It my new job I am doing a ton of program development in these first few weeks. I need to do seven weeks of relapse prevention counseling. At first I thought it was going to be difficult to fill that much time. Oh, low and behold, it is not that tough. There is a lot that goes into relapse preventions - mainy every single bit of recovery plus some.

I logged on today to renew my membership for another couple of years. Happy Anniversary to Grateful for Recovery.com! :) One whole year.....I realized  upon logging in that I have not been on here blogging for almost a month now. Wow. Where does the time go?

This month has been another learning experience in the world of recovery. Since getting sober, my career has been all over the place and mainly because of me. I am coming up on 10 years in the nursing field this winter. I have been back and forth, up and down with all sorts of employment throughout those 10 years. While I have been at the same place for over 5 now, I have still had a variety of positions. Nights, days, part-time, full time and now I am working from home. The working from home part has probably been my favorite. I get a lot of work done and I have my own project. No one else's fingers in my pie, so to speak. I just had a meeting with my boss this last week. It was nice to see the old place again. My name tag still hangs on my "former" cube which was probably one of the worst spots in the whole office. Got some hugs and HIs from people I haven't seen in a while.

I entered the LADC world in May and it is turning out to be much like my experience in beginning nursing. Lots of uncertainty plagues my day. I try to remember what it was like in early nursing, but I think those memories of the real trials in the beginning have faded somewhat. I believe that I feel more uncomfortable right now. Maybe because I feel like I should know more or being doing more. Who knows. Like my nursing career, my first position started from another arrangement. When I started my first nursing job, this facility had hired me as a PCA and I was to take over the nursing area for a series of group homes when I was done with school. About 2 months in, I couldn't handle it - I felt too unprepared and had absolutely no answers when people would call the triage line for help. Heck, two weeks before my first call, I was the one calling the triage line for help. I had a great boss who tried to mentor me as much as she had time for. Ultimately, it was not enough for me and we parted ways. 

With my first LADC position, I started as an intern with 2 or 3 clients. No treatment planning, just some groups and a few individual session.. I was hired to be an outpatient counselor and hit the ground running. Before I knew it, I had 12-14 clients, working part-time, feeling extremely overwhelmed. I have to admit my attendance was not great at this position. I became overwhelmed and was struggling with a crisis of confidence. The crisis of confidence was starting to effect my health in pretty bad ways. I was constantly tired, I couldn't get out of bed. I was up all night and needing to sleep during the day. I started relying on fast food as my primary source of nutrition. The weight keeps piling on, I have low energy and my nerves are shot.

I was offered an opportunity to move to a different area. I accepted the transfer. It was a huge mistake. Maybe I wasn't doing so bad in my previous spot. I had to put in my notice and leave under less than ideal circumstances. Again, I had a wonderful boss who was attempting to mentor me the best she could. I think I was too broken there to get back on feet again. I didn't like who I was becoming - enterally negative, self-critical and quite frankly - depressed. There were no medications that could save this situation. For my sake, I made a heart-felt plea to leave and my boss was very gracious to me for a rather untimely and abrupt departure. Ultimately, my physical health was suffering and I can say that my mental health was not doing well either.

I have started working at a new facility now. I am on straight days. I worked really hard to change my sleep schedule the week before I started. Guess what I noticed? A normal sleep pattern does wonders for someone's mental health. I am tired but not exhausted. I can fall asleep without the aid of any sleeping medication. I sleep for 8-9 hours and naturally awake a hour or so before my alarm. I dropped 7 pounds from just bring my lunch and not being bed-ridden all day. I am active and more engaged. I know it has only been a week but what a difference. 

I still carry some of the crisis of confidence with this new position. I wonder if I really do know anything. I know that I do, it's just hard being in a new field. I try to remember back to 2012 when I started the processing of returning to school. What was that all about? What was the passion? What was the desire? It's still there, the passion just needs some dusting off after a very difficult summer. I suspect this time next year, I will be looking back on these struggling entries and tell myself "geez, you just needed to give it some time!"I am hoping to restore some of patience with myself again.

During all this chaos in August and September, it did help me look at a few things in my life and what I want to do. I started writing my book. So far, I have started out with a history of my addiction. I am finding that to be something more therapeutic than a book. It dawned on me last night.....maybe this book should be about all the research I am doing about gastric bypass and the unintended side effect of altered alcohol metabolism - aka people are turning into alcoholics at twice the rate of the general population after gastric bypass. Hmmm.....my TED talk will be for 15 minutes, but maybe there is much more I can do with the wealth of knowledge I am collecting at this point. Not that my story doesn't have value, there is just something more I want to say. There is something more I want to accomplish with a book. I will keep you all posted.

