Three Things I Admire

My good friend and colleague, Carolyn, died today. I’ve thought about all the things that I’ve learned from her over the years. I’m so grateful for the things that she taught me. Here are my top three things that I admire about Carolyn:

1.    Our Wound is Our Gift.

Carolyn really understood that our "wound" is our gift. The greater our struggles and challenges, the more we have to give to others when we learn the lessons that those challenges provided. We become inspirations and models as well as teachers and guides. We are not here just for ourselves, but for something much greater.

She was an alcoholic who relapsed a number of times over a period of thirty years. She had a necklace made of dozens of 30-day chips from Alcoholics Anonymous. (Chips are the little circular pieces of plastic that you receive at an AA meeting when you’ve had thirty days of sobriety.) She became a drug and alcohol counselor because she REALLY understood addictions. And she helped thousands of alcoholics and addicts. She was loved by everyone. And she knew that she was no better than anyone else because of her wound.

2.    A Positive Attitude is a Choice.

I really admired Carolyn’s joie de vivre. Even as she was dying, she joked and laughed with us. She knew how to handle the stress. She wasn’t about to suddenly become depressed about dying. I can’t remember a time when Carolyn wasn’t excited about life. I believe she was able to be so happy because she worked on having a positive attitude and was fully present. She didn’t have a negative story running through her mind, like, “This is just awful.” She could always put a positive spin on any event that appeared to be negative.

3.    It's Not About the Money.

Even though Carolyn lived on social security, she was rich. She didn’t have money, but she was rich in friendships, rich in laughter, rich with stories, rich in experiences. She placed little value on money and lots of value on what really counts in life. We will miss her.

Enabled or Disabled?

When you're the parent of a substance abuser, it's often difficult to decide what to do. On the one hand, you love your child (no matter how old they are) and want to do everything possible to help your child, particularly if they seem to be missing some basic life skills (such as budgeting their money or paying their bills on time).  On the other hand, you don't want to enable them to continue to use drugs or drink alcohol. Addictions can be tricky. Let me give you a real-life example:

My oldest brother began to smoke cigarettes and drink alcohol in high school. Marijuana came shortly after that. My parents often didn't know what to do. Naturally, they did the best that they could, but it wasn’t enough. When he was eighteen, my brother joined the Marines. Five painful years later, he was discharged. He had a habit of going AWOL and had to make up his time for doing so. When my dad was assigned by the military to work in Taiwan, they had little time to decide what to do with my twenty-something brother.

Weeks before my parents were to be transferred to Taiwan for two years, they set my adult brother up in an apartment in Denver and found a job for him working in a gas station two blocks away from his new apartment. They asked themselves, "Are we enabling him?" Two years later when they returned, my brother was nowhere to be found. The gas station owner said that he only showed up for a few weeks before he took off. We saw him a few times over the next decade. He would visit for a week or two, and then leave. We knew that he was struggling with substance abuse and alcoholism, but we didn't know that substance abuse and mental illness are often associated with each other.

When we saw him, he would talk about the voices in his head that told him what to do. Clearly he was in need of psychiatric help. But this was the 70s, and my parents weren’t very tuned in to seeking help. Jim talked about riding the rails (as a bum) all over the USA. He introduced us to some of his very interesting homeless friends, who also heard voices. He tried a few jobs over the years, but never stayed with a job. He needed to be free. And he needed to do what the voices told him to do.

Then my parents moved again and there was no way to notify Jim. So we lost touch with him for twenty-five years. Twenty-five years! When my sister located him through the Salvation Army, we were all grateful.

My brother is schizophrenic. Thank heavens he now lives with my widowed dad and they take care of each other. My parents took him in and made sure that he got enough to eat each day. He’s clearly disabled, but doing well as long as he takes his medications (which he does as a condition of living there). He no longer smokes, drinks, or uses illicit drugs. This was also a condition of living at home. And Jim was just plain tired of living the life of a homeless man. He was in sad shape when we found him—thin, toothless, and frightened.

