Answer Addiction

Tag: therapy

  • The Million Dollar Smile: My Life with Bipolar Disorder

    The Million Dollar Smile: My Life with Bipolar Disorder

    As many as 60 million people worldwide have bipolar disorder. Many of those people, like me, lead productive, happy lives.

    He said my smile was worth a million bucks, or was it that I had a million-dollar smile? 

    I remember when smiling was foreign to me. I’d wake in the morning feeling great for a few minutes, and then the dark clouds came, weighing in on my body, pressing down on me. Depression overwhelmed me, so much so that my entire body ached. I felt empty, hopeless, sad beyond belief, and exhausted.

    An Emotional Black Hole

    It was another day filled with mental and physical pain…another day spent looking for ways to make the pain stop. I sought help from the big one – God. I was in the early stages of finding Him. I also saw a psychologist for therapy, joined a support group, and listened to Melanie Beattie healing tapes. I read books like Happiness Is a Choice and joined a running club. Nothing worked. I sank deeper and deeper into an emotional black hole.

    I wondered how I could enjoy my new relationship with God, love Him, and still feel this intense pain. It was like nothing I ever experienced. I began to understand why people kill themselves, they want to stop the pain. So did I, and I entertained thoughts of committing suicide. Once when running, I visualized doing the deed. It felt real. I sobbed and limped home.

    Even in my desperate search for help, my suicidal thoughts were a closely-kept secret. I was afraid that if I revealed them to anyone I would be admitted to a hospital – maybe locked up forever.

    My life was spiraling down fast. Scared, I called my therapist. He referred me to a psychiatrist who focuses on chemical imbalances.

    The psychiatrist listened to me and asked me a series of questions. He seemed to know the symptoms I experienced without me telling him. Our session ended when he diagnosed me as bipolar 2. He said after six weeks of taking the medication he prescribed, a lot of those symptoms would disappear. I left his office feeling optimistic. Maybe this was the help I needed.

    A Real Smile

    Six weeks later, something wonderful happened. I was in my car and heard something funny on the radio. I smiled – something I hadn’t done in a long time. It felt so good that I pulled the car over and looked at my smile in the mirror.

    It was as if the sun burst out from behind the dark clouds, gobbling each one up. The cobwebs in my brain cleared, and I was smiling – even laughing. The medication wasn’t a miracle worker, but it squelched my black depression and left me with the ability to deal with my problems. 

    That was nearly 20 years ago. I don’t remember what it felt like to live with intense mental and physical pain for no apparent reason, and I don’t want to go there again. So, I take my medication and see my psychiatrist regularly. The dark clouds came back to haunt me once in the last 20 years, and I immediately saw my psychiatrist for help and got back on track.

    The Big Secret

    For the most part, I prefer to keep my bipolar status under wraps. I guess it’s out of the bag now with this story. There’s stigma and prejudice against people who are bipolar. Most people don’t know much about people with mental illness and expect us behave in negative, sometimes scary ways. Some of the most common beliefs are that we have wide mood swings, engage in manic behavior, and that we’re promiscuous, wild spenders, and we can’t sustain relationships or jobs. Even worse, some people, including the media, promote characteristics that bipolar people have tendencies to be violent.

    Sometimes the media reports a story about a criminal or murderer, adding that the person is bipolar. This makes me cringe. They don’t comment if a person has asthma, hypertension, allergies, or was overlooked for a promotion. Labeling these people as bipolar compounds the negative stereotype of violence. People with bipolar disorders don’t come in one category, and most of us, like the general population, do not have violent tendencies. 

    Should I Tell Him?

    Because of the negative stigma and prejudice, I’m careful about who I share my diagnosis with and when. I decided 10 months into a relationship would be a good time for this revelation. By that time, the person I’m in a relationship with would know what I’m typically like. I’m an okay, normal person who gets sad when the situation merits it – like when my boyfriend died from cancer or my job was eliminated. 

    Things moved fast when I met my husband. We started falling in love on our first date, so I felt he should know that I’m bipolar 2 sooner rather than 10 months later. Three months into the relationship, I told Larry about my diagnosis. I remember that nerve-wracking evening. When I tried to speak, the words stuck in my throat. It seemed to take hours before I had the courage to tell him. During this time, Larry grew nervous and wondered if I was going to break up with him. After I told him about my diagnosis, Larry acted like I told him about the weather – not anything serious like being bipolar 2.

    At my suggestion, Larry came with me to the psychiatrist so that my doctor could tell him about my case and answer his questions. Again, I was nervous. I believe I’m okay, but what will my psychiatrist say? What if I’m a nutcase in denial? My psychiatrist of 17 years told Larry that I have a mild case and will be okay as long as I continue taking my meds regularly and get enough sleep.

    Larry and I have been married for three years. As I expected, there haven’t been any crazy episodes or depressions.

    I feel very lucky that I’m getting the treatment I need. I started seeing my psychiatrist four times a year; now I see him twice a year. When I asked him if I could get off the meds, he said it’s not a good idea. I’m fine because I take the medicine.

