Breakingthecycles.com – Changing the Conversations

The following is a cross post from Patrick Meninga, a recovering alcoholic and addict with over eight years sobriety, and the author of the website, Spiritual River.

Addiction Recovery Is About Discovering New Layers

Figuring out how to live a life without drugs and alcohol requires new information.

This should be evident to anyone who is trapped in a cycle of addiction and has tried every which way in order to try and keep drinking successfully. The alcoholic just cannot do it for any length of time…..eventually we screw up again, go off on a huge bender, get into trouble, and so on. Lack of control defines our addiction, obviously. If we could control it there would be no problem.

Every person who has wrestled with alcoholism tries to overcome their problem on their own. They use known solutions to other similar problems they have experienced in their lives. For example, they might simply try to cut back on drinking. Or they might say “I know….I will just drink on the weekends.” These ideas make sense because they have worked for other types of problems. Why would you not try these approaches?

Our experience in life is that we will apply ideas that may have worked for us in the past to a new problem.

But we all know what happens to the struggling alcoholic at this point: none of their ideas work. Nothing that they attempt on their own seems to help their drinking or drug problem. This is almost always because of either one of two possibilities:

1) The person is trying to moderate rather than to stop entirely, or

2) The person is trying to stop entirely, without also trying to change their entire life around to support a sober existence.

Both approaches lead to failure.

So what is the secret to sobriety?

The secret is counter-intuitive. If it were intuitive, then getting sober would be easy and natural for any alcoholic. But of course it is not.

The reason that the solution is counter-intuitive is because it involves surrender. Almost every other (tough) problem in our life involves fighting hard for the solution. But peeling back the first eye-opening layer of information in recovery is not about fighting harder, it is about giving up. You have to let go of everything in order make a fresh start in recovery. You must surrender.

Surrender to what?

I think you have to surrender to 2 things:

1) You have to surrender to the fact that you cannot control your drinking. You have to accept total abstinence. This is a crushing defeat that has to be embraced before you can achieve serious recovery.

2) You have to surrender to the fact that you need help from outside of yourself. Surrender to the idea that you cannot defeat addiction alone. In my opinion, this is one of the biggest reasons that alcoholics and addicts should go to rehab. They need help.

So if someone is in the process of getting clean and sober then they have to grasp this about surrender. It is vital information. Without it, you cannot recover.

But some people who do surrender still manage to relapse. What other layers of information are critical for recovery? What has to be learned in order to maintain sobriety?
New layers of information

In my opinion, there are a number of things you have to learn if you are going to remain sober. The thing is, you may not learn them in a specific order. For example, one thing you might learn is how to have fun again in recovery without drugs or alcohol. Yes, this is a learning experience, and it might take some time for you to discover this new information.

Likewise, you may have to rediscover how to communicate your feelings honestly with other people, rather than simply covering those feelings up with alcohol or getting angry and being verbally abusive.

You may have to learn how to forgive. How to forgive yourself, or how to forgive others. There are people in recovery who fail to do this, and it ends in relapse. So for some, this is critical information. It must be learned.

I know a person in recovery who died young because they failed to embrace holistic health. They were overweight, continued to smoke cigarettes, and failed to heed several warning signs. We learn through experience, by doing stuff. If this person had learned to live healthier, and embrace an holistic path in life, then they might still be here.

Lessons to be learned in recovery

One of the mysteries of recovery is that you have to keep learning new things. It is pretty tough to explain why exactly, but it is true. If you stop learning in recovery you will relapse. The ultimate form of relapse prevention in recovery is continuous learning about holistic health.

Why is this the case? Probably because:

1) Life is cyclical – old issues that you may have dealt with in the distant past will pop back up “to haunt you” eventually. The same is true for people you may resent, etc. So just because you think a certain issue in your life may be dead and buried, it almost never is. The nature of life is that we have to keep revisiting our past, over and over again. This requires us to constantly be on our toes, learning new things, so that we can effectively remain sober through these cyclical swings that we will eventually experience.

