Archive for October, 2014

Wealthy, famous, powerful, and addicted – Part VII

Oct. 24th 2014

Barriers to recovery: suppressed pain

Suppressed pain: submerging the intolerable and denying our experiences

“Hey, it’s not so bad.”

 

When we ask ourselves, “Why am I killing myself with alcohol and drugs?”, it’s a question many are unable or unwilling to explore: The answers are either buried deep or too intolerable to address. When coupled with addiction, our pain only intensifies, with suppressed pain being the primary reason affluent people who actually want to recover relapse repeatedly.

 

Growing up in families of wealth, power, or prominence, the outside world perceives us as fortunate, equating good fortune with an easy and contented life, far superior to the other 99%. We were raised to believe happiness meant avoiding pain. With money and means, we can limit suffering, keep up appearances, and avoid embarrassing situations. The art of living then becomes the art of learning to suppress and deny negative experiences. When coupled with addiction-based denial, it becomes a double-edged sword too painful to touch.

Undermining our assumptions

Years ago, I joined a support group for adults from wealthy families. Many of us were suffering and uncomfortable, but we couldn’t identify why. Only when candidly speaking with one another did we discover common childhood experiences that undermined our assumption that being born into affluence guaranteed happiness and satisfaction. Later in life when I went to treatment, these insights helped me dig deeper and examine what was driving my addiction – an essential task to achieve sobriety.

 

Addictive behaviors inevitably are rooted in suppression or avoidance of pain. Even when we do recognize things aren’t right, it’s so much is easier to gloss them over with a drink or drug than do anything to resolve them. Unfortunately, the treatment community offers little in the way of expertise or rapport in supporting us as we pursue feelings relating to difficult childhoods and – too often – trauma. Because understanding and exploring suppressed pain is so critical to our recovery, this blog will discuss its meaning and manifestation, saving its impact on treatment and recovery for next time.

 

What does suppressed pain mean?

 

Events and experiences that hurt us and are submerged into our subconscious, denied, or reinterpreted.

 

Repressed pain comes from experiences that are too intolerable to hold in our consciousness. Examples:

  • Absent, perfectionistic, and critical parenting.
  • The child as the parent’s primary emotional relationship (i.e., becoming the love or hate object of a parent).
  • Abuse.

Denied pain comes from events we reinterpret so as to change their meaning. Examples:

  • “We had it so much better than others, we don’t deserve to complain.”
  • “When the going gets tough, we keep a stiff upper lip.”
  • “They invited me to dinner because they like my company, even if they do want a donation.”
  • Not speaking up when negative comments are made about the wealthy to be “nice,” when we’re actually afraid of confrontation or feel we “deserve it.”

We’re constantly told how wonderful and important our family is that it’s hard to fathom we might suffer from neglectful and misdirected parenting. By denying or suppressing painful experiences, we internalize negative messages about ourselves or our families.

Our childhood reality

Negative messages about us or our families

  • Children hear these messages more often than parents because saying them to us is safer than directly attacking the source of the resentment.

Parental pressure to be perfect

  • The object of parenting is to turn out the perfect child, with no infraction too minor to overlook.
  • We are expected to follow in the footsteps of previous generations.
  • An overly-critical environment leads to an internalized sense of never being good enough.

The molded child

  • If we accept the role of the molded child, all aspects of our life are directed by others. (Often money is the carrot.)
  • We fear leaving this protected environment. We have no idea of who are apart from our parents and little insight into our lost self.

Parents relate to us on their terms and ignore our wishes

  • We learn to deny our own feelings. “What I feel doesn’t matter.”
  • This leads to low self-worth, particularly when we see our parents being attentive to others, like servants or social friends, or spending time on philanthropic events. “Why don’t our parents have time for us?”

Parents absent, raised by servants

  • We feel abandoned. This leads to detachment and inability to connect with others. “A sense of observing ourselves participating in life, rather than feeling present.”

Turnover of (hired) primary care giver

  • This inconsistency leads to lack of trust and feelings of powerlessness, resulting in both abandonment and furthering the detachment generated by parental absence.
  • Our closest relationship is often with our nanny, not our mother. “The only time my heart was broken was when my Nana left.”

Parents confuse being present in the home with having a relationship with children

  • We experience a lot of isolation and insecure feelings, even around siblings or the extended family (i.e., anxiety, a sense of unease, “an acute sense of loneliness”).

