7 “SLOGAN-FREE” Tips

“Tough love” and “let them hit bottom” DID NOT make the list. As our country fights through the “opioid crisis” we see the limitations of an addiction treatment system that came of age in the 1970’s. Today families need as much help as we can give them. Here are a few tips for families dealing with addiction.

(Note: in reality it is addiction crisis not an “opioid crisis”-but the opioid narrative works better for the press. The narrative being that evil pharmaceutical companies got middle class white kids addicted. Addicted and everyone started to die etc…)

These limitations are most evident in the strange phenomenon of recovery slogans that seem to guide healthcare/addiction treatment policy.

Slogans such as “wait until they hit bottom” or “he is in denial” or “these addicts have to want recovery ”.

One Size Fits All

Generated out of mutual support recovery groups, these sayings guide everything from insurance reimbursement to one-size fits all treatment models.

Some slogans are probably grounded and based in fact.

All slogans are generated from a place of wanting to help. But they should not be applied universally and they are not adequate in terms of guiding healthcare policy.

The lack of evidence supporting many abstinence only treatment models is stunning.

The lack of accountability in the industry is baffling.

The unwillingness of some programs to adopt evidence-based models is probably illegal. Certainly unethical.

M.A.T. Resistant

The most glaring example is the lack of acceptance, as well as those being resistance to medication assisted treatment (M.A.T.).

I’m not one of the M.A.T. zealots. I do not promote M.A.T. as the only acceptable treatment for opioid use disorder (that mentality is just as problematic as the current abstinence only model).

However, M.A.T. is an option that is systematically suppressed and ignored by many treatment providers. The only logical conclusion: slogans are taken more seriously than research.

Slogan Driven

Families are also subject to slogan driven “professional” help.

Unfortunately, the slogan-based model has been extended into professional work with family members. Family members looking for information related to addiction are met with their own version of one size fits all treatment.

Family members are labeled enablers and co-dependents.

They are told “you are loving your child to death”. They are told “let them hit bottom”.

OF COURSE THEY ARE TOLD “YOU NEED TO START PRACTICING TOUGH LOVE”.

90% Never Get Help

Most family members, like most people in addiction, run from professional advice and recoil from this approach.

We know that 90% of those in need of addiction treatment never get help.

I would argue even more than 90% of families in need never get help.

They vote with their feet. Also, they don’t come back.

They can’t tolerate the professional judgement. They can’t tolerate being chastised for their “enabling behavior”.

What Does Work

The concept of “working on yourself” is also difficult for families to grasp. In our Family Recovery Groups at FAVOR Greenville we spend a lot of time on this issue.

• We know there is validity to the idea of family members focusing on themselves.
• Too often, family members are automatically told: “you’re sick too” and “you need to detach”.
• These ideas have a place in the family recovery process, however, they should not be mechanically applied to every situation.
• Furthermore, there is a matter of timing to the conversation.
• You want the family to stay engaged in the process. Don’t chase them away with this type of label.
• When someone comes to realize the seriousness of their loved one’s substance use, they are confused and terrified. They are looking for expert advice. That advice should be grounded in sound theory, research and compassion.
• We also need to over-emphasize the importance of individualized family interventions.
• We need to understand how the structure of each individual family influences the approach we take with that particular family.

Opioid Use Disorder

For example, there is a big difference between talking to the wife of a 40 year old struggling with alcohol and the mother of a 20 year old with opioid use disorder.

Say it again for the people in the back of the room:

There is a big difference between talking to the wife of a 40 year old struggling with alcohol and the mother of a 20 year old with opioid use disorder.

Cultural Context

Detachment and tough love were developed in the 1950’s to help wives deal with alcoholic husbands.

These ideas made sense in that cultural context. They made sense in the context of a married couple.

Wives should not over protect and rescue husbands. It is not healthy. It is not natural.

Natural For Parents

However, parents are certainly going to react in a protective manner. It is natural for parents to try to rescue kids. Especially young adults.

The impulse to control and fix is natural. It’s not pathological to want to rescue your child. It is biologically hardwired into you as a mother or father.