2) We forget idle information – even if you have a mind like a steel trap, you will forget the important parts of how you actually stay sober through certain events. “If you don’t use it you lose it.” This is true for remaining sober through a wide variety of different life experiences. In other words, we have to keep relearning how to live sober, over and over again, because it is the experience of doing so that we need to learn, not the information itself. In other words, we need to keep relearning the application of knowledge about recovery, not about recovery itself. Memorizing a whole book about overcoming addiction is useless. The knowledge we need in recovery is applied knowledge. It is experiential knowledge. And we have to keep building that as we go along, or we fall out of touch with how recovery actually works.

3) If you stop learning, for any reason, you have the wrong attitude for recovery. You are setting yourself up for failure.
The lifelong solution

Always be learning.

But even more than that, always be open to peeling back that next layer of information. For example, maybe a friend of yours just experienced a huge breakthrough in their life when they learned about forgiveness. So they get excited about their new found freedom and they tell you all about it and you have this great little discussion.

Now the key is to take that information and apply it to your life. Does it apply? Do you have issues in your own life that might benefit from this insight? Do you have anger or sadness or frustration because you cannot let something go? Are you beating yourself up, over and over again, over the same things?

So maybe it applies to you and maybe it does not. Fine. The key is to be ready for the lesson, in every interaction. If you want to see learning in action, read through some of the comments on this thread. People there help each other to make real progress in taking the first steps towards overcoming addiction.

Ask yourself: What do I need to learn today?

Am I ready to see the lesson that is in front of me?

Lost and Found in America (LAFIA), along with partners Halogen TV and Special Program on Substance Abuse and Related Violence (SPSARV), will be hosting a free screening of Lost in Woonsocket at various locations across the U.S. starting on September 1 in Los Angeles to kick off National Recovery Month.

Lost in Woonsocket (see trailer below), directed by John Chester, documents the story of two addicts living together in the woods, and follows their unlikely journey to recovery thanks to the help of strangers. The resulting film is a testament to our power as individuals to make a difference in the lives of one another. Lost in Woonsocket offers two distinct messages to its audience – one person can make a difference and there is hope for those who appear hopeless.

To find a screening near you, please check the map at www.lafia.org.”

by Lisa Frederiksen

Many of us have known or seen people who seem to be able to drink far more than others without ever seeming to get drunk. Some people even aspire to being able to drink a lot without getting drunk — in other words, building up their tolerance.  But the bottom line is that the impacts on a person’s brain occur whether they appear/feel drunk or not. This is because it still takes their bodies approximately one hour to metabolize one drink.

As you may recall reading other posts on this site, alcohol is metabolized by the liver. Alcohol enters the bloodstream through the walls of the small intestine. Because alcohol dissolves in water, the bloodstream carries it throughout the body (which is 60-70% water) where it is absorbed in body tissue in proportion to the body tissue’s water content. Contrary to popular belief, we cannot rid our bodies of the alcohol we drink by peeing or sweating or vomiting it out. It’s our liver that rids our bodies of the alcohol we consume.

“So, what does that have to do with being able to drink a lot and not appear drunk?” you might ask. The brain is mostly water and highly vascularized (lots of blood vessels). When a person drinks more alcohol than their liver can metabolize, the excess alcohol stays in their bloodstream and suppresses certain brain functions — especially those related to judgment, learning, memory, pleasure, motivation and emotion.

Additionally, “too much to drink” is relative. The impact of alcohol on the brain and body depends on a number of factors beyond this very general rule of thumb that it takes the liver about one hour to process one standard drink. Weight, stress, gender, medications, tolerance, stage of brain development, lack of sleep, amount of food eaten and how quickly the alcohol is consumed are a few of the factors. Additionally, some people have lower amounts of the enzyme ADH in their livers, so their liver doesn’t process the alcohol the same way as someone with normal levels, and thus the alcohol remains in their system longer. Some people have genetic differences, such as a genetic predisposition as a result of having a parent or sibling with the disease of alcoholism. [Alcoholism is one of the diseases of addiction. Addiction is a chronic, often relapsing brain disease.] Other people have brain changes caused by early use of alcohol and/or having experienced one or more of the other risk factors for developing alcohol misuse problems.

