This week has been a test of patience quite honestly. The week started off good with a day off on Monday in which I was able to accomplish a lot of little things except getting oil changed. I just couldn't do the whole snow thing at 7:00am rush hour drive. That reminds me, I need to get that rescheduled. 

My internship was going relatively well this last week. I find it interesting now that I have been there a litte more consistently, I have noticed a reoccuring theme in our discussions regardless of the topic at hand - ANGER. The first couple of times I would talk about how anger seems to me the only emotion available immediately after the detoxification period. Addicts haven't felt anything for several months, years or decades. In fact, most of the time, addicts don't even know how to define their feelings. So it comes out as "I am mad/angry". I felt that way for about 6 months. Angry, about everything. 

We weren't really getting anywhere so I did a mini-presentation about "Anger as a Drug". It perplexed the group in the beginning..."I don't need this, I don't do this....". The presentation was mirrored after my own experiences with anger post-divorce, post-alcohol consumption, post-detox, etc. There were a few things that I liked about anger. It made me feel righteous on some level, especially when people would tell me that I was justified in my anger. There was also something kind of powerful about anger as well. Instead of feeling nervous, etc, I felt angry, full of adrenaline and....well...powerful. I felt as though I could say or do anything,

In the terms of anger as a drug, I described a slow build up of unexpressed emotions. There is a sense of irritability and annoyance with everything, not just the situation a person might be angry about. At some point, something needs to give and the anger comes out as lashing out or sabatoshing a relationship or fights with someone else. In the situation, for a minute, it feels good. The anger is getting released. There is a sense of control over something. Ahhhh......Then, just like having picked up a drink, there are more consequences and more issues to deal with now than before. As the situation defuses, now there is a sense of remorse and annoyance with self. Then, the cycle begins again, I hate what I did, I suck and now I am getting mad again....only a matter of time before the cycle repeats itself. Apparently this was a good description because it launched into an hour long discussion about using anger as a substitute for addiction. 

So, yesterday, I was angry. I have a situation with school that is leaving me short credits for a mental health licensure I really wanted. The school has been changing the program a lot and since I started there have been many changes which left me short of credits. Sadly, my school was aware of the situation last fall and failed to alert me to the situation.  I cannot take the credits I need this semester. This situation has woken up all the old grudges I have been carrying. I have been talking to my therapist about this anger. She reminded me once that my favorite DBT skill in the beginning 2010 was "Radical Acceptance". In essence, coming to a point of acceptance with a situation. Acceptance does not mean I like it or care for it. I just need to accept this situation and start the process of moving forward. In my past experiences, this skill was tremendous helpful in getting me to "move on" from a lot of things a few years ago. I used to hate when people would tell me that I needed to move on....I wanted to know "How do you do that??" Well, radical acceptance was the finally the answer I had been looking for.

Fast forward to 2014. Radical acceptance is like the first, second and third steps of the AA 12-steps. I have to do this more than once and usually on a daily basis. I wake up everyday and remind myself that I am powerless over alcohol and before I stopped drinking, my life had become unmanageable. I have to stay in the mindset of believing that my Higher Power will restore me to sanity and lastly I need to turn my will and life over to the care of my Higher Power. Apparently, except when it comes to this situation. This most recent issues drudged up a whole slew of feelings that I have not accepted yet. I have merely let them simmer under words of "whatever will be will be." Now, all those old feelings from last summer coupled with a new reason to be angry have set me in a spiral of bad thinking. (***Please note: I am not talking of relapse here. I am committed to my sobriety....). The hard part about the first 3 steps and radical acceptance, it needs to be done over and over. It's just not a one-time deal. That frustrates me, of course, I just want to have to do the acceptance-thing once and be done with it. Sadly, I can go from a place of acceptance to a place of unacceptance and allow the anger back into my life. 

