Press Trivializes the Treatment Process and Devalues the Suffering

I read this morning that Casey Johnson, heiress to the Johnson & Johnson fortune, died alone in her Los Angeles apartment after a well-publicized life of drugs and partying. I feel sad to hear yet another story of a celebrity who succumbs to addiction after cycling in and out of a series of boutique rehabs.

If you follow the news the story is familiar. Train wrecks of pop check into posh $100,000-a-month beachfront rehabs, where they demand - and appear to receive - special indulgence. In my mind this kind of press trivializes the treatment process and devalues the suffering that I see every day as a therapist at Cottonwood Tucson. In the morning paper I read of the rich and famous going to treatment to save face and then go to work and treat less famous patients who struggle to save their lives. Too often, the news media leave general public with the notion that treatment doesn't work.

I know better. As an "in the trenches" clinician, I see overwhelming evidence that treatment does in fact work. While miracles can be hard to quantify, the Substance Abuse and Mental Health Administration's National Outcome Measures show that treatment results in improvement in every life domain, including: abstinence from alcohol and other drugs, decreased symptoms of mental disorders and improved functioning in all major areas. The same study reports that those who have completed treatment also have decreased involvement with the justice system and are better able to find and keep safe and stable housing for their families.

That's what miracles sound like when measured in the dry, public sector language of the National Institute on Drug Abuse. For a more personal take on the value of treatment, please consider the words of a grateful mother who recently sent a thank-you note to one of the family therapists at Cottonwood:

"We are still floating. None of us will ever be the same.
Our son is doing great - happy and clean out in
California. He told me the other day that he had gotten
a sponsor. The sound of his laughter has returned to us.
We have gotten a miracle."

I wish you could have had one too, Casey.

Jeffrey C. Friedman, LISAC
Primary Therapist
Cottonwood Tucson

Gratitude for Gifts Received

What are You Grateful For?

As the New Year approaches I find myself thinking of how different my life is after 22 years of sobriety. Today I am grateful, not just for the countless gifts I have received but also for the life lessons that brought me to Alcoholics Anonymous. At one of the first AA meetings I attended in 1986 the 12 Promises of Alcoholics Anonymous were read. Being sober only a few days and still feeling very sick and tired of feeling sick and tired, those Promises sounded unbelievable. I asked several people at that meeting where I could find the 12 Promises in print and received the same response from every person! The 12 Promises are in the "Big Book" of Alcoholics Anonymous. Read the book! They also suggested I "keep coming back."

Since then I have read the Big Book several times over and continue to work the 12 Steps of Alcoholics Anonymous. True to the word "promise", the 12 Promises have all come true in my life. Although many of the life lessons that brought me to this point in life were painful or at best unpleasant, they also brought me to a place of gratitude and they serve as good reminders of what I could go back to if I chose to pick up a drink or some other mood altering substance.

When I came to Alcoholics Anonymous I regretted my past, lived in constant fear, and was full of self pity. I was selfish and self seeking and was forever trying to fill what my first AA sponsor taught me was a God-shaped hole with a square peg. Today that hole has been filled with my higher power, who I choose to call God, the loving people in my life both in and outside of AA, and the fullness of a sober life. I truly have a new freedom, a new happiness, and serenity. Through working the 12 Steps I have cleaned up the wreckage of my past and have become the daughter, sister, aunt and friend that I had always hoped to be. In my 19th year of sobriety I even got married for the first time!

When I got sober gratitude was just a word, not a feeling. I recently sat down to write a list of 5 things I was grateful for and realized that I couldn't stop at just 5. I have so much in my life that I am grateful for, and as I focus on what I am grateful for the list continues to grow.

What gifts are you grateful for in your recovery?

Leslie W.
A Grateful Member of Alcoholics Anonymous

Sober Holidays From Cottonwood de Tucson

A recent article in the New York Times, It's the Holidays. How About Just One?, (Jim Atkinson, December 8, 2008) caught our attention. The author, an alcoholic with 16 years of sobriety, describes the cultural discourse that supports and encourages the over-use of alcohol at most events during the holidays. The readers, in this case two family therapists at Cottonwood Tucson, were interested to better understand why people continue to drink, or go back to drinking, despite seriously devastating consequences (Vicki) and for a perspective on moderation versus abstinence (Dan). Atkinson addressed both issues.