The awareness of us versus them

  • We notice the real differences between us and others, in contrast to the egalitarian principles learned at school and religious institutions.
  • We observe, but do not understand why. Many of us adopt the belief we truly are superior in order to reconcile the reality of differences. Others try desperately to fit in.
  • In either case, the feeling of separateness is in the driver’s seat.

Above all, we grow up learning that it almost impossible to act on our own beliefs, if our beliefs differ from our parents’, because of internalized messages and a “system” designed to foster dependence, not independence.

Our adult reality

As we mature, we realize our lives aren’t any better than others. In fact, they’re worse in many ways because we are different from our friends; our parents aren’t around; and we’re pressured and expected to excel. As we think back on our childhood, we become increasingly aware as to how our upbringing impacts our lives and behaviors as adults:

 

Longing for a normal life

We often long for “normalcy,” but don’t know healthy ways to achieve it or quell the underlying feeling that something is wrong. Because we don’t know our own needs, it is easy to be misled, duped, exploited, and a “people pleaser.”

 

Problems? What problems?

We may actually want to stop or cut back, but without our reliable “friend” to keep our uncomfortable thoughts and feelings from surfacing, we continue on until we believe we can’t live without using. Life becomes intolerable without alcohol and drugs, but unresolved pain drives our addiction and our relapses.

 

Living in a cocoon

By minimizing our experiences and telling ourselves it was “not that bad,” we deny reality. And by deliberately ignoring or suppressing our reality, we lose the ability to learn information about our lives, including our drinking or use. Our feedback mechanism is defective, and people who are honest with us are replaced or ignored.

 

Money and resources to the rescue

Shopping, spending, sex, and other peak- or adrenaline-driven activities can be just as useful to avoid pain. All are interchangeable, and when drugs and alcohol become a problem, do we realize how pervasive pain avoidance has become? When the going gets tough, we spend money. And why not? Without understanding the connection between money and addiction, recovery is a fantasy.

Who can help us?

In moments of clarity, we have all these feelings we want to try to identify and talk about. But with whom? Who understands us or can help us gain insight and perspective? Who will be respectful of our experiences and not exploit us?

 

Here’s the bottom line: Without insight, we tend to reenact the struggles of our parents, even though we often vow not to – leading to our own dysfunctional lives. The same rejection and abandonment issues that create the drive for fame and wealth in the family founder can replay themselves in their offspring – leading to their need to be significant in their own right.

Pain as a source of information

We are taught from day one to learn to treat pain as a negative, rather than a source of information. A healthy attitude toward pain recognizes that pain is the soul crying out for help or the body crying out for attention. If we didn’t have physical pain, we wouldn’t know when our bodies are in grave danger.

 

Certainly, having discomfort gets our attention, so it’s not necessarily a bad thing. But for us addicts, alcohol and drugs are the reliable friend who is always there for us. And we prefer our “friend” over connection to aliveness. The consequence of our double denial is living an unconscious life, not understanding what life is about, not taking care of ourselves, and not listening to the data from our own life.

 

This all may seem bleak, but it’s our reality – a reality that we can change by understanding how suppressed pain impacts recovery and how a healthy attitude toward pain treats it as an opportunity to improve our lives. Don’t stress out too much; help is on the way in Part II.

Wealthy, famous, powerful, and addicted – Part VI

Oct. 18th 2014

Barriers to recovery: the Myth of the American Dream

Myth of the American Dream: With money and success, all our dreams will come true.

“While we spend our time enjoying the American Dream, in reality, is it all a lie?”

 

For the well off, America – The Land of Dreams, becomes America – The Land of All Your Dreams Come True. We’re raised to believe that having money means being happy and successful. For those working hard to accumulate wealth, we know one day our life will be one of leisure and worry free, as we delight in our deserved riches.

Wealth creates its own set of problems

“I have all this money, everyone tells me I should be happy, but I’m not and my using is out of control. What happened to me?”

 

The reality is that having wealth, earning high incomes, or accumulating money creates its own set of problems. Those who aspire to “make it” fail to understand the (mostly) hidden, pervasive dysfunction permeating affluent families and the ensuing guilt over leaving friends behind. Wealth, beauty, fame, and power are called the four curses due to their negative impact on the lives of their owners. Yet most people aspire to or would like to have any one of the four curses, believing their life would be better off no matter what the trade offs are.

Another hurdle to overcome

Being an alcoholic certainly is not fulfilling the American Dream, and when struggling with addiction, the Myth can be another hurdle to overcome. When addicted, we are living proof that the American Dream is fantasy, but the Myth soothes us and allows us to believe that we are living the good life and there can’t be any problems, so we continue on.