    There Are a Lot of Us

    As many as 60 million people worldwide have bipolar disorder. Many of those people, like me, lead productive, happy lives. Some articles state that our 16th U.S. President, Abraham Lincoln, had bipolar disorder. Other people with this diagnosis include Catherine Zeta-Jones, Oscar-winning actress; Mariah Carey, singer; Jean-Claude Van Damme, an actor; Ted Turner, media businessman and founder of CNN; Patricia Cornwell, crime writer; Patrick J. Kennedy, Jesse Jackson, Jr., and Lynn Rivers, former members of the U.S. House of Representatives; Jane Pauley, a television journalist; maybe your colleague, sibling or neighbor…and me, a corporate communications and freelance writer.

    Bipolar disorder is a chronic illness with no cure, but it can be managed with psychiatric medication and psychotherapy. I’ve been doing it for nearly 20 years and plan to do that for the rest of my life. Being free of bipolar symptoms enables me to smile…and mean it. 

    View the original article at thefix.com

  • On Ascension: Finding the Courage to Heal and Grow

    On Ascension: Finding the Courage to Heal and Grow

    My optimism was the reason I had stayed in abusive situations as well as my catalyst for leaving.

    The first garden I ever really tended to, I planted with an ex-partner. We’d spent several weekend mornings tilling and nurturing a small plot in my backyard, transforming the soil from arid and unkempt to rich and fecund. Upon harvesting, we filled a large basket with robust vegetables: chards, bright magenta-colored beets, green-leaf lettuce, cherry tomatoes, Anaheim peppers. I was most excited with the constant supply of tomatoes, amazed we’d started the produce from seeds and yielded such healthy plants. 

    Months later it became obvious that the garden was flourishing but the relationship was ending. I realized that after years of single motherhood, I’d allowed myself to attach to an emotionally abusive person out of loneliness.

    When the relationship ended, I was bedridden for three months, falling deep into a clinical depression. Whenever I’d get up, my head felt dizzy, my thinking dulled and lagging. I was unable to keep up with my full-time job and just let it fade away, hoping my savings was enough until I was well again. In the mornings, I would struggle to get my daughter ready for school and I’d return from the bus stop exhausted. 

    The Shame of Mourning

    The garden was forgotten. I couldn’t bear to weed or water, and every plant became shriveled and dry. Winter was approaching and as the cold settled in, I’d look out into the backyard from the window and watch the dead plants swaying with the freezing winds. As painful as it was, I felt stronger letting something we’d tended together die, as if in that letting go I was reminding myself that it had been only temporary, the needing anyone so badly.

    “You need to let go of him and focus on your daughter.” This was the constant advice I received from well-meaning friends. As a single mother, I always found it strange how policed my emotions were by others when it came to any romantic endeavors, how shamed I would be for mourning anyone at all. 

    I’d already known heartbreak, had mothered alone when my baby was only one. I didn’t need the reminder; single moms know well how to mitigate their sadness and still nourish their babies. Although I’d known it before, the depression had never taken hold of me so fiercely. I realized I was mourning more than losing a partner, or the aftermath of emotional abuse; I was also far away from the writing career I’d always imagined I’d have. And I was finally feeling the deep pain I had buried when my relationship with my daughter’s father ended. Even then, I’d been shamed for my sadness and advised to focus on my child. 

    It was a difficult winter, alone in my thoughts. I remember wishing there was a way someone could crawl into my mind and cradle it, almost like holding my hand to lead me out of my sadness. I didn’t even know what clinical depression was, though I realized I had experienced episodes over the years. I remember sitting blankly, staring at the grimy walls of a community mental health clinic where I was finally prescribed antidepressants. 

    Renewal

    A month after that, I was taking regular runs again, a practice I used to love. My stamina returned and the body that had shriveled up all winter grew robust and strong. 

    The following spring, I finally gathered enough intention to walk down the deck and face the garden. Pulling out the shriveled roots, I felt ashamed at my neglect. When I’d finished clearing the space, I watered and turned the soil, taken with how rich it had become. I sat in silence and thought about how that reflected inward, as well. The pain and solitude had alchemized me and what had sat inside that whole winter was now made anew.

    Years later, I’m sitting in my therapist’s office. She’s white, Midwest-born and raised. I hadn’t planned on having a white therapist, but when I’d filled out the preference form I only checked off “woman.” She had an optimism I appreciated, and I didn’t feel especially inclined to inquire whether she was aware just how much of that optimism came from her privilege. I saw parts of myself reflected in her personality. One of the more painful aspects of my internal calcination was accepting how hopeful I’ve always tended to be, even despite the harm I would seek out. My optimism was the reason I had stayed in abusive situations as well as my catalyst for leaving. I’d hope it would get better and once I saw it wouldn’t, I’d hope a doorway would appear. 

    My career was now in motion. I was dumbfounded by the task of negotiating a book contract without an agent and didn’t know how to proceed. I’d written and performed largely for free for my entire career and was realizing that I was afraid to ask for a substantial sum because I still struggled with my own self-worth. 

    A Reluctant Astronaut

    “Did you send the email?” 

    “I didn’t. Not yet, I just, don’t want to seem off-putting, you know? What if I ask for too much and they rescind their offer?” 

    “I don’t think that’s going to happen,” she said. “They approached you.”

    I cradled my head in my hands. “I don’t know how to do this. No one taught me about money. All of this is new. I’m navigating this alone and there’s no map, no manual.”

    “You know what you are?”

    I looked up.

    “You’re a reluctant astronaut. That’s what my mom called me and my sisters when we were afraid. You have the ability to travel through the universe, and you’re afraid to get in the captain’s seat. You’ve trained, you’re ready. You’ve got to get out there for all those who didn’t get the chance, and more so for those who will.”

