Tag: how to

  • A Practical and Comprehensive Guide to Finding a Suboxone Clinic

    A Practical and Comprehensive Guide to Finding a Suboxone Clinic

    It took me 10 hours of phone calls, 20 voicemails, 3 chewed fingernails, and many packs of cigarettes before I found a Suboxone provider in my new town. This is the list I wish I had then.

    When I pulled a “geographic” a few years ago, leaving Portland for my home state of North Dakota, I underestimated the stress of starting over. In fact, stress isn’t a strong enough word to describe driving 1,300 miles with my recent ex-boyfriend in the passenger seat and the fear of restarting life without heroin; not to mention I had no full-time job prospect, no health insurance, no apartment, and very few of my possessions. I also had a unique fear that loomed over me like an ominous storm cloud: trying to find a new Suboxone* provider in a rural state. 

    It took me almost ten hours of phone calls, twenty voicemails, ten games of phone tag, three chewed fingernails, and many packs of cigarettes to find a clinic that would dispense the medicine I take to maintain my recovery. 

    Unfortunately, my situation is a common one. Despite our nation being in the throes of an opioid epidemic, finding a Suboxone provider is a widespread problem; only about one-third of addiction rehabilitation programs offer long-term use of methadone or buprenorphine (the active ingredient in Suboxone). And according to the National Alliance of Advocates for Buprenorphine Treatment (NAABT), only about half of all Suboxone providers are accepting new patients.

    Finding this life-saving medication shouldn’t be so hard. When you are committed to getting better, you shouldn’t have to worry about whether or not you’ll be able to find a clinic to dispense your medicine. A person with diabetes wouldn’t have to search hard to find insulin. So I’ve compiled a round-up of tips and suggestions. 

    This is the list I wish I’d had in early recovery:

    1. Find friends and family who are supportive of your Suboxone journey.

    2. Remember that your form of treatment is just as valid as all other types of treatment and recovery.

    Although Suboxone is a widely stigmatized and divisive medication in the recovery community, it has been shown to reduce opioid overdose death rates by 40 percent.

    3. Join online support groups and forums for people on Suboxone.

    Since I lived in a rural area, I couldn’t find any in person groups. So I joined secret social media Suboxone support groups on Facebook, recovery Reddit threads, and peer-support forums such as the Addiction Survivors website and Suboxone Talk Zone.

    4. Allow Plenty of Time to Research, Call, and Locate Providers.

    This was the most daunting and lengthy part of finding a new provider. Dr. Bruce Seligsohn has been a board-certified internist in Southern California for 30 years and practicing addiction medicine for 10 years. Dr. Seligsohn advises: “Patients really need to be very careful selecting a doctor if they have a choice. I would suggest that a patient looking for a new doctor do their due diligence and see what comes up online about the doctor.”

    I have compiled the most current resources available as of August 2018. See the sidebar for a sample phone script for calling providers.  

    Pros: Convenience, ease of navigation. You will be able to easily search for a provider based upon zip code, state, and the distance that you’re able to travel for a clinic.

    Cons: Out of date, inaccurate, not comprehensive. Be prepared for hours of phone calls depending on your location and financial situation. Not all providers are listed on the site. I also found that some of the clinics listed were not accepting new patients, had been closed, or had their numbers disconnected.

    Pros: Ease of navigation, instant results. Similar to the Suboxone manufacturer’s website, this is a good launching point for starting your search based upon zip code, state, and the distance that you’re able to travel. 

    Cons:  Not comprehensive and despite being a government resource, it is not up-to-date.

    Pros: Easy to use, more accurate. Treatment Match only connects you with providers in your area who are accepting new patients, reducing dead ends and calls to providers who aren’t accepting new patients or insurance. 

    Cons: Wait time/ lack of timeliness, not as many provider connections. This is not a straightforward directory and while it’s easy to sign up, you have to wait for a provider to respond to your email. The site claims that doctors respond 24/7, including weekends and holidays, but I only heard from them during normal business hours.

    • Yelp Reviews of Clinics

    Pros: Hearing directly from other patients about their experiences, easy to use, instantaneous, accessible.

    Cons: Questionable trustworthiness. Dr Seligsohn said: “Patient reviews can sometimes be very misleading.”

    • Calling Your Insurance Company

    Note: Insurance companies vary widely, so I can only speak from my experience. For example, in Oregon I was easily able to locate a Suboxone provider through my insurance company, but my North Dakota insurance did not provide referrals. They stated that their preferred addiction treatment was therapy and 12-step based treatment programs rather than medication.  

    Pros: Possible thorough list of doctors certified to prescribe Suboxone. Those Suboxone providers who accept your insurance are required to keep their information listed and up-to-date.

    Cons: Time-consuming and you have to deal with the hurdles of bureaucracy. Plus, some studies have found that only about 50% of eligible Suboxone doctors accept insurance. Some insurance companies like mine will allow you to submit an appeal asking them to cover part of your Suboxone visit or prescription, especially in rural areas. I saved all of my receipts and had my psychiatrist and Suboxone doctors write letters of support. After months of appeals, the insurance company agreed to cover part of each appointment. Each month I sent in a claim and receipt, and then I received a reimbursement check about a month later. 

    • Asking for a referral from your primary care provider, psychiatrist, or hospital.

    Another note: This is also difficult to give specific advice on because they vary depending according to location and providers, among many other factors.

    Pros: In-person support and assistance, more direct medical guidance and advice. 

    Cons: Stigma, lack of education about Suboxone, judgement, lack of timeliness. 

    5. Be Persistent!  

    6. Moving? Set Up an Appointment Months in Advance.

    Dr. Seligsohn advises finding a doctor and setting up an appointment prior to moving. “Patients need to find out as much information about how their perspective new doctor runs his practice…They also need to find out what the doctor’s philosophy is about long-term vs short-term Suboxone. If I was a patient I’d be reluctant to move to an area where there’s a shortage of Suboxone doctors.”


    Sidebar: Sample Phone Script for Calling Suboxone Providers

    I remember being so nervous, overwhelmed, and frustrated while also dealing with the symptoms of opioid withdrawal. Make sure you set aside a few hours for making calls in a quiet, safe place. I know some of these tips might seem like common sense, but when you’re in crisis and everything feels overwhelming, it can be a relief to have a guide.

    1. Introduce yourself and tell them that you’re looking for a suboxone provider.

    2. Where are you located?

    3. Are you accepting new patients?

    • If yes- when is your earliest available appointment?
    • If no- don’t hang up just yet! Ask: do you have a waiting list? Can you give me an estimate for how long it would take me to get an appointment? 
    • Do you have a cancellation list and if so, can you please add me to it?

    4. How often do I need to come to the clinic or office? 

    • Most clinics and offices require monthly or bi-monthly visits, but some require daily visits and dispense suboxone in a similar manner to methadone.

    4. Do you accept my insurance? 

    5. If the clinic does not accept insurance, how much does each appointment cost?

    • How much does the intake appointment/ first visit cost? This is an important question to ask because initial intake appointments can cost anywhere from $100 – $200 more than a regular visit.
    • Some clinics require pre-payment to reserve your appointment and prevent cancellation. Do you require a down payment before the appointment?
    • What forms of payment do you accept? (cash, credit, check?) Note that most clinics do not accept checks.
    • Do you allow payment plans or is payment due on the day of the appointment? A majority of clinics will not allow patients to do a payment plan and payment is due on the day of the appointment.
    • Are there any additional costs or required fees? Some charge additional fees for mandatory counseling, drug screens, etc.

    6. What are the counseling requirements?

    • You may be required to do weekly or monthly therapy groups with others at the clinic, and/or meet with an addiction counselor. This varies depending on how long you’ve been clean and your insurance coverage. (For example, one of my previous clinics had no counseling requirement, but my new clinic requires me to meet with an addiction counselor for one hour each month. Other clinics require weekly or bi-monthly group support meetings.)

    Quick Resource List:

    The Substance Abuse and Mental Health Administration (SAMHSA)’s Buprenorphine Treatment Practitioner Locator

    Suboxone Website’s Treatment Provider Directory

    Buprenorphine Matching System on Treatment Match on The National Alliance of Advocates for Buprenorphine Treatment (NAABT)

    Addiction Survivors

    Suboxone Talk Zone

      

    *(Writer’s Note: Suboxone is the most common brand-name buprenorphine medication, but this article is also applicable for patients seeking any form of buprenorphine treatment including: Subutex, Zubsolv, Bunavail, and Probuphine).  