That famous saying: "Resentment - I take the poison and wait for the other person to die". That is exactly what I am doing right now. I refuse to move past this anger. I feel justified. I feel righteous. I feel right. On some level, I feel like I lose that intensity if I just accept it. I feel like I am backing down from the "man" so to speak if I move on. On another level, I will have this school's name forever attached to me. It was something that I was supposed to be proud of. People will always ask about my education, especially in this field, etc. I just don't feel proud about this experience. I feel angry. I feel justified and righteous. I just do not want to give it way, not right now. In the stage of change, I know that I need to change but I remain in this pre-contemplative standpoint. I know there is a problem. I know what I need to do to fix it or at least attempt to fix it...and quite frankly...not even remotely interested. Nope. No thank you. I would rather sit in my little corner and wait a little longer to see if the other person suffers. Meanwhile, I sit in the corner and suffer under the weight of my own thoughts. 

Let me start off this blog entry with one statement: I love my therapist. I hadn't seen her in a while. I popped back in this week per the request of my doctor. It had been 9 months or so since I saw her last. In giving her the fast and nasty summary since I withdrew from school in May, I realized a few things. Yeah, I kinda have a lot of stuff going on and, wowser, I am one pissed off little lady at the moment. 

Here is the brief synopsis provided to her: 
1. Withdrew from school - very mad, very angry, still holding a major resentment that I refuse to give up on.
2. 5 year relationship with my significant other terminated - had a complete lack of closure and one small form of communication since August. 
3. Dating disaster - losing my faith in humanity among other things
4. Stopping attending classes regularly, stop attending my internship regularly, started to have negative thoughts that were starting to feel oppressive. Called in, got a medication change, couldn't afford to make the medication change until January. Holidays were actually good.
5. Thought after the year started, things would start getting better. I pulled the bad habits in from last semester to this semester. Missing days of internship, not going to class when I probably could have made it.
6. Walk on to the campus and have such a miserable and nasty attitude, I can make the world around me miserable. 
7. Went on a trip to Honduras that has majorly confused my sense of self. 
8. Feeling conflicted at my current placement.
9. I feel like I might have made a mistake in pursuing Addiction counseling.

Needless to say, she told me that she would see me next week and it was important for me to remember what I have learned in the past and start getting into intervening on myself again. She gave me a diary card. I had to fill these out weekly for over 2 years. I guess I didn't really miss thinking each day about everything. But, in a weird way, I was totally happy to see one again. It reminded me of a time when I felt more confident and happy than I do now. She commented "you have a heavy sense of anger and resentment, and while there is a lot of reasons for that, there feels like something bigger is going on....". I agreed and I told her that I was having a difficult time putting my finger on it. 

On the way home, one of my favorite Tool songs came on the radio - "Schism" with my favorite verse:

There was a time that the pieces fit, but I watched them fall away.
Mildewed and smoldering, strangled by our coveting
I've done the math enough to know the dangers of our second guessing.
Doomed to crumble unless we grow, and strengthen our communication.

I suspect that Tool probably wasn't thinking of a female recovery alcohol who is struggling with a sense of self-identity. I have no problem interpreting the lyrics for me, of course. I do know that the pieces of my life fit together. I have actually seen and experienced them all pulled together. I do feel like that puzzle has been falling apart over the past 9 months. I have also done the math enough to know that danger of second guessing myself. AND, I also know that everything starts to fall apart when I stop communicating. So, whether it was their intention or not, I believe this song to be a good reminder to myself. I believe very much that my Higher Power threw that song out there to raise my consciousness some.

I have Philip Seymour Hoffman on my mind still. He was sober for 22 years and just relapsed in the past year. It started with a drink in celebration and ended in his death. I am reminded of a statement I heard in one of my first AA meetings. "30 seconds, 30 days, 30 years, we are all the same distance from the ditch.....just one drink" or one use of any drug. In the remote parts of myself, there is still a wish and a desire that I could drink again. Fortunately, I am strong enough in my belief to know that will never be possible. I try to remind myself of all that I have and all that I can do with sobriety. It doesn't make sense to pine over 1 thing in the world that I can't have. 

