CONNECTED AND SEPARATE IS A FINE BALANCE

In my last posting I told you about a counselling session I had some years ago with a woman who was desperately looking for some solutions (or so I at first assumed) to her unhappiness about her husband's drinking.I remembered listening to her recount how miserable she was and how much her husband's drinking was ruining everything about their life together. I listened for a good part of the session, appropriately I think - because a counselling therapist's first responsibility is to make an assessment of the situation in order to help her find the solutions she was searching for. An assessment requires data and a sense of the client's personal strengths and resources.

I told you that after about forty minutes of observing her high anxiety and listening to her obvious distress, I began cautiously to shift the conversation from her husband's  behaviour to hers.

I did this because I had to begin to direct this conversation.

In a therapeutic relationship the therapist must take a directive role. Even though it can be a collaborative dialogue - the therapist is being paid to blaze a trail to a satisfactory conclusion for the client. And one can't do that by sitting passively and nodding wisely.  

To be sure, I could have decided to listen for the full sixty minutes, then make appointment after appointment with her to do the same thing. I could have remained a sympathetic listener and encouraged her to talk about how she felt when her husband drank and acted-out, which certainly could have been helpful to her.

But when addiction has infiltrated a relationship, or when the person in front of me - my client - expresses helplessness in the face of another's behaviour, it's really important to shift the direction of the conversation to my client's part and help them see that they do in fact have some choices. In other words, they may be powerless but they are never helpless. They may feel that way and they can give a mountain of evidence to prove it - but helplessness is a learned behaviour, whereas powerlessness is a profound spiritual reality at the core of human experience.

But I digress.

When addiction has infiltrated a relationship, probably the most difficult thing a loved-one of the addict has to do is take responsibility for themselves - their own behaviour and attitudes - and their own happiness and peace of mind. To put these things in the hands of another person - especially when that person is sick with addiction - is to invite suffering, chaos, disappointment, resentments and so on and so on ....

But as you saw from the conversation I told you about last time, taking responsibility for oneself and not waiting for, or expecting, another person to change is a tall order.

It is a hard road no doubt about it, but the rewards are immeasurable.

Now, to look at this stand-on-you-own-two-feet thing from a different angle: If you're old enough to remember how popular Kahlil Gibran's book The Prophet was in the 1960's you'll appreciate the timelessness of his poetry and his wisdom. I offer the following quote from his reflection on marriage - but it holds true as an ideal and a reminder for any intimate relationship between people:

Give your hearts, but not into each other's keeping. For only the hand of Life can contain your hearts.
And stand together yet not too near together: For the pillars of the temple stand apart, and the oak tree and the cypress grow not in each other's shadow.

No matter how close and intimate the relationship, it is important - not only for the individuals, but for the relationship - that each person has a deep and felt sense of themselves as separate from the other.  

BREAKING THE SPELL IS HARD TO DO

A few years ago I spoke with a woman in my counselling office about her relationship with her husband who, based on what she told me about his behaviour, was in active addiction. And, his drug-of-choice - his committed love relationship - was with alcohol.

She had a long litany of stories and experiences to tell me: what it was like to live with a man who drank heavily when they got married ("he always drank - we drank with our friends - but up until a few years ago, he could always handle it. It seemed normal."), and how she saw his relationship with alcohol slowly consume him. She described a family  that was repeatedly traumatized (my word, not hers) by his behaviour when he drank - which for awhile now had become virtually every day ("our daughter hates him - she doesn't want to be in our house anymore").

She was desperate for a solution. In her opinion she'd tried everything to make him change. She said she was at the end of her rope ...  she needed help ... come to think of it though, she never said that.  

Actually, I remember her search for solutions more as a stream of accounts about her husband's bad behaviour, his lies and manipulations .. his defiance and grandiosity ... her fear and anger, anxiety and despair, embarrassment and shame. She really wanted me to agree on what a jerk he was.

"Here I am in counselling and he's at home drinking right now", she said.

What I saw, even more than a solution was her desperate need for affirmation from me that indeed this was an terrible situation. She wanted me to hear and understand very clearly that he was out of control and she was not insane - that she was not what he accused her of being -  a controlling bitch who spoiled his life's only pleasure, having a few drinks after a hard day's work.

After about forty minutes of observing her high anxiety and listening to her obvious distress, I began cautiously to shift the conversation from his behaviour to hers. 

I asked questions like:

How did you feel when ....?
What did you do when ...?
How did you handle yourself ...?
What was it like for you to .....?
What was that like for you when ...?

However, instead of seeing her become more grounded and reflective (which I'd hoped), the more I asked about her the more distant was her manner ...

In the end I had to give up on my cautious tone and speak more directly.

"It sounds like it's survival time in your marriage. It's time for you to look after you own survival. You've got to stop thinking about him or the ways you can get him to change, and start thinking about yourself ... about your own health and happiness."

She wanted no part of that. All she heard was my advice to leave him. (Did you hear that in my words?)

I was trying to help her see that her happiness did not depend on him changing. She didn't have to leave him to find happiness (on the other hand she might) but in my opinion whether or not to leave him didn't have to be her first concern. What that first concern needed to be was to turn her attention to, and take responsibility for, her own behaviour which was, through and through, enabling behaviour.

Enabling is essentially the inability, or the refusal, to allow another person to experience the consequences of their behaviour. 

And what's the payoff for the enabler? They don't have to take responsibility for themselves. 