    View the original article at thefix.com

  • Let’s Get Real: How To Handle the Tough Stuff in Recovery Without Using

    Let’s Get Real: How To Handle the Tough Stuff in Recovery Without Using

    Of course, people had good reason to think that I couldn’t handle upsetting news. Every time a hardship, breakup, or something unsettling happened, I wound up in the psych ward, detox, ER, or a bloody, tear-filled mess.

    When I was drinking, I was the girl who took pulls of rail vodka right from the bottle. I took it straight, no chaser. Others looked at me with a mixture of surprise and disgust. Girls were supposed to mix their vodka with fruit juice or soda. Girls weren’t supposed to out-drink the men or keep straight razors in their wallet for chopping up fat lines. Fellow drunks patted me on the back. I was one of them. I embraced my heavy drinking as a point of pride, wore it like a badge of honor.

    But the point of this isn’t to share my war stories or act like I was the most bad ass alcoholic or junkie to ever haunt the planet. Rather, I want to share how I still prefer to apply the “straight, no chaser” motto to other areas of my life. I prefer when loved ones are straightforward, blunt, and honest with me about tough stuff and hardship rather than trying to gloss over the truth or protect me from pain. Even though I have been in recovery for years, some of my loved ones have continued to worry that I will relapse upon hearing bad or heartbreaking news, as though I was some sort of wounded dove with the word “fragile” stamped on my forehead.

    Of course, they had good reason to think that I couldn’t handle upsetting news. Every time a hardship, breakup, or something unsettling in my life happened, I wound up in the psych ward, detox, ER, or a bloody, tear-filled mess. I categorized people as either “normies” or “addicts and crazies” because it was easier than embracing the messy complexity of human beings. In my mind I was broken. Normal people went to the gym, spa, or the mall when they were troubled. But those options didn’t work quickly enough to soothe my mercurial temperament and smooth my edges. I labeled myself as a crazy addict, so I went straight to the liquor store or to the organic grocery store (ironically this was where my dealers were, standing outside with signs reading: “needs money, anything helps”).

    If you’re someone who struggles with addiction, you understand this self-destructive pattern. It’s hard to deal with “life on life’s terms,” as they say in the program. When stressful life events happen, we often turn to our familiar coping mechanisms. In fact, the National Institute of Drug Abuse found that up to 60 percent of people relapse within their first year of recovery. 

    There is a constellation of reasons that people relapse. Studies have found that being exposed to stresses that originally caused someone to excessively drink or use drugs is a major trigger for relapse. Another study found that patients with alcohol and opioid dependence were most likely to relapse when they had a family history of substance use and high number of relapses, used maladaptive coping strategies, and also had “undesirable life events.”

    I can relate as I had my share of undesirable life events this past year. Even though I’ve been clean for a few years, I still felt a massive urge to use after hearing about the death of my god-daughter and, on a less serious note, a heartbreaking romantic let-down.

    These events were handled very differently. The morning after my god-daughter died, my mom called and told me the tragic news. She wanted to make sure I heard it from her directly rather than passively finding out about the death on social media. Although this was devastating news, I appreciated that she was direct and real with me.

    What really triggered my cravings was ambiguity and a romantic disappointment. Although we broke up a few years ago after I relapsed, I still consider my ex one of my best friends. We text every single day and I even stayed with him for five days when I was visiting Portland in December. He let me sleep in his bed while he slept on the couch. Wrapping myself in his blankets, I was comforted by his familiar smell of Camel cigarettes and Old Spice. Although the visit was platonic, there were moments when I felt a possible rekindling of our romantic relationship.

    He paid for all my meals, opened doors to restaurants, and even took me to the Oregon Museum of Mental Health in Salem where I researched an essay. Okay, maybe going to a museum of mental health isn’t exactly a hot date, but the fact that he was willing to take me felt positive. He also talked about taking a road trip together in his new BMW coupe, laughing at how when we had been together he drove a Buick and we barely made ends meet. I reminded myself that my intention for this visit was to make amends in person for spinning him in my addictive chaotic orbit and leaving him in the wreckage of our relationship. Yet I still got my hopes up that we would get back together and I wrote him a long letter proclaiming my feelings for him.

    He never responded. He faded away from me, and his texts became infrequent and vague. He said that he was busy and stressed with work. Finally, he admitted to our mutual friend that he had a girlfriend but was afraid to tell me because I was “constantly on the verge of suicide” and he was worried about relapse.

    I was crushed, but at the same time I sort of understood his perspective. He knew the story of my old self. I had shown him in the past that I couldn’t handle such rejection or disappointment.

    So how do we deal with the tough stuff in recovery? Amanda Decker, a Licensed Addiction Counselor (LAC) and Licensed Professional Counselor (LPC) in Fargo, North Dakota, explained: “There will be growing pains throughout the ebb and flow of recovery. It’s hard knowing how to deal with life without drugs or alcohol but it’s helpful to remember that perspective shifts over time. It also helps to develop hobbies and interests. When people in recovery can embrace these things, drugs and alcohol become white noise in the background.”

    Decker suggested developing a “pre-emptive” relapse prevention plan by thinking about how to handle life stressors without alcohol or drugs. If we are in the position of telling difficult or uncomfortable news to a family member or friend who is in recovery, Decker advises: “As an addiction counselor, I’ve had to tell my group about a fellow group member who has overdosed. The first thing I did was to be direct and be present with my group members who were struggling in that moment. There will be a lot of grief and sadness that we have to learn to cope with.”

    The truth is that hardship, tragedy, and disappointment are parts of life that we have to learn how to come to terms with in recovery. We have to start embracing and seeing the shades of wellness and addiction rather than labeling things “normal” or “crazy.” It’s hard to tell a different story about ourselves, it’s even harder to break the story that others have about us. But I have faith in myself and I have faith in you, my fellow humans in recovery. For we are resilient, brave survivors, not fragile wounded doves.

    View the original article at thefix.com

  • No Vacation from Recovery: A Packing List

    No Vacation from Recovery: A Packing List

    Recovery cannot be left to chance but requires planning, even—and maybe especially—on vacation with its temptations: tropical drinks, laissez-faire schedule, swim-up bars, and late nights.

    For a long time, when my bipolar disorder, alcoholism, and eating disorder were out of control, I believed that the geographic cure, specifically travel, was the antidote to all my ills, as if I could take a vacation from addiction and mental illness. I would pack my bags and land in some exotic port of call, a Greek island, for instance, certain that I would find happiness in the reliable sunshine, the deep blue water, the daily swims, the Mediterranean food, and in a self somehow suddenly better—better in illness and better in soul.

    “Surely, surely the less frenetic island pace will slow me down,” I would tell myself. “I’m always happy there, lying on the beach, eating ripe peaches, hiking through the olive groves, and snorkeling in search of sea urchin shells.” Within days of arrival, I’d be miserable, again, flat out suicidal, wanting to swim out into the blue sea, going and going, or wanting to hurl myself off a steep cliff. No vacation from addiction and mental illness.

    What I have learned in my eight years of stability and sobriety is that there is no vacation from recovery, either.

    My first sober vacation with my now-ex-husband was to Jamaica. Hubris testing those waters, which was a paradise for my ex with its endless supply of Red Stripe and ganja but treacherous for me, only a few months sober. My then-husband had been travelling to Negril for twenty years chasing that perfect beach buzz while I was trying to stay steady, surrounded by all these happy (seeming) vacationers, and trying to remember why I did not want to drink, why I could not ever drink again. Naively, I packed without a contingency plan, bringing just a bikini, sunscreen, and a dress. Nothing to support my recovery. Thankfully, my Higher Power had a contingency plan. 

    The first day while we were lazing in the sun, another couple, Amy and Rich*, sat in the lounge chairs beside us. We made small talk and my then-husband said, “I’m heading up to the bar for a Red Stripe. Anybody want anything?”

    “Coke for me,” I said.

    “I’ll take a coke,” Rich said. “Thanks.”

    “Me, too,” Amy said.

    My antennae attuned, I said, “Are you guys in the club, too?”