I am interning full time this semester. I am struggling in this internship. I am having a huge crisis of confidence. I am finding all that I don't like about my selection of career right now. I talked at length about this my therapist. She was able to get me off the ceiling. Another verse from this song:

I know the pieces fit 'cause I watched them tumble down
No fault, none to blame, it doesn't mean I don't desire to
Point the finger, blame the other, watch the temple topple over.
To bring the pieces back together, rediscover communication

So, like the last time I met with my  therapist all those months ago, I know that I have some work to do. I prayed for a long time last night that I have the strength and more so the desire to let my resentments go. This whole last week in my internship we have been talking about anger and dealing with it in an appropriate manner. Talk about one of those moments that I was talking the talk but not walking the walk. I will continue to do what I tell others to do. It's only fair. I also know it works too. I ask my clients every day to take direction and do what is asked of them. I, today, turn that same advice over to me. I will do as I am asked. I also need to quiet down my anger some. I believe that I am blocking the conversations I normally have with God. After feeling such an intensity in my trip to Honduras, I feel like that relationship has receded and I am a bit lost. I am losing my trust in my fellow man which is such a 180 degree turn from where I thought I once was. I am carrying a certain amount of hurt and skepticism that  I didn't have even 6 months ago. So much has changed in that six months, it has changed my view on things in a way that is unknown and not full in line with what I once thought. I am not sure I like it. In fact, I can say with relative certainty that I don't like it. 

When I try to educate others about why addiction is disease, I generally see this look of, "Ummmm....OK...but I don't get it." I am reading an excellent book right now that might help me to explain it better one day. In the meantime, I have been searching around the web to find out better information that is easy to understand: http://www.addictionsandrecovery.org/what-is-addiction.html

One of the hardest for the "normies" as we addicts like to refer to you out there who are not addicted to anything, is why we continue to make bad decision after bad decision when clearly nothing good is coming of the situation. I guess that is the strange thing to me about addiction. I would wake up with the world's nastiest hangover in the morning. Spend the first two hours of work throwing up or feeling like I was going to throw up. Start feeling better after lunch. Then spend the afternoon thinking about the first drink when I got home. It was like I complete forgot how miserable I was in the morning. I would continually obsess until that first drink was poured when I got home. 

In the hallowed hall of AA, we talk about an allergy of the body and an obsession of the mind. Not only did I have a real physical allergy to alcohol (the barley and hops made me sneeze and get all stuffy), but I believe that my body and mind react differently to alcohol than that of my non-addicted friend. I kid you not folks, the idea of sitting and having a beer for taste kills me. What? It tastes horrible. Secondly, the idea of just having one? Or not finishing an entire alcoholic beverage? What is wrong with you people?? That is a travesty and you cannot convince me otherwise. Why would you waste it like that? That is how my mind operates around alcohol. Once I have the one drink, I literally cannot stop. In one of my classes, we were shown brain scans of alcoholic and drug addicts. After one use of our drug of choice, the communications between the reward center of the brain and the frontal lobe where decisions are made starts to decrease at a significant rate. Additionally, once the brain started to get the desire the chemical, the reward system lit up like a 474 airplane cockpit and extreme happiness ensued. 

These scans made perfect sense to me. I would make such horrible decisions when I was drinking. I would try to plan things out ahead so that when I started drinking I would put myself in a need to make a bad decision. Sometimes I would convince myself that I was going to drink that night. I would have maybe enough from the previous night in the house. I would change my mind and "just have the rest of that". Well, once I started, I needed more and more until I would get in the car and go to the liquor store on Lake & Chicago and try not to look at the cops in the eye because I had already been drinking. The same thing would happen if I started drinking and I ran out of cigarettes. I never thought I would start drinking and driving. I ended up doing that because I make horrible decisions under the influence. I am sure there are people shaking their heads saying "shame on you for putting others in harm's way..." I couldn't agree more. The next day and even today, I wake up thinking "How could I do that? I know better. Nothing is worth endangering the life of another person?" That is why most addicts start scratching their heads wondering how they got to the point they are. How can one liquid or powder bring me so low? When the mind is obsessed with the drug, the mind is also crafty enough to think of every justification in the book to keep the focus on getting more of the drug. The mind literally believes it is dying when the process of withdrawals starts. The dopamine levels in the brain drop so quickly and significantly, the brain is pretty sure its dying and so did I. I would shake, tremble and sweat. My stomach was in knots all the time. My head pounded and I saw sunspots most of the day. You know what the one thing that made me feel instantly better? A drink....the cycle continues.

