Tag: jowita bydlowska

  • A Kinder, Better Way: How CRAFT Uses Love and Kindness to Heal Families with Addiction

    A Kinder, Better Way: How CRAFT Uses Love and Kindness to Heal Families with Addiction

    There are programs designed to help families but many of them advocate “tough love” and aren’t terribly effective.

    About ten years ago, I got one of those letters. It was painful to read it but once I had a drink, my pain turned into indignation. I folded the letter multiple times till it ended up a tiny square, which I shoved into a shoebox where it lives till this day, next to old birthday cards and love notes from exes. I’m talking about my first Intervention Letter. 

    If you’ve never gotten one of these, then you were probably not destroying your family’s life successfully enough! I’m kidding, of course, and not everyone gets an Intervention Letter; some of us also get a serious talking-to; most of us get ultimatums and threats; and all of us get tears. This is what it’s like to have a family while high or drunk. Not fun. But it’s even less fun for the families—they are some of the most tortured, miserable, angry, confused people entangled in their misery by love. 

    It’s no wonder that resentment is ever-present, fuelling many misguided attempts to help circumvent addiction. Why misguided? Because those attempts rarely get anyone better. And a person going to a rehab to please their loved ones has less of a chance of staying clean than a person going on her own account. On top of it, the families are still often left without any solid tactics in place on how to keep their loved one sober, how to prevent relapses, and how not to fall back into the muck of co-dependency. There are programs designed to help families but many of them advocate “tough love” and aren’t terribly effective. So Intervention Letters and ultimatums are common. 

    Instead of Ultimatums and Threats, Compassion

    Fortunately, there might be a better way—specifically the CRAFT way. According to one definition, “Community Reinforcement and Family Training (CRAFT) teaches family and friends effective strategies for helping their loved one to change and for feeling better themselves. CRAFT works to affect the loved one’s behavior by changing the way the family interacts with him or her.” At first look, CRAFT’s techniques might appear contra-intuitive as a lot of its teachings seem to advocate dismissing the addictive behavior—complaining, arguments and demands are discouraged. In fact, on the cover of the popular book on CRAFT, Get Your Loved One Sober, the tagline reads “Alternatives to Nagging, Pleading, and Threatening.” Instead of tough love, CRAFT advocates gentle love—and that approach seems to be working.

    According to one trial by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), CRAFT was more effective than Al-Anon and Johnson Institute Intervention. CRAFT had a 64 percent success rate of getting the person with addiction into treatment compared to 30 percent for Johnston Institute and 10 percent for Al-Anon. Johnson Institute is a model that’s based on confrontation that is supposed to motivate the person with addiction to enter treatment. Al-Anon, similar to CRAFT, teaches detachment with love, but it is also a 12-step-based program which includes the sometimes-problematic concept of Higher Power and advocates a certain kind of passivity, which might not be conductive to strengthening the very fragile fabric of families dealing with active addiction. 

    In contrast, CRAFT focuses on attending to your own needs along with steering the problem user toward treatment, which often happens organically as the patterns of interaction change. CRAFT’s mission is to help reduce the loved one’s alcohol and drug use, whether or not the loved one has engaged in treatment yet. CRAFT discourages enabling, encourages problem solving, employs reward systems and aims to empower the beaten-down, frustrated family members. CRAFT doesn’t approve of breaking the family apart and its goal is to not only keep it all intact but also get everyone better. 

    A family member who’s part of CRAFT is taught to change her/ his reactions—from negative to positive—in response to the triggers from the person with addiction. For example, a husband coming home late after a night of drinking with his buddies again won’t get a lecture for being late for dinner, as he usually does in that situation, because the wife will have been instructed to take care of her own needs, and she will have eaten the dinner on her own. 

    Observing and Adapting

    As part of CRAFT, the family members are asked to observe and monitor the addictive behavior of their loved one—this means noting what situations might cause the person to reach for another drink, what creates conflict, and observing any patterns in behavior. With time, as these patterns become obvious, the family member changes the approach—from aggressive to more passive and compassionate—and in that more loving way, upsets the predictable trajectory of maladaptive interactions with the addicted person. Instead of yelling at someone and accusing her of being a liar, the family member might say, “I know you haven’t been going to work all this time and I am hurt that you’re lying to me. Let’s talk about it in the morning after you sleep it off.” A calm, reasonable way of dealing with the situation will most likely elicit a reaction that’s not combative. Eventually those kinds of interactions will become a norm and change will occur.

    It’s not exactly “kill them with kindness” but it’s a similar principle. When you expect Intervention Letters—like I did—and you’re stuck in a hamster wheel of constant conflict, getting something completely opposite might just shock you into action. Receiving praise for sticking to commitments—even something as small as coming home on time—or staying sober for a string of days, is more effective than having those subtle changes ignored or taken for granted. No, we don’t need to applaud every nice thing a person with addiction does but in the beginning, perhaps it makes sense to do so. People who are just starting to get sober are very much like babies—deregulated emotions, lack of impulse control—and praise goes a longer way than punishment does. Punishment tends to prolong trauma where praise leaves the person wanting to earn it again, which leads to repeating the desirable action. 

