CAA Meeting - Jane Hall

The Canadian Author's Association, Vancouver Branch held their monthly meeting, chaired tonight by poet, Jean Kay. I've expressed my suspicions about what shifty characters authors are. Well, the proof of this was evident tonight. The RCMP finally sent a spy to keep an eye on the lot of them, especially Bernice. Bernice Lever is an editor. She's kind of a talent scout for publishers and we all know how shady those characters are. Jane Hall was the RCMP woman. Amazing what this world famous force will do to infiltrate an organization. The RCMP clearly figured they needed an authentic author. Jane must have been a volunteer. She admitted tonight that she spent 8 years writing her book, The Red Wall, a woman in the RCMP. She had to spend another year re writing it. It's the first book by an RCMP woman about her time in the force. Creative Non Fiction, she called it. "Like Farley Mowat but I didn't have to chase wolves naked." She was told she said, "If anything I protected people who didn't deserve to be protected" Truth without love is cruelty, said Ben Nuttall-Smith. Married 26 years and mother of 2 boys and 2 girls, her husband, "a classic", was there tonight filming her presentation. She compared the major traditional publishing house offer she'd received where she'd have been a 'small fish in a big pond', to the General Store Publishing House http://www.gsph.com/ offer in which she co published her book getting the same 10% royalties while sharing 50% cost. In the end she got 50 % profit and kept the right to direct sell which she does at http://www.theredwall.ca/ . "I need a new motorcycle," her husband said. They'd both ridden motorcyles together when they met. "There are 6 themes in the book, but it's really about a social revolution. " "There's murder, arson, rape and the Depot but there's a lot more than that." Short listed for a prestigious writing award, reference read now in universities ,it's already going on to the recommended read list. That's the kind of dedication that goes with the RCMP. 9 years of effort just to get someone into the Canadian Author's Association to keep an eye on things. No doubt, that famous medical writer and CAA member, Patrick Taylor, skipped back to Ireland on a tip the RCMP were following him. With the Red Wall into second printing, Jane Hall is working on a follow up book. My grandmother friend had commissioned me to buy the Red Wall in which Jane's dedication reads. "if we all work together we can 'maintain the right'". The meeting ended with Jane reading an hilarious passage from her book. Sure she's a great author, a great speaker too, but no one's fooling me. The RCMP spared no expense in getting the best to keep an eye on the CAA. Probably she's tasked personally by the Prime Minister to make sure the guts of Canadian culture don't get spilled to the Americans or worse.

Masturbation

Sexuality – Masturbation
- By William Hay
There is no psychiatric or medical disorder called ‘masturbation’.
It’s hard to believe that Kinsey’s and Masters and Johnson were revolutionaries less than 50 years ago. Havelock Ellis and Freud and others all the way forward to Foucault and more have studied the ‘taboo’ subject of sexuality. Freud talked about libido in children in the first years and female child psychiatrist, Melanie Klein, postulated even earlier libido development than her male counterparts saying it was present in the first months. What parent hasn’t seen their child touching themselves with apparent pleasure. Indeed it’s a common family concern especially if the minister is a frequent visitor.