 

The Myth influences our lives in many ways:

  • We believe the Myth. Everyone tells us we have it so good – so we believe our experiences and feelings must be wrong. We don’t acknowledge the problems in our lives because we buy into the idea that our lives must be wonderful. This leaves us open to exploitation and an inability to take action to protect our selves because we can’t see our vulnerabilities – we are bullet proof.
  • People around us believe the Myth. We can be treated as objects to be seduced, deceived, or conquered by those who want a piece of the dream. Even our peers and counselors believe our lives are fantastic and refuse to accept that we might have problems.
  • We idealize the “family founder.” We adopt family stories about the famous family founder – without also examining the negative traits or luck that led to his/her success. We can never live up to the achievements of our family or fulfill our obligations to the world, when our forbearers become our idols.
  • We think achievements will make us happy. Especially for the self-made, we assume reaching our goals would make us happy – instead they often leave us miserable and searching for meaning.
  • We live our public image. We comply with the ought-tos and shoulds imposed by the life stylized for us by the media, merchandizers and our internalized messages. Whether ski goddess, corporate gladiator, trust funder, rock star, or philanthropic do-gooder – we spend our time acting the part and rarely experience who we really are.

Few experiences are more compelling than speaking with:

  • A lottery winner who is in treatment and can’t figure out what happened or why the newly-adopted lifestyle might be part of his problem: “You mean I should stay away from the Cubs, Blackhawks, Bears, Bulls, and the casino when I get home! What will my friends do without me?”
  • The tech guy who cashed out, with the much-envied wine cellar basement and accompanying bottle habit that makes him an unreliable parent and absent spouse.
  • The 40-year-old beneficiary who is filled with self-hatred when working at a recovery job at Home Depot.

These scenarios call for compassion, not scorn, because we, like them, all buy into the Myth at some level.

The Myth as an external message

While there are many similarities to other barriers, a difference is that the Myth is much more of a cultural, social, and media-driven concept, reinforced multiple times each day. In one sense, this is the other side of the coin from envy and resentment, which offends us, in that the Myth is something we become committed to. It makes acknowledging our addictions and seeking help to recover more challenging because we believe we cannot possibly have a problem when we’re following the recipe for success.

 

And if we become aware of problems, we cannot admit to them because that would be admitting failure where others are succeeding – failing to enjoy our privilege and power, failing to handle it, etc. That’s one reason why the thought of working at Home Depot or giving up the tickets generates so much shame, even revulsion. (Note: Recognizing our feelings as valid and reaching a compromise is far better than forcing us into a work or housing setting to prove a point.)

 

It’s usually when suffering the physical effects from using or we dry out for a while, that we come to grips with the reality that the Myth is not working for us.

 

And you may find yourself behind the wheel of a large automobile

And you may find yourself in a beautiful house, with a beautiful spouse

And you may ask yourself – Well how did I get here?

And you may ask yourself, what is that beautiful house?

And you may ask yourself, where does that highway go?

And you may ask yourself, am I right…Am I wrong?

And you may ask yourself, MY GOD, WHAT HAVE I DONE?

 

The Talking Heads express what many of us feel as we begin to realize how much deeper our hole is when abetted by money, power, and status.

Our reality

How is the Myth supporting our use?

  • People close to us or helping us may look at our assumed power (or the power of those associated with us) and be afraid to confront us with our behavior.
  • If we are related to or associated with the moneyed, powerful, or famous, we may be so dependent on the connection for self-worth, livelihood, or recognition, we can never let go long enough to develop a life of our own.
  • Drug and alcohol issues are about managing the image of abstinence or recovery – not necessarily about changing anything.
  • It is hard to experience healthy pleasure (including sex) in relationships because of doubt: Is it me or my money/body/fame? Am I being star-screwed? Substances help us gloss over all these feelings.
  • While the well-off are able to afford household help, this supposed luxury is belied by physical/sexual abuse by child care assistants or other employees. Because parents are dependent on their help, parents are reluctant to take action or are “too busy” to pay attention to what is actually occurring with their children.
  • Professionals, such as school personnel or doctors, refuse to believe us, because we come from such good homes, and their careers could be jeopardized by filing a complaint.

Different life, new dream

Reflecting on personal experiences, tallying up the high percentage of relatives with addiction and mental health issues and talking with others from similar backgrounds, provides solid evidence the myth is a sham. There is no American Dream! But we can learn to live a different life with a new Dream.