    I blinked back tears. A reluctant astronaut. In all my life, no one had ever said anything even remotely close to those words, that concept. 

    “You’ve got to send that email.” 

    I realized how much her words had struck me. The queer daughter of first-generation parents, I was told that I would not be allowed to leave home for college. My older brothers were encouraged to exercise their freedom while I stayed in my hometown and worked while I went to school. I could only move out when I found a husband. I wasn’t taught I was a reluctant astronaut. Instead, I was tethered to the ground from birth. 

    I wondered what would have been of me had I been encouraged to fly. 

    ***

    There are times when I have to leave my daughter, now ten years old. Sometimes she’ll watch me pack, her eyes heavy.

    “Mommy, don’t go. I get scared when you’re far away, scared you won’t return.” 

    I don’t tell her I’m afraid, too. I’m not afraid that I won’t return, but that I won’t get to leave at all.

    I need her to be brave for both of us. She’s now old enough to understand she’s a reluctant astronaut, too. I want to make this natural for us, how sometimes I’ll have to go sit in the captain’s chair and close the hatch, home becoming small as a pin before fading out.

    View the original article at thefix.com

  • I Don’t Always Feel Better After a 12-Step Meeting

    I Don’t Always Feel Better After a 12-Step Meeting

    Why would someone continue to go to something that they don’t always like and don’t feel immediate relief from? I’m playing the long game.

    I can’t seem to figure it out, the sinking feeling in my gut, the feeling that I am too visible, too likely to be ogled and leered at by some man old enough to be my father. What the actual hell is this feeling in my gut? I call it a homesick feeling. Maybe it is something else entirely, but it makes me want to cloak myself in a protective layer, strip myself of sexuality and erase the sexualized parts of myself. I feel a deep shame and am overcome with a sorrowful lonesomeness as if a hole has cracked into existence and swallowed me whole. I feel stripped naked: Too visible. Too human. Too vulnerable.

    It happens almost every time, at almost every 12-step meeting. I want to disappear. There is a black hole in my gut, a homesick longing that begs me to give in, and I would, if I knew what it wanted. I fear it wants to swallow me whole.

    An Emptiness Inside Me

    I don’t always feel better after attending a recovery group meeting; sometimes at the end I feel worse than I did before I got there. I don’t share the experience of always feeling supported and comfortable that seems to echo through the rooms. At nearly every 12-step meeting, someone invariably says, “When I walk into the rooms, I feel immediately at ease and at home.” 

    Well, I don’t.

    There are times when the entire affair goes swimmingly. I’ll laugh and relate and feel at ease. I will connect to other people’s shares and fully articulate my own. It will all be very nice and fun. It will feel really good, on all fronts. Then, as soon as I leave, a pit in my stomach opens and I can feel myself falling in. Other times the aching lonesomeness begins as soon as I step inside the room.

    Dangerous Adaptability

    I survived my life because I could change according to outside circumstances. It has always felt dangerous to do anything other than adapt. For much of my life, it was dangerous.

    From my adaptations have sprung multiple versions of me. Other people are privy to the Light-Hearted Jokester and the Loud and In Charge Diplomat. Being honest when sharing about my experience with addiction and recovery means another part of myself might become visible. I have spent a lot of time with Depressed Me and revealing her is scary. The Quiet One fears she makes people uncomfortable with her silence. She’s acutely aware that she is not the Jokester and doesn’t want to be noticed and doesn’t want to slip into Depression in public.

    My defenses are up in spaces where I’m allowing unvetted people to know something real about my life. I begin to feel unworthy and not good enough: proof that my worst enemy is my own mind. My instinct tells me: Don’t reach out for a while. Don’t be early for the meeting tonight, go late to avoid chitchat and leave early. My brain fills with excuses to avoid discussions and socializing.

    Getting to know me means you may grow to understand who I am in all my contradictions, which will make it harder for me to adapt. I know that facilitating communication between all of myself is necessary for healing. But the truth is, sometimes it’s really difficult. It’s difficult to be seen, to be open. Yet each time I attend a meeting, that is exactly what I’m doing. I’m expressing myself with complete honesty. I am trusting the process, despite my fear and discomfort.

    I can no longer neglect the parts I’ve long tried to keep hidden. Together we must heal. Together is the only way we can heal.

    Playing the Long Game in Recovery

    Why would someone continue to go to something that they don’t always like and don’t feel immediate relief from? I’m playing the long game. Seeking immediate relief is what I did in active alcoholism. In recovery, I’m learning to resist that behavior. 

    Over time I have seen the subtle and dramatic improvements in my mental wellbeing and quality of life. I can see the changes in my life outside of those meetings. The people around me notice my rediscovered joy, my grounded perspective, my newly formed boundaries. I go to the meetings because it’s part of a treatment plan that works for me. It’s a commitment I made to myself. A commitment to heal from trauma, because I deserve to experience a better life than I once lived. 

    I feel inspired by the possibility that if I keep trying, the healing work will be able to fill the hole that is always there; the emptiness which has eternally been ebbing and flowing in strength, making me happy and fearful in turn. I’m aiming for a stable emotional baseline. 

    It’s not going to happen overnight, but it is happening over time. The inspiration itself comforts the sorrow.