Parents have brought their kids to me to help stop this “socially inappropriate behaviour”. I have bound hands in duct tape and gauze to allow genital healing in psychotic populations in asylums. Monkeys happily do it in full view seeming at times to even appreciate an audience. The Canadian parent and especially the easily offended teacher cannot stand such public display. Meanwhile the rock and roll idols of children continue to act like monkeys on MTV.
The origins of shame may well be found in the socialization of the normal self touching of children. But even daring researchers have rightfully feared too much ‘investigation’ in this nebulous world of the mother and child union or father child interaction. Much more is said about ‘toilet training’. We’re more ready, in Canadian culture, to talk about shit than sex.
A joke went that ‘they don’t believe in evolution in Kansas’, Answer, ‘WHY SHOULD THEY, IT HASN’T ARRIVED THERE YET.”
Part of the religious ‘social control’ has been the perverse interest of the church in the sexual behaviour of individuals, specifically, masturbation. Now that the old priests of religion are being replaced by the new lawyer priests sex is still very much in the public eye which takes perverse pleasure in ‘judging’ others while denying their own activities. Judges in adult ‘sexual trials’ to date are not ever required to study biology. The very moment that Prime Minister Troudeau said that the state had no business in what consenting adults did behind closed doors the courts jumped into the vacuum. The priests, ministers, imans and rabbis never left. And it’s a busy bedroom today.
It’s not just Christian Churches , though Origen’s cutting off his testicles to stop his masturbation was an extreme sacrifice worthy of eventual sainthood. Meanwhile his fellow saint and father of sexual reprobates was throwing himself into thorns to stop his sexual arousal, possibly one of the earliest references to ‘aversion therapy’.
The Hindus have much negative to say about masturbation as well.. Tantra discourages loss of sacred essence. Techniques are taught for climax without loss of semen. While these techniques are recommended for men it’s unclear if there are any such techniques for women. And the question obviously is why? Then there’s the ‘yin’ and ‘yang’ of Chinese schools with their own sets of taboos and regulation.
Possibly as sexual self regulation is so difficult and once a sacred secret it is possible to externally implant a sense of failure in the best. The many exposures of the last 50 years certainly go to show that the foremost prudes and superiors in the church and state were themselves up to far more offensive behaviours than masturbation. Just as state officials and attourney generals and jail leaders in the secular realm are routinely exposed for sexual misbehaviour, so the church leadership has had it’s own notoriety. With all the soap opera bed hopping in high places it's no doubt modest masturbation remains officially frowned upon.
The biblical key for Christians, Moslems and Jews is the the phrase ‘spilled his seed on the ground.” I once explored the bible for references that would support the perverse interest of oftimes supposedly celibate clergy in sexuality expecting to find all manner of reference to hairy palms and people struck dead. Certainly the allegory of Adam and Eve can be interpreted as more sexual than relating to disobedience but without where would redemption be?
The only clear reference to masturbation turns out to be this ‘spilt his seed on the ground’ passage. In that passage Onan who is, because of the law of levy, supposed to impregnate his dead brother’s wife instead commits ‘coitus interruptus’ (not even masturbation) to stop his brother’s wife from being pregnant. He thereby greedily keeps all the inheritance for himself and his children. Nonetheless masturbation has been known ever since as the sin of Onanism. The church ever cherry picking in matters of sexuality fails to find fault today with all those men who might gladly impregnate their attractive in laws, but do not. Instead it continues to bemoan masturbation.

The partial explanation for the censorship of masturbation was that reproduction was desired by church and state. The ‘army of Christ’ was no different from the early days when political decisions of all nations were decided by how many warriors could be mobilized. This reflected the power of each tribes maternal factory. Masturbation clearly would be discouraged as not adding souls or warriors or workers to the greater good. Communal living in general discouraged individual pleasure especially in times where tribal existence depended on collective endeavours and consensus arrangements. Individualism was a luxury of the aristocracy to a degree but only really came into it’s own in present postmodern times.

Which might explain the present day rage for masturbation. The evidence of this is simply reflected in the extent of the pornography industry, the rise of ‘sexual addiction’ as a diagnosis, compulsive masturbations showing up clinically as a concern and many other indicators that suggest that masturbation is probably more prevalent today in adults and especially for women than perhaps at any previous time (Victorian times excluded). This may simply reflect the rise in ‘leisure time’, the privacy of ‘space of my own’ and certainly in the present day and age masturbation for men and women is a form of ‘safe sex’ when the church ‘taboos’ and ‘state taboos’ have been taken over by the ‘medical taboos’. What was once ‘evil’ is now properly called ‘unsafe’. But masturbation isn’t really just ‘unsafe’. In an abortion/divorce culture children are considered a ‘liability’ and ‘expense’ with hugely delayed smaller families and the reproductive “work” of western societies literally outsourced to the fertile reproductive third world mothers.

Is masturbation safe? Is it healthy? Is it good? Should it be made legal? Should it be taxed? Is simple and sweet somehow ‘better’ than ornate and involved. Should one ‘date’ oneself or just wham bang thank you mam have sexual release masturbation?.

Can we talk about it? Compare notes?

Increasingly conversation about sex even with a doctor is viewed as ‘sexual abuse’ by the prevailing new ‘politically correct’ bullies profiting by the vacuum in sexual control lost or forfeited by church and state. The consequences of these commonly self appointed perverse watch dogs is that a new ‘inquisition’ is becoming the norm and masturbation with all forms of sexuality except and sometimes even missionary position are being relegated to the closet. Given how busy the bedroom became the closet is perhaps the only place of privacy left.

