Archive for the 'Wealth' Category

Marijuana: Family and advisor responses and recommendations

Mar. 31st 2015

Part II

As emphasized in Part I, it’s important to acknowledge the positive and enjoyable aspects of pot use to establish credibility with young adults. After all, they know many of us older folks smoked in our early days and we did indeed inhale, unlike one of our presidents.

 

However, to reiterate, marijuana’s downside is that repeated use impairs learning and executive/problem-solving brain functions. With many regular users chasing higher THC concentrations (up to 27 percent), being able to identify at-risk and dependent users becomes an imperative. Note that, in contrast, medical marijuana is effective at 9 percent THC in very small quantities (two or three times a day) – one way to identify those truly in need of pain relief vs. those gaming the system.

The survey says

Another important part of any discussion with young adults is putting marijuana use in the context of other substance use, including alcohol.

  • Surveys show within a two-week period, 13 percent of college students had 10+ drinks in one night and 5 percent had 15+ drinks in one night.

Potheads are quick to point out this comparison (binge drinking at 18 percent vs. regular pot use at 9 percent) while also noting the difference in post-use effects – namely no vomiting or hangover. But let’s not fall into the trap of arguing which type of substance is superior. Going down that rabbit hole with Alice (a.k.a. your client, son, or daughter) leads you to a land of never ending rationalizations and justifications.

 

By the way, these drinkers and smokers are two separate groups, so the total for male students with substance use symptomatology is at least 27 percent. Add in the one in nine in 2013 who used Adderall without medical supervision and smaller numbers using other drugs, and you can understand why we keep harping on the fact that this problem can no longer be ignored.

 

A recent New York Times article on 12 hospitalizations due to ingestion of “bad Molly” on the Wesleyan campus led police to discover 600 Xanax and at least 15 other prescription drugs in room searches. Noted one expert at Columbia College:

 

“Where did this kid get such a bizarre collection of drugs? … It’s very frightening, because these drugs can cause fatal reactions.”

 

Great question. The answer is everywhere. This type of use by different groups – the drinkers, smokers, and stimulant freaks – is prevalent on all campuses and upon graduation will either become part of your client base or potential work force. 

Evaluation

Clients come to us suggesting we evaluate a young adult to see if there is substance dependence. But good luck conducting an assessment based on self-reporting. All we hear is minimization and excuses. Reports from concerned family members are rejected as overreactions or one-time “experimental” events. When marijuana comes up for discussion, the attitude is “It’s legal or should be legal.” Without objective external evidence, convincing a young adult to cut back or seek help can be fruitless, particularly if they have access to trust funds or are employed.

 

Be aware that for an evaluation to be accepted in court in our state, at least three outside collateral sources are needed to verify information about the subject’s drug use. Identifying and then even suggesting talking to these collaterals can be contentious, to say the least.

 

As mentioned in Part I, by understanding marijuana’s effect on the body and why people like it, family offices and advisors can tailor an approach that focuses on education, establishes behavioral standards and performance expectations, and puts policy in place for family members.

Recommendations

For the office, drug testing is the most reliable and prudent approach to ensure you are not putting your reputation and fiscal integrity at risk. If a person wants to smoke dope or use other drugs, they can work at a coffee shop, but not for you or the families and clients who rely on you.

 

For your clients, there are two complementary tools: education (scientific advances, including brain scans) and behavioral expectations and standards.

 

Education: the science of brain scans

Showing younger generations how brains of pot smokers compare to the brains of non-smokers is an excellent educational tool. When accompanying accurate information on how weed affects the body – both the fun and unfun sides – scans can be persuasive. Another tactic is to find a respected family program, like Hazelden’s, where teenagers and their parents can learn more about substance dependence and how it is linked to brain changes.

 

Behavioral expectations and standards

Aside from the educational approach, the critical piece has to do with behavioral expectations and standards. Start with solid baseline information on aptitude, skill level, and any learning concerns. Assuming you or the parents you are advising have this information, assess whether there are underperformance or behavioral concerns that warrant evaluating the reason for the differences between expected and actual results. This may require educational or other testing to explain the disparity.

 

As you continue on, it’s necessary to come to an agreement or otherwise establish goals for the young adult in question. It is through a thoughtful goal-setting process with measureable standards that dysfunctional behavior can be identified, particularly if there is some indication drug testing is a necessary part of the process.

 

Note the connection to the Social Impairment diagnostic criteria for substance use disorders:

 

Social Impairment is the second grouping of criteria (Criteria 5-7).

  1. Recurrent substance use may result in a failure to fulfill major role obligations at work, school, or home.
  2. The individual may continue substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.
  3. Important social, occupational, or recreational activities may be given up or reduced because of substance use. The individual may withdraw from family activities and hobbies in order to use the substance.

Setting measureable goals and expectations can provide the factual basis to support findings relating to social impairment, an area of vulnerability for pot smokers. When facts become apparent, it’s a good time to introduce drug testing. Tests can now be justified to parents and families who might previously be concerned about an unwarranted invasion of privacy.

 

present in an alcoholic as you would in someone whose drug of choice is marijuana. For example, take impairment criteria 3 and 10, more common to binge drinkers:

  1. The individual may spend a great deal of time obtaining the substance, using the substance, or recovering from its effects.
  2. Tolerance is signaled by requiring a markedly increased dose of the substance to achieve the desired effect or a markedly reduced effect when the usual dose is consumed.

The people consuming 10-15 drinks in one sitting will have a high tolerance and spend a great deal of time recovering from the effects of doing so. Each drug presents its own set of challenges and impairments. By DSM standards, one is not better or worse than another. Disordered use is disordered use.

Three points

1. Take action or problems will get worse
Don’t let under performing, slacker, next-generation family members meander through their formative years without a plan to investigate drug or learning concerns. (Otherwise they become dependent – in the full sense of the word – 30-, 40- and 50-year-olds.)

  • Of course, this assumes the family office and governance documents contain expectations as to performance.

If not, and each branch handles these issues individually, you will be an observer of the long-term effects of drug use and living proof of affluent “falling generations.”

 

2. The code of silence

Don’t expect siblings, cousins, or friends to blow the whistle on heavy pot smokers (or other drug users or drinkers, for that matter). There is a fierce unwritten code not to rat out substance users.

  • If you do hear something, follow it up because it usually means the person of concern is in way over their head.

However, even if the information is persuasive, you will need to determine if it carries the same weight with the deciders (i.e., parents or grandparents) before you proceed. They will often either be in conflict or more concerned about reputation and succession, and thus eager to shoot down stories from their heir’s friends.

 

3. Cross-addiction

Simplistically, the brain reacts to most drugs in the same way. It doesn’t distinguish between weed, alcohol, coke, and other substances in terms of their addictive nature. So when someone comes out of treatment and says, “They told me I can’t do vodka, but I can have beer and weed,” that’s a lie. Ask them to sign a release so you can see their discharge summary with their diagnosis. This type of misinformation is a lot more common than you would imagine.

Not going away

We hear from our friends in Denver that home prices are skyrocketing due to an influx of younger folks of independent means who seem to be moving in so they can enjoy legal bud. Who knows if this is fact or old folks’ imagination, but what we know is weed is not going away. It’s going to be more pervasive and impactful on communities, including the families we serve and the people we employ. Doing nothing is not an option.

Recovery dilemmas: Should I stay or should I go?

Feb. 19th 2015

Wealthy, famous, powerful, and addicted

A dilemma is a situation in which somebody must chose one of two or more unsatisfactory alternatives.” Also called a “quandary,” “tight spot,” or “Catch-22.”