I tried to help her see that turning her attention to herself and her own behaviour (to her self-care) was to stand up to her husband's relationship with alcohol. Being attentive to her own happiness was to live no longer at the service of addiction. It would break the spell and begin to set her and her family free.

As I said, she didn't want any part of it ... we ended the session and parted politely without scheduling a follow-up session. I never saw her again.

THE BEST WAY TO SUPPORT SOMEONE'S RECOVERY

I'm often asked: "What can I do to support my wife/son/father's recovery. Should we have alcohol in the house? Should we drink wine at Christmas? And so on ...

Here's the answer I always give:
The best way to support the recovery of someone you love is to undertake your own emotional recovery. Loving someone who is chemically dependent is a traumatic experience. Accepting that fact is difficult, but the sooner you can do so, the quicker your own recovery can begin - and happier, healthier relationships can be built.

Everything will not be OK just because the chemically dependent person stops drinking or using. New relationships must be built - even with family members.

It's also important to accept that you don't have to wait until the chemically dependent person starts his or her healing before you can start yours.

If you're tired of waiting for somebody else to change, you might think about changing the only person you have any influence over - yourself.

Here are some simple but profound reflections by someone who is doing the work of emotional recovery from loving someone who is chemically dependent. (I've altered some minor details to protect the person's confidentiality).

I'm realizing that I cannot do my recovery alone

- being OK to ask for help  ... it's not a sign of weakness.
- being vulnerable is OK ... it's OK to let people in and trust them.
- I need a mirror to be held up to me by somebody I trust so I can become more self-aware.
- I'm so intent on self-control 
- I'm too hard on myself and blame myself for my wife/son/father's addiction.
- I've been focusing too much on me and figuring it out on my own instead of  letting people in and allowing them to walk with me on my journey.
- I need my support network to help me in my recovery - to work at my resentment - to separate forgiveness from saying what my wife/son/father is doing is OK - and to release the power that my wife/son/father still has over me.

I welcome your questions and comments

ANNOYING EUPHEMISMS PART II: SUBSTANCE ABUSE

In a recent post I wrote about mild or indirect words or expressions substituted for one considered to be harsh or blunt when referring to something unpleasant of embarrassing - which is the definition of a euphemism according to the Oxford dictionary. 

Of course our language is full of euphemisms, they're a normal part of everyday life (rest room, sleep with, ....  ).

We use them to speak delicately about something, or to be polite (she's expecting...).

For some reason that I can't figure out, the subject of alcoholism/addiction is full of euphemisms (wild partying lifestyle ... tie one on ... three-sheets-to-the-wind ... getting wasted ...)

I find two of these euphemisms particularly annoying. Last time I addressed the functional alcoholic - this time let's turn to the ubiquitous expression substance abuse.

Something unpleasant or embarrassing ..............

Diseases don't normally have euphemisms - cancer is cancer ... diabetes is named that. They, and other diseases that are potentially fatal, are unpleasant and sometimes embarrassing, but we name them and use that name when talking about them.  Why does this disease have so many names? Chemical dependency, addiction, alcoholism and so on. Even if it could be narrowed down to those three, discourse about it would become more direct and to the point.

Obviously the weakness in any discourse (and the temptation to use euphemistic language) begins with the disagreement about what to name the problem itself - in this case, the disease.  (At an even more basic level one must admit that there are still - even though decreasing in number - people who deny there is a disease present at all.) 

And the terms we use are all too narrow, they don't cover the pervasiveness of the behaviours that characterize the disease. It's more than just chemical dependency - certainly more than alcohol (although alcohol is still by far the behaviour of choice for people who suffer from the disease). Even the word addiction has been domesticated so much that its everyday meaning has been minimized and made cute (being addicted to chocolate brownies, or Seinfeld reruns, and so on.) 

So, what are we left with?  Euphemistic language - delicate terms designed not to offend or be seen to be judgemental - about a disease that is permanent (incurable), pervasive, progressive, primary and predictable - and above all, fatal.  

Even professionals in the field of assessing and treating the disease are not immune to the trap of using euphemistic language when talking about addiction.

An example from the Huffington Post recently caught my eye: "Veterans dealing with substance abuse and PTSD suffer as much from stigma as they do from these very real illnesses."

I certainly do agree there's a stigma associated with the disease. My point is, substance abuse is not the name of this very real illness - substance abuse is a euphemism.

And, the point I'm coming to realize even as I write this, and why I find euphemistic language around this disease so annoying: because it is dangerous. 

Why?

Because using a euphemism in itself minimizes, or at least speaks delicately about, a deadly illness that has the potential to destroy lives and relationships - a disease that exacts a toll on communities - societies, cultures, nation-states. A disease that is a plague on families generation after generation after ....

Am I overstating it?

I don't think so. I'm zeroing in on the euphemism because our language reflects our attitudes, and substance abuse is an expression that reflects an attitude that is, at the very least, two-fold: 

First of all, that it's all about the substances (eliminate or enforce strict limits on addictive substances and there should be no more problem - declare WAR on the substances if necessary) ...

And secondly, that it's only abuse, it's not an illness (even though, as we've seen from the example above, some use the euphemism to talk about the illness itself). And, directly related to the stigma referred to above, the attitude behind the euphemism is that everyone can control their use of substances - especially alcohol. Using substance abuse when talking about addiction supports and promotes the belief that no one should be denied the pleasure of 'a few drinks' , or (insert here the alcohol-related advertising slogan of your choice ... ) by alarmists who call the relational process between a person and a life-threatening substance a disease. 

