Category: Addiction

  • Thinking about mistakes from the past

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    Melissa Killeen

    One of my clients, Caroline, is a brilliant woman who has hit bottom, very, very hard. She is an Ivy League-educated woman, mother of three, and the wife of a wealthy professional in the suburbs of Chicago. But unfortunately, she drinks. After two years in and out of five rehabs, of countless detox stays, restraining orders and divorce proceedings, she is now 8-weeks sober and living in a homeless shelter in the city center of Chicago. She is working with a family reunification therapist to slowly piece together the relationship she lost with her teen-aged children. Caroline expressed to me that she is afraid her past actions have permanently affected her children, so much so that they will reject her and hate her, forever:

    “I am having an especially hard time with my “past mistakes.” The Daily Reflections yesterday spoke to me about leaving the past baggage behind, which of course I would love to do, but it’s hard. I feel terrible and ashamed of the things I did. I try to stay in the present but right now, in the family therapy sessions, my past mistakes are coming up in such big ways and will continue to do so when I see my children in supervised therapy. I can’t imagine what they think of me, a homeless drunk. I don’t know how to help them put the past behind, but I guess that’s what the therapist is for.”

    I shared with Caroline some thoughts about having an especially hard time with mistakes from the past. Sometimes, I told her, how we deal with our personal mistakes is by beating  ourselves up, by not letting go of a mistake we have made and/or worrying about what other people think about that mistake. Yet, in our recovery, we have an opportunity to let go of those old tapes. However, the tapes that are playing, over and over, in our heads, are actually old tapes from our childhood, remembering how our parents treated us when we made a mistake. Perhaps they “beat us up” either emotionally or physically, or both. Well, it is time to let those old tapes go, because they were never about you and the mistake you made. They were really about your parents who were triggered by your actions into reliving the mistakes they made, and then reacting to them.

    Not letting go is part of our addiction. Let’s say this: we are hardwired for compulsive thought. It is part of us, and in our sobriety our compulsive thought is switched from one focusing on drugs and alcohol (or work, sex, gambling or purchasing things) to something more productive and positive. Just as you are successfully turning off the compulsive thought about using or acting out, it’s time to switch off the compulsive thought about not being good enough and beating up yourself over your past mistakes. You can use these slogans: “Let go, let God,” “lesson learned,” “what is in the past is in the past.” They should be the new words, the new mantra you use to combat these destructive and negative tapes.

    What do other people think about your mistakes? Research proves they think very little about your mistakes. Yes, I know it is your kids, your husband and/or your parents and you worry about what they think of you or how they judge you. But honestly, that same research shows people really don’t spend that much time thinking about you. As much as you think they do, they don’t. Your kids are thinking about what to wear to school, what the new girl in history class thought about what them, or your husband is concerned about the bills or the next Harvard Alumni meeting. The fact is your neighbors don’t think about you at all! Yes, maybe a little gossip in the parking lot of the school, but truly, that two-minute exchange is dwarfed by them worrying about what people think of them. So let that go. People care about themselves. They think about themselves. (Just like you are thinking about yourself, right now?)

    Now here is the most important part of my conversation with Caroline. “I don’t know how to help them put the past behind them.” Caroline is a co-dependent. She is always doing, doing for others. She has placed herself behind her husband, his business, and her children for more than twenty years. It got her a little angry sometimes, and so she drank. Well, things got a little out of hand when she began drinking alcoholically. Caroline thinks she can help her kids put the past behind them. But, she can’t. That is her kids’ job. Yes, she recognizes that a therapist can help her children. But still she wants to do their job for them. No she can’t rob her children of this opportunity. The life lesson her kids will learn about putting things in the past and forgiving, will be one of the biggest “Ah-ha” moments they will have.

    I explained to Caroline the only way that she will be in her kids lives going forward is if she is sober. She said she knew that. The only way she can help her children put the past behind them, is by emulating that for them, by doing a 9th step, by making her amends. She seemed to digest that comment. Today, she had a lengthy session with the reunification therapist, so I am hoping Caroline will call me tonight.

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  • Picking up the Pieces after a Relapse (Part 1)

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    Melissa Killeen

    One of the worst feelings your client will have is waking up after drinking or drugging for a week straight and realizing that their hard-won sobriety has veered into the ditch. Not only do they hate themselves for relapsing, they know they have let down you and their loved ones, as well. I have seen men break down and cry knowing that their kids won’t allow them to come back into their lives, their wife is filing for divorce or their mother will never hug them again. Often this was their “last chance” and they blew it. It’s now time to make some hard decisions and that is where a recovery coach really can help their client.

    The recovery coach has to be there for the client, because the client fears everyone has abandoned them. Show the client you are there, whether it is a text two or three times a day or a phone call that goes into voice mail. But be there. Say something welcoming in these messages; show your client you have not left them. You want to help them to right this ship, to allow them to resolve this temporary setback. Emphasize the phrase: temporary setback.