 

Many affluent addicts in treatment find themselves in “recovery dilemmas.” These dilemmas stem from conflicts between how we were raised and what we learn is needed to achieve a sober life. These can be presented as choices between actions to take, but I think they really are better described as emotional conflicts between staying in our comfort zone (existing attitudes, behaviors, and social norms) and the fear of trying something new and unknown.

 

The following are common dilemmas those of us with wealth, fame, status, or power encounter when trying to transition into recovery.

 

(Where do we see ourselves when reflecting on these dilemmas?)

 

Shame re: money/status vs. talking about the issues

Money is very confusing to children. They enjoy the material benefits that come with wealth, even though such benefits are unequally distributed among socioeconomic groups. When children are taught it is wrong to think of themselves as superior, those teachings are easily converted into feeling guilty and thinking they are “bad” for enjoying their privileges. Because children think in black and white, this thought process leads directly to shame and a more fragile sense of self.

 

In treatment, we tell ourselves: “I can’t talk about this – both the pleasure from having money and the opposite – the shame from enjoying our privileged status.”

 

The antidote to this disease is honesty. Will our shame keep us sick? Will it keep us from talking?

 

High expectations vs. the disease concept

The burden of high expectations, coupled with much criticism by adults and a never-good-enough educational system, makes it very difficult for us to accept that our behavior stems from having a disease. Instead, we view the problem as the failure to control drinking or use.

 

The resistance to the disease concept also makes it difficult to seek family support: “I never knew my nephew was a heroin addict until he died of an overdose.”

 

Where am I with my beliefs as they relate to control vs. accepting I have a disease?

 

Expected behavior vs. recovery activities

There is a narrow range of acceptable behaviors in all areas (e.g., career, speech, friends, social activities, hobbies, etc.), and many of us in the moneyed class fear deviating from the “norm” and being rejected by our social/business class or by our parents.

 

It’s the “save your face or save your ass” dilemma: “I can’t give up doing what others expect of me. But then I can’t recover that way, either”.

 

Recovery requires taking risks, redefinition of self, and hanging out with others on the same path.

 

Outward appearances vs. internal feelings

Parental absence, isolation, and “don’t trust anybody” rules can lead to shy and lonely adults. This comes across to as being a “snob” or as “not one of us,” particularly in groups. Sadly, this is usually the opposite of what the person intends to communicate.

 

Another result is a superficial sociability, which is also off-putting. These kinds of interactions may be attempts at intimacy, but the truth is that those raised in wealthy culture often do not know how to express feelings. We are at loss to do so: “I feel so cut off, so alone.”

 

Can we talk about why we are unable to talk?

 

Controlled emotions vs. empathy

Repression and control of feelings for us are the social norm (but it’s OK to give reasoned criticism). In trying to show no pain, many often feel no pain. Other times we feel the pain but don’t express it, leading to the same problem.

 

This makes it difficult to empathize with others in groups and form relationships based on expressed feelings: “I feel no emotions.”

 

Stick with the basics: sadness, anger, fear, and joy. Can we be angry about losing our only way of coping? Or is that too embarrassing?

 

What shows is what matters vs. it’s what’s inside that counts

The emphasis on the positive public/social image prevents us from acknowledging the private and personal effects of use and the harm to family members. This attitude often allows the addiction to become so embedded, it is almost impossible to recover. The effects on children are devastating. But “What will they think of us?” predominates.

 

Why wait to address the problem until the overdose, the car wreck, or the cirrhosis goes public? Besides, many people know anyway.

 

Concealing WFSP attributes vs. being real

Limiting what information we share helps avoid resentments but creates an incomplete or misleading “protective” identity in treatment and recovery. This concealment comes at the price of dishonesty and the stress of managing information.

 

We tell ourselves: “I just try to fit in. I won’t talk about the money. It doesn’t matter.”

Can real progress happen with a big piece missing? True acceptance of our disease rarely occurs when so much energy goes into controlling information and the perception of others.

 

If the whole me is not out there, the whole me can’t recover. The missing part will stay in addiction. Worrying about whether they like me won’t get me sober.

 

Limited relationships vs. recovery relationships

Associating with people from similar social or economic backgrounds limits access to meaningful relationships with the whole spectrum of the recovering community. Reality checks offer perspective and balance. Staying within our social set may keep us away from the resentments of others and the feelings of guilt and isolation from being privileged and different, but avoiding these reactions comes at the price of learning about the real world.

 

We must be careful not to try to manipulate our world for the sake of personal comfort: “I don’t relate to those people.”

 

Rejoining the human race around the commonality of shared disease is part of the recovery process. Trusted counselors and peers help teach us how to benefit from group interactions and 12-step meetings.

 

The experience of control vs. the experience of consequences

We are used to exercising power over our environment (control). We make decisions and watch as things happen. However, our consequences remind us that we are not in control. Rather, it is consequences that make the disease a reality. Recovery cannot be controlled, but we can allow ourselves to feel what recovery is like for us.

 

Exercising self-will, thought, and direction is useless for addicts and alcoholics when we want to use: “I know what to do to stay clean or not drink” is a common delusion.

 

How does it feel to be an addict without a drug or drink? What does if feel like to be powerless? Once we let go and begin to experience recovery as it happens, we understand we were never in control.

 

The problem (social) drinker vs. the alcoholic

Affluent culture downplays alcoholic and addicted behaviors, using terms like “problem drinking,” “having a good time,” or saying we “deserves to relax.” The predominant role alcohol plays in social settings and the expectations regarding drinking reinforces concepts of normal use that are, in fact, alcoholic. The point here is naming the behavior and use as addictive.

 

The serious drinker or drugger will socialize with others using at the same level, hide use, and develop dependent business associates, assistants, and family members to avoid being identified as alcoholic or drug addicted: “If I am an alcoholic, so are all my drinking friends.”

 

Who will call it as it really is? And once called, who will stick with it?

 

Public behavior vs. private behavior

If the problem is defined or caused by a public incident or social disgrace, it’s easy to focus on the behavior that caused the incident/disgrace, rather than the big picture. By the time the latter comes into play, there is usually severe emotional, mental, and spiritual degradation.

 

Solving the problem becomes eliminating the public behavior, rather than true recovery: “I will make sure they won’t see me drunk or high again.”

 

The trick here is to move beyond public behaviors or incidents to private/personal conduct, emotions, and mental status – to define us as addicts/alcoholics. Without this transition, motivation to recover is tough to sustain.

 

Looking different vs. identifying with others

Due to the protected environment and lack of consequences resulting from money, power, and status, it can take a long time for use to hit home. That is why we come into treatment sicker than many others. But the tragic irony is that so many of us believe we are better off and different than others in treatment who have experienced serious consequences.

 

This is an illusion is fostered by the ability to maintain outward appearances during heavy drinking and drug use when others cannot: “Who are these people?”

 

The inability to identify with others compromises our learning from them and asking for help.

 

Without money, influence, or friends to cushion our consequences, what would we do for our drug or drink? What would we look like?

 

Pseudo-recovery vs. true recovery

Pseudo-recovery is running a program that looks good to the outside observer. We are socialized to focus on the externals, hang out in the right places, and show no perspiration. Too often the question is, “How should I behave in recovery?” Not, “What do I need to do for recovery?”

 

What does it mean to be in recovery? Who knows the answer?

 

Silence vs. talking (the isolation trap)

We are trained to present everything as fine – at the expense of ignoring personal difficulties and withholding information. But if we don’t talk about issues, we can’t get help. Our counselors/peers are then unable to provide relevant feedback and advice, thus reinforcing our sense of isolation and hopelessness.

           

I can’t talk about these things with my counselor.” Actually, “won’t” is a better word.

 

We are not unique. We fit an all-too-common pattern. Our counselors have heard similar stories many times. The choice is to trust and talk or continue using.