But specifically to the issue of tolerance — the ability to drink a lot without seemingly having any consequence — is a problem. It is not good. In fact, tolerance can contribute to a person developing the disease of alcoholism and/or problems related to alcohol misuse. Please find the following links for more information on tolerance and alcohol.

University of Rochester Health Services, “Tolerance and Beyond”

National Institute on Alcohol Abuse and Alcoholism, “Alcohol and Tolerance,” Alert  No. 28 PH 356 April 1995

© Lisa Frederiksen. For this and similar information, order Lisa Frederiksen’s 20-page booklet, titled: “Seven Myths That Can Kill…,” available September 2010.

This is a guest post from The Discovering Alcoholic, who writes a top rated recovery blog, www.discoveringalcoholic.com, covering alcoholism, substance abuse, treatment and recovery issues.

Inevitably I have someone come up after a recovery meeting to ask me what is the secret to long term sobriety and recovery. It is usually someone new to the program, that has attended meetings routinely on the weekends for a while, and has decided that now they are “really serious” about recovery. I know I did the same thing many years ago, asking my temporary sponsor as he explained his thoughts on the twelve steps, “but how do you do it for the rest of your life?” Apparently I didn’t get an exactly inspirational answer since I can’t remember his response. Neither did I stay in AA after I had finished my ninety meetings in ninety days after rehab, but I still credit much of my successful recovery program to the things I learned in those meetings.

In retrospect it is easy for me to see why my sponsor didn’t exactly wow me with a response to my question because I was already doing what it took to stay sober. I just needed to keep doing for the rest of my life, but oh how I craved that there was something more. There had to be some kind of ancient magic, secret society, or a mystical panacea that was necessary- I mean surely it had to be a pretty complex solution to solve this problem I had battled over the years… but it’s not.

The recovering alcoholic is no different than the professional athlete or concert pianist in the fact that we must train every day. Practice. Practice. Practice. Same workout, same practice routines, and an unending dedication to the single purpose of improving one’s life- we must constantly train our brains to respond quickly to temptation, instinctively avoid dangerous situations, and maintain a solid emotional balance.

Regardless if it is NA, AA, or a personal recovery program the key to its effectiveness is action and dedication. Like the back of the shampoo bottle- wash, rinse, repeat. If the routine becomes too monotonous, mix it up! There is only one person responsible for recovery and that is you. NO program will keep you sober; no counselor can keep you safe.

What is TDA’s secret of long term sobriety? Find a program, make a program, any program… and just do it.

This is a guest post from The Discovering Alcoholic, who writes a top rated recovery blog, www.discoveringalcoholic.com, covering alcoholism, substance abuse, treatment and recovery issues.

Ever asked a family member that most assuredly does have a drinking problem if they are thinking the same? Well unless they are at the rock bottom step of a devastating spiral then be prepared for dogged denial, obfuscation, and feigned indignity. Be warned, those nursing an addiction can be wickedly convincing about this subject having already mastered the talent of lying first to their self. They will define the issue using a grey dictionary from the vague area of the bookshelf so that you leave the conversation with all the answers to none of the problems.

Even if offered a straight answer, what really has one gained by making the alcoholic plead guilty to the charge? My suggestion to family members who want to make actual progress is to try a different question (see the flip side of this issue here). Ask about the repercussions of the family member’s drinking instead. Ask where has the money gone? How much time did you spend with your children? Why did you not come home last night? The answers to these questions are black and white, not subject to the alcoholic’s rationalization and an instant veto of the I’m not hurting anyone but myself campaign.

This helps in two ways. One, it lets the alcoholic know that even if they refuse to realize they have a problem drinking- there is no doubt there are still problems galore. Two, the family can’t help the problem drinker until they are ready to help them self… but by identifying the problems caused by this drinking they can move forward* implementing their own plans of how to recover.