When someone uses the phrase substance abuse there appears to be no understanding of the pathology - lack of control, obsessive thinking, and so on - of addiction.  

The use of euphemisms can be harmless - they are part of the language of everyday life. But when I hear one used to name the disease of addiction I get a little passionate. 

Excuse me while I take a few deep breaths. I'll be calmer next time.      

You can read more articles on Relationships and Recovery at my new blog address:   www.dalemacintyre.blogspot.com

HELPING KIDS UNDERSTAND ADDICTION

When I come across something that I think will be useful in demystifying addiction and correcting opinions and attitudes about it, I want to share it with you.

Especially when it concerns talking about addiction with kids.

Alicia Sparks writes a blog, and this one is called Mom You're a Junkie!: Explaining the Disease of Addiction to Children. (You can read the entire article at http://blogs.psychcentral.com) 
 
Once I got past the first part of her title, I found I don't have any quarrel with anything Ms. Sparks writes about and the advice she offers -  except her use of that ubiquitous term  "substance abuse". But in this context, it's a minor complaint.

If you have children and you know you have to talk to them about somebody they love who drinks too much or uses other drugs, there's some good advice in this article. 

The following are edited excerpts from Alicia Sparks' blog: 

... addiction is not a “junkie” lifestyle choice, but an actual disease that sufferers have to learn to manage.

(It is important to explain) ... the difference between the initial decision to take drugs (a choice) and the body and mind’s addiction to drugs (not a choice):

Addiction is not a choice, a sign of moral weakness or a character flaw. While the initial decision to use drugs may be a choice for some people, drugs change the brain in a way that makes it extremely difficult to stop. Over time, the brain craves drugs like food or water and it’s difficult to feel normal without them.

(Here are) three ideas on approaching a discussion about the addiction as a disease with children:

1. Explain that addiction is a chronic disease much like other diseases. “When talking to a child about addiction, it’s important to explain that addiction is a chronic disease similar to diabetes and heart disease.”
2. Make sure the child understands his parent’s addiction itself is neither his fault nor his parent’s fault. “Children need to understand that addiction is not their fault, nor is it their parent’s fault.”
3. The child should be able to talk freely and safely with the parent and/or therapist about his feelings and his parent’s progress. “Children should be encouraged to talk about their feelings without criticism or judgement, whether with a parent, therapist or other trusted adult, and be reassured that the parent is getting the help they need to get well. “

I think it's important always to remember that children know that something is not quite right in their family when someone they love is suffering from the disease of addiction (even though they can't put their finger on exactly what it is that isn't right).

And secondly, when talking to children about anything - and especially when talking to them about addiction - the best strategy is always the truth. 

THE JOURNEY OF GRIEF

Last week I made the point that when encountering grief - yours or somebody else's journey through the natural, normal response to loss in our everyday lives - it is important to remember that the suffering and sorrow of grief is a long journey when the loss is something of great meaning: a close family member, one's health - or a even a career.

What often makes the journey more difficult is our cultural discomfort with grief. 

We don't like to acknowledge or accept loss of any kind. Especially death. Even though it sounds ridiculous, if we were to admit it, most of us believe in the depths of our hearts that we will not die. If I eat healthy and exercise I won't die. If I stop smoking I won't die. Ever. The everyday encounter with death is a great shock to us - there's a sense of failure about it. 

That's why most people aren't given the time they need to grieve. There's an expectation that it should be over and done with in days - or weeks at the most. Friends and relatives don't like to be around grieving people - they're a downer. (Get over it.) Or the the grieving person is a source of worry - maybe they're getting depressed ... or they won't be able to cope. (What'll happen then?) 

A grieving person is evidence before our eyes that we can't always feel good - that the ideal of perpetual, unrelenting happiness is an illusion. Unless, of course the meaning of happiness is expanded to include the reality of loss and the response to it. But that's not something we like to consider - sadness, pain and sorrow as part of happiness? That's an oxymoron if ever there was one. 

Anything other than a feel-good definition of happiness doesn't make sense to us. In the face of grief and the grieving person (including ourselves) we find ourselves needing distraction, cheering up, mood-altering. The idea of acknowledging our pain, allowing it to run its course - of somehow befriending it, talking about it and feeling the loss deeply, strikes most of us as morbid. 

But therein lies the paradox. The way to transcend the experience of grief is directly through it. We have to undertake the journey, and most of us are too afraid. 

Death is part of life. And it must be given respectful attention.

Consider the analogy of a wound - say your arm is cut. There are a few possible responses: one is to make sure it is kept clean and covered with proper bandages. You pay attention to it - clean and change the dressings as needed. Pretty soon it begins to heal. The bleeding stops. The pain diminishes as a scab covers the wound over. If you guard it from further injury, with time the wound heals. You may be left with a scar, and on certain days, years later, there may be a flare-up of pain. Maybe a change in temperature will cause it to ache briefly for the rest of your life. 

Another way to respond to being cut is to slap a moleskin over the wound and ignore it. You pretend its not there and carry on as if nothing has happened. Of course we know that the result will be a festering, infected sore that will cause no end of problems down the road. The wound, if ignored and not tended properly, will become a threat to your long term happiness - maybe even your life. 

You cannot avoid grief. Sooner or later you will have to go through it. 

Grieving people have taught me a lot. I remember a lady many years ago who came to see me for counselling after her husband of fifty-something years had recently died. She was calm and sad. We talked about her husband and the long life they had shared - happily - together. She reminisced in affectionate tones. Sometimes she cried softly.