 

Class expectations vs. commitment

The attributes of having money, status, and power and what they bring become ends in themselves. Recovery requires committing ourselves to something we care about outside of our lives that is not based on money, etc.

 

Who am I without my money, status, power, fame, and image?

 

Material success vs. self-esteem

Luxury, money, power, and fame are not fulfilling. Often we lose our sense of inherent value and set out to distinguish ourselves from others by developing false pride base on our name, wealth, or connections, instead of true esteem derived from deeds.

 

People equate material success with well-being: “Look at all I have, I can’t be an alcoholic.” “Look at how well I am doing, I can’t be in relapse.”

 

Rather the opposite is accurate. Early recovery is about limiting our materialistic trappings, resisting contact with outside voices that reinforce the material, and working a comprehensive program as our first priority.

 

Recovery is finding well-being in the non-material activities.

 

A life with WFSP vs. reality

We often are too insulated and lack accurate information about the world. This allows problems and feelings to become magnified and intensified out of proportion. Correction occurs through contact with regular people, particularly those in AA.

 

On the opposite side of this coin, mentoring by others with similar backgrounds has powerful impact because we can no longer use the excuse that money makes us different and, therefore, we can ignore advice on recovery. (This attitude also may be why we don’t want to hang out with our peers in recovery from similar backgrounds – they can call us out.)

 

Are we open to risk exposure to learning opportunities?

 

Institutional power vs. personal inadequacy (pseudo-power)

Often we exercise institutional, professional, or family power, but on a personal level we feel inadequate because we may not have lived up to our own expectations or our values. To compensate for these inadequacies, we can turn to pseudo-power (the arbitrary, self-serving use of power): “Talk to so-and-so. They’ll tell you I can’t do what you are recommending.”

 

But pseudo-power does not work in recovery. This kind of attitude or the actual use of parents, agents, or other outside forces is not going to keep us clean. Some other solution must be found.

 

Are we willing to sit with our feelings of inadequacy long enough to take at look at their origins?

Many tough questions

These are tough questions that many of us face when no longer using and when ignoring them is no longer an option. When people ask “What’s going on?”, often we are mulling over these and similar quandaries in our minds, trying to figure out whom we trust enough to talk them over without being judged or scorned. Should we test the waters with some trial balloons, jump right in, or keep quiet (and keep suffering)? There are no easy answers here in ambivalence land – where staying in the middle of the teeter-totter is only a temporary solution.

Why don’t they change?! – Evaluating the therapeutic environment vs. blaming the addict

Feb. 12th 2015

Wealthy, famous, powerful, and addicted

This phrase – “Why don’t they change?!” – expresses the frustrations many counselors and family members experience when we enter treatment, complete our stay, and then struggle with relapse.

 

  • They tell us we don’t understand the first step, meaning we are unable to talk about or accept our powerlessness over drugs or alcohol or we believe we can control our use of alcohol or drugs by saying, “I’ll do a better job next time.”
  • We also are described as “running our own recovery program” and “unwilling to ask for help or take direction.”

Counselors will say in their treatment meetings that we have not suffered enough or need to go back out and use again so there will be more consequences. Their thinking is that with more consequences, we will admit to powerlessness over use and listen our counselor.

 

In my view, the answer to “Why don’t they change?” lies as much with counselors and the protocols used to treat us as within us. After all, we are the ones who need help, and to reject us out of hand is anti-therapeutic, to say the least – especially given the amount of money charged upfront for treatment. If we seem stuck, resistant, and likely to relapse, a far better approach is to evaluate the treatment setting and see if the right conditions exist to promote change.

Safety and trust

People – even those of us with wealth, fame, status, or power (WFSP) – generally do not change unless they feel safe and trust in their surroundings and counselors enough to risk new behaviors and shed old attitudes.

 

In my experience, there is far too much labeling of us by treatment center staff as uncooperative and far too little self-examination and acceptance of responsibility on the part of counselors and staff for how they can help promote change.

 

This means assessing why change is not happening and how the situation can be modified to help us take the risks and make the emotional shifts necessary to begin recovery.

Accessing emotions

Another impediment stems from the current treatment model, which emphasizes education and information. This is based on the idea that by reading and thinking about addiction, we will be inspired to stop using. To the contrary, we need an approach that builds trust and accesses our emotions – one that is based on relationships with empathetic counselors. While we may be motivated to enter treatment, once there, we need a supportive environment to create the conditions necessary to encourage us to adopt new behaviors.

 

To aid our discussion of these conditions, I developed the accompanying chart (below) with the client in the middle (that’s us), the counselor on the outside, and the interactions between the counselor and client that promote change (in yellow). For the client, there are four factors that set the stage for the change process (in blue) and four counselor attributes needed to encourage us to change. This chart helps in assessing where the blocks are to the change process.

Screen Shot 2015-02-12 at 12.02.45 PM

Conditions for Change for the Client 

  • Safety
  • Time
  • Space
  • Commitment 

Interactions Promoting Change 

  • Content
  • Personal Reflection
  • Dialogue
  • Coaching 

Counselor Attributes Supporting Change 

  • Conviction
  • Real
  • Compassion
  • Integrity

Conditions for Change

The client; the client’s family, social, and business relationships outside of treatment; and the counselor determine these four factors. For example, time can be influenced by how long the client is expected to remain in treatment or spend in recovery activities after treatment. Space is both a function of whether the client is expected to do business or communicate with family and friends while in treatment, as well as whether the client intends to do so or focus on treatment. In contrast, safety is very much influenced by the environment and counseling staff.

 

Safety

Treatment should foster an open environment in which it is safe to speak up without fear of reprisal, retaliation, or personal rejection. This includes:

  • No sharing of information with outsiders.
  • No reactions of resentment, envy, or awe.
  • No asking for money, favors, or a personal relationship.
  • Hearing what is said, not making it “off limits” because it doesn’t fit preconceived ideas about what is supposed to be said in recovery (i.e., talking about how money and privilege has impacted our life and addiction).
  • Setting boundaries.

Safety allows trust to develop. With trust comes the opportunity for honesty.

 

Time

We must allow time for the process of recovery. Getting over the physical affects of drugs and alcohol has little to do with recovery. Living a sober life means:

  • Recognizing the mental, emotional, and spiritual impacts of the disease.
  • Working on changing behavioral patterns from using to “normal.”
  • Learning to have personal relationships based on intimacy.
  • Establishing boundaries with non-WFSP.

These tasks rarely are accomplished in an in-patient program. The usual 28 days in treatment merely provide a foundation for continuing the process in the community.

 

Space

Treatment is supposed to create the space to reflect on core issues where we transition from our heads and into our hearts – where it is OK to feel confused. Having the space to recover means:

  • Getting away from it all.
  • Limited business transactions.
  • Minimal relationship calls.
  • Not using money or prominence in a way that separates us from others.

Allowing space is part of our recovery journey as we begin, over time, to gain insight and feeling into the layers of our experiences.

 

Commitment

Are we willing to do what is necessary for recovery? Committing to the process includes:

  • Recognizing we don’t have the answers.
  • Staying the course without knowing the outcome.
  • Asking for help.
  • Allowing counselors to “encourage” our efforts.

Part of commitment is the courage to try new ways of interacting with others – to engage in trial and error.

Interactions Promoting Change

The counselor’s role is to engage in interactions leading to a change of perspective and, subsequently, behavior. The perspective change may occur during therapeutic encounters or later when we have an opportunity to process our experience. Thus, desired counselor attributes include the ability to communicate and interact with us in ways that support internal change.

