Answer Addiction

Tag: Features

  • Growing Up Gay, Muslim, and Addicted to Sex (and Drugs)

    Growing Up Gay, Muslim, and Addicted to Sex (and Drugs)

    I craved love and attention, and as I started to rebel against my religion, porn and sex became a hobby that distracted from my loneliness; later it evolved into an obsession, and eventually, an addiction.

    You sit comfortably in the cinema with an extra-large bucket of popcorn on your lap and a diet coke in the cup holder while the movie characters on the screen are trying to survive their ordeal.

    You can cry with them, yell at their stupid decisions, smile when they finally get their happy ending (or feel sorry for them when they don’t). In the end, it’s just a movie and you’re safe in your seat.

    Then suddenly, your seat begins to shake. At first you think it’s just a 4D effect until you see white tentacles ensnare your body and lift you up, pulling you into the movie. You are no longer safely in your seat at the local cinema.*

    Growing up as a gay man In Indonesia, a country with the world’s largest Muslim population, the first LGBT story I read was published in Hidayah, a magazine aimed at conservative Muslims.

    The feature article was about a gay flight attendant who ended up contracting HIV and later became terminally ill due to AIDS complications.

    I shuddered when I read the portrayal of that poor gay man. It seemed that the writer could not hide his or her own repulsion toward the idea of two men falling for each other. The words “unnatural” and “sinful” were used. The AIDS complications that the man suffered were described in specific detail—it was horrifying.

    The message of the article was clear: If you choose to be gay, no happy endings will ever come to you.

    That story flashed through my mind when the doctor told me that my HIV test came back positive. I was no longer comfortably seated watching a movie. And I had just became a cliché: an HIV-positive gay man.

    How did I get here?

    I had watched quite a few gay-themed movies before that point and I knew the rules of safe sex. There was also a TV series that was funded by the government that touched on HIV/AIDS. And when I was a teenager, my boyfriend at the time invited me to attend a workshop on HIV and AIDS.

    I knew all the rules yet there was something in me that got me here, something that took me a while to come to terms with: my addiction to sex (and later, drugs).

    To say that growing up gay in Indonesia was difficult is an understatement.

    I was around four when my mother caught me using her lipstick. Of course, at that age, it was perhaps deemed adorable. My mother even took a picture of us together: me, a toddler, smiling from ear to ear with a face full of lipstick, while she looked amused.

    I was probably around 10 or 11 the second time I was caught. My father found me looking in the mirror and trying on my mother’s earrings. He rarely got angry with me but I’ll never forget his reaction that day. He pointed at me and yelled that what I did was an abomination and I should never, ever do it again.

    “No one is f***ot in this family, period!” he screamed.

    I was scared. For the first time, I didn’t feel safe under their roof. I realized there was something about me that my parents would never approve of.

    As I entered 7th grade, things didn’t get any better. While I was never physically assaulted for being gay—mostly because I tended to avoid any altercations—I got verbally abused a lot, like the time I was waiting to be picked up and a kid yelled at me “Hey, f***ot! You got nothing to do?” out the window as his father was driving him home.

    I never felt like I truly belonged.

    Around this time, a childhood friend introduced me to porn, and it quickly became a welcome escape. I will never forget the first scene that I watched. Porn created a space in my brain that I could always visit whenever life got too hard. I also began to masturbate.

    As a gay man, my focus was on the guys. With their muscles, their appearance, and cocksure attitude, they represented the ideal man. I convinced myself that in order to become “a real man,” I should be like the men in the videos I was watching.

    When I watched porn and masturbated, I was in my own time and space. Everything was good, for a while.

    Later, I started to look for guys online (the Internet was finally here) but it was really, really difficult to find gay men who I could befriend.

    Was it because gay men in Indonesia could not truly express themselves unless it was behind closed doors? Was it because, for gay men in a country with strict cultural and religious conventions against homosexuality, sex arguably became the only way to connect with other gay men?

    I craved love and attention, and as I started to rebel against my religion, porn and sex became a hobby that distracted from my loneliness; later it evolved into an obsession, and eventually, an addiction.

    I tried to become a good Muslim to make my parents happy—I attempted to denounce homosexuality and started to pray more. But it never lasted very long. In fact, I became more and more rebellious toward my religious teachings.

    On the one hand, this rebellion served a good purpose: eventually I became who I was born to be. But on the other hand, rebelling against my religion also meant that I didn’t have any moral or spiritual structure that could help save me from my troubles.

    On the outside, I was motivated and ambitious. I knew that in order to be accepted, I had to do everything I could to be successful. So I became a diligent student in college, and eventually got my first job as a newspaper journalist.

    I was very determined, even cutthroat; I basically did everything I could to become the star in my office. I believed that as a gay man, I could not fuck things up. I needed to double my efforts in order to get half the recognition of my peers.

    Inside, none of this was enough. In my head, the addiction was still there, hungry and needing to be fed. After spending most of my daytime hours working, at night I would cruise. I became a regular at a local gay bath house where I had plenty of anonymous sex in those dark rooms.

    I also became addicted to food and it became so out of control that I became overweight and thus I felt unattractive. Being a fat gay man was, as much as I tried to deny it, not an easy task. At one point I started to get involved with male escorts because I did not feel worthy of genuine connections.

    From time to time, I discarded condoms. All I could think about was how to fill the void in my soul. I didn’t care about myself or my health. I just wanted more of everything.

    That’s when I found out I was HIV+.

    In response, I began experimenting with drugs, starting with poppers and moving on to crystal meth. It was a full-blown addiction. That “safe” space in my head expanded and I found myself released from any inhibitions. When I was under the influence of drugs, I was no longer insecure.

    But altered states are temporary and once the effects wore off, everything felt worse and I just had to mess things up again with porn, sex, or drugs. It was a never-ending pain.

    Eventually, I lost my job, my dream job. Being a journalist was something that I aspired to but I messed it up. During my full-blown addiction, I made some fatal mistakes and the newspaper had no choice but to let me go.

    I lived in Shanghai, China for a while and started to attend 12-step meetings. But it wasn’t until I moved to Chiang Mai, Thailand that I started to see the wrongs that I’d done and began to take recovery seriously.

    There were a lot of anonymous meetings in this town and several treatment centers (including an LGBT drug rehab). There were many recovering drug addicts who I could relate to. I began to find my community: people in recovery.

    For the first time in my life, I started to believe that I was worth it. I knew that while my addictions did a number on me, they did not define me. I lost things due to my addiction, but I could gain other things—as long as I wanted to recover.

    I met my sponsor in this town as well as my current therapist. I began to realize that I needed to get out of my chaotic mind if I wanted to live. I needed to leave that “safe space” in my brain and open myself up to a new life.

    For many years, I sat in that cinema seat with my denial. When I was finally pulled into the movie, I was still in denial. It took a while but I eventually realized that I, an HIV-positive, recovering addict, gay man from a Muslim world, still had choices.

    And I chose life.

    *Thanks to my favorite writer Dee Lestari who came up with this analogy.

    View the original article at thefix.com

  • On the Job and on Drugs: Police Officers Who Struggle with Addiction

    On the Job and on Drugs: Police Officers Who Struggle with Addiction

    A police officer who is using opioids illegally is breaking the very laws that he or she has sworn to uphold. This makes it even more difficult to reach out and get help for an addiction that may be spinning out of control.

    No one ever said being a police officer was easy. The job alternates between crushing boredom, bizarre situations, and unimaginable danger. When you’re a cop, much of the population that you’re paid to protect is afraid of you. You’re always being judged, whether it’s in the media or when you go to the corner store. Your hours are usually pretty awful, which means you don’t get to spend as much time with loved ones as you want to. You see things, horrible things, that mess up your head. If you talk to your peers about how traumatized you are, you’re seen as weak. The pressure can be intense.

    Police officers are human, so they seek ways to cope with the stress. Sometimes they find relief in opioids. And sometimes they become addicted.

    Two recent deaths of police officers due to drug overdose are stark reminders that no one is immune to addiction. In fact, police officers may be more at risk than others.

    Under Pressure and Self-Medicating

    Dr. Michael Genovese, a clinical psychiatrist and chief medical officer at Acadia Healthcare, told The Fix, “Not only are law enforcement officers not immune to addiction, but they are also more susceptible to addiction because the stress of their jobs renders them so. Police officers to whom I have spoken, who suffer from addiction, are not generally using drugs to get high or have fun; they are using them to numb emotions they find painful. Every day, police officers witness things that are outside the scope of normal human experience, and the frequency and intensity of traumatic events are overwhelming to the officer’s brain, even if he or she thinks they’re not.”

    While outsiders don’t think of Lewiston, Maine, as a hotbed of crime and drug use, locals know the old mill town has long been a place where heroin and crack are bought and sold. Officer Nicholas Meserve was attempting to stop the flow of drugs into this small Maine city, until he died of an accidental overdose.

    When announcing Meserve’s death by fentanyl overdose, Lewiston’s police chief Brian O’Malley said,“I hope it’s a reminder that the opioid epidemic touches the lives of many in the community, regardless of their wealth, race, religion or profession.”

    In Baltimore, Officer Joseph Banks Jr. died at a local motel after overdosing on heroin. His girlfriend, who was with him when he died, told police the two had been hanging out at the motel, using drugs throughout the day. Banks was suspended from the police force at his time of death. A police spokesman refused to state the reason for his suspension.

    Vernon Herron, who runs safety and wellness programs for the Baltimore Police Department, said, “Like a lot of police officers, sometimes we are so hyper-vigilant that we medicate ourselves. I’m not talking specifically about him [Banks], but I see officers over-medicate themselves to deal with the stresses of police work.”

    Michael Koch was a police officer for 15 years, 10 of them as an undercover narcotics detective. Over time, he started using heroin and became addicted, eventually to such a degree that he was arrested after taking heroin from an evidence room.