So, what do parents do when they have an adult substance abusing child who clearly needs help? Talk to a professional….at length. You've got to figure out if your loved one is disabled or enabled. It's too difficult for a family to try to make these kind of distinctions on their own. There are often no easy answers. Boundaries and rules need to be clearly defined. Love needs to be shown. A contract needs to be made in many cases. But I’m here to tell you, there are often very happy endings. Good luck and God bless.

How to Talk to Your Kids if You Did Drugs

Teenage drug abuse is a serious problem and you don't want your child to have self-destructive habits. You, in fact, did drugs yourself. You know a lot  about it and you have valuable opinions. Addiction can lead to a lot of misery. A few things to consider when talking to your kid:

1. This isn't about you.

We all want to warn our kids against the dangers of drug abuse. But the single biggest reason so many of us are reluctant to start the conversation is because we're afraid we'll be asked that uncomfortable question: "Mom, Dad...did you do drugs?" So let's start by stating the obvious: This isn't about what you did or didn't do. It's about what your child is going to do or not do. So let's talk about how your personal experiences might help steer your child in a good direction.

2. Experts disagree.

For every therapist who recommends openness and honesty about your past, another advises caution. The fact is, you can say too much. A good place to start is by considering your child.  Some kids demand candor. Others are happy just to talk. Use your judgment. You know your kids better than anyone.

3.  When to lie.

In our opinion? Never. Some parents who used drugs in the past choose not to tell the truth, but risk losing their credibility if their kids discover the real story from a talkative uncle at a family party. Many experts recommend you give an honest answer--or no answer at all.

4. The whole truth?

Try to avoid giving your child more information than she or he asked for. (No need to reveal you smoked marijuana 132 times!) This is not a courtroom; it's a conversation.

5. Say what you mean to say.

Like other important conversations you'll have with your kids, the point you're trying to make is what really matters. In this case, it's crucial your kids understand that you don't want them to use drugs. Don't beat about the bush; say so. ("I don't want you to use drugs.") Then give your reasons why. ("Drugs are dangerous, expensive, unpredictable, distracting...") And yes, it's okay to have a lot of reasons.

6. What have you learned?

Before you talk, take stock. You've lived your entire life in a culture where drugs are a fact of life. From the headlines on TV to your own experiences, you've seen too many examples of how drugs can change young lives for the worse. Your own experiences with drugs are just part of the bigger picture. The real opportunity here is to share what you've learned.

7.  You could say it like this:

"I tried drugs because some kids I knew were experimenting, and I thought I needed to try drugs to fit in. It took me a while to discover that's never a very good reason to do anything. Do you ever feel pressured like that?"

8.  Or like this:

"Everyone makes mistakes and trying drugs was a mistake I made. It made me do some dumb things. And it's hard to look back and see that I got anything good out of the experience. I love you too much to watch you repeat bad decisions I made."

9. Or even like this:

"My experience with drugs is no guarantee that yours would be the same. Drugs affect everyone differently. So I wanted to share my experiences with you, because even if drugs didn't ruin my life, I've seen them ruin other people's lives. And God forbid you should be one of those people."

10.  Don't just talk. Listen.

You can anticipate that your child's first reaction when you raise the subject of drugs will be to be quiet. So do your darndest to make it a two-way conversation. Ask what they think. Ask if it's a subject their friends talk about. Ask what they think of celebrities who use drugs. Keep asking questions. And listen to the answers.

11. Stay calm.

Whatever happens, try not to raise your voice.  If you do lose your temper, try to catch yourself. It's okay to admit that these conversations aren't easy for you, either. And if things aren't going so well, suggest talking about it again another time. ("I didn't mean to surprise you or make you feel awkward. Let's talk again in a day or two.")

12. Good luck.

Yes, it's difficult to know how to talk to your kids about drugs. You don't want them to hold your history up as some kind of a precedent to follow, or as a tool to use against you.  But you may be able to use your life experiences as a teachable moment. So even if you're nervous, don't put off having the conversation. This isn't about your past. This is about your child's future.

This article as been reprinted by permission from drugfree.org.

Parents’ Checklist: Ways You Can Help Your Addicted Teen

Teenage drug abuse is a growing problem. Here are some commitments you can make to help your addicted teen. These suggestions are intended to help families who are working with a therapist. The therapist can point out which commitments will be most helpful to your family.