 

Content (Information)

This includes what counselors know about the clinical needs and childhood experiences of the affluent, wealthy, and prominent (and how it is different for men and women). By knowing actual content, counselors build trust with patients. Examples:

  • Secrets
  • Lack of consequences
  • Being special
  • How money affects relationships
  • The connection between money, prominence, position, and addiction
  • The resentments and misconceptions of others

And most importantly: how this has impacted our lives.

 

Personal Reflection (Feelings)

Pain and emotional turbulence leads to change. There are countless ways we experience confusion regarding our addiction:

  • This is not how I planned my life.
  • What has happened to me?
  • How did I get here?
  • Why can’t I stop using?
  • Will I ever feel better about myself?

Counselors should be mindful of childhood issues (i.e., where is the pain?) and, for the newly successful, the fear of failure and feeling like a fraud.

 

Dialogue (Intimacy and Honesty)

Through honest discussion, counselors should be able to identify some of the challenges and dilemmas we face in the treatment setting in terms of relating to other patients, staff, and AA attendees. These obstacles can include:

  • Isolation vs. connection
  • Living in images vs. being real
  • Comparing differences vs. seeing similarities
  • Money and fame vs. recovery and humility
  • Remaining static vs. starting the process of insight

Coaching (Model Interactions)

Counselors are tasked with understanding where we are in terms of time, safety, space, and commitment to being in treatment and recovery. The counselor can help suggest words to use and ways to communicate with other patients, staff, and in meetings, such as:

  • Describing life experiences in ways that reduce distractions over details but still convey the meaning.
  • Owning one’s own bottom.
  • Setting boundaries (e.g, saying “no, I am here for treatment, not loans, tickets, or autographs.”).

Counselor Attributes

We often have very low trust levels in helping professionals, as well as the general public. This low trust level results from exploited relationships by counselors and apparent friends. Most of us have developed a “radar” to distinguish between people who are being genuine and those who are presenting a false front (exception: when we are using or with skilled manipulators). Counselors must be absolutely comfortable with their feelings about money and status, and if they cannot treat us without resentments, disrespect, or genuine empathy, they should not take us on as patients.

 

Conviction

Counselors must have confidence in what they are telling their patients and have faith that the information will promote recovery. If they think we do not really have specialized clinical needs, we will pick up on this attitude. Here’s what’s necessary for a counselor to be effective and convincing:

  • They need to walk the walk (and not speak negatively of us when we’re not present).
  • Focus on recovery.
  • Believe what they say.

Real

Putting on a false front to impress a patient or hide insecurities about having a patient who is very wealthy or famous is all too common. We easily see through the façade. Keeping it real includes:

  • No images
  • Humility
  • No hidden agendas

Compassion

An effective counselor needs to understand that money and prominence are barriers to recovery and that every person’s “story” is valid, despite the circumstances. Showing compassion means:

  • Hearing what is being said – not thinking “I wish I had that problem!”
  • Listening without judging.
  • Understanding the difficulties of recovery unique to the patient’s situation.

Integrity

Counselors are here for the patients, not the other way around. Too many times we become a source of vicarious pleasure for the staff. This becomes self-evident and destructive to the counselor-patient relationship. Integrity depends on the following:

  • Boundaries
  • Privacy
  • Focusing on the problems and issues that brought the patient to treatment

Trust comes from integrity, when we can see that the counselor is not focusing on who we are, what we have, and what we’ve done.

The professional’s therapeutic task

Recovery requires effort and commitment on the part of the patient and the counselor – neither can be held solely responsible for the success or nonsuccess of treatment. It’s true that many of us with WFSP show up to treatment with self-imposed limitations and expectations, but it’s a therapeutic task on the part of the professional to convince us to stay, encourage us to let go of our old habits, and to trust the process. But as we all know, trust is hard won, and we need the appropriate conditions. It’s on us to remain open to treatment, and it’s on the professionals to be worthy of our trust.

 

Not many treatment centers are up to the challenge of creating the conditions for change discussed here. But once a safe and trusting treatment environment is established, it’s up to us to choose to venture into the uncharted territory of recovery and say goodbye to our using lifestyle, friends, and ways of thinking.

 

Upcoming blogs will delve into dilemmas that inhibit our ability or willingness to commit to recovery.

Recovery ambivalence: a rich man’s son

Feb. 2nd 2015

Wealthy, famous, powerful, and addicted

I might start off by giving the experience of a man whom I have not seen for two or three years. His experience so well illustrates the nature of the problem with which we have been dealing. This man was a rich man’s son. …

 

Well, he did a conventional amount of drinking, and that went along nicely a number of years, and then he found he began to get drunk, very much to his own consternation. …

 

I have indicated, I think, that he was a person of character, and great force of character. Therefore the question immediately arises in everyone’s mind: “Why didn’t he stop?” But he did not. … [L]ittle by little, matters got worse and he began to go from one hospital or cure to another.

 

And the very strange thing is that while this is going on, many of us seem to all outward appearances to be sound and able citizens in other matters. Our minds waver, and we wonder what in thunder is the matter.

 

This quote from Bill Wilson’s presentation at the Rockefeller dinner in 1940 introduces the second section of our “Wealthy, famous, powerful, and addicted” series: Ambivalence!

 

After previously exploring barriers to quitting drinking and drugging or entering treatment, we now turn to the next challenge: ambivalence about whether we actually want to stop using and commit to recovery.

 

Do we truly want the drug-free lifestyle, or would we rather return to substance use – although modified, “under control,” and less visible?

 

Ambivalence commonly occurs after detox, once the drugs are out of our system. We’re already feeling so much better – relieved to have dodged that bullet. But our emotions are raw, and our coping mechanisms and reliable friends are gone. Now what?

The internal tug of war

A tug of war starts with competing voices in our head, as the enormity of the task sinks in. Having money or connections heightens the challenge, providing so many options for figuring out how to get away with it, to deceive ourselves, family, and friends, and to return to our old ways of being. And the shame of falling from high places and ever regaining our standing, combined with the shame of being an addict, makes it all the more difficult to choose to face the reality of our lives.

 

Aside from this internal debate, there are many external pressures – family, social milieu, profession, business, media, etc. – that bear on us when contemplating embarking on a sober life. In the book, The Power of Habit, the author points out that we have limited amounts of energy to learn new behaviors. If we are dedicating a great deal of this energy to fending off external forces that cue using triggers or distract us from our chosen path, we don’t have enough left to win the internal battle.

Outside forces

While future blogs will explore this internal struggle, this one focuses on the many ways outside forces undermine recovery, essentially tipping our ambivalence over to the dark side. Having seen this happen over and over again, the remainder of this blog aims to support those of us exposed to these pressures.

 

From brain scan research, personal experience, and observation, we can answer Bill Wilson’s question of what in thunder is the matter with this rich man’s son: a level of external pressure that can make attaining a sober life near impossible.

 

We now know that using drugs repeatedly over time changes brain structure and function in fundamental and enduring ways that persist long after the individual stops using. Core areas of the brain are reprogrammed so that in the presence of “environmental cues,” we will want to use mood-altering substances. Even after long periods of abstinence, brain scans show that the “craving” areas of our brains light up in the presence of alcohol and drugs in ways unique to us addicts.

 

Too often parents, employers, or media all pay lip service to supporting our recovery, but their behavior belies their verbal encouragement. In reality, we are supposed to go off to treatment and then return to our normal lives – just not drinking or drugging. It’s easy for us to buy into this scenario, as we long for acceptance and try to get back into their good graces, rather than focus on the danger our old life poses to our hard-won “days” of new freedom.

 

How many times have I heard:

 

“My family/law firm/production company/business wants me back, or there will be repercussions.”

 

Or how about:

 

“If I don’t go to my family’s vacation home in Hilton Head for the annual reunion, my parents will cut me off.”