Wealthy, famous, powerful, and addicted – Part V

Oct. 10th 2014

Barriers to recovery: cultural and social rules

These rules act as breeding grounds for our addictions and prevent us from asking for help.

“What shows is what matters, and, above all, keep it in the family.”

 

In many settings, the very act of refusing a drink is viewed as being anti-social – so much so that when someone says, “No thanks, I’m in recovery,” common responses are: “You can have just one, right?” “Beer’s OK.” Or “Try this pill, it’s non-addictive.” Abstaining almost implies that anyone partaking has a problem, and that defies a heavily-invested-in norm – both literally (wine cellars and journeying) and emotionally (anticipating that drink or drug and conviviality).

 

The alternative of staying away is often viewed as an act of disloyalty, particularly for family summer or holiday gatherings, even though alcohol use is rampant and can awaken old using feelings for those trying to stay sober. And there may be a not-so-unspoken price to pay, when our economic wellbeing is dependent on family business employment or discretionary trusts. We may get a pass when first out of treatment, but many times we are simply expected to attend and tough it out, regardless of relapse triggers.

Examining social norms

One primary rule among wealthy and prominent families is that alcohol is served at every gathering. It is the social lubricant that allows many of us to function, connect with each other, and make our lives tolerable. (For the next generations, drugs serve the same function and are considered more socially acceptable than alcohol.) As Joanie Bronfman points out, this is one of many similarities between wealthy family culture and alcoholic family culture. Let’s look at others:

Our reality

  • The importance of maintaining appearances. What matters is what shows. What does not show does not matter.
  • Dress, manners, possessions, clubs, schools, activities, etc., show that one has money or is of privilege or power (can be counterculture as well).
  • Control and repression of feelings.
  • Limited interactions with people not like us. We’ve surrounded ourselves with “our kind,” going to the right schools, camps, colleges, living in the right communities, and associating with the right people.
  • A sense of entitlement. We believe we deserve what we have and expect to be treated differently than other people.
  • Judging ourselves in comparison with other people. This can be subtle or more direct, but comparisons often lead to feelings of superiority, based on what we have or who we are.
  • Expectations about appropriate work, mates, and social activities, which limit our individuality and creativity.
  • The message that we will be rewarded by our parents if we conform to their expectations as to how we should think and behave.
  • An emphasis on not showing off our wealth and prestige. Although some of us are ostentatious by choice – either deliberately modest or obnoxious.

And above all, when the going gets tough, we solve our problems our own way – thank you very much!

 

We learn social norms and rules as children, often by emulating role models or simply living a life organized around private schools, country clubs, camps, and second homes. The culture and expectations can be so internalized and stifling that we don’t speak our truth or have little idea as to what we want and who we are – a setup for the cocktail hour, joint, or pill taking on a life of its own. Handed down from generation to generation, this way of life is adopted by new entrants who are often unaware of the accompanying dysfunctions.

Save your face or save your ass

We can please our family and try to reclaim the veneer of respectability lost through our use, or we can recognize that committing to recovery means exploring, recognizing the limitations of our upbringing, and examining our delusions:

 

We live in the best neighborhood, our children attend the best schools, we support the best charities. Our family life is perfect – a credit to our family name… La-di-da.

 

When addiction strikes and it’s time to take a hard look at our lives and what needs to be changed to recover, breaking addiction means breaking the “rules.” It’s save-your-face-or-save-your-ass time; you can’t do both. Is what we tell ourselves, how we live our lives, and what we are told to do, working for us or contributing to our downward spiral?

 

Time to take a hard look at answering that question:

Sociability

A valued trait for fundraisers, parties, business, and volunteer work, gregarity doesn’t work in treatment. For those shy or uneasy with small talk, alcohol and drugs ease the way at these gatherings.

Happy hour medicating out of reality

Alcohol and drugs make it possible to remain in intolerable situations.

Speaking the truth is betrayal

Destroying the family picture that “life is good” feels like a betrayal of family and social class, no matter how ugly the scene is: neglect, physical and emotional abuse, incest, etc.

Women: deference begets abuse

Women are taught not to make a scene and do as they are told, resulting in a reluctance to respond to emotional and physical abuse, date rape, or guilt trips by outsiders. (Although this is slowly changing with new generations.)

Male dominance

The family and cultural imperative to produce a worthy male heir at any cost can lead to a sons’ dominance over sisters and toleration of “boys will be boys” behavior.