According to Atkinson the same social message heard by the addicted and non-addicted brain is interpreted differently. The fundamental struggles of alcoholics, he believes, include the euphoric recall of drinking and the tendency to use the moderate drinking versus total abstinence arguments to support the alcoholic's denial. It was a well-written article combining research and anecdotal information. While we did not come away with therapeutic strategies guaranteed to guide alcoholics safely through the holidays, we did come away with respect and awareness.

Jim Atkinson's courage to address the elephant in the room is to be respected. The most difficult family experiences occur when addiction is present and unidentified. The family members walk around the issues without naming the root problem. The feelings and difficulties become chaotic despite efforts at a cover-up; the addiction exerts great influence on interactions. Atkinson addresses that elephant by saying that our culture promotes irresponsible drinking during the holidays. He explores how people understand their own addiction, the addiction of others, and the dilemma of whether a recovering alcoholic can ever have "just one." What he doesn't say is that once an individual is engaging in inappropriate drinking the same culture that encouraged drinking in the beginning is quick to condemn and shame individuals for their lack of "judgment." It is easier to point fingers when we deny our part in the responsibility of promoting irresponsible drinking.

I (Dan) was struck by the author's perspective on the need for total abstinence. Rationalizing one drink is not an option for him. His experience is that when he begins rationalizing moderation he will have increasing difficulty in maintaining moderation. It supports the current thinking of my colleagues and I that alcoholism is a progressive disease that does not stay at a minimal use level; recovery is an all or nothing choice, even during the holidays.

There is comfort in a community of others who understand the disease and have found their own systems of surviving the holidays and maintaining their sobriety. We appreciate all of the bloggers, many of whom present themselves as persons in recovery, who contributed their own experience, strength and hope to the discussion. It provides safety; a community available and willing to support progress, and a community where struggle is accepted and not judged. The unique and unpredictable trajectory of alcohol for each alcoholic is clear from Atkinson's work. For many people, parties and alcohol go hand in hand, blurring alcohol consumption and the social quality of the gathering. Many of the bloggers talked of needing to differentiate the alcohol from the social gathering. Separating holiday parties and alcohol can be difficult, yet necessary for sobriety and ultimately recovery. People discover their own path. Cottonwood Tucson uses a holistic approach to recovery, evaluating each individual and addiction, and any co-occuring disorders at intake, so that a comprehensive program takes into account those individual differences. And personal accounts such as this article by Atkinson provides the information that research does not typically include; information from the front line. In the end, the alcoholic is a critical member of the treatment team. Personal awareness of one's own best way to achieve stable sobriety is the best guide for getting safely through the holidays.

Vicki L. Loyer-Carlson, Ph.D., LMFT
vloyer-carlson@cottonwoodrecovery.com

Daniel Cook, LMSW
dcook@cottonwoodrecovery.com

Cottonwood Tucson
4110 W. Sweetwater Drive
Tucson, AZ 85745
(800) 877-4520
www.cottonwoodrecovery.com

Here is a link to the article:
http://proof.blogs.nytimes.com/2008/12/08/its-the-holidays-how-about-just-one/?emc=eta1

The Use of Journal Writing As a Recovery Tool

"In this poor body, composed of one hundred bones and nine openings, is something called spirit, a flimsy curtain swept this way and that by the slightest breeze. It is spirit, such as it is, which led me to write. . ."
Basho

Basho was a traveling poet and student of Zen meditation. He is most famous for a travel journal he wrote in 1689, Narrow Road to the Interior, which describes a trip he took to Northern Japan:

"In which year it was I do not recall, but I, too, began to be lured by the wind like a fragmentary cloud and have since been unable to resist wanderlust, roaming out to the seashores."

Basho's book is full of brief paragraphs, often followed by very short poems, which describe the people and places he encountered, as well as his own moods and perceptions:

"Autumn---even birds and clouds look old."

With a little guidance and encouragement, we can all benefit from journal writing. Like Basho, we can celebrate and record our journey into the "interior"---the landscape of our struggles, hopes, insights and experiences.

