Recovery Coaching sows seeds for the future of addiction treatment

We have all heard the definition of insanity, especially if you are in recovery. It means doing the same thing over and over expecting different results. As we work in the field of trying to help addicts move into sobriety and stay in sobriety, we can’t help but get frustrated and saddened by repeated relapses, death of our clients, and incarceration of our client due to relapses.

Addiction truly is insanity in action. But perhaps we need to be taking a look at our treatment plans and ask if we aren’t behaving in the same manner. Repeating the same patterns with each client, and expecting different results. Sometimes the plan works, which gives us enough inspiration to keep repeating the treatment plan with hopes that sooner or later it will work with each one because we will get good enough at our jobs, find the rights words, give the client the right tools, etc. Is it time to treat addiction in a completely new way?

As science has made huge advances in brain imaging and understanding the mechanisms of addiction, treatment has made slow progress in comparison.  What is progress though? How do we measure progress in the field of addiction treatment? In a recent article Telehealth rises as crucial tool for substance abuse treatment, by Joseph Goedert, Jacob Levenson states “In the addiction treatment arena there is no standardization-we can’t agree on what success looks like and what relapse is, or what treatment methods to utilize.” Levenson is the CEO of Map Health Management.  And he hints at the core of the addiction treatment problem: We haven’t even been able to clarify -- and insurance companies are growing tired of paying for -- treatments that can’t be proven to improve outcomes for the consumers once they leave.

Levenson goes on to state that Map Health Management (a data analytics vendor focusing on behavioral health) has multiple insurers lined up to measure quality among provider networks. One of the key things they use to measure quality is how adequately providers engage patients AFTER they leave the hospital or rehabilitation center.  Cost effectiveness and return on value are also components to measure quality.

Telehealth is one way that is proving to be extremely effective, and relatively low cost, in engaging consumers to stay focused on their recovery plans and goals. Consumers are monitored via telephone or video by professional recovery coaches and peer specialists who are able to check in with whatever frequency the consumer needs to feel supported and not isolated.

Hope Council on Alcohol and Other Drug Abuse of Kenosha WI has been a leader in their county, utilizing recovery coaches to work with their clients in the Intoxicated Driver Program. Through a grant, they are able to provide free coaching to clients who qualify, for up to two years. The grant also allows monies to support people referred to Hope Council through other agencies. Recovery coaches provide weekly support to clients via telephone monitoring.

The future of the addiction recovery industry points clearly in the direction of professional coaching helping to ensure results following a PHP or IOP engagement.  While we need to continue to keep evolving addiction treatment in the initial assessment and care, telehealth and professional coaching can make certain we’re not doing the same thing over and over, expecting different results.

The place within

There is a place inside I often go to hide. Upon the start of a new day, I fight to stay in that place. I want to retreat and not get up and face the planet. The tug of war begins in my mind. "Get up! You can't lay in bed; you cannot retreat today! You have responsibilities and challenges that you have to overcome. Don't let fear win! Come on, fight!!!" This is the voice of logic, the brain. The science of logical thinking. But wherever there is logic, emotion is never far behind. Emotion says, "You are tired. Take a day to yourself. Relax. Humans are not meant for grueling endless days of pushing yourself so hard." An observer of my thoughts, I can see both of their points. Yes, I have to fight. I have to face fear. I have to challenge myself. BUT I am tired. It's been a lot of work and I have so many things vying for my attention. I would like, just for one day, to choose where my attention goes. Can I just for today do what I want to do?! The choice to get up or not get up shouldn't be so difficult. But for me, it is.

When you suffer from depression and anxiety you always have to weigh out and determine whether you are partaking in self-care or escapism. Being tired is a real symptom of depression. Not just tired, but bone tired. Exhausted. So sometimes self-care means rest, sleep, retreating. Never getting out of your pajamas for the entire day and sleeping so your body and brain can repair and rejuvenate. 

On other days though, retreating is dangerous. It will add to your depression and isolation. You wake up and think you need to stay home and sleep. But when you follow that course, you find you feel guilty, and you start to judge yourself as being "bad" or a "loser" or "hopeless". What began as you thinking it was going to be a day of self-care turns into a day of self-hate. And self-hate has a way of snowballing fast.

This is something I have suffered with for so many years. As long as I can remember. Only recently was I able to see the connection between depression and this behavior, this resistance to life. I went to a support meeting and laid it out on the table to these women how horribly I was struggling and how much I hated my behavior and myself for not being able to stop this dialog I had to go thru daily with myself just to make a move in one direction or another. 

A wonderful thing happened at that meeting. It was as if each woman there held up a mirror. I saw myself in each one of them. My story was their story. My challenge was their challenge. They each opened up about their struggles with the same thing. We shared in the same pain, the same tears, the same fears, and the same challenges.  I left that meeting feeling loved, accepted, and understood. I left that meeting feeling at peace with myself.

Will I still struggle with this inner dialog? Yes. Certainly. I already have since the meeting. But I learned a few things.

1. Don't judge your feelings as good or bad. They just ARE. Of course Eckhart Tolle and Don Miguel Ruiz, along with others, have been saying this for years. But I am finally internalizing this and putting into my Nowcovery program. Be the outside observer without judgement.

2. Acceptance. This goes along with not judging your feelings. Radical Acceptance is a tool I am finding works in almost any situation! Everything is as it is. There is no "should" or "I wish it wasn't this way". Everything is just as it is. Not good. Not Bad. Just IS.

3. I can't do nowcovery alone. I need people. My group saved me that night.

4. Surrender. I heard a quote once, and I wish I could remember the source. The words in quotations are not my own. "Immediately and without hesitation, submit to the changes your higher power is trying to make in you." I don't always know what those changes are. That's okay. What I can do to cooperate is totally surrender. Hand over the pain, hand over the fight, hand over the struggle, hand over the depression, hand over the outcome. God cannot take it from me. I have to give it to him. As long as I hold on to it, he can't take it from me. That's because of free will. I am holding on to those things for a reason. There is some kind of perceived pay off that I think I am getting by holding on to it. God is waiting to give me grace and healing, but I have to give him my pain first. By letting go of the outcome, I am accepting God's perfect plan for my life. When I am within
God's plan I feel peaceful and happy. I feel sure of myself.

 Perhaps God is able to take my depression and use it for good, into drawing me closer to him. When I turn to the place within for Sanctuary, I have to make sure I ask God to meet me there.

NOWCOVERY. What is it and how do I get it?

• Are you miserable with your life? 
• Do you wake up feeling helpless and hopeless? 
• Do you feel fatigued most of the time? 
• Do you have a sense that something is wrong in your relationship, but you can't quite put your finger on what the problem is? 
• Is your financial life in a shambles? 
• Have you been suffering from physical ailments recently? Like irritable bowel syndrome, migraines, and over-all aches and pