More on Ernest Kurtz

interviewing-ernie-kurtzBill White shares a personal tribute to Ernie:

Ernie knew stuff, and he knew people. What he did for me and so many others, including legions of M.A. and Ph.D. students, was connect us to information and sources that escaped the usual search methods. He was a walking encyclopedia of the subjects he held most dear and freely shared those resources. So many people’s research had crossed Ernie’s path that he served as a crossroads continually connecting people with shared interests. Ernie loved connecting people and he played a key role in forging a community of A.A. historians in collaborations with Brown University, A.A. Archivists, A.A. History Lovers, and other such groups.

Read the whole thing here.

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Let it begin with me

photo_20150123_WM0028911_0_ek1991_20150123Points blog has a nice, personal post about Ernie Kurtz and some of the lesser known parts of his legacy.

“Let it begin with me” is not an AA but an Al-Anon slogan, but it’s a fitting way to close.  Scholarly history of AA began with Ernie Kurtz.  His willingness to engage and share, to encourage thought and research among academic disciplines, between the academy and the public, and, yes, across the sectarian rifts within AA itself– this willingness provided a model for the many collaborative projects through which AA history is now being done: the national AA archives workshops, the Sedona-Mago history symposia, the revitalization of Dr. Bob’s House and Stepping Stones, the publication projects of the Hindsfoot Foundation, and the work of Points.  When anyone, anywhere, reached out for help with AA history, the hand of Ernie Kurtz was there– inspiring, prompting, gently correcting, encouraging us all (a couple of generations now) to take part in the mystery of collaborative exploration of our history.  For that I am grateful, and I know I’m not alone.

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Bill White on “Symbolic Firsts”

hopeBill White had a very interesting post a while back on the concept of “symbolic firsts” and how it relates to recovery advocacy and recovery initiation.

The concept is based on the idea that:

. . . the pioneering achievement of a single individual from a historically marginalized group affects the self-identity, aspirations, and performance of other members of that group as well as culturally dominant attitudes toward members of that group (e.g., the effects of Barack Obama’s 2008 election on the academic performance of African American children and attitudes toward African Americans).

This reminded me of an interview I heard on the radio and a previous post on the concept of “the adjacent possible”.

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.

Bill links the concept to hope and recovery initiation:

Symbolic firsts in recovery stand as a living invitation for individuals, families, and communities affected by addiction and a source of motivation and guidance for those seeking and living in recovery. Through their achievements, symbolic firsts expand the roles and community spaces in which people seeking and in recovery can envision themselves.  Symbolic firsts in recovery diminish the community cues conveying that people in recovery do not belong in particular positions or places. They offer living proof of what can be achieved in recovery and the principles and strategies of how such achievements have been and can be made in the context of recovery.

But Bill doesn’t stop there. He calls on those us us in stable recovery to out ourselves to reduce stigma, inspire hope and make the adjacent possible known.

Symbolic firsts in recovery achieve such status by acts of destruction (tearing down historical barriers of exclusion and their supporting machinery) and acts of creation (forging new niches and styles through which people in recovery can personally excel and socially achieve and contribute).

Symbolic firsts in recovery eschew “passing” (hiding concealable stigma for personal advantage) to achieve a higher social goal–even in the face of personal challenges and socially-imposed limits on opportunities that can potentially flow from this decision.  Symbolic firsts face extremes of experience different in nature and intensity than others who will subsequently fill the space that the trailblazers created. As a result, symbolic firsts in recovery need the full support of communities of recovery.

 

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Hope

“Hope” by Victoria Safford

hopeOur mission is to plant ourselves at the gates of Hope — not the prudent gates of Optimism, which are somewhat narrower; nor the stalwart, boring gates of Common Sense; nor the strident gates of Self-Righteousness, which creak on shrill and angry hinges (people cannot hear us there; they cannot pass through); nor the cheerful, flimsy garden gate of “Everything is gonna be all right.” But a different, sometimes lonely place, the place of truth-telling, about your own soul first of all and its condition, the place of resistance and defiance, the piece of ground from which you see the world both as it is and as it could be, as it will be; the place from which you glimpse not only struggle, but joy in the struggle. And we stand there, beckoning and calling, telling people what we are seeing, asking people what they see.

(Source: On Being)

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Take care

takeCareLogoThe Central Michigan University student newspaper, Central Michigan Life, has published an editorial in response to a recent tragedy.

An 18 year old man was visiting friends over homecoming weekend, drank himself to the point of intoxication and drowned in a campus pond.

Our community failed to take care of Hartnett while he was intoxicated, and he is not alone. The National Institute on Alcohol Abuse and Alcoholism reports that  1,825 college students aged 18 to 24 die each year due to “alcohol-related unintentional injuries.”

The editorial calls on students to participate in the campus “Take Care” initiative, where students “are encouraged to observe what is going on around you, notice potentially dangerous or serious situations, and respond to the best of your ability to influence a better outcome.”

. . . adhering to the “Take Care” initiative by no means is an abandonment of fun.

Taking care of each other is as simple as organizing a ride home for someone, calling to make sure a friend is OK or staying near to someone who shows signs of distress or inebriation.

A “Take Care” mentality is even more essential now that icy roads, cold winds and below-freezing temperatures rule the campus and Mount Pleasant area.

 

My comments are not a criticism of the CMU office of student affairs or the paper. I’m open to the idea that this may be the best approach to preventing tragedies like Hartnett’s death. However, I find it interesting that we twist ourselves in knots and put so much effort into protecting and normalizing binge drinking and drunkenness. There was no comment on the widespread practice of drinking oneself into a state where one can no longer take care of oneself. In fact, they felt the needed to proactively address any assumptions that they were kill-joys.

It says something about how much we value getting drunk, doesn’t it?

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We all wish love was enough

fear_false_evidence_appearing_realThis article, claiming to have discovered the long suppressed cause of addiction, has been making the rounds and has been recommended by a lot of people.

Like a lot of things, it contains some truth but is not the Truth.

People generally bring up rat park and returning Vietnam vets to advance 2 arguments.

  1. That you can’t catch addiction by just being exposed to the drug.
  2. That environment is the real problem. If you put people in bad environments, they’ll look like addicts. If you enrich addicts’ environments, they’ll stop being addicted.

I whole-heartedly agree with argument #1. You can expose 100 people to drugs like cocaine and heroin and a relatively small minority will develop chronic problems–5 to 23, depending on the study you look at. So, even if the outlier studies were true, we’re still talking about 77% not becoming addicted.

Every field has its goofballs, but in my two decades in the field I have not heard any serious practitioners or researchers argue that simple exposure (even to large doses over an extended period) causes addiction.

Argument #2 is much weaker. It’s my understanding that follow-up studies with rats have failed to reproduce these findings and suggested genetic factors were important. The strongest statement you can make about environment is that it is a risk factor, but not anything approaching a cause.

As for returning Vietnam vets, this is from a post I wrote a few years ago:

These stories often ignore the fact that:

“. . . there was that other cohort, that 5 to 12 per cent of the servicemen in the study, for whom it did not go that way at all. This group of former users could not seem to shake it, except with great difficulty.”

Hmmmm. That range….5 to 12 percent…why, that’s similar to estimates of the portion of the population that experiences addiction to alcohol or other drugs.

To me, the other important lesson is that opiate dependence and opiate addiction are not the same thing. Hospitals and doctors treating patients for pain recreate this experiment on a daily basis. They prescribe opiates to patients, often producing opiate dependence. However, all but a small minority will never develop drug seeking behavior once their pain is resolved and they are detoxed.

My problem with all the references to these vets and addiction, is that I suspect most of them were dependent and not addicted.

So…it certainly has something to offer us about how addictions develops (Or, more specifically, how it does not develop.), but not how it’s resolved.

Why is it so frequently cited and presented without any attempt to distinguish between dependence and addiction? Probably because it fits the preferred narrative of the writer.

So. . . rat park and returning Vietnam vets are not quite what he describes. Let’s continue.

I do appreciate the article’s call for compassion and I am a believer that purpose, meaning and connection are important elements of stable recovery. However, as I continue reading the article, I am reminded of Ralph Waldo Emerson:

Their every truth is not quite true. Their two is not the real two, their four not the real four; so that every word they say chagrins us, and we know not where to begin to set them right.

mencken-complex-problemHe says that addiction that begins with  prescribed pain medication “virtually never happens.” Well, it’s hard to pin down exactly how often it happens, due to chicken and egg questions related to how many pain patients have pre-existing substance use problems. However, reported estimates range from  “from 2.8% (Cowan et al., 2003) to 50% ( Saper et al., 2004).”

What about the Portugal miracle? We’ll a few things to keep in mind. First, the decriminalization approach is focused on getting addicts into treatment. Housing and treatment may be addressed, but it’s clear the focus is on treatment. Second, Portugal was starting from the position of a terrible heroin problem. They’ve gone from 1% addicted to 0.5% addicted. That’s great, but to provide a little context, the National Survey on Drug Use and Health pegs current heroin users at 0.1% of the U.S. population.

So . . . the article doesn’t tell the whole story, it oversimplifies some very complex issues and presents us with straw man arguments. (Who says that anyone who uses heroin is going to get hooked for life? [Note that he had to go back to a commercial from the 1980s and that a search for the reported text of the commercial only produces references to his article.] Or, that behavioral, environmental, social and other factors are unimportant in the development, course and recovery from addiction?)

I also worry about the implied message that we just love them enough, they’ll get well. I see countless families that provide housing, jobs, connection and love–only with watch their loved one slip further and further into addiction.

Addiction is a complex problem. Multiple factors influence it’s development, course and resolution. This is always the case with chronic disease. There’s a cultural narrative out there that addiction is not a disease, that it is rational, that it’s a product of environment, that it’s a learning disorder, that framing it as a disease is a foundation for violating individual liberties and that recovery needs to be redefined. Intended, or not, stories like this are part of that narrative.

I don’t engage in ad hominem arguments, but, while we’re on the topic of narratives, it would seem strange to not point out that this author has a history of playing fast and loose to advance a narrative.

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“slavishly rationalist” and “mere logic”

ASUS CVFZFrom Kas Thomas, on the limits and overselling of CBT:

CBT has been criticized (appropriately, I believe) on theoretical grounds for its slavishly rationalist bent and its insistence that mentally ill people can fix their problems with what amounts to exercises in clearer thinking. M.B. Shapiro Award winner Chris Brewin (University College London) questions the idea that challenging a person’s thoughts leads to changes in feelings and behaviors. He suggests that human cognition actually draws from multiple memory systems and personal-knowledge stores, not all of which are open to introspection. Teasdale (in this book), along the same lines, contrasts “propositional” meanings (which are semantic and declarative) with “implicational” meanings (holistic meanings reflecting the “felt sense” of experience, thus tied to emotion), and questions whether the latter can be assailed with mere logic. Someone suffering from depression isn’t necessarily interested in having his logic proved wrong, or being told that every problem can somehow be reduced to a distortion in perception. One of the signature features of mental illness is the convincing illusion that everything you’re thinking is 100% real and accurate, even when you’re delusional. Indeed, depression is often (subjectively) a feeling of experiencing reality too accurately.

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