Additionally, I am working on starting my own private practice. It will be a year or more before I have the means to get really started. However, with all the work experience in nursing, etc., I have found that I do best working in an independent setting. When I worked nights with the transplant center, I walked in motivated and always got my work done. I enjoyed solving problems and gaining knowledge. I built that position from the ground up and it was probably one of the best jobs I ever had. My self-motivation has been low since leaving school. Heck, I would say that my self-motivation was lacking for about 6 months prior to that. I got lost somewhere. Starting up my own business, working under my own rules (and the licensing board of course), I feel like I would have the opportunity to do specifically what I want. On my time. On my terms. Build it from the ground up. I am not afraid of hard work. This just seemed like the right direction to move right now. 

In my MIA status, life has been chaos as usual. I have worked hard to see the silver lining in all of this. There is one. It's just difficult to see in the middle of everything. I am seeing the sunshine again. Sleeping at night is always helpful for that one. I just feel more positive and less stressed by life right now. I am tremendously busy - working on the business, working as an LADC, working as an LPN from home, volunteering for two organizations, getting ready for my TED Talk. Ironically, this is the most relaxed I have felt since leaving school. I think I was in a survival mode for the past 4-5 months. I was getting by financially. I was getting by with my work. Just getting by....Just getting by isn't enough. I have never been happy living like that. My drinking days were all about getting by....working enough to afford to drink. Doing the minimum to not get caught. Just skating by. I wanted a different life than that and that started the journey of getting sober. Four years into this new life, I was starting down an old path. While I was drinking, on some levels I really felt like I had started again. Some of the same feelings and the same actions. I would call the last 4 months an emotional relapse. I was thinking about it. The Cons well outweighed the benefits but I was letting my mind wander down that path. "What if...." 

I am no longer there and back in the groove of recovery. Actually, all this program development has been helpful to see all the tools and recovery assets I know and usually employ in my own life. Although I hadn't quite fallen off of the wagon, I feel like I have been hoisted back up in the front seat again. I was starting to look at the ground....it was getting closer and closer....but now I have my eyes back on the road again. God is still driving the wagon though. If I were to take the reigns full I would be in the ditch in no time. :)

When I started going to school for addictions counseling, I had a dream and a desire. Much like when I started nursing, I wanted to help people. Nursing, I did because I saw all the awesome nurses (my Mom included) who took care of my Dad when he was battling cancer. I wanted to be one of those people who sat by a patient's side, helping them get better. 

Once I got into the thick of things with nursing, I was quick to realize that things out in the real world are much more difficult than that romanticized version I was playing out in my head. I walked on the floor to find a 3 hour med pass, 30 patients, detached and disillusioned staff and my dreams of being "that nurse" fading into oblivion. I made a promise to myself, however, no matter how bad things got, I wanted to be a good nurse. I did that, for the most part. 

I think I had the same vision with going into addictions counseling. I wanted to help people get into recovery. Living a life of addiction is so lonely and hard. I wanted to be out there educating about addiction, helping people find resources. Well, I have hit about the 5 month marker in the field and I believe I am having a bit of a "nursing" moment now. I am realizing the reality in the world of addictions counseling. It's a bit of bitter pill to swallow. Fortunately, I made the same commitment to myself in this field as well. No matter what the scenario, I will do the best that I can. 

It's a good thing that I am feeling more steadfast in my beliefs and values than I did when I first started school. In early recovery, I was very much interested in finding out who I really was. The alcoholic Julie was a basketcase on good days and raging mess on bad days. Now that life wasn't like that anymore, who is Julie? Just an alcoholic? Just a nurse? Just a human being without a path? It took a full year of soul searching and reading to figure out that sober Julie is going to be force to be reckoned in all the right ways. I was going to take the addictions world by storm and make a difference. Grad school was the first stop to making this happen. Now what?

For the first time in my paid career, I found that I am at ideological different place than many in the addictions field.  I was a bit naive to think that my ideas and conclusion were that of all other professionals in the field. So, I want to have a frank discussion about the one thing I will not budge on when it comes to the discussion of addiction. Addiction is a disease of the brain. 

I wrote a blog while I was in grad school about the disease model. I really felt that by giving addiction the title of a disease was kind of a cop out. It absolves the addict of responsibility. "I have a disease I can't help it." A few years later, I believe I have solidified this belief 100x over. Yes, you have a disease, but, YES you can do something about it. Why is addiction considered a disease in the first place?