    Progress Not Perfection

    When I first got sober, I was in a very dark place. I was trapped in my own head and despite having survived everything, I couldn’t feel safe. I could only feel the pain from the past. I thought I was alone. I believed I was too broken, too sick, too lost. Finding anyone else who could truly understand what I was going through seemed out of the question. I didn’t think I was unique or special in my pain, I just believed I was hopeless. 

    Then I found a therapist, a psychiatrist, and 12-step meetings. All of which worked in tandem to lead me from the darkness.

    Today I’m not feeling that despair or sorrow. I feel content more often than I feel abject depression. I used to cry every single day and now I laugh every day. I used to swing from one overwhelming emotion to another, with no control over where my mind was taking me.

    Climbing out is an ongoing effort, but what kept me down—one of many things—was that I expected myself to be just be “better.” I thought I had to be different than I was. I now accept that this is hard work, but the results keep me doing it. It isn’t supposed to always be easy. I have to continually work on dismantling the defensive walls that have become maladaptive in their formations. 

    So, I let myself be, I take breaks to enjoy the view that is coming into perspective as the stones of my fortifications are disassembled. Sometimes I get scared, and put back a stone that was particularly heavy, afraid to lose such a significant tool of protection. That’s okay, too. I try not to judge myself. It’s a journey of progress, not perfection.

    View the original article at thefix.com

  • What Is Evidence-Based Addiction Treatment?

    What Is Evidence-Based Addiction Treatment?

    12-step programs are an incomplete approach and do not meet the requirements for evidence-based treatment because they lack biomedical and psychological components, and they use a one-size-fits-all approach.

    When looking for treatment for addiction, there is a lot of information out there and countless opinions. Friends, family, doctors, researchers, and people in recovery all have their own beliefs about what you need to do to get well. Unlike in other areas of healthcare, addiction treatment is often deemed “effective” based on anecdotal reports. In fact, most people who seek or are forced into treatment do not receive health care that is aligned with evidence-based practice.

    A frequently-cited definition comes from a 1996 article in the BMJ Medical Journal: evidence-based “means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” Other definitions also include the patient’s individual circumstances, preferences, expectations, and values.

    These variables are not necessarily constant, and there is no one-size-fits-all solution; any list of evidence-based treatments is going to include a wide variety of approaches.

    What is Addiction?

    In the United States, addiction is still treated more as a crime than as a chronic illness or disorder. Until that perspective changes, treatments will not meet their full potential and will not be as effective as they could be. Addiction, or substance use disorder (SUD), is a chronic medical condition that has remissions, relapses, and genetic components.

    Are Relapses Normal?

    A relapse is not a failure but a symptom. The brain of a person with SUD has gone through neurobiological changes that increase the risk of relapse because the damaged reward pathways stick around much longer than the substances stay in the body. Stressful events and other painful life experiences can trigger that maladaptive coping mechanism and cause a relapse.

    For other chronic illnesses we would consider a relapse to be an unfortunate symptom of the disease, and we might call it a recurrence instead of a relapse. When successfully managed, the condition is considered to be in remission. Remission is a term that is relatively new in addition treatment; substance use disorder was not always believed to be a disease but rather a moral failing and a problem of willpower. We now understand that addiction is a chronic medical condition and that remission is the goal of treatment. Remission, as defined by the American Society of Addiction Medicine, is “a state of wellness where there is an abatement of signs and symptoms that characterize active addiction.”

    What Is Successful Addiction Treatment?

    Let’s take a look at what it means to have an effective treatment outcome in terms of addiction. The primary goal is usually abstinence or at least a “clinically meaningful reduction in substance use.” To measure effectiveness, we must look at how and if treatment improves the quality of life for the patient. Improving quality of life is the aim when treating all chronic conditions that have no cure.

    Evidence-based therapies do not support the notion of “hitting bottom.” As with any chronic disease, early intervention is going to provide the best outcomes. Even more effective than early intervention is prevention because SUDs are both preventable and treatable.

    Pharmacotherapies to Treat Substance Use Disorders

    Addiction is an overstimulation of the brain’s reward pathways, and as the condition progresses, the brain becomes less sensitive to the rewarding effects of a drug and requires more of the substance to get the same effect. This overstimulation can play tricks on memory recall, turning experiences that were not good into ones that seem better than they actually were. It creates false memories to encourage re-indulging in the addictive substance or behavior.

    From a medical standpoint, this disparity needs to be interrupted and corrected. Akikur Mohammad, the author of The Anatomy of Addiction, argues that successful treatment of addiction “must first address the biological component and correct the brain’s chemical imbalance in the process.”

    Pharmacotherapy is used in medication-assisted treatment and recovery. Depending on the patient’s individual drug history, different medications may be used to mitigate the brain’s compulsive race to stimulate the reward loop.

    Therapy for Substance Use Disorders

    Most research on therapy for substance use disorders has been done on cognitive behavioral therapy (CBT)—a form of typically short-term psychotherapy that combines talk therapy with behavioral therapy. Patients are taught how to adjust their negative thought patterns into positive thoughts. There is clinical evidence that CBT can be as effective as medications for many types of depression and anxiety. For treating SUD, CBT has been shown to have a “small but statistically significant treatment effect” but doesn’t necessarily have a long-lasting effect. As it’s a chronic illness, it stands to reason that SUD requires further maintenance beyond any short-term treatment.

