Recovery Coaching Freud: A Novel of EPIC IMPORTANCE

Recovery Coaching Freud: A Motivational Interviewing Approach

Freud. I would have enjoyed being his recovery coach & helping him overcome his addiction to cocaine.

I would start with. Mr Freud tell me more about your cocaine use? He responds “it helps me write. not a problem”.

Leaning on my old school training and using a traditional approach I respond. “That’s your denial system you need to admit you are a garden variety addict and go to rehab”.

Not surprisingly Mr Freud becomes defensive and launches into a dissertation on defense mechanisms Given the fact he invented the concept of denial he renders me useless. He continues the Jedi mind trick. Steals my car keys and goes on epic crack run. I have ruined Freud.

His second session I use a motivational interviewing approach. I open. “Mr Freud tell me more about your cocaine use”

He responds. “I really don’t think it’s a problem. I use it to help me write”.

In classic motivational style I reflect back. “So. It makes writing easier”. Sigmund says- “yes I get more done”. Therapeutic rapport is established.

I affirm him. “Thank you for being so open. This is a tough topic”. He seems to warming to the relationship.

I move to highlight dissonance “tell me about any times when cocaine may have hurt your work performance”.

Sigmund relates a story of how he stayed up for 13 days on cocaine and in the middle of a drug induced psychosis formulated some strange theory that involves subconscious sexual attraction of children toward opposite sex parents. Sigmund says “that was some crazy shit. I’ve always regretted writing that. Now everyone thinks it true”…

I highlight change talk stating. “Maybe you should get some help so you don’t destroy mankind any further and spend eternity in hell”…

Sigmund reluctantly agrees…”maybe you’re right. I will go to rehab”.

So we spend the next 3 days calling facilities and no one will take his insurance. Eventually we find a faith based program that he can afford but they have a waiting list and by then Sigmund changes his mind. Fortunately we believe in multiple pathways and put together a plan of group therapy, FAVOR GREENVILLE support groups and hot yoga. Sigmund lives happily ever after.

 

Chapter 2: RECOVERY COACHING FREUD—The Recovery Plan
Mr. Freud jumped into his recovery plan full force. He attended a meeting everyday, continued his coaching with me and even secured a sponsor. His effort and involvement at HOT YOGA was described by the instructor Mr. Carl Jung as being “truly inspired as if Sigmund is the archetype of the downward dog”. Clearly I was the greatest recovery coach in the world.

However, as time progressed something strange started to happen. Mr. Freud got a job at Hot Topic at the Mall and had to work “strange hours” that cut into his meeting attendance. He also missed a couple of coaching sessions. A couple weeks went by and Sigmund just disappeared. A few random phone calls to Sigmund were not returned. It was apparent that Sigmund had disengaged from recovery. A little voice in my head told me it was not my fault. If Mr. Freud didn’t want recovery it was his fault. But my rational voice came in and said…”what could I have done different. Why do we blame the patient when the service doesn’t work”?.

The little voice in my head came back at me: “Rich…Sigmund is just taking his own will back and this demonstrates that he is not fully surrendered. He needs to go back out there and experience some more pain. Just sit back and wait until he really wants help. You can’t help the unwilling.”

But my logical and rational voice said: “Dude call his mom and see if she has seen him. See if you can do some outreach to bring him back into recovery. Yeah some people will call that professional enabling but those people will be obsolete in short order and who gives a shit what they think”.

So I called his mom. She was really hard to understand due to a thick Austrian accent. But after some time I realized that Sigmund was sleeping on her couch, refusing to pay rent, and eating all her food. Mom said she wasn’t sure what to do. I ask her “do you have anyone who could help us with an intervention”. She said she would ask his friends: Dr. Maslow, Dr. Frankl, and M.C. Hammer. She said his younger brother would “help out too if I can get him off the weed for a day”.

We met at Coffee Underground for the intervention preparation. I tried to review the basics of addiction and recovery but Dr. Maslow kept rambling on about self-actualization and heirarchy of needs while Dr. Frankl waxed poetic about making meaning out of suffering. Mr. Hammer kept telling me I couldn’t touch this and Freud’s brother was good and blazed. They struggled mightily with developing a recovery message that came from a place of love. They said things like “all addicts are liars and manipulative and you have to be tough. No love”. It was a difficult preparation. But eventually we got everyone involved to agree to a loving and kind recovery message. We scheduled the intervention for the upcoming Monday night after family group. We would meet at the FAVOR Greenville Recovery Community Center…I was anxious…
Stay tuned for…The Intervention…

Chapter 3: Recovery Coaching Freud: THE INTERVENTION
The intervention was scheduled for Tuesday but by Saturday afternoon I was already receiving frantic phone calls from Sigmund’s beloved mother. She was upset because Sigmund had been missing for nearly 2 days and he must have turned off the GPS tracking device she had hidden in his car. I reassured her the intervention would help and ask her if she had been talking to her family recovery coach.