Ironically the secular world has become bizarrely coupled with everyone as a rapist sloganeering and women especially as fragile little girls best considered victims in the making while at the same time men and women are making windfalls in the porn industry which caters to the masturbatory singles of the post modern society. At the same time modern pornography not only sells in high volume to a male audience but also to couples and to single women and of course the gay, lesbian, bisexual and transgender populations. It appears everyone is masturbating by the sales. Alternatively people could be watching pornography for it's critical merit.
Sexuality and the western culture of sexuality is further counter to the medieval leanings of the religious terrorists who would quite gladly return us all to the closet despite their excessive fetishism for young girl virgins and polygamy.
Further women who were once largely ‘ignorant’ are now highly informed through internet and television and sex research. June Kaplan Singer showed the rise in female masturbations a decade a go could well be predicted to match men at some level. In addition, women in this society can have sex on demand because they are commonly ‘in control’ of the reproductive apparatus and initially ‘control’ the sexual access of couplehood and marriage. Cost however remains controversial and risk or lack of attractive choices might well make masturbation more appealing. Certainly celebrities and female singers have by their behaviour demonstrated all manner of masturbatory practice and all manner of educational material pro masturbation is probably more widely distributed today than the ‘anti masturbatory’ literature of yesterday.
Meanwhile Pope Paul II not one for speaking to masturbation did however celebrate the sex of marriage raising it to sacramental status and implying though not recommending that one might miss mass if the husband and wife did have sex though it would still be a sin to miss mass and go golfing The liberalization of the church was counterpoised to the perversion of the secular ‘politically correct’ world which disdainedtalking about sex almost as much as prayer. Both God and sexual discussion were banned while one leaders after another was caught involved in the outrageous hanky panky. Clearly the ‘lady protesteth too much’.
At the most ironic I had caring single mothers coming into my practice asking me how they should teach their sons how to masturbate. The sons had shown no interest, to say the least. Sons and daughters meanwhile have often told me of parents wanting to teach them about masturbation rather late in the scheme of things. A pregnant teen ager told me her well meaning single father had tried to tell her about the birds and the bees when she felt it timely to tell him she was already pregnant.
Several legal forms for just dating have been developed and widely distributed. Those who are not masturbating might well be waiting for a legal consent form. What is wholly surprising is that there is as yet no license required for masturbation within city limits.
The whole question of toys entered the discussion as many women have difficulty achieving orgasm in intercourse and dildos and vibrators brought them out of the desert into the pleasure of reproducible orgasmic experience. Modern dildos have their counterparts in ancient phallic pieces. It is probably good advice not to touch some museum artifacts considering where they might have last been.
Couples have taken to mutual masturbation and young people might openly masturbate rather than have intercourse which seems still so ‘brave’ to an older generation that loves candlelight, groping and quickies. The idea of foreplay requires the reduction in the guilt and shame departments that is not common in the older generations. Yet the young in part responding to the potential threat of stds has brought a new elegance to the old fumbled exercises of steamy gas guzzling college cars.
Along with all of this there is a new ‘virginity’ with young men and women waiting for marriage at a later age but wanting more of the traditional values, with or without masturbation.
For any parent who wants to talk to their children about sexuality they had better be quick about it because all evidence suggests that children are more informed and sexually active at a far earlier age. This may be as much to do with food additives as television but it remains a fact.
Finally whether we like it or not masturbation is likely to remain with us for sometime despite computers, Velcro and terrorism. It may well be one of the causes of global warming. Whether seen as acne or chocolate it is a fact of human existence. Of course we don’t need to talk about it. Apparently it doesn’t exist in Kansas either.