_____I’m willing to sit down and listen to my child. Really listen. I’m willing to do this often. I’ll ask my teen what I am doing that gets on his/her nerves. I’ll listen and take notes.

_____I’m willing to give up nagging, lecturing, guilt-tripping, yelling, judging, and moralizing.

_____I’m willing to “let the cat out of the bag.” I know that it takes a village to raise a child. Therefore, I’m willing to set aside my pride, abandon secrecy (except where it would be harmful to do so), sit down with my family and extended family to explain the nature of the problem, ask for help, brainstorm solutions, and really listen to suggestions from family.

_____I’m willing to spend time with my teen every week. Lots of time. I’m willing to attend family activities that may or may not be especially fun for me. I'm willing to spend time, even though I have a lot of work to do. I’m willing to enforce time together with my teen, even if he/she doesn’t want to spend time together.

_____I’m willing to set and enforce strict boundaries about drug/alcohol usage around my family. If my teen’s friend smokes, drinks, or uses drugs, that teen will not be allowed to come to our home. I realize I can’t control what happens outside the home. If I have using friends or family members, they won’t be allowed in the home if they are drunk, stoned, or high. We will not visit them when they are drunk, stoned, or high. No exceptions.

_____I’m willing to educate myself about becoming a drug-free family. I’m willing to read website articles, research areas where I know I’m weak, talk to other parents about the problem, humble myself so that I can listen for help, and ask for resource materials if I can’t find any. I’m willing to attend therapy or classes so that I can learn.

_____I’m willing to improve my parenting skills so that I’m an appropriate parent—not a drill sergeant, not a helicopter, not a marshmallow, and not a friend. I need to be firm, fair, and friendly. If necessary, I’ll sign up for a community class on parenting. I’ll read books on the subject, watch videos, research the internet, and listen to audiobooks. I realize that a strong, healthy relationship with my teen is absolutely vital.

_____I’m willing to look at my own addictions. If I smoke, drink alcohol in excess, or use drugs (even excessive reliance on prescription medications), I’ll get the help I need so that I can quit. If I have other addictions, such as being a workaholic, churchaholic, rageaholic, foodaholic, or even chocaholic, I’ll get myself into treatment so that I can stop. I want to set a good example for my teen. Addiction runs in families. Ultimately, there are no secrets in a family. Sooner or later everyone knows anyway. Better to be honest if I want my teen to be honest.

_____I’ll look at my codependency. I realize that everyone in the family plays a role in the problem. Therefore, I have a role in this also. I’ll seek to find out what my role has been, and how I can change it. Perhaps I’ve been an enabler. I will take the problem seriously and work very hard to quit enabling. I’ll seek help from others, perhaps attend Al Anon, and ask how I can stop enabling.

_____I’ll look for community resources to address our family needs. If I’m a single parent, I’ll find a substitute parent of the opposite sex, a role model, to spend time with my teen.

Copyright © 2009 Kathie Keeler, All Rights Reserved. No part of this publication may be reproduced, stored, or transferred by any print or electronic means without the express written consent of the copyright owner. Thank you!

Does Relapse Mean Treatment Failure?

Relapses are Painful

"Relapse should not be viewed as a failure; it is part of a learning process that eventually leads to recovery," says Susan Merle Gordon, Ph.D. Even though relapses are painful for the addict and hurtful to the addict’s loved ones, a relapse can often help the addict discover where his efforts have been incomplete. Unfortunately, many people are under the mistaken impression that a relapse with drugs means that the program failed. Let’s examine why this belief is mistaken.

Addiction is a Disease

Although addiction starts with a choice to use drugs or alcohol, it can progress to disease proportions in many people. Addiction is a pervasive, progressive, chronic disease. Pervasive means that it affects every area of the person’s life. Progressive means that it gets worse and worse over time. Chronic diseases are diseases of long duration and generally slow progression. Examples of chronic diseases and conditions are heart disease, obesity, osteoporosis, diabetes, asthma, arthritis, Alzheimer’s Disease and other dementias, and cancer.