    Are 12-Step Programs Evidence Based?

    Alcoholics Anonymous and other 12-step programs use a social model of recovery. They are built on the basic notion of peer support in a safe environment. There is research on the efficacy of 12-step programs, which shows it works for some people and that there are benefits to this social model of recovery. The steps, or rather the principles of the steps, must be internalized into a person’s psyche in order for the person to achieve lasting abstinence. 12-step programs are an incomplete approach and do not meet the requirements for the classification of evidence-based treatment because they lack biomedical and psychological components, and they use a one-size-fits-all approach.

    One central tenet of the 12-step solution requires turning one’s will over to the care of a higher power. Certainly, letting go of the notion that force of will can change the trajectory of addiction is necessary for any treatment. It’s a disease, and willpower will no sooner cure addiction than it will cure diabetes or heart disease. An evidence-based approach could mean that a doctor recommends a patient attend a 12-step program, or other support group, as part of a maintenance regime.

    The addiction treatment world is overrun with rehabs that primarily utilize 12-step programs, which are touted as the only treatment for addiction. That simply isn’t true. Addiction researchers have found that individually, cognitive and behavioral therapies, including social supports like 12-step programs, are incomplete treatment for a chronic disease that is both physiological and genetic in origin. From a treatment perspective that is grounded in evidence-based practice, involvement in a support group would be merely one piece of the puzzle.

    Holistic Care

    In evidence-based practice, the treatment process individualizes care and uses a holistic perspective to see what combination of resources will work best for a particular patient. The combination of treatment tools depends on a clinician’s specialized knowledge, the patient’s values and preferences, and the best research evidence. We need more specially trained addiction clinicians who can help people with SUDs make informed treatment decisions.

    Are you in recovery from addiction? What worked for you? Tell us in the comments!

    View the original article at thefix.com

  • Ariana Grande: Therapy Saved My Life So Many Times

    Ariana Grande: Therapy Saved My Life So Many Times

    “I’ve got a lot of work to do but it’s a start to even be aware that it’s possible.”

    Singer Ariana Grande has had quite a few painful moments over the last 18 months. From the Manchester Arena bombing at her May 2017 concert to losing her ex-boyfriend, rapper Mac Miller, to a drug overdose in September—life hasn’t been easy for the 25-year-old pop star.

    On Monday, Grande lent some words of encouragement for people who may benefit from counseling. Responding to a tweet, she said, “In all honesty, therapy has saved my life so many times. If you’re afraid to ask for help, don’t be. You don’t have to be in constant pain and you can process trauma. I’ve got a lot of work to do but it’s a start to even be aware that it’s possible.”

    Grande has not shied from talking about her own battles. In an emotional interview with Ebro Darden of Beats 1 radio in August, the singer emphasized the importance of helping one another through the good and the bad.

    She said that her song “Get Well Soon” is about “just being there for each other and helping each other through scary times and anxiety. We just have to be there for each other as much as we can because you never fucking know.”

    She added that the song, which appears on her latest album Sweetener, is “also about personal demons and anxiety, more intimate tragedies as well. Mental health is so important. People don’t pay enough mind to it… People don’t pay attention to what’s happening inside.”

    Not only did she lose her ex-boyfriend Mac Miller (born Malcolm McCormick)—who she called “my dearest friend”—this year, she was the target of shame and blame from some misguided individuals.

    Responding to Mac fans who blamed her for triggering his fatal overdose, she said, “I am not a babysitter or a mother and no woman should feel that they need to be. I have cared for him and tried to support his sobriety and prayed for his balance for years (and always will of course) but shaming/blaming women for a man’s inability to keep it together is a very major problem.”

    A medical examiner confirmed this week that the Pittsburgh rapper had died from mixed drug toxicity of fentanyl, cocaine and alcohol.

    McCormick was candid about his drug use, and seemed to struggle to find a balance. In a 2015 interview with Billboard, he said, “I’m not doing as many drugs. It just eats at your mind, doing drugs every single day, every second. It’s rough on your body.”

    View the original article at thefix.com

  • Narrative Therapy, or What Angelina Jolie Tells Herself About Herself

    Narrative Therapy, or What Angelina Jolie Tells Herself About Herself

    Ask yourself: As a sober person, who am I? What is my new story? What will I tell myself and others about who I am and what my life is like sober?

    Human beings are fascinated by stories. Indeed, we are particularly enthralled with stories about the lives of other people. Biographies and autobiographies always hover near the top of the New York Times bestseller lists. Kids love bedtime stories as do adults these days: Popular smartphone apps like “Calm” tell bedtime stories that send their adult users into a soft, peaceful slumber. As a therapeutic approach, narrative therapy dives into the human instinct for storytelling to help people in need. Stories can be a profound vehicle for healing.

    Not everyone, however, uses storytelling in such a positive fashion. Taking advantage of our instinctive love for stories, entertainment magazines make millions by publishing articles about famous people like Angelina and Brad, whose seemingly fascinating lives offer distraction from our own. If you were awake when the news broke out about Angelina Jolie and Brad Pitt’s divorce in September of 2016, you probably saw the headlines. Everybody saw the headlines.

    The tabloids and media alike snarled and ripped apart both Brad and Angelina, trying to create negative hype and drama. Negative stories sell a lot more than positive ones, so this particular narrative was salacious, with accusations by a vengeful wife against her husband that included out-of-control substance use and physicality towards his children, teetering on the edge of abuse.