Then in one of the sessions she said something very important, and it's stayed with me ever since. 

Out of the blue she said, "Y'know I'm sad that my husband has died and I miss him very much. But I don't feel a lot of pain about it. We had a good life together and we loved each other. What I'm finding really hard to deal with in all this are the feelings that are coming up for me over a baby I lost over forty years ago. They didn't let me hold her, I didn't even see her. She was a still-birth and they took her away immediately. The biggest thing I remember was my mother saying to me, 'Don't let your husband see how upset you are'. I stuffed it down and left the feelings behind. Now they're coming up ... it's very hard ..." 

Grief is a complicated subject, as are most things about the human experience. But hopefully I've made my point that there two simple things that must be acknowledged and accepted about the journey if grief is to be transcended and a new relationship with the relationship that has been lost is to be transformed.

Those two things are: time and attention. 

GRIEF: THE SORROW THAT CAN LEAD TO NEW LIFE

SORROW PREPARES YOU FOR JOY.

IT VIOLENTLY SWEEPS EVERYTHING OUT OF YOUR HOUSE, SO THAT NEW JOY CAN FIND SPACE TO ENTER.

IT SHAKES THE YELLOW LEAVES FROM THE BOUGH OF YOUR HEART, SO THAT FRESH GREEN LEAVES CAN GROW IN THEIR PLACE.

IT PULLS UP THE ROTTEN ROOTS SO THAT NEW ROOTS HIDDEN BENEATH HAVE ROOM TO GROW.

WHATEVER SORROW SHAKES FROM YOUR HEART, FAR BETTER THINGS WILL TAKE THEIR PLACE.

(RUMI)

Another word for sorrow, is grief.

Here's a few things I've learned about grief over the years - my own and the grief I've encountered in the people I've supported (and learned from) as they worked through their grief. 

Grief is a natural, normal response to loss. 

Loss is a fact of everyday life. Life is about loss; how we encounter and deal with our life's losses has a major impact on the quality of our lives. 

It must be said again and again: grief is normal and natural. It is not a sickness. It is not something that needs to be treated medically. It makes me very sad to hear from people that they have been prescribed antidepressants when they are grieving. 

The suffering of grief is not the depression we want to call clinical. When we do that we are pathologizing the core of our human experience. 

The suffering of grief is about being human. It is about the depth of love. It doesn't need to be treated. Above all, grieving people need to know they are not alone and that there is a way through the pain of loss. They need to know their love and loss can be transformed into something new.   

At it's core, grief is relational. It is about meaning.

The depth of one's grief is directly proportional to the meaning one, perhaps unconsciously, has placed in the relationship that has been affected - the relationship that has been lost.

Here's what I mean by that. 

If I lose a cheap object - say a pen: my experience of grief is very short, maybe a few seconds. "Oh, I lost my pen. Where's another one?" There has been little or no meaning invested in my relationship with that pen.

But, if I lose a pen my children gave me for father's day - a unique, wooden, multicoloured ballpoint pen, chosen with care and love, my experience of loss is deeper. That pen had some meaning to me and my life. (You guessed it. I really did lose such a pen.) Of course I don't collapse into tears when I think about it, but thoughts and feelings of sorrow do come up - even years later, "I wonder what happened to that pen?" The experience of loss - of grief is a little deeper.

The same thing holds true with our relationships with people. The meaning of the relationship is directly proportional to the grief we feel at its loss. 

Say you're in a store. If you stop and look at the cashier for a few seconds just before you leave and say to yourself, "I may never see that person again." You probably won't feel very much in response to such a loss. the cashier may be a lovely, warm and giving person, but you haven't invested very much meaning in the relationship with him or her. You may feel a little pang in that moment as you encounter the loss that reveals the impermanence of our reality. But beyond that you'll most likely go on with your day without giving it another thought.

But the loss of a relationship of greater meaning - through death, or moving or .... any of the thousand other ways people are lost to us, can create pain of great suffering. It touches us at the deepest level of our being. It can make us feel like we may be losing our minds. It may even make us question the meaning of life itself. 

The deeper the meaning in the relationship, the deeper the pain of grief when the relationship is lost - and the longer the grieving lasts.

This the pain we dread. It is the pain of our existence.  

It is crucial to remember for yourself, or when trying to support someone you care about who is grieving: when a person is living through profound grief - the loss of a deeply important relationship - everything one does or thinks or feels is normal. (Grief is a normal response to loss.) There is no one 'right way' to do it - the only wrong way is to pretend it isn't there - or otherwise (consciously or unconsciously) not acknowledge the pain.

Grief cannot be avoided. It can only be gone through - at some point.

The other thing that must be remembered is that the suffering and sorrow of grief is a long journey when the loss in one of great meaning: a close family member, one's health - or a even a career. (I'll write more about this next week, because it touches on our cultural discomfort with grief.)

One more thing before I stop: Earlier on I said life is about loss. It's true. 

But it's only half the story.

Life is also about wonder and awe and the excitement of anticipation - and all the other thousand experiences that bring us joy. 

The challenge we must acknowledge and face is that joy and sorrow are always with us as two sides of one reality. They complete one another. There is no joy without sorrow. 

That is the truth that defines the word relationship. There are always at least two parts to it - two participants. 

It is also the truth of love and meaning. The greater the depth of love, the greater the joy. And the greater the sorrow at its loss.

To paraphrase Kahlil Gibran: When we love, we experience it's joy - and we laugh all our laughter. But when we love we also - cry all our tears. 

