Listen Share and Pray
‘When working with a man and his family, you should take care not to participate in their quarrels. You may spoil you chance of being helpful if you do. »
When trying to help a fellow alcoholic, I’ve given in to an impulse to give advice, and perhaps that’s inevitable . But allowing others the right to be wrong reaps its own benefits. The best I can do ….and it sounds easier that it is put into practice….is to listen, share personal experiences, and pray for others.
I remember well meaning individuals offering kind suggestions. The difficulty is that they didn’t realize the depth of betrayal I’d experience of myself and with others. I simply did’t trust. I trusted God but those closest to me had abused my trust. I was at that point quite frankly paranoid. In the sense that schizophrenics are delusional because of the depth of their anxiety and alienation so are addicts and alcoholics however they appear normal at times and can hide the insaniety brewing beneath the surface.
Motivational therapy is the treatment of choice today for addition. It first says listen. It says identify the ‘stage of change’ the addict or alcoholic is at . The first stage is « precontemptlation’. In precontemplation stage the individual is in such depth of denial they reject even the suggestion of a problem and become angry with anyone or any discussion of their ‘problem’. Their problem is ‘you’. They don’t see any reason to change, The problem is that others need to change. Others need to cut them some slack, get off their backs, quit bugging them. Others are the problem, not them.
Contemplation phase is different. In this phase the person might accept there is a problem and they might even consider they may be doing something wrong. They may think they drink too much or that drugs aren’t helping. They aren’t ready to change but they are open minded enough to consider the possibility that their best friend and solutions, drugs and alcohol and those who use them might no longer be helpful. Before Prochaska and others studied Motivation it was found that government funding and intervention immensely wasted and counterproductive because it was aimed at those in ‘precontemplation phase’. This only entrenched alcoholics and addicts against change. The timing of intervention is critical in addiction and when the person shows openness to the idea of their use of alcohol and drugs being part of the problem that’s the time when it’s good to simply off solutions. Persons’ in the ‘contemplation phase’ welcome being given ‘literature’, ‘invited to come to a meeting’, offered a phone number, advised where rehab and detox centres are. They are like people who say they were thinking of having their house painted so don’t mind hearing what’s out there but don’t want anything onerous or involved. Just offer them information and be prepared to follow up at some time.,
Determination is a critical time and distinguished by the person admitting they have a problem and committing to making a change This is like the smoker who says they need to quit smoking and say they’re going to fo it in the spring. This is the time to offer time and resources to assist the person in getting to the next and most critical phase. Unfortunately many alcoholic and addicts with talk ad infinitum about needing to quit and planning to quit but the rubber never seems to touch the road. When it does that’s the time to pull out the stops. In the past those who cared had wasted endless energy on those in the precontemplation phase they were angry by the time the person actually was determining to make a change. Listening carefully to the alcoholic or addict is the key to identifying the fundamental changes
The Action Phase is evidenced not by talk but by action. The key statement that came out of the AA experience was ‘if you talk the talk, walk the walk’. Action is evidenced by a number key actions. The first was attending a meeting of AA. Today people can attend a meeting of SMART or any of the faith based and secular ‘group therapy’ meetings. The corner stone of therapy for addiction is the group. Social anxiety is central to addiction along with shame and dishonesty. When a person is actually in the action phase they will literally leave their basement, pub, crack house, drinking and drugging friends and join a group of people who have and are leaving the old world for the new. These are the people who don’t just talk about exercise but actually go into the gym and buy a membership. In the action they admit they have a problem and need help. Other major actions are going to a clinician and saying they have a problem with addiction or alcoholism and asking for help. There’s going to a Detox centre. The action is picking up the phone or going to the building and asking for help. There’s calling the rehab centre and speaking to intake and then attending.
This is where resources need to be focussed because this is what the person is truly ready and making an effort to change.
The success of treatment for alcoholism and addiction is truly amazing if the person had a job and family in tact. Too commonly people have looked at addicts that are homeless and on the street and not seen the success of treatment because of these few individuals who have end stage disease. It would be like saying cancer can’t be cured. Every day cancers are being cured if caught early. Countless skin cancer and cervical cancer and breast cancer and even lung cancers and brain cancers are cured routinely because they are caught early and treatment is initiated. In the past early diagnoses and treatment wasn’t available and people avoided seeking help for a lot of medical conditions, many of the worst known, because we screen for them and treat them early. Pilots and doctors have a 90% success rate in treatment of alcoholism and addiction because their conditions are recognised early and treatment is initiated.
The Gold Standard Navy pilot program involved 30 day in patient treatment followed by 3 AA meetings a week and monthly meeting with a psychiatrist and counselling as needed resulting in 80 to 85% of pilots remaining sober and clean and flying 5 years later.
That’s like the success with early detection and treatment for Tuberculosis and Diabetes. These used to be lethal diseases and still have major complications at end stage but the life expectancy in the past was at 20 to 30 years but now is 60 to 70 years. Alcoholics used to die 10 to 30 years younger but now are living out their lives. Heart disease, lung disease, liver disease, hypertension and various cancers were all often caused by addiction and alcoholism but now are recognised as treatable life style diseases. The longevity research show now that the greatest thing individuals can do to improve the length and quality of their lives is simply to quit drinking and smoking.
People change, Addiction and alcoholism are diseases that are curable. Abstinence is the treatment of choice and AA remains a cornerstone of long terms success. Not surprisingly it was called the ‘miracle of the 20th century’ because prior to the 1930’s alcoholism and addiction were a deadly scourge akin to the various infections that were treated by the introduction of sulfa and penicillin.
Today we also have ‘harm reduction’ therapies for those in the determination phase of change but still ambivalent about abstinence. I liken them to those who are told that surgery is the solution to their hip disease but want to do physiotherapy and exercise first. If that works great. In medicine clinicians want success and realize that scientifically there are superior treatments so that we describe efficacy of therapy as ‘primary’ , ‘secondary’ and tertiary.
Because of the insaniety associated with addiction and compulsion and obsession often an addict will think that if only they don’t use heroin in the afternoon and limit their use to the morning all will be well. It’s important for others to listen and not argue but to explain what indeed has been proven to be effective in the same way as we’d not agree with a dying man that using a salve on his bullet would will be sufficient. We would recommend taking the bullet out and treating the would with antibiotics instead. Of course if he wants to try his salve and lotion first that’s okay. Insurance companies and governments and jobs won’t usually support these subjectively appealing but objectively questionable solutions yet it never helps to ‘argue’ with insanity.
I prefer to pray myself.
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