    A Better Alternative to Tough Love

    My family has always taken the “tough love” route and my addiction did contribute to me eventually separating from my husband. I imagine if we were a part of CRAFT program, things could’ve gone differently. I lived through ultimatums and anger and once I was kicked out of my house. I’ve often felt alone and ashamed and angry with myself for disappointing everyone. I thought I was worthless and my loved ones’ attitude confirmed that. But I don’t think they knew any better. So many of us with addiction still live in an episode of Intervention; we have never been shown a kinder, better way.
     

    View the original article at thefix.com

  • Happy Destiny or a Life Sentence: Thoughts on Leaving AA

    Happy Destiny or a Life Sentence: Thoughts on Leaving AA

    If you do decide to leave, there are many alternatives to AA, places where you can meet likeminded people, share your experience, and make social connections just as in 12-step meetings.

    I don’t know if I’ve left Alcoholics Anonymous for good, but it’s been a while since I’ve been to a meeting. In the past, I’ve left for long periods of time and then come back. I’d come back because I missed the people; yet the “simple” program confused me more and more. Still, I loved making connections. Even though I’m not a group-type of person, it was obvious to me that the “magic” of the whole thing was being able to relate to people with a similar problem and helping one another. 

    I’ve had slips while very much in as well as while out of the program. I’ve slipped after months of not going to meetings, but I’ve also taken a drink right after an AA retreat. There were years where I did the steps and stayed sober and years when I didn’t do the steps and stayed sober. For those reasons, I might not be the best judge of the effectiveness or the harm of AA. I know of many people who stayed in and flourished, many who stayed and relapsed and came back, and many who have left and are still sober despite keeping their distance. 

    AA has always been controversial. It keeps even the most hopeless drunks abstinent, but it’s known for its dogma and ritualistic—some say cult-like—practices. It has saved many people (although there are no reliable statistics) from death from substance use disorder, and it’s helped to mend many families and relationships. Attending AA is also frequently court-mandated for those charged with Driving Under the Influence and other alcohol-related convictions, including domestic violence. For many years AA seemed to be the only effective solution for those who wanted to keep abstinent from alcohol or other drugs. 

    But I’ve noticed a shift, and it’s been happening for a while. As new programs and methods of getting clean and sober pop up on the horizon, some AA members choose to leave despite the ominous farewells of members who believe that leaving AA always equals a relapse. It’s no accident that one of AA’s most popular slogans is “Keep Coming Back!” The way I used to interpret it was that the AA’s door was always open but later, as I became a little disillusioned, it read as if I was doomed to rely solely on AA as a place to recover. I was terrified to leave. Often it felt as if I was nailed to those plastic chairs by fear. 

    So I stayed. It started to feel like a life sentence. 

    Ego Deflation

    David D. Bohl, addictions specialist and author of the acclaimed memoir Parallel Universes, left AA recently. He says, “I went to a hospital to check in because they told me I was going to have seizures if I didn’t. I had medically monitored and supervised detox. That was the beginning of my stabilization. And then they sent me to an inpatient or a residential treatment facility that included 12-step facilitation. So I stabilized in treatment and through the 12 steps.” Bohl got sober in AA but it took a long time before he was able to address other issues, such as his trauma due to adoption. 

    Today, Bohl believes he would have healed faster if he’d had more access to other resources—such as ongoing therapy—on top of having to go to meetings. For him, the side effect of being in AA was “ego deflation.” 

    “No one gave me informed consent that if you don’t have ego strength, this could destroy you. You come to AA and don’t know where to go from there. No one explained that to me. So, had I known that there were (other resources) out there and offer other forms of support, knowing that I had no ego strength, I would’ve gone another route. I would have opted for something else, no doubt about it. The message that I was hearing–whether it’s an AA message or not–is that because of my lack of ego strength, AA was the only safe place for me. And my experience was: ‘if you fail at this, David, you failed at everything. Even not just sobriety. You failed at connecting with people. You failed at life.’”

    But he hasn’t failed and today, 14-plus years sober and calling himself “recovered,” Bohl is embarking on a journey to create individual recovery services, hoping to help people with substance use disorder and their families. He says he will, of course, connect people to AA—if it’s something that would suit them—but he will also offer all kinds of other recovery options. 

    Alternatives to AA

    If you do decide to leave, there are many alternatives to AA, places where you can meet likeminded people, share your experience, and make social connections just as in 12-step meetings. Currently, I’m attending a group that applies Dialectic Behavioral Therapy (DBT) and offers trauma therapy among its methods. The members are free to respectfully comment on each other’s shares (this is discouraged in AA). In SMART Recovery, which is commonly suggested as an alternative to AA, there is sharing and a sense of community, but there is an official facilitator and you graduate when you’ve completed the program. There is also Refuge Recovery, which uses some Buddhist teachings and meditation, as well as sharing. Secular Organizations for Sobriety (SOS) is a network of groups devoted to sobriety and abstinence. And there are brand-new programs like She Recovers (founded in 2017) that just deal with recovery in general, be it from trauma, an eating disorder, or addiction. Google “leaving AA” and you’ll get hundreds of happily-ever-after accounts, as well as resources devoted to helping you find an alternative method of obtaining and sustaining recovery and making connections with other sober people. 

    I haven’t closed the door on the 12-step program yet. I will still go to meetings and I will keep the friendships I’ve made. But I’m also surrounding myself with other programs, groups, and methods because I need some extra mental-health padding to feel fully realized and like I can rejoin the world, sober. 

    I’ve realized that Alcoholics Anonymous is not the only road to recovery.

    View the original article at thefix.com