In really basic terms, the brains of addicts process drugs and alcohol different than our friends we all "normies" in addiction-land.  In more complex terms, please follow this link below - gets really nitty gritty on all the science. 

http://science.education.nih.gov/supplements/nih2/addiction/guide/essence.htm

The imaging between addicts and non-addicts shows fundamental changes in the way the brain processes things. The "reward" area of the brain becomes corrupt. The reward center of the brain is a primal part of the brain. If you ever watch Celebrity Rehab, Dr. Drew put it nicely "The brain actually believes it is dying without the drug...." which makes it pretty hard to stop.
 "How Does Addiction Take Hold in the Brain?
The rewarding effects of drugs of abuse come from large and rapid upsurges in dopamine, a neurochemical critical to stimulating feelings of pleasure and to motivating behavior. The rapid dopamine “rush” from drugs of abuse mimics but greatly exceeds in intensity and duration the feelings that occur in response to such pleasurable stimuli as the sight or smell of food, for example. Repeated exposure to large, drug-induced dopamine surges has the insidious consequence of ultimately blunting the response of the dopamine system to everyday stimuli. Thus the drug disturbs a person’s normal hierarchy of needs and desires and substitutes new priorities concerned with procuring and using the drug.

Drug abuse also disrupts the brain circuits involved in memory and control over behavior. Memories of the drug experience can trigger craving as can exposure to people, places, or things associated with former drug use. Stress is also a powerful trigger for craving. Control over behavior is compromised because the affected frontal brain regions are what a person needs to exert inhibitory control over desires and emotions.

That is why addiction is a brain disease. As a person’s reward circuitry becomes increasingly dulled and desensitized by drugs, nothing else can compete with them—food, family, and friends lose their relative value, while the ability to curb the need to seek and use drugs evaporates. Ironically and cruelly, eventually even the drug loses its ability to reward, but the compromised brain leads addicted people to pursue it, anyway; the memory of the drug has become more powerful than the drug itself."
~http://science.education.nih.gov/supplements/nih2/addiction/guide/essence.htm~

I did believe for a short while that calling addiction a disease took away the responsibility. However, it really does not. If I have a bum pancreas or heart, I have a disease right? The doctors are going to give me all sorts of medical, physical and dietary changes to combat my issues. Eat better (healthier, less carbs, less processed food), start exercising more, stop smoking and/or drinking, reduce stress. You want to know the ironic thing? These are all the things we will tell a newly in recovery addict to do. Among other things like support groups. Diabetics have support groups. Cancer has support groups. Not many people make fun of those on TV, just alcoholics. They have "funny" traditions. We ask our addicts to make life changes and just like diabetes and cancer and obesity and organ failure, and, and, and there is a lifestyle change that needs to happen in order for the condition to improve. 

So, I have a lifelong condition that needs daily monitoring. That description could really be any disease. Just recently, I have been in contact with folks who are not interested in having the discussion about addiction as a disease. Not really into the whole "disease"thing. My thought is to present the information we have and let the client decided what they believe. There is always more than one way to view a condition. My questions usually to the non-addiction-as-a-disease crowd - then what it is? Mental illness has been proven over and over to be a chemical imbalance of the brain. That falls under a disease to me. So, if you call addiction and mental illness (which I also believe this too) we are still talking about a disease. With mental illness the same lifestyle changes are request in conjunction with medications. Less stress, eat better, get exercise, be a routine in order to minimize exacerbations of a mental health condition. 

I would hope as a society, we have turned away from addiction as a moral issue. Although, that is probably very wishful thinking on my part. There are still lots of whispers when someone says "I went to rehab...." AA had the hopes of getting people to understand that addiction was not a moral failing. It doesn't affect just one "type" of person. Rich, poor, celebrity, guy under the bridge, mothers, fathers, sisters, brothers, presidents....anyone can suffer from addiction. I think we are slowly getting there in helping people understand what is going on when someone becomes addicted to drugs and alcohol. Because people addicted to drug engaged in amoral activities, it is easy to assume that there is something "morally" wrong with this person. If you talk to an addict though, they will often say "I never thought I would do something like that. In the moment, I just went with it because I thought it would make me feel better." I had a line in the sand that I was never going to drive drunk. Well, I crossed that barrier 4 years before I stopped drinking. The only time I drove drunk is when I needed more alcohol. The idea of sitting the rest of the evening without liquor versus driving to the liquor store 10 blocks away? Liquor always won. I was a woman under the influence. I made stupid and bad decisions. If you had taken a snapshot of my brain when I was making those decisions, I believe that my "business brain" would have been dark as midnight. I am a moral failure? I sure felt that way the next morning and drank even harder the next night to quash the guilt I felt, only to promise to never do it again. Then when it happened again, I just cycled out of control. 

