Melissa Killeen

[This is the fourth in a series of short posts about my interactions with recovery coaching clients. I want to share what happens during a recovery coaching engagement, the discussions that take place, what usually comes up for the client and how as a recovery coach I respond. In this post, I am still working with the client who relapsed.]

As discussed in my last few posts, I am working with a gentleman who relapsed some two months ago. At our last meeting, he and I discussed Medication Assisted Therapy (MAT). My client is considering using a specific medicine to aid him in his recovery. Appropriately, he mentioned this to his 12-step sponsor, and not surprisingly, the sponsor expressed his objection to MAT. The sponsor was adamant that my client not use drugs of any kind as a crutch for getting and staying clean. “No matter what, don’t pick up,” his sponsor warned, along with a litany of other 12-step slogans.

My client is affected by drugs, alcohol and a variety of processes or behavioral addictions. At the risk of discrediting any of the 12-step programs because of one person’s opinion, the following describes the impact that opinion had on my client.

In our meeting, he began to rant, spewing out the negative thoughts and feelings any addict holds against recovery, against 12-step programs, and for giving into his addiction. Giving up was number one on his list of negative talk. Even though there are statistics that show 12-step programs are credited for approximately 10% of the addict population getting clean, I could not allow my client to go down that path of giving up. Not with so little clean time under his belt. So what did I do?

Listened. I just listened. I could hear (and see) the emotional distress he was feeling. I knew this was no place for advice giving. And if I wanted to hear what he really had to say, I had to be quiet. I had to resist the voice in my head that was compiling good statistics on recovery. The general comments I could make to persuade him to feel and believe otherwise were best left unsaid. I had to block out all distractions, like his son upstairs playing Hip Hop music, and really concentrate on what he was telling me.

I chose to find greater value in observing this client, how he was sitting, leaning forward or pushing back into his chair, even the way in which his hands were waving about or hitting the armrest. You can glean a lot of information from tone, delivery, and body language.

I wanted him to know I was listening to him. So I leaned forward, maintained eye contact, and when I agreed, I nodded in the affirmative. When I disagreed, well, I remained still. As a coach, I often use my personal recovery experience to help my clients. But not this day, even though I had suffered a similar incident, it was not about me.

Eventually, at what seemed an appropriate moment, I spoke up. Using motivational interviewing techniques, I repeated some of the points my client had heatedly made. When unsure, I said, “Let me see if I have this right,” or words to that effect, and I would paraphrase a statement he had made. I asked open-ended questions beginning with the interrogatives, what, where, how, and when, and did not use the word why.

To the untrained ear, it was fifty minutes of listening to a high-volume tirade. But to me, much became apparent. He was frustrated with the slowness of his recovery. And tired of battling with his personal demons. He feared losing everything — his sobriety, his job, his girlfriend — as well as the calm provided by his drug of choice. He felt he couldn’t win. (Not winning for my client was never an option, coming from a high-pressured, always competitive family). He was convinced he’d run out of options. At least, he said, “when using he didn’t worry about winning, losing or anything else, for that matter.”

When his emotional fire had cooled, he popped the tab on a Diet Coke, took a good pull from it and said, “You know, no one listens to me. Thanks for listening to me.” Seeing the gratitude on his face was all I needed. The process of working out his feelings and expressing his thoughts was what he needed from his coach that day.

Lesson learned.

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2 Responses to Listen

  1. Mike Logan says:

    Good job Melissa. Would love to know more about medication assisted therapy. Mike

    • Melissa Killeen says:

      Hi Mike:
      Thank you for your kind words about my blog.
      I will send you a chapter from my book that discusses medication assisted treatment (or also called medication assisted therapy).

      The range of medication assisted treatment (or therapy) is quite wide. It could include methodone or suboxone for recovery from heroin use, or it could mean using Vivitrol to thwart alcohol use. I also extend MAT into the behavorial health field, which could mean using Abilify for paitients diagnosed as bi polar, SSRI’s for people experiencing anxiety and so on. At all times, this treatment includes a weekly therapist appointment and monthly visits to a psychiatrist for medication checks and prescription updates.

      Let me know what you think after you receive the chapter on MAT and I will be open to answering any questions you might have.

      Check out Medication Assisted Treatment (or therapy) Wikipedia as well.

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