    They knew what I meant and from then on, we were inseparable. Amy and Rich, sober for decades, prepared in advance for the trip. With a little online research, they’d found a 12-step meeting off the beach in a tiny church and we went together, in flipflop solidarity. Lesson learned? Recovery cannot be left to chance but requires planning, even—and maybe especially—on vacation with its temptations: tropical drinks, laissez-faire schedule, swim-up bars, and late nights. What happens in Vegas or London or New York City or Rome or Kathmandu doesn’t stay there, but stays with you, a permanent souvenir. In recovery, we don’t get a free pass.

    I now have a packing list that I stick to for all my travels, the practical essentials and spiritual necessities that support my recovery and stability. When we leave home for the unknown, we can get lost, even with the precision of GPS, even with years of sobriety or stability, even if we are confident in our now reliable happiness.

    My Recovery Packing List:

    1. Proper Running Shoes: Know whether you are running away from your life or running towards a bigger life. I have used travel as an escape from myself, from the circumstances of my life that felt out of control (my drinking, my starving, my depression). Every time I tried to run away to some other place, I wound up desperate, without family or friends, without a support system, and hit a new bottom each time. But when I am running on stable ground towards a joyful life? A few years ago, I stayed at a yoga ashram in the Bahamas. One morning, I took a sunrise walk down the beach and felt utterly content breathing in the sun and sea, at ease with myself in my solitude. 
    1. A Map: Know where you came from, where you are now, and where you are going. On a three-week solo trip to Morocco, I meticulously planned the route between the Atlas Mountains and Marrakech and Ouarzazate and Essaouria—unfamiliar terrain without a co-pilot. But more, I needed to remember how far I had come in sobriety so that I could travel alone, out into the world, without family and friends worrying that I might hit bottom, and to know that my journey forward was now one filled with adventure rather than danger. So, I wrote myself a note that I kept inside my wallet: I was once at the bottom of the well; I am now on dry land; I am heading for the horizon!
    1. Carry On (Not Checked Luggage): That is pack light. Don’t carry the weight of the past, only your sober and stable self. What use are sandals and sneakers and snorkels and sunscreen and travel guides and a Kindle downloaded with beach reads if you don’t have room for The Big Book or a journal to record 12-step work? And what use are these essentials for continued recovery if they get lost in checked baggage? If books are too heavy, download 12-step apps and The Big Book to your phone. And why bring them along if you don’t read them? Begin the day reading whatever you might find that anchors you to recovery. Me? It is usually the poem “Late Fragment” by Raymond Carver:

    And did you get what
    you wanted from this life, even so?
    I did.
    And what did you want?
    To call myself beloved, to feel myself
    beloved on the earth. 

    1. Emergency Contacts: Not just family and friends, but sponsors, therapists, and doctors. Too expensive to call overseas? Download an app (such as WhatsApp) so it is free to call people who will remind you who you are becoming, to hear a familiar voice when you’re out there wandering the world and veer off map. In the middle of the Sahara, just off a camel ride through a sandstorm, I Skyped with my sponsor. “Hellooooo,” I said. “I’m calling from the middle of nowhere though I am somewhere beautiful and not at all lost!”
    1. Local Hangouts: Once upon a time, you might have researched bars and nightspots. Now, as I learned from Amy and Rich, I research local 12-step meetings and make it a traveling priority to attend the meetings. Fellowship exists across this world and all we have to do is walk through the door to find our tribe. And if no meeting exists? Keep our antennae attuned to those around us who aren’t ordering booze. On a recent trip to Ireland, I met a local over dinner who I noticed wasn’t drinking. I mentioned to him that I didn’t drink either. “Are you a friend of Bill W.?” he asked, then invited me to go with him to a 12-step meeting later that night. Home on the road.

    Of course, make sure your passport—proof of citizenship and of far-flung travel—is up-to-date. A passport is a dream journal: where have I been and where do I want to go? And in recovery, a passport is a record of courage (those stamps) and of hope (those blank pages) that says: I want to risk myself in the world and am ready for the journey. Necessities packed. Never alone on the road.

     *Not their real names

    View the original article at thefix.com

  • Re-Balancing Act: How to Restore Marital Equilibrium in Recovery

    Re-Balancing Act: How to Restore Marital Equilibrium in Recovery

    Was I really at an AA meeting as I claimed, or was this the night that I—and all hope for our marriage—would vanish anew?

    For my wife Patricia and me, it’s been a long road to even. Ish.

    My wife said “I do” in April 2007 to a man who, despite depression and anxiety issues, did not suffer from addiction. The honeymoon period didn’t last long: By 2009, I was a full-blown alcoholic. A year later I became unemployed and, as substances other than alcohol steepened my spiral, unemployable.

    After a semi-successful rehab stint in early 2011, I began stringing together sober weeks instead of days, disappearing once a fortnight while my wife waited hopelessly. Finally, with one of Patty’s feet firmly out the door, I started my current and only stretch of significant sobriety in October 2011.

    We’d been wed just 4½ years, and the rollercoaster marriage dynamic was about to take its third sharp turn. Patty had gone from a warm wife to a cold caretaker – from a blushing bride to blushing with anger and embarrassment as her husband descended into addiction and all its indignities. She was fed up and worn down.

    And now she would be asked to transition yet again, to cede the necessary high ground she’d claimed so that someday, hopefully, we could once again stand on even footing.

    Our journey together has been imperfect, but has taught us both about how addiction warps the dynamics of a marriage – and how that damage can be repaired in recovery. For couples committed to staying together in addiction’s aftermath, let’s explore likely marital dynamics at three stages of single-spouse alcoholism: active addiction, fledgling sobriety and long-term recovery.

    Active Addiction

    Ironically, perhaps the least complicated dynamic any marriage can have is when one partner is mired in active addiction. One spouse has lost all credibility and the capability to make mutually beneficial contributions, while the other has, onerously, had the scales of responsibility tilt completely into her lap – or, more accurately, fall on her head. The addict has been stripped of all rightful respect and authority; he is a nuptial nonentity, because adulthood is a prerequisite for marital influence.

    Simply put, my wife signed up for a husband and got a child instead.

    The logistical stress my wife shouldered—scraping by on one income, coming home to a drunk husband in a smoke-filled apartment, the transparent excuses and laughable lies—should be familiar to most spouses of alcoholics.

    Throughout this stage, the marital power dynamic is non-negotiated and unsustainable. It is also deeply scarring, for both parties. My guilt and shame, her resentment and disappointment. My elaborate schemes and emphatic denials, her eroding ability to give me the benefit of the doubt. For us both, a creeping sense of confusion, hopelessness and doom.

    All of this creates a silo effect. The deeper my bottom fell, the higher the wall between us rose. For the marriage to once again become… well, a marriage—a union of two equal halves—the walls would need to crumble. But they had to crack first.

    And then, after one last humiliation comprised of a drunken hit-and-run and handcuffs, I was finally done.

    A marriage stumbling on a high wire now had a chance to regain some balance. But for couples, one spouse’s early recovery can shake like an earthquake, causing seismic shifts to a power dynamic that, though broken, proves nonetheless stubborn.

    Fledgling Sobriety

    However simple (albeit awful) the marital dynamic during active alcoholism, the relationship during nascent sobriety becomes, conversely, exceedingly complex. This timeframe is crucial to the marriage’s long-term survival, as both parties simultaneously try to heal fresh wounds, regain some semblance of normalcy and find a workable path forward together.

    For Patty and me, my fledgling sobriety was, at the same time, emergency and opportunity. This might not have been my last chance at recovery, but it was likely our marriage’s last chance at enduring.

    In those vital first months, the power dynamic shifted dramatically, despite my wife’s understandable reluctance to budge an inch lest I take several yards. After being on the receiving end of years of lying about our actions and whereabouts, our spouses struggle to believe we’ll come home at all, let alone come home sober. Was I really at an AA meeting as I claimed, or was this the night that I—and all hope for our marriage—would vanish anew? The PTSD of a waiting wife, burned too many times to trust, is an excruciatingly slow-mending injury.

    That injury is soon joined by insult. Because my wife watched as perfect strangers did something her most fervent efforts could not: get and keep her husband sober.

    She felt suspicious, and scornful… and guilty for feeling either. Her downsized role in my recovery seemed unfair given the years wasted playing lead actor in a conjugal tragedy.

