Saturday, May 28, 2016

The Meeting Makers

The views express may not represent those of my employer or any other organization I am affiliated with.

I started this little project I call Grey's Recovery to fill what I felt was a void in my professional development. I want to share my development as a professional in the chemical dependency field but also share my development as a person in long term recovery. The two things often don't overlap but they do parallel each other. When I make a decision, take an ethical stance, or more importantly change my ethical stance I can't help but feel the effects of that change from both sides. A major change which started in my professional life and has moved to my personal recovery is the role of AA and the 12 Steps. 

"Meeting makers make it" is one of the countless platitudes you will hear around the tables. We all know that people who attend regular AA meetings can achieve sustainable abstinence and by doing so long enough a richer more satisfying existence follows but that's often not the message of the person who pulls out this gem. The intended message is often that the opposite is not only true but but an absolute certainty. The message is that while meeting attendance and specifically 12 Step meeting attendance can't guarantee sobriety and a better life, not going to meetings will doom you to jail, institutions, or death.

Is this true? The short answer is no, but like all answers about recovery it's not that simple. The truth is that there are "meeting makers" that have very successful recoveries that grow into rich satisfying lives and there are some that get stuck in a perpetual circle of abstince and relapse that spirals into the very same jails, institutions, and graveyards reserved for the non makers. Those who don't attend meetings have a similar range of experience, some make it, some don't, and of course it isn't either/or for either group but a vast sea of grey between one extreme and the other. 

Do meetings help at all? Should you recommend meetings to a friend, loved one, or a client you are counseling? Should you make meetings a staple of your own recovery? If meetings don't guarantee success do they at least increase the odds of it? Funny how recovery turns us all into gamblers. The answer to this question is a less satisfying maybe. There is data to suggest that 12 Step attendees do better in recovery than those who do not attend, there is some that might suggest that there is no difference at all. Some experts have said 12 Step work with its dogma of helplessness actually does more harm than good.  I am not one of those people who sees all data as equal but if you are looking for clear scientific research that proves 12 Step attendance is helpful or harmful it really doesn't exist. 12 Step members are anonymous and that makes them hard to count. So what do you do? The answer is easier than you might think. You ask your friend, loved one, or client something like "did you try a 12 Step meeting? Was it helpful?" and the answer you receive will be the best indicator you will get. 

I will say 12 Step meetings helped me, but the 12 Steps did not. Through 12 Step meetings I broke through the isolation I felt in the years leading up to my problem with alcohol. I learned that sharing my struggles with a group was a healthier coping skill than drinking my anxiety away and brought people closer to me. I learned that I could have close meaningful friendships with people who believed in a higher power though I myself did not. With the help of the fellowship I recovered, grew, became a better person, and found my career. But I never did the 12 Steps. I maybe took the first, but even that I've taken back. My sponsor advised me that if I wasn't comfortable with 12 Steps I should try 3. Don't drink, don't think, go to meetings, and that's what I did for almost 8 years. That's what I still do, though I now attend SMART Recovery instead of AA. While I don't see myself regularly attending AA meetings again I don't think anyone who knows me would doubt I am far better off for having done so.

I broke with AA professionally about a year before I did so personally. When I started as a counselor I tried to take my personal experience in recovery and apply it to those I worked with. Meetings had helped me, meeting attendance had been the turning point that brought me from abstinence to recovery and like many new counselors I assumed some version of that experience would work for everyone. I suppose it worked about as well as anyone who practices 12 Step recovery counseling. I had several ethical problems with professional 12 step work.

1) I was using clinical techniques that were developed a long time ago and had changed very little. It felt like we were practicing surgery with techniques developed in the 1930s.

2) I was using a technique that in its instruction manual required belief in a higher power, something which I did not myself believe. 

3) I was paid for my services when there when the same service was available for free.

4) I became more and more concerned that the people who appeared to succeed after working with me could have succeeded with anyone or with no help at all.

5) Science, the lack of it.