The shame of thinking I was a moral deviant kept me from getting into treatment. I had this idea that the world was going to hold me back once I admitted I was, indeed, an alcoholic. I was truly shocked when I got into treatment the first time to see this whole list of things that people do when they are addicted. There was an established pattern of behavior associated with addiction. I had done everyone of those, for sure. I was out of control and that was because I was stuck using. Once out of that pattern, I had the opportunity to make different and better choices. I am not a bad person. I am a person with a disease. I choose to follow my brothers and sisters before me to do something different. I manage my disease. I just will not back down on my stance that addiction is a disease. It is one of the many incurable diseases out there.  However, we, as addicts, have a much better chance at living a long and prosperous life. In order to get to that life, we have to understand what brought us down in our addiction. It is not that you are a bad person, or that you are a person with no will power. You are not weak willed or stupid. You are not your addiction. If you keep using and search for no other lifestyle, you will surcumb to your addiction. I was well on my way to drinking myself to death. For those of you who cannot possibly conceive why person would do this? You don't suffer from addiction. The idea of a life without alcohol was so terrifying that I would protect my relationship with it over all other things. 

The journey is not easy, but let me tell you ~~ You have a disease that can be managed. In the past four years, I have done more positive things for my life than the previous 18 years combined. I have released active alcoholic Julie into sober Julie, proud recovering alcoholic with a serious agenda. Before the "normie" get out there and tell us everything is wrong with us, please do your research.

I was giving a lecture this morning and I was talking about a fearless moral inventory that those doing step work do as a part of cleaning house. In the fourth step of AA, "we made a fearless searching inventory". I think one of the many benefits of doing such a step is get all that garbage off our souls so that we can really restart our lives. Many people worry about this step. Lord knows I did. What happens if I start writing down my resentments and I can't ever stop? What I face all my behaviors and find out that I am the absolute worst person the world has ever known? So typical of the alcoholic in me to think that everything about this process is only about me. My clients today were quite fixated on worrying about it, much like I had. 

I was reading something recently and in this little internet blurp, I saw the following statement, "If worrying worked, your friends would advise you to just do that....." Worry is such an interesting phenomenon.  Before I stopped drinking, I worried about EVERYTHING. Worry seems to be an attempt to control an environment. I worried about what other people are thinking about me - mainly because I need to know if they know what's really going on here. I would also worry about the past and the future. I would worry that I wasn't responsible for something in the past and then worry about how not to do the same thing in the future. Worry, worry, worry.

In the first year of sobriety, I would have to say that my level of worry didn't really decrease. I still worried about everything my monitoring program.  I worried what others would think of my addiction. I worried if I was going to be able to make it the rest of my life without drinking. I would worry about about tomorrow and if I would have to provide a UA. I would worry about pretty much every action I took in my job. 

The only thing I can think of that moved me past the bulk of the worry was going through some acceptance. Step 3 was made for worriers. "Made a decision to turn my will and life over to God (as I understand Him)". Most people see this and roll their eyes about the whole "God"-thing. I know I did. In fact, I worried about having to "give it all up". I think it is pretty common with most alcoholics and addicts - we like to control things. We are, by no means, any good at it, but we sure like to try. Back in Step 1, I admitted that I was powerless over alcohol and my life had become unmanageable. I don't think I really understood what Step 1 was after until I got to Step 3. See, I really understood that I was powerless over alcohol. I proved that a million time over. When I got to Step 3, I realized I didn't really believe that my life had become unmanageable. In my powerlessness over alcohol, I still had a job, owned a condo, had income/money, no legal concerns,  a boyfriend. How is that unmanageable? However, I worried about each one of these all the time. I was always on the the brink of losing it all. If I got busted for drinking at work....well, there goes the house, income, money......Get pulled over for drunk driving.....there goes the clean legal record and enter all the issues of likely losing my job over it. 

Once I finally came to acceptance and my life was actually unmanageable, this paved the way for me to look at "turning it over". As a quick note, Step 2 was a pretty quick one. I believe in God. Step 2 - Came to believe that a power greater than ourselves could restore us to sanity. I think I did step 2 before totally getting step 1. I believed in God. God was a way better bet than anything else as far as my recovery was concerned. Anyway, so acceptance came around about Step 1. My therapist in my early recovery used to constantly ask me: "Can you do anything about it?" If the answer was "yes", then let's look at the course of action. If the answer was "no", then it was time to let it go. I ran around after my first inpatient treatment asking everyone "how do I let it go? Please tell me! How do I let it go?" I wanted a one-step movement that would facilitate "letting go". As I worked the steps more, I realized that acceptance was going to be the only key to letting go. In addition, I needed be able to throw that problem somewhere once I accepted it. Thanks, God! He's got this one. 