That is the fullness of life.

HOW WE BEGIN OUR DAY MAKES ALL THE DIFFERENCE

Most days, most people awake from sleep to the sound of an alarm. 

Some get up peacefully and happily - rested and energized, joyfully anticipating the challenges of the new day. Others get up under protest ... leaving sleep reluctantly and taking some time to allow the grogginess to dissipate. They may even feel full of fear with anxiety clutching at their throat or gut. 

For some, the day brings excitement. 

For others, the only thing that gets them up are the responsibilities they shoulder. And sometimes, even the demands of job and family aren't enough to get their heads out from under the covers. The bliss, the escape of unconsciousness will be their daily temptation. That is until guilt bids them into the world.    

You may be of the first type. If so, you are very lucky - some would say you are naturally skilled like a gifted athlete, musician or artist. You don't know why or how you are able to begin the day so positively. You just do. You may not need to read on. 

But for those of us of the second type, waking up and beginning our day requires some attention - some mindfulness - because it's not easy. 

But why not? Why isn't it easy and exciting for everybody? Who knows? It seems to me that it's a combination of factors including natural inclination based on temperament, the development of habits, circumstances - and, the old stand-by of western thinking - genetics. 

Waking up and getting up well may require some skill development. 

Here's why. 

Based on my own experience and what I hear from others, I'm becoming more convinced that how we wake up and begin our day has a great bearing on our happiness, our sense of well-being, our creativity and our productiveness. The first minutes of the day even have a bearing on the quality of our relationships.

The first few minutes of the day can determine the quality of the whole day. And, as Annie Dillard said, how we spend our days is how we spend our lives. 

Looking at it that way, those first few minutes are pretty important if the quality of your life is a value for you ... 

There are many ways of developing the skill of establishing a good beginning to our day

Recently I came across some advice that I really like and has been a big help to me. It's from a Tibetan lama, Tai Situ Rinpoche:

We should begin our day, with a very clear decision. 
And that should be: I will do one or two or three good things today - at least. 

And with that, if we start our day as a routine then it will stay in our mind.

Also, we should get up as early as possible.

How does it sound, if you have to say  - I have never seen the sun coming up?

It doesn't sound good.

Something is missing. Right?

So, nature is rising. The sun is rising. So you should rise.

And you should be able to see the sun rise. 

In order to do that, you should go to bed as early as possible - so that you can get up early.

These things are interdependent.

And when you get up with nature, the birds, the sun, the plants ... everything together ... then you feel you are part of the universe.

Sounds really simple and straightforward, maybe deceptively so. But experiencing and accepting oneself as a part of the universe is a powerful antidote to the death loneliness of an anxious morning.

You could add, as Rinpoche encourages, some prayers and meditation. 

Then, the day can unfold peacefully and with some serenity. 

FUNCTIONAL ALCOHOLIC and other euphemisms

First of all, here's a reminder of what a euphemism is.

The Oxford Dictionary defines a euphemism as a mild or indirect word or expression substituted for one considered to be too harsh or blunt when referring to something unpleasant or embarrassing.

Euphemisms lessen the impact of our language, and in so doing they can make difficult realities easier to bear. In some situations, we need to put things delicately - it's understandable I suppose (it's hard to say dead when we can say passed away).

Some euphemisms make things vague (adult entertainment) and acceptable (put to sleep), while others are obviously ridiculous (negative patient care outcome)  and funny (follicley challenged).

But sometimes euphemisms are used to sustain and deepen delusion. I was tempted to add 'create' delusion ... but, if you think about it, the reality being named by the euphemism usually creates the delusion, the euphemism (our use of language) collaborates with our attempt to deny the reality - and so sustains and deepens the delusion.

When we're talking about addiction euphemisms are everywhere and they reflect our attitudes toward the disease ....

imbibe

feel no pain

Some slide by unnoticed (like most euphemisms), others annoy ...

Two of my favourites in the annoying category are - functional alcoholic and substance abuse.

When I hear functioning alcoholic, I ask myself, what does it mean?  Does it mean "not quite an alcoholic", not a "full-blown alcoholic"?  Does it mean the person has a job, provides for others, holds positions of prestige, power and respectability? Does it mean that because of the above reasons the person needs to be cut some slack in our judgements? Of course it means all of these things. But ....

So-called functioning, or functional, alcoholics (read also functioning addicts) drive drunk, cause trauma, chaos and heartbreak in their relationships and families and die from the physical effects of alcohol and other drugs. They suffer all the negative consequences of the disease (aka alcoholism or addiction) because they are the face of the illness.

The fact is, there are very few so-called non-functioning alcoholics. Alcoholism (aka addiction, aka chemical dependency and so on) is an illness,  and whether or not a person  functions as he or she (and their family) succumbs to it is beside the point.

Functional alcoholic is a tragic, idiotic term that sustains and deepens delusion - which sustains and deepens the disease itself.

By the way, does the child who stiffens in fear when he or she hears the car door slam outside - signalling the arrival of a drunk and/or raging mom (or dad) - know that dad (or mom) is 'functional'? Would it make the child's road to his or her loss of self easier to bear? 

I'll save my thoughts on the ubiquitous euphemism substance abuse for next time.

WHAT IS ALCOHOLISM OR OTHER DRUG ADDICTION?

One of the really important things that complicates our basic understanding of addiction (aka chemical dependency or alcoholism) is distinguishing between what is normal use and when use becomes problematic ... and what people need to do when they finally accept that they have a problem - or their gut tells them someone they love or work with has a problem.

