab Center

By Geoff Thompson – MA, CCC
Program Director
Sunshine Coast Health Center

Introduction

Anyone interested in recovery can find any number of videos and books that define what an addiction is and how to recover from it. Today, of course, the brain chemistry argument is huge, and if one believes that drugs hijack the brain then recovery is a matter of simply doing helpful things until such time as the withdrawal lessens. Today, this includes an emphasis on relapse prevention techniques, diet, exercise, sleep hygiene, and so on. Other experts provide us with help on how to deal with anger and other emotions that seem to accompany addiction. Still other experts recommend understanding one’s place in the family and how addiction has been a response to family dysfunction.

All these are valuable, but they seem to tell us that the key to recovery is to focus on this or that aspect of life. At Sunshine Coast Health Center, we help clients with any medical issues, diet, and exercise and with any psychological issues such as anger, guilt, depression, anxiety, etc. In addition, we help clients with family matters. But we place a special emphasis on what it means to be human. There are certain dynamics in being human that seem to be true, regardless of what family we grew up in or what country we were born in or what era we lived.

It’s interesting that some people seem to think that addicts shouldn’t be human in recovery or, at least, that they magically don’t operate by the same principles that all human beings operate. For instance, some people seem to think that addicts can just change habits and thinking that they’ve used to survive in the world for years. Stick the addict in a treatment center for a few weeks, and he’ll be cured.

Many of our clients have this idea as well. They rely on exercise and diet to keep them clean and sober, or they believe that attending 12-step meetings alone will lead to the good life, or they think that if they could just reduce the stress at work they will have no problem with substances. But human beings are very complicated creatures. And we know that addiction operates at deep psychological levels — if it didn’t, we would have eliminated the problem a long, long time ago.

At Sunshine Coast, we define addiction in line with the great psychiatrist, Viktor Frankl, who believed that addiction was a response to living a life that has little personal meaning. As valuable as exercise, diet, relieving anger or depression, reducing stress at work, and other tactics are, recovery has to address the feeling that life is, to borrow a phrase from Narcotics Anonymous, “meaningless, monotonous and boring.” Such a feeling affects us as total human beings — physically, emotionally, mentally. Because it is at the core of addiction, the emptiness that addicts talk about their lives pervades their physical bodies, their attitude, their emotions, their thoughts, their actions.

Human beings live by principles that seem to operate regardless of what family one is raised or what country or what era. If we do not account for these human qualities, chances are that recovery will not be very successful. Addiction is an entirely understandable response if one feels he doesn’t belong, he is different, that sober life is boring, and so on. It is a very human response to do something that makes one feel vital and alive, even if it lasts only temporarily. 

In this article, we’ll look at a few of these principles of what it means to be human. And, of course, we’ll borrow some ideas from Viktor Frankl.
 
Principle #1: You are a Whole Human Being (Wholeness)

When we follow up with clients after they have left treatment, we are often surprised that they focus only on one part of themselves. Perhaps they spend enormous time and energy in a recovery group, such as AA or NA. Perhaps they spend a great deal of time focusing on their physical health. Perhaps they spend the vast majority of their time focused on family.

All this is good. But it’s important to remember that people cannot be reduced to one or two or three aspects of their lives. People are complex wholes. The great psychologist, Rollo May, said that each of us lives in three worlds at the same time. One world is the physical world, another is our interactions with others, and the third is the world inside our heads. Paying attention to our physical health is important but so is our relationship with others and our self-awareness. Going to AA or NA meetings is great, but so is the time spent with families and friends in the community, and time we reflect on our own lives.

One of the things we’ve discovered from research is that the idea of “addiction” appeared only when people started to compartmentalize their lives. Work and family and play more or less happened in the same place, often at the same time. Then what is known as the industrial revolution hit (somewhere around the mid-1700s). We started going to the workplace, which was different than the home. When we wanted a drink, we went to the Public House (the Pub). There was a time for work and a time for family and a time for fun and a time to be religious. We started fragmenting our lives. We began living our lives in separate compartments, as if we were not whole, unified individuals. We put on a different face depending on where we were, behaving differently depending on whether we were at work or with family or with friends or at church. Interestingly, the industrial revolution seems to be a time when major mental health issues suddenly appeared.