    Finding Relief in Opioids

    Koch told The Fix, “Drinking was always a part of my life. It was an unhealthy coping mechanism, but it’s what I did. At one point, I hurt my knee badly and I got a scrip for Vicodin. As soon as I took that drug the reaction in my body was amazing, like it was sent from heaven. So then my drinking dropped off and I got more into the pills. I was part of the SWAT team and evidence team, and kept getting injured at work and when I did I would go to the doctor and get more pills. So then I started using it recreationally; instead of drinking, I took pills.”

    Koch’s addiction continued to progress. As he told me, “I was dealing with immense pressure at work. We would see things the average person wouldn’t see. Bodies cut open, heads on the ground, all of that stuff just stacks up. I might have looked like I had it together at some of these scenes but inside I was dying. So I started using more and more pills and became dependent on them.”

    Koch kept sinking deeper into his addiction and he felt like he had no place to turn. Letting your fellow officers know that you might have a problem is just not how it’s done. A police officer never wants to appear weak amongst his or her peers.

    It got worse. As Koch relates, “In 2010 a lot of heroin was on the streets and we were doing a lot of busts where we confiscated heroin, and also things like Oxys. I crossed the line and started taking things out of evidence for my personal use. I justified it by saying it was going to be thrown out anyway, but by that time I’m an addict and living a double life as a well-respected undercover cop and also as someone that was smoking a ton of heroin. Eventually, I got caught taking drugs out of evidence.”

    He was charged with second-degree burglary, which was pled down to a misdemeanor and he was placed on probation. He now works as an addiction counselor at True North Recovery Services and has been clean and sober for years. He also has a podcast where he and guests discuss issues of addiction and mental health that affect first responders.

    He told The Fix, “It was devastating being found out but I was relieved that this secret hell was done. In the first six months of sobriety I went to rehab, lost my career, went through criminal charges, got divorced, went through bankruptcy, lost my reputation and friends and stayed sober. I have five and a half years of sobriety thanks to the support of 12-step recovery.”

    Other officers were not as lucky as Koch. They lost their lives to addiction before they could get clean.

    Overcoming Stigma and Acknowledging Vulnerability 

    Police officers are often thought of as brave protectors who work tirelessly to keep us safe, putting themselves at risk in the process. While true, police officers are also regular people who have the same amount of everyday stress in their lives as the rest of us, who at the same time are experiencing and processing traumatic experiences that most people couldn’t dream of. For some, death and violence are part of a day’s work. They spend less time with their loved ones and in other traditional support systems because they often work irregular hours, leaving them even more isolated.

    And then, of course, there is the issue of the drugs being illegal. A police officer who is using opioids illegally is breaking the very laws that he or she has sworn to uphold. This makes it even more difficult to reach out and get help for an addiction that may be spinning out of control.

    Even legally, police officers have fewer barriers to drug use. Mark Restivo was an NYPD officer who was forced to retire because of a severe injury to his knee after he was thrown down a flight of stairs and badly beaten while attempting to stop a thief from stealing a woman’s purse. He quickly became addicted to opioids. He told The Fix, “There is a sense of inherent trust in officers; while dealing with my injuries, I firmly believe that I was prescribed so many prescription painkillers because of my status as former NYPD officer.” After a stint in a First Responder rehab, Restivo has been sober for almost six years. He credits his sobriety to 12-step programs and Vivitrol.

    Police officers might sometimes seem intimidating, and like they always have a situation well under control. But addiction affects everyone, sometimes with tragic results.

    Changes are on the horizon. There are numerous treatment centers and recovery programs focused on helping police officers, whether they’re a first responder or not, and many police organizations are working to develop programs to locate and help cops who might be struggling with addiction.

    View the original article at thefix.com

  • Please Don’t Tell Me How to Grieve

    Please Don’t Tell Me How to Grieve

    We are not taught how to grieve. Acknowledging that death is inevitable means that we have to come face-to-face with our own mortality and the mortality of everyone we love in this world. It’s incredibly scary.

    “Get over it.”
    “I’ve moved on. You need to move on too.”
    “Don’t talk about that.”
    “What’s wrong with you?”

    When it comes to grief, everyone seems to be an expert. We may not have life or death figured out, but life after death? People know how to do that. Or at least they think they do. According to them, there’s only one right way to grieve:

    Their way.

    Grief is universal. The way we experience it and process it, however, is not. To approach grief as if curing it were as easy as taking a pill is both irresponsible and insensitive.

    And yet, there are still people who take it upon themselves to try and tell you how, where, and when you should grieve. Now, in the age of social media, the shoulds and should nots have only gotten stricter. Grieving online is perhaps the biggest no-no. Experts have even coined the term “grief police” to describe the trend of policing just how people grieve — telling them they’re grieving too much or not enough.

    And in the last six months, we’ve even seen this grief-shaming play out in the headlines. First, people criticized The View co-host Meghan McCain for talking too much about her late father Senator John McCain following his death. Then, following actor Luke Perry’s sudden death, online trolls criticized his daughter Sophie for seemingly doing too well and not grieving enough.

    We get it: No matter how we grieve, people will have opinions about it. But it’s important to remember there is no “right” way to grieve, says Lauren Consul, a California-based licensed marriage and family therapist specializing in grief. Grief can be difficult to navigate because it’s not something our society is open about.

    “We are not taught how to grieve. Acknowledging that death is inevitable means that we have to come face-to-face with our own mortality and the mortality of everyone we love in this world. It’s incredibly scary,” said Consul. “Seeing someone who is grieving is a stark reminder that one day that will be us too. It’s painful to think about, so people tend to avoid and downplay other people’s grief. It can give a sense of control; if they can manage that person’s grief, they don’t have to think about their own.”

    This grief policing is especially true when the death is unexpected, as was the case when my father died from suicide in 2003. I learned pretty quickly that talking about death on places like Facebook makes some people uncomfortable. We may be a society that lives our life online, but for all the sharing we do on social media, there’s still this stigma associated with posting about our grief and the loved ones we’ve lost. It feels like an unspoken rule of sorts: grieve in silence. Don’t talk about it. And, if you do talk about it, make sure you find just the right balance – not too much and not too little.

    But here’s the thing about grieving: You’re never going to please everyone. You’re never going to grieve the “right” way because there is no right way to grieve. That’s something that took me a while to learn and understand. At first, I was afraid of what people would think or how they would view my grieving process, which included writing about my father’s suicide regularly on my blog. I even began to feel as though I needed to hold myself back and not talk about it, but you know what? That wasn’t good for me. In fact, it stalled my grieving process, and that wasn’t healthy.

    Maybe that’s why I’m always thinking of what I’d like to say to the “grief police.” If I had the chance to sit down with them and have an honest conversation about the realities of figuring out your life after losing a loved one, here are four things I’d tell them:

    My grief is not your grief. And your grief is not my grief.

    Grief is perhaps one of the most intense and most confusing emotions we’ll ever feel. And even though a plethora of grief books line the self-help sections of bookstores and libraries, how we actually go through our grief is a very personal journey. The strategies and coping skills that work for some may not work for others. Grief is as individual as the person going through it. For every loss, there are a hundred more ways to grieve. There is no right way, no one size fits all. Grief is an individual journey and no one can tell us how to do it. We must find the way that works for us and not judge others because they may grieve differently.

    Grieving is a journey – not a destination.

    That sounds cliché, but it’s true. Grief has no timetable, no script, and definitely no shortcuts. It’s not as easy as getting from Point A to Point B because the grieving road is far from linear. Elisabeth Kübler-Ross may have outlined the five stages of grief, but it’s not uncommon to vacillate back and forth sometimes. Even 16 years after my father’s death, I find myself returning to emotions like anger every so often. It doesn’t mean that I’m still in the throes of deep grief, though; it just reminds me that the work of grief is never really done.

    Sometimes, we just want people to listen.

    Grief demands that we feel, think, process, reflect – over and over. And there are times that we need to give voice to those feelings as we process. To put words to our emotions. To try and make sense of everything that’s happened to us. Maybe that’s why my writing has been such a healing part of my grief. I’ve been able to put the unimaginable into words, even at times when those words were hard to come by.

    Being there for someone during this time is a powerful thing. You don’t necessarily have to say anything. Trust me, your presence means more than you’ll ever know.

    Not everyone wants to be “cured” from their grief.

    People might be surprised to learn that I don’t want to “get over” my grief. There’s this misconception that you can easily move on, and that couldn’t be farther from the truth. As painful as some of these emotions are (hi, regret), I need to feel them. So while it’s tempting to listen and then try and offer advice to help us move on, I ask that you just listen. In the end, there are no magic words that will make everything better. We need to feel what we feel when we feel it — and feel it without judgment.

    I’m always going to talk about my father, my grief and my journey. It’s all part of my life and my story. We each have to move through grief at our own pace and in a way that is comfortable for us. But that doesn’t mean that we can’t be there for each other — in a way that is comforting without being condescending, sensitive without shaming, and helpful without being harmful. That just might be the greatest gift we can ever give someone: a safe space to grieve and begin the healing process.

    View the original article at thefix.com

  • Sex Addiction, Porn, and Online Dating: An Interview with Dr. Stefanie Carnes

    Sex Addiction, Porn, and Online Dating: An Interview with Dr. Stefanie Carnes

    More and more women are getting involved with porn, cybersex, hook-up apps and sexting. Given the technological advances, it’s not surprising that these behavioral addictions have blown up.

    Dr. Stefanie Carnes, Ph.D., CSAT-S is the President of the International Institute for Trauma and Addiction Professionals (IITAP) and a senior fellow for Meadows Behavioral Healthcare, where she works with people struggling with sex, love, and intimacy disorders and their families. As the daughter of Dr. Patrick Carnes, the nationally recognized expert credited with popularizing the term “sex addiction” in the early 90s, she grew up in the midst of the theoretical underpinnings of modern behavioral disorders like sex addiction, porn addiction, and love addiction.

    The Fix is honored to have the opportunity to speak with Dr. Stefanie Carnes about the rise of sex and porn addiction and how it’s tied to the increased availability of online pornography and hook-up apps, the necessity for a different paradigm in treating family members, and how stigma is causing harm to a growing and largely unrecognized population of sex addicts: women.

