![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 31 to 55 of 56. Go back in thread:
Posted by SLS on November 4, 2005, at 10:00:31
In reply to Re: Apologies, posted by mama141 on November 4, 2005, at 7:16:06
> This has to be the best, basically most open discussion to come down the pike in a long time.Thanks guys and gals.
> We have mentioned Rational Recovery, what other alternatives is anyone aware of? (religious, non religious, just not traditional 12 step) Mama?
I haven't read through it.
- Scott
Posted by SLS on November 4, 2005, at 10:28:54
In reply to Apologies » alexandra_k, posted by ClearSkies on November 4, 2005, at 5:16:33
> It's stifling.
I have felt stifled quite a few times in the past ever since Dr. Bob began implementing a civility policy. I sometimes get the urge to kick some *ss. I usually compose my posts in a word processor rather in the message box. It helps give me time to reconsider whether I want to actually submit it or not.
Often, I'm left with a sense of ambivalence as to whether I want to post or not. I usually act on my ambivalence by NOT posting until enough time passes that I feel more confident in making a decision. I often go back and edit my emotional posts so that they are not only civil, but communicate what I feel is important and relevant to the issue being discussed rather than directed at other participants personally.
It is a learning experience with a pretty steep curve if you've never been forced to interact with such stringent civility guidelines.
I hate apologizing. I would rather take the time to avoid writing things that place me in a position of having to do so. I still do apologize, though, when I become aware that I've been uncivil towards someone else. I don't always know in advance what is civil and what is not, so I often learn through trial and error. I think the key is to be as deliberative as possible during the composition and editing of a post, keeping civility in mind as a tool to maintain the relevance of the post to the issue being discussed.
I apologize in advance if this post contains comments that are either uncivil or otherwise irrelevant. I forgive anyone for doing the same.
:-)
- Scott
Posted by SLS on November 4, 2005, at 10:43:51
In reply to Re: I'm Powerless, posted by alexandra_k on November 4, 2005, at 4:11:37
I'm powerless to communicate without civility under the sovereign moderation of Dr. Bob. He doesn't miss a thing.
:-)
For some people, I think admitting their initial powerlessness over their drive to use is helpful. This is probably an accurate description of the predicament some addicts find themselves in before they have had the time to be treated and do the volumous amounts of work necessary to abstain. It makes for a good first step.
Just an observation.
- Scott
Posted by AuntieMel on November 4, 2005, at 12:48:14
In reply to Re: Non-12 Step » AuntieMel, posted by alexandra_k on November 3, 2005, at 16:23:36
Mind you, I'm not a blind AA follower, but....
"The government does force people to AA / NA treatment programs BY LAW. Does the government pay for the person to attend by any chance?"
AA/NA do not cost a nickel. Most people donate $1.00 at meetings they attend, but it isn't required. I've seen many people not donate.
--------------------------------------
"What are the success rates? I've heard the relapse rates for people relapsing 6 months, 1 year, 5 years etc after AA / NA attendance. They are staggeringly high."
Yes, they are. Relapse for other programs are equally high. I've heard that about 2% 'make it' through the first year, but my experience has been better than that. Meaning of the people who started around when I did, more than 2% made it that long.
But according to my psychiatrist, the 12 step programs have the highest percentage.
---------------------------------------------
"But you still have the steps. You still have the stated mission and so on and so forth. It is that stuff that I'm objecting to."
Again, it largely depends on the group. At the group I went to the guy that usually led the meetings said "you're here. That means the first 3 steps are done."
----------------------------------------------
"How did you go with confessing your sins to your higher power? Did that variety of higher power make it tricky to do some of the later steps?"
There is no time frame on the steps, and they don't have to be done in order. I've done some, and not others.
One of the sayings at the group - "take what you need and leave the rest" - I took to heart...
So, I didn't 'confess' my 'sins,' but I did take a good look at them.
-----------------------------------------------
"The message they say you HAVE TO GET (otherwise you will die of your disease - yes they say this) is that you are powerless and your higher power will save you."
I do believe you have to get the powerlessness thing first. Meaning you have to admit that, by yourself, you can't stop.
And I *do* believe that if you are an addict, you do have to quit or you will die.
Do you have to "stay quit?" I don't know. I'm a bit nervous to test that one yet.
Higher power? It can be your own soul.
-------------------------------------------------"Sorry - what isn't your fault?
Did someone chain you to a chair and force your drug of choice down your throat or up your arm or whatever?I agree that it isn't your fault that you jolly well LOVE whatever it is... I agree that your behaviour is UNDERSTANDABLE given your pain etc etc. But one does need to take responsibility... And that is ultimately what helped me to progress... Not accepting powerlessness but taking responsibility. IMO there is a difference...
------------
Maybe.
Yes, you do have the choice.
But it isn't your fault that you have the physiological makeup to become an addict. That is the part that you are powerless over. You aren't powerless over your behavior, just the fact that it's so damn hard to change it. And that you have physical as well as mental cravings.
Posted by alexandra_k on November 4, 2005, at 16:11:03
In reply to Apologies » alexandra_k, posted by ClearSkies on November 4, 2005, at 5:16:33
> Alexandra - you have made 2 apologies on the boards in one day. How do you feel about posting words you feel you must later apologize for?
Well. At the time I guess I feel okay about posting them - which is why I post them. Later, when I apologise I really am genuine. Its not so much that I wish I could take back what I have said. Its more that I wish I could have phrased my response a lot more sympathetically, open mindedly, etc.
> What affect do you think those posts have on the others who read and post here, keeping in mind that these are public discussions and not private; and that others are interested in the subjects being discussed?Well. I think different people respond differently. Some people find me to be something along the lines of a breath of fresh air. Some other peoples responses can be summarised something along the lines of AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAARGH
But I don't mean to hurt.
And when people feel hurt
belittled
like I have stomped on them
That is not my intention
And I'm prepared to work to changing my behaviour (best I can)
To minimise that.
> I hold my tongue lately.Well done.