Psychosis

PSYCHOSIS
- By William Hay
I was called from my room. A phone rang. I awoke and listened to the succinct description by a very competent nurse. Dressed in minutes I left a beautiful soft skinned woman in my bed. Her hair was tousled. I looked back at her still sleeping as I quietly departed. Minutes later I was on the ward.
“He’s the fellow who killed his relative the last time he was psychotic,”the little dark haired nurse told me. I took the chart she handed me, paging through it speed reading as she spoke. “The police said he was threatening his family again. When they found him he was waving a knife. He said the devil was telling him to kill. They didn’t have any difficulty getting the knife though. He gave it to them. He’s always had respect for the police uniform. “
I read the emergency doctor’s report saying he was disheveled, not speaking but apparently hearing voices. They’d admitted him to psych. It was the emergency nurse who called me.
“We gave him 10 mg of Haldol , 2 mg of Benztropine and 2 mg of Ativan IM and he’s just been sitting in the corner of his room since.”
There wasn’t much more in the chart, blood pressures, pulse, respiratory rates. Nothing that would change the situation from so many before.
“I’ll see him now,” I said.
With the nurse beside me I walked down the hall. Out of the corner of my eyes I saw the stocky male nurse and long haired orderly had joined our group. They’re being protective of us, I thought.
It was always this way. In the out of the way places I’d worked the staff knew that people were most important. They just knew to leave the paperwork for another time and join together to get the real work done. More and more it wasn’t that way in the city. Everyone looking over their shoulder at the paper pushers. I didn’t let my mind go there. This was here and now. I was surrounded by competent people. This was going to go the way it should go, the way it almost always did go.
I looked in the little window on the solid metal door. In the corner a man sat hunched in blue ward pyjamas on the single sheeted mattress the only furniture in the locked room. The only other item was the stainless steel seatless toilet.
The young man’s hair was greasy. I couldn’t see his face. Maybe 6 foot tall. The chart said he was 25 years old. His feet were cut, bruised and scratched. I saw similar abrasions on his hands. He’d been living in the bush. Last anyone had seen of him was three weeks ago. The police notes had said something about a family argument.
He was supposed to be on injectable antipsychotics every two weeks. It looked like he’d missed at least two or more injections. Psychosis didn’t always come back right away. There was usually a grace period. In his case it had been days or maybe weeks.
The little nurse pulled the very big key out of her pocket and inserted it in the door. She opened it a crack and said,
“Joe, the doctor is here to see you,” Joe didn’t look up. He just sat there slumped and despondent. I knew he had heard, though. The nurses did too. We knew things like that after years of working in these environments with patients whose reality was different than ours. A 6th sense. Something one came to rely on.
I walked in past the nurse and stood for a while looking down at Joe. I was hardly inside the room. A classmate had almost died as he was attacked entering a patients room. The two police he’d been with had hardly had time to save him. He’d been scarred physically for life. The emotional scars almost always went deeper. I wonder if he ever talked about that time. Now wasn’t a good time for reflection.
I looked carefully at the young man. His hands were wrapped around his knees. He was on his butt in the corner of the mattress, back to the wall. His feet would not have much purchase. There’d be time, I thought.
I knelt. I felt the nurse moving closer behind me and sensed the other nurse moving into the corner of the room. The orderly was still in the doorway. It was a coordinated effort.
“Joe, I’m Dr. Hay, how are you feeling.”
He didn’t answer me. His breathing changed slightly but he didn’t move.
“I understand you’ve been having a difficult time.”
He shifted slightly.
I felt my knees straining under my weight, wanted to make myself more comfortable, but knew it was too soon.
“Could you tell me what’s been going on?”
I saw his head begin to move. He looked up at my knees. No eye contact. The wall behind him was cement. He leaned back a little. His eyes came up to my chest. His hands relaxed around his knees. He seemed to rock a little.
“Go away,” I thought I heard him say. It was a frightening otherworldly whisper.
I resisted the temptation to move closer, to lean in.
He’d killed a man. The chart had said he’d been violent on other admissions. I was thankful for the foreknowledge but it wouldn’t have changed my procedure. I’d been kicked so hard in the chest, I was bruised for weeks, as a student. A catatonic 70 year old went from catatonic stupor to catatonic frenzy when I’d asked her about her husband. I’d learned later he’d run off with her younger sister after 50 years of marriage. I’d been too close that time and if I could help it I wasn’t going to make that mistake again, ever.
“What did you say, Joe, I couldn’t hear you,” I said louder than need be in that little room.
His hands went to the mattress beside him. I watched his musculature. He was pushing up, just shifting his position. I didn’t stand up and move back. Any quick movement could startle him and backing away now could undermine the relationship I’d need to build.
His head came up and he looked me straight in the eye. Almost feral. “I said, go away. Go away. Go away or he’ll kill you!” He repeated before looking away and turning his head to the wall.
“Alright Joe, the nurse will give you some medication to help you feel more comfortable.”
With that the nurse and orderlies came forward as I nodded and we gave Joe another 5 mg of haldol IM and 1 mg of Ativan. He’d not moved when the nurse pinned him somewhat with her body and injected his right buttock with the needle she’d obviously been carrying with her. The other nurse had moved in beside her and the orderly and stepped around me. I had just stood up when this fluid teamwork took place and we all moved back out of the room keeping our eyes on the patient.
It was a couple of days before the routine changed much. The nurses gave him other injections when I wasn’t there but together we repeated the routine until the third day he agreed to come to my office and talk to me. A nurse stayed behind his chair. Those first days he didn’t say much. More medication. More observation. More firmness and respect. Then one day he talked about the nightmares and the dead bodies haunting him. He said they’d been all around him in the room stopping him from speaking to me there. We moved him to the open area after that. After a few more days he was talking non stop to his primary nurse telling her about the time in the bush.
He told me about the man he killed. I didn’t ask. He just walked through it like he might a shopping list. He told me he’d stopped hearing voices and that he thought the medication was helping.
“I’ll take the injectable medication if it will let me go home,” he said about 10 days after he’d been admitted. I started that then. On the weekend he had an afternoon pass with his mother . When she returned she said he’d done well.
A day pass went just as well and then he was gone for a weekend before I discharged him on injections arranging home visits with the community nurse. He was so pleasant when he left. All the scariness in him that had been there on his admission was gone.
I was laying awake in bed beside my beautiful partner when I told her, “Remember I told you I admitted a violent guy a week or so ago. I discharged him to the community today.”
“So soon?”, she asked.
“Yea,” I said. “He’s back on meds and I think he’s going to be okay” I didn’t say the other reason: lack of beds or resources. In the best of possible worlds I’d have kept him a little longer. Too often I was cutting corners because of the pressure from above.
“Still, “ she said.
I knew what she meant. I’d felt the madness that first day. Now it wasn’t so palpable. Lurking, maybe, but not so overt anymore. I hoped this time he’d stay on his medication. His family were something else. I’d never have been able to sleep in the same house with him when he first came in but they took it in their stride. They’d been caring for him for years, even after the death.
“It’s the illness, doctor. It’s not him. He’s better now” His brother said when he came to take him home. He reminded me of what’s so easy to forget. Especially when afraid.