Believing I can do this myself

Individualism and the feeling of being on our own inhibit us from talking about our lives and asking for help. Our training about self-determination prevents effective treatment since we believe we “should” deal with the disease on our own.

What’s public is what matters

It is the public display of drunkenness that matters, not the private display. Thus, dealing with a drug or alcohol problem is figuring out how to limit the public display – not how to sober up.

Secrets take priority over connecting with peers and therapists

Keeping the family secrets is viewed as a valued act of personal loyalty, rather than as perpetuating separation between us, our counselors, and peers, who perceive our “loyalty” as distant and withholding.

A no-win situation

Keeping secrets is also a no-win situation: “I can’t talk about what it is like to be me. But I can’t get help if I don’t talk.”

 

Ultimately, it’s tough to maintain the appearance that we are fine when we are in a treatment center because our life is a mess and our use is out of control. But many prefer to ignore these facts, perhaps because the alternative is too scary and holding on to the outward manifestations of success is all we have left.

Escaping social rules and expectations? Or not!

“That ain’t me. I’m not a creature of my upbringing. In fact, I am doing things differently from what I learned as a child.”

 

You may say that. But not so fast. Family and past experiences are very influential, particularly when overusing drugs and alcohol or returning from treatment to the same environment but without our “helpers.” In these stressful situations, the ingrained behaviors and relationship ties, often at an unconscious level, take control and steer us into trouble spots. Too many cannot give up or postpone pre-recovery activities (e.g., the weekly lunch at the country club, fundraiser, hunting trip, etc.), and relapse is around the corner.

 

For those whose identity is centered on rejecting the rules, we often fail to recognize a real element of belonging is knowing what the rules are – whether we choose to obey them or not. This is a common experience for many addicts who perceive themselves as rebels or marching to a different drummer but who are still dependent on the monthly check.

Learning a new culture

As mentioned, this blog is about how cultural and social rules inhibit our recognition of addiction and keep us sick or in relapse mode. Learning a new culture – the culture of recovery – is key to overcoming the power of norms and expectations that perpetuate our disease. Other practices include building intuition (learning to access your heart and feelings, rather than the voices of others) and spirituality (connecting with a power outside of ourselves, not the expectations of others). Neither is a quick fix and both require almost daily focus to be successful. More on these topics in future entries.

Helping addicts stay the course

Oct. 6th 2014

8 ways leverage works to improve outcomes

Today’s topic could be called “Why We Love Leverage.” That’s because we use it for many purposes, including compliance with treatment recommendations, signing releases, and drug testing. As mentioned in past blogs, programs for substance-dependent physicians use leverage for similar purposes and achieve spectacular results when compared to other approaches.

 

To refresh: A high percentage of people who need treatment do not believe they need it and do not perceive themselves as having a problem with alcohol or drug use. Therefore, they are resistant to being forced into treatment. Adopting a leverage-based approach allows the family, working with their professional, to adopt a long-term strategy to address the addiction, including chipping away at the self-perception problem over many weeks, if not months. Continued pressure provides situations for the addict to develop insight into the disease over the stages of recovery.

 

Currently, no treatment center offers the medical board model to non-physicians, so we adapt and modify their model. Here’s why leverage is needed and how it works.

1. To help the addict complete the stages of recovery.

A recent article in a professional addiction journal discussed the developmental approach to recovery and the six stages to achieving stable remission[1]:

  • Transition – Recognition of Addiction
  • Stabilization – Recuperation
  • Early Recovery – Changing Addictive Thoughts, Feelings and Behaviors
  • Middle Recovery – Lifestyle Balance
  • Late Recovery – Family of Origin Issues
  • Maintenance – Growth and Development

In our experience, this is a two-to-five-year process, depending on the progression of the disease, severity of use, and co-occurring conditions (trauma, abuse, learning, mental health, etc.).

 

Leverage becomes especially important in the second stage.

 

Stage Two: Stabilization – Five Tasks to Facilitate[2]:

  1. Achieving recovery from withdrawal.
  2. Interrupting active preoccupation.
  3. Creating short-term social stabilization.
  4. Learning non-chemical stress management.
  5. Developing hope and motivation.

These stages take much longer than 28 days, which is why leverage needs to be maintained over many months – and also why relapse is so common: Addicts leave treatment without being stabilized. (By the way, did your loved one’s counselor ever tell you where s/he was in the recovery process? I think not!)