That can be quite a feat.
Another option is to put it in word.
I do that a fair bit and then go over it and be very careful abotu how I phrase that.
I should have done that with a few of my posts from here and from politics yesterday.
But i didn't.And... I may well get a blocking.
>I write many responses to posts, and then do not confirm them, because I'm not looking for debate or argument, and feel that's what would result in my posting. It's stifling.
Do you look for debate or argument?
Is the implication being that thats what I'm doing?
Maybe also...
But never just.
I assure you of that.Debate / argument isn't personal...
It is what I do
It is part of who I amBut hurting people...
No, thats not supposed to be a part of that.
Posted by alexandra_k on November 4, 2005, at 17:38:42
In reply to Re: Apologies » ClearSkies, posted by alexandra_k on November 4, 2005, at 16:11:03
it can be stifling to not post things that lead to debate or argument...
that was what you were getting at?
yeah. it can be stifling to not post things because one shows more concern for how other people are likely to feel (regardless of whether that is more their issue than a problem with the posts objectively considered).
i won't do that.
i won't be silenced because of that.but when i could have said what i needed to say in a way that is less likely to upset people...
then yeah. i regret not having done that.
if you are opposed to 'argument' or 'debate' as a matter of principle...
you may just want to avoid my posts
because that is something i do sometimes
i need to get better at how i express myself
i need to get better at not upsetting people needlessly
but i'm not going to stop saying what i think
i'm not going to stop having arguments / debates with peopleif you don't like that about my posts than you best avoid them.
because i need to express myself for my sanity
and i refuse to alter that because of the feelings of others
moderate...
work towards comprimise...
yes
cease...
no
i'll be blocked for a year first...
Posted by alexandra_k on November 4, 2005, at 17:39:17
In reply to Re: Non-12 Step, posted by AuntieMel on November 4, 2005, at 12:48:14
i'm not ignoring you (here or on politics)
i'm thinking...;-)
Posted by CleverGuy on November 4, 2005, at 17:47:29
In reply to Re: Non-12 Step » AuntieMel, posted by alexandra_k on November 4, 2005, at 17:39:17
Wow. This thread is doing well IMO. What is wrong with debate anyhow. I haven't read any personal attacks, just lively discussion. I think it is wonderful.
Moderation Management is another option if anyone dare take it on. I am sure it is for some and not for others, as are all programs.
"Smart!" I believe was a spin-off of Rational Recovery. What the difference is between the two I am unaware. I have been busy lately, and haven't had much time for research. I say it again, however, that I think this debate is wonderful and much needed.
Posted by alexandra_k on November 4, 2005, at 18:35:37
In reply to Re: Non-12 Step, posted by AuntieMel on November 4, 2005, at 12:48:14
> "The government does force people to AA / NA treatment programs BY LAW. Does the government pay for the person to attend by any chance?"
> AA/NA do not cost a nickel. Most people donate $1.00 at meetings they attend, but it isn't required. I've seen many people not donate.
Okay. But I'm not talking about the meetings. I'm talking about inpatient treatment programs that people are required to attend BY LAW. I'll just talk about what I know of the way things go in New Zealand and you guys can decide whether this is true of the US or not...
Over here... Some people get court orders to attend inpatient treatment programs. And also: Ourpatient treatment programs. And also: detox. They have to do the program / detox by law. And the requirements on the programs / detox ALWAYS (no exceptions that I know of) involve AA / NA attendance. The programs / detox usually has some therapy componant too. That you HAVE to attend as part of the program. The therapy (individual and group) is AA / NA based. That means your therapist is trying to help you work through the steps. That is what therapy is about. The group therapy is in much the same vein.
You have to do therapy on 'relapse prevention'. That is based on the idea that total abstinence is the ONLY way to go and anything aside from that counts as a relapse which is unacceptable.
You have to do therapy on how you have this disease etc.
And thus... The New Zealand government is forcing people to go to something that IMO constitutes a religious program...
> But according to my psychiatrist, the 12 step programs have the highest percentage.
Okay. You might want to ask him about his source of information and how recent it is. I have heard they have had better success with token economies. Strictly speaking, that is psychological treatment rather then psychiatric treatment. He might not be aware of modern advances in psychological interventions. I'd be interested to look at the stats...
> "But you still have the steps. You still have the stated mission and so on and so forth. It is that stuff that I'm objecting to."
> Again, it largely depends on the group.I'm thinking here of the standard jargon that is read out at the beginning of every meeting. Or every meeting that I ever attended. I thought that was the standard way of opening meetings. That all AA / NA groups did this. I'm also opposed to many things that are said in the handbook / bible.
I appreciate that different people take that stuff differently. Some people insist on a literal interpretation. Other people are more common sensical (IMO) and take it with a grain of salt and take what works and don't push the official line. But it is the official line that concerns me.
> At the group I went to the guy that usually led the meetings said "you're here. That means the first 3 steps are done."
Okay. That sounds pretty common sensical to me...
But that is not the standard line.
I mean... If it was the standard line then why don't they just drop those steps (seeing as they have been done already). I remember being told that those first three... Were the ones people typically had the most trouble with....> "How did you go with confessing your sins to your higher power? Did that variety of higher power make it tricky to do some of the later steps?"
> There is no time frame on the steps, and they don't have to be done in order. I've done some, and not others.
Yeah. But once again... Not really the official line. Thats cool. I just wish the official line wasn't government funded. I wish it wasn't presented as the only option to recovery. I wish they would stop saying they are the 'best' option too... Because... Like I said... they have had good success with token economies and even if they are 'the best' so is CBT and yet (IMO) some people are more harmed than helped by it. ESPECIALLY when the AA / NA line doesn't seem to be working for them and yet they are told it is their only hope and there aren't any alternatives.
> Do you have to "stay quit?" I don't know. I'm a bit nervous to test that one yet.