    For alcoholics, swallowing pride is a life-and-death prospect pounded into our heads by program literature, AA meetings and sponsors. For their spouses, though, this ego deflation is just as necessary to the survival of their marriage, and generally comes without guidance or reassurances. Considering this, my wife’s humility-driven leap of faith was far more impressive than my own.

    And throughout this, she was forced to cede more and more marital power to a man who, mere months ago, deserved all the trust afforded an asylum patient. I was gaining friends, gaining confidence and, sometimes, even gaining the moral high ground.

    When your spouse has been so wrong for so long, the first time he’s right is jarring. Somewhere in my wife’s psyche was the understandable yet unhealthy notion that the one-sided wreckage of our past absolved her of all future wrongdoing. Fights ensued as I argued for the respect I was earning while she clung to a righteousness never requested but reluctantly relinquished. Unilateral disarmament—intramarital or otherwise—is counterintuitive and, given my history, potentially unwise.

    The harsh truth was that the marriage had to become big enough for two adults again, and the only way that could happen was for one partner to make room. This is patently unfair and, I believe, a key reason many marriages end in early recovery. That my wife and I navigated this turbulent period is among the most gratifying achievements in each of our lives.

    Long-term Recovery

    Our road became considerably less rocky when my wife, for the first time, became more certain than not that her husband’s sober foundation was solid enough to support a future. For us, that unspoken sigh of relief came about 18 months into my recovery, though this timeframe can vary widely.

    For couples, an invaluable asset ushered in by long-term recovery is the ability to openly address not only each individual’s feelings, but the likely influencers behind those feelings – especially those concerning the disparate, often difficult-to-pinpoint damage one spouse’s alcoholism inflicted upon both partners’ psyches. My wife and I each have our own semi-healed, often subconscious wounds that, still frequently, reopen in the form of a visceral repulsion, reflexive resentment or other knee-jerk reaction.

    At times, then, there remains residual weirdness between us. But the reassurance of my reliable recovery provides safe harbor to explore these issues as our marriage’s power dynamic draws ever closer to even.

    Many of these mini-problems are a blend of individual personalities and lingering, addiction-related trauma. My wife and I both have foibles that, we agree, are part intrinsic and part PTSD; fully parsing the two is impossible, even when examining ourselves rather than each other.

    An example: My wife is markedly introverted, and I certainly know her better than anyone. But even for her closest comrade—me—praise and positive acknowledgement come sporadically at best. At least some of this, she admits, is not simply her quiet nature but rather a prolonged hangover from years of my alcoholic drinking. Perhaps seven years is too little time for proactive cheerleading; check back with us in another seven.

    There are also times when my 12-step recovery delivers on its promise of making me, as the saying goes, “weller than well.” For my wife, who’s been consistently well enough her whole life—insomuch as she’s never sideswiped a taxi blind drunk and then tried to outrun a cop car—sometimes this growth is mildly threatening, especially in terms of our still-tightening power dynamic. Her character defects were never so dangerous that they required emergency repair. Still, as my demeanor has become less volatile, there has been a softening of her own character. Whether this is her absorbing some of my progress or simply letting her guard down another notch is anyone’s guess – including hers.

    No matter the progress, we will both always be damaged, however minimally, by my addiction – a permanent weight that makes truly equal marital balance unlikely, if not impossible. We will always be better at forgiving than forgetting, and the inability to accomplish the latter carries a weight that tips scales, slightly but surely.

    We have, we believe, as much balance as possible considering where we were and where we are now. For couples with a spouse in long-term recovery, appreciation for that tremendous leap forward in fortune can more than make up for the inherent inequality addiction inflicts on a marriage – a gap that shrinks substantially but never completely closes.

    View the original article at thefix.com

  • Sex, Money, and Power in Recovery

    Sex, Money, and Power in Recovery

    What are the things you can’t live without in a relationship? Those are your needs. And what are the things you’d like but could live without? Those are wants.

    Romance and Finance. Two of the toughest things to manage in recovery—and the most likely to lead to a relapse. While someone with addiction can stay abstinent from drugs and alcohol, we must learn to moderate when it comes to love and money. This is a tall order for a group of “all or nothing” people. So what do we need to know to make sex, money and power work out more Hollywood ending and less tabloid headline? I spoke with three experts who offer their wisdom and tools for understanding and solving the riddle.

    Psychotherapist, Sex Addiction, and Financial Disorders Expert Debra Kaplan points out that underlying attachment issues surface a few years into sobriety from drugs and/or alcohol, and when they do, romance and finance become all the more difficult. ”Attachment is the process by which we gain our knowledge of self— we know who we are because it has been reflected back to us by a co-regulating other,” she explains. Most people with substance use disorders suffer from some ruptures in attachment— a bond that may not have been consistent throughout our developmental process. When this process goes awry, we may become insecure about our self-worth. Kaplan says we must understand that sex and money are “stand-ins for self-esteem and self-worth.” This is why so many people who start in one 12-step program like NA or AA also end up in DA (Debtors Anonymous) and SLAA (Sex and Love Addicts Anonymous)—many times when they’ve been brought to their knees by these issues. So this this is a question of both living sober and relapse prevention.

    According to a 2016 Ameriprise study, “Approximately 31% of all couples clash over their finances at least once a month.” We all know this is a leading cause of divorce. Sex and money are tied like Christian Gray’s shoelaces: tightly. As Kaplan says, “When there are financial troubles, the bedroom is the canary in the mine.” Her years as a successful Wall Street trader and her work as a psychotherapist make her uniquely qualified to acknowledge the connections and disconnections between sex, money and power.

    All of the experts I spoke to agree: the first key to success in love and money is negotiation. There is no question that a power differential exists in romantic relationships. Just as we create contracts in business, we create contracts with one another. Would you sign a business contract without knowing what was important to you? And yet so many of us in sobriety will rush into relationships because of our insecurities. One pitfall Kaplan warns against is the tendency to blend money early in a relationship by buying or leasing property together too soon. Kaplan says, “Ask yourself, do I know how my partner operates when it comes to money and work?”

    These conversations are scary but in order to have successful relationships, we need to develop some negotiation skills. The truth is we are communicating all the time every day whether we speak or not. Kaplan says: “There are two levels of negotiation; spoken agreements and silent arrangements.” From the outset, even in the early stages of dating, we must acknowledge what Kaplan calls “relational currency.” She defines this as “My worth, what I’m bringing to the table, what we expect from each other.” It can be anything from youth or beauty to social access or financial wealth. This currency plays into the negotiations we are making silently, even with ourselves. For example: Well, he’s not making as much money as me, but he’s ten years younger and considerably better looking.

    Dr. Pat Allen, a Certified Addiction Specialist and Transactional Analyst and author of the recovery tome Getting To I Do, agrees: “Ninety percent of all communication is nonverbal,” she says. One of her five tools for negotiation is a marvelous way to bring that nonverbal communication into conversation. The script she suggests is: “I sense by the look on your face you’re upset, yes or no? What can I do?” Or, for a man: “I think by the look on your face you’re upset, yes or no? What can I do?” The languaging, Allen says, varies from gender to gender. Generally, the feminine “feels” and the masculine “thinks.” This tool brings the issue to the floor and allows it to be dealt with rather than festering in a dark corner and becoming a resentment.

    Allen explains her point of view: “Einstein said ‘everything is energy’ and we are both yin and yang, this is physics. Men have yang bodies but yin souls, women have yin bodies but a yang soul.” So there is a built-in duality in all of us to consider in relationships and in negotiating. People—even pansexual people— play different roles in relationships, not necessarily based on gender, but on the choice between masculine and feminine principles. They may not be static, but we usually have one that is more prevalent. So, Allen says, “Before you even go on a date, know which role you want to play.”

    Kaplan echoed the importance of self-examination, saying that the key in early stages is, “Know thyself.” Know what your needs and wants are and the difference between the two. What are the things you can’t live without in a relationship? Those are your needs. And what are the things you’d like but could live without? Those are wants.

    According to Allen, a quick way to determine which role you are playing is to ask yourself— “Do you want to get laid or paid?” The masculine wants to get “laid” and picks with his eyes. The feminine wants to get “paid” and picks with her ears.