    The Fix: Can you explain why compulsive sexuality is similar to substance use disorders?

    Dr. Carnes: Although the treatment can be very different, the latest neuroscience research reveals very similar patterns in the reward center of the brain. In the latest edition of the journal World Psychiatry, the WHO recently released an article that said they are moving the behavioral addictions into a new category under the umbrella of addictive disorders. Thus, gaming, gambling, and substance use disorders are all going to be included in a single category. My hope is that they will move compulsive sexual behavior from the impulse control disorder category to this much broader addictive disorders category. It’s the same path that gambling took, and I hope we will follow that classification path as well. Although the WHO remains somewhat conservative by keeping compulsive sexual behavior as an impulse control disorder, it is possible that it will be moved over once more research is examined and evidence accumulated.

    The definition by the WHO in the World Psychiatry article is as follows:

    Compulsive sexual behaviour disorder is characterized by a persistent pattern of failure to control intense repetitive sexual impulses or urges, resulting in repetitive sexual behaviour over an extended period (e.g., six months or more) that causes marked distress or impairment in personal, family, social, educational, occupational or other important areas of functioning.

    The focus is on behaviors that are out of control, thus there are a lot of similarities with gambling and substance use disorder.

    Dr. Patrick Carnes believes that at least 40 percent of female Internet users engage in problematic cybersex. Do you agree with this statistic? If so, what percentage of those women are potentially sex addicts? What steps could be taken to help this massive population gain awareness and receive potential help?

    I’m not sure what specific study was being cited in that article, but I can tell you that we are seeing huge increases for women in terms of such behaviors online. It’s very underestimated how both sex addiction and porn addiction are impacting women. A big part of that gap is that the stigma is greater for women. It’s harder for them to come forward and ask for help. If you look at a recent study done by Dickenson and colleagues, the results proved surprising:

    In a nationally representative sample that asked how many people in the United States were struggling with some form of out of control sexual behavior, the percentage of the overall female population came back at about seven percent. It was much higher than what people in the field had anticipated. There are over 150 million adult women living in the United States, and 7% means that over 11 million women are struggling with this issue to one degree or another. Even if we cut that number in half, it’s still an enormous number of people.

    We are seeing that a lot with women struggling with pornography, for example. For example, Porn Hub designated 2017 as the “year of porn for women” because rates of women using porn almost doubled during that period according to their statistics. We are seeing more and more women getting involved with porn, cybersex, hook-up apps and sexting. We see really high rates in the college student population where porn is normalized. In that group, the use of porn has become normative behavior. Any time you have greater availability and accessibility of an addictive substance or behavior, you are going to have higher rates of addiction. There is a reason why there are more gambling addicts in Las Vegas than in any other part of the country.

    The higher rates for women mean the battle against destigmatization has become even more important. The stigma prevents women from accessing help and professional support. In terms of porn addiction for men, you have a lot of well-known men ranging from political leaders and athletes to movie stars and other public figures that have come out and said they were struggling with this problem and were getting help with it. In contrast, there still have been very few women that have done the same. Like with alcoholism, we need the Betty Ford moment where women stand up and say that we, too, are struggling with this. Such a moment had a tremendous impact on the process of the destigmatization of alcoholism and substance use disorder. We have seen a lot of men coming forward, but we haven’t seen that as much with women. This is a women’s problem too, and we need to open and expand that national discussion.

    How has the rise of the internet and online dating affected sex addiction?

    Availability and accessibility almost always is a key part of the development of any form of addiction. Given the technological advances, it’s not surprising that these behavioral addictions have blown up. Today, we have hook-up apps with location features on every smartphone and any kind of porn at the tip of your fingertips at any point in time. Thus, we are having much higher rates and much higher instances of sex and love addiction than we’ve ever had in the past.

    Can you help illuminate the relationship between sex addiction and porn addiction, particularly online porn addiction? Is there a widespread direct relationship or is it contextualized case by case?

    There is a widespread relationship. One study done recently showed that about 80% of people that identify as sex addicts also said that they had some form of problematic pornography use. Having made that point, there’s a difference in terms of treatment for people that just have porn addiction versus people that have both sex and porn addiction. The people who only identify as porn addicts, and it’s a large group, their behavior has not transitioned to being problematic in real life and offline. Although porn addiction affects their life, it tends to be very isolating and lacks interaction with other people. Thus, treatment looks very different for them. As a population in general, they look very different from sex addicts and have very different needs in terms of a recovery program.

    For example, a recent paper made a very interesting distinction between contemporary porn addicts and classic sex addicts. Most of the classic sex addicts have multiple addictions, high rates of trauma, attachment problems, and mood disorders. They are using sex and porn to self-medicate, and that’s the typical classic presentation. In contrast, the contemporary presentation of porn addicts tends to be young people that got exposed to pornography online at a very young age. They tend to have less trauma, fewer attachment problems, and fewer co-occurring disorders. Instead, they simply got hooked on internet porn at a very young age and it deeply affected their sexual interactions as they grew older. With someone like that, it’s a very different treatment process than with somebody that has the attachment wounding, the trauma history, and serious co-occurring substance use disorder.

    With porn addicts, we focus on healthy device management, content filters, social support, and managing triggers and cues. Those kind of treatment methods are very important when it comes to treating porn addiction. The goal is to foster a healthy way of living moving forward.

    On November 14, 2017, IITAP released a position statement about Harvey Weinstein and the sexual assault and abuse scandals that led to the #MeToo movement, which reads in part: “It is critical to understand that sex addiction and sex offending behavior are not the same things. A sex offense occurs when there is a non-consensual sexual behavior that has a victim…. most studies show that only about 10%-30% of sex addicts have behaviors that constitute sexual offenses. The majority of sex addicts struggle with issues like pornography addiction, prostitution, anonymous sexual behaviors, and sexual promiscuity and boundary failure.”

    How severe is the damage done by these misconceptions to the sex addiction treatment industry? How can the industry rehabilitate itself, shifting public opinion?

    The media and the public have a hard time making the distinction between a sex addict and a sex offender. Since they classify sex offenders like the Craigslist Killer as sex addicts, suddenly everyone with a problem with compulsive sexual behaviors becomes a sex offender. This is not right, and it prevents many people from admitting their problem and reaching out for treatment.

    For example, let’s take Bill Cosby and his crimes. Bill Cosby is a sex offender who was committing crimes, yet the media would refer to him as only a sex addict. His actions were coercive, exploitative, and criminal. The Craigslist Killer had anti-social personality disorder so it doesn’t make sense to define him as a sex addict. He was sociopathic and psychopathic. By defining him as a sex addict, you are making the implication that sex addicts are sociopathic and psychopathic, and this implication is grossly unfair. From a clinical standpoint, we understand the distinctions. However, the media conveys a wrong message to the general public by looking at extreme sex offenders and saying, “Oh, this person is just a sex addict.”

    We have to be better about teaching people the appropriate language. We have to help them understand the distinctions. Indeed, we need to educate them so they understand that sexual harassment, rape, and other criminal behavior are sex offenses. Sex offenses and sex addiction are two very different things, and people need to understand the difference.

    In the position statement, you also write, “There are many misconceptions about sex addiction treatment. The first is that it is a retreat or a way to escape problematic behavior. Nothing could be further from the truth.” Can you describe how sex addiction treatment works at your facilities?

    A lot of people have the mistaken perception that sex addiction is an excuse for bad behavior. They believe that sex addicts go to treatment only to escape the consequences of their actions. In my firsthand experience treating clients, such a perspective is just not the reality of what treatment is like. By the time you are going into inpatient treatment for sex addiction, you have done damage to yourself, and you truly need help. Many have destroyed their lives. Thus, there is no escape without doing the work.

    At our treatment center, we have both a men’s unit and a women’s unit. Gentle Path is our men’s unit and Willow House is our women’s unit. When both men and women enter treatment, we have very high rates of suicidality. To ensure their safety, many clients are put on one-to-one suicide watch at the beginning of their stay until the threat passes. In terms of the work being done, the clients are in group sessions for almost forty hours a week. Then, they have individual therapy sessions on top of it. They also have homework to complete as well as 12-step meetings at night. If you want a vacation to avoid consequences, the Meadows is not the right choice to make. Our program is about attaining sobriety from addiction and working a program that leads to long-term recovery.

    One of the aspects about my father’s treatment philosophy that I have always admired because it really works is the idea that you have to grab onto a client’s frontal lobes and hold on. What he means is that to enact positive change in a person’s core personality takes focus and determination. Thus, it’s a very intensive treatment program because the addictions we are treating are life-threatening. The stakes are high, and people come to us really needing to be helped and supported.

    From morning meditations and journal entries to a whole protocol of exercises and nutritional support, everything is designed to foster this process. Then, it’s also extremely emotional on account of the trauma work which pulls up the root causes behind the behaviors and all of the original pain points. The very deep experiential work around the root trauma is not easy for anyone.

    Beyond their own work, the process builds up to family week where they have to face the devastation caused by their addictions within their own families. Revealing the truth and facing your family for an entire week is heart-wrenching. As I mentioned, the men’s unit is called the Gentle Path, and that is also the name of the program. Our clients jokingly refer to it as the Brutal Path because the process is so difficult. They are grateful for the results of the work because they know by the end that they have done the work. It’s not easy by any stretch of the imagination. As you can see, there is a huge discrepancy between the public perception of sex addiction treatment and the reality of sex addiction treatment. The blatant falsehood of sex addiction treatment being an easy escape is an unfortunate perception because it puts treatment in a negative light. One of our goals is to change this perception.

    In contrast to your father’s focus on treating sex addicts, you also have become laser-focused on supporting their partners and loved ones. How does your work help the loved ones of people with sex addiction?

    Coming from a family with sex addiction and having been impacted by it as a family member, I feel it has often been overlooked. When I first entered the field, many therapists denied the existence of sex addiction. If you asked for help, you were sent along your merry way. Thus, many people looking for help were turned away, and many families were negatively impacted.