I would say... That it would be preferable to give the stuff the heave ho altogether. But I don't believe this has to be the answer for everyone. I just think that it would be easier to avoid it altogether than attempt to moderate it (which hasn't worked so well thus far). like with chocolate... if you don't have any for a while you don't really crave it so much. but have a little bit and boy oh boy do you start to crave for more. why put yourself in that position? but that being said, some people manage to do this and i don't see why we should frown on them.
> Higher power? It can be your own soul.
Not on the official line. Your higher power has to be something 'other' than you. because 'you' are powerless and this 'other' being will save you. and you need to confess your sins to your higher power (officially). thus... according to the official line you are required to believe in a higher power who is 1) beneficient (wants to help you not drink / drug 2) has the power to stop you drinking / drugging 3) is interested in your confessing your sins.
isn't this higher power that you are required to believe in (or you will die of your disease) starting to appear increasingly christian?
according to the offical line.
but that is the official line.
and hence... it is preaching christianity (or christian like conception of god) and saying one HAS to do this in order to get better.
I don't believe the government should fund that.> I agree that it isn't your fault that you jolly well LOVE whatever it is... I agree that your behaviour is UNDERSTANDABLE given your pain etc etc. But one does need to take responsibility... And that is ultimately what helped me to progress... Not accepting powerlessness but taking responsibility. IMO there is a difference...
> Maybe.
> Yes, you do have the choice.
> But it isn't your fault that you have the physiological makeup to become an addict.
I agree. That is not your fault. I dont' think anybody would choose that for themself.
>That is the part that you are powerless over.
yes. same with having mental health issues. we don't choose those either. and yet... we still have to be responsible for our behaviour.
> You aren't powerless over your behavior, just the fact that it's so damn hard to change it. And that you have physical as well as mental cravings.
yeah. i agree. its not our fault its so damned hard to change it. its not our fault our bodies love it so. its not our fault that we have had crappy things happen in our lives. its not our fault that we hurt so much somtimes.
Posted by alexandra_k on November 4, 2005, at 18:44:05
In reply to Re: Non-12 Step » AuntieMel, posted by alexandra_k on November 4, 2005, at 18:35:37
but all those things that we are powerless over...
our higher power can't change them either.
our higher power doesn't change our brains
our higher power doesn't make our poison taste bad to uswhat we have power over is our behaviour.
and that is what we do have the power to change.
it is about finding the strength / motivation / faith / ability / whatever to do that.i think a problem with saying you are powerless and your higher power 'does it for you' is that you can't even take pride in *your own* accomplishment of taking control over your own behaviour.
every minute
every hour
every day
every yearyou manage not to drink / drug
because you manage to prioritise the long term consequences
over the short term consequencesis a triumph indeed
(if that is your goal of course)
and its something we have the power to learn to do
all of us
and when we do it...
*we* do itempowering...
i think it should be about empowering towards change
not depowering so some 'other' being can save you from your intrinsicly wicked sinful nature...but that is of course just my 2c.
Posted by mama141 on November 5, 2005, at 12:47:37
In reply to Re: Non-12 Step » AuntieMel, posted by alexandra_k on November 4, 2005, at 18:35:37
Just as a clairfication as to what one can be "forced to do or pay for". In many, if not all, states in the U.S. there is a program for liscensed professionals that monitors people, even when suspected of drinking, drug use, abuse, diverting etc (Doctors, pharmacists, nurses, technicians etc.) You have no choice - you must go to, and PAY for a rehab. Then attend X number of meetings a week for usually three to five years -- AND pee in a cup at random intervals. It's either that or lose ones liscense. In some cases this is true even for mental health issues. Usually these programs are covered by the name "Employee Assistance Program" and operated by the state liscensing board and are run by NON-professional nazi-like functionaries. In at least one state and maybe more, you have no appeal, and NO redress...just suspicion is enough! Refusal to submit means you lose your license -no ifs ands or buts!
> > "The government does force people to AA / NA treatment programs BY LAW. Does the government pay for the person to attend by any chance?"
>
> > AA/NA do not cost a nickel. Most people donate $1.00 at meetings they attend, but it isn't required. I've seen many people not donate.
>
> Okay. But I'm not talking about the meetings. I'm talking about inpatient treatment programs that people are required to attend BY LAW. I'll just talk about what I know of the way things go in New Zealand and you guys can decide whether this is true of the US or not...
>
> Over here... Some people get court orders to attend inpatient treatment programs. And also: Ourpatient treatment programs. And also: detox. They have to do the program / detox by law. And the requirements on the programs / detox ALWAYS (no exceptions that I know of) involve AA / NA attendance. The programs / detox usually has some therapy componant too. That you HAVE to attend as part of the program. The therapy (individual and group) is AA / NA based. That means your therapist is trying to help you work through the steps. That is what therapy is about. The group therapy is in much the same vein.
>
> You have to do therapy on 'relapse prevention'. That is based on the idea that total abstinence is the ONLY way to go and anything aside from that counts as a relapse which is unacceptable.
>
> You have to do therapy on how you have this disease etc.
>
> And thus... The New Zealand government is forcing people to go to something that IMO constitutes a religious program...
>
> > But according to my psychiatrist, the 12 step programs have the highest percentage.
>
> Okay. You might want to ask him about his source of information and how recent it is. I have heard they have had better success with token economies. Strictly speaking, that is psychological treatment rather then psychiatric treatment. He might not be aware of modern advances in psychological interventions. I'd be interested to look at the stats...
>
> > "But you still have the steps. You still have the stated mission and so on and so forth. It is that stuff that I'm objecting to."
>
> > Again, it largely depends on the group.
>
> I'm thinking here of the standard jargon that is read out at the beginning of every meeting. Or every meeting that I ever attended. I thought that was the standard way of opening meetings. That all AA / NA groups did this. I'm also opposed to many things that are said in the handbook / bible.
>
> I appreciate that different people take that stuff differently. Some people insist on a literal interpretation. Other people are more common sensical (IMO) and take it with a grain of salt and take what works and don't push the official line. But it is the official line that concerns me.
>
> > At the group I went to the guy that usually led the meetings said "you're here. That means the first 3 steps are done."
