Stephanie Brown Interview on Addictions and Psychotherapy

l4c6db7e6bdd48Stephanie Brown on object attachment in addiction and recovery:

RW: Is this what people refer to as hitting bottom, or surrendering somehow?

SB: That’s the first experience – to hit bottom, to surrender, and to reach outside the self. So people seek help, they go to 12-steps. They then shift their object attachment from alcohol to a 12-step group, or to a treatment or mission- based center. They shift to whatever substitute will take the place so that they are still taking in, they still have an attachment. They begin to go to meetings; they’ll get a sponsor. They begin to take in the new object replacement for the substance.

VY: Why do you think this shift is so crucial to recovery?

SB: It is important so that you are not asked to give up your substance for nothing. The recognition is that you need a substitute attachment, so you get it. When you reach out for help, you’re going to reach out for a new object that represents recovery. It represents abstinence in the 12-step model and so the process of transformational change is under way with the shifted object attachment and the substitute new behaviors. What are the new behaviors? Going to the meetings, reaching for the phone, being in action to substitute something that represents recovery.

She very clearly describes a challenge we see frequently when a psychiatric diagnosis has been made. We see clients attaching to that diagnosis or their medication more strongly than to their recovery. It’s a fine line. We must be and we are responsive to their emotional/psychological suffering, but we also need to be cautious and conscious of the iatrogenic harm that can result from an inappropriate diagnosis and treatment.

RW: How much does it matter what that attachment is?

SB: I now see a lot of people going into treatment for addiction who are taking so many legal medications. They’re making their object attachment to the medication, instead of, “I have hit bottom. I am attaching to recovery.” These people are struggling in AA and NA. They’re sitting at meetings thinking about, “How’s my level of medications, should I up my antidepressants?” They’re talking all about the new object attachment to their medications.

via Stephanie Brown Interview on Addictions and Psychotherapy.

“Recovery High” a Respite for Young Addicts


Maybe this is a better way to address pediatric addiction?

Called The Bridge Way School, the specialized high school in the Roxborough section of Philadelphia focuses on getting teenagers back on track with their education and lives after exiting rehab. It is the only school of its kind in the region – one of only some three dozen nationwide.

“We have kids come in with 30 days [sobriety], they’re not sure how school is going to go, they haven’t done well in school for a while and then they see the environment that we have here,” says Rebecca Bonner, who runs the school. “And in two or three weeks, you see kids who haven’t worked in class for years who say ‘Oh, I’m getting a B’ and they’re actually working.”

Ranging from 9th to 12th grades, every student is recovering from some type of addiction and goes through regular coursework like English, Math and Science. But unlike typical schools, the teens talk about their recovery regularly.

Students begin their day with a 20 minute face-to-face with a counselor and staff to discuss how they’re feeling and whether they’ve been triggered to use again.

“If it’s serious enough, our counselor may just pull that kid for 20 minutes. It is so different from what a regular school does where a kid might sit on something all day,” Bonner said. “They learn nothing because they’re processing whatever that is. We try to catch it early so they can process that and get right back on track.”

Before leaving for the day, the students have another sit down to discuss their plans for the afternoon and evening. They also spend about 50 minutes, four times a week, in group sessions talking about their addiction and recovery with peers.

“The adults can say whatever we say and we can be supportive and encouraging, but the kids are the ones that give each other the support. That is positive peer pressure,” Bonner said.

via “Recovery High” a Respite for Young Addicts | NBC 10 Philadelphia.


If it wasn’t rational, cont’d


All right, last one.

This time, Sally Satel makes the case that recovery comes down to choice and “grit and conviction.”

It’s not just American Enterprise Institute fellows who make these arguments. I’ve heard people in recovery say to other AA members in relapse, “You need to make a decision!”

Of course, the relapser has made the decision to recover many times. Lack of decisions/choices to recover is not our problem.

My response to these kinds of statements is usually something like, “If it just comes down to a choice, why don’t we party this weekend and just make a decision on Monday to recover?”

Of course, these people know that they, too, might find themselves unable to follow through on that choice. Ever. In their gut, they know recovery not something you can earn or simply choose to do. If it was, they would have recovered much sooner to avoid years of agony and loss. Or, they could have postponed recovering a little longer.

To make her case, she points to one of my favorite cohorts–addicted doctors.

When at risk of losing their licenses, addicted physicians show impressive rates of recovery. When they come under the surveillance of their state medical boards and are subject to random urine testing, unannounced workplace visits, and frequent employer evaluations, 70 to 90 percent are employed with their licenses intact five years later.

Of course, there’s a little more to the story. Addicted doctors get a lot more than monitoring and the threat of losing their license. They also get high intensity, long term treatment and long term recovery support.

Of course (I’m sick of reading myself say that!), there are some truths in what these people say, but their blindness to so many other truths makes it difficult to take them too seriously.