28 Days

28 days, written by Susanna Grant, directed by Betty Thomas, starring Sandra Bullock is taglined, "the life of the party ...before she got a life." It was playing on TV last night and I caught the ending especially enjoying the scene with the fellow trying to keep his plant alive having been told maybe that's where he should begin before jumping right back into a relationship with human being. It was touching and amusing and true to the heart of recovery. I recalled how much I enjoyed it the first time, how I've loved all of Sandra Bullock's movies and thought how sensitively she'd portrayed this party girl journalist going through rehab. It's one of the movies I recommend especially to women who are enterring recovery. Alcoholism is a bitch but the laughter after is a kind of special reward. Clean and Sober, starring Michael Keaton, is the classic recovery movie. Certainly it's more raw. Sandra Bullock is an alcoholic in 28 days. Michael Keeton is an addict. There are high bottoms and low bottoms. The other great movie to watch in recovery is Post Cards from the Edge, written by Carrie Fischer and starring Meryl Streep and Shirley MacLaine. It speaks to the disease of addiction as a family and societal disease.

Bill Bryson - Thunderbolt Kid

Bill Bryson is the Stephen Leacock to America or America's own Mark Twain in modern times. His "Life and Times of the Thunderbolt Kid, A Memoir" is the funniest most enjoyable read I've encountered in years. No wonder it's a National Best Seller. It tells the story of growing up in Des Moines in the 50's. Growing up in Winnipeg in the same era I was over and over again reminded of the cultural gap between then and now.

To quote: "I don't know how they managed it, but people responsible for the 1950's made a world in which pretty much everything was good for you. Drinks before dinner? The more the better! Smoke? You bet! Cigarettes actually made you healthier, by soothing jangly nerves and sharpening jaded minds, according to advertisements. "Just what the doctor ordered!"...........Happily we were indestructible. We didn't need seat belts, air bags, smoke detectors, bottled water, or the heimlich maneuver. We didn't require child safety caps on our medicines. We didn't need helmuts when we rode our bikes or pads for our knees and elbows when we went skating. We knew without a written reminder that bleach was not a refreshing drink and that gasoline when exposed to a match had a tendency to combust......As many as four nuclear detonations a month were conducted in Nevada in the peak years. The mushroom clouds were visible from any parking lot in the city, but most visitors went to the edge of the tests to enjoy the fallout afterwards......What a joy it was to be indestructible."

The book is a non stop trip down a remarkably funny memory lane. Seen from today's perspective through the eyes of Bill Bryson, the 50's of my childhood became a Norman Rockwell painting done with crayons and plastocene. Every sentence was jam packed with nostalgia and humor. I would recommend this book to anyone but the young who would never understand how much they missed! Thank you, Bill Bryson!!

My friend says, "I literally laughed out loud over and over, all alone!"