>
> Okay. That sounds pretty common sensical to me...
> But that is not the standard line.
> I mean... If it was the standard line then why don't they just drop those steps (seeing as they have been done already). I remember being told that those first three... Were the ones people typically had the most trouble with....
>
> > "How did you go with confessing your sins to your higher power? Did that variety of higher power make it tricky to do some of the later steps?"
>
> > There is no time frame on the steps, and they don't have to be done in order. I've done some, and not others.
>
> Yeah. But once again... Not really the official line. Thats cool. I just wish the official line wasn't government funded. I wish it wasn't presented as the only option to recovery. I wish they would stop saying they are the 'best' option too... Because... Like I said... they have had good success with token economies and even if they are 'the best' so is CBT and yet (IMO) some people are more harmed than helped by it. ESPECIALLY when the AA / NA line doesn't seem to be working for them and yet they are told it is their only hope and there aren't any alternatives.
>
> > Do you have to "stay quit?" I don't know. I'm a bit nervous to test that one yet.
>
> I would say... That it would be preferable to give the stuff the heave ho altogether. But I don't believe this has to be the answer for everyone. I just think that it would be easier to avoid it altogether than attempt to moderate it (which hasn't worked so well thus far). like with chocolate... if you don't have any for a while you don't really crave it so much. but have a little bit and boy oh boy do you start to crave for more. why put yourself in that position? but that being said, some people manage to do this and i don't see why we should frown on them.
>
> > Higher power? It can be your own soul.
>
> Not on the official line. Your higher power has to be something 'other' than you. because 'you' are powerless and this 'other' being will save you. and you need to confess your sins to your higher power (officially). thus... according to the official line you are required to believe in a higher power who is 1) beneficient (wants to help you not drink / drug 2) has the power to stop you drinking / drugging 3) is interested in your confessing your sins.
>
> isn't this higher power that you are required to believe in (or you will die of your disease) starting to appear increasingly christian?
> according to the offical line.
> but that is the official line.
> and hence... it is preaching christianity (or christian like conception of god) and saying one HAS to do this in order to get better.
> I don't believe the government should fund that.
>
> > I agree that it isn't your fault that you jolly well LOVE whatever it is... I agree that your behaviour is UNDERSTANDABLE given your pain etc etc. But one does need to take responsibility... And that is ultimately what helped me to progress... Not accepting powerlessness but taking responsibility. IMO there is a difference...
>
> > Maybe.
>
> > Yes, you do have the choice.
>
> > But it isn't your fault that you have the physiological makeup to become an addict.
>
> I agree. That is not your fault. I dont' think anybody would choose that for themself.
>
> >That is the part that you are powerless over.
>
> yes. same with having mental health issues. we don't choose those either. and yet... we still have to be responsible for our behaviour.
>
> > You aren't powerless over your behavior, just the fact that it's so damn hard to change it. And that you have physical as well as mental cravings.
>
> yeah. i agree. its not our fault its so damned hard to change it. its not our fault our bodies love it so. its not our fault that we have had crappy things happen in our lives. its not our fault that we hurt so much somtimes.
>
>
Posted by Reggie BoStar on November 5, 2005, at 18:48:37
In reply to Non-12 Step, posted by CleverGuy on November 1, 2005, at 0:15:42
Hi CleverGuy,
I currently use a combination of AA and dual-diagnosis groups (substance abuse + behavioral health, e.g. depression in my case).BUT: I unconditionally support anyone who explores 12-step alternatives and/or any other means of staying sober. The important thing is to find something that you feel comfortable with and works for YOU, regardless of what it is.
Here's what I did: I also explored alternatives such as Rational Recovery, SMART, "Beyond the 12 Steps", Eastern philosophy, just about anything I could get access to.
It turns out that I'm the type of person who likes to get together and chat with other folks who share the same issues, mainly because they're the only ones who really understand what it's all about. Even AA people will tell you this: only other alcoholics really have a good understanding of alcohol addiction and everything that goes along with it.
This is the only reason I didn't like Rational Recovery. It's a good method, well thought-out, and is no doubt great stuff for a rationalist who knows how to go it alone. All power and success to those folks.
As far as SMART goes: from what I've seen, SMART is essentially "Rational Recovery with Meetings." As such it would be right up my alley, because I really do need to shoot the sh*t about this. The only reason I don't go to SMART meetings in my area is because there aren't any. If there were, I would certainly do both AA and SMART.
For similar reasons I backed away from the Eastern philosophy approaches ("Tao of Sobriety" et al). The concepts and the literature are fantastic, and I read the stuff all the time; but there just isn't anybody around here to talk to face-to-face about it.
The need to talk to other people steered me towards AA, simply because there are tons of groups near where I live. So here's what I did to compromise between all the different methods, 12-step or otherwise: I shopped around. I went to as many AA meetings as I could, until out of the many different types of meetings there are around here, I find a few smaller ones whose members were all sensible people. Many of them consider the "Higher Power" and/or "Spiritual Experience" to be a state of mind, originating internally - not externally. Religion, surrender, and all of the other concepts that tend to alienate independent thinkers from AA are not in the minds of these folks. Rather, they use an approach that amounts to accessing a potential that's in each one of them - not an external divine being of any sort.
There are more people in AA who think this way than is commonly believed. I discovered this by chatting with AA meeting goers before, after, and during breaks in the meetings. I basically just asked them, "What do you really feel about this", in reference to concepts of "God" and spirituality. Some responded with party-line religion. Some, however, told me what I just wrote in the last paragraph. After that, I just looked for AA meetings wherein the "state of mind" belief about the "Higher Power" was in the majority.
It was surprisingly easy.
So, in a nushell, here's what I do:
1. AA meetings in which most folks think the way I do about an internal "higher power" or state of mind. It can be done.
2. Dual diagnosis therapy groups (the FREE ones, naturally!). In those types of groups, "spirituality" is only one of many tools used to deal with substance abuse and behavioural health issues. This is where you can get a lot of info about different types of therapy, medications, natural solutions, etc. In addition, most of the other participants are not necessarily AA members.