Principle #2: You Must Grow as a Person (Growth)

One of important things to realize about yourself is that well-being depends on your growing emotionally as a person. This means overcoming challenges, pursuing dreams, gaining self-awareness, being true to yourself. Psychologist Abraham Maslow described in 1954 a theory of motivation, which has laid the foundation for the principle that the individual has an inherent tendency toward self-actualization. Similarly, psychologist Carl Rogers believed that “there is an inevitable directional course in people and all forms of life toward increased complexity, differentiation, evolution, completion, and wholeness.”

Those who do not grow run into trouble. Psychologist Rollo May said that if someone is “not growing toward something, he does not merely stagnate; the pent-up potentialities turn into morbidity and despair, and eventually into destructive activities.” What he meant by this is that each of us has a natural tendency to grow and develop mentally; if we interrupt this process, we run into big problems. The addict is one example of someone who stops growing because his or her mission in life is to satisfy the addiction, leaving all those other things, such as love and dreams, forgotten.

What is particularly interesting is that modern research has indicated that if the addict can overcome barriers to this growth process, then a transformational change in values and beliefs often results. And you may recall from previous online programs where we talked about Joseph Campbell and his recipe for happiness: “Follow your bliss.” When you follow your bliss, when you are true to yourself, then it will feel as if hands are magically helping you through life. You will begin to meet people who seemed as if they came out of nowhere. In fact, they were there all along; you simply didn’t see them until you were on the right path.

Consideration #3: You are Responsible for Your Life (Responsibility)

Psychiatrist Irvin Yalom described what it means to be responsible for your life: “Responsibility means authorship. To be aware of responsibility is to be aware of creating one’s own self [identity], destiny, life predicament, feelings, and, if such be the case, one’s own suffering.” True, advances in psychology have shown that most of our decisions are unconscious, but we must ask, with Yalom, “Whose unconscious is it?”

The idea that each of us is the author of his or her life continues to be one of the most difficult for those in early recovery to grasp. It’s not a simple idea. It means that, fundamentally, your life is the result of the choices you make, as well as luck, where you were born, your genetics, and so on. But it is the choices that you make that have the most impact on the kind of life you lead, the amount of suffering you endure, how others see you, and how you see yourself.

Clients attending Sunshine Coast Health Center soon learn that our counsellors spend a lot of time trying to help them figure out how to take control of their lives – to be the author of their own lives. The AA version of this is “To thine own self be true.” Psychologically, this is necessary for good mental and emotional health. But it’s tough because it’s so easy to retreat to playing a victim or blaming others or life for suffering. In fact, it’s well known in the addictions field that addicts use drugs as an attempt to control their moods. The drug offers a proven, reliable method to achieve a certain altered state of consciousness. Well, at least for a period of time, until the strategy backfires.

Yalom was a firm believer that to be the author of your life, it was not enough to be aware of this fact—you have to do something. Action is an essential component of responsibility. This takes practice. It’s no good knowing that you are the author of your life if you continue to be passive and not stick up for yourself. It’s no good being the author of your life, if your actions don’t match your beliefs and values. It’s no good trying to be the author of your life when what is really controlling you is a drug.

Consideration #4: You Have Many Untapped Abilities (Potentiality)

Human beings have a remarkable capacity to dig deep inside when things get tough. When the going gets tough, the tough get going. Of course, when the going gets tough, some people crash and burn. But the reality is that they have it within themselves to overcome great adversity—if they believed it and were willing to work.

When people are motivated enough, they can find courage, resilience, hope, forgiveness, and other qualities that psychiatrist Viktor Frankl described as the “defiant human spirit.”  Of course, all of us have to face certain givens of existence, such as the knowledge that we will die. But there are many positive givens of existence. Even in the worst possible circumstances, as Frankl told us about the Nazi death camps, human beings are still free to choose the attitude they take toward the situation. At Sunshine Coast, we promote the client’s ability to transcend biological and environmental limitations, take control of their lives, turn failures into learning experiences, and so on. 

Here is one example of an alumnus who tapped into his defiant human spirit. Harry was in his mid-20s and was overwhelmed by his family. He relied on them for money, since he spent all of his on drugs. He relied on them for his truck, since they had bought it for him and it was in their name. He relied on them for a place to stay, since they were helping pay his mortgage. In fact, Harry had relied on his family pretty much during his whole life.