Drug addiction and Alcoholism

The DSMIV (Diagnostic and Statistical Manual of the American Psychiatric Association) the principal psychiatric diagnostic reference in North America, is cross referenced with the International Classification for Disease used elsewhere. This text begins with a generic heading 'substance related disorders' which includes alcohol and all other substances of abuse. The principal division is 'substance abuse' and 'substance dependence' with the latter usually indicating greater severity, the disease being seen as a continuum. This reflects the tendency to group alcoholism and drug addiction under the same umbrella and to treat all alike. This has an appeal in many ways to 'programs' and counteracts the rationalization and denial in individuals in both groups which results in so called 'terminal uniqueness' because of the inherrent selfishness of addiction. Self absorption in this regard is commonly adaptive and defensive for the individual but nonetheless remains fundamentally selfish and self centred in the community sense. The programs of Alcoholics Anonymous and Narcotics Anonymous and indeed all the 12 step programs, because of the divisive nature of the disease and the tendency to isolate and have greatest difficulty with novel and unstructured community situations ,encourage individuals to 'look for the similiarities, not the differences."
This said, there are differences within the groups and in individuals which give rise to some confusion and persist as controversies. This is not new. Medically speaking it is indeed normal for a collection of related conditions to be treated under one heading by specialists in that 'field'. There are significant differences in the various arthritis conditions but they are commonly treated by rheumatologists and there is a lot of similiarity in the diagnosis and treatment of these conditions. In contrast to the psychiatric disorders where there always seems to be alot more personality it seems those with more physically dominant conditions aren't on campaigns to be 'different' and 'special'.
The disease of alcoholism per se is however different from the diseases of drug addiction in certain specific ways. One is genetically. The genetic contribution to alcoholism is more significant and more clearly defined than it is for drug addiction. The addiction to cocaine appears to occur more rapidly and not require any significant family history. Jaenneck early described the deterioration in character associated with long term alcoholism and this general pattern can be seen with the different addictions. However with alcoholism the common deterioration was seen over decades whereas with some drugs this same deterioration can occur in months. On the streets addicts and alcoholics clearly group themselves around those who like 'uppers' and those who like "downers' as opposed to those who liked 'hallucinogens'. Clearly the groups overlap as in Venn diagrams but research will eventually deliniate what it is that creates so called 'drugs of choice' and associated behaviour and possibly explain why over time the groups tend to coalesce. How much of this is a product of brain chemistry, psychology or sociology.