 

Sad, ignorant, and perverse, yes – but all too frequent. We are expected to pick right back up as if nothing happened. Whether self-imposed or required, premature exposure to our “craving cues” leads to relapse.

‘Do you mind if I have just one?’

How many times do friends and relatives ask that question at cocktail hour or when out to dinner? While we have no choice but to tolerate other people drinking in our presence, why drink at all around a friend or loved one in early recovery?

  • Show some respect for what we’ve been through and for the power of the disease.
  • For families where drugs and alcohol have caused so much harm to so many, set an example.

After 19 years of saying “Go right ahead,” on my birthday, I finally said, “Yes, I do mind.” It felt liberating.

Navigating the social scene

At larger family functions, where alcohol flows freely, often 30 percent or more – depending on your definition of substance dependence and how self-serving the answer is – are alcoholic. (Excluding those dependent on pills or weed.)

  • How about the great uncle spotted with a tall glass filled with vodka at the holiday party?
  • Or the cousin with pinpoint pupils toasting his father?

What’s that? Nobody wants to know. The senior leaders who can set an example or chart a different course turn a blind eye. Then they ask where you are. Sayonara – that’s what I say, but many feel we must remain and endure.

 

For those of us encouraged to maintain our social connections, friends ask us to join them, telling us they’ll make sure we only drink Pepsi. As an added bonus, we can drive them home! Or we can join them at the 19th hole or country club lunch and drink Perrier. Yeah, right. And then they wonder why we are drinking “again.”

 

Some of us also face our friends, family, and colleagues inserting themselves into our recovery program/plan.

  • How about the mother who wanted her daughter only to attend high-end AA meetings?
  • Or the producer who pressures his newly minted 28-day graduate movie star into attending the media tour, promising a sober companion?

In these instances, we are treated as commodities to save face or earn money – they don’t appreciate that this is a life and death matter.

No wonder

We are supposed to say nothing, fit in, and resume our old lives. No wonder there is so much relapse. No wonder people are convinced treatment is a failure. Do you get it? Our external environment – our social life, family, and economic pressure – works against us.  Even when we learn new responses to these “cues,” our brain unconsciously registers them. Our will to stay clean can collapse, and we succumb to our internal voice that says, “Hey, this time it will be different. This time I can handle it.”

 

I will say this to you, dear readers:

 

For families with loved ones in early recovery, gladly join in abstaining and finding enjoyable activities to engage in that do not involve going to bars and parties. Reorient your life to one that supports sobriety. Do this for several months, and for the next few years don’t drink in the presence of your loved one. Consider having at least one alcohol-free social event at family gatherings and setting time aside for a 12-step meeting.

 

For those of us with “the problem,” it really helps to have an intermediary – a savvy person who can fend off outside pressures and explain that recovery is the top priority for now. This intermediary can be the one to tell our friends and family to leave us alone, to focus on healing from our disease, and of course to vociferously object to any reprisals for putting our health first.

Preparing the next generation

Jan. 27th 2015

Rethinking advice for parents

A recent article in The New York Times by Ron Lieber with the headline “Growing Up on Easy Street Has Its Own Dangers revealed the shocking news that many adult children of the moneyed class are not self-sufficient functioning adults. The article states:

 

There is an emerging consensus among academics that children of the affluent have higher rates of depression and anxiety and elevated levels of substance abuse and certain delinquent behaviors.

 

OMG! If this is news to you, what planet are you living on?

 

Ever since the ’60s, members of wealthy families have been self-reporting high rates of addiction, behavioral health disorders, abuse, and generalized dysfunctions in memoirs. Aside from personal stories, Joanie Bronfman’s 1987 dissertation, The Experience of Inherited Wealth: A Social-Psychological Perspective, documents what is common knowledge among the next-generation affluent: Yes, Houston, we have a problem!

 

But almost every wealthy family, when asked, will not admit to significant concerns about substance use disorders or underperforming, economically-dependent younger generations. Those of use on the inside – either because we are in recovery or in the helping professions – see a reality that is far different than the public façade. Not only are there high levels of substance dependence, but increasingly, financial conflict with parents and trustees stemming from the inability to independently sustain the lifestyle and social standing experienced as children.

Great expectations

As commented on in the New York Social Diary (your link to society), over the last 20 years there is the growing phenomenon of new wealth supplying their children with an endless supply of money to live the high life and impress their friends. While this assures those of us in the recovery business an endless supply of clients, old money’s younger generations feel enormous social pressure to compete and maintain prominence.

 

This group, having grown up in an environment of surplus, expects to live in a similar manner as adults and be supported by family money in doing so. Their parents often inherited in their 40s or even earlier. But now, with increasing longevity, the next generations are facing shortfalls and not happy about it. Lacking the skills or inclination to earn significant incomes in the job market, they are pressuring parents and trustees to pony up. While resorting to violence is obviously an extreme measure, cutting off access to grandchildren and threatening litigation with the attendant disclosure of family secrets is becoming more common.

 

Few take responsibility for slacking off in high school and college and consequently failing to develop marketable skills or spend within their means. Accepting a lower social profile or adopting a reduced standard of living is not an option. Resentments surface and demands increase, often fueled by excessive alcohol and prescription medication abuse.

Reaching a crisis level

We continue to identify substance abuse and behavioral disorders as the No. 1 risk to wealth preservation and next-generation well-being. While drinking and drugging have always been part of high-end culture, intensifying external social and media influences are leading to increased use and at younger ages. It’s beginning to reach a crisis level; parents are overwhelmed and outgunned, and we are not using our expertise to help them respond.

 

In my view, the primary task for family offices, advisors, and professionals is to support parents in setting limits, requiring accountability, and limiting communication tools, as well as being role models rather than peers. Advice on involving the younger group in philanthropy, family meetings, and business/economic exercises is secondary and can detract from the more important goals of learning life skills, developing academic and career interests, and differentiating from “the family.”

 

Let’s devote 2015 to assisting our clients in educating themselves on the risks to their children and responses that allow them to successfully navigate an increasingly hazardous culture.

Between 30 Rock and A Hard Place: The Rockefeller-AA Connection

Jan. 16th 2015

As Bill Wilson observed early on, while the well-off are welcomed in AA, many do not stick around for long. That may be due to the widespread resentment expressed by members of the recovery movement, including those in the helping professions.  Having experienced this resentment firsthand, I decided to write Between 30 Rock and a Hard Place in hopes that a detailed recounting of the vital role John D. Rockefeller, Jr., played in supporting Bill and Bob in the early years might make AA a more inviting place for the affluent.

 

Based on my reading of this history, without JDR, Jr.’s support during the early years, the AA movement would have either failed or, at the very least, taken many more years to become self-sustaining.  My e-book provides a comprehensive review of JDR, Jr.’s role in the development of the 12-step movement and details how his support of Bill and Bob is one of the first examples of entrepreneurial philanthropy.

 

I might add that the affluent can and do recover by participating in AA if they are careful about disclosing personal information and maintaining firm boundaries so that “dual relationships” are minimized.


The e-book is available on Amazon as a free download for a limited time! Click here to download now.

Posted by Bill Messinger | in Addiction, Substance use disorders, Wealth | No Comments »

Wealthy, famous, powerful, and addicted – Part VIII

Jan. 12th 2015

Barriers to recovery: suppressed pain

Fame: The personal and family impact of being prominent/famous.

“Who are you: a real person or the object of projected fantasies?”

 

When addicted, recovery is not so much about how outsiders perceive, define, and interact with us, but understanding the emotional intensity associated with fame and seeking ways to diminish its power over us. The struggle is really at our inner core – our sense of being.