His family told him that they would help him out with money but only under strict conditions: he had to be drug-tested regularly, he had to have a job, he had to go to 12-step meetings everyday, and so on. Harry told us that he felt as if he were “being held hostage.” At Sunsine Coast, we, of course, helped him understand that he is the author of his life.

He had to make a decision whether to accept the deal his family gave him or not. It took Harry most of his time in treatment to figure this out, but in the end he decided that the money was not worth the cost of his desire to feel free. So he decided to decline the family’s deal and went off on his own.

This was really a courageous act on Harry’s part. He gave up all the safety and ease of his family’s money for the unknown world, with only himself to rely on. Interestingly, within a year, he had found a good-paying job, rented a nice place, bought a car. When the family saw this, they too were very impressed. But, most important, Harry told us that he feels so much better now.

A Bad Attitude Doesn't Explain Why Addicts Struggle With Showing Up on Time

By Geoff Thompson, MA
Program Director
Sunshine Coast Health Center

Introduction

Weird as it may sound, researchers are beginning to take a long look at how people with addictions interpret time.

One reason for this interest is to better understand a very common phenomenon that all addiction counsellors face. Anyone who has ever worked or been a client at a treatment center knows that it’s almost impossible to get everyone together at a workshop at 9am or have people consistently show up to appointments on time.

Mainstream addiction counsellors often pull their hair out with the lateness and the missed appointments. Interestingly, they make sense of this situation by blaming the addict as irresponsible or, perhaps, passive-aggressive. They think that the self-centered addict is so wrapped up in his own life that he doesn’t care about another person’s schedule. Or they say that addicts’ lives are chaotic (which is why the need a structured program). Or they make sense of the lateness as a typical symptom of those who are trying to assert control over their lives — an unspoken statement that sends the message “You can’t tell me what to do.”

Most addiction treatment programs create structures that leave little opportunity for choice. The argument is that addicts need structure to deal with their chaotic life. Of course, since it’s difficult to get everyone in the same place at the same time, the usual tactic to deal with lateness and missed appointments is, at least in residential treatment programs, to threaten clients: “If you don’t show up on time for programming, then we will discharge you.” But making sense of lateness by suggesting that addicts’ lives are chaotic may not be all that accurate. A growing number of addiction experts tell us that lateness may be more a factor of how addicts make sense of time.

When you think about it, time is actually weird. Of course, we all know that a minute is a minute. It’s 60 seconds regardless of whether it is a minute in the middle of the night or middle of the afternoon, whether it’s a minute in Hong Kong or a minute in Vancouver. (Of course, Albert Einstein said this isn’t true, but for everyday purposes, it’s the same.)

Regardless of this factual knowledge of time, people usually have a different perception of it. For example, you know that time slows down when you are bored. On the other hand, time speeds up when you are absorbed in some activity. Younger people often complain that time moves too slowly; older people often complain that time moves too quickly.

Add to this that we are a very time-oriented society. Almost everyone wears a watch and owns a calendar. It is considered rude to be late for appointments, suppers, and so on. People complain that someone might be “wasting my time.” And there’s the old saying, “Time is money.” It’s almost as if time can be good, bad, or neutral. In fact, we say that we had a “good time” or “bad time.” And “Time management” is very important in our society.

For the nonaddict, time flows from the past to the present and then into the future. But for the addict, only present time is truly important. The present, the now, has the priority. In this month’s online program, we’ll look at the way those in active addiction and those in recovery look at time. Surprising as this may seem, it actually will help you in your recovery. Research is showing that how the recovering person interprets time is linked closely to how well they do in recovery.

Part One – Addicts Want Things NOW

Ryan Kemp, a researcher in the UK, who is interested in how addicts interpret time quotes a passage from the famous artist, Jean Cocteau:
Everything one does in life, even love,
Occurs in an express train racing towards death,
To smoke opium is to get out of the train while it is still moving

Time, for most people in active addiction, is ‘present’ time. What is important is ‘right now’, this moment. “Drugs,” says Kemp, “call out to the addict to be used, and to be used now!” Drugs have no future. How many times have you bought more of the substance that you planned to use—to save some for the future—only to use it all up as soon as possible. Kemp talks about the desire that addicts have to have “now” linger on. They want the present state of being high to linger.