Whereas marijuania which has a profile similiar to alcohol in north america was commonly associated with non violence in the white population, in Africa it is more commonly a drug associated with violence. The origin of the name, Assassins, comes from the hashish using group of killers. Robert Graves showed that mushroom cults were at the basis of ancient European 'berserk' warfare strategy. This would come as great surprise to the normal British Columbian psychedelic mushroom user lethargically face planted in a cow paddy.
In the farming community of Rosedale there was once an older AA meeting which was specific for alcoholics alone, attended by many leading members of society, which refused to discuss "outside issues' such as drugs. This was an 'exclusive' AA meeting and offended mostly younger "newcomers" whose own history had more drug abuse along with alcoholism. Asking a long term sober member of that group what this was about I was told, "We're alcoholics here. We want to talk about our alcoholism and can't relate to alot of the kids with drug addiction. All of us believe in the law and are good citizens when we're sober and we didn't break the law except when we were drunk. But we found alot of the addicts were disrupting our meetings and trying to take them over because they'd never learned the basic community values and their addiction began with breaking the law when they were sober." The stirling examples of recovery at that meeting were remarkable but only the most 'willing' from the start were likely to benefit from the wisdom and success of that group where long term recovery was the norm and the majority of members had rapidly returned to being useful competent and caring members of their greater society, highly regarded and respected throughout the region.
Indeed it was alcoholics and such AA members whose success individually and collectively changed the whole world's attitudes to addiction. In 1935 when AA began it was the societal norm to consider addiction a moral issue and demonstration of lack of character. Freud said alcoholics were untreatable and the general consensus was that addiction in many ways was worse than any other mental illness both for the individuals and for the community. The consequences were jails, institutions or death and the morbidity and mortality of those afflicted with addiction was profoundly greater than normals. Today outside of those countries influenced by the examples of Alcoholics Anonymous this is pretty much the way that addiction is still treated.
Growing up I remember my father working in the north and telling us that alcoholics were some of the best workers that he hired but that he could never pay them before the job was done because they could not be depended on to complete any work once they had enough money to drink with. It was standard advise when I was growing up to avoid friends or marriage to those with family history of alcoholism. The ripple effect of the disease is seen in the organization of Al Anon and Adult Children of Alcoholics. One of the books whose title I unfortunately forget did an historical analysis of the great reversals of history and the alcohol and drug addiction of leaders showing the profound negative consequences of alcoholism historically on society. As a progressive illness alcoholism was commonly associated with a high early success phase and later a decline in decision making. With drugs this is also commonly seen but the reversal can occur much more rapidly.
It was the success of alcoholics in recovery, those anonymous early members of AA, who changed societal attitudes and community beliefs profoundly. The pilots, doctors, judges, mechanics, farmers, parents in recovery demonstrated that they could not only maintain their abstinence and thus stop the progressive disease but further could be trusted in positions of highest responsibility. Their extraordinary performance and high acts of character and selflessness gave rise to alcoholics collectively getting a second and many times more chances at work, marriage and membership in the civilized society of gentleman and gentlewomen. Indeed the famous psychiatrist Rabbi Twerski who has written and worked for decades with alcoholics and addicts, says that he would rather have a recovered alcoholic as his pilot because then he can trust that the individual is sober and safe.
Honesty was seen as the key characteristic necessary for being able to grasp and follow the program of Alcoholics Anonymous. Jaenneck's curve shows that the deterioration of character associated with alcoholism involves increasing society deception and self deception. First there is the minimization of how much is drunk, then the lies to family about where one has been, the excuses, missing work, and increasing self deception about how one is able to 'handle the alcohol". The program of AA states that if one is able to be honest with oneself they can have hope.
Not ironically there is a joke that circulates AA and NA meetings which goes like this: an alcoholic might steal your wallet but an addict will steal your wallet and then help you look for it.
The organization of Narcotics Anonymous was developped along the lines of Alcoholics Anonymous and has had increasing success in helping addicts recover from lives of addiction and become useful contributing sober and clean members of society. Much of it's success has come from the pioneering work and trust and experience gained from the parent organization of Alcoholics Anonymous. Cocaine Anonymous and Marijuania Anonymous have followed these earlier examples. More and more there is overlap between those who attend Alcoholics Anonymous and the other anonymous programs because collectively these addictions are seen in the light of these programs as all being a Spiritual Disease. In this regard, churches collectively cater to sinners and welcome pedophiles and presidents alike.This inclusivity is admirable.
Yet I continue to advocate for the police to accept a recovered addict who for 20 years has been a model citizen who now wants to serve his community as a police officer. He continues to be refused whereas my recovered alcoholic patients are certainly welcome to join the police force after 5 years of abstinence. Collectively addicts in recovery have not as yet convinced society at large in the way alcoholics have, that they can be trusted.
Part of this problem has arisen from the earlier ages of many addicts. Commonly alcoholics especially those in the early years of AA had completed schools, attended churches and held down responsible jobs while caring for families well before their alcoholism caused them increasing social and occupational dysfunction. Occupational functioning is the last to go in addiction because it's what pays for the substances and also assists the denial which says "I'm okay, I can hold down a job." More and more addicts are cycling through their addiction in adolescence and arrive in recovery in their late teens and 20's going on 11 and 13 years old emotionally, having never learned any forms of self control, emotional self soothing, societal expectation and the reasons for community. As one old timer said, "more and more of these addicts are downright feral." The programs are therefore being given the task of literally parenting these people, teaching them right from wrong and helping them understand for the very first time that they have to clothes and feed themselves and that everyone else should not be expected to be their mommy. Further, many of these younger addicts come with a burden of trauma including sexual abuse and physical abuse from the early age lives of crime, drug dealing, violence and prostitution.