    Back in the 1980s and 90s, since the only therapists treating sex addiction in the beginning were addiction therapists, the same treatment principles used for substance use disorder were applied to sex addiction. However, when it comes to families, there are some big differences between chemical dependency and sex addiction. When I entered the field, there was so much that was misunderstood, and there simply were not a lot of resources for partners and family members. It seemed that what happened after treatment in the context of the family was more of an afterthought. The treatment of the sex addict was put first during treatment and helping the family was nothing more than an adjunct to the addict’s treatment.

    Another problem was that the codependency model was being applied to the majority of these families when most of them did not actually know that the addiction was going on. The families felt they were being pathologized by such an approach. I’ve tried to use a lot of my efforts in outreach and training to educate therapists about the traumatic nature of these kind of addictive behaviors for family members. Beyond being very difficult to even learn, it often becomes downright devastating for them. They really need a kind of help and support that is not the same as with families dealing with chemical dependency. For example, disclosure is a huge issue. How does a sex addict share information about the sexual betrayals with their partner without traumatizing the heck out of them?

    Moreover, think about the challenge of the children. What are you going to tell the children about this? It becomes very complex and very age specific as well. In our Certified Sex Addiction Training for therapists, I teach our second module which is all about how to work with the couples, how to handle the betrayal trauma, and how to talk to the kids about what is happening. It’s an incredibly important aspect of treatment. If it’s not handled well, it can really derail the addict’s recovery. When it comes to compulsive sexual behavior, you have to look at the family from a relational paradigm. You have to examine and address the whole system or treatment doesn’t work.

    Dr. Stefanie Carnes is the author of numerous publications including Mending a Shattered Heart: A Guide for Partners of Sex Addicts, Facing Heartbreak: Steps to Recovery for Partners of Sex Addicts, and Facing Addiction: Starting Recovery from Alcohol and Drugs.

    View the original article at thefix.com

  • Sobbing with Sir Elton While Watching “Rocketman”

    Sobbing with Sir Elton While Watching “Rocketman”

    John’s seeking earned him fame and financial success and love from millions of fans, but it wasn’t enough for his emotionally starved heart.

    To me, a sign of a good movie is one that makes me cry at least three or four times. I sobbed during Rocketman. And apparently Sir Elton did the same. 

    In a piece he wrote the week before the movie came out, he said, “I was in the cinema for about 15 minutes before I started crying…really sobbing, in that loud unguarded emotionally destroyed way that makes people turn around and look at you with alarmed expressions.” 

    I never realized how much I connected with Elton John until now.

    The movie opens with John (played by Taron Egerton) decked out in an orange sequined satanic-like costume with magnificent horns and wings, striding down the hall of a treatment center. He barges into an AA meeting, the same 12-step group that helped get me sober. He then spouts the familiar introduction, “I’m Elton Hercules John and I’m an alcoholic,” followed by a list of his other addictions: cocaine, weed, sex, prescription drugs, bulimia, and shopping. 

    I’ve seen lots of movies about addicted personalities, but this is my new favorite. It just so happens that Elton and I not only belong to that same addiction club, but we also got sober the same year. 

    As vastly different as our lives have been—and I sense I’ll get some heat for this—we seem to have a lot in common, as many addicts do. We both came from an era rife with emotionally stilted fathers and discontented mothers. His dad was a quiet, reserved man, as was mine, while his mom was more outgoing. His mother seemed to despise his dad for his uncommunicative ways; their unhappy relationship was replicated in my own damaged family. 

    The scene at his Middlesex dinner table was painfully familiar and often the same one we had at my home in New Jersey. Angry parents and their innocent children, all who just wanted love. Unfortunately, the baggage that occupied the table was never addressed in a reasonable way. This was one part of the film that resonated deeply with me, making me (and Elton) sob. While my parents stayed miserably together, his split up, with a poignant scene of his father leaving the family without giving his son a hug. It’s an image many of us who grew up with addiction can relate to. 

    In a 2011 interview, John said of his dad, “He left us, remarried and had another family, and by all accounts was a great Dad to them. It wasn’t children, it was me.”

    My mom once told me, in the heat of an argument we had when I was 12, that my dad never liked me. She said he never picked me up as a baby and didn’t come home at night until I was in bed. This type of emotional abuse plays unconsciously on a still-developing brain and leaves lasting psychic wounds. When I finally found the numbing qualities of booze and drugs, I searched for a father figure in the men I pursued. I sensed it was the same for Elton. 

    As children, we all seek attention and validation, and when we don’t receive it from our parents, we’ll find other—frequently destructive—ways to get it. John’s seeking earned him fame and financial success and love from millions of fans, but it wasn’t enough for his emotionally starved heart.

    After the scene of young Reginald (Elton John was born Reginald Dwight) dancing with an ensemble in the cul-de-sac where he lived, he’s mostly portrayed as a shy, somewhat lonely child. Though extremely gifted, he doubted himself at every turn. As a child, I was so shy I’d hide in corners at family gatherings. And I still tend to doubt myself today. Our parents knew little of propping their children up and confidence was hard to come by, which made the insecurity-relieving properties of drugs and alcohol even more appealing. Like Elton, I discovered the buffering effects of substances as I forged my way into a terrifying world. 

    The movie’s use of the 12-step meeting as a story-telling vehicle was effective, with Elton gradually losing bits of the devil costume and the persona he used as a mask as he rambles on about family, revealing more of his wounded self each time, which I also did in early meetings. One of the ways we heal is by telling our stories, by venting and listening to others tell theirs. Identifying with someone else’s pain helps us to heal our own, releasing some of the shame that comes with things we did to ourselves and others while we were using. 

    Aside from the sad childhood memories, the part that brought the most tears for me was hearing still-Reggie Dwight play the beginnings of what became “Your Song,” the first Taupin and John hit and the piece that my Almost Cher impersonator friend, Helene, sang to me on my birthday while kneeling at my feet. She sang just for me, and for those moments provided some of the love I missed as a child.

    As the movie ends, we find out recovery’s been good to Sir Elton, as it has been for me. 

    We’ve both forgiven our parents and have been sober for 29 years. And yes, we’re both still standing.

    View the original article at thefix.com

  • A Newborn Kitten, 12 Steps, and One Night of Fatherhood

    A Newborn Kitten, 12 Steps, and One Night of Fatherhood

    When I put him in his makeshift little crib I had the first of several revelations that night: “When you were using you probably would have let that kitten die.” At that moment I fully embraced the experience.

    As a product of too many 12-step meetings to count in my multi-decade fight with three addictions, many themes stream through my inner recovery. One recurring theme that is anchored in that addiction library is the seminal moment when a fellow brother shares their impending fatherhood as a monumental reason for getting sober. Having been denied the opportunity of fatherhood myself (through the trifecta of alcohol, gambling, smoking), I secretly envied those who could use parenthood as an inspiration for getting clean.

    Rightfully so! What could be a more powerful reason for getting clean than wanting to be present physically and spiritually during perhaps the most important time in your life? Especially when most of us enter adulthood as wounded children with no modern-day guide to change that reality. Consequently, parents need every vicissitude of human awareness to help their partners raise a child in as stable a way as possible. The idea of getting a fresh start and having an AA or GA baby is uber-logical to even the most helpless addict.

    However, even the strong evolutionary pull in our chromosomes for parenthood is sometimes no match for the intense psychological and physical demons that obfuscate our nature when addiction has hijacked our soul. Since I was never in a position to experience fatherhood, I could only postulate from the ill-formed axons, dendrites, synapses in a substance abuser’s brain that the conscious mind desperately wants to rise to the occasion, but the unconscious is probably already working out the details of its next encounter with dopamine.

    Fortunately, I have seen many addicts seamlessly climb out of the abyss and become great parents. There are a small minority who work on a quick timeline and apparently “will” themselves to sobriety, leaving the rest of us marveling at how easy they make it look. These are what I call the “one and done group.”

    The rest of us have to get well in small increments. If we are sincere about our recovery, we need to rehab for as long as it takes to get a reasonable modicum of sobriety. Detox, if needed, happens quickly, but it’s the ability to handle environmental cues that is the 800-pound gorilla. That learned process can take years to build adequate defenses to handle cravings. The good news is no matter what threshold you’re at, just the contemplation of getting clean for parenthood’s sake is huge.

    Most of my adult life I was in self-destruct mode and the insanity of it all was that I was conscious of it, but if anyone tried to stop me, I would hit the jettison button sooner rather than later. Even though when I was high, I often wished that a stork would knock at my door and a wife and a child would magically appear, I knew deep down that I was not equipped for fatherhood at that time and it would have been an unmitigated disaster.

    Fast forward many years and today at 58 I have been clean of all the aforementioned vices “for many a 24 hour” as they say in 12-step parlance. It took many years but fortunately I stopped just short of the triple-crown (insanity, prison and death). I was a very slow learner.

    When I look back at my state of entropy, what bothers me the most was how selfish I was. If I saw a person who needed help or a good friend needed a ride to a doctor’s appointment I would give them a half-baked excuse. The only time I did something for others was if it furthered my self-interest. Today I cringe just thinking about how I let so many people down (including myself). I was oblivious to the world that existed outside my addictions.

    Today I feel like I am one with the universe. Whether it is an injured bird or counseling work with addicts, I am grateful that my desire to help people has been restored to what I feel is my purpose in life. I try to put forth a reparative approach to all organisms in the universe whether animals or humans (I draw the line with candida in my gut). However, my one big regret which I am patiently learning to accept is that I will never be a father. But that all changed a couple of weeks ago. I experienced one night of fatherhood that only could have happened if I was clean and sober. Ironically, the experience left me higher than a kite!

    My Fatherhood Tripalogue

    We are all guilty of talking the talk and not walking the walk at times. It is especially true of writers/addicts like myself who are sometimes guilty of “pontification by proxy,” whereby we sit on our cozy perch and lecture about things we may not have experienced, but we have book or third party knowledge of. While I have street and book credentials about addiction, I have never been a father. But after 58 years on this planet, sooner or later you’re apt to experience a temporary role as a father, even if the source of your caretaking is a kitten. And this kitten was especially dicey because it was only four ounces.