Of course we we know deep down when our, or someone else's, use of alcohol and other drugs  becomes a problem. We know by the problems they create - in relationships, work and careers, with the law, in physical and psychological health and spiritual well-being.

It is our individual and collective refusal to accept the evidence of reality that leaves us scratching our heads and wringing our hands as lives and families crumble in the grip of alcohol and other drugs. 

We use terms like "social use", "abuse" "recreational use" - and my favourite, "experimenting" - to identify our own or others' patterns of ingestion, which in the end are ways of sugar-coating reality. 

But to be fair, it is confusing because most adults drink alcohol and many people ingest drugs in reasonable ways - for a good purpose. 

Let's try and sort out how the use of alcohol and other drugs becomes problematic, and what that means, in practical terms, for our relationships. There is a continuum of ingestion: Use, Abuse and Dependence. 


USE:

Alcohol ingestion that is moderate ... or reasonable ingestion - for a purpose that can be described as beneficial. A couple of examples: drinking alcohol in moderate amounts that enhance the pleasure of a social situation, or taking a drug in regulated amounts and periods of time for the express purpose of say, relieving pain or other physical symptoms.  
The relationship a person has with alcohol is casual, and his or her relational focus is still person-to-person and not person-to-alcohol or other drugs. If you think about it, getting drunk or stoned is essentially anti-social, so when the person's relationship focus shifts to alcohol or other drugs the ingestion moves from use, to abuse.    


ABUSE:

When person ingests alcohol or other drugs in an unreasonable way, which is essentially harmful. This causes problems directly related to their ingestion of alcohol or other drugs - such as arguments with family and friends about their drinking, binge drinking (defined as 4 or more drinks for women and 5 or more drinks for men on any one occasion), blackouts, lying about how much they’re drinking, driving while under the influence, work or school performance problems, arrests, unplanned or unprotected sex — in other words, doing things they just would not do if they hadn’t been drinking.

In relational terms, the person abusing alcohol or other drugs is in process of shifting from a casual to a committed relationship with them. It is still possible to return to a relational focus of person-to-person, but he or she is sliding into a person-to alcohol or other drugs commitment.

Abusive ingestion patterns can be changed. A person can step back from their problematic ingestion and return to reasonable use.

All addicts (chemically dependent people) go through the abuse stage of ingestion. but not all alcohol or other drug abusers become addicts.


DEPENDENCE:  

Addiction (aka alcoholism) is a chronic, relapsing brain disease caused by biological, environmental and developmental factors.

It occurs when a person’s alcohol or other drug abuse causes chemical and structural changes in their brain (by interrupting normal neural connections), which sets up the characteristics of addiction:  increased tolerance, cravings and loss of control. A person with the disease suffers the same, and more, consequences as the person abusing alcohol or other drugs.

It can also be viewed as a relational and spiritual disease .

In relational terms, the person's primary concern is the person-to- alcohol or other drug relationship. All other relationships become secondary, because of the commitment a person makes to their drug(s) of choice. This commitment is obsessive and compulsive. It is total self-surrender of the whole person to the relationship with alcohol or other drugs. 

The disease of addiction (aka Chemical Dependency or Alcoholism) cannot be cured (meaning you can not go back to drinking after a period of time of abstinence), but it can be treated.

THE ROLE OF CHOICE IN ADDITION AND RECOVERY

I have to admit that I feel some weariness as I wade into the ongoing argument about whether addiction (aka alcoholism, chemical dependency and so on) is a disease or a choice to drink or use alcohol or other drugs.

I can't speak for those who insist that addiction is simply a series of bad and selfish choices - stemming I suppose from some moral failure or weakness or bad character. But it seems to me that for them to accept that it is a disease means having to absolve addicts from responsibility for their actions - actions that have had personal, relational and social consequences throughout human history. And those consequences have been damaging, if not catastrophic.

Believe it or not, I get their argument. Anyone would be tempted to go there when faced with such inexplicable behaviour. "Can't you see what you're doing?" we plead, "why don't you just stop?"

But the behaviour doesn't get to the root of it ... that is, behaviour doesn't explain the nature of addiction as a disease. The drinker or other drug user has no volitional control over contracting addiction - any more than we have control over getting sick with diabetes, or hypertension and so on.

To help you understand what I mean, I'll call up the expertise of two medical professionals:
Dr. Raju Hajela is past president of the Canadian Society of Addiction Medicine, and chair of the American Society of Addiction Medicine's committee on the new definition of addiction.
Dr. Michael Miller is the past president of the American Society of addiction Medicine. 

I'll quote Dr. Hajela to develop my argument that addiction is an illness and that the choices an addict makes - which are sick choices - are symptoms of the disease and not its cause.

Dr. Hajela: "There is longstanding controversy over whether people with addiction have choice over antisocial and dangerous behaviours ... the disease creates distortions in thinking, feelings and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviours are a manifestation of the disease, not the cause."

If I understand Dr. Hajela correctly, the behaviours we see in addicts (all the crazy, self-centred, dangerous, thoughtless choices they make) are symptoms of the disease.

I agree, but I'll put it slightly differently: Simply having the disease is not a choice (a person is not responsible for being sick), but people are responsible for the choices they make (addictive behaviours).

[NOTE: A symptom is a characteristic sign or indication of the existence of something else. It is a sign or an indication of disorder of disease, especially when experienced by an individual as a change from normal function, sensation or appearance (Oxford English Dictionary)]

I have no problem agreeing that addicts active in their addiction make bad choices and behave badly. However, it is the biological, psychological, relational, spiritual nature of the disease that drives the behaviour - not innate moral weakness, sin, or bad character.