On the other hand, the addict thinks that any state of discomfort will go on forever. If they have to wait to get high, then this is an unendurable wait and seems to go on forever. Drugs can end that miserable state of not being high. The waiting feels like a vacuum—what Sunshine Coast clients have described as feeling a “void” or “hollow.”

Studies on addicts have shown that they will choose a small reward right now, rather than delay gratification for a larger reward later. This is, in part, why many addiction experts say that addicts are impulsive. Similarly, almost everyone in active addiction grabs the immediate reward of using the drug, even though they know it will cause them problems in the future. Getting drunk the night before having to work, getting loaded before having to write a school test, using before the big family supper, getting money out of the bank for the drug even though they know they will have to answer to the family later, and so on are typical behaviours.

The past is not very meaningful for addicts—other than as a source of good stories about how they got away with something or some dumb, but funny, thing they did. For many in active addiction the past is filled with guilt, so they actively work to avoid thinking about it. In any case, it’s not useful for using drugs right now to spend time thinking about the past.

Similarly, the future has little meaning for addicts. Any competent addict knows that it would be useless to think about the future if they wanted to use drugs right now. If they started thinking about the future, then they would think about consequences of their actions, the withdrawal, the guilt, the money spent, and so on.

Part Two — The Problem of the Future for Addicts

Problems with the future give the addict more pressure to live in the present, in the now.

The first problem with the future is that if you live for the future, then you have to have some goal or mission. To really pay attention to the future, you have to be doing something, achieving something, working toward some goal. For example, if you want to learn how to play the guitar—a goal for the future—you have to put in all those hours and months of practice to achieve more competence. Or if you want to get a degree in forestry, you have to put in all those years of study. Addicts have little interest in working to achieve a future goal. They want a state of feeling that is immediate. Now.

Another problem with the future for those in active addiction is that it is not guaranteed. Things may not happen as the addict wants them to happen. The future is uncertain. And one thing that people in active addiction do not like is uncertainty. That’s why we say (affectionately, of course) at Sunshine Coast that all addicts are control freaks. They want to control life, but it’s impossible to control the future. Given that, there is little reason for paying attention to the future.

Part Three — Therapies that Do Not Help with Recovery

There are many types of therapy that are used to help people recover. Every few years, William Miller, a world-renowned addiction expert, ranks how well about 50 official therapies work for addicts in recovery. You may have heard of some of them: solution-focused therapy, motivational therapy (this is Miller’s), cognitive-behavioral therapy, community reinforcement therapy, relapse prevention therapy, and so on.

We have a good idea of types of therapies that just don’t seem to work for addicts. One of the most famous examples of a therapy that does not work is psychoanalysis, the type of therapy developed by Sigmund Freud. This therapy analyzes the person’s childhood experiences to help them understand that their problems are actually rooted in the past.

There’s a lesson here. Therapies that focus on the addict’s past have little success helping the person to recovery. At first, this may seem very odd. It seems reasonable that if the addict could figure out his past and how it left him with poor coping skills or whatever, then this would be useful for recovery. Add to this that these therapies often work well with people other than addicts.

But research is showing that the addict’s perception of time screws up the process. The past is really not the addict’s focus, so focusing on it is likely not that useful. And we’re discovering that any therapy that focuses on the past is not very successful: psychoanalysis, family of origin therapies, and so on.

Part Four — Therapies that Improve Recovery

So we mentioned that any therapy that focuses on the addict’s past will likely not help him very much. Research is showing that therapies that focus on the future are likely to offer much better help.

One of the most famous therapies in the addiction field is motivational therapy, developed mainly by William Miller and Stephen Rollnick. This therapy deals with the present but has a big focus on the future. It helps clients figure out what they truly want out of life and then supports them in achieving their goals.

Another successful program is the 12-step program. If you take a close look at the steps you will notice that they are aimed at the present and the future. This makes sense. Bill W., the driving force behind the 12-step program wanted you to go on and live a great life. He wanted you to feel alive right now, today, the present. The steps that deal with the past are merely there because you need to overcome jealousy and guilt and anything else that would be a barrier to feeling alive each day. But he also reminded you of the future. That’s one of the reasons why the last three steps are called the “maintenance” steps. He knew that you had a life to be lived.