2. To allow time for converting external motivation to internal motivation to recover.

Therapeutic leverage to enter treatment and comply with post-treatment recommendations is needed because it is very difficult for people with substance dependence disorders to change harmful behaviors on their own.[3]

 

The goal is to maintain pressure until the person develops sufficient internal motivation to want to remain abstinent and active in a program of recovery on his/her own volition.

 

Internal motivation to recover is a much stronger indicator for success than external pressure. However, because the degree of internal motivation is measured by acts and attitude, rather than talk and intentions, it takes time for internal motivation to “kick in” and show itself – again, usually more than 28 days, especially after relapses.

 

To be effective, leverage must be used with sophistication and discretion and is much more a carrot-and-stick proposition than raw force. For the affluent, leverage comes from controlling money, participation in family businesses, access to family resources, and relationships. Leverage is most effective if senior family members, trustees, or others in positions of power support its use and are united when dealing with an addicted family member.

3. To obtain full releases of information.

One key element in recovery is open communication among the substance user, treatment center, and key players in the addict’s life. Substance dependence lives in secrecy, with the person often leading a double life and understating the amount and number of drugs, when caught. Insisting on being informed on treatment of your loved one’s disease is not only good practice but sends the message that your relationship is now different.

 

Leverage is an effective tool for encouraging an addict to sign releases. It is indeed more than ironic that so often families pay for treatment and then a wall of silence is erected based on confidentiality laws.

 

Affluent patients often will sign only partial releases and withhold information about post-treatment recommendations if the recommendations defy the patient’s wishes. One way to counteract game-playing by addicts regarding the scope of the release is to request the treatment provider to send a copy of the signed release to the professional hired by the family, who will understand any limitations in the document.

4. To encourage signing recovery contracts.

These contracts specify activities the addict will engage in when leaving treatment, such as counseling, drug testing, meeting attendance, etc. It usually includes a relapse plan and an agreement to sign releases of information for all therapists, who must be approved as addiction specialists. In exchange, the contract specifies expectations regarding support by the family or trustee for recovery activities and lifestyle.

 

If the person leaving treatment does not agree to the contract, the family can refuse to support him/her or provide minimal support, depending on their level of comfort.

5. To encourage long-term compliance with all treatment recommendations.

Failure to comply with treatment recommendations is the No. 1 cause of relapse. If a person had cancer and all they had to do to recover was follow treatment protocols, they would do so without fail.

 

Substance-dependent people – who also have a chronic disease where there outcome is death or disability – commonly ignore advice from professionals and go back to their old ways. Leverage encourages long-term compliance.

6. To require effective and comprehensive drug testing.

This should not even be up for discussion, given anyone’s history with an addict. Not only is it very wise to condition support and access to family resources on regular, observed, full-screen tests (because addicts lie), but testing helps keep loved ones on the path to recovery because they know they will be caught if they use.

7. To allow early intervention in the event of relapse.

When combined with drug testing and a written agreement as to what to do in the event of relapse, leverage provides for fast intervention before a relapse gets out of hand.

 

One problem with people who relapse is they can do so for some time before others become aware of it. Then, they deny it happened, and if proof exists, claim it was a one-time occasion. This is why drug testing is so important: It is undisputable data regarding use. And it allows for quick interceding before relapse becomes embedded.

8. To increase consequences of use to make the disease real.

One major block to recovery for affluent, substance-dependent people is that they suffer few external consequences from their use of drugs and alcohol. Research shows that the more consequences a person experiences, the more likely they are to take their disease seriously and take action to abstain and recover. For the affluent, a key challenge is figuring our how to recover without losing everything.

Making the disease more real

By using leverage to accomplish the goals in topics one through eight, we are in effect Creating Consequences™ by making the disease more real: Drug testing, recovery contracts, and treatment compliance create accountability and require action upon leaving treatment. Along with the written plan in the event of relapse, it means that if the addict returns home and takes it easy – does nothing much regarding further efforts at recovery – there will be consequences. The hard work begins after leaving treatment, and leverage provides the foundation to encourage continued progress towards stable recovery.

References

[1] Recovery From Addiction, A Developmental Model, Part One, It’s All in the Journey, Sept. 2008, p. 8.

[2] Ibid, p. 12.

[3] Satel, Sally, M.D. 2006. “For Addicts, Firm Hand Can Be the Best Medicine.” The New York Times, Aug.15.