The good news is, no matter how sick an addict is, he or she can also make choices that make recovery from the disease possible.

Dr. Hajela again: "Choice still plays an important role in getting help. While the neurobiology of choice may not be fully understood, a person with addiction must make choices for a healthier life in order to enter treatment and recovery. Because there is no pill which alone can cure addiction, choosing recovery over unhealthy behaviours is necessary.

Because we are a materialist culture that looks to the evidence of our senses and the findings of science to determine what is real and true, we are fascinated by the neurobiology of addiction. I don't have any quarrel with the discoveries of neuroscientists that are revealing how the chemical reactions in an addict's brain are different than those of a so-called normal person.

But it is interesting to note that choice - and consequent behaviours - plays a role in the field of biochemistry. While it is true that chemical processes in the brain cause behaviour - whether healthy or sick - it is an established, scientific fact that is works the other way around too: Behaviour causes a change in brain chemistry. In other words, addicts can put their disease into remission - get into recovery - through the choices they make.

The last word goes to Dr. Miller: "Many chronic diseases require behavioural choices, such as people with heart disease choosing to eat healthier or begin exercising, in addiction to medical or surgical interventions ... So, we have to stop moralizing, blaming, controlling or smirking at the person with the disease of addiction, and start creating opportunities for individuals and families to get help and providing assistance in choosing proper treatment."

And by treatment I'm sure he doesn't mean surgical or pharmacological treatment, but behavioural treatment that is about learning to make healthy choices - behavioural treatment focused on honesty, with self and others, responsibility to oneself and others and forgiveness of self and others.

LOVE CANNOT BE HELD HOSTAGE

It is perfectly natural and normal to love someone who happens to be sick with the disease of addiction. We don't stop loving someone just because they're sick.

And, even when a person behaves really badly while in the throes of the illness, it's understandable that friends and family still love them.

But it's really horrible - and sad to see - when an addict uses that love to serve their addiction. People will allow themselves to be used and abused in the name of love. Their heart tells them the truth but they still feel compelled to do what, in the end, is wrong. It feels like they are being held hostage by their love ....

It's one of the most difficult things to manage in any intimate relationship - to love without being manipulated. To love and still be able to say 'no'. To love and not be at the service of addiction. 

In recovery language, someone who loves an addict is encouraged to 'detach with love'. But often the detaching feels impossible to do .... 'how can I be OK when my fill in the blank (son, daughter, spouse, sibling or parent) is so miserable? I can't stand to see them suffer."

People - for a multitude of reasons - take on the belief that love, real love, means that they must climb down into the muck along with people they love. Even when the misery is self-made - such as that created by active addiction - people feel compelled to share in it - in the name of love. 

But the exact opposite is true.

The truth is, love, real love cannot be held hostage.

Let me explain what I mean with a little help from a book that has become a spiritual classic.

In 1946, C.S. Lewis wrote a fantasy story called The Great Divorce.  It's about a man who, in a dream-like state, travels on a bus to heaven and observes people, who have recently died, face choices about whether to remain clinging to their earthly beliefs, opinions, desires and so on, or let go of them and enter heaven. It's a marvellous story in every sense of the word. Its most important lesson is that we have to choose - there is always, and everywhere a choice - even about whether or not we will enter heaven. The second important lesson is, once you make your choice, the door closes. We are faced with choices - and their consequences - throughout our lives. And ultimately, one chooses to remain in hell, or surrender into heaven.

I must point out too that Lewis implies that our choices create our heaven or hell here on earth, in this very life. Heaven or hell don't begin only after we die. They are with us in our choices right now, today.

One particular episode in the Great Divorce speaks to my point - that love cannot be held hostage by misery (misery created by self-pity, shame, addiction and so on).

It centres on a Lady who is Love. She personifies Love and lives in the heavenly realm, surrounded by adoring 'sons' and 'daughters'. 

As Lewis explains, in her earthly life: "...every young man or boy that met her became her son - even if it was only the boy that brought the meat to her back door. Every girl that met her was her daughter. Those on whom her love fell went back to their natural parents loving them more ... it was the kind of love that made men not less true, but truer, to their own wives ... there is joy enough in the little finger of a great saint such as yonder Lady to waken all the dead things of the universe into life."

This remarkable Lady encounters her earthly husband - who has recently died - on the borders of heaven. Their meeting is memorable. She joyfully invites him to join her there, in Heaven. But he, portrayed as a ghostly phantom, refuses - demanding that she come down to him, in his misery - self-pity, resentments, playing the victim.  He tries every trick he knows to get her to join him in his unhappiness and tries to manipulate her into believing that her happiness and joy is a sham. But the Lady refuses to buy in:
    
     "Darling" says the Lady, ... you don't want me to be miserable for misery's sake. You only think I must have been if I loved you. But if you'll only wait you'll see that isn't so."
     "Love!" says her ghostly husband, ..."Love! Do you know the meaning of the word?"
     "How should I not?" said the Lady. "I am in love. In love, do you understand? Yes, now I love truly."
     "You mean, ... you mean - you did not love me truly in the old days."
     "Only in a poor sort of way," she answered. "... what we call love down there (in our earthly life) was mostly the craving to be loved. In the main I loved you for my own sake: because I needed you."
     "And now! ... Now, you need me no more?"
     "But of course not!" said the Lady; and her smile made me wonder how ... the phantom could refrain from crying out with joy.
     "What needs could I have," she said, "now that I have all? I am full now, not empty. I am in Love Himself, not lonely. Strong, not weak. You shall be the same. Come and see. We shall have no need for one another now; we can begin to love truly."