Three Dog Nightmare

Chuck Negron, vocalist and founding member of the band, Three Dog Night, is a good example of how the disease of addiction can progress. Although he’s an extreme case, his struggle with addiction is illuminating. Remaining in the grip of addiction for nearly 20 years, Negron wasted away to 126 pounds and went through 36 rehab programs. In his book Three Dog Nightmare, he details his ordeal with this painful disease. He sold his gold records to subsidize his $2000 a day heroin habit. He talks about overdoses, car crashes, gun play, suicide attempts, and contracting hepatitis C. Did he hit bottom? Many, many times. And yet the disease of addiction ruled his life for decades. He has been clean and sober since his 37th rehab. That doesn’t mean that the 36 prior rehabilitation programs were a waste of time and money. He clearly states that he learned important things from each one of the recovery programs that he went through. And he slowly made important life changes that helped him on his journey to sobriety. And as he matured, he began to look at his selfish, self-destructive path with more clarity. Each one of those 37 rehabs played a part in his recovery and helped him to look at himself.

How Many People Relapse?

Terence Gorski, internationally-famous lecturer and author on relapse and addiction states: “Relapse is not necessarily a sign of treatment failure. Between one half and two-thirds of all patients treated will relapse, but at least one half of all relapsers will find long-term recovery. The belief that relapse means that treatment failed ignores the fact that, for many patients, recovery involves a series of relapse episodes. Each relapse, if properly dealt with in treatment, can become the learning experience which makes the patient less likely to relapse in the future."
A woman that I’ve seen off and on in psychotherapy for the past 10 years has made great progress in addressing her chronic disease. Her path in addressing obesity has been typical of so many recovering addicts. She gained and lost well over 1000 pounds. She would diet, then binge. She felt sabotaged by every social event, birthday party, special holiday and Sunday dinner. She “cheated” on her diet (a relapse in recovery terms) many times and gave up on herself many times. As we slowly worked on her self esteem and identity, she made baby steps in changing her habits. Today she is at her ideal weight and has been at that weight for three years. Has she completely conquered obesity? Heavens, no. She’ll need to be vigilant about her habits the rest of her life. But she is absolutely not sabotaging her health the way that she was ten years ago. “Cheating” today involves eating a 1 inch square of birthday cake (rather than the whole cake ten years ago).

This Disease is Complex

The disease of addiction is extremely complex. Overcoming it involves learning new skills, new habits, allowing the brain (and organs) time to recover, making new friends, and learning how to make self-enhancing choices. This takes time—often years. Parents who take teenage drug abuse seriously and get help for their teens are helping this process to begin.  Any stepping stone along the path to recovery is helpful.

Recovery is a Process

And this process takes time. Recovery is not an event. That's why you don't hear people in AA say, "I'm a recovered alcoholic. They say, "I'm an alcoholic." They don't know what tomorrow will bring. None of us want them to relapse, but it's not uncommon if it does happen.

The ultimate purpose of treatment is to keep the patient alive until the addiction is finally controlled. Addiction too often results in suicide or accidental death by overdose, experimentation, or contaminated products.

Copyright © 2009 Kathie Keeler, All Rights Reserved. No part of this article  may be reproduced, stored, or transferred by any print or electronic means without the express written consent of the copyright owner.

10 Myths of Addiction

There are a lot of misconceptions about drug abuse and treatment. Here are a few of them:

• MYTH #1: You have to want treatment for it to be effective.

FACT: A very small percentage of people voluntarily seek treatment. People get into treatment for two reasons: either they were court-ordered into it or because loved ones urged them to do so. One research study after the next shows that people who enter treatment in which they face "high pressure" to confront their addictions do better in treatment than those who don't. The reason that they sought treatment in the first place is relatively insignificant.

• MYTH #2: People don't need treatment. They can stop using drugs if they really want to.

FACT: People who are addicted find it extremely difficult to achieve and maintain long-term abstinence. Long-term drug abuse actually changes a person's brain function, causing them to crave the drug even more over time. In the case of teenage drug abuse, it is absolutely critical to intervene and stop substance abuse as early as possible. This is because children become addicted much faster than adults. Consequently, they risk greater physical, mental, and psychological harm from illegal drug use.

• MYTH #3: You have to hit "rock bottom" in order for treatment to be effective.