    Once you know what role you want to play, the trick is negotiating the contract of the relationship. “Ask for help!” Kaplan says. Her work with couples involves uncovering some of the underlying beliefs about self, sex, and money in order to make conscious decisions. This is important considering the underlying attachment disturbances that may be triggered. Her book, For Love and Money: Exploring Sexual and Financial Betrayal in Relationships also has an inventory that can be helpful in identifying patterns. Allen says that couples should negotiate every three months for the first year, then once a year, or whenever any large issue arises.

    Dawn Cartwright is a renowned Tantra teacher who received her degree in psychology from the University of California, Davis, and has had extensive training in Tantra, Yoga, Sexuality, Bioenergetics, Meditation, and Expressionistic Movement & Art. When it comes to negotiating, she too brings it back to self-responsibility. “When I can keep myself regulated and stay in an emotionally available state even when I need to say no, that gives the person I’m involved with a lot more freedom to be my ally, rather than my therapist. I have to make sure that I’ve had enough sleep, eaten well, I’ve got some friends. I need to look at how many hours I’m working and make sure that I develop a well-rounded life so that when my partner and I come together it’s about being partners and it’s not about being rescued.”

    Cartwright suggests setting aside a specific time to solve problems and talk budget, “Create a chart of all the things that need to get done but only talk about that once a week during a family meeting— even if it’s just the two of you, so those things don’t bleed over into your romantic sexual connection.”

    It’s easy to get complacent at any stage of a relationship. Cartwright suggests: “We can continue to let every date be the first date.” She recommends a process she calls pleasure mapping. “Maybe we take some nights where we don’t actually have intercourse but we explore and experiment, what are some places on your body that you’d really love to be touched? Do we like massage there or feather kisses here? Do we want to hear sweet words? What is our pleasure map? When we do that we’re actually creating a greater bond with our partner and releasing more neurochemicals and we’re not falling into habits that are just highlighting certain parts of the brain over and over again. Each person has their needs and we negotiate. But we stay in the game. We stay in the yes and.”

    With tools like these, you are on your way to that happy ending! I know what you’re thinking, but I didn’t mean it like that. Or did I?

    View the original article at thefix.com

  • 5 Tips For Staying Sober In College

    5 Tips For Staying Sober In College

    At the end of the day, the college experience is about so much more than just alcohol.

    For most people, college is not associated with sobriety.

    Such was the case for me during the first two years I spent away from home. I drank often and partied hard, convincing myself that it was normal. I liked to be the one outdoing everyone else, thought there was some badge of honor I could earn by doing so. And honestly, I had a blast—until I didn’t. I didn’t realize this right away, but I drank differently than my peers. While they knew how and when to stop, I didn’t. I all too often crossed from having fun to being a sloppy, drunk mess, saying and doing things I regretted come morning light.

    It all came to a head at the end of my sophomore year, when I ended up hospitalized with a .34 blood alcohol content. My parents gave me an ultimatum: get sober, or I wasn’t allowed back home for the summer. I went along with getting sober, never planning for it to actually be something I stuck with. I wasn’t even 21 and was still in college. Who got sober in college? I didn’t know of anyone, and I didn’t intend to be that person.

    But as time passed and I refrained from drinking, I realized that I felt good, both physically and emotionally. I liked being in control of my actions, knowing what happened the night before. It felt freeing. So, I ran with the whole sobriety thing, staying sober my junior and senior year of college, and now, for the three years following college.

    I won’t lie, maintaining a social life while being sober in college wasn’t easy. In fact, at times it was one of the hardest things I’ve done. But it is possible. Along the way I discovered a number of tricks that helped remind me why I was sober and made it easier to stay that way. Here are a few:

    1. Be honest with the people close to you. Sobriety isn’t easy. But it’s even harder when you try to do it alone. It’s understandable that telling people about your decision to stop drinking is scary. It’s not something very many people choose to be open about, especially in college. But if you can, pick two or three people you are close to and tell them the truth. Tell them why you decided to get sober and why it’s important to you to maintain that sobriety. If they ask how they can help, tell them. Express what you need, what makes you feel supported. They wouldn’t ask if they didn’t genuinely care and want to do what is best for you. Give people the chance to surprise you with their support, because they often will.
    1. Make self-care a priority. It’s easy to let self-care fall to the side in college. You get so busy with classes, with friends, with study groups, with sports, that you forget to take time for yourself. This is always important, but even more so when you are sober. In sobriety, you need to know when and how to take time for yourself. This means different things for different people. For one person, it may be a bubble bath and reading a book for fun. For another, it could be working out, or journaling, or attending 12-step meetings. Whatever the case, make sure you identify what it is you need and make it a priority in your schedule.
    1. Remind yourself you won’t be hungover come morning. For some reason, this was always a powerful tool for me. Just knowing how physically awful hangovers felt and how unproductive they made me for the entire next day was usually enough to quell any desire for a drink. When I first got sober, someone told me hangovers are actually a form of withdrawals from alcohol, which is why mine had been getting progressively worse. Reminding myself that the morning would be clear and I would be able to be productive and reach my full potential always brought me back to reality when I found myself wishing I could drink with my college friends.
    1. Connect with sober peers. Though it’s somewhat unlikely you will find these people in college, it’s not impossible. But if you don’t, there are other options. Because I went to a semi-small college, there were no other people my age who had gotten sober. But by going to some 12-step meetings and joining online communities, I was able to connect with people who shared my experiences and who were in situations similar to mine. Having that connection with others in recovery is vital in moments when you need support and understanding, or even need someone to tell you it just isn’t worth it to pick up a drink.
    1. Remember that the main reason for college is to receive an education—an expensive one, at that. This may sound odd, but for some reason it really helped me when I was wishing I could have a “normal” college experience and drink with my friends. I found it helpful to remind myself that first and foremost I was at college to get an education so I could pursue the career I wanted to pursue. College is not a cheap investment by any means. If I had continued to drink at the rate I had been, I likely would have wasted a good amount of money and not received the quality education I had hoped to attain at the college I chose. But today, I can say I got the most out of my education (the last two years of it at least) because I was fully present and invested.

    At the end of the day, the college experience is about so much more than just alcohol. Sure, at times this may be hard to remember. There will be days when it may seem like everyone around you is drinking or talking about drinking. It’s easy to feel left out, like you’re missing out on a college rite of passage. But that’s not true. These are the days it’s important to remind yourself why you set out to live a sober life and why it’s important for you to continue to do so.

    View the original article at thefix.com

  • How Sponsoring Fellow Alcoholics Is Teaching Me How To Parent My Son

    How Sponsoring Fellow Alcoholics Is Teaching Me How To Parent My Son

    How do I, an alcoholic with a dysfunctional childhood who didn’t even begin maturing until his early 30s, go about the daunting duty of raising a son to manhood?

    Recovery through Alcoholics Anonymous has helped me build an incredible life. A restored marriage, a promising career, and a comfortable suburban home highlight the tangibles; the wisdom of the program and mentorship of its members have provided the intangibles – accountability, purpose, sanity.

    Two years ago marked the most notable blessing to date: The birth of my first and only child, Nicholas.

    This gift, however, also presents my most vexing sober challenge yet: How do I, an alcoholic with a dysfunctional childhood who didn’t even begin maturing until his early 30s, go about the daunting duty of raising a son to manhood? How do I break, as much as any parent can, the cycle of insanity Nicholas has inherited?

    As Nicholas approaches toddlerdom – where he’ll start truly developing lifelong memories – solidifying certain notions of parenthood has become increasingly urgent. “What type of dad do I want to be?” is quickly becoming “What type of dad am I?” It’s becoming clear that these child-rearing concepts aren’t going to magically manifest; I need to search for them.

    And where I keep finding answers is the only relationship in which I’m actually qualified to give guidance: my role as an AA sponsor. Here are just a few of the many parenting perspectives my experiences as a sponsor have helped formulate.

    Coddling Is Counterproductive

    The most meaningful child-rearing principle that sponsorship has instilled in me carries even more significance considering our helicopter-parenting, participation trophy-wielding times: Coddling trades short-term ease for long-term hardship.

    Many addicts, myself included, are recovering from people pleasing as well as alcohol and drugs. Our diseases demanded instant gratification and, by necessity, we were talented at telling people what they wanted to hear in order to skate by or score more.

    When we become sponsors, we must play a longer game. We learn that giving a sponsee an undeserved pat on the back when what he needs is a kick in the ass is not only counterproductive, but downright irresponsible. Enabling a sponsee’s laziness or self-denial can mean being party to his relapse.