    The stories provided classic schadenfreude — that guilty, yet pleasurable feeling you get when you hear about someone else’s pain. And we, as a collective whole, loved it. Even the rich and beautiful are not perfect, so us “average” people don’t have to feel so bad and so “less than” after all. The media capitalized on this phenomenon, and Angelina was portrayed as enraged and merciless, a bitter accuser of someone she once loved. But some people felt Angelina was going too far; an angry woman airing her husband’s dirty laundry felt like a betrayal.

    Yes, such a characterization could be true, and it could be a legitimate take on the story. But, from her viewpoint, could there be another? Could the negative portrayal of both Angelina and Brad be slanted by our society, namely the newspapers and magazines, for their own benefit? Was Brad really that unhinged and was Angelina really that vindictive?

    If Angelina and Brad chose to deal with their struggles through therapy, there would be a number of different approaches from which they could choose. Narrative therapy, a type of psychotherapy, is all about looking at the world from different viewpoints and perspectives. By looking at how narrative therapy could apply to this celebrity break-up, we can gain good insight into why this approach can be effective for adults in recovery.

    Let’s use Angelina as an example. If Angelina went to a narrative therapist, she might present a quite different perspective about her actions and the divorce than what the tabloids were touting. According to an analysis based on the theory of codependence, Angelina could be staying with her husband out of desperation, even if he were dangerous. I am not claiming that Brad Pitt was a danger to his children in actuality, but rather examining this overall narrative for argument’s sake. In this analysis of the situation, the fear of “being alone” can have a damaging influence on people’s lives.

    Rather than coming forward with this codependent explanation, Angelina most likely would present a radically different narrative. Instead, Angelina was standing up for those very people she holds most dear – her children. If the accusations were true, she could have told a story about herself as a guardian of her kids, strong and fiercely protective. Rather than being scared of being alone, her decisions were based on her natural instincts, akin to a mother bear protecting her cubs. Ultimately, their welfare was her number one priority.

    A narrative therapist could help Angelina see that being committed to her children was a powerful narrative to embrace. Her fervency could be seen as having its roots in protection. She bravely stood up to protect that which she loved. And she made a number of potentially difficult sacrifices for the welfare of her kids (namely, her marriage), but she also stood for her values and intuition as a mother.

    What’s more, maybe Angelina has gone against the societal definition of a so-called “happy family.” According to the People website, Angelina made a statement to Vogue in 2006 about being a single mother when she met Brad. “I think we were the last two people who were looking for a relationship. I certainly wasn’t. I was quite content to be a single mom,” she stated.

    This vantage point would support what is called in narrative therapy the “sparkling moment” when Angelina Jolie stood up to the problem. She made the choice to leave a situation that was potentially harmful to her kids, perhaps taking the chance of becoming a “single mother” again.

    The therapist taking a narrative approach would ask questions of Angelina to guide her as she developed hope in the aftermath of her divorce. The therapist would remind Angelina Jolie of her confidence in being a single mother as shown by the quote. The potential goal would be to help her deal with the inevitable effects of her divorce.

    Single motherhood often has a negative connotation in our society. We are told how hard it is to be a single mother, but could this be different for Angelina? Could it be a way of life that Angelina enjoys? She chose to adopt multiple children before getting together with Brad, actively taking the role of “single mother.” She broke society’s mold of the “ideal” mother: someone who is in a partnership while raising kids. Perhaps the narrative therapist would examine this with Angelina, helping to posit it as one of her strengths.

    A narrative therapist helps you uncover the other side of the story that often doesn’t get told, for one reason or another. The pressures of traditional roles and mainstream ideas in society often keep these other narratives buried. A significant part of narrative therapy is about telling your story about who you are and why your life counts.

    The therapist helps clients to understand the situations and events of their lives in a manner that helps to reveal how the clients want to be in the world. A goal is to create a tangible image of what they want their life to look like and finding the evidence to support this image, which may already be in place.

    Narrative therapy works particularly well within recovery scenarios. People who have struggled with addiction often have negative stories about who they are, often because of the shame associated with being an “alcoholic” or “addict.” Finding a different story is a way of seeing yourself apart from the “alcoholic” or “addict” label and developing a way to view yourself and your life that has nothing to do with the drug or alcohol problem. A narrative therapist believes that you, as a person, are separate from the drugs and alcohol, and he or she will always remain curious and respectful.

    Many people call themselves different things and have “stories” that depend on the labels they put on themselves. For example, a “hipster” is someone who may dress in a chic, alternative way that most people outside of big cities don’t encounter in daily life.

    What story do you tell yourself about yourself in recovery? Ask yourself: As a sober person, who am I? What is my new story? What will I tell myself and others about who I am and what my life is like sober?

    There are a myriad of questions that can offer access into new stories. For example, have you ever thought about what you want to be written on your gravestone? If you were at a party, what would your elevator pitch be about who you are and what you have done in your life? What would your theme song be and why? 

    The therapy work is about developing a storyline that runs counter (or opposite to), but also at the same time as, the story of addiction. It is separate from the storyline involving the problem of drugs, alcohol, and other addictions. Just as Angelina could feel shameful for being called a “bad” wife who did not stick by her husband, there is an alternative story in which she is a “good” mother protecting her children. The therapist helps clients view themselves and their lives apart from the shame of the addiction and the resulting resentment at being viewed negatively by society.