FACT: There are many things that can motivate a person to complete substance abuse treatment before they hit bottom. For teens, parents and the schools are often the driving forces in getting them into treatment once problems at home or in school develop. Pressure from family members and employers can be powerful motivating factors for individuals seeking treatment.

• MYTH #4: Drug addiction is voluntary behavior.

FACT: Drug use starts as voluntary behavior. That's a fact.  But as time passes, the brain changes. The person goes from being a voluntary drug user to a compulsive drug user. Sometimes this happens in very dramatic ways, and sometimes it happens in very subtle, slow ways. The end result is that drug abuse becomes compulsive behavior; the use is out of control and sometimes even uncontrollable.

• MYTH: #5: Treatment just doesn't work.

FACT: Treatment can help people. Studies show that treatment reduces drug use by 40 to 60 percent and can significantly decrease criminal activity during and after treatment. There is also evidence that drug addiction treatment reduces the risk of HIV infection and improves the prospects for employment, with gains of up to 40 percent after treatment.

• MYTH #6: Treatment for drug addiction should be a one-shot deal

FACT: Addiction tends to be a progressive, chronic, and pervasive disease. Certainly some people can quit after deciding to or after entering a treatment program. But most of those who have a drug abuse or drug dependent disorder require longer-term treatment and, in many cases, repeated treatments.

• MYTH #7: Drug addiction is a moral problem, a character flaw.

FACT: Drug addiction is a brain disease. Changes in the brain range from changes in the molecules and cells that make up the brain, to mood changes, to changes in memory processes and in such motor skills as walking and talking. And these changes have a huge influence on all aspects of a person's behavior. The drug becomes the single most powerful motivator in a drug abuser's life. He or will do almost anything for the drug. This happens because drug use has changed the person's brain and its functioning in critical ways. (See Addiction--The Hijacked Brain)

• MYTH #8: You can't force someone into treatment.

FACT: Treatment does not have to be voluntary. People forced into treatment by the legal system can be just as successful as those who enter treatment voluntarily. Actually, they sometimes do better, as they are more likely to remain in treatment longer and complete the program. Nearly half of the teens in treatment are there because of the criminal justice system.

• MYTH #9: People can successfully finish drug abuse treatment in a couple of weeks if they're truly motivated.

FACT: Research indicates a minimum of 90 days of treatment for outpatient drug-free programs and residential programs, and 21 days for a short-term inpatient program to have an effect. To maintain the treatment effect, followup supervision and support are essential. In all recovery programs the best predictor of success is the length of treatment. Clients who remain at least a year or more than twice as likely to remain drug free, and a recent study showed teens who met or exceeded the minimum treatment time were over one and a half times more likely to abstain from drug and alcohol use. However, completing a treatment program is merely the first step in the struggle for recovery that can extend throughout a person's life.

• MYTH #10: Drug addicts are hopeless.

FACT: Drug addiction is a chronic disorder; relapse does not mean failure. A relapse can be triggered by so many things: playgrounds where they have used previously, playmates that they have used with previously, and playthings that trigger subconscious memories, in addition to family problems, work stress, and school stress. Recovery is a long process and frequently requires multiple treatment attempts before complete and consistent sobriety can be achieved.

Sources: National Institute on Drug Abuse, National Institute of Health; Dr. Alan I. Leshner, former director of the National Institute on Drug Abuse; “The Principles of Drug Addiction Treatment: A Research-Based Guide” (October 1999); The Partnership for a Drug-Free America.

Recovering from Codependency

I have seen so many spouses of addicts who have similar complaints. Last week I had a session with a woman whose husband's pornography addiction has been spinning out of control for many years. I've heard the same laments hundreds of times.

"I'm hurt that he chooses pornography over me."

"Why aren't I good enough for him?"

"I can't compete with the images he looks at online."

For many women, their husband's addiction feels like he's having an affair. I usually advise them, "It's not about you.  Addiction is a brain disease." What starts as voluntary behavior becomes increasingly less controlled over time as the practice becomes a habit and then an addiction . Although the neurobiological processes of addiction are still being studied, imaging shows specific abnormalities in the brains of some addicted individuals. Knowing this can help you to feel more understanding and less victimized by the problem.