    Sponsorship has taught me that I can’t shield someone from tough choices, uphill climbs and heavy lifting. As much as I root for a sponsee, I can’t want his recovery more than he does; as my son grows, I’ll fight similar urges to carry an oversized share of burdens he himself must bear.

    The overall message is clear: work hard for worthwhile goals. In a sponsee’s case, that goal is long-term sobriety and perpetual personal progress; in my son’s, the goal is responsible, upstanding citizenship and self-sufficient adulthood.

    Here, AA is endearingly traditional in its nose-to-the-grindstone approach to progress.

    There is a grit factor in the rooms that, these days, is sorely lacking outside of them. To both sponsees and children, “get to work” is the kind of simple but meaningful instruction that is easily understood and, when followed, results in both tangible and character-building rewards.

    I’m finding that the less I coddle my sponsees the more favorable the result. I am increasingly confident that the same will hold true for my son. Soft sponsorship yields soft recovery. Ditto for soft parenting.

    Keep Calm and Carry On

    Roll your eyes all you want, but when this starting appearing on mugs and memes everywhere, I hoped (beyond hope, it turned out) that more people would adopt a mantra that AA so effectively espouses.

    Few markers are more telling of one’s maturity than the breadth and depth of people, places and things that anger, cower or otherwise derail him. As someone who, according to men with many more years sober than me, had “smoke coming from his ears” as a newcomer, I’ve learned this lesson particularly harshly. It’s taken years of trial and error – of getting a little less angry to similar situations, then reflecting on how useless and toxic that rage was – to form a demeanor even remotely resembling even-keeled.

    Watching my sponsees struggle with this journey – with getting totally jammed up over matters of dubious-at-best significance – is Exhibit A of sponsor-sponsee symbiosis. As I talk my sponsees down off the inevitable next ledge, I remind myself to practice what I preach.

    I am committed to developing this big-picture, c’est la vie attitude in my son. And while anyone with a two-year-old understands how successful I’ve been thus far (not much, if at all), I can look to my own imperfect, ongoing transformation as proof that progress takes trial, error and – most of all – time.

    For now, this concept lives in little things. “I can see that you’re very sad about having to stop watching TV, but you’ll see Peppa Pig tomorrow,” I’ll tell a crying Nicholas, as the credits of his favorite show roll while I usher him off to bed. Or “It’s PJ time,” I tell a sobbing, splashing boy engrossed in his bathtime toys. “We’ll get all dry and get some milk, how’s that?”

    These gentle nudges, I hope, will push Nicholas toward a more bird’s-eye worldview where he realizes that the little things in life aren’t worth getting upset over. As he grows I’ll instill in him, gradually and imperfectly, that a precious few things warrant more than a brief moment’s annoyance. Here, my role as a sponsee gives me the best chance to break yet another inglorious familial cycle: rage-aholism.

    Think for Yourself

    Though AA most assuredly isn’t a cult (cue the usual troll bile in my comment thread), at times it is certainly prone to an unsophisticated, unhelpful herd mentality. There are sayings and beliefs in the rooms that I find silly, arrogant, or wildly inaccurate.

    I am upfront about this with my sponsees; they are free to disagree with me on any of my program-related peccadilloes. The overarching lesson is each of us needs to find a recovery that is workable within the construct of our authentic self. “Faking it to make it” will only take us so far; eventually, recovery through the 12 steps is a journey in self-discovery, one which, per popular program prose, demands rigorous honesty.

    First and foremost is the childish belief, held by far too many in AA, that God has saved them specifically. Simply put, this implies that God chose to let others die. I often wonder whether the person proclaiming such nonsense realizes that his belief system is based on declaring himself more special than fellow sufferers. Neither my sponsees nor my son will be weaned on such pompousness.

    Oddly, another whopper that permeates AA is the polar opposite of this holier-than-thouism. It is uttered every time a newcomer is told that his experiences, strength and hope matter as much as someone with longstanding sobriety – that each of us “only has today.”

    This well-intending white lie creates an unproductive false equivalence between those who’ve thoroughly followed recovery’s path and those just beginning to trudge the trail. Because AA – like parenthood, I’m educated-guessing – is about mentorship more than anything else. My responsibility to pay it forward isn’t as relevant if everyone has the same amount of currency.

    This all boils down to three words that I find myself repeating to sponsees and, because of this, will find myself repeating to Nicholas: “You’re still learning.”

    Sit back. Relax. Learn. Don’t overextend yourself. No, sponsee, you shouldn’t go to a bachelor party in Las Vegas at four months sober. I have enough sobriety to handle that, you don’t. Yet. And no, 17-year-old Nicholas, you aren’t driving across the country with your friends because you aren’t ready to do that. Yet.

    These are just a few examples of how the privilege of guiding recovering alcoholics through the 12 steps will help me guide my son through childhood. As my sober experiences grow in tandem with my son, there will undoubtedly be many more points where sponsorship intersects with parenting – much to Nicholas’ benefit.

    And of course, there’s this: if Nicholas comes home with his eyes pinned, I’ll know what’s up. My rocky past and recovering present will allow me to recognize the warning signs of the scourge of my son’s generation: opioids. Should that day come, my recovery may help save my son’s life, as it did my own.

    View the original article at thefix.com

  • 6 Tools That Empowered Me to Quit My Lifelong Eating Disorder

    6 Tools That Empowered Me to Quit My Lifelong Eating Disorder

    There are no simple answers or all-encompassing solutions for the complex state of being that is abstinence from compulsive overeating.

    I wouldn’t wish an eating disorder on anyone else, not even on those who bullied me about my weight as a child and adult. Growing up both depriving myself of food regularly and being fat was a dual hell for me, and I’ll never forget the many days walking by the school cafeteria and feeling so hungry, inhaling the aromas, having had no breakfast and no lunch to look forward to eating myself. From the time I went on my first diet at 11 years old, I woke up every morning on a diet for decades; it just didn’t always last through the day. People want to label fat people as lazy or foolish, with no concept of the complexity that actually goes into the eating disorders behind changes in size.

    Psychology Today reports that eating disorders are the most dangerous of all psychological disorders, and they bring so much pain along with the physical dangers. However, today I am happily in recovery from my compulsive overeating disorder, and I work to stay that way every day, often relying on the practices that empowered me to quit the eating disorder that plagued me since early childhood. Today, I am walking the road of recovery with the help of these tools.

    1. Radical Journaling

    Writing in my journal has been a passion of mine since I started a “Little House on the Prairie” diary as a kid. It brings me such joy to express my feelings on paper. In addition to keeping a diary for fun, I engage in what I call radical journaling. I’ve made a commitment to myself to write at least three pages every day, and within those specific three or more pages, I write about the deepest thoughts and feelings I’m having that day. These may include thoughts I have about my old tendency to self-destruct or how I feel about the future. I just try to get out the innermost feelings I have. Getting them out on paper helps me to make sense of things and no longer feel that I’m repressing the pain or longings of the day. That’s especially important for me since repressing my feelings can be a trigger for my old behavior.

    2. Being Kind to Myself

    Compassion for others has always come easy for me, but I was always extremely hard on myself. The simple notion of being kind to myself was a difficult concept to put into practice. I’d spent so much time berating myself for all the times I’d binged and hurt myself. For my own recovery, I had to learn to be kind and extend compassion to myself. And you know what? When I looked back and delved into the origins of my eating disorder in therapy, it was impossible not to have compassion for my younger self and understand how I’d waged a hard battle against my eating disorder before I had the tools to truly recover.

    Professionals agree that finding compassion for oneself is a strong tool for recovery. Carla Korn, LMFT, who specializes in treating those with eating disorders and body image issues, advises, “Have compassion for yourself. Disordered eating develops as a way to help a person cope with uncomfortable feeling and emotions. The eating disorder probably helped you to function when you didn’t know a better way to do so.”

    3. Maintaining My Motivation

    At the start of my recovery from disordered eating, I was very enthusiastic. I was on a sort of beginner’s high and couldn’t wait to see my progress. That’s how I’d also started every diet of my life, too. I soon remembered that it’s impossible to sustain that level of enthusiasm over the long haul. It’s just not practical. Human nature is such that motivation ebbs and flows. So, to stick with my recovery, I had to figure out ways to maintain my motivation.