    About 6 p.m. one day last week I was returning from the grocery store, looking forward to putting on the baseball game and relaxing. As I walked up the three wooden steps to my front door, I heard this faint whine and between the wood steps was what looked like a small baby stuffed animal, the size of a potato. Wait a minute, I thought, stuffed animals do not make sounds unless you wind them up. This rocket scientist then realized it was a newborn kitten. Wonderful, I thought as I picked it up gently. I know as much about newborn kittens as I do about opera.

    My first response was I wanted to bolt, like the first time I went to AA and wished I was in the witness protection plan and was relocated to Siberia, but sanity prevailed and I assessed the situation.

    I realized that the kitten was no more than a few hours old. Not only was it not of my species, but now we’re talking about neonatal care of a kitten. Now Mr. Bigshot, purveyor of love, a Holden Caulfield wannabe was thrust in the middle of a conundrum: do I take care of the cat or watch the ballgame? Thankfully, since getting sober I’ve learned not to trust my first instinct.

    I thought of a compromise: I will pass the kitten off to all those cat lovers I know! But my sudden relief didn’t last as all of those ubiquitous cat lovers were not calling me back. A neighbor passing by told me to go get kitten milk and wait several hours for the mother to come back.

    Guilty thoughts permeated: “well that’s what I get for not going to enough meetings or maybe because I lied about jury duty or some other white fib, the gods were punishing me.” I stood in the open doorway waiting and watching for what seemed like an eternity for the mother to come back. (I was feeding it special kitten milk and put a light knitted blanket on it and picked it up every 15 minutes.) I then had a horrible thought: the nocturnal raccoons would probably eat it.

    Right then and there I drew a line in the sand and said to myself “that ain’t happening on my watch.” I picked the little guy up (I did not know the gender) and brought him inside and realized that at least for that night I was going to be his father and mother. When I put him in his makeshift little crib I had the first of several revelations that night: when you were using you probably would have let that kitten die. At that moment I fully embraced the experience.

    After giving him a couple of drops of milk (not as easy as it seems—I managed to get more on the little guy’s cheeks and neck then in his tiny mouth), I figured the cat and I would have a long snooze. No such luck, 10 minutes later he was crying. I petted him for a bit and got back into my crib. A cat person friend finally called and said “it is 50/50 whether he will survive the night without his mother.” Once again I said chauvinistically “that ain’t happening on my watch.”

    “Just hold him as much as you can,” she said. Realization #2 then crept into my brain: Whether you like it or not, you are going to have to be a surrogate parent for the night. Incredulous as this sounds, I said to myself, “here is your shot at fatherhood.”

    As the night drew on, I would pick him up for 10 minutes then put him down and he would cry, and just by hearing my utterance “it is all right little friend,” he would sleep for about 20 minutes. (Once I learned that kittens can’t hear or see for a week after birth, I realized my talking was a placebo for me; it calmed me down and maybe my little buddy sensed that and also relaxed). After holding him for another 10 minutes, I realized I was too nervous to sleep and at about 3 a.m. I took him with a towel and small knitted blanket and put him on my chest. He only cried three brief times after that. I think the little guy probably thought I was his feline mother because he positioned his body right over my heart. 

    It is incredible: these little guys do not have working ears, eyes, legs at birth and their thermostats are very nebulous. No wonder my cat friend gave him a 50 percent shot of making it through the night!

    When light befell this newly anointed kitten kennel, I realized I was responsible for the kitten’s life. Eye-opener #3: I might have saved him from the raccoons that night, but most importantly, his welfare was in my hands and I knew I had to get him some professional help.

    As soon as 8 a.m. rolled around, I went to the local vet and lucky for me, the newbie, they said they would take care of him and find a home for him. I felt relieved, but then epiphany #4 hit me like a load of bricks: I realized I would miss this itsy bitsy bundle of joy.

    Before my deep seated abandonment issues kicked in, out of nowhere a warm sense of calmness pervaded my being. Vision #5: I was “high.” For the last 10 hours my ego went into some sort of dissolution…I was tripping, like a psychedelic high — my sense of well-being was no longer about me, my whole apparatus shifted to the care for a four ounce cat.

    That is about as stoked up as I ever felt in recovery.

    HAPPY FATHER’S DAY!

    View the original article at thefix.com

  • You Are Not My Father

    You Are Not My Father

    I had spent my whole life seeking certainty and security and this break exposed the foolhardiness of that quest. Here was the raw slate of rock bottom once again.

    Last year, a few days before Father’s Day, we were driving home after a week in South Carolina with my parents, the kids asleep in the back. My husband and I had basically just spent a whole week as strangers, sleeping in different bedrooms, not connecting. He had to work late every night — his reason for sleeping in a separate room. I felt our bodies repelling each other from the moment we arrived at their house. I had sensed that force around him often but something about the new setting made it more palpable.

    For months I had been unable to wear my wedding bands because a rash flared up each time I kept them on for more than a few hours. Denial protected me from these not-so-subtle warning signs.

    On one of the first nights of the trip my son woke up screaming with ear pain. It could have been from the pool water or from the mounting pressure of his parents’ silent stalemate. His dad very kindly ran out to get him medicine; he was always very loving about things like that. Our little boy’s seeming agony mysteriously vanished as quickly as it came on and we retreated to our separate rooms.

    I made some really terrible meals that trip. I had brought my Insta-pot, which I was not yet savvy with. I made big pots of mushy things amidst a lot of steam. I worried he was quiet because the food sucked; he wasn’t super on board with my change to a plant-based diet. It was both sweet and heartbreaking how hard I was trying. As if I could make it all okay by making a good enough meal; so the family could be good enough, so I can be good enough. Food wasn’t going to fix it.

    The hardest moment was on the third day of the trip. We were in the living room and it was late morning. He and I had been coming and going in opposite directions. He’d take our son to a golf lesson early, then I’d take the kids to the beach while he stayed at the house to work. That third morning I decided to speak up.

    “Do you have to work so much? Usually when people go on vacation they send an auto-response email that they will be unavailable until such and such time. Do you think you could do that?”

    To be fair, I don’t even know if I asked him. It’s very possible that I was indirect, and just insinuated that he was being a big old disappointment for working.

    He erupted. He was clearly under stress and I had poked the bear. His explosive anger was nothing new. On that day I didn’t know the full extent of what was really going on with him, but I would find out soon enough.

    I decided to make the most of the trip with the kids and my parents’ company. I made sure I got to some recovery meetings. I called my sponsor. I’m sure she and I laughed at some things. Which brings me back to the beginning of this story about the end of my 12-year marriage.

    I was sitting on the passenger’s side, well into the 13-hour drive back to New Jersey, when he turned to me.

    “What are you going to get me for Father’s Day?”

    Cool as a cucumber, out glided: “Why would I get you a Father’s Day gift, you’re not my father.” Suffice to say I got the intended reaction, both from him and for myself. He raged and banged the steering wheel saying I was so heartless and cruel, while I was able to seal myself off inside, emotionally protected and walled off. The next day I tried to make it right with a card and apology. My comment that day in the car is not the reason for what happened next, but it has taken me a long time to truly accept that.

    By the end of that week he told me he was leaving, that our relationship had been “too turbulent” and that he “needed to stop living his life trying to please other people.”

    I didn’t see my husband as a man, but as a burden, an overgrown child. At times I hated him for that and other times I took advantage of it. That is not a partnership and this was no longer a union. I suspect it may never have been. A part of me understood his announced departure. The loudest parts of me did not.

    For the first month I chewed on his abandonment (I mean break-up) speech in my mind and was reminded of what my first sponsor said to me when I disingenuously bemoaned my people pleasing defect. She looked me in the eye and said “Jane, there is no such thing as people pleasing, the only person you are interested in pleasing is yourself.” That resonated. I had considered myself a virtuous victim and was seeking attention for how taken for granted I felt. But I wasn’t able to use that card anymore. And yet here I was, years later, applying my sponsor’s observation to my husband’s behavior so I could justify my resentment, superiority, and self-pity. Ugh, I had become a smug sober person.

    He had to rehearse his break up speech to me several times, as I tried coaxing him to go see a therapist together or be open to any more conversation about it. He was resolute, and he moved out the next day. He had been in therapy for six months and knew this is what he wanted. The last night with him in the house, I lay alone in the giant king-size bed, a terrified child. I had spent my whole life seeking certainty and security and this break exposed the foolhardiness of that quest. Here was the raw slate of rock bottom once again.

    From the beginning my wrongs and disappointment haunted me: I see-sawed between guilt/shame and blame/anger. I had been sober long enough at this point to remember men and women who had walked through the death of children, unexpected illness, and other horrific circumstances, and they continued to show up and not drink. So I knew I could do that too, one day at a time.

    The following weeks and months after were brutal. I rapidly dropped 20 pounds, found a lump in my breast, got into twisted relations with an older man in a 12-step meeting and did my best to care for two confused and upset children as an angry-hungry-tired-lonely-just-not-drinking mommy. I got an excellent therapist right away. I upped my meditation game by taking the TM training and sticking with it. I wrote a fourth step, did the fifth, immediately tried to make amends and get him back (yes I’m embarrassed to write that).

    After about six months I started coming out of it. I learned that my willingness to talk and express and work things out with people can go to an extreme, placing me in a position to be harmed. I made my circle smaller. Slowly I’ve experienced a loosening of all the places inside me that had wrapped and toiled and contorted to survive in what I had perceived as a very unfriendly place to live, because it had been, because of how I had been living.

    We got married before I got sober. We spent 15 years together, during which I discovered 12-step recovery. My husband never objected to my meetings and I was able to make recovery the center of my life from the beginning. While together, I gave birth to two healthy, loving, fearless children. I’m grateful for all that my marriage gave.