You are compelled at an instinctual level to “save your child”.

When people dismiss you out of hand and scoff at your desire to help they are being short-sighted. They are demonstrating a fundamental lack of understanding.

When people tell you to detach and “kick the bum out” they are being cruel and engaging in classic “do as I say not as I do” behavior. These good people would not follow their own knee-jerk advice. If we were to reverse the roles.

What About Rescuing

Rescuing can, however, become counter-productive. Rescuing and ignoring bad behavior can enable the addicted individual to engage in ongoing self-destructive behaviors. In addition, you are going to personally self-destruct.

You can only handle so many sleepless nights and anxiety filled days.

I know what it is like to find yourself in the worry cycle.

That endless path of chasing scenario after scenario. All the “what ifs”.

Impact of Stress

The negative impacts of stress on the physical health is documented very well.

Up to 70 serious health conditions are directly caused or exacerbated by chronic stress. The addiction will take you out as quick as it will take out your loved one.

This is why people say: “work on yourself”.

The added bonus is, as you work on yourself, you increase the likelihood of change in your loved one.

Family Systems Theory

The family is a system; changing one part of a system influences all other parts of the system.

Family systems theory holds that individual family members fall into predictable roles and serve particular functions within the larger family system.

In addition, the family system (indeed any system) exists to preserve itself.

Unless acted upon by a strong internal or external force the system will proceed down the path of collective destruction. Given this reality, it is self-evident then that any individual part of that system could impact the system as a whole. This means the addicted individual will need to adjust to changes in any other part of the system.

Therefore, when in doubt. Work on yourself. It seems to me that all family recovery addresses three interrelated issues: Anxiety, Worry, and Chronic Stress. Focus on positive actions that reduce anxiety, worry and stress.

Helpful and Healthy Suggestions:

Become part of a group. We are social creatures.

You don’t even need to enjoy the content of the group. Just being around people with similar struggles will prove uplifting.

The benefits of group are clear:

• Universality — you realize you are not alone
• Altruism — you get to help others
• Imitative Behavior — you hear from others who have gone through the same thing and
• Develop Coping Skills — more adaptive responses.
• Instillation of Hope — Perhaps the most powerful factor

The “FREE THREE”

Practice the “FREE THREE”. Easily accessible activities which have proven to reduce stress:

1. Go outside, take a walk
2. Listen to your favorite music
3. Smile and laugh

Do something fun for yourself. Something meant for entertainment.

All for fun and not work related.

Prayer and meditation. Regardless of your personal beliefs we know that prayer and meditation have positive impact on neurobiological pathways.

The Confidant

Find a confidant. One to one. Sometimes you can’t share at group level and having a one to one relationship can be invaluable.

This could be a therapist, a sponsor, or a coach.

Eliminate toxic people from your life. You have no time for people who drag you down.

Eliminate judgmental people.

And Most Important. –

RESIST THE TEMPTATION TO ISOLATE. ISOLATION FEEDS DEPRESSION.

Isolation makes everything worse.

Some people think it is the main cause of depression, not serotonin.

Get outside, go visit someone. Try to do your life despite your despair.

Give it try… trust me.

The post Tips For Families Dealing with Addiction appeared first on The Recovery Cartel.

MANUAL FOR THE SLOGANS: ONE DAY AT A TIME.

In recovery slogans like ONE DAY AT A TIME , as well as cliches, and bits of advice are tossed around like candy on Easter. Flying rabbits and rainbow pastel stained eggs everywhere.

Some of the candy is good like the Reese’s Peanut Butter Eggs. Some of the candy is bad like jelly-beans.

Some of it is straight up weird like those little styrofoam sugar chickens. (see featured image above)

That’s my experience with slogans.

When used responsibly, slogans are impactful and essential. Also, when mindlessly tossed around they are irritating.

When presented as simple go to solutions to life stressors, slogans are dangerous.

The Slogans Challenge

In my humble opinion, the challenge is as follows:

A slogan, in and of itself, is not an answer to a life challenge. It is a good way to show empathy, a good way to fill up the conversation.