    4. Eating Regularly

    Eating may seem like a darn weird tool for staying abstinent from compulsive overeating, but eating regularly is definitely among the more important things I do for my health and recovery each day. By making sure I eat regularly and don’t skip a lot of meals, I avoid getting too hungry, which triggers me to eat far more than I need.

    Stacey Rosenfeld, Ph.D., CGP, CEDS, and author of Does Every Woman Have an Eating Disorder? Challenging Our Nation’s Fixation with Food and Weight, cautions that it is important to eat regular meals and snacks to avoid getting too hungry. Feeling hungry and deprived can trigger eating disorder behaviors.

    5. Surrounding Myself with Support

    I have a team of people who are there to offer me support, which is a huge blessing. If I’m in crisis, or just need someone to be there for me, I know I can turn to a dear friend who coaches me, a therapist, other friends and loved ones, and support groups.

    A variety of support groups are available for compulsive overeating and other eating disorders. Overeaters Anonymous is probably the largest group with meetings all over the country, including online, telephone, and face-to-face meetings. The Overeaters Anonymous website allows you to easily search for a meeting that works for your schedule. Other support groups include Compulsive Eaters Anonymous and SMART recovery groups. If you don’t know where to start, you can contact the helpline at the National Eating Disorders Association at 1-800-931-2237.

    6. Making Choices Before Temptation Comes

    If I wait to see how I’m going to feel about eating an entire chocolate cake before I am sitting alone in a room with a delectable vegan chocolate cake, I’m probably going to want to scarf it down as quickly as possible at the earliest opportunity. However, if I carefully assess the situation and make a decision about eating the cake beforehand, I am able to pause before the desire to binge and whatever else may be fueling the temptation at the moment take over.

    Making advance decisions on how to fill the empty feeling and raw pain that fueled the addictive behavior is crucial to my ongoing recovery. Before I am at an event with that chocolate cake or even if I’m going to have it all to myself, I decide exactly how much I am going to eat and why. That doesn’t mean I won’t eat other, healthier foods at the event if I’m still hungry, but I won’t binge on any of my trigger foods. I know what moderation means to me and I choose that before I’m in the heat of the moment when I may be unable to make any rational decisions.

    Finally, I’ve found that there are no simple answers or all-encompassing solutions for the complex state of being that is abstinence from compulsive overeating. However, I do know that not one penny spent on the hugely profitable diet industry got me any closer to releasing the pounds than I was before and that relying on these tools has seen me through some difficult times of my recovery. I believe there is hope for anyone.

    View the original article at thefix.com

  • So You Want to Write About Addicts

    So You Want to Write About Addicts

    At its best, addict lit satiates our quintessential human yearning for stories that may lead to salvation. We want warm fuzzies. We want sweet, sweet, redemption.

    We started each morning of residential treatment with burned muffins, a house meeting, and introductions.

    “My name is Tom and I’m a junkie here on vacation. My goal today is to lay in the sun and sample the delicious food in this all-inclusive resort.”

    Tom’s sarcasm made orange juice squirt out of my nose. Humor was an elixir for the boredom of early sobriety and monotony of the rehab center’s strict daily schedule.

    Our addiction counselor corrected Tom: “You need to take this more seriously. I need you to redo that and tell us your real goal for today.”

    The story that society tells about addiction is one of tragedy. When we talk about addicts, we talk about pain, drama, and heartbreak. Of course, addiction is all of these things, but it’s also a rich, multi-faceted story with humor and joy. When we let addiction define the entirety of a human being’s existence, we flatten people to one-dimensional caricatures.

    The story that society tells about my favorite tragic hero Kurt Cobain is a prime example; his sense of humor gets buried beneath his pain. The media glosses over parts of his personality, like how he wore pajamas on his wedding day and a puffy-sleeved, yellow dress to a heavy metal show on MTV. “The show is called Head Banger’s Ball, so I thought I’d wear a gown,” Cobain deadpanned. “But nobody got me a corsage.”

    Two weeks after Nirvana released Nevermind, they pranked the famous British show Top of the Pops. Wearing sunglasses and a smirk, Cobain infuriated producers and the audience when he dramatically sang “Smells Like Teen Spirit,” in a mopey style that evoked Morrissey from The Smiths.

    If you want to write about addiction, remember that two seemingly contradictory things can be true at the same time. Addicts can be both funny and tragic. Another example: Cobain’s original name for In Utero was I Hate Myself and Want To Die, but the record company opposed the title, fearing that fans wouldn’t understand the dark humor.

    While I love satire, I also understand why we don’t want to minimize the seriousness of addiction. Addicts suffer. Addicts bleed. Addicts, like Cobain, die too young.

    *

    I know a thing or two about almost dying.

    I recently discovered an old home movie of my ex Sam* and me. In the video, we were strung out like Christmas lights. Watching it made me feel like a voyeur in my own life.

    Thick tongued, I slur, “Let’s jaaammmm,” to my musician boyfriend. He pushes a tuft of blonde hair out of my face. My unruly David Bowie mullet always gets in the way.

    Sam’s strumming his acoustic guitar and singing “Needle and The Hay” by Elliot Smith, a classic junkie song.

    I’m taking the cure/ So I can be quiet whenever I want.

    He hands me a bass guitar, but I can’t hold it. My limbs go limp. Thunk. The maple-neck, cherry wood bass crashes to the floor.

    So leave me alone/ You ought to be proud that I’m getting good marks.

    The bass doesn’t break, but I do. I try to pick it up, but my body slumps into a question mark. I look like a bobble head doll, with glassy blue-green eyes. Doll eyes blinking open and shut. Opiate eyes. Open and shut. Haunting thing.

    Sam stops singing. “Are you okay? Tessa, did you take Klonopin this morning?”

    Shut. When my eyes roll in the back of my head, he grabs my shoulders and commands, “Wake up! Wake up!”

    “I’m fiiiinnnneeee,” I mumble as my pale skin turns blue.

    I wouldn’t be fine for years.

    *

    When I heard there was going to be an opioid overdose memorial, I was skeptical. When I saw that Showtime was releasing a new docuseries about the epidemic called The Trade, I was skeptical. When Andrew Sullivan christened a non-addict “Poet Laurette of the opioid epidemic,” in a New York Magazine essay, I was skeptical. But not surprised. Never surprised.

    I’m skeptical because I’ve been devouring books, essays, documentaries, and movies about the opioid epidemic for years, charting their predictable rhetoric, cliché story arcs, and stigmatizing portrayal of addicts: addicts as cautionary tales, signal fires, propellers for drama. We’re afraid to color outside these lines, to show the ways in which addicts contain multitudes.

    I wear skepticism like a shell. It feels safer than being vulnerable. My skepticism asks questions like: who has the right to tell the addict’s story? How can a writer dip their plume into the well of an addict’s pain without having been there herself? How can we do justice to addicts and the addiction story?

    If you want to write about addicts, you first need to familiarize yourself with the formula and conventions of the “addict lit” genre. The territory has been well-charted in recent books like Leslie Jamison’s The Recovering.

    Human beings are intrigued by conflict and drama. We are all complicit. I am, too. Even though I’ve been clean for multiple years and know that I shouldn’t be gawking, I do. Even though I feel like they exploit people’s pain for entertainment, I still watch shows like Intervention and Celebrity Rehab with Doctor Drew. These shows jolt us out of the doldrums of our own lives or, if we are addicts ourselves, they reassure us that we are not alone.

    We watch from a safe distance, with the luxury of returning to the comfort of our own cocoons. At its best, addict lit satiates our quintessential human yearning for stories that may lead to salvation. We want warm fuzzies. We want sweet, sweet, redemption.

    *

    If you want to write a story about the opioid epidemic, you must imagine how addicts hunger for stories that represent us, encourage empathy, and feel believable. We long for stories to be our anchors and buoys to keep us afloat. Unfortunately, some stories sink. We must study those too, as a lesson of what not to do.

    The Prescribed to Death Memorial is a dehumanizing failure. It features a wall of 22,000 faces carved on pills to pay tribute to those who overdosed in 2017. If I died of an overdose, I wouldn’t want my face carved on a pill.

    I’ve spent my whole life being carved out. Instead, I’d like to know what it feels like to be whole.

    When I heard about the docuseries The Trade, I quickly signed up for a free trial of Showtime and checked its Metacritic score: 84.

