Category Archives: Mutual Aid

Faith is given in sufficient quantities to communities

charles outreach accept

I recently listened to an interview with Nadia Bolz-Weber. There were a lot of keepers in the interview (even for a non-believer). She’s described as a recovering drug addict. Her recovery shines through in this, “fake it till you make it” discussion:

Ms. Tippett: So a sermon of yours I wish I could have heard is “Loving Our Enemies Even If We Don’t Mean It.”

(laughter)

Ms. Nadia Bolz-Weber: Yeah, I think meaning it is overrated. I mean, I think …

Ms. Tippett: I think this is profound. I really do.

Ms. Nadia Bolz-Weber: No, I’m serious. Like, my gosh, if God’s going to wait till I mean it, that’s going to be a while, right? So I think that the key is praying for them, not like feeling warm feelings towards people who’ve hurt you or towards your enemy. I don’t think it’s about feelings. I think it’s about an action.

That was kind of neat, but what she said next really leapt out to me. [emphasis mine]

…I think that’s what the sort of love your enemies and pray for those who persecute you means. I will actually ask other people to do it for me sometimes, like it doesn’t always have to be us. And so it’s like this thing like I don’t think faith is given in sufficient quantity to individuals necessarily. I think it’s given in sufficient quantity to communities.

Wow. It reminds me of my persistent despair many months into my recovery and Dave H. telling me, “It’s okay if you don’t believe it’s going to get better, just believe that I believe it’s going to get better for you.”

This reminds me of an aha moment I had when listening to Bill White describe the recovery coaches of Project SAFE. I remember listening to him and thinking of the clients in those stories as having no protective factors–none!–only risk factors. He went on to describe the assertive support and engagement that these workers provided. I realized that these workers were becoming and creating protective factors in the lives of these women.

It also reminds me something my friend Ben often says, “Too often I fail to notice how much of the time I’m carried by others.”

What a gift it is for our profession to have access to a recovering community that, a group and one-to-one level, provides so much hope, faith and tangible support.

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Filed under Mutual Aid, Random, Treatment

The adjacent possible and hope

I heard a radio show this morning about where ideas come from.

They interviewed a guy who wrote a book and gave a TED talk on the topic.

During the interview he discussed the concept of the adjacent possible and it’s importance in forming new ideas. During the interview, he described it as the building blocks of new ideas. Without the right building blocks, any innovation is not possible. He described it another way in a WSJ article:

The adjacent possible is a kind of shadow future, hovering on the edges of the present state of things, a map of all the ways in which the present can reinvent itself.

The strange and beautiful truth about the adjacent possible is that its boundaries grow as you explore them. Each new combination opens up the possibility of other new combinations. Think of it as a house that magically expands with each door you open. You begin in a room with four doors, each leading to a new room that you haven’t visited yet. Once you open one of those doors and stroll into that room, three new doors appear, each leading to a brand-new room that you couldn’t have reached from your original starting point. Keep opening new doors and eventually you’ll have built a palace.

During the interview, he pointed out that it doesn’t matter how smart one is, it was not possible to invent a microwave in 1650, because the building blocks, the adjacent possible, just wasn’t there.

One factor is that the physical building blocks did not exist. The other factor is that the imaginative/inspiration building blocks did not exist.

This reminded me of a metaphor Bill White once used when talking about hope-engendering relationships offering kindling for hope.

I think this helps explain the resistance some recovery advocates have to interventions focused on something other than drug-free recovery. There’s a sense of how precious this adjacent possible is, and how easy it is to imagine a world where drug-free recovery is not possible because the adjacent possible has been lost.

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Filed under Controversies, Harm Reduction, Mutual Aid, Random, Treatment

Book Review: The Recovering Body

download (3)Jennifer Matesa’s The Recovering Body: Physical and Spiritual Fitness for Living Clean and Sober seeks to provide “a roadmap to creating our own unique approach to physical recovery” and frames “physical fitness as a living amends to self–a transformative gift analogous to the “spiritual fitness” practices worked on in recovery.”

She focuses on five areas, blending her own experiences, other recovering people, empirical research and practical to-do lists. The five areas are:

  • exercise and activity
  • sleep and rest
  • nutrition and fuel
  • sexuality and pleasure
  • meditation and awareness

I see two reasons this book is an important contribution to recovery literature.

First, it’s the first book I’ve seen (not that I’m well read in the area) that places such emphasis on physical wellness and self-care as an important element of recovery within traditional 12 step recovery paths. I’ve seen it addressed as an aside, and I’ve seen it offered as an alternative path, but not as an important element within traditional recovery paths.