3. Regular visits to my shrink/therapist support network. I have to do this in order to treat severe depression and migraines.
I hope you find this lengthy tirade useful. And by all means, if you can find help with ANY type of sobriety program - self-help like Rational Recovery, secular group support like SMART (if there are any meetings in your area), free dual-diagnosis type therapy groups, and the RIGHT kind of AA meeting - then DO IT. Never give up. Keep looking until you find the one that works for YOU.
Good luck, CleverGuy !!!
PS: post anything you find that looks interesting. I'm always on the prowl for good programs in addition to what I already do, and I always will be.
Take care my friend,
Reggie BoStar
Posted by verne on November 5, 2005, at 19:14:12
In reply to Re: Non-12 Step, posted by Reggie BoStar on November 5, 2005, at 18:48:37
In your search of alternatives did you try meditation? I noticed that when I did TM or centering prayer twice a day for six months, with a little yoga thrown in, I couldn't drink 2 beers.
I discovered that I couldn't do both - meditate and drink. Eventually, I found my way back to drinking and gave up meditation. Now I'm trying to meditate again but it's really hard to settle down.
I'm not in any sort of program. I'm so isolated I sometimes have difficulty even speaking on the phone - I mean, I don't talk to anyone for a week at a time and forget how to make the sounds. AA Meetings and church are simply beyond my ability right now; or at least way out of my comfort zone - which seems to be expanding.
Tom Hanks in the movie "Castaway" had more conversations with his soccer ball.
Verne
Posted by alexandra_k on November 5, 2005, at 22:31:14
In reply to Re: Non-12 Step » Reggie BoStar, posted by verne on November 5, 2005, at 19:14:12
Hey Verne.
I find a benefit to meditation too.
But it is something that I get out of the habit of doing...
Even though I know I really benefit from it when I do it.Must get back to that...
Tonight.
I promise.
(And now I have to do it):-)
Posted by CleverGuy on November 6, 2005, at 2:13:46
In reply to Re: Non-12 Step » Reggie BoStar, posted by verne on November 5, 2005, at 19:14:12
I am glad you have found something that works. I too have explored many options, and i appreciate the input. I continue to search for a method that is perfect for me on all levels. I will, hopefully, remain imperfectly sober until then. I have some questions for you, and they are not meant as an attack. I struggle with these questions constantly, and I am interested in your opinion. How do you feel phisosophically about spending so much of your life devoted to your addiction? Do you think it is a necessary evil to remain sober? Do find your addiction be a prison in this way? Far different than using, but a prison none-the-less? And if so, how does that sit with you?
Posted by antigua on November 6, 2005, at 10:23:29
In reply to Re: Non-12 Step, posted by CleverGuy on November 6, 2005, at 2:13:46
I am part of a SMART group and that has helped me tremendously. I only go once a week, but I do my best not to miss it because of the support it provides. There is a whole philosophy of ABC's that are part of the program (and many groups follow them faithfully), but the gist of our group is to think the desire all the way through to the consequences. We point out things to one another that may not be so obvious because we're always in our own head.
Nobobdy gets beat up for slipping or a relapse, but we do try to hold each other accountable when it looks like we're talking out of both sides of our mouth and are ready to slip.
This group just works for me, and helps keep me sober.
antigua
Posted by Reggie BoStar on November 6, 2005, at 14:36:39
In reply to Re: Non-12 Step » Reggie BoStar, posted by verne on November 5, 2005, at 19:14:12
Verne,
When you say "AA Meetings and church are simply beyond my ability right now; or at least way out of my comfort zone", it sounds as though you might be battling social phobia/anxiety on top of alcoholism. If that's the case, it might be time to pull out the big guns and get into some one-on-one therapy.Bear in mind that I'm not a doctor or psychologist, so take this with a huge grain of salt. It's just that in my experiences going to all these different types of meetings, most of the folks in AA aren't troubled by social anxieties. The folks who ARE troubled by social anxieties on top of substance abuse are always at the dual-diagnosis therapy groups, and they almost always report seeing a therapist and/or psychiatrist for one-on-one sessions. Nearly everyone is also taking medication to ease their symptoms of social phobia.
Anyway, that's what I see. It might be different in your area. But I think the main thing you need to do is find out whether or not you do have some sort of social phobia that's preventing you from getting out and trying new things - especially if those things involve some sort of interaction with one or more persons.
Here's the disclaimer again: I'm not a doctor or psychologist. I'm just an old, alcoholic, depressed f*rt who goes to a lot of different kinds of group and one-on-one meetings. This sort of activity helps me. It may help you, too. Who knows?
Good luck, Vern !!!
Reggie BoStar
> In your search of alternatives did you try meditation? I noticed that when I did TM or centering prayer twice a day for six months, with a little yoga thrown in, I couldn't drink 2 beers.
>
> I discovered that I couldn't do both - meditate and drink. Eventually, I found my way back to drinking and gave up meditation. Now I'm trying to meditate again but it's really hard to settle down.
>
> I'm not in any sort of program. I'm so isolated I sometimes have difficulty even speaking on the phone - I mean, I don't talk to anyone for a week at a time and forget how to make the sounds. AA Meetings and church are simply beyond my ability right now; or at least way out of my comfort zone - which seems to be expanding.
>
> Tom Hanks in the movie "Castaway" had more conversations with his soccer ball.
>
> Verne
Posted by verne on November 6, 2005, at 23:05:41
In reply to Re: Non-12 Step » verne, posted by Reggie BoStar on November 6, 2005, at 14:36:39
Reggie,
I've always ended up in dual-diagnosis groups when I was in the VA hospital. My "rehab" stints lasted days, if not hours, before I was transferred.
But I haven't really had much in the way of treatment for depression, alcoholism, or anxiety during the last 5 years. I've found a way to survive without leaving my house. Lots of deliveries and VA compensation.