    Steve Greene of Indie Wire praises the series. The Trade “doesn’t purport to be a corrective or some magic key to unlocking the problem. But as a means for empathy and a way to understanding the human cost at each step of an international heroin trade, it does far more than hollow words and shallow promises.”

    Each episode shifts between three main story arcs: a Mexican drug cartel, law enforcement, and addicts and their families. It is technically well-made, with sharp cinematography and juxtapositions like masked members of the cartel guarding poppy fields in Mexico as children play in the street; a grieving mother and father at a memorial rally in Ohio flying signs that say, “Hope Not Dope.”

    But the series was predictable and flat. The addict’s story arc of The Trade is a simple five-part dramatic structure. In the exposition, we see white middle-class young adults are prescribed painkillers for a sports injury or surgery. As their physical dependence grows, they need more and more to manage their pain. At the climax, they switch to heroin because it’s cheaper and sometimes easier to find than painkillers. They fall deep into the well of addiction.

    Then they go to rehab or they don’t. Cut. End scene.

    Paste film critic Amy Glynn says it was “dangerous from a watchability perspective…Junkies don’t make good television because they are really, really damned boring. They are painfully uninteresting, because heroin turns most people into zombie reptiles who are deeply depressed and deeply depressing.”

    At first, I was taken aback by this quote. But Glynn has a point. If you want to write about the opioid epidemic, you might want to do more than rely on pain porn. The poetry of a needle plunging into the crook of a junkie’s arm, crimson swirling into the plunger. Junkies drifting through public streets like zombies.

    Glynn redeems herself: “Someone needs to start telling the rest of the story. Like now.”

    *

    If you want to write a story about addicts, you need to realize that it’s still a stigmatized condition. My friend had to leave a grief group because other parents said her son’s overdose death was his fault and not as sad as a child who died of cancer. It’s as though grief was some sort of competition of suffering and pain. But an entire super bowl stadium could be filled with dead bodies like her son. There were 64,000 overdose deaths in the US in 2016.

    If you want to write a story about addicts, you need to know that life-saving medication-assisted-treatments like Suboxone and methadone are still expensive and difficult to access. Unfortunately, many treatment centers are “abstinence-only,” meaning they don’t allow their patients to take Suboxone or methadone. For a more in-depth plunge into the world of harm reduction, read Tracey Helton, Tessie Castillo, or Maia Szalavitz.

    *

    In addition to these dire facts, we have to deal with our stories being appropriated and exploited. Enter the poet William Brewer, who has never used opioids or struggled with addiction himself. Brewer inhabits the voice of addicts in his poetry book, I Know Your Kind. The title derives from a Cormac McCarthy quote, but it’s very clear to me that Brewer doesn’t “know my kind.”

    I don’t want to be harsh on Brewer. Being from the polite Midwest where we’re supposed to avoid confrontation, I almost deleted this part. But Brewer’s words feel like a chisel mining people’s pain. I also feel it’s my responsibility as a recovering addict and writer to call it like I see it.

    Brewer writes lines like: “Tom’s hand on the table looked like warm bread. I crushed it with a hammer, then walked him to the E.R. to score pills” and “Who can stand another night stealing fistfuls of pills from our cancer-sick neighbors?”

    In a world where artists and writers are constantly being called out for cultural appropriation, I was surprised that nobody called Brewer out for appropriating the addict’s story for his own artistic gain. Brewer’s sole connection to the epidemic is that he was born and raised in Virginia, the state with the highest overdose death rate in the nation. In an interview with Virginia Public Radio, Brewer said when he visited over the holidays, he inquired about whereabouts of former classmates. “People replied, ‘They’re on the pills. We don’t really see them anymore.’”

    If you want to write about an addict, you should avoid infantilizing and dehumanizing addicts, along with the trope that addicts are all “lost and forsaken.” Some of the strongest, most courageous people I know are addicts. Active drug users like The People’s Harm Reduction Alliance in Seattle established needle exchanges, distributed the overdose reversal drug, naloxone, and are fighting to open supervised safe injection sites.

    *

    If you want to write a story about addiction, realize that most addicts struggle with whether or not they should publicly share this part of their identity. For a long time, I didn’t think I’d ever write about my addictions to alcohol, opiates, and benzos. I didn’t have the courage. Here in the Midwest, we keep the laundry to ourselves. We don’t air it out. When I wrote about my first struggle with alcoholism in 2011, my family warned me that it could impact my future job opportunities and dating. I knew they were just looking out for my “best interests.” But I insisted: my privacy, my mistakes, my choice. I hoped that sharing my addiction and vulnerability might be therapeutic for me and maybe even help others.

    If you ‘re going to write a story about addiction, realize how it’s affected by different identities. For example, I’m extremely lucky, because I have supportive friends and family. When I was broke and had nothing, they offered me food, shelter, and support. Also related to my privilege as a white, middle-class woman is that I don’t have a criminal record. Yes, my hospital records bother me, but they are protected by confidentiality laws.

    In a way, writing about my addiction felt like making these private records a public matter. I was hesitant. Brewer was also reluctant to write about the opioid epidemic, for different reasons. He said, “West Virginia is very rarely looked at in a positive light. And so here again is a situation where something really quite terrible is going on, but it became so clear that this thing wasn’t going to go away and was starting to seep into my daily life.”

    *

    Heroin doesn’t seep into most people’s daily lives. Heroin is a tsunami. Heroin drowns.

    *

    There may be value in writing beyond our own experience, as Brewer did. Representation is important and if we all followed the advice to only “write what we know,” things could get bland and boring. Artistic expression would suffer. But it’s a tightrope. It’s a practice in tremendous empathy, wanting to diversify representation, while also being respectful and staying in your lane.

    *

    If you want to write about addicts, you’d benefit from also depicting the humor of early recovery, a story that often falls outside the margins. When I was digging through my own videos and journals, I was of course humiliated by some of my own narcissism and self pity. But I was also surprised and heartened by the unexpected joys like my friendship with Tom at my first rehab.

    On my first day, I noticed him in the smoking tent, wearing bright red Converse, a beret, and long sleeves to hide his track marks. I noticed the way his brown eyes brimmed with both kindness and sadness as he deadpanned in meetings.

    “You guys are like The Wonder Twins of rehab,” staff said. Despite our 20-year age difference, we were inseparable.

    Tom bummed me Parliament menthols and lent me one of his ear buds, so we could listen to The Replacements, The Pixies or The Velvet Underground together. On weekends, we went to record stores, ate pizza, and he read my shitty poetry. We made beaded lizards and built crooked birdhouses bedazzled with feathers and glitter.

    One day in group, we had to watch a 1987 film called, The Cat Who Drank and Used Too Much.

    “Was I just daydreaming, or did you just say we are watching a movie starring a cat?” Tom asked.

    “Yes, it’s made for kids. Lost and Found Ministries recommended it as a good way for parents to explain addiction to their kids.”

    “Drunken cats, who knew?” I said.

    I later learned that the film was praised as an “audience favorite about a beer drinking, drug addicted cat,” when it was screened at the Oddball Film Festival in San Francisco.

    Our story begins in any town USA, a sleepy suburban neighborhood lined with rosebushes and plush green lawns. Cue sappy flute and piano elevator music with too much treble.

    The film opens as Pat the Cat is getting into a red car for his morning commute. We see Pat drinking alcohol from a pitcher and beginning to experiment with other things. A cigarette here, some prescription pills, a bit of coke there (powdered sugar).

    “He’d try anything, it was never enough. Then it was too much.” Pat crashes his car and almost loses everything, but then decides to go to rehab!

    “I’m not trying to be catty, but Pat seems to be pretty well-off to me,” Tom said.

    At the end of the movie, Pat has a cupcake to celebrate his sobriety. Ah, it seemed like only a few weeks!

    “If only it were that easy!” I said.

    “Sure, his life isn’t purr-fect, but it’s pretty close!”

    *

    What I’m trying to say is: If you want to write a story about an addict, we might not be perfect, but we can do better. Starting now.

    If you want to read stories about heroin or the opioid epidemic, I recommend starting with nonfiction. There is power in reading about people’s lived experiences.

    Of course there are also excellent and illuminating fictional books about the opioid/ heroin addiction. Check out this list by Kevin Pickard.

    View the original article at thefix.com