    The narrative therapy approach can be empowering: The client is always the expert, and the therapist is the guide who asks questions. The goal of this process is to help the client build the confidence and self-esteem to be the person that knows his or her life the best.

    To the narrative therapist, you are so much more than just an “addict” and the negative experiences that happen to you in the throes of addiction. Doing this work can help you uncover and discover the other parts of who you are; your hopes, dreams, and preferences for living in sobriety as the protagonist and main character in your own, entirely new storyline. Is there something that only you know about who you are and what your life is like that would help you evolve into sustainable sobriety with the right attention and care? Maybe developing this side of yourself could help you stay sober and live a healthy, satisfying life in long-term recovery.

    View the original article at thefix.com

  • Deeper Cleaning: How I Came to Accept My Mother’s Hoarding Disorder

    Deeper Cleaning: How I Came to Accept My Mother’s Hoarding Disorder

    About 50% of all hoarders have blocked access to their fridge, bathtub, toilet and sinks. 78% have houses littered with what could be deemed garbage. My chances of finding a spot to sleep were next to nil.

    For the second time in my life I was saying goodbye to my mother and moving to California, and this could have been a very sentimental moment if it we hadn’t found it so damn funny. With all of my worldly possessions packed up into two great Jenga towers of luggage, Mom and I were doing our best to control the fits of laughter while maneuvering these teetering carts of death toward the terminal. It was the irony that had finally gotten to us. There we were—wrestling with this stuff that could at any second escape our control and come toppling down on top of us—when for the past two months we had been living through a very similar scenario; but one that had been nowhere near as funny.

    And one where my mother’s life had been quite seriously at risk.

    My mom suffers from a clinical hoarding disorder. According to a recent survey by the National Alliance of Mental Illness (NAMI), about 5% of our entire planet’s population struggles with this condition typically characterized by the cluttering of a home with personal possessions to an often debilitating degree. A type of anxiety disorder, hoarding is still working its way into the medical books, but thanks to a steady stream of reality TV shows featuring the worst case scenarios of the condition, social awareness of hoarding has reached an all-time high.

    These were the shows that I YouTubed as I tried to better gauge the house that I had walked in on during a surprise visit to Mom’s. Compared to the episodes I watched, my mother and her hoard weren’t ready for primetime just yet—though at the rate she was going, next season was quickly becoming a strong possibility.

    Mom had turned her two bedroom, single level ranch style house of around 1,400 square feet into a storage unit, filling it up with everything from groceries on clearance to thrift store finds too good to let go. As toys, crafts, books, tools, plants, snacks, clothes, shoes, bags and boxes slowly rose to the ceiling, my mother’s home began to look like the bottom of an hourglass, only the sand was her stuff—and once filled up there’d be no easy reset.

    Once her cover was blown, so to speak, she felt the time had come to not only admit she had a serious problem but to finally accept some help dealing with it. And as fate would have it, Mom’s epiphany just happened to coincide with a major shift in my own life. After 15 years of working through my own addiction (drugs and alcohol) I was moving back to California, clean and sober. But, since there was a two-month gap between the lapse of my lease and the end of my teaching year, I just happened to need a place to live.

    So we came up with a plan.

    I would spend those final two months living at Mom’s house, helping her get the clutter under control. At the same time, we would go scouting for some professional help, agreeing that therapy to address the hoarding was in Mom’s best interest. We had a plan: by the time I left Connecticut, Mom would have regained a sturdy foothold on the road to recovery and I could move away, assured that I had done my part in helping.

    And it worked, too. Until it didn’t.

    In that previously mentioned survey by NAMI, about 50% of all hoarders have blocked access to their fridge, bathtub, toilet and sinks. 78% have houses littered with what could be deemed garbage. My chances of finding a spot to sleep were next to nil, though the toilet wasn’t too tough to get to. A garage sale seemed like the perfect solution for opening up some much needed space. Plus, instead of just throwing things out (and to be fair, a lot of Mom’s stuff did have some value) this would give my mother and me an opportunity to really start working together as a team, as opposed to simply strangling one another—which started to have its own appeal once we realized what we were up against.

    Hoarding is a disease based very much on feelings. Boston University Dean and Professor Gail Steketee LCSW, MSW, PhD, who has been studying the condition since the mid-1990’s concluded that “Hoarding may induce feelings of safety and security and may reinforce identity.”

    In other words, Mom’s things helped her feel safe.

    Her stuff was in many ways who she was.

    So emotions began to run high as we debated on what in the house could be sold. At first we were able to work for just a few hours before Mom had to quit, visibly shaken, promising better endurance for the next attempt. Sometimes a span of days would pass where no progress was made at all. Because my mother had the final say on every item’s fate, during these times of indecision there was little more for me to do than just sort through the piles. This part of the process was most challenging for me.

    Finding myself truly face to face with my mother’s disorder, I often spiraled into great bouts of anger and deep depression. Getting lost in the work for hours, I would start dissecting a section of the hoard, piece by frustrating piece, trying to make sense of it. It was during these times that I began to realize my mother was in the grips of a very serious and complex mental illness.