However, the slogan itself is not the answer.

Let me give you an example:

Let’s pretend I’m struggling with my son’s health issues and concerns. I’m preoccupied. I’m worried and I’m not getting much sleep.

A good friend would say: “Rich, just take it one day at time. That’s all you can do”.

My response: “How do I do that? “

Good Friend: “What do you mean. You just take it one a day at time”.

Rich: “Yeah, okay, but how. How does it work?”

Good Friend: “Well, you just take it a day at time”.

Rich: “I get that. But how do I do that? How do you do that?”

Good Friend: “Well, I just decided to take it one day at a time”…..

You can see my point. And, perhaps, I’m exaggerating just a little bit. However, this is a common challenge.

What A Slogan Is

A slogan, is NOT a plan of attack.

A slogan represents a philosophy. It is a way of approaching life. Not necessarily the nuts and bolts of life.

Today’s slogan is “One day at a time” and it’s many variations.

• One day at time!
• Just for today!
• All you have is today!
• Stay In The Present Moment!

This is good solid advice.

Impossible & Universal

The type of advice that is impossible to ignore. The type of advice that is universally agreed upon.

You CAN NOT argue about the utility of “One day at a time”.

Can you imagine the following exchange?

“Hey Rich, you should take it one day at time….”.

And then I would respond:

“No man, I don’t think that’s a good idea. I think I should focus on what’s going to happen 10 days from now”.

Or better yet…

“No man, I think it’s better if I obsess on things that happened 5 years ago and how that makes me a bad father”.

Of course, I should take it “One day at a time”.

• One moment at a time.
• One minute at a time.
• One second at a time.

I get it. I do not disagree.

I have struggled mightily with this simple concept for the majority of my life. I tend to obsess on interactions and resentments that happened yesterday. I tend to play-out scenarios and “what-ifs” that may arise over the next couple weeks.

It’s not as simple as, “One day at a time”.

I guess I am a slower learner. Being told one day at time does not translate to living one day at time. I have to operationalize these things.

And there seems to be a clear path to ONE DAY AT A TIME:

The Clear Path

HOW to do “One day at a time”:

1) Getting Started

Start with routine and daily maintenance practices that support one day at time living.

• Daily meditation.
• Routine schedule with morning readings and evening readings.
• Part of the routine schedule includes journaling.

D) Practicality

Practical time management and calendar reviews.

• Make sure I coordinate with important players in my life.
• What do we have to do today?
• What is coming up?
• Talk about the circumstance(s) and adjust/change the things you can.

E) Daily Discipline

Daily routine focused on the “body/health”: exercise, walking, free three.

• Throughout the course of the day I need to constantly redirect my thinking toward present moment. Notice my thoughts. Allow the unhelpful thoughts to float away, savor and grab the helpful thoughts.
• Pray, if so inclined: “Dear God, please help me stay present and focused on the here and now”.
• Build recalibration into my day. A time to stop, pause, brief meditation.
• Perhaps we “restart” the day. Maybe we will need to do this 4 or 5 times throughout the day or maybe just once. Maybe, should schedule it into our day.
• Focus on transitions, when you are done with work and you move into “home”. This is particularly difficult in today’s “work from home” environment.
• Remember that the “One day at time” techniques used at home are different than the techniques used at work.
• Finally, establish some type of evening routine for yourself. Pray if so inclined. Focus on gratitude.
• Definitely engage 3 good things. Give yourself 30 mins to unwind.
• PRO TIP: Plug your phone in “away” from the bed”. Do not “read” on your phone and then just toss it aside and go to sleep.

My Opinion

In my opinion: ONE DAY AT A TIME is a way of life with many operational units. You can’t DO one day at a time. You must do a bunch of things that add up to a “One day at a time orientation”.

There is more to this.

I am just beginning this process of “operationalizing” the slogans.

The post ONE DAY AT A TIME – INSTRUCTIONAL MANUAL FOR THE SLOGANS appeared first on The Recovery Cartel.