Then enters the erratic behavior. My mind was racing with guilt and shame that I did whatever I did the night before. The chemicals in my brain were so out of whack that I could be laughing one minute and crying the next.  I would get into trouble because I still had some liquid courage in me from the night before and start mouthing off where I didn't need to. I started to cut corners at work because I was physically too tired to do everything to the best of my ability. There were a few days towards the end when I showed up for work when I wasn't supposed to be there. That was embarrassing. I was so anxious all the time and in my own world obsessing about the next drink. I was depressed. Nothing made me happy. I would be calling people all night, every night and ticking off the neighbors in my condo complex for taking out on the porch at 3am. 

So, what needs to be done in order to get into recovery. Well, that is an easy answer, just change everything. Change the way I think. Change the way I approach life. Change my schedule. Change my friends. Change my habits. Just change everything. Simple, right? I remember giving one of my patients in the nursing home some education about diabetes management. He had been recently diagnosed and wanted to understand what was going on. We talked about how the pancreas wasn't working as well anymore and his body was not able to produce enough insulin. His blood sugars would then be elevated and he had some complications from that. We talked about diet and getting some exercise. We talked about letting nursing staff know right away if he had any problems with his feet. He thanked me for all the information. About 10 minutes later, I saw him eating sugar cookies and ice cream. I went over and asked him how he thought these treats might affect his diabetes. His response "well, you are going to give me some of that insulin stuff later, right?" Same idea, change the lifestyle and the way things are perceived. It's not easy, especially when it comes to drugs and alcohol (and also ice cream for me...I love ice cream).

Look back today, I can say that I changed just about everything in my life. One of my biggest priorities was to change my living environment. I still live alone with two cats, but I could not stay in that condo. From the day I walked in to the day I stopped drinking, I had done all my drinking there. I drank nearly everyday in that place for 5 years. I went through my divorce in that place. I struggled financially in that place. I felt stress all the time, drinking or not. I needed to change my living environment ASAP in order to secure some sanity. On my way out the door for the last time, I dropped to my knees in the living room and asked God to rid this place of my demons. Please make it a happy home for someone else. I sure couldn't do it. A change in environment when a long way for me. 

The next priority was for me to get my mental health back in line. Common issues with chemical dependency and mental health are  follows:
1. Was there mental health issues prior to the starting of chemical use? To what degree? 
2. Are the mental health concerns presenting after cessation of use because of the chemical use or is there organic mental illness present?
3. Has there been permanent brain altercations because of use? If yes, medication management can prove to be difficult.
4. The brain takes approximately 1 year to 18 months to re-calibrate after the substance is no longer active in the system. What can be done in the meanwhile to manage major depressive symptoms and anxiety while the brain works to heal itself?
It was pretty easy for me - I had mental health issues for a long time. I think I suffered from anxiety from a younger age. I felt a lot of panic all the time in grade school. I know that in middle school and high school I was probably suffering from depression. The rest is history since I started my substance use in early high school. Anything that was already going on just got exacerbated when I used. Then, when I started to use on a very regular basis, it was the only thing I was using to control my symptoms. 

When I stopped, I still suffered with major depression-like symptoms. Seriously, folks, after 1 year, life took an amazing turn for the better. Before that year, it was feeling like I felt that was an excuse to relapse. "Well, if I am going to feel this crappy,I should just drink.....I still have all the same problems, but now I don't have alcohol. What the hell do I do now???" There was a lot of medication intervention, a lot of therapy and skill training classes along with treatment that got me to where I am today. I am fortunate in that I have a lot more resources that most folks. I had full insurance. I had a boss who really wanted me to DO ANYTHING to get better. I had full time employment. I had one of the best case scenarios. It still was hard to make it through the mental health stuff. Heck, I still struggle with mental health to this day. It is infinitely better than it ever was, don't get me wrong. I do need a little tweak now and then. 