A myth is that the addict must be motivated to quit – that, as it is often put, “You have to do it yourself.” Not so. Volumes of data attest to the power of coercion in shaping behavior. With a threat hanging over their heads, patients often test clean.

Goodman and Levy. Biopsychosocial Model Revisited. p. 3.

Chemically dependent patients, free of co-existing mental illness, with intact jobs and family, tended to do well in rehabilitation programs if families and employers applied therapeutic leverage and support.

Susan Merle Gordon. Relapse & Recovery: Behavioral Strategies for Change. Caron Found. Rept. 2003: p. 18.

Internal motivation is a more powerful predictor of recovery than external motivation. Moving from external motivation to internal motivation is a long process. Therefore it is critical for external pressure to continue until this transition is fully underway, if not complete. The failure to follow this advice is a major cause of relapse (paraphrased from report).

Chuck Rice. “Impaired Lawyers Overcome Denial, Stigma to Achieve Road to Recovery.” Hazelden Voice. Vol. 9, No. 2. Summer, 2004.

My experience with attorneys tells me that long-term outcomes are dramatically improved when lawyers can be monitored and when there is an accountability system with a fair amount of external support.

Alan I. Leshner, Former Director, National Institute on Drug Abuse. National Institute for Mental Health. Science and Technology. Spring, 2001: p. 2.

Treatment compliance is the biggest cause of relapses for all chronic illnesses, including asthma, diabetes, hypertension, and addiction.

 

Wealthy, famous, powerful, and addicted – Part IV (cont’d)

Oct. 1st 2014

Barriers to recovery: resentment and envy

“Oh no, you are one of those people, I can’t sit with you.”

 

We continue our discussion of negative reactions to us as a barrier to recovery by exploring its origins and, in our pursuit of sobriety, ways to offset or overcome it. As mentioned, many us go to treatment actually wanting to recover but hostile reactions on the part of other patients and staff impede our efforts – one reason for our high relapse rates.

Understanding resentment, envy and wealthism

In our society, it is still permissible to make negative comments about people who are well-off, prominent, or powerful. This unfavorable opinion can come from various places. For one, we can be assholes, particularly when using or stressed. In some cases, people have had negative experiences with wealthy or famous people, finding them arrogant, rude, obnoxious.

 

The growing income disparity also breeds animosity.

  • The top 10 percent now receive one-half of all income and own 75 percent of all assets.
  • The top 10 percent also received 116 percent of income growth since 2009, while the bottom 90 lost 16 percent – that’s right, they went backwards.

No wonder people are angry with us.

 

Additionally, wealthism stems from myths we and others create. Many people believe that material experiences or possessions lead to happiness – and if you have money, you shouldn’t have problems. People subscribe to the idea that we are happy, have an easy life, and can do whatever we want when we want to do it. There are several reasons for this:

  • We build our image to give the appearance life is easy and grand.
  • We’re unwilling to talk about the realities of our lives, especially the problems and dysfunctions.
  • We believe we have transcended the basic activities ordinary people engage in to survive, yet we behave in ways that prove we are unworthy of this transcendence. (See bad behavior of the week in people or the tabloids.)
  • Our culture sells Americans on the idea that those who work hard will be rewarded with success. Many people work hard, yet do not achieve their goals for success. This can lead to anger against the successful, their family members, and successive generations who simply inherit money. (See: our upcoming blog on the myth of the American dream.)
  • The media sell Americans on the idea that material experiences or possessions create happiness and satisfaction (or access to happiness and satisfaction). Since we have money, a name, or are in positions of importance, others conclude we must be happy, and they either want what we have or resent us for having it. (See: our blog on materialism.)

Whether legitimate or not, being self-aware and sensitive rather than dismissive of the views and feelings of the non-wealthy reflects an appreciation for how our circumstances in life could so easily be different.

Wealthism in counselors and the recovery community

In the counseling therapy community, unspoken and sometimes barely-veiled attitudes include:

 

“I work hard and I’m not rich. Why should you be rich, rather than me?”

 

“I hope you never recover because I will loss my cash fee.”

 

“As an alcoholic (or addict), you don’t deserve your money.”

 

Insight into counter-transference seems to be gleefully ignored and therapeutic integrity sore lacking.

 

When in treatment, our counselors encourage us to let down our guard and begin to trust our peers and the recovery community. But when we do, too often our newfound friends – even “sponsors” – ultimately are more interested in accessing our wallets, pants, or famous parents than supporting our sobriety. Halfway or sober homes with meetings open to outsiders are open season for sophisticated predators taking advantage of vulnerable clients just out of inpatient treatment. For those from out of town or with no stable outside friends, when this duplicity become evident, we withdraw – or even worse, relapse or give up on life.