    Let’s say I just left a message on my client’s voice mail, urging him to stop isolating, stop hiding the fact he has slipped and immediately seek help regaining his sobriety. I tell him to go to a meeting, have a cup of coffee with another member, and call me, his recovery coach! He knows there is a great deal of hard work ahead of him. Even though he may not want it, sobriety is the only answer. He already knows how difficult the first few days and weeks of sobriety are. He’s been there before, at least once. So he can do it again. And that was just one message. I will three the first day, and will continue every day until I hear from him.

    Making a return call is going to be difficult; your client will feel terrible and shame-filled. There’s no getting around that. But it is a call they will need to make. If they can’t find the courage to speak about relapse on the phone, text or email, it may be the end of your recovery coaching contract with him. However, if they do call, make yourself immediately available for a face-to-face meeting. Perhaps the client was discharged from an Inpatient/Outpatient Program (IOP) or other outpatient program due to the relapse. Helping the client find another program is important, and a program’s group therapy sessions are an integral component of recovery. Meeting with a therapist certified in addictions is also very important. Have a list of the therapists in the region and give this information to your client. A recovery coach should have an ample supply of agency addresses that can offer low- or no-cost outpatient treatment. Bring that information with you at your meeting with the client.

    There are a few other pieces that will need attention. The family is always disappointed. This is where a recovery coach can help. Speaking to a spouse in the company of the addict/alcoholic, or perhaps alone with the spouse so that they can open up an avenue of discussion previously not raised. When beginning the discussion first quote the research that shows that 80% of recovering people relapse within the first year after treatment. It isn’t a matter of your client begging for forgiveness. It is a matter of your client resolving to make things right and taking the necessary action to do so. Urge the family to begin focusing on their recovery, taking care of their needs, and therefore releasing the addict/alcoholic to focus on their recovery.

    Family Recovery Coaches are a perfect solution for helping families recover from the presence of an active addict in their household. Ala-Non or Nar-Anon are certainly important components of support for the family. Recently Parents of Addicted Loved Ones (PAL Groups) and Families Anonymous groups can be seen springing up for all families with an addicted loved one. Therapists are also receiving certification in Family Reunification. Originally Family Reunification Programs were offered by a State’s Child Protective Services. The services were aimed at working with families in which one or more children have been placed in foster care and are coming back into the home. The effectiveness of these programs with reunifying families has subsequently led to adapting this program model to serve families affected by mental health and substance abuse problems.


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  • Relapse

    In the course of most recovery coaching assignments, there is a relapse. The client often 30–60 days into their sobriety becomes confident that they have this “recovery” thing down pat. They may conclude that their problems are over, and that there is no need to do anything more to maintain their sobriety. They feel good and can now handle the world.

    The pink cloud of recovery can sustain some or it can allow others to slide down that slippery slope. It depends on the client and how they react to various triggers. Perhaps, there is a bit too much euphoric recall on how the drug or drink made them feel, sparked by a bottle of Xanax found in the luggage, or a whiff of scotch while enjoying a dinner out.

    Relapse is inevitable. I know a relapse has happened when a coaching call is missed or, say, a commitment to a homework assignment is not kept. The usual reason a relapse occurs is that the individual stops putting enough effort into staying free of addiction. They start ignoring their problems and stop asking for help.

    In fact, as a coach I am prepared for relapse to happen. Once identified, the beginning of a relapse-prevention plan can be put into place. Such a plan allows for introspection, the looking inside oneself and trying to figure out “why I picked up.” A focus is placed on the healthy fear of the consequences of a relapse and is pivotal to a client’s understanding of why they “slipped.” Indeed, my own personal fear of the pain of withdrawal kept me sober for years. A relapse early in recovery for clients can be devastating, with such results as an angry spouse, mandatory discharge from an Inpatient/Outpatient Program (IOP), a night in jail or a visit to the detox. These consequences can be positive influences on the client’s recovery process.

    I look for the signs that the client has obtained a small level of humility. As a result of the relapse, does the client recognize they are neither God, nor the son or daughter of God? They are human, with the basic frailties and insecurities that every alcoholic/addict has. The first slip is a good time to examine who this client is. Is there still an air of superiority, the “I can beat this addiction” mentality? Or has a spiritual component started to appear in their conversations, such as “Higher Power” or “Your will not mine?”

    Post-relapse is the best time to write a relapse-prevention plan. Ensuring the client has a week or two sober, I pull out the book by Mary Ellen Copeland, WRAP-Wellness Recovery Action Plan, or print out the template on the NAMI website[i] and hand it to my client. During the next week, the client uses the experience of a relapse to create their relapse-prevention plan. The following week, we both meet and review their plan, and discuss how to integrate it into their overall recovery plan and their life.


    [1] The pdf version of the WRAP plan with authorization by Ms Copeland to reprint. Blank WRAP Forms

     

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