Part Five — Live in the Present but Keep an Eye on the Future

It is interesting that everything we’ve been talking about this month says that recovery demands that the addict make sense of time in a new way.

In active addiction, the addict is concerned only with present time, the now. The past and future have no positive meaning. The past is mainly a source of guilt, and, in any case, it does not help him get and use drugs. Living with an eye on the future demands that the addict accomplish something, follow a plan, live for some future goal. This is not a useful strategy for addicts to keep using drugs. Perhaps worse, the future is unpredictable, and so it can be dangerous. What if things don’t work out? There are no guarantees with the future.

In recovery, on the other hand, the addict needs to live in the now, but be oriented toward the future. For example, he has to work through cravings, which means giving up immediate relief for the goal of abstinence. He might have to put off some immediate reward by going back to school for training, for the goal of getting a new job. He might have to work to take risks and be uncomfortable in the moment, for the goal of meeting someone to love.

If you remember some of the wise people we have talked about in other online blog articles, you’ll recognize how important it is for recovery to keep an eye on the future. The great psychiatrist Viktor Frankl said that each of us has some mission to fulfill, some goal or goals to accomplish in this life. If the person does not achieve this mission or this goal, then they suffer. Joseph Campbell, the famous expert on mythology, said that the recipe for the good life is to “Follow your bliss.” There is a future that awaits you. And, of course, the AA chip says on one side: “To thine own self be true.” You have some life that awaits you if you follow what you truly want out of being alive.

But to find the good life means that you have to live more than in just the moment. You have to keep an eye on the future. This is very difficult for most people in early recovery (and pretty much impossible for anyone in active addiction). But it offers hope. It all depends on whether you choose to pay attention to the future.

Geoff Thompson, Program Director for the Sunshine Coast Health Centre, talks about overcoming fear to pursue your dream job or life’s ambition. Famed mythologist Joseph Campbell is discussed in regards to his classic phrase, “Follow Your Bliss.”

By Cathy Patterson-Sterling, MA RCC
Director of Family Services
Sunshine Coast Health Center

PART 3 OF 4

What Is The Gift Of Adulthood?

As our children mature, it is natural for we as parents to transition from the role of authority to one that more closely resembles being a trusted friend. It is a time where parents allow their children to grow into adults. As our children grow, so do we as parents where we can reclaim our own lives and return to some of our interests that were put on hold in order to raise our families.

Some of us parents, however, may hesitate to hand back to their adult children the responsibility of living independently. The reality, however, is that adult children who are developing responsibility for their own lives probably will struggle and their decisions, while not always perfectly executed, never fail to provide valuable life lessons.

When little toddlers learn to walk, their first steps are always unsteady. A few falls are inevitable. It is by falling and failing, however, that humans come to terms with reality which, in the case of a toddler learning to walk, is gravity.

Similarly, our adult children are also dealing with the realities of life such as paying the bills, embarking on a career, and finding a life partner. During this time, we as parents need to remember that, beyond providing words of encouragement and the occasional steadying hand, the bulk of the work remains with our children.

Will our adult children accept the challenge? Some will embrace this opportunity while others will do so kicking and screaming. In the case of the latter, it behooves us as parents to listen as objectively as possible, acknowledge our parenting mistakes when necessary, then support our adult children to face the most pressing challenge currently awaiting them in life.

Along these lines, here are six recommendations for parents who are supporting their adult children  as they begin to embrace their own adulthood:

Letting Go Tip #1 – Accept the Consequences

Accepting consequences is the very essence of learning personal responsibility. Any attempts by we as parents to remove negative consequences is a step backward for our adult children. 

If we are invited into solving our adult children’s problems then there must be an accountability measure in place. For example, if we loan money then there needs to be a repayment plan or a condition in which money is provided for schooling so long as the person is passing courses, staying sober, etc.

Conversely, we should be quick to give our adult children credit when credit is due for making the right decision. Our adult children may not also recognize their accomplishments so, by recognizing these, we as parents can encourage additional positive consequences in the future.