Needed: good treatment centers and supportive counselors.

Unfortunately, centers providing quality treatment that address the needs of the affluent and therapists who can support us and advise us on how to tell our truth are hard to find.

 

(Note to us: We need to start our own one.)

 

What about centers that specialize in affluent clients?

  • First, many of the patients in these centers are not interested in recovery; they are there to dry out or please others – not a healthy peer group.
  • Second, many of these centers are high-end spas and lack the rigorous treatment programs necessary to build a foundation for recovery.
  • Finally, one core principle in recovery is that we become comfortable in our own skin – who we are as a person. We can’t do that if we avoid 90 percent of the population.

Aside from these three concerns, in my view specialty centers do not truly understand our underlying drivers of addiction or the barriers to and challenges of recovery. Treatment approaches tend to be superficial, rather than helping us gain insight into deep-seated fears and well-guarded feelings about our childhood experiences and relationship with money, power, and prominence.

 

My experience

 

On personal level, I was outed by someone who knew of me, so I made a decision to be honest regarding my general circumstances. Because I had talked about the loss of my brother and son, a good connection existed with many peers. And having spent years in sports and all male schools, I knew how to navigate the treatment unit environment. But many others are not at all successful.

 

When I did discuss how my finances and upbringing were part of my addiction, several peers came up to me and talked privately about their situation. But when their time to share came, they kept all that quiet. I could see the difference between the relief I felt from being honest and their continued obsessions and resentments about being in treatment. This was a light bulb moment for me and a motivator for exploring how wealthism impacted other affluent people attempting to recover.

What to do?

Some recovery practices combat resentment and envy. Here’s how:

  • Ask for help from trusted counselors, mentors, or friends (a support team) about how to tell our truth to others. This is about coaching and support. Since this is new for us, there will be a variety of experiences to talk about with our support team. No one gets this right the first few times. It is empowering to let others know who we really are.
  • Tell who we are in a safe environment. The fear of speaking our truth is much greater than the reaction we receive when we do talk about our lives. Most people will still like us. A few will not. Don’t take it personally.
  • When describing events, use the general description of the problem rather than the specifics. Otherwise the focus of the listener is on the details, rather than the problem. Example: “I went to political events to make me feel important. I was able to donate large sums of money which gave me access to the most important politicians.” Do not say, “I donated $100,000 to the Republicans, which allowed me to have lunch with Dick Cheney.”
  • Speak to the feelings and emotions in our lives as any normal person would. Allow yourself to be fully human. It is OK to acknowledge serious problems in our lives and deficient upbringings, while at the same time having or being related to money or prominence.
  • Set boundaries. Another time to ask for help or coaching. Examples of boundary talk:
    • “I am afraid to tell you about me for fear that you will not like me, ask me for things, or gossip about me.”
    • “No, it is not OK to ask me for my autograph; I am here for treatment (a meeting).”
    • “I am hurt that you seem angry with me, but I am here for help and I can’t get help unless I talk about my life.”
    • “The person you see in the picture or film or on TV is not the real me. It is an act or an image. The real me is an alcoholic/addict.”
    • “I am angry that when I told you money was an enabling factor in my life, you turned around and asked me for money. I feel that is a violation of the group trust.”
    • “Just because I look good by society’s standards does not mean I don’t have problems. I do have problems and I would like your support.”

All of these suggestions require sound advice and strategizing with a trusted therapist or friend and the courage to try new behaviors. We need to be better prepared to face resentment and envy in treatment and outfitted with the skills required to work through wealthism and focus on what brought us there in the first place: recovering.

Tragedies in the making

In our work, many of our most painful conversations are with parents who give up on children who keep relapsing and are deemed treatment resistant. When we dig deeper, we find their adolescents and young adults were afraid to participate and sometimes abused because of their background. These are tragedies in the making – almost all avoidable – one critically important reason to ignite a conversation about wealthism.

 

Too many of us go to treatment and are blindsided by negative comments or withheld interventions by staff and it’s time to bring this problem out in the open. It’s our experience and if people resent us for who we are, it’s their problem, not ours. Individually and collectively, it’s essential to summon the strength to be who we are – tell our truth and get on with recovery. Nothing makes the resentful angrier than to see us become sober without losing everything. And nothing makes us happier than doing so.