Now there's a new trend coming out of the harm reduction traditions which says that "only cocaine" was my problem and since I've stopped cocaine I can handle alcohol and pot and the occasional heroin chaser. Whereas in most AA meetings there are the old timers with 20 to 50 years of sobriety and societal contribution, not uncommonly today there are some meetings of NA where the longest sobriety is 5 years. More commonly too is the idea that I've done my part by being clean and sober and now only have to take care of myself. Hence the essential self absorption remains whereas the program of AA was a 'we' program and 'service' and contribution to the community at large were the best evidence of recovery. Recovery was not solely about not drinking or drugging but rather addressed the overall disease of thinking and behaviour that separated the individual from God and community. The axiom commonly used is that one can 'sober up a horse thief' but then all one has is a much more dangerous and effective 'sober horse thief." The programs of recovery were indeed directed at addressing the character flaws as well as the addiction. Harm reduction programs have often lacked a coherent agreement around issues of community and individual responsibility.
Addicts collectively while riding on the shirt tails of Alcoholics need to recognise that they themselves must now demonstrate to society at large that they too can be honest responsible citizens who will benefit society. The previous 'honour system' that worked for alcoholics is increasingly in the job situations being replaced by urine drug testing because of the issues of dishonesty which persist today in the addiction population in general.
To this end alcoholics whose drug of choice was alcohol are encouraged to attend AA even if they used other substances but as members of Alcoholics Anonymous identify as alcoholics. One individual amusingly states, I drank alcohol, I smoked alcohol, I snorted alcohol and if there had been an alcohol to inject when I was drinking alcohol I'd probably have injected alcohol as well." This was the understanding of the original alcoholics when they accepted their first addict and recognised that AA would work for addiction as well. However, those who do not consider alcohol their drug of choice are advised to attend Narcotics Anonymous because the old timers there are perhaps firmer and have a better understanding of addiction specifically. Generally speaking it's okay for individuals to straddle programs and this works where the individuals have sufficient sobriety and clean time and socialization to be respectful of the group they are in and recognise that they are there to learn rather than teach the group.
This said, there are significant medical and psychiatric differences within the overall disease of addiction. The lessons learned from tobacco addiction and gambling addiction can indeed help us to understand alcoholism and vice versa much in the way the study of the DNA of fruit flies has helped eludicidate the human genome. There are more similiarities within the group than differences but the field is increasingly developping to a state where more individualization of therapy can be expected. The once universal 28 day prescription for in patient treatment is now being modified on an individual basis. This was first done sadly based on the insurance and bank accounts of individuals with those having more money getting more treatment whether or not it was beneficial. Increasingly though there's a new trend to looking at what is specifically needed for each individual and developing programs specific to those needs while at the same time keeping the overall notion of recovery in tact.
A recent joke regarding this trend to claiming recovery from one drug at a time went, "I've been recovered from heroin for several months now but I'm still doing cocaine. I was recovered in Texas from cocaine and got my AA one year medallion there because I was only drinking in Mexico. I never had a problem with pot so I'm still doing that and I think now that I've quit heroin completely I can probably have a social drink." Probably the old timers were right about the need for honesty. In many cases today it's the NA program where a fellow addict in recovery can better assess honesty and help multiply addicted people with their Steps. Interestingly though some of the old time low bottom alcoholics described different alcohols causing similiar effects to different drugs today ie 'scotch made me racy and wanting to fight', 'tequilla made me hallucinate', 'gin made me mello'. One wonders if the psychosocial factors associated with 'context of use' and 'expectation' are not as relevant as the factors of neurochemistry. Increasingly MRI's and PET scans are adding to our understanding of the contributions of different disciplines to our understanding of the whole.
Dr. Nady el Guebaly former president of the International Society of Addiction Medicine and foremost researcher today in gambling addiction has begun to establish occupational standards to assist physicians in saying when and what jobs a recovered person can be trusted with. International Doctors in Alcoholics Anonymous has however demonstrated that the Addicted doctors there can be as successful in their recovery as the purely alcoholic doctors. In that population the use of drug testing in the first 3 to 5 years of recovery appeared to assist the alcoholics and addicts and the the community collectively.
In time it is likely that the examples established by the original AA members will spread throughout the recovery programs as a whole and individuals will consider and care that their own recovery affects how others will be treated who follow them. This altruism which was so much a part of the original alcoholics anonymous program is likely then to replace the essential narcissism which dominates addiction itself but is not a part of the recovery process originally envisioned by the founders. With that in mind I'm hopeful that in time enough addicts will demonstrate their value to society that I can get the police to accept a recovered addict as easily as I now see them accepting recovered alcoholics. I believe it's the same disease essentially but the devil still remains in the details.

Pineapple Express

This incredibly funny story written by Seth Rogen and Evan Goldberg, directed by David Gordon Green, starring Seth Rogen, James Franco, and Danny McBride, is reminiscient of the English movie, Lock, Stock and Two Smoking Barrels. A stoner witnesses a drug murder by the police and senior drug dealer only to have them chasing him and his junior drug dealers as an hilarious cast of asian competitors ninja after them. It's gut wrenchingly funny as Cheech and Chong meet Miami Vice. One might be triggered by the acreage of pot with all the paraphernalia but the message is essentially a good one. Red, played by Danny McBride makes the duracell bunny look like he's a slouch as he keeps on ticking with seven bullets and Monty Python flare. The sound track which includes Huey Lewis is great. All round a ridiculous anti hero action movie well worth watching straight.