*serenity to accept the things I cannot change; courage to change the things I can

by Lisa Frederiksen

One of the most difficult aspects about trying to find a treatment center and/or program that is “right” for you and/or your loved one is the frustration over the inability to actually “measure” how one program works vs. another. This Opinion, by Bankole A. Johnson, Chairman of the Department of Psychiatry and Neurobehavioral Sciences at the University of Virginia, appearing in the August 8, 2010 The Washington Post and titled, “We’re Addicted to Rehab. It Doesn’t Even Work,” does an excellent job of presenting the issues. I’ve included an excerpt below:

Last week, Lindsay Lohan left jail and entered a drug and alcohol rehabilitation facility. If the scene inspired deja vu, it wasn’t just because it was the fourth time she had headed to rehab in four years. It was because the spectacle of a celebrity entering a drug and alcohol treatment center, relapsing, then heading to rehab again — and again and again — has become depressingly familiar.

For decades, Americans have clung to a near-religious conviction that rehab — and the 12-step model pioneered by Alcoholics Anonymous that almost all facilities rely upon — offers effective treatment for alcoholism and other addictions.

Here’s the problem: We have little indication that this treatment is effective. When an alcoholic goes to rehab but does not recover, it is he who is said to have failed. But it is rehab that is failing alcoholics. The therapies offered in most U.S. alcohol treatment centers are so divorced from state-of-the-art of medical knowledge that we might dismiss them as merely quaint — if it weren’t for the fact that alcoholism is a deadly and devastating disease.

And the way we attempt to treat alcoholism isn’t just ineffective, it’s ruinously expensive: Promises Treatment Centers’ Malibu facility, where Lohan reportedly went for her second round of rehab, in 2007, has stunning vistas, gourmet food, poolside lounging and acupuncture. It costs a reported $48,000 a month….

To finish reading the Opinion piece by Bankole A. Johnson’s piece, click here…

by Lisa Frederiksen

I share the following excerpt from an article by Simona Sikimic, titled, “Alcoholic Anonymous Takes Root in Lebanon, Attracts Clients From Across the Region,” appearing August 6, 2010, online, at The Daily Star, Lebanon, to remind us all that addiction is worldwide. It knows no boundaries. There is no “typical” alcoholic or addict.

But addiction, to both alcohol and drugs, is a growing problem in Lebanon and the Middle East alike. It is eating away at the lives of hundreds of thousands of people and is indiscriminate of age, sex or religious belief.

The number of alcoholics is known to be rising, especially among young women, while the number of drug addicts in Lebanon alone is estimated to be somewhere between 10,000 and 15,000. Even staunchly conservative Saudi Arabia has not escaped this trend and has one of the world’s worst amphetamine problems with the UN Office of Drugs and Crime (UNODC) revealing that almost half of the world’s illegal-pharmaceutical amphetamine seizures take place in the kingdom.

“The program is big in Saudi Arabia, too big! There are chapters in nearly every city,” said Said, a recovering Saudi addict who visited AA Lebanon for the first time in July. “There is every kind of drug there. It is just more underground but just as destructive. I didn’t know there was a meeting in Lebanon but I’m grateful to be here at the fellowship and that the meetings happen in Arabic.”

While numbers across the region may be rising, understanding and acceptance of the problem remain low and treatment options are limited. Close family ties often mean that an alcoholic or addict will be sheltered from the worst of their problem by their relatives, claims Bob.

I encourage you to read the article in its entirety – Alcoholic Anonymous Takes Root in Lebanon, Attracts Clients From Across the Region.

by Lisa Frederiksen

This NPR news piece, “Food For Thought: Meat-Based Diet Made Us Smarter,” by Christopher Joyce, appearing on KQED’s August 1, 2010, program/website,  brings to mind the importance a healthy diet plays in a person’s recovery from an addiction or the impacts of secondhand drinking/drugging (SHDD). Both (addiction and SHDD) cause brain changes, and its the rewiring of these brain changes (changing them back, if you will) that helps a person recover from an addiction or the impacts of SHDD (living with a loved one who misuses substances – alcohol or drugs). 21st century brain research now shows the importance of nutrition in that change process.