Not very healthy but I have managed periods where I've been able to get to a park to walk and even hike a few hills. But most of my getting out hinges on the kindness of friends - of which I have fewer than ever.
One bright spot is my daughter who wants to go hiking a couple times a week. She's in the middle of a management course though and we can't start until later this month.
I've run out of pyschiatrists in this small rural midwest town. I'm seen as a trouble-making, drug-seeking, patient and burned too many bridges when I argued with the doctors. The conservative docs around here won't prescribe benzos at all and don't see drinking as much of a problem. Drinking oneself to death is preferable to benzo addiction I guess.
So I'm mucking along, hoping to leave this area in a year or two for anywhere else. Not sure I can swing another move though. If I can't walk across town, how will I be able to move across country?
Verne
Posted by AuntieMel on November 8, 2005, at 8:53:39
In reply to Re: Non-12 Step » Reggie BoStar, posted by verne on November 6, 2005, at 23:05:41
Kicking addiction is difficult in the best of circumstances - mainly having a huge support system.
The fact that you made 90+ days alone is a miracle indeed!
Maybe you could find an AA "speaker's meeting" where you go to listen to someone else talk about their experiences. It means going out, but at least you wouldn't be called on to "share."
And don't forget that even if you *are* called on you don't have to say anything. Just say you're there to listen.
I fully understand the social anxiety. I've got a huge case of it myself. If I had VA benefits I wouldn't leave the house much either. Maybe it's a disguised blessing that I have to make a living.
Posted by Larry Hoover on November 18, 2005, at 16:02:54
In reply to Re: Non-12 Step » verne, posted by AuntieMel on November 8, 2005, at 8:53:39
Sorry I missed the conversation, but it sure got me thinking. And the idea that courts order attendance has always been a sore spot for me. At meetings, I want to meet with people who want to be there, not some non-repentant drunk driver or violent person.
As to effectiveness, I went to Medline/Pubmed and asked the question. Not a lot of good statistical work from well-conducted studies. Very few head to head comparisons with e.g. Smart either. I did the 12-step thing, so I have no intimate knowledge of other programs. Any program might have been equally effective for me, because I'd had enough of addiction.
Does AA work? I read hundreds of abstracts. Followed many paths. Came up with an interesting finding. The single biggest predictor of abstinence in 12-step programs is formal participation in helping others to remain abstinent, i.e. becoming a sponsor. And it looks like AA works as well as any other treatment, if not better.
Anyway, to each his own. Smart/AA/RR/whatever you wanna choose.....you gotta wanna. That's the bottom line, in my book.
And about the powerlessness thingie. I look at it like my mind has many rooms. If I'm in the room with my addiction, I'm gonna lose. But if I move out of that room, and close the door behind me, it doesn't matter if I'm powerless or not, because the addiction is behind a closed door. Recovery for me was realizing that I didn't have to fight my addiction head to head. I could turn and walk away.
Away towards what turned out to be my spirit. But that wasn't obvious to me, at first. I had to make an act of faith. No, not of religion. Of faith. Faith is believing in something without evidence or proof. I had to trust those who where reaching out the hand of hope. I had to believe that what they were offering me was good for me. (Not god for me. My higher power was good, not god.) All the rest was coping strategies, to stay out of that room in my mind were addiction had control. I surrendered that room to it. I don't miss it.
Anyway, I did collect some abstracts along the way re:efficacy. If anybody is interested, here they are. There was a fairly weak but constant tone of criticism that AA was an American thing, and that it might reflect a bias (Christianity?) in what was written about it. The evidence is otherwise, though. I couldn't find any regional bias in outcomes. Anyway, here you go:
Aust N Z J Psychiatry. 2005 Jun;39(6):431-6.
Alcoholics Anonymous: cult or cure?Vaillant GE.
Harvard Medical School and Division of Psychiatry, Brigham and Women's Hospital, 1249 Boylston Street 3rd Floor, Boston, MA 02215, USA. gvaillant@partners.org
OBJECTIVE: To discuss the mechanism of action, the efficacy and the safety of Alcoholics Anonymous (AA) in the treatment of alcoholism. METHOD: The published works on effective treatments for alcoholism is briefly reviewed and a prospective multidisciplinary follow-up of recovery from alcoholism in two community cohorts of adolescent males followed from 1940 until the present day is reviewed. CONCLUSIONS: The suggested mechanism of action of AA is that it employs four factors widely shown to be effective in relapse prevention in addictions: external supervision, substitute dependency, new caring relationships and increased spirituality. In addition, AA serendipitously follows the principles of cognitive behaviour therapy in relapse prevention. Alcoholics Anonymous appears equal to or superior to conventional treatments for alcoholism, and the skepticism of some professionals regarding AA as a first rank treatment for alcoholism would appear to be unwarranted. Alcoholics Anonymous is probably without serious side-effects.
J Stud Alcohol. 2003 Jul;64(4):579-88.The persistent influence of social networks and alcoholics anonymous on abstinence.
Bond J, Kaskutas LA, Weisner C.
Alcohol Research Group, 2000 Hearst Avenue, Suite 300, Berkeley, California 94709, USA. jbond@arg.org
OBJECTIVE: The role of changes in Alcoholics Anonymous (AA) involvement and social networks in relation to abstinence following substance abuse treatment is studied. Specifically, the role of AA and network support for abstinence are examined in relation to their effect on changes in abstinence states between follow-ups. METHOD: Study sites were 10 representative public and private alcohol treatment programs in a northern California county. A recruitment of 367 men and 288 women seeking treatment were interviewed at intake and re-interviewed 1 and 3 years later to collect information about alcohol consumption, dependence symptoms, social support for reducing drinking, number of heavy drinkers in the social network and AA involvement. RESULTS: Significant predictors of 90-day abstinence at both the 1- and 3-year follow-up interviews included AA involvement in the last year, percentage of heavy or problem drinkers in the social network, percentage encouraging alcohol reduction and AA-based support for reducing drinking. Panel models estimated an increase in AA participation between 12 and 36 months posttreatment increased the odds of abstinence at 3 years by 35% above those at 12 months. The only significant mediator of AA's effect on abstinence was the number of AA-based contacts supporting reduced drinking, which reduced the magnitude of the relationship by 16%. CONCLUSIONS: AA involvement and the type of support received from AA members were consistent contributors to abstinence 3 years following a treatment episode. The enduring effects observed from supportive networks demonstrate the importance of ongoing mechanisms of action that contribute to an abstinent lifestyle.