I broke with the 12 Steps professionally after starting work at a medication assisted recovery center. While I could reconcile my discomfort in an abstinence only program I couldn't recommend AA and 12 Step work for clients on methadone and Suboxone. I couldn't recommend 12 Step meetings to my MAT clients because I didn't want them to have to lie about their type of recovery and I wasn't sure what reception they would get if they told the truth. There were "methadone safe" NA meetings in the area and some if my clients attended them. The center hosted a group called MARS which is a peer led support group for people in medication assisted recover that is not 12 step based. My office was across the hall from the MARS meeting and they were loud and proud of their recovery. I think MARS benefited my clients who attended but for the clients who went to NA it was a mixed bag. Some seemed to find healthy connections, others seemed to find more shame. The majority of my clients attended no meetings, and the majority of them did just fine.

As this post seems to be running away with itself I'm going to wrap it up. My point is I now treat meeting attendance much like I treat church. If a client tells me they are going to church and church is helping their recovery I assume that it is and tell them to continue. I make meeting information available to my clients but I make no judgment about the type of meeting they go to or how often they go. What the clients need is meaningful human connection, and while a meeting can be a place to make meaningful connections it isn't for everyone. I believe the client is the best judge of what will work.

Meeting makers make it and don't make it. What's more important is that one doesn't give up on positive change no matter how long it takes.

Monday, May 2, 2016

Selling Storm Clouds and Linings

The opinions here are my own and may not reflect those of my employer or any educational institution I may be affiliated with.

4 months after my last drink was the day I decide to kill myself. I was having panic attacks daily, they weren't just uncomfortable, they were painful. I ended up in the ER with chest pains only to find out my heart was very healthy. The people at the AA meetings just talked about how great sobriety was. Every day someone got a new job or saved there current one, I was barely hanging on to mine. Every night I dreamed about drinking and every day I was terrified of relapse.... and everything else. I figured my wife was already making plans to leave me and who could blame her? My oldest child was openly hostile to me, my youngest would hate me soon enough. I had always been anxious but this was different. Before I could make it through the day knowing that once I got home it would all be alright. But now without my chemical vacations the pressure carried over from day to day and I knew for certain any day now it would crush me. I remember when it hit me that I couldn't continue living like that, and if I couldn't live I would have to.... I started making plans.

I composed a note and saved it in a secure file. When I was ready I would copy and paste it to an email and set it to send shortly after the deed was done. I would leave for work in the morning but instead go to a secluded spot in the woods. There I would hang myself. My note would contain directions on how to find me as well as the numbers of some psychologists that could help them with the trauma. But I couldn't do it to my wife and kids. I tried to find studies on children whose parents killed themselves. I couldn't find much but what I did find wasn't good. In the best case scenario the children were scarred. Many grew up blaming themselves. I couldn't do it to them. So if I couldn't die I would have to.... I started making plans.

I realized that I was going to survive my recovery. I continued to struggle with depression and anxiety (I still do) but it was different. Once I realized anxiety wasn't going to kill me, that I could continue breathing through the worst of it, continue walking, working, living, it never had the same power over me again. Looking at my life now I can definitely say it was worth it, but back then I didn't know.


I didn't tell anyone for years how close I came to attempting suicide. I didn't tell my counselors for fear they would have me committed, I didn't tell my wife because she might blame herself, and I've never even told my children that they saved my life that day. They don't read this blog so it's possible they will still never know. The experience didn't make me stronger it traumatized me and I still get a cold shiver when I think about it. The strength came later with a lot of time and a lot of help but at that time I believed that my life would never get better.

What I hope this dark little bit of over sharing brings to the conversation is some perspective. When we are dealing with a client who can't see how lucky they are, who can't see how good their life is, it might be that it's not. The client's experience of early sobriety may be very different from how it appears to us. So what do we do?

Telling the client that things will get better will be of limited use but we have to tell them. If they trust us enough it may keep them going. More importantly we need to realize/remember that recovery isn't just wonderful, it's also very hard. Having to sit with the feelings that you once so easily numbed is bad enough. The idea that you have to do it forever is overwhelming. What finely saved me was a counselor who made me feel safe enough that I shared my anxiety in group. She in turn referred me to an anxiety group which in turn changed my life. There are worse things that can happen to a client than to relapse, and while the silver lining is real we can't ignore the clouds.