 

Becoming famous or growing up in a family with a famous parent has it own energy and dynamic. For those of us living in the spotlight, our personal experiences are so very different from what the public imagines or projects onto us. And our public image comes at the price of hiding our genuine selves. Either we live in fear that with one misstep, everything could fall apart, or we convince ourselves we are invincible and can do no wrong – a sentiment common among newly-minted tech barons and celebrities.

 

Whether we are the famous person or a family member, fame is always there to be reckoned with – a powerful force in our lives. Equating fame with invulnerability is a trap for many struggling with addictive behaviors. Equally self-deluding is attempting to recover while also protecting that all-important public image.

What does prominence/fame mean?

  • Being known for our name, our brand, our company, our relationships – whatever brings us into the public eye.
  • Exceptionalism: athletic, good-looking, highly intelligent, charismatic, artistic, etc.
  • Being a big fish in a small pond. “Our family company employed everybody in town, and they all knew who I was.”
  • Always being “on”: Wherever we go, people might know who we are.
  • Being objectified: People respond to who they think we are.
  • Transforming the room: We are the person everyone wants to meet.
  • A conduit to the prominent one: As the son or daughter, confidante, or entourage member, we can get you close.
  • Being too important to recover.

What is the experience of being prominent/famous?

Private and public

 

For the self-made, the prominence that comes from success affirms our aspirations and dreams. However, it comes at the price of increasing isolation due to our lifestyle and security concerns. As adults, the overwhelming desire for privacy conflicts with dependency on servants, socializing, and maintaining a public image. We can’t simply withdraw and hope it all goes away. Fame has its own energy and will put us in the public eye whether we like it or not. And there always the nagging fear that we need to keep going or it will all fall apart. Don’t stop now!

 

Modeling behavior

 

Those of us with new wealth or prominence look to the rich and famous as models for how to live our new life, without comprehending the accompanying risks and vulnerabilities. And our family, friends, and business associates are only too happy to join in. Why not celebrate the big contract, award, or stock option with alcohol, drugs, and peak experiences?

 

Can’t live with it, can’t live without it

 

We all like to tell ourselves that fame is a pain in the ass because we are recognized by sight or by name. Many more people know us than we know them. But the name is also an ace up our sleeve when we want special favors or need to get out of a jam.

 

‘Can I touch you?’

 

People use us as an instrument to confirm their own delusions that being famous or suddenly wealthy means living a charmed life. It can be almost impossible to develop genuine relationships; few can be trusted, save childhood friends and family members.

 

Responding to the image

 

We are treated by the general public as “not normal” . . . larger than life . . . somebody special. This applies not only to the famous but to their children, staff, and advisors. Soon, we begin responding to the public by acting in kind, believing our own hype, and assuming an artificial life or personality.

 

As children growing up with a prominent parent, we witness the transformation when people meet our parent, as well as our parent’s transformation in relating to admirers. We also see the personal disparity between the public image and personal behavior.

 

The drive for success

 

As we work hard and are rewarded for our success, the cycle becomes self-fulfilling – and addictive. We become consumed with our work and won’t even consider taking time off to deal with our personal issues or other addictions (i.e., go to treatment).

 

Checking out

 

For the big name in a small town, getting out of dodge seems like an easy solution, but our problems leave with us. Hiding out only works for a while. If we can’t actually skip town, we stay home and take a magic carpet ride or use Mommy’s little helpers to escape our notoriety.

How prominence/fame impacts addiction and recovery

The experience of being famous or prominent impacts – and complicates – our addiction and recovery alike.

 

Fame can be intoxicating

 

For the well-known, the public applause and admiration can create its own addictive cycle. “Getting out of the limousine as a child with my father made me feel special, a feeling I could only recreate with drugs.”

 

Restoring public image

 

Are we seeking treatment to get well? Or are we here to fix our image, dry out, and then return to the good life? Aided and abetted by lies or misleading information from our publicist, staff, and family, we try to perpetuate the myth that all is well. This dishonesty is the antithesis of what is needed to begin recovery.

 

We know best

 

If our success was due to our hard work, talent, and brains, we believe that because we knew what to do to be successful in life, we know what to do for recovery. We won’t take feedback, and we don’t need your advice.

 

Difficulty trusting others

 

It’s always difficult to sort out the motives of those close to us or those who want to be close to us. We’ve been burned by people who violate our trust, appear to be trustworthy but are not, or who get vicarious thrills from being our friends. But sticking with our original set from our youth has its own dangers because they won’t challenge our dysfunctional behaviors.

 

Being a commodity

 

We become a commodity – a means to make money – for those who benefit economically from us. We are sent to treatment when our productivity diminishes and are expected to sober up and return to work. Relapses will be tolerated until our liabilities are too great – then we are goners.

 

Ulterior motives from peers and staff

 

Being in the presence of money and fame distorts many people at a core, emotional level. Over and over and over again, we are exploited by people who want something from us or to be near us. Why should we try to engage in authentic relationships? How is a treatment setting any different? And how should we interpret the requests from peers for money and from treatment centers for donations?

 

Issues of abandonment

 

With parents caught up in the limelight, high society, and workaholism, it’s easy for children to be neglected and left in the hands substitute caretakers. When divorce or parental chaos strikes, the impact is exacerbated.

 

Lack of empathy from others

 

“I’d trade places with you in second.” “If you don’t want to do what we tell you, go out and use some more and come back and see us.” How many times have we heard this garbage? We have a right to our stories and a right to get well.

 

Loss of self

 

Who are we? Are we the famous person? The brand name? The son of the governor? The star? Are we superior to other people because we are prominent? Or are we simply people with significant problems that will take us down unless with do something about them?

Helps us and hurts us

It’s not easy for us to talk about something that both helps us and hurts us, often in dramatically different ways. Being famous or growing up in a prominent family can be so much fun, but it also can cost us genuine relationships and drive us to compare ourselves to other, more famous people.

 

In treatment, isolation from peers, as well as from our authentic selves, can keep us from lasting recovery. The challenge is finding safe spaces where we can experience true intimacy and healing from interacting with others.

Pills, pot, and legalized impairment

Dec. 4th 2014

Cautions for parents, family offices, and wealth advisors

At recent conferences in Colorado and California, several colleagues asked for my thoughts on legalizing marijuana and how it might impact families and the workplace. It’s all over the news and one everyone’s mind, but frankly, it’s not just pot that’s a concern – there’s a whole range of substances family offices and advisors should be aware of.

 

So it’s time to introduce a new concept into our lexicon: legalized impairment. This term refers to society-sanctioned drugs that significantly alter mood, behavior, and judgment. As they become more widespread and readily available, more and more people are using these drugs to excess. This group includes underage users, who, as we know, have easy access to all kinds of substances.

 

Due to their legal or quasi-legal status (often doctor-prescribed), these substances pose a significant risk to family office integrity. As a family office executive or wealth advisor, the last thing you want do is explain odd, unprofessional, or improper behavior by a colleague or employee to clients. While you may want to address the concern in family members, increased drug use is growing and impeding efficient professional-client interactions.

 

So, what drugs are we talking about?

 

Pain killers, benzodiazepines, ADHD meds, sleeping pills, e-cigs, weed, salts/herbs, and alcohol.

 

It’s quite the list and growing weekly. No doubt these drugs have already invaded your office and befriended your clients. As an advisor said to a friend of mine in recovery, “You mean when you wake up in the morning this is the best you will feel all day?” This question reflects the reality that in our culture, we routinely use drugs to feel better. And now we have more and more-potent options that bring with them greater risk of abuse and dependency.