She responded rather tersely: “I’m not the one with the problem Sigmund is. I don’t need a coach I need someone to fix my boy.”

I took a deep breath and redirected her with the utmost care. I wanted to be gentle given the fact that family recovery is difficult and given the fact that she was 175 years old. “Well Mrs. Freud you agreed that you would work on your own recovery program in support of Sigmund. Have you checked-out any Alanon meetings?”

She said she did and “everyone was nice” but I am not at all interested in working steps and plus Wheel of Fortune comes on at 7 pm and “there is no way I’m missing that. Pat Sajak is a hottie”. I encouraged here to attend the FAVOR Monday night family group and she agreed. She had heard wonderful things about the facilitator of that group. People in that group had described the facilitator as genius, gifted, amazing and the world’s most interesting man. Finally we were able to discuss the other participants.

She told me all the key players would be there except for Sigmund’s father who had been killed by Sigmund already consistent with normal pre-adolescent development (anyone get that?). So all that was left was to wait until showtime on Tuesday afternoon.

Tuesday came and we all gathered at the FAVOR center. Dr. Skinner was sure that Sigmund would not show because the appropriate mix of negative and positive reinforcement had not been struck. I assured him that he would show and told him the ARISE intervention method I had been trained in was evidenced based. He responded…”What the hell does evidenced based mean…We do what ever the hell we want and the only evidence we need is “that sounds pretty legit”.

Dr. Frankl kept muttering something about making meaning out the “apparent suffering”. A new addition to the group, Dr. Pavlov spent all his time tending to his dogs. Which was really weird. I was sure all these dudes were high but decided to proceed with the intervention anyway. My goal was to get Sigmund into treatment.

As instructed, Sigmund sat quietly while his friends and family made heartfelt pleas for him to seek help. It was truly inspirational the way the intervention network came together. They stayed on point and spoke from a place of love and genuine concern. Now it was time for Sigmund’s response.

He stared at us with what could be described as an IRON GAZE. He lit into the crowd trying to justify and minimize his behavior. “Everyone smokes crack when they are trying to develop a comprehensive explanation for human behavior”. We stood firm. He called people out one by one… “Skinner you smoke weed with pigeons and Pavlov you and those dogs freak me the hell out”.

Finally, he turned his attention to me. “And you. You call yourself a therapist. You are one stupid shit and you have no idea what is best for me. I wrote the book on therapy (couldn’t argue with that one) and you couldn’t therapize your way out of a wet paper bag. Plus you head is too large for your body and I can’t stand the way you chew gum with your mouth open”. Sigmund was trying to lure us into a confrontation. He wanted this to degenerated into an A & E made for TV special. I was unfazed. I had been here before. I stood firm.

“Sigmund…The point is everyone on this team cares about you. You can refuse treatment. But we will all continue to meet to work together to get you help. And we will not go away. We are going to stay on you until this gets better”.

Sigmund began to tear up. He then broke into an ugly cry like I have never seen before. SNOT flying everywhere. He kept yelling things about the ID and the EGO and all this weird shit about being in love with his mother. But in the end he agreed to go.

Fortunately we had hired a “sober transport” company to get him to a very special rehab located in California. We were sure this program would do the job. The website touted the facility as a premium program (but so did every other one we looked at) but the real differentiating factor was their use of Acupuncture (oh wait all the others did that too) and Equine Therapy (wait..darn it they all do that too). Actually we picked California because it was so far away making it less likely he would leave AMA.

We crossed our fingers as we watched the sober transport drive away. I thought to myself… “Holy shit… I just sent Freud to rehab!”

Chapter 4: Recovery Coaching Freud–The Rehab Experience
To say that Sigmund’s rehab experience was difficult is a massive understatement. That is like saying the Titanic was a small boat accident. It all started when he landed in California and got settled at the posh Malibu Do As We Say Or Die (DAWS or Die) Center for Recovery and Spiritual Awakening. We had utilized a national recovery hotline (1-800-we-rob-addicts) to secure the referral and they assured us that his insurance would cover the stay. The referral call was odd as I noticed a distinct Indian accent on the part of “admission consultant”. I questioned if this was “a call center in India” and “Jack” reassured me that he was in fact an official representative of Malibu Do As We Say Recovery Center.

Well… after about 3 days in treatment Sigmund’s mother received a call from Malibu DAWS or Die. The staff reported that Sigmund had been adjusting well and that he seemed ready to make a change. They felt he was finally ready for lifelong sobriety. They could clearly tell this because they are geniuses and he had been there for a whole 72 hours. However, they were sorry to say his insurance had been denied and that Mama Freud would need to remit full payment of $1,764,123.87 by midnight or he would get “dropped off at the local Costco” (they had determined that was the safest place for administrative discharges).