Therapeutic Journal Writing

James Pennebaker, a professor of psychology at the University of Texas, reports that writing, in-and-of-itself, is not necessarily therapeutic. In fact, many of his clients who suffer from anger and depression report feeling worse after writing in journals. The process of writing about feelings, without any direction or structure, seems to exacerbate suffering instead of providing relief.

Dr. Pennebaker notes however, clients do report relief from journal writing under specific conditions. For example, clients who record events and thoughts as well as emotional experiences report greater relief after writing. Combining these three elements of daily life into a cohesive narrative is an essential component of therapeutic journal writing.

Additionally, Dr. Pennebaker notes that clients who write for at least twenty minutes a day for three days in a row report greater emotional comfort after writing in their journal. People in recovery can utilize these findings to receive more benefit from writing.

The Use of Sentence-Stems and Repetition

Dr. Nicholas Mazza, founding member of the National Association of Poetry Therapy (http://www.poetrytherapy.org/), believes that structure is an essential component of therapeutic journal writing. Structure can help us explore uncomfortable feelings while providing a positive direction. Dr. Mazza favors the use of sentence-stems and repetition to create meaningful poems or paragraphs.

The following journal entry is copied, with permission, from the journal of a young woman in treatment for substance abuse. It represents the use of sentence-stems and repetition. It was written after the young woman agreed to end a romantic relationship, over the phone, that had been extremely abusive and destructive:

"I used to trash my emotional wreckage onto those who neither deserved nor understood
But now I peel off the layers and stand naked in the responsibility of my grief
I used to stab the dagger into my heart and demand any willing boy to pull it out
But now I'm stitching up the wound and reflecting on the scar tissue
I used to play on words to be a puppet for applause
Now I am down on my knees in amends for my guilt
I used to die in the apocalypse with every mistake
But now I live in the moment with every experience
I used to crave the bittersweet lingering of the past
But now I'm driven by the desire to savor the curiosity of tomorrow
I used to see God in the pleasures I was granted
But now I see God in the ironic challenges I face
There was a time when I let go of the past for him
And now, finally, I let go of all of this for me."

The author reports that she used the sentence-stem and repetition with great reluctance in her journal. She thought the structure would mute her voice and her range of emotions. However, she discovered that the structure helped her stay clear of the habitual thoughts and feelings toward her boyfriend and opened a new avenue of hope and strength. In fact, she reports being surprised by the power that comes out in the entry. She sees a quality of self-esteem she would like to experience more.

Considerations for Practice

Journal writing, as a recovery tool, provides a number of advantages. First of all, the journal is immediately available to us, whenever we need it. As we practice therapeutic journal writing, we can develop much needed skills in mood management and regulation. Hopefully, as we become proficient in the use of specific structures, we will discover important information about our barriers to recovery. This material, when uncovered, can deepen and enrich the counseling experience for both clients and counselors.

Perhaps most importantly, the therapeutic journal can become our record of progress in recovery. In the tradition of Basho's travel journal, the therapeutic journal becomes a mirror reflecting our spiritual struggle, our spiritual accomplishment, as well as our spiritual need.

Charles Gillispie, MFA, LISAC
Cottonwood de Tucson
4110 W. Sweetwater Drive
Tucson, AZ 85745
(800) 877-4520
cgillispie@cottonwoodrecovery.com
www.cottonwoodrecovery.com

Note: This article by Charles Gillispie was previously published in Arizona Together.

Recovery from Addiction Is A Process

I Learned How Easy It Can Be to Relapse

A young lady was having a wonderful last day at Cottonwood de Tucson's Rocks & Ropes Program. She was attempting climbs rated with difficulty levels of 6.5 and 7. She had completed 5 climbs and was very sure of herself. She told me she wanted to try a Level 8 climb. We found one and she started climbing with me belaying. As she climbed higher she said "the handholds are too small and too slippery."

She continued climb and with some effort she got two thirds of the way up the wall where she got stuck. After several attempts to complete the climb she finally asked to be lowered. From being happy, self confident and self assured, in just 10 minutes she had become fearful, angry, sullen, withdrawn and depressed.