    I’ve grieved the loss of what I thought we could have had. There are days when I am hurt and take his choices and continued actions personally but I do not miss his presence in my life. I’ve experienced a year full of character defect withdrawal. I notice how the spaces where the unhealthy behaviors used to be sometimes fill up with stories about how terrible I am, how unworthy I must be of love and belonging, how I’m too much, and don’t really matter. These stories are loud and call for my attention. I tell them I hear them and continue taking positive action in my life anyway.

    Now, a year out from that car ride and the ensuing events, I am changed. I speak up where I once would have avoided a conversation, I am no longer interested in being all things to all people, I don’t feel the need to be busy all the time, and I’m really good at enjoying my own company. My relationship with my family of origin also dramatically changed this past year and sometimes I feel that as an unexpected additional loss. And yet, having grown up within a family with the disease of alcoholism, it’s a loss I have been suffering my entire life and not grieving.

    My husband’s leaving revealed a lot of my dependencies. I had used his presence as a source of security after getting sober. His absence is no longer a source of insecurity.

    On Father’s Day this year I know my God as an unconditionally loving parent. Like it says in the Big Book of Alcoholics Anonymous “He is the father, we are his children.” I didn’t have to drink to hit bottom and find a new relationship to a Power that allows me to thrive. If I had continued living like I was, I would be missing out on the experience of my own sobriety.

    View the original article at thefix.com

  • Mother Interrupted

    Mother Interrupted

    We would go to Disneyland, attend little league games, and participate in the school bake sales. What set us apart from other parents? We were smoking copious amounts of methamphetamine.

    The following is excerpted with permission from Mother Load: A Memoir of Addiction, Gun Violence and Finding a Life of Purpose, from Rothco Press. Copyright 2019 by Wendy Adamson. All rights reserved.

    A mother’s body against a child’s body makes a place. It says you are here…. Without this body against you, there is no place. The absence of a body against my body created a gap, a hole, a hunger. That hunger determined my life. -Eve Ensler

    When I looked out the peephole of my front door, Kim, a twenty-four-year-old tweaker, was standing in a cropped t-shirt and skintight jeans, her blond hair covering one eye, peek-a-boo style. She had scored earlier that day and was back for more. It was obvious that she was doing a shit load of meth. But who was I to judge? It was the early nineties and my husband Max and I were living the so-called American Dream. We had two boys and managed apartment complexes with a swimming pool in a quiet suburb outside of Los Angeles. We would go to Disneyland, attend little league games, participate in the school bake sales and enjoy an occasional Sunday Bar-B-Q. What set us apart from other parents? We were smoking copious amounts of methamphetamine.

    Opening the door a crack, I looked over her shoulder to make sure she wasn’t being followed. “Come on in,” I said, quickly shutting the door behind her. Our nine-year-old son Rikki had fallen asleep in his room, while my sixteen-year-old, Jerry, was staying at his friend’s house a few blocks away. I hadn’t gotten any real sleep in days and I was exhausted. I was just about to call it a night when she knocked.

    A fringed leather purse bounced off her hip as she sashayed to the couch.
    “I like your purse,” I said. “Very sixties.”
    Kim sat down and fondled it like it was a puppy, “Oh this thing? I got it for ten bucks.” “Ten bucks?” I was struck with envy.
    “Yes ma’am.”

    Why does this bimbo refer to me as a ma’am? Is she trying to imply I’m old? How about I smack you upside the head with your puppy purse, you blond dimwit? I flashed her a phony smile.

    Just then, Max walked in, shirtless, rubbing his jet-black curly hair with a towel. “Yo, what’s happening Kim?”

    “Hi Max,” she giggled. “I came by to see if it’s too late to score a gram?”
    The dealer, wanting to cut down on foot traffic, had assigned Max as the middle man and for his efforts he’d get a cut of whatever he bought.

    “Giiirrrrlll, you know speed freaks don’t sleep,” he wagged his finger. “It’s never too late to score from a meth connection.”

    Kim laughed, while I blankly stared off in space. I had heard the recycled-speed-freak jokes before, just like I had heard all of Max’s jokes. I figured that’s just what happens when you’re married to someone for twenty years. Everything ends up being old recycled news.

    Within minutes Max and Kim headed out the front door to the connections across town. When I was sure the coast was clear, I rushed to the master bedroom and pulled out a stash I had tucked away earlier that day. Due to my increasing paranoia, I had convinced myself Max was doing speed behind my back. So, why not beat him at his own game?

    I poured a generous line of the white, glassy powder onto the crease of six-inch-squared- off tinfoil. With a straw gripped in my teeth, I held a flame a few inches underneath. The powder began to smolder and a metallic smoke spiraled upward. I sucked it in like a human vacuum cleaner, determined not to let any of it get away. I held the smoke in my lungs until they felt they might explode.

    As I set the foil down my heart was pounding like a drum. I gripped the edge of the mattress, riding the rush of adrenaline like a racecar driver hugging the wall of a sharp turn. The ceiling fan spun overhead. A dog barked somewhere in the neighborhood. The neurons fired in my brain like it was the Fourth of July.

    I was as jumpy as a lab rat and wanted to direct the frenetic energy in a constructive manner so, I went to the kitchen, sat on the sticky linoleum floor and started emptying the cabinets of all its pots and pans around me. I was trying to scale back because I had way too much ‘stuff’. I mean who needs three cheese graters when I barely use one?

    I looked down at the soles of my feet. They were filthy! Deep cracks ran along the edges of my heels. I made a mental note to take a shower but quickly dismissed the idea. The meth always made the water feel like tiny needles shooting all over my body. I shoved a nostril in my arm pit. It smelled like old meat. Maybe I’d take a bath later on?

    It was hard for me to stay focused on meth. One minute I would want to attend to house- wifey chores and the next I would feel a creative impulse come on. When inspiration hit me there was just no stopping it. I pushed myself up and rushed to the hallway cabinet where I kept my craft supplies. I had everything from dried flowers, beads and embroidery thread to ceramics, paintbrushes, and crayons. When I opened the cabinet a roll of gold ribbon fell to the floor and spun down the hall.

    As I stood my brain released an enormous cascade of creative ideas. I felt like such a visionary who could craft anything with my nimble hands. Eventually, I decided to make a colorful Easter bonnet, even though I had an aversion to anything churchy since being kicked out of Catholic school in the ninth grade. I grabbed my trusty glue gun, a batch of yellow silk flowers and a wide brimmed straw hat. With my arms full of supplies I went to the living room to set up a work station.

    I spread everything out on the floor when it occurred to me that the Johnny Carson Show was on. Geez. Was it that late already? Looking at the clock I saw it was now past midnight. Holy shit, Max had been gone for over two hours. Drug dealers may not have the best customer service skills, but normally it wouldn’t take so long. Worried, I began flipping through worst- case scenarios in my head. What if he had gotten in a car wreck and he’s in the emergency room somewhere? Or what if they got busted, and he was sitting in the back of a police car? What then? I didn’t have the money to bail him out.

    Then it hit me. Call it a hunch, women’s intuition or instinct, but I knew down to the marrow of my tweaking bones that Max was cheating on me. In a flash everything slotted into place and made perfect sense. The way Kim giggled at his stupid jokes, the countless trips to the dealer they made, and the way she looked at him when he walked into the room. Why hadn’t I seen it sooner? How could I have been so fucking stupid!

    A tightness gripped my chest. I couldn’t breathe. I wanted to throw something, hit something with my fist. I wanted to scream at him, “You can’t do this to me you fucking asshole!” Instead, I went to the bedroom and smoked more speed. My hands shook as I sucked the spiraling metallic smoke into my lungs. My jaw clenched so hard it was a wonder my molars didn’t turn to dust. How could he do this me? Hadn’t I given him children as well as the best years of my life? In this moment it never occurred to me that I could leave him or kick him out of the house. Instead, I thought, maybe if I scared the shit out of him he’d think twice about ever cheating on me again. So, I had a plan as I slipped into the closet and stood on my tippy-toes, reaching around until I found the gun at the back of the shelf. My fingers gripped the hard steel of the .38 Smith & Wesson as I pulled it out. Max and I bought the gun a while back from a tweaker who was in need of cash. We somehow convinced ourselves it was a good idea to have around for protection in case anyone tried to break into our home.

    I went to the living room and placed the .38 on top of the armoire. Waiting, I paced back and forth like a feral cat. Images of Max and Kim fucking in the back of her El Camino played inside my brain like bad porno. Mother fucker! my head screamed, you can’t do this to me. I cooked your food. I washed your dirty drawers. For what? To be discarded like some old coat you don’t want anymore? No fucking way. I won’t have it!

    I pushed the screen door, stepped onto the front porch but there was still no sign of them. My thoughts were coming at me like the rapid fire of an AK-47. He said he would always be there for me. He said he would never leave me. We made a promise to each other twenty years before that we’d grow old together. He can’t do this to me.

    My heart hammered against my chest. Sweat dripped down my back. I had managed to work myself up into an eyeball-boiling rage when I looked out the door again, I saw them. Max was driving Kim’s white El Camino, looking for a parking space. I grabbed the .38, barreled through the screen door and ran into the middle of the street. Taking a military stance, behind them, I extended both my arms, with the gun in a two-fisted grip, I aimed above the car and pulled the trigger.

    POW!

    The sound felt like it reverberated through my chest. The noise was so piercing it’s a wonder I didn’t give myself permanent hearing damage. The car didn’t stop so I ran after it with both my knees and arms pumping away. I distinctly remember seeing my neighbor, Mrs. Brown, peering out her large bay window with her head bobbing back and forth.

    Mind your own business you nosy bitch. This is a domestic affair.

    When they turned the corner I darted in between two parked vehicles and caught my foot on the curb. I fell onto the wet grass but popped back up like one of those blow up dolls that won’t stay down. When I turned the corner I was shocked to find the El Camino sitting in the middle of the street. I rushed over like a deranged special ops commando and hurled my torso across the still warm hood. My chest heaved. I was panting like a dog in heat. Kim was sitting shot gun with her jaw unhinged. I pointed the gun directly at Max’s face. His big brown eyes were filled with terror. It was a look I’d never seen before. Those were the same soulful eyes I’d fallen in love with at sixteen years old. He was the love of my life. My best friend. The father of my children.