Letting Go Tip #2 – Look Past Short-Term Setbacks

There is no such thing as failure when our adult children assume greater personal responsibility. After all, personal responsibility is a verb, not a noun. In other words, personal responsibility is something that adults do, not something they possess. A mistake today will teach us how to get it right tomorrow. Furthermore, as a parent, it is important to remember that our adult children’s setbacks are not reflections on our character or our parenting skills.

Letting Go Tip #3 – Provide Emotional Support

As parents, it may be difficult to watch our children struggle through the process of learning personal responsibility. However, this doesn’t mean that we withdraw all support. Emotional support is something we all need, particularly when it is provided by a family member. Financial support is a poor substitute compared to the humanizing, empowering effect of emotion support.

A good metaphor to remember is to “walk alongside” our adult children rather than “walking ahead” to clear away problems or challenges that lie on their path. Walking alongside our adult children may sound like, “Wow! That is difficult. I wonder how you are going to deal with that” or “Yes, that does sound stressful. What did your recovery team tell you to do about that?”

Letting Go Tip #4 – Listen First, Hesitate Before Giving Advice

Further to Tip #3, emotional support sometimes means taking the time to simply be with our adult children and listen. All too often, we instinctively want to help our children by giving advice. However, when we listen we also provide the opportunity for our adult children to come up with their own solutions. When we listen in such a way that supports our children to come up with their own solution, we are practicing active listening. Active listening is much more rigourous then passive listening, which typically involves waiting for our turn to speak with little regard for the speaker.

We as parents also need to remember that what worked for us in the past may not always solve the current challenge facing our adult children. So, giving advice not only prevents active listenting, it may even be the wrong advice!

The next three tips are further along in the process of developing personal responsibility and are intended more for us as parents than for our adult children:

Letting Go Tip #5 – Hesitate Before “Collaborating”

Similar to our instinct to giving advice, we as parents instinctively may want to collaborate with our children. The truth is, however, that our children may prefer to work without our involvement. Although this may sound similar to Tip #3, the difference is that our adult child is no longer coming from a place of need but, rather, is fully engaged in the creative process.

For example, our adult children may become excited about post secondary education so we as parents rush out and get the course calendar and fill out the application forms ourselves in fear that our adult child may lose motivation. In essence, we have actually created the opposite effect by dampening their spirits. Instead, as parents we may need to give our adult children the space to create their own dreams.

Letting Go Tip #6 – Allow our Children to Choose Their Own Path

Each of us have our own unique path in life but sometimes, as parents, we may have difficulty accepting the chosen path our children. Examples include when our children choose a life partner, entering post-secondary education, or embarking on a career. We may have our own expectations of having a son- or daughter-in-law with similar values, socioeconomic status, religious perspective, etc. We may hope that our child carry on the legacy of the family business or entering an esteemed profession such as medicine, law, or engineering.

When asked for advice from the many admirers of his work, famed mythology expert Joseph Campbell advocated that we “follow our bliss,” meaning that we pursue our dreams no matter what others think. Mr. Campbell insisted that when we follow our dreams we are embarking on a heroic path of personal freedom. The path is not always easy, but Mr. Campbell promises a life infinitely more rewarding.

The business world abounds with individuals who followed their dreams and created profitable businesses that started out as mere hobbies, artistic pursuits, or crazy ideas. As parents, we provide a great service to our children by having faith that, they too, have the potential to join the long list of successful entrepreneurs or entertainers that followed their dreams.

Letting Go Tip #7 – Avoid Living Vicariously

Once our children have embarked on their chosen path, we may one day come to the realization that our children have actually exceeded our own accomplishments. While many parents are content to continue to provide the emotional support that, in part, contributed to their child’s acheivements in the first place, others may feel threatened by this success. 

For example, we have all attended amateur sporting events and have observed parents who seem just a little too obsessed with their sons or daughters winning at all costs. We may cringe when they holler at the referee, or berate their kids for not playing hard enough.

Similarly, we as parents must also learn to separate our own dreams from those of our adult children. Deep down, successful adult children may stir our own insecurities and failing to take notice of these insecurities can lead us to react out of jealousy and actually prevent us from embracing our own personal responsibility.

In part 4 of The Gift of Adulthood we conclude this series of articles by examining the transition to adulthood.