As researchers and clinicians search for every tool to give addicts any possible edge as they initiate and maintain their recovery, we’d be wise to take notice. There is a growing body of evidence to support Matesa’s assertions that these are important elements of recovery rather than frivolous and indulgent accessories to treatment and recovery programs.

Second, I am convinced that the future of treatment and recovery programs (All chronic disease management programs, really.) should emphasize a lifestyle medicine as the foundation of care. After all, “recovery as a lifestyle” epitomizes one of the things addiction treatment has gotten really right historically and something the rest of chronic disease care could learn from us.

Despite this, professionally directed treatment that discusses the idea of the “recovery of the whole person” has mostly been lip service. Matesa brings this concept to life and presents holistic recovery as a lifestyle to be cultivated, practiced and maintained. On this front, she’s far ahead of professionals and researchers. The field is not there yet and too often equates recovery with swallowing pills or passively doing what professional helpers direct them to do. Matesa bypasses professionals and speaks directly to recovering people as a peer, calling them to action and offering experiential and empirical truth. That’s radical, in the best sense of the word.

Her writing is very accessible, is not preachy, and unpretentiously conveyed a lot of deep truths that I hadn’t considered but seemed self-evident as soon as I read them.

On a personal note, as someone who only started paying attention to physical fitness after 20 years of sobriety, the book takes a lot of previously disparate pieces of information that I vaguely knew to be true and organizes them into framework that not only deepened my understanding, but offered a concrete path to continue enhancing and securing my own recovery. I highly recommend it.

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Filed under Advocacy, Mutual Aid, Research, Treatment

Urban myths exposed

1242257784-vaillantPoints blog is back with a great interview with George Vaillant.

Here’s one of the questions and his response:

2. What do you think a bunch of alcohol and drug historians might find particularly interesting about your book?

The value of the Grant study to the history of alcoholism is the number of urban myths that it exposes, and for this reason it received the biennial Jellinek prize for the best research in alcoholism in the world.

The first urban myth exposed is that depression causes alcoholism. Our prospective study shows beyond a doubt that alcoholism causes depression.

Second, alcoholics have unhappy childhoods due to their parents’ alcoholism; unhappy childhoods without a history of alcoholism do not lead to alcoholism. Therefore, the relationship between childhood and alcoholism appears to be genetic.

The third urban myth exposed is that AA is only for a few alcoholics and drugs are more useful. There are no two-year or longer studies of Naltrexone, Antabuse, or Acamprosate that have been shown to be effective, nor has long-term follow-up of cognitive behavioral therapy proved to be effective. On the other hand, when we followed, over 60 years, our sample of roughly 150 alcoholics, the men who made complete recovery—that’s an average of 19 years of abstinence—as contrasted to those men who remained chronically alcoholic until they died, the men who “recovered” went to 30 times more AA meetings than the men who remained chronically ill. Like outgrowing adolescence, it takes a long time to learn to put up with AA, but when you do, it works.

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Filed under Controversies, Mutual Aid, Research

Sober fun on St. Patty’s day

ryanhowell

I teach at a local university and some years I teach on Saint Patrick’s day. It’s bad. Green beer starts flowing early, there are very drunk people wandering around all day, people passed out on the sidewalk, etc. Worst of all, it’s the default thing to do if you’re a young college student on St. Patrick’s day.

That’s why it’s so nice to see the growth of the Collegiate Recovery Program at University of Michigan. It would be cool no matter what, but it’s even cooler because they’ve been such good friends to Dawn Farm.

USA Today covered their St. Patty’s day event:

“Priority number one is to have fun,” says Molly Payton, 23, a general studies senior at Michigan, who has been sober for one year and attended the Sober Skate. “When I was in recovery, my big fear was that I wouldn’t have fun anymore … it was baffling to think I could have a life outside of drugs and alcohol.”

“For me, Fridays and Saturdays were tough,” adds Garrett Gibbons, 27, a graduate student in pathology at Michigan who is also in recovery.

“Those were nights when I knew I would party, knew I would drink. That’s why this is an important time for us.”

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Filed under Advocacy, Mutual Aid, Tribes of the Recovering Community

Hope, empowerment, capability, connection and purpose

Hopeworks Community recently listed his core beliefs related to his recovery from mental illness:

The idea was simple. There are a few core beliefs about recovery that make a difference. To the extent you are able to live them your recovery will be positively impacted.