    In an instant it felt like I slipped out of my body and was staring down at myself sprawled out across the hood of the car. I heard a voice reason inside my head say, “You know, Wendy, if someone were to see you right now they might think you were crazy.” And they would have been absolutely right. I was in the middle of a drug-induced psychotic break. Sleep deprived and smoking way too much methamphetamine for any human being to consume, I had snapped. I had lost my mind just like my mother had years before.

    Then Max must have come to his senses because he stepped on the gas. As the car moved forward I slid off the hood and landed solidly on my feet. Pointing the gun downward so I wouldn’t hit anybody, I fired another round. As I did Kim’s face contorted before they drove off. Oh shit! Did I hit her? No way! The gun was pointed down.

    I stood there out of breath and watched as the taillights disappeared with the weapon dangling by my side. That was not the result I had in mind when I picked up the gun. In some strange way I thought he wouldn’t leave me if I showed him I meant business. My next thought was to change my clothes so no one could identify me in a lineup if the cops happened to show up.

    I ran back to the house but before I went inside, I shoved the gun under a pile of dead leaves by the back porch.

    Once inside I checked on Rikki, who was still asleep. As I stood watching him breath one would think his pure innocence might penetrate my drug-induced state but that was not the case. It was as if the meth, a diuretic, had not only leached my sanity, but drained my maternal instincts as well.

    I headed for the bedroom where I caught sight of my reflection in the mirror. My breath nearly jackknifed. My brown hair was disheveled, the bones in my face were all sharp edges and I was hunched over. My eyes were like two dead, vacant pools and my skin was a sallow gray. It was jarring how much I looked like my mother had when she had gone insane.

    A familiar darkness grabbed me like fingers around my throat. I wanted to stop the madness but had no idea how.

    I flinched when I heard something outside the window. I opened the front door and when I stepped onto the porch I was blinded by a dozen spotlights, pointing at me like fingers of accusation. “Hands in the air!” a disembodied voice yelled from beyond the glare.

    The Catholic girl still inside me did exactly what she was told as a stampede of Lomita sheriffs surrounded me. It all happened fast after that. One of them cuffed my hands while another patted me down and others rushed inside the apartment.

    My legs shook like a high-strung Chihuahua. A scruffy-looking cop slipped plastic baggies over my hands and manila envelopes over that.

    “What’s going on? What, what what are you doing?” I asked, feigning innocence.

    A young cop, who looked barely out of high school wrapped duct tape around the envelopes secured the envelopes at my wrists.

    “My son is asleep in there…”
    A cop yelled inches from my face. “SHUT UP!”
    I flinched. I felt like I might pass out.
    When they were done, it looked like I had two flippers where my hands were supposed to be.

    A young sheriff led me by my arm, shoved me into the back seat of his squad car and slammed the door. I leaned my forehead against the window and watched as cops scurried in and out of my apartment. Where was Max? Why hadn’t he come back to see what was going on? What was going to happen to me? I needed a cigarette so fucking bad.

    I looked down at the strange appendages resting on my lap. I realized the cops were trying to keep the gunpowder intact on my hands as evidence. I gripped the corner of the envelope with my teeth and began ripping, tearing, spitting the scraps of paper on the floor. Ripping, tearing, biting, and spitting like a trapped animal determined to get free. Finally, I broke through the plastic baggies and started licking my hand and fingers. I was no dummy. I knew how to outsmart those cops. I was in a frenzy when the front door of the squad car flew open. A good-looking cop peered through the thick mesh screen.

    “Look, Wendy.” He paused. “Why don’t you just tell me where you put the gun? It will be easier for you if you cooperate with us.”

    “Under the leaves by the back porch.” The words just rolled right off my tongue. You clearly wouldn’t want to drop me behind enemy lines. He ran off like a school kid picked for the winning team. When I thought about Jerry and Rikki my heart sank to my feet.

    Oh God, oh God, oh God, oh God oh shit shit shit. My poor, poor boys. What the fuck have I done? What have I done?


    Want to read more? Buy Mother Load on Amazon.

    View the original article at thefix.com

  • Trauma, Addiction, and Abortion: My Story

    Trauma, Addiction, and Abortion: My Story

    I never allowed myself to accept that doing the right thing and feeling pain and loss aren’t mutually exclusive.

    I should avoid the comments on this piece, but I won’t. I’ve danced on a lot of bars and crashed a lot of cars. There isn’t anything anyone can call me that I haven’t already been called. Except “Mom.”

    With new laws sweeping the South making abortion past six weeks (generally around the time one finds out they are pregnant — if they’re lucky) a felony, it’s important to tell this story. It may offend dozens of people, but if it helps even one person release the shame around their past, I will know that I’ve done my job.

    Abortions are like relapses in liberal society. One is permissible: a slip, a do-over, an I’ve learned my lesson and never again. But more than one and it’s what the hell is wrong with you? Why aren’t you taking care of yourself? AS A WOMAN?! I don’t know the answer to that.

    I’ve had several; relapses and abortions. I’ve had relapses because of an abortion. And I’ve had an abortion because of a relapse. I was always on the pill, and I was always in or about to be in active addiction. For a long time, I saw the pill the same way I saw drugs and alcohol: I watched others use it with impunity and even though I was shown time and again that it didn’t work for me, I kept thinking I could figure out how to use it the right way.

    The first time I drank, I was seven. My parents’ friends brought over a box of liqueur-filled chocolates and I ate them all and played Twister. I was too young to understand what happened, I just thought I really loved Twister and was confused when it wasn’t as fun after that.

    The first time I tried to get sober, I was 27 and I hadn’t missed one day of cocaine in the previous 365 days. Things I had missed: work, the mortgage, all other bills, being faithful, knowing I could leave an abusive relationship.

    The last time I drank I was 37, the age I am now. I decided to have just one beer for a friend’s birthday. And I did just want to have one beer. But then I turned into a different person. And that person wanted to get wasted, do a pile of coke, and blow someone in a dive bar bathroom.

    In the past ten years I’ve let a lot of people down and I’ve caused a lot of harm. As I make my 9th step amends, the list continues to grow as my brain feels safe enough to allow the memories in. I owe a lot of amends, but none of them are to my child. Because of abortion, I don’t have one. The one saving grace through the insanity of my using is that I never dragged a child through it.

    I learned to drink from my mother, whose passed-out body I used to struggle to drag to the bedroom. She wasn’t there for me when she was awake, either. I would wake from night terrors and attempt to get comfort from her. I remember her scream: “Your mother is dead!” 

    My mother is in the program yet she has never made amends to me. I’ve often wished she would, but not everyone is ready to face themselves.

    I was born nine months after my mother had an abortion. A doctor told me that the body’s tricky that way: when you abort, it thinks you miscarried and sends another egg right away to take the lost one’s place. I can’t find any medical studies to support this but I learned firsthand one summer when I went to get a checkup and an IUD (which they will gladly give you once you’ve had more than one child or abortion) and found I was pregnant again. My boyfriend didn’t want to have that one either.

    I didn’t know my own origin story then but I knew that there was no way I could grow and care for a once again drunkenly-conceived embryo after I had just terminated the previous one. In that way I understood a bit of the complicated feelings my mother had for me. 

    My grandfather started a pro-life charity and my grandmother had a bumper sticker on her car that said, “Save the baby humans.” My favorite aunt sends out Christmas letters detailing the positive energy at the pro-life booth this year at the Big E. I never felt bad about what I had to do, except when I did. These things are endlessly complicated. 

    The first time I was pregnant I was 16. My high school sweetheart asked me if I was sure if it was his. There was never a doubt in my mind. When my mother found out, I was grounded for the remainder of the summer and forced to give up my first job. My boss, a strict Greek Orthodox woman, found out.

    “No!” she screamed. “You aren’t going to kill it!” 

    I saw no other option. That was my only surgical abortion and it hurt. I was 6.5 weeks along, just this side of felony. I dragged myself out of the room to a boyfriend upset that I didn’t bounce out like the woman before me. He never thought I responded appropriately to anything, even terminating our pregnancy. Twenty years later, he is finally ready to be a dad. I think he’ll be a good one. Now.

    The next time I got pregnant it was with the first man I did cocaine with, a man who once held me hostage in my own apartment, bit my hand, and sat on my back for several hours while telling me that I’d never publish anything. (Hi.) We were broken up when it happened and I had a restraining order. Restraining orders are aphrodisiacs to some men.

    Thankfully I remembered my symptoms from the previous time, and the early option pill was now available stateside. I took it. Seven weeks. 

    As I write this, the Mourner’s Kaddish runs through my head. Yitgadal v’yitkadash sh’mei raba.

    I’ve been so protective of myself and so full of bravado because I know I did what I needed to do, that I’ve never really mourned. I never allowed myself to accept that doing the right thing and feeling pain and loss aren’t mutually exclusive. Women who’ve had abortions don’t need your shaming. We can feel bad all by ourselves. 

    Then I married, and I went to rehab, and I got divorced, and I got pregnant with my rehab boyfriend, the first man who ever shot me up. Such romance. He wasn’t ready to to be a dad, either, and with his history — dozens of rehabs, overdoses, having been declared legally dead more than once, and my own history not more stable, I agreed. Back to the gynecologist. They sent me back, saying it was too early. I was 5.5 weeks. Just under the new law’s limit.

    After me, that man met a very Christian woman. And now he has a child that he doesn’t see or take care of.

    My last abortion was almost six years ago. I was trying the pill (and controlled drinking and using) just one more time, and I was dating a guy with a baby he didn’t want on the way, the result of a work fling with a girl who insisted that she’d had too many abortions already to have another. He was so angry with her. I fell down the stairs drunk when he was in the hospital for the birth and hurt my shoulder. I went to the hospital and found out that I was pregnant too. When he came home as a new dad, I greeted him with “I’m sorry I didn’t fall down the stairs harder.” Humor is my best defense mechanism, my strongest armor. 