 

Let’s look at these drugs in greater detail:

Pain killers: oxycodone, Percocet, hydrocodone

Over-prescribed in large quantities for relatively minor injuries or procedures, they are easy to get hooked on and hard to quit. When doctors do restrict refills, pills are available from dealers but are often more expensive or harder to obtain than heroin. Substituting more readily-available heroin for pills is a main reason why apparently well-off and functioning people die of opioid overdoses. (Dealers offer free samples, so why not give it a try?) Pain pills are also highly sought after by students to come down from Adderall and Ritalin and other stimulant-induced study or test-taking highs.

Benzos: Xanax, Klonopin, Valium, Librium, Ativan

Commonly prescribed for anxiety, these drugs are known as “alcohol in a pill.” Contrary to the opinions of some doctors, they do lead to increased tolerance and dependency. They’re also known for their boomerang effect: Over time, they produce the same symptoms they are designed to alleviate. Supposedly prescribed for the short-term, many are in it for the long haul, with mind-boggling withdrawal symptoms when users run out or try to ease off.

ADHD medications: Adderall, Ritalin, Vyvanse

Known as study drugs, parents seek them out for their children to give them an advantage on tests. Whether used for legitimate ADHD or just for a leg up on the competition, these drugs open the door to illegal stimulants such as cocaine, ecstasy, or meth. Coming down from the high can be a problem, and kids resort to fighting the high with depressants. Common “antidotes” include pain medication, weed, or alcohol.

Sleeping pills: Ambien, Lunesta

Touted as risk-free, when taken regularly these drugs cause restlessness, anxiety, memory loss, and occasionally bizarre nighttime behavior. When taken with alcohol in the blood stream, it can be difficult to wake up in the morning.

E-cigarettes: nicotine

E-cigs contain varying doses of nicotine – a highly addictive stimulant. They’re a go-to for people who’ve overdone it the night before and need to shake the cobwebs off in the morning. Other users believe nicotine helps them concentrate, so it can serve as an alternative to Adderall and other stimulants.

Marijuana

The younger generation believes it’s benign. The older generation is getting back into it (or never quit) – for medicinal purposes, of course. So what do we know about it? Marijuana can interfere with memory, perception of time, and motor function. Repeated use during adolescence can result in long-term changes to brain function. Available in increasingly higher percentages of THC (the active ingredient), drug-induced psychosis is becoming more prevalent.

Salts and herbs

Claimed to be unregulated and largely flying under the DEA’s radar, they are often as potent and destructive as the other drugs discussed here and can be highly hallucinogenic. Available online, from head shops, and from your friendly shaman, these substances run the gamut from bath salts to rue plant derivatives and ayahuasca.

Alcohol

Alcohol is easily the most prevalent of the legalized impairment substances. As the accepted social lubricant among the affluent, you’d be hard pressed to find a work, family, or social gathering that doesn’t serve cocktails before, during, and after the event at hand.

 

It’s no secret that excessive drinking is considered a major public health problem, but most of us in the affluent community would scoff at the medical definition:

  • For men, it’s five or more drinks in one sitting or 15+ in a week.
  • For women, four drinks in one sitting or eight in a week.

In our culture, these suggested limits are exceeded regularly and with little awareness that tolerance is increasing. We ultimately can become dependent, particularly as we age. After age 40 or so, alcohol takes longer to leave our system, meaning drinking the same amount will have greater effect.

What to do?

I encourage drug testing because it is the only way to truly determine actual substance use. It also has a preventive effect because people are less likely to use when they know they will be tested regularly.

 

For the family office:

 

Because of fiduciary responsibilities and client relationships, it’s important to regularly drug test all employees. There’s nothing more maddening than trying to figure out why an employee is acting strangely and mishandling client interactions. I also recommend establishing a policy for persons using prescription narcotic medications – and include marijuana as well. Of course, these procedures will need to be vetted and approved by a lawyer who is familiar with state and federal employment and disability laws.

 

I’d also recommend an educational program for staff on different types of narcotic prescription drugs, dosages, and their effects and side effects. This will help with self-awareness and also with client relations because many clients discuss medical conditions with their account representatives.

 

For clients:

 

Encourage your families to establish effective provisions in their policies and governing documents to address substance and behavioral health disorders (see my article, “Model Language for Addressing Substance Use Disorders [Addiction] in Trust Documents: Best Practices for Treating Substance and Other Behavioral Disorders). Educational programs are also helpful, as are discussions among the younger generation about what they would like to see happen if someone is abusing alcohol or drugs. Taking a strong stand on alcohol and drug use can set the tone for the family, especially if it is backed up by moderate, responsible drinking at family events.

 

For families with a history of addiction or mental health issues, a joint project such as a family genogram can help trace these disorders through the generations to the present (see: www.2164.com). It really helps illustrate the concept of “genetic load,” meaning that when the gene linked to addiction is present, there is good chance that the next generations will be susceptible to the disease.

 

This may sound very controlling and Machiavellian, but drug testing young adults as a condition of receiving funding might also be appropriate, given the widespread substance use in this group. Family members don’t like to see a relative destitute, so there might be two levels of payment for compliance and non-compliance (e.g., minimum subsistence for positive test and the regular payment for passing the test).

Address legalized impairment head on it will steamroll you!

Addiction is already the primary threat to family stability and well-being. With more heavy-duty drugs legalized, legitimatized, and available, this risk is only going to increase. Your choice, as an advisor, leader, or family member is to attack this issue head-on, or it could very likely become the predominant driving force in your clients or your own family system.

 

Due to popular demand, a future blog will explore in detail the topic of marijuana. Before doing so, I wanted to place weed in the overall context of legalized impairment.

The family office and advisor guide to ayahuasca, rue seed, and shamans

Nov. 12th 2014

What the shaman is up with these people?

A recent article in the Times on ayahuasca highlighted a growing phenomenon on the use of this drug and a rue seed alternative sweeping the high-end community.

 

In a world increasingly dominated by screen time, not dream time, its not surprising that many people, having binged on yoga, are turning to a more dramatic catalyst for inner growth.

 

It’s said to be a spirit-enhancing, mind-altering, insightful experience leading to profound revelations and improved relationships.

 

It first came to our attention when a wealth advisor commented to us about a client who makes frequent trips to the rain forests and Peru. How often can someone visit Machu Picchu and travel the Amazon? And why is she so thin? Now it’s being alluded to at family meetings during sharing time as life-changing, with details provided in private conversations for the curious.

           

Talk of “journeying” and “shamans” – with offers to join in – are also pervading summer downtime at second homes and on the beach.

 

“Just try it once; it won’t hurt, we’ve done it many times; wait until you meet our shaman!”

 

Among upscalers, it’s hard to resist invitations from higher-caste friends to join in, given the dullness and intensity of corporate life and the opportunity to bond with the wealthy.

Lines in the sand

Right now lines in the sand are being drawn between family members who use or want to use the drugs and those appalled at the naiveté and self-serving justifications of the proponents. The former group usually has several heavily-invested participants who have journeyed multiple times, swear to its therapeutic benefits, and swear it is safe and non-addictive. In fact, advocates assert ayahuasca cures addiction (attested to by Lindsay Lohan, no less), as does the rue herb.

 

Dissenters are depicted as closed-minded and rigid for suggesting that users are simply drug-seeking under the guise of a spiritual or therapeutic experience. Those in recovery are dismissed as overbearing scolds and misguided for questioning the legitimacy of the claims and objecting to participation by next-generation family members. And it’s becoming increasingly difficult to counteract the momentum of the one-two punch sales pitch of the devotees and purveyors of these drugs.

What is really going on? What is the attraction?