After a few minutes we discussed what had happened on the wall. She said, "I am very judgmental of myself. When I came to Cottonwood and when I couldn’t do something I would give up on everything. At the end of that climb I went right back there. I learned how easy it is to relapse."

We then discussed that recovery is a process and not a terminal event, and the importance of having a plan to handle setbacks, be they family, school, social or recreational in nature.

Richard "Butch" Patterson, MS, CTRS
Recreational Therapist
Cottonwood de Tucson
4110 W. Sweetwater Drive
Tucson, AZ 85745
(800) 877-4520
www.cottonwoodrecovery.com

Aging & Addiction by Kathleen Parrish, LPC

Sam is a 73-year-old retiree living in an upscale, gated community located in the Southwest sunbelt. He has enjoyed a long and successful career as a real estate developer. Sam and his wife raised three happy and successful children, though he lost his wife of 45 years to cancer about two years ago. All who know him think of Sam as witty, intelligent, and thoughtful. Sam is also an alcoholic who, for the past six years has been addicted to prescription pain medication...

Click here to read the story in .PDF format from Arizona Together,Arizona's Good News Newspaper.  

Written by our very own Kathleen Parrish the Clinical Director here at Cottonwood Tucson. We strive to provide a holistic approach to alcohol and drug addiction; treating mind, body and spirit. 

If you or a loved one needs help feel free to contact us today!

Farewell Letter to My Addiction

My sponsor asked me to write a farewell letter to my addiction. This is what I wrote.

Farewell, Dear addiction, you were there for me when I needed you most. When my mother died you were my comfort. When I was scared you made me feel safe. When I was alone you were always there for me. You comforted me through pain and sorrow and you were always around to help me celebrate my victories. I never gave you credit for all the times you stayed with me when I was at the bottom of the heap. You gave me a voice and although it was not a voice heard by anyone but me it was with me constantly, chattering away non-stop like white noise. All these times you were there for me. You gave me the ability to be invisible, a gift that served me well and probably saved my life. However, and there is a huge however, all these things you gave me came with a price. I was never allowed to grieve because I hid with you behind closed doors. I never developed courage because you told me that the substance I craved would take away all fear and protect me. I isolated and had no meaningful relationships because the wall between me and others (which you helped me build) was ten feet thick and made with stones of fear held together by mortar made of resentments, lies, shame and guilt. You told me I was unworthy or others weren't good enough and most of the time I was unable to see a person's true self because I was kept enveloped in a fog. The fog you created for me to keep me safe, in the shadows, unseen. My pain and sorrow grew because I never worked through it. And every time I felt some hope you were there to whisper in my ear, "You don't have to go there, stay here with me I will keep you safe. I am comfortable and I am your life." I listened to you thinking you were my closest friend. And then one day I heard a voice. A hand reached out to me. Gradually I stepped into the light. I saw a glimpse of you smirking as I fell back into your waiting arms time and time again. I heard you laughing as I told others about you. You thought I would never break free and sometimes I thought you were right. But there is something much stronger than you and that is God. I saw the light and I heard someone's sweet voice say, "You can have this - you can be free." All those years when I thought you were my friend you were scheming behind my back, slowly you robbed me of my dignity, joy, and faith and you did it with a smile and a lie. I always believed you until I saw the light and I saw the difference between the lie and the truth. So here we are. It has taken a long time. You and me are looking for different things. You want me bound, desperate and alone and I want release. I want to be free. I want to grieve, feel fear, grow courage, experience pain, hunger, happiness, love, disappointment, joy. I thank you and I release you. Go to wherever addictions go when they are no longer needed or wanted, when they have finally been exposed to the light. It's okay to leave I'm stronger now. I can see through the fog, I have seen the truth, I've experienced the light of God. We weren't made for each other anyway. I was meant to live and walk with a source greater than you, I was meant to be, to feel, I was meant to live unchained. Go attach yourself to another. You and I know longer exist together. I release you with love but I do release you completely. But know this, I will be watching. If I see you deceiving others I will share the light with them. I will expose you and your lies. So, you lier, cheat and thief, farewell, skedaddle, adios, arrivederci, ciao, auf Wiedersehen, so long, good bye, adieu, hit the road Jack and don't come back!

~ Anonymous