    That time I thought maybe I can do this. I tried the same argument his other baby momma used, but it didn’t work.

    “In eight years,” he said, “I’ll have an eight-year-old son. And you’ll be a waitress who does comedy at night.”

    Oh, Tanner. Always the charmers, the men I’ve had abortions with. So it was back to Planned Parenthood one final time, a place that has always treated me with respect and kindness and compassion. They’ve been there when no one else has.

    At 6.5 weeks I bled out my last pregnancy in a hidden room off the winter rental beach house I would get kicked out of early just a few months later. I watched the waves crash against the shore and I cried for every single one. And I cried for myself, a grown woman who was still unable to even raise herself on her own. A few weeks later I got fired from my job for stealing wine, which was, honestly, Tanner’s idea, and I chugged some tequila and swallowed a bunch of Xanax and drove right into the guardrail, which is probably my favorite thing to do when I’m drinking.

    Other than, obviously, get pregnant.

    The one boyfriend who gave me a hard time about my history is the one I never got pregnant with. He chased me into the shower after choking me and spat baby killer into my face. He has four children, ranging from 2 to 25, none of whom he can afford to care for, none of whom he didn’t severely damage with his using and his anger and his refusal to look at himself. Their mothers took up the slack, and I think most of them will be mostly okay. 

    Those were their choices, and these were mine. It’s a pretty extreme example, my story, and that’s why it needs to be told. If I can forgive myself, so can you. If I can walk through this world and know I did right by myself, that I did the best that I could in the place that I was in with the knowledge and abilities I had at the time, so can you.

    Trauma is handed down, and people in active addiction cannot care for children. The cycle of child abuse in my family stopped with me. Abortion is a basic human right, the hallmark of a civilized society.

    Je ne regrette rien.

    View the original article at thefix.com

  • Addiction Treatment in Hispanic Communities: How We Can Do Better

    Addiction Treatment in Hispanic Communities: How We Can Do Better

    Numerous cultural norms and expectations reinforce the collective silence on substance use. Among many Latinx people who are first generation immigrants, there is a desire or expectation to be a “model minority.”

    Evan Figueroa Vargas wears the scars of a hard-knock life in his voice. In gravely intones the Philadelphia native recounts years of criminal justice involvement and chaotic drug use that followed his brother’s sudden overdose death in 2002. It’s not easy to find help when drugs, incarceration, and the streets intertwine, he says. But it’s even harder when you’re Hispanic.

    “In the Latino community you come from a place where machismo rules,” Figueroa explains over the phone. If you admit to mental health or substance use issues, “somebody is going to call you a loco.”

    Culture of Silence Around Drug Issues

    Many people who identify as Latinx (originating from Latin American countries) or Hispanic (from Spanish-speaking countries) describe a culture of silence around drug issues. Particularly for men, asking for help or admitting vulnerabilities can be seen as a weakness to be ridiculed or exploited.

    Numerous cultural norms and expectations reinforce the collective silence on substance use. Among many Latinx people who are first generation immigrants, there is a desire or expectation to be a “model minority.” Communities may emphasize the importance of hard work, education, family loyalty, and showing your new country that you are an asset. Drug use, especially chaotic use of illicit drugs, is seen as running counter to these goals.

    Tanagra Melgarejo, who immigrated to the United States from Puerto Rico at 17 years old and now works for the Harm Reduction Coalition, cites a popular Latinx idiom: Los trapos sucios se lavan en casa. Basically, don’t air your dirty laundry in public. Drug issues are hard to bring up because “you feel like you’re betraying a cultural norm,” Melgarejo explains. “You are exposing something and then you are bringing shame to yourself and other people.”

    The desire to hide drug use may have pragmatic roots. Among immigrants and people of color, who are often the target of police or other state institutions, openness about illicit drug use might attract unwanted attention, including raids, harassment, and incarceration. Avoiding illicit activities or hiding any that may occur becomes a necessity for undocumented immigrants as well, who may fear deportation.

    But reluctance to speak about drug use exists not just within the Latinx community, but in external discussions that focus on this community as well. In the United States, the rhetoric around race and ethnicity revolves around dichotomies, with Latinx populations often excluded from the dominant narrative on drug use and other structural issues such as incarceration, housing, and health care access.

    “Anyone who is not black or white is invisibilized in this discourse,” explains Melgarejo. While culture wars rage about how black Americans were treated during the crack epidemic versus how white Americans are treated during the opioid epidemic, Hispanics, who are affected by both, are often left out of the discussion entirely.

    The silence not just among Hispanics but also about them is what motivated Angelo Lagares, a Florida resident whose family is from the Dominican Republic, to quit his day job in 2015 to found Latino Recovery Advocacy (LARA). LARA’s mission is to provide linguistic and culturally appropriate resources to Latinx people who use drugs and to stimulate discussion about how drug policy affects them.

    “I went through all that shit,” says Lagares, whose passion blazes through his speech. “When you are using cocaine, and the cocaine runs out at 3 a.m., that desperation, that pain [has] no language…People don’t have help. Everything is in fucking English.”

    Now 53 years old and in recovery, Lagares says he is still haunted by the memories of his community decimated by drugs, AIDS, and incarceration when he lived in New York City during the 1980s. He works to honor “the people who died in the barrio.” He says the first step is to raise awareness about how drugs and drug policy are affecting Latinx people.

    Overdose Deaths Increasing Fast

    In general, reports of illicit drug use among Hispanics or Latinos aged 18 and older are lower than the national average, but that is changing. While U.S. overdose death rates are climbing among all races and ethnicities, mortalities are increasing fastest among Latinos, Native Americans and black Americans. From 2016 to 2017, overdose deaths in these groups increased 12%, 13%, and 25%, respectively, compared to an 11% increase among white Americans.

    But despite these increases, few materials on harm reduction or drug treatment programs are crafted to target Latinx people. Even the SAMHSA Behavioral Health Treatment Services Locator, the largest national collection of online resources for people seeking treatment, does not offer a Spanish version of their website (though they do have interpreters available by phone).

    Many programs for people who use drugs claim to offer Spanish-language services on site, but often this consists of one or two employees who speak Spanish. Support groups, guest lectures, and other group programming are almost always in English.

    Language can be an obvious barrier to Latinx populations seeking services, but even that obstacle is more complex than it seems. Not everyone from Latin America speaks Spanish. Some speak Portuguese or indigenous languages. Further, even Latinx people who speak fluent English can be turned off by the lack of services available in their native tongue.

    “I understand English very well but when I speak about difficult issues I prefer to speak in Spanish,” says Haner Hernandez, who is Puerto Rican-born but currently directs a program in Springfield, Massachusetts that trains Hispanics to become certified drug use counselors. He explains that when dealing with issues as sensitive as mental health and substance use, people feel most comfortable speaking their first language.

    Lack of cultural awareness can also be a barrier to effectively engaging with Latinx people. It’s important to recognize the diversity of culture throughout Latin America. Someone of Cuban descent raised in Miami will have a vastly different background than someone who recently fled violence in Guatemala. There are however, some cultural norms that many Latinx people have in common. For example, religion, especially Catholicism, can play a critical role in how the Latinx community views drug use.

    Melgarejo explains that Catholicism teaches about the purity of the body, so drug use is often perceived as morally wrong. “There is this shame [about drug use] that comes with religion,” she says. “If people are not aware of that, it makes it difficult for them to be able to connect with folks in a way that allows them to speak to that and feel safe engaging in services.”

    Cultural views on womanhood also influence how people react to drug use in their communities. Although the Latinx culture may frown on men with mental health or substance use issues who seek help, the worst stigma is reserved for women.

    Latinx people often emphasize marianismo, or female purity, “the dichotomy of the saint or the whore,” says Melgarejo. Women who engage in substance use “are punished for being women, they are punished for being women of color, Latinas, and they are punished for violating that role in the community, for not being pure.”

    Citing the work she did with victims of domestic violence in Puerto Rico, Melgarejo says that when it comes to drug use, the culture is rife with double standards. Mothers who used drugs were often stripped of their maternal rights, while fathers who used drugs were still allowed to interact with their children.

    Programs engaging with Latinx populations should also be aware that many people, especially those who have recently emigrated from Central America, may be fleeing violence and state-sponsored oppression. This trauma can stoke strong fears about any program connected to the government or perceived as such. It can take time and effort to build trust among populations that are initially suspicious. And not all programs are up to the task.

    “We look at these populations and we say ‘Oh they are hard to reach,’” says Hernandez. “They are hard to reach for the people who don’t have experience working in these communities. For those of us who are from these communities, who work in these communities and live in these communities, those populations are not hard to reach.”

    How Programs Can Improve Outreach

    Claiming that a population is difficult to engage is one way for service providers to recuse themselves from having to make the extra effort. But lack of participation or retention of underserved communities may signal not that the population is hard to reach for the program, but that the program is hard to reach for the population.

    The first step towards bridging this divide is humility. It’s easy to blame “them” for “not wanting” to engage with services instead of looking inward. Organizations should conduct a self-inventory of the populations in their community and note those who are effectively engaging and those who are not. Growth can’t happen all at once, but there are many small steps organizations can take to improve their outreach.

    Some questions to ask are: Do staff speak the languages of the community (not necessarily just Spanish)? Do staff practice cultural humility and recognize the diversity in the Latinx population? Does the organization hire Latinx people and place them in positions of leadership? Are program services located in areas easily accessible to Latinx communities? Can the organization partner with others who have built trust in the Latinx community?

    Hernandez stresses the importance of having active and visible Latinx involvement in program development and implementation. Regarding behavioral health, he says, “The majority of people working in the field are white and baby boomers. The majority of the people seeking services are younger and more diverse, so the needs of the people seeking services are not in line with the folks who work in the field.”

    It can be challenging to engage underserved populations, especially those driven underground by various forms of institutionalized oppression. Navigating the diversity and complexity of these communities can seem overwhelming at times. It is easy to give up. But the real measure of an effective program is not how well it serves people who are easy to reach, but how well it engages the ones who need it most.

    View the original article at thefix.com