Using drugs to gain insight into personal or relationship concerns and enhance spirituality has a great deal of appeal, particularly after years of failed therapy. Many inheritors have been on a life-long search for ways to overcome chronic dysthymia, attachment disorders and anxieties stemming from poor parenting and an inability to connect with others. With a full understanding of the risks, experimenting may lead to insight for some people. However, after doing so once or twice continued use can easily transition into drug seeking – using for the sake of using. As psychologist Terry Hunt says, “Once you get the message, hang up the phone!”

 

But that’s not happening.

All the perks without the stigma

Now at later stages in life, a “spiritual person” comes along offering a supposedly safe, therapeutic herb that provides a heavy-duty escape from reality – the first time they feel like real people. It’s an experience they want to repeat over and over again, and share with others. For many who experimented with hard drugs (or wanted to) in their younger days but are stuck settling for a few cocktails, glasses of wine or Xanax, journeying is the high they are seeking without the stigma of LSD, PCP, or MDMA. They consider themselves on a spiritual journey, the perfect antidote to the ennui of the affluent lifestyle. And what’s the going price? As much as $2,500 per day for a house call – drugs (whoops, herbs) included.

‘Have I told you lately that you’re crazy?’

Inspired by an article in a NYT Sunday Review with the same heading: “Have I told you lately that you’re crazy?”, it’s time to present an alternative view, examining the very real risks and potential damage from using these drugs.

 

“It’s safe!” (Not!)

 

Ayahuasca is said to be a psychedelic affecting dopamine receptors in particular and can penetrate deep within the brain. It causes many users to vomit, which is why a rue seed herb is offered as an alternative, particularly to newcomers. The latter is a stimulant, acting on the limbic system (the reactive, fight-or-flight, primitive area of the brain) and depressing the executive control area of the brain. It also causes altered visual perception and gait. Alcohol is given to help bring users down off the high. Both last for six hours or more and require oversight by a “minder” – often the shaman – to make sure the user does not wander off or trip out.

 

We are talking about heavy-duty drugs. Like LSD, ayahuasca has the potential to create flashbacks. The larger problem is that stimulating the limbic system while deregulating the executive frontal lobe can lead to impulsive decisions and destructive communications. There are also reports of disorganized thought process from multiuse. But hey, what’s more important than expressing feelings and acting on gut instinct? For vulnerable people, taking these drugs even one or two times can lead to a marked personality change (e.g., blowing up a Type-A personality).

 

Take them 10, 20, 50 times and it’s a recipe for permanent brain alteration, even for the most resilient.

 

It’s a tea or herb concoction.”

 

These drugs are described in medicinal or culinary terms – tea and herbs – to overcome the stigma associated with hard drugs. However, when any mind-altering drugs are ingested, the body converts them into molecules that pass through the brain barrier and react with brain cells.

  • The brain does not distinguish between ayahuasca or rue seed and meth, cocaine, PCP or LSD – the reaction is similar. Nor does it care whether you got them from a dealer, an ostensible healer, or the Pope.

Both drugs have major impacts on the body and mind – that’s why the shaman babysits users.

 

No, ayahuasca and rue seed are potent drugs, regardless of how they are described.

 

“It’s a permitted spiritual practice, exempt from drug laws.”

 

That’s the line for first-time initiates who may be concerned about getting into trouble with the law. Passing use off as spiritual – and therefore legal – is bogus unless the participant is a member of a recognized religious group authorized to use ayahuasca in ceremony. Promoters tend to skip over the fact ayahuasca is a controlled substances and is therefore an illicit drug. (One reason why users go to South America.) The rue seed alternative in its various forms, flies under the DEA radar for now, although a very potent drug.

 

“It’s non-addictive.”

 

The real measure of addiction is whether drugs impact brain cells in the pleasure center (dopamine, serotonin receptors) limbic system and frontal lobe. As discussed earlier, since the reactions when taken are similar to other drugs that alter the brain, the conclusion is that ayahuasca and rue seed do indeed modify cell structure, unless proven otherwise. Take them enough times and there will be significant and permanent alterations. By the way, anticipating the next journey, common among many repeat users, is indicative of addiction.

 

It acts like other mood-altering addictive drugs, so why take the risk?

 

“It’s therapy.”

 

Prospective participants are told shamans are therapists. Some even come with university degrees (but no credible credentials or license certifications). It’s a two-for-one deal. But wait! What kind of therapist prescribes the same treatment to every patient after a five-minute conversation and then drops fame-names of clients as a selling point.

 

That’s not a healer, that’s more like a sales pitch.

 

Don’t ask, don’t tell approach to medical issues

 

A lot of these insight-seekers are not young people. (Many would be eligible for social security if they had ever worked.) Some have heart problems (e.g., a-fib, weak valves, high blood pressure, etc.). But why take a medical history, that’s so allopathic! Just crank that old beater up to 120-130 BPM for a few hours. And then “journeyers” wonder why their meds don’t work or they are at the Mayo clinic for major surgery. (Note to advocates: This is another criterion for addiction – taking a drug that you know could give you a coronary or a-fib problems and doing so anyway.)

 

Inexcusable in so many ways.

 

“It cures addiction.”

 

The first question to ask anyone touting this cure is “Show me your supervised drug screens!” because addicts are notorious liars. Both ayahuasca and rue seed act on the very areas of the brain affected by use of alcohol and other drugs. Actually, rue seed triggers intense cravings for anyone in remission from a substance use disorder. So no, it does not cure addiction and is just another form of addicts tripping out on a mind-altering substance.

 

This is the most bogus of all claims: giving someone addicted to controlled substances another psychoactive substance to cure addiction.

 

“It cures depression.”

 

How about encouraging participants to stop taking their antidepressants because their un-medicated self is just fine? Then they wonder why family members stop visiting and friends are so busy. You can be sure participants did not discuss this “cure” with their psychiatrists or other prescribers.

 

No, you are not fine!

 

Multigenerational use

 

Apparently, parents are advocating multigenerational use to become closer to their children. Whoa. What a way to avoid the hard conversations about the multiple marriages and being too self-absorbed for effective parenting. Get high together and all is forgiven.

  • And who doesn’t want to take parent-approved heavy drugs? Come on down!

Talk about playing with fire! Many adult children are in families with histories of alcoholism and drug dependence. Prolonged and intense use of any drug can trigger the addictive gene, despite apparent parental immunity.

 

Does it get much crazier?

Alternatives to seeking meaning and improved relationships through drug use

Participants are reported to say things like “I was never able to talk to my sister about our differences until we went on a journey together for six hours.” Well, did you ever try? Spend six hours with any competent therapist (yes, they do exist) and you will likely explore in depth any ill feelings between relatives or friends – and actually remember the conversation and what happened during the session. Moreover, drug-induced insight does not necessarily lead to behavioral change (e.g., more time with and an improved relationship with the sister).

Do no harm

It seems every few years, a new mind-altering phenomena spreads like wildfire through trust-funders and the newly-minted affluent. Remember Swami Rama, the Rajneeshee, Ram Dass, cults, EST? The list goes on and on. These guides to enlightenment are completely unregulated and hold no licenses yet are purporting to fix major trauma and behavioral health issues. The first rule of any healer is to do no harm. From observation and reports, the harm done to some participants far outweighs any asserted benefits: destroyed relationships, distorted thinking, drug cravings, and untreated depression. Keep at it and we are likely to see drug-induced psychosis.

 

Unfortunately, the wealth and prestige of many of these journeyers keeps them insulated from contrary opinions and negative feedback on personality changes or distorted thinking. Like any good addict with unlimited resources, they have little incentive to stop. Contradictory information isn’t going to change their minds, but it should give pause to anyone thinking about joining the club. Perhaps by alerting family offices and advisors to this very underground and growing phenomenon, proselytizing can be minimized and support provided for the contrarians who are telling their friends and relatives, “YOU’RE CRAZY!”

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.