Lewis then says: "I do not know that I ever saw anything more terrible than the struggle of that Ghost against joy."
Sadly, the Ghost continues to do his pathetic best to guilt and manipulate the Lady into coming out of Love into his misery. In the end though, he can't win ...  and he fades into nothingness - in spite of the Lady's persistent invitation to join her in happiness and joy - free of emotional blackmail.

    "Come to us," she says, "We will not go to you. Can you really have thought that love and joy would always be at the mercy of frowns and sighs? ... I cannot love a lie, I cannot love the thing which is not. I am in Love, and out of it I will not go."

The episode comes to and end with a reflection between Lewis and his Teacher who is with him on this journey:
     "And yet . . . and yet ... ," said I to my Teacher, "even now I am not quite sure. Is it really tolerable that she should be untouched by his misery, even his self-made misery?"
     "Would ye rather he still had the power of tormenting her? He did it many a day and many a year in their earthly life."
     "Well, no. I suppose I don't want that."
     "What then?"
     "I hardly know. What some people say on earth is that the final loss of one soul gives the lie to all the joy of those who are saved."
     "Ye see it does not."
     "I feel in a way that it ought to."
     "That sounds very merciful: but see what lurks behind it."
     "What?"
     "The demand of the loveless and the self-imprisoned that they should be allowed to blackmail the universe: that till they consent to be happy (on their own terms) no one else shall taste joy: that theirs should be the final power; that Hell should be able to veto Heaven."
     "I don't know what I want."      "It must be one way or the other. Either the day must come when joy prevails and all the makers of misery are no longer able to infect it: or else for ever and ever the makers of misery can destroy in others the happiness they reject for themselves. ... The choice of ways is before you. Neither is closed. Anyone may choose eternal death. Those who choose it will have it."

This is a metaphorical, imaginative way of explaining the meaning of 'detaching with love' and 'setting boundaries'.  

Real love cannot be held hostage: I couldn't put it any better than to repeat Lewis' words:

     "It must be one way or the other. Either the day must come when joy prevails and all the makers of misery are no longer able to infect it: or else for ever and ever the makers of misery can destroy in others the happiness they reject for themselves".

I know that's what it feels like sometimes when we are confronted with the disease of addiction in someone we love: that their misery is the ultimate power.

But hopefully we can learn to see that it just isn't so.

INVITING THE LOVER IN TO LIVE

A couple of weeks ago I wrote about addiction being an exclusive love-affair. 
Let's take the metaphor of the love-affair one-step further.

Imagine this:

You're in a committed, long-term relationship (a.k.a. marriage, common-law or otherwise). You know things aren't perfect between you - never have been, never will be. But compared to some, you have a pretty happy life together.

Your partner has always had weaknesses - like flirting. You've never liked it, but you're sure the behaviour is harmless. After all, you can't really complain because that's how you got together in the first place - by flirting with each other.

Then, and you can't even exactly remember when, you start to feel really uncomfortable. Things begin to take a more serious turn - you become suspicious that there's an affair going on. You watch, you listen carefully to your partner's tone of voice when making excuses about being late or not calling. You start to investigate - checking into alibis, looking at telephone records ...

Finally, it all comes out - there is an affair going on, and it's been pretty long-term. Betrayal. Recriminations. Anger ... Hurt ... Disbelief ... Devastation ... Despair.

What do you do?

Well, after considering everything, including your own fear of many things ... You invite the other person in to live with you - into your family home. Into your bedroom. 

You make every accommodation you can think of to fit this third person into your marriage:
     You give them space for their time together (which is nearly every evening and weekend.)
     You soothe your partner when they have a squabble.
     You protect the lovers from outside interference from employers or the police.
     You keep the children clear so their noise and questions don't annoy the lovers. 
      You make excuses to the kids.
     You protect their privacy. 
     If your children are teens or adults, you do everything you can to convince them this arrangement is best for everyone.
     You always have your inner antennae out to detect any and all of your partner's emotional needs.
     You keep secrets from friends and extended family - or you come up with clever excuses if they become suspicious.
     You endure the abusive comments - or worse - to keep the peace.
    

In the end, you lose yourself in their relationship.

But somehow, it all makes sense to you.  

I'm sure you're asking yourself where I'm going with this ...

Well, it seems to me that all the accommodations we make to our loved-one's addiction are exactly those we would make if we invited the person they were having the affair with in to live with us.

Addiction is a relational illness. The disease lies in the relationship a person has with their substance of choice. It's an emotional relationship that is more important to the addict than all other relationships in their life. That's why it affects all their other relationships. That's how families become alcoholic, or addicted families. 

The addict may protest that it's not true - but all the evidence and behaviour points to an emotional, love connection with a substance (or substances and behaviours) that is the first priority in an addict's life.

Addiction doesn't lie solely in the substance

Addiction doesn't lie solely in the person.

Addiction lies in the relationship between the addict and the substance.

And it is an emotional, love relationship.

When you make the decision to live with a loved-one in active addiction (and the same holds true if the addict is your son or daughter) you are making accommodations to a relationship that is as emotionally deceitful, disrespectful and devastating as inviting the person with whom your partner is having an affair into your home - to live - 24/7.

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