The last thing I had to change was what I did in my spare time. Boredom is a huge trigger for relapse. I would be sitting and watching TV. I would drift off and get bored or be uninterested. My brain says...."you know what would make this 100x more fun? RUM!" I had to find things to do to keep my mind off of all the madness in my mind. Meeting were a good place to go. I always like going to meetings. When I walk into that room, no matter who is there, young, old, white, black, native, long hair, short hair, everyone in that room knows one of my greatest life's struggle. I don't ever have to say anything other than "Hi, my name is Julie and I am an alcoholic". After that, I am immediately bonded with everyone in that room. We share our strength and hope with each other and if it is a good meeting, we can have a good laugh about how insane we were at one point in our lives. On February 12, 2010, I walked from detox to the treatment center. The floor leader came up to me and took me into my first group. The three people next to me all introduce themselves as alcoholics....I bawled like a baby. I felt like I belonged somewhere. These people knew how my heart felt and they didn't even have to ask. They just know. Nothing in the world tops the fellowship in recovery - nothing.

Anyway, I am hoping this provides some insight to beginning in recovery. It is really hard for people to understand the behavior of an addict. In reality, the addict is confused too. That was one of my favorite parts of treatment, finding out that this craziness is part of the deal. I wasn't a horrible, dastardly human being, I was a sick human being that needed to get better. And I had to change everything to do it.

Julie  

The news is certainly flying around the internet about the death of Philip Seymour Hoffman. In what I could find about in his biographical information, Mr. Hoffman had a lifelong battle with drugs. He was most recently in rehab in 2006 and in one interview it sounded like he understood his situation as life and death. Thus, staying sober.


Often times, this is what we hear both from our celebrity friends as well as the members of AA, NA and those in recovery. In my own personal experience, I begged and pleaded to get into treatment. Three days into detox, I wished I had never done it even though I was sick and tired of being sick and tired. I did want to get well, but addiction was clouding my judgement. I did believe that I was invincible to some degree. That first round in detox, my liver function tests were relatively normal considering the amount of alcohol I was putting away on a daily basis. I was scared I was doing something bad to my health, but I couldn't see it, so my addict brain convinced me that it wasn't a matter of life and death anymore. The only death I was feeling was the agony of not using for a week. 


Mr. Hoffman died from an apparent overdose of heroin. He was apparently shooting the drug IV and overdosed in the bathroom of his apartment. He died alone in there, doing the only thing his brain felt the need to do. I suspect it was not an intentional overdose. He probably had himself convinced that he would not perish this way. Of course, I don't know any of this for sure. It is just a guess given my own addict mind and now working with so many others who struggle with this disease.


When Whitney Houston died from her drug overdose, I had read a fascinating article on LinkedIn about "Who failed Whitney?" At one point, everybody's hat was in the ring for the blame including Whitney herself. Whitney knew that she was chemically dependent and probably received her fair share of education about the possibility of death if she continued to use - thus, it was her fault. She relapsed as many addicts tend to do and there were people around her who knew it and never got her back to treatment. She wasn't in her right mind- it was their fault for enabling her behavior. Lastly, her treatment team - whatever they worked through in treatment was not enough. She did not have the appropriate tools to stave off a relapse. The treatment center was deficient in their treatment of her addiction. Sadly, I can see valid points in just about everybody's argument. In fact, I see most of these scenarios everyday.


When I look at my own course of addiction, I feel like anything that would happen to me, both good and bad are because of me. When I walked out of the rehab center after my 28 days of treatment, I did not say a word to anyone that I had absolutely no intention of staying sober. I don't think I was quite telling myself that so boldly but everything about my behavior indicated just that. I never went to a meeting. I never told anyone how I was feeling. I attended 2 aftercare groups and then stopped. I had been recommended to participate in the nursing monitoring program but never enrolled because I knew I would be held accountable and I didn't want that. Did the treatment center fail me? I don't think so. They are not there to babysit me and tell me to not drink every time I am on my way to the liquor store. They provided me education and aftercare plans based on what I told them. See, therein lies the difficulty - I had the treatment center convinced that I would be totally fine going home, mainly because I knew I lived alone there and I would have the option to whatever I pleased if I could just get back there. I had them convinced that going to aftercare once a week was going to be plenty because I was SOOOO motivated to be sober. Had I been willing to do whatever it took to be sober, I would have been honest and I would have followed the recommendations of the people who are trained to treat this disease. But I wasn't ready, I just thought I was.