Alcohol Alcohol. 2003 Sep-Oct;38(5):421-6.
Is attendance at Alcoholics Anonymous meetings after inpatient treatment related to improved outcomes? A 6-month follow-up study.Gossop M, Harris J, Best D, Man LH, Manning V, Marshall J, Strang J.
National Addiction Centre, Maudsley Hospital/Institute of Psychiatry, 4 Windsor Walk, London SE5 8RF, UK. m.gossop@iop.kcl.ac.uk
AIMS: This study investigates the relationship between attendance at Alcoholics Anonymous (AA) meetings prior to, during, and after leaving treatment, and changes in clinical outcome following inpatient alcohol treatment. METHODS: A longitudinal design was used in which participants were interviewed at admission (within 5 days of entry), and 6 months following departure. The sample comprised 150 patients in an inpatient alcohol treatment programme who met ICD-10 criteria for alcohol dependence. The full sample was interviewed at admission to treatment. Six months after departure from treatment, 120 (80%) were re-interviewed. RESULTS: Significant improvements in drinking behaviours (frequency, quantity and reported problems), psychological problems and quality of life were reported. Frequent AA attenders had superior drinking outcomes to non-AA attenders and infrequent attenders. Those who attended AA on a weekly or more frequent basis after treatment reported greater reductions in alcohol consumption and more abstinent days. This relationship was sustained after controlling for potential confounding variables. Frequent AA attendance related only to improved drinking outcomes. Despite the improved outcomes, many of the sample had alcohol and psychiatric problems at follow-up. CONCLUSIONS: The importance of aftercare has long been acknowledged. Despite this, adequate aftercare services are often lacking. The findings support the role of Alcoholics Anonymous as a useful aftercare resource.
Addiction. 1998 Sep;93(9):1313-33.
Network support for drinking, Alcoholics Anonymous and long-term matching effects.Longabaugh R, Wirtz PW, Zweben A, Stout RL.
Brown University, Center for Alcohol & Addiction Studies, Providence, RI 02912, USA.
AIMS: (1) To examine the matching hypothesis that Twelve Step Facilitation Therapy (TSF) is more effective than Motivational Enhancement Therapy (MET) for alcohol-dependent clients with networks highly supportive of drinking 3 years following treatment; (2) to test a causal chain providing the rationale for this effect. DESIGN: Outpatients were re-interviewed 3 years following treatment. ANCOVAs tested the matching hypothesis. SETTING: Outpatients from five clinical research units distributed across the United States. Participants: Eight hundred and six alcohol-dependent clients. INTERVENTION: Clients were randomly assigned to one of three 12-week, manually-guided, individual treatments: TSF, MET or Cognitive Behavioral Coping Skills Therapy (CBT). MEASUREMENTS: Network support for drinking prior to treatment, Alcoholics Anonymous (AA) involvement during and following treatment, percentage of days abstinent and drinks per drinking day during months 37-39. FINDINGS: (1) The a priori matching hypothesis that TSF is more effective than MET for clients with networks supportive of drinking was supported at the 3 year follow-up; (2) AA involvement was a partial mediator of this effect; clients with networks supportive of drinking assigned to TSF were more likely to be involved in AA; AA involvement was associated with better 3-year drinking outcomes for such clients. CONCLUSIONS: (1) In the long-term TSF may be the treatment of choice for alcohol-dependent clients with networks supportive of drinking; (2) involvement in AA should be given special consideration for clients with networks supportive of drinking, irrespective of the therapy they will receive.
J Consult Clin Psychol. 2003 Apr;71(2):302-8.
Alcoholics anonymous involvement and positive alcohol-related outcomes: cause, consequence, or just a correlate? A prospective 2-year study of 2,319 alcohol-dependent men.McKellar J, Stewart E, Humphreys K.
Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Menlo Park, California 94025, USA. mckellarjd@yahoo.com
A positive corelation between Alcoholics Anonymous (AA) involvement and better alcohol-related outcomes has been identified in research studies, but whether this correlation reflects a causal relationship remains a subject of meaningful debate. The present study evaluated the question of whether AA affiliation appears causally related to positive alcohol-related outcomes in a sample of 2,319 male alcohol-dependent patients. An initial structural equation model indicated that 1-year posttreatment levels of AA affiliation predicted lower alcohol-related problems at 2-year follow-up, whereas level of alcohol-related problems at 1-year did not predict AA affiliation at 2-year follow-up. Additional models found that these effects were not attributable to motivation or psychopathology. The findings are consistent with the hypothesis that AA participation has a positive effect on alcohol-related outcomes.
Tidsskr Nor Laegeforen. 2005 Oct 20;125(20):2798-801.[Self-help programs in drug addiction therapy]
[Article in Norwegian]
Kristensen O, Vederhus JK.