"So what should I do?"

That's an important question. For every person who loves someone who is addicted, I advise this:

Learn to take good care of YOURSELF. You see, you have a recovery process, too, that needs to be addressed. You need to learn to shift your focus to yourself instead of watching out for your loved one. And learning how to become your own best friend is a big, big job.  I would recommend that you get some help for yourself. And be sure to include a support person on your journey to recovery. Attend twelve-step meetings for yourself. It's tough to do it alone.

Varieties of Parental Denial About Teenage Drug Abuse

• Minimizing-- “It’s not so bad. He only smokes pot.”

• Accepting the Con-- Your child manipulates you. You choose  to believe him or her.

• Ignoring the Advice of “outsiders” “It’s none of their business.”

• The Blame Game--(to your ex) “I hope you’re happy now. Look what you’ve done to your son.”

• Looking for Another Cause--“Tell me it’s anything but drugs.” A learning disability, depression, a health problem, ADHD

• Kids Will Be Kids--“When I was his age, I used drugs, too. I turned out OK.”

• Everything’s Fine-- If I ignore this situation, maybe it will all go away.

• Rationalizing “He’s had a hard life because he has diabetes.”

Sometimes when parents come out of the fog of denial, they become very hard on themselves and start blaming themselves excessively. For those parents who are blaming themselves, my advice is this:

Stop!

It won't help the situation to blame yourself. Did you bend her little elbow to take that first drink? Did you hold his fingers to hold that first joint of marijuana? No matter what problems exist in the family, ask yourself this: WHO USED? Your teen used OF HIS OWN FREE WILL. Don’t forget that. He did it knowing that it violates values and rules in our society. He did it knowing right from wrong. He did it FEARING that he would be caught. HE did it. Not you. He didn’t do it because you were too strict with him or because his parents got a divorce or because you work too hard. He probably first did it because his friends told him it felt good and he was curious. Or maybe he just wanted to be liked. Blaming yourself will NOT help your teen.

Parents’ Denial Checklist

Denial--It ain't just a river in Egypt. These questions may help you to pull your head out of the sand (in case it is). With teenage drug abuse being the enormous problem that it is now, any of these questions could strike a nerve; you may have a problem. If several of them seem frighteningly familiar, you probably do have a problem. And if you recognize them, you could need further help.

• Does your child have red eyes most of the time? Does he have his own supply of eye drops?

• Are you ignoring changes in your child’s behavior? Changes in his personality? Changes in his grades?

• Do you attribute unacceptable behavior to “being a teenager”?

• Do you blame your spouse or “the divorce” for your child’s problems?

• When your spouse or outsiders suggest that your child may have a problem with drugs or alcohol, do you listen? Or do you just get mad at the accuser?

• Are you feeling like a failure as a parent?

• Do you buy your child’s story that the drugs and/or paraphernalia that was found in his room or his car “belongs to a friend”?

• If you are a working mother, do you blame yourself for your child’s problems because you’re not in the home? If you’re a working father, do you blame yourself for your child’s problems because you have to work such long hours or you’re on the road a lot?

• If you went into your child’s room right now, would you find any signs of drugs? What would you do if you did?

• Are you blaming divorce or the absence of one parent in the home for your child’s behavior?

• Are you feeling anxious about the problems your child is having adjusting to growing up?

• Has your child admitted to trying marijuana? Will he talk to you about it?

• Does your child say that he only “smoked pot”? Do you believe him?

If you have answered "yes" to any of these questions, you may want to seek the help of a therapist.

The Rules of a Drug-Free Family

Teenage drug abuse is rampant. One of the protective factors that you can add is setting the rules for having a drug-free family. If you choose to have a drug-free family, here are the six basic rules:

1. No illegal drug use by anyone in the family or anyone who comes into the home

2. No misuse of prescription or over-the-counter drugs by anyone

3. No alcohol use by minority-age kids in the family

4. No routine use of alcohol or cigarettes by adults—that is, no use pattern that communicates drinking or smoking as an important or necessary daily function

5. No intoxication by adults

6. No use of drugs to lose weight, gain weight, go to sleep, relax, or wake up

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