    Hoarding has been listed as a symptom of OCD for years. As defined by the Mayo Clinic, people who have obsessive compulsive disorder experience unwanted thoughts that incline them to perform an action repetitively—usually outside of their control—in hopes of alleviating stress, when in actuality the behavior is only compounding the discomfort.

    Did this explain the bags upon bags of clearance items and price-reduced canned goods? The gathered pile of expired and stale holiday candy? The drawers of zip ties, rubber bands and Tupperware lids. That infuriating metropolis of 7 Eleven cups always collapsing off the microwave. The balls of yarn, rolls of fabric, reams of paper, baskets of shoes. Bed sheets, power cords, energy drinks, sun catchers. Nesting shelves, cleaning fluids, shampoos and conditioners. Paper plates, napkins, condiments—bags of them. If I was disturbed while sorting them, I had to imagine what it must’ve felt like to always need more of them.

    But what I really needed was to seek out that professional help Mom had agreed to from the beginning. In addition to the increasingly alarming nature of the collected stuff, according to a report by Compulsive-Hoarding.com, “A hoarder’s problem will not be solved by someone else throwing away or organizing their possessions.”

    Another invaluable online resource, HoardingCleanup.Com, offered an impressive roster of psychiatrists and psychologists dealing specifically with the disorder. Fortunately, we found a local doctor with whom Mom felt comfortable with right off the bat.

    Then, suddenly, positive results were coming in from every front.

    Once the garage sales got started, they quickly gained momentum and we were setting up the driveway with Mom’s wares every Friday through Sunday. So by the time my departure date rolled around we had become old pros—and one hell of a team. There was nothing at the airport but sincere gratitude and a shared sense of accomplishment. We had done it! We’d beaten the monkey off of Mom’s back, shoved it in a box and sold it in front of the house for a dollar.

    No, fifty cents!

    Seventy-five!

    Okay, seventy-five, sold!

    Over the following months, as I worked on getting my own home together, I would check in with Mom to see how things were coming along. She continued with the garage sales until the weather no longer agreed. The therapy continued unabated. Her psychiatrist was big on baby steps, discouraging Mom from taking on too much at once. Instead, the piles were shrinking through consistency and perseverance, my mother showing him photos from week to week. Also, my father was visiting the house regularly so he was able to give me a report every now and again. 

    According to an article in Psychology Today, “willful ignorance” occurs when a person knows the truth, or at least fears it, but chooses to ignore it altogether. Turning a blind eye was an especially easy behavior for me to indulge in from 3,000 miles away, so I was flabbergasted when one night my father called and told me that Mom’s house had reverted to its previous state of congested disarray and that her hoarding was back with a vengeance.

    What an awful moment of deja vu. Were we really right back to where we had started, just like that?

    Though my 12-step meetings and sponsor helped calmed me down with some much needed perspective, for the first time in recovery I found myself resenting the solution that was being offered—which was, as always, acceptance. “God grant me the serenity to accept the things I cannot change,” blah blah blah.

    No.

    I refused to accept it. I would not sit idly by while my mother sat on the one spot she had left on her sofa, watching a TV she had to crane her neck around piles of junk to see—the same piles that were slowly but surely burying her alive. Somebody had to take charge of this mess. Who was responsible? I blamed her, her doctor, my father, myself. I blamed thrift stores, dollar stores, America, God.

    What went wrong? How could Mom go back to hoarding after such encouraging progress? This had been the strongest attempt at complete recovery from her disorder so far.

    There was a night I called Mom up ranting and raving, horrendously demanding to know exactly what was the problem—and her timid response to me, plain and simple was:

    “It’s hard.”

    That was a mouthful. And it’s actually the one thing all the research and professionals in the field agree on. Recovery from hoarding is incredibly difficult. The statistics tell us it’s downright unlikely. A study conducted by the Journal of Clinical Psychiatry on patients with various forms of OCD, including hoarding, found that after five years only 9.5% of hoarders achieved and maintained full recovery from their condition.

    But then this begs the bigger issue—and it’s where my eyes opened.

    When we’re looking at recovery from hoarding, are we also looking at recovery from OCD? This experience showed me that my mother isn’t just struggling against shopping and filling her house up with stuff—but she’s battling an obsessive-compulsive disorder. Unlike my substance abuse where complete abstinence from drugs and alcohol is the solution (though of course there’s lots more to it), my mother is dealing with a behavioral disorder. And when it comes to long lasting recovery, therapy continues to be the key.

    Compulsive-Hoarding.com told me that if a hoarder’s space is just cleaned out, “The clinical compulsive hoarder will simply re-hoard even faster and fill up their home again, often within a few months.” However, that NAMI survey showed that as much as 70% of hoarders responded positively to cognitive therapy.

    So Mom is on the right track.

    It’s just that the odds are not in her favor.

    But so far she’s beaten a lot of those odds, hasn’t she? My mother’s already admitted to having a problem when NAMI reports that only about 15% of all hoarders do so. And she’s in therapy where her recovery has the highest likelihood of success. How many attempts will it take before Mom finds long term recovery? Nobody knows.

    All I know is that recovery from hoarding seems to be an inside job and that’s the stuff that really needs to be worked through. Once I accepted that about my mother and her hoarding condition I knew the best thing to do was leave that work to her.

    Find info about hoarding here:

    https://namimass.org/hoarding-and-ocd-stats-characteristics-causes-treatment-and-resources

    View the original article at thefix.com