Avdeling for rus- og avhengighetsbehandling, Sorlandet Sykehus HF, Serviceboks 416, 4604 Kristiansand. oistein.kristensen@sshf.no
BACKGROUND: Treatment of drug addiction is complex; hence there is a debate in the field of what is the best approach. An honest desire to stop using drugs is the entry ticket into the self-help programmes Alcoholics Anonymous (AA) and Narcotics Anonymous (NA); these groups are a possible supplement to ordinary treatment. They employ the twelve-step programme and are found in most large cities in Norway and around the world. The usefulness of these groups has been disputed, and few Norwegian treatment facilities have developed a systematic cooperation with them. The purpose of this study was to examine whether the use of self-help groups is associated with higher rates of abstinence two years after participants started attending groups. MATERIALS AND METHODS: 114 patients, 59 with alcohol addiction and 55 with drug addiction, who started in self-help groups after a drug treatment, were approached two years later with a questionnaire. The response rate was 66%; 6 (5%) patients were dead. RESULTS:Intention to treat analysis showed that 38% participated in self-help programmes two years after treatment. Of regular participants, 81% had been abstinent over the previous 6 months, compared with only 26% among non-participants. Logistic regression analysis showed odds ratio = 12.6, 95% CI (4.1-38.3), p < 0.001, for participation and abstinence. CONCLUSION: The study has several methodological problems; particularly that correlation does not necessarily indicate causality. These problems are discussed here; the conclusion is that the probability of a positive effect is strong enough to recommend participation in self-help groups as a supplement to drug addiction treatment.
Fortschr Neurol Psychiatr. 2005 Mar;73(3):150-5.
[Catamnestic study on the efficacy of an intensive outpatient treatment programme for alcohol-dependent patients: impact of participation in AA on the abstinence rates][Article in German]
Bottlender M, Soyka M.
Psychiatrische Klinik und Poliklinik, Ludwig-Maximilians-Universitat Munchen, Deutschland. bottlend@psy.med.uni-muenchen.de
This study analyzed the Alcoholics Anonymous participation and the impact on the abstinence rate of 103 alcohol dependent patients (ICD-10) during the 24 months after their discharge from high-structured out-patient treatment. The treatment retention amounted to n = 74 (72 %), 18 of the 25 dropouts took place because of alcohol relapse. At 6-, 12- and 24-months-follow-up 87 - 95 % of the patients were successfully located and re-interviewed. Analyses revealed that 64 % of the patients were abstinent at the 6-months-follow-up evaluation, 56 % at the total 12-months-follow-up evaluation. 49 % of the patients remained abstinent until the 24-months-follow-up evaluation, 14 % were improved and 37 % relapsed. 56 patients (55 %) participated in selfhelp-groups the first six months following treatment, two years later 45 patients (44 %) still attended a group. 53 - 56 % participated on a weekly basis. Patients who participated regularly on a weekly basis in self-help-groups fared the best on 2-year outcome. Patients who infrequently at all participated or not had the poorest outcome (relapse). After controlling for confounding variables (sex, treatment drop-out, relapse during treatment) these results were still statistical significant. Results indicate the predictive value of AA attendance for relapse prevention after controlling for confounding variables. The value of self-help-groups in the network of alcoholism treatment is discussed.
Posted by AuntieMel on December 5, 2005, at 16:23:59
In reply to Re: Non-12 Step » AuntieMel, posted by alexandra_k on November 4, 2005, at 18:35:37
I just stumbled onto this today. It talkes about the "steps" from a sort of practical perspective. While it *does* mention prayer and higher powers, it certainly doesn't dwell on them.
I think that the idea behind the steps is to help the whole person, not just get them to "suck it up."
A lot of the things it talks about are good for anyone to do, not just drinkers.
http://home.capecod.net/~rogerg/recovery/WkgAA.html
Posted by deirdrehbrt on December 10, 2005, at 15:22:20
In reply to Re: Non-12 Step » alexandra_k, posted by AuntieMel on December 5, 2005, at 16:23:59
I've been away from Babble-land for a while, but decided to come back and see what was up. When I left, I "wasn't an alcoholic". I just liked to drink... even though my doctors told me that it was absolutely dangerous with the meds that I was on. I was seeing a therapist, who finally convinced me to check out AA.
When I went to my first few meetings, I KNEW that I wasn't like "those people". I had never had a DUI. I had never been arrested, put into protective custody, I didn't have the stories that all of those people had. I couldn't be an alcoholic.
Still, though, at my therapists request, I kept going. I got a sponsor. I started seeing a pattern. Aside from the troubles with the police, etc. I realized that no matter how many times I had told my doctors and myself that I would quit drinking, I couldn't stop. Then, I started looking at my life. I had driven drunk MANY times, even with my kids in the car. I would go to restaurants with my kids, and drink, and give them shirley temples. How stupid is that? I was a daily drinker, and was to the point that I considered a six-pack or a bottle of wine a single serving, and I needed more than one serving a day.
I couldn't 'not drink' on my own. I needed help. I'm getting it from AA.
Could there be another program that would work out there? maybe. Will I stay with AA forever? I don't know. I've only been sober for 90 days, but AA is doing something for me that I couldn't do on my own. I'm much safer now. I'm not driving drunk anymore. I'm recognizing that I really did have a problem, and how bad it was.
I have no idea of who or what a "higher power" is, but I know that I can't do things alone. Maybe my higher power is society, or the fellowship of AA. Maybe it's Quantum physics. I don't know. What I do know is this: I need to stop drinking for my own safety, for my kid's safety, and for the safety of society as a whole, and I can't do it alone.
So far, AA is working, and I'm not ready to test the waters of those groups that tell me I CAN drink in safety.
Dee.
Posted by gardenergirl on December 10, 2005, at 15:36:48
In reply to Re: Non-12 Step, posted by deirdrehbrt on December 10, 2005, at 15:22:20
It's nice to see you back!
gg
Posted by deirdrehbrt on December 10, 2005, at 15:53:08
In reply to Dee!!!!! » deirdrehbrt, posted by gardenergirl on December 10, 2005, at 15:36:48
Hey there!
Can't really 'sneak' back here, can you? :-)
Good to see you too.
Dee.
Posted by AuntieMel on December 12, 2005, at 12:40:54
In reply to Re: Non-12 Step, posted by deirdrehbrt on December 10, 2005, at 15:22:20
Womderful news.
I didn't have any of the "problems" they talk about either - legal, work related, etc. Ok, the family nagged me a lot, but that was their problem, right?
Things are so much calmer now. Maybe some day I'll "test the waters" but I'm too scared to do it now.
Keep up the good work.
Go forward in thread:
Psycho-Babble Substance Use | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.