My list of core beliefs was simple:

Life can get better.
I can help make it better.
I can learn the things I need to do to make it better.
I have support. People care about me and what I am doing.
What I do matters. It has meaning and purpose.

Or HOPE….EMPOWERMENT…CAPABILITY….CONNECTION…PURPOSE…

This rings very true for addiction recovery as well. Any practitioner or program that ignores these dimensions is inadequate. Some people will need no assistance with this kind of recovery–if we reduce their symptoms they can take care of all of this on their own without mutual aid or extended professional help. (I’m thinking of people with major depression or a problem drinker.) Others will more severe and chronic mental illness or substance use disorder will need lifelong professional and/or peer support. (Here, I’m thinking of an addict or chronic, debilitating mental illness.)

There’s a lot of pushback on this for addiction. Just this weekend, Anne Fletcher tweeted a dismissive reaction to a Bill White post about developing geographic communities of recovery.

Would she have the same reaction to a post about building communities of recovery for people with chronic and severe mental illness? Would she tweet a response that implies it’s overkill and these people (Who, together, are re-engaging in full family, occupational and community life.) need discover that there’s more to life and they need to get out of some growth-limiting bubble?

There’s been a whole new wave of these kinds of reactions recently. To me, they suggest a couple of beliefs:

  • The failure to acknowledge the different needs of people who have less severe or time-limited problems with alcohol and other drugs versus those with severe, chronic and debilitating addictions. Their reactions often focus on the experiences of the former, framing substance use disorders as a lifestyle choice.
  • The perception that recovery advocates (12 step recovery in particular) can’t tell the difference between these two groups and are bent on evangelizing every problem user into their one and only path to recovery while obstructing access to any treatment or recovery support that isn’t perfectly compatible.
  • That this perceived pattern of behavior undermines the legitimacy of mutual aid groups and the empirical evidence for the their effectiveness and their mechanisms of change.

Hopeworks Community closed with a thought that sums up recovery as a way of life.

But I know recovery is never a thing to have, but a way of doing.

Interesting that there is so much resistance to lifestyle change as an approach to managing addiction while there’s no dispute that lifestyle change is critical to successful management of other chronic illnesses and that peer support is important for successfully initiating and sustaining lifestyle change.

I don’t hear any of these reactions regarding people who join a gym, spend an hour there 5 days a week, start eating healthier, integrate being physically healthy into their identity and develop new social networks around these changes, like, say, a tennis league or a biking group. Why is that? We don’t hear that push back, and we’re not even talking about people who were occupationally, socially, emotionally and familially impaired. And, if some faction of these people exhibited evangelical zeal and insisted this was the only way to be healthy and that everyone needed to do this, would we be so dismissive of scholarly work describing the development of some communities organized around this kind of wellness for really sick people?

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Filed under Advocacy, Controversies, Favorites, Harm Reduction, Mental Health, Mutual Aid, Policy, Research, Treatment

The Doctor’s Opinion – Dawn Farm Ed Series

silkworthResearch continues to shed light on the neurobiology of alcohol/other drug addiction. Modern research supports much of what was intuitively and experientially believed by the medical specialists who supported the Alcoholics Anonymous program in its earliest days.  This program will describe a physician’s view of alcoholism, as presented in the literature of Alcoholics Anonymous and updated with the modern neurobiology of addictive illness. It will include a discussion of Dr. Silkworth’s explanation of alcoholism as a twofold disease affecting mind and body, how Dr. Silkworth’s opinion relates to the modern neurobiology of addictive illness, identification of therapy for alcoholism as promoted by Alcoholics Anonymous, and the relationship of this therapy to Dr. Silkworth’s opinion.

Handouts and other goodies:

Handouts and slides:

Related reading suggestions:

Video

The Doctor’s Opinion on Alcoholism from Dawn Farm on Vimeo.

Slidecast:

View more webinars from Jason Schwartz.

About the presenter

Dr. Herbert MalinoffHerbert Malinoff, MD, FACP, FASAM, is a specialist in chronic pain and addictive illness. He is the Medical Director of Pain Recovery Solutions, PC; and an attending physician at Saint Joseph Mercy Hospital in Ypsilanti, Michigan. Dr. Malinoff is a clinical faculty member of the University of Michigan Medical Center in the Department of Anesthesiology, and a consultant to Michigan Pain Specialists in Ann Arbor, Michigan. He is also a past President of the Michigan Society of Addiction Medicine. Dr. Malinoff received his M.D. degree from the University of Michigan Medical School.

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Filed under History, Mutual Aid, Research, Treatment