When I went back to using after about 60 days, some of my friends and family knew about it. They were certainly not enabling the use and recommended that I get back doing whatever it was that I needed to do. Beyond that, the responsibility of sobriety is mine. I say regularly to clients, "I can't want your sober life for you." If you don't want to be sober, then you won't be sober. In the AA world, we ask each other, are you willing to go to any length to stay sober? It took me about 6 months after the first treatment, several relapses and a threat of losing one of the most important things to me to be willing to go to any length to stay sober. I used to complain that my monitoring program took away the choice to drink. No, I still had a choice, I could still drink if I wanted to, I was just going to have to play a game of russian roulette to see if I got caught. If I did, I would have to decide that the benefits of drinking outweighed the severity of the consequences if I got caught. 


Back to Mr. Hoffman....it is so sad to see talent like this die from a heroin overdose. From what I hear from people, heroin is back on a resurgence because of the opioid epidemic. Opiates are basically synthetic heroin. The pills on the street are expensive and heroin is not. People end up changing over to heroin in order to sustain the high AND be able to get higher for a much cheaper price. In Minneapolis, I have seen reports that the heroin here is stronger and more potent than anywhere else in the country. People are getting addicted faster and they are dying at a more rapid pace because of it. One former drug dealer told me that when the suburb kids come into downtown to score for the weekend, he will offer one "free" bump on the house in order for 1 more kid to get addicted. He told me the extra bump paid off almost all of the time. Someone who was not even going to buy any, tries and becomes instantaneously addicted. Just more business for him. I don't know if the story is the same in New York, but when people are buying stuff off of the streets, there is truly a threat that the drug could be laced with something, additives are used, etc. Every time there is a risk that this is going to be bad dope, no matter how much you trust your dealer. Or, tonight might be the night, in a stupor, you decide that you need one more bump before going to bed. Without even realizing how high you already are, you inject more, alone and there is no one there to save you. 


What breaks my heart the most about overdose deaths is thinking about how lonely this person must have felt. Sitting alone, in a room, doing the rituals around the use. There is only one focus, one end product, one thing to do to. The action is done, a moment of euphoria and then life turns back to the chase to get the next high. Most addicts will tell you that they are frustrated and annoyed with this lifestyle but don't have the ability to change the pattern of behavior, not to mention access to help is completely limited. If you are out chasing the high, there is not way you are shelling out money for health insurance (which probably won't pay anyway). Most ERs are too over crowded these days and people don't get admitted for help. They will get some drugs to sooth the side effects and get discharged with the recommendations to get help somewhere else. Most of the time, addicts at the final stage of addiction literally have nothing left. No home, no job, no family, no friends. The drug is truly the only friend and probably the worse enemy. My final days of leading up to my last detox, I prayed to God every night to die because that kind of loneliness was just too much to bear. Alcohol no longer was working to fill the emptiness and hopelessness that I felt. I wouldn't wish that pain on my worst enemy. I know that pain and even though the last time I felt it was 4 years ago, I remember very vividly how that felt. I wonder if this is how Mr. Hoffman was feeling in the past few days. 


So, who fails the addict? Who needs to take responsibility for relapse? Who has to bare the brunt of blame for someone dying with 3 young children and a boat load of unused talent? Maybe it is just a little bit of everybody. It's too hard to say. Too many unknown details quite frankly. Heck, the news wasn't even reporting a cause of death until the friend that found him started talking. Immediately, however, when I saw his picture and his age, I knew it was drugs. He looked so aged in his photos. He has the look of a well-fed heroin addict. His eyes look tired. It is sad that we lose so many people this way. I wish I had the answer. 50% of the people who leave treatment have success staying sober. It take an average of 5 treatments for people to stay sober. That's a lot of people who risk life and death everyday from relapse. 


Here is the lesson - get help. Don't die this way. You don't have to.....


Julie

One of the things I found interesting about my trip to Honduras was feeling light I had spotlight shining down on me. While I would like to attribute that to my raging beauty, it had much more to do with obviously being American and dealing with the assumptions that come along with that. I have a whole new appreciation for being a minority and feeling like somewhat of an outcast. Not to mention a reminder (as I had been through this once before), how hard it is to function in a place when I don't know the language. I forgot about how frustrating that is and how my pride tends to ache when I have to ask someone else for assistance. Not to mention my pride twitches in having to say "I don't know" or "no comprende" as the case may be.