Let's take a hard example in early recovery. My divorce. I had lots of intense feelings around this event in my life - disappointment, death of a dream, resentment, anger, abandonment, feeling worthless and unlovable, cheated upon, ignored, sad, depressed, anxious, worried about finances, worried about the future.....Hopefully that give you some insight into the complexity of divorced - remember I asked for the divorce. I walked into my second treatment, desperate to let this divorce go. I was 2.5 years post divorce at this point. The sad part is, I never dealt with it, I was just drinking away the pain. I kept asking in class - I want to let go of this, how did I do it? I was instructed to "accept" the divorce and all the associated feelings and let it go. Since I believe in the Steps, I was encouraged to give it all over to God. I was constantly digging a hole with all these feelings. My therapist told me to stop digging. Allowing myself to re-experiencing the same feelings every minute of every day, I will start living there. Getting outside of myself and giving it over stops the process of digging, gives me the best chance of getting to acceptance. It finally happened about a year into recovery. I just let go. I let go of the pain, I let go of the negative feelings. All of a sudden, my whole body and soul relaxed. 

My worry also decreased substantially this time as well. Around a year, I was finally able to start living in the "NOW". In the last 4 years of my drinking, I was living in the past all the time, trying to figure out how I could change it all. In the first year of recovery, I was both living in the past and future. I lived in regret of the past and in total fear of the future. In the past 2 years, I have been working on trying to stay in the present and not get myself worked up about the past or the future. Today, I would have to say I am a little worked up about the future. The things I am working on, however, are things I can take action on and I am doing that. I am still reminding myself to come back and live in the present. It is so true, living in the past or the future just makes me miss all that is going on right here, right now. 

In regards to Step work, I worried the most about Step 8 & 9 - the steps of amends. I was so worried who I was going to have make amends to and how I was going to do that. Was I going to have to go back and say "I'm sorry" to people I don't really feel like saying that too? So, meanwhile, I am worrying about all of this, I am not at all focused on Step 3 - give it over. Just GIVE-IT-OVER. Can I do anything about it? No, not right now. Then just give it over to God. Is there anything I can do about it at some point? Yes and I will seek guidance when that time comes. Even before I started LOOKING at getting sober, I had decided I was too worried about the God aspect of the steps, Step 1 - I didn't want to admit anything and about the amends steps. So, even before I was looking at Step one, I was already concerned with steps 4-9. I don't believe that I am very unique  in my experience. The alcoholic mind will do just about anything to save the alcohol and abandon recovery. Worrying about step 8 when I haven't even considered step 1 is the perfect way to get myself overloaded and overly concerned. Oh, alcoholic mind, you are something else. 

When I talk to people who have relapsed after long periods of sobriety, one of the universal comments I hear attests to the essence of worry. People will talk about not going to meetings (where we are reminded all the time to give it over), taking control back and attempting to control life. When a person starts to take control back, it is so overwhelming. Think of all the little things in life that we can't control. I can't control the stoplights, the person driving in front of me, the weather, the time the mail comes, someone else's decisions......As alcoholics, when we start down the path of relapse, one of the first things we tend to do is try to control all of these things. We get heated about the red light, we are honking and screaming about the driver ahead, cursing God because its raining, acting annoyed at the mailman for coming at a different time and complaining about consistency, offering excessive amount of advice to a friend trying to convince them to change. Instead of letting go and keeping an open mind, the mind turns inward. Instead of looking at life from a worldly position, the mind focuses on how the world is attempting to screw me and only me. Yanking that control back (remember - I commented earlier, addicts and alcoholics are poor at this...) is a recipe for total disaster and leads right back to the bottle. We get a case of the "F-its" and decide that there is not one positive thing left in the world, so I will just drink. When people relapse, that is why the shame and guilt is so overpowering. It's a selfish decision and deep down, when it happens we know that what we are doing is totally selfish. There are 1.5 million other beverage options and all I am doing is focusing on the 1 that I can't have. 

Anyway, I have had some worry in my life recently. I am working diligently to turn it over and make some changes in my life where I can. I am using some of the worry to help continue my motivation to continue to working on some projects that I started a few months ago. When I start to complain in my mind about job related things, I always remind myself - THIS, yes, this I can change if I want to. Not really on the job hunt so to speak, just working on some other angles to help myself. 

Hope all is well out there!
Julie