Mama Freud called me in a full fledged panic. She clearly did not have that kind of money. She thought about tapping into her 401k or maybe taking a loan. The rehab had told her that they offered loans at 125.8% interest. Mama Freud was between a rock and a hard place. We decided to consult with a friend in California to seek out alternative placement. We contacted a local recovery center to see if they could help us navigate the system. They hooked us up with a really great guy. Mr. Garcia was somewhat spacey but very helpful stating “man I’ve been to every rehab in California”. He was able to locate a free faith based program staffed by recovering Dead-Heads. Apparently this place had “the cure”. It was called Passages Malibu Sugar Magnolia campus.

Sigmund had a rough landing at Passages Sugar Magnolia. He was chronically late for morning meditation and yoga and had a very contentious relationship with his primary therapist. Apparently the therapist kept saying that Sigmund’s problem was his EGO to which Sigmund replied “That’s the biggest crock of shit I ever heard. If my EGO were not in tact I would be a floundering piece of whale dung”.

The therapist then replied. I have been doing this work for 3 years and I’ve been in recovery for 20 years. Your job is to listen and follow directions. You don’t know anything….”

To which Sigmund replied: “I invented the concept of EGO”….

To which the therapist responded: “Yeah in the middle a cocaine induced hedonistic marathon..”

To which Sigmund replied: “Yeah… Good point”…

Boom… Therapeutic breakthrough. From that point forward Sigmund was a model patient. Yes he complained frequently about the kale salads and he struggled because “all these staff smell like patchouli oil; but overall he was a treatment superstar. He was named CHIEF of the men’s primary unit and his “graduation” ceremony was truly heart-warming. He was able to complete the program and he arrived back in Greenville South Carolina with 35 days sober and a new improved attitude.
Stay Tuned for Chapter 5: The AFTER-CARE PLAN…

 

Recovery Coaching Freud: The Aftercare Plan
I was somewhat nervous as I anticipated my coaching session with Signmund. This was our initial meeting following his inpatient stay at the Promise Sugar Magnolia campus. I had heard nothing from any of the counselors at Promises SM and had no idea what the aftercare plan was for Sigmund. I was used to this as it had essentially become the industry standard to not communicate with me as a community based provider despite the fact that I refer 10 to 15 people to private facilities each month (sorry). I had no idea what the recommendation for aftercare was or if Sigmund had agreed to any specific recovery plan.

“Where’s a copy of your aftercare plan?” I uttered.

“My aftercare plan? What the hell does that mean” Sigmund shot back

I was completely aghast and stunned despite the frequency with which this occurs (sorry). “You should have an aftercare plan for recovery that we can help you implement. Usually it involves meetings and probably some type of intensive outpatient program. Did they refer you anywhere?”

Sigmund seemed confused but stated: “You mean that thing we did when my mom came to family week?”

“Yes probably”… “Did you get a copy of that”. My exasperation was clearly evident.

Sigmund laughed. He was amused by my disbelief. “No man I threw that shit away. But it’s not hard to remember the plan. They told me to go to the local clinic for psychiatric follow-up (Passages SM is a co-occurring facility THANK GOD) and to do 90 meetings in 90 days. But I can’t remember the appointment date for my follow-up and I am not doing any 90 meetings in 90 days”.

I was completely incredulous: “Why did you agree to 90 meetings in 90 days if you had no intention of doing them?”

Sigmund smiled: “Because you get in trouble if you don’t agree to do 90 meetings in 90 days. I figured out what to say and what not to say early on in that place. Hell I don’t even think I’m an addict but I sure as hell wasn’t going to tell anyone that. There was some dude named Ozzy there who said he was going to quit heroin but still smoke weed. They put him in the “special re-education” group and he is still there. I got out early “for good behavior”. His mom was so upset. The rehab called Ozzy non-compliant and in denial”.

Wow. Now here was a dilemma. This guy just completed inpatient rehab but was already planning to smoke weed. Sigmund was sure he was never going to do crack cocaine again but stated: “marijuana is not a drug and no one ever over-dosed on marijuana”. I called Passages SM and tried to get clarification. The intake person would not direct me to Sigmund’s primary counselor and suggested we put him back on a plane for “another round of inpatient. Or better yet”, the staff member said, “let him go out and get high and hit bottom then he will come back and be ready to follow directions”.

I said “bottom for Freud probably means death. And he still has some really weird theories to develop.”

My well-intentioned friend responded: “Well some of us have to die…so others of us can live”…

I went into what could only be described as a epic twerking type fit of rage. My body gyrated uncontrollably and I strung together cuss words which were never intended to run together. I couldn’t believe a treatment professional would utter such words. I don’t know why it struck me so hard. I had heard similar things before. Perhaps it was because these people were working hard to kill off the father of psychotherapy or maybe everyone has a breaking point. But something inside me snapped. Fortunately Mike Tyson was standing by to give me a swift punch in the mid section to bring me back down to earth. I immediately utilized my HOT YOGA skills to calm myself….

As Sigmund looked cheerfully on I couldn’t help but think: “Holy shit….we have killed Freud…”

Stay Tuned for Chapter 6: “Freud Gets Ninja Recovery”

TO BE CONTINUED….