The following is an excerpt from my upcoming book, Loved One In Treatment? Now What!. The other keys to brain health/changes are: exercise, sleep and mindfulness activities. You can read all about these and other important research when the book is released August 20, 2010.

Unlike other body organs, the brain is incapable of making and storing glucose, which is its sole fuel source. No fuel, no brain activity. The brain requires a daily dose of about twenty percent of the body’s glucose supply – a staggering amount given the brain is only two percent of the body’s total weight. (1)

The brain gets its glucose supply from the carbohydrates in the foods we eat, which are broken down and transported to the brain via the bloodstream. For optimum brain health, however, it can’t be any old carbohydrates, like those in candy or sugar-packed soft drinks. The brain needs the complex carbohydrate variety, such as that found in whole grains, fruits and vegetables.

And while glucose is essential, so is protein (like that found in lean meats, poultry, fish, beans, eggs, milk products). Protein serves as “the basic building block of the brain’s tissue,” AND it helps in the production of neurotransmitters(2) and neurotrophins.

Healthy fats, like omega-3 fatty acids found in tuna and salmon, are important for building the neuron’s cell membrane and nerve fiber insulation,(3)  as well as “synaptic plasticity” and functions related to memory and learning.(4)

And it goes on and on from there.

Healthy nutrition is astoundingly important to brain health – something only known and understood as a result of the new brain research. But if you are not inclined to learn the nitty-gritty about nutrition, and let’s face it, who has the time when grappling with a loved one’s addiction and/or treatment, following the U.S. Department of Health and Human Services and U.S. Department of Agriculture’s Dietary Guidelines (visually shown in the Food Pyramid) covers the basics. In a nutshell, these guidelines suggest you:
- emphasize fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products
- include lean meats, poultry, fish, beans, eggs, and nuts
- keep saturated fats, trans fats, cholesterol, salt (sodium) and simple sugars low
- stay within daily calorie needs(5) (yes, excess calories impact brain health – especially the flexibility of the synapses and increased vulnerability to cell damage(6)).

Visit www.mypyramid.gov/guidelines for more information.

Think of nutrition as “food” for “thought.” The more nutrient-rich the food, the “better” the thought.

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1) Carter, Rita, et al., The Human Brain Book, New York: DK (Dorling Kindersley Limited) Publishing, 2009, p. 45.

2) Gilmour, Patricia, “Nurturing Health Brains,” Bardstown City Schools Comprehensive School Health, January 4, 2010, http://bardstownschools.us/health/bloghealth/?p=146

3) Gilmour, Patricia, “Nurturing Health Brains,” Bardstown City Schools Comprehensive School Health, January 4, 2010, http://bardstownschools.us/health/bloghealth/?p=146

4) Wolpert, Stuart, “Scientists Learn How What You Eat Affects your Brain – and Those of Your Kids,” UCLA News, www.newsroom.ucla.edu, July 9, 2008, <http://newsroom.ucla.edu/portal/ucla/scientists-learn-how-food-affects-52668.aspx>

5) USDA’s Dietary Guidelines, U.S. Department of Health and Human Services and U.S. Department of Agriculture, <http://www.mypyramid.gov/guidelines/>

6) Wolpert, Stuart, “Scientists Learn How What You Eat Affects your Brain – and Those of Your Kids,” UCLA News, www.newsroom.ucla.edu, July 9, 2008, < http://newsroom.ucla.edu/portal/ucla/scientists-learn-how-food-affects-52668.aspx>

by Lisa Frederiksen

1 in 4 American children live in a home where there is alcohol abuse or alcoholism. Countless others live in homes with illegal or prescription drug abuse or drug addiction. Helping the children in these families is critical.

This hour long film celebrates September as National Alcohol & Drug Recovery Month and is produced by CSAT (Center for Substance Abuse Treatment) and SAMHSA (Substance Abuse and Mental Health Services Agency). It  presents a panel discussion on this critical situation because children who grow up in an addict/alcoholic famly live in chaotic family environments with little stability or emotional support. As a result, many will develop behavioral and emotional probems that may impaire their ability to live happy and normal lives. Watching this film is important for this is a condition that affects some 28.6  million American children of alcoholics, of which 11 million are younger than 20 — figures that do not include the numbers of children whose parents are addicted to drugs.

by Lisa Frederiksen

NPR’s news program, today, “Commanders Have Ignored Major Mental Health Issues, Army Report Concludes,” reinforces the importance of talking about the connection between substance abuse and mental illness. [Note: substance abuse and addiction are two different things, although both cause changes in the brain.]

Substance abuse (whether it is of alcohol and/or prescription or illegal drugs) causes chemical and structural changes in the brain (see SPECT scan below). Thirty-seven percent of alcohol abusers and fifty-three percent of drug abusers [NOT addicts or alcoholics but drug or alcohol abusers] also have at least one serious mental illness,(1)(2) such as depression, PTSD, bipolar, anxiety, schizophrenia. Often what happens is the person starts to drink or use drugs to self-medicate the mental illness.

When you change the chemical and structural make-up of the brain, you change how the brain works, which in turn, changes how a person thinks, feels and behaves. This is because “neural networks” in the brain control EVERYTHING we think, feel, say and do. “Neural network” is a name for the process by which neurons talk to one another. In the brain, neurons are also known as brain cells. The way our brain cells talk to one another is determined by how our neural networks wire – talk to one another. Drinking too much or abusing drugs interrupts neural networks, which is part of what makes a person unable to think straight or behave “normally.” Repeatedly drinking too much or abusing drugs can cause chemical and structural changes in the brain like those shown in the image on the left, below.

SPECT Surface Scans, Courtesy Amen Clinics, Inc., www.amenclinics.com

LEFT = SPECT Surface Scan confirming substance abuse. RIGHT = SPECT Surface Scan of normal brain.

Now look at SPEC Surface Scans of the brain of a person with ADHD below (for comparisons, look at the bottom, right scan — that’s the same view as the two scans above). As you can see, mental illness also changes the brain.

SPECT Surface Scan Showing ADHD, Courtesy Amen Clinics, Inc., www.amenclinics.com

Looking at scans like these helps one see what substance abuse (such as repeated binge drinking) and  mental illness, such as ADHD, do to the structural make-up of the brain. This in turn can help you appreciate why a person whose brain has experienced these kinds of changes does not “think” or “behave” normally. It helps explain, in part, why suicide can seem like the best option to those who suffer from an undiagnosed, untreated mental illness and a substance abuse problem. A person suffering PTSD or bipolar or anxiety or depression needs help (see Resources below). A person who is abusing substances also needs help (again, see Resources below).

Looking at these kinds of scans also helps us appreciate that just removing the substance – the “coping skill” – without replacing it with something else (such as treatment and/or medication for the mental illness), or treating the mental illness without stopping the substance abuse, is a set-up for failure.

THE BOTTOM LINE: the brain change change. A person can heal their brains with proper treatment. Healing the brain changes how a person thinks, feels and behaves.

RESOURCES:

The Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services offers a Locator database with comprehensive information about mental health services and resources in the United States.

The National Alliance of Mental Illness (NAMI) offers excellent, free self-help programs. Visit www.nami.org for information and locations in your community.

NIAAA’s (National Instittue on Alcohol Abuse and Alcoholism) Rethinking Drinking website can help a person anonymously assess his/her drinking patterns and find tips for cutting down.

NIDA’s (National Institute on Drug Abuse) Info Facts: Science-Based Facts on Drug Abuse and Addiction

Bring Change 2 Mind.org – working to end the stigma associated with mental illness.

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(1) “Factsheet: Dual Diagnosis,” Mental Health America, <http://www.nmha.org/index.cfm?objectid=C7DF9405-1372-4D20-C89D7BD2CD1CA1B9>
(2) “Dual Diagnosis and Integrated Treatment of Mental Illness and Substance Abuse Disorder,” National Alliance on Mental Illness, <http://www.nami.org/Content/ContentGroups/Helpline1/Dual_Diagnosis_and_Integrated_Treatment_of_Mental_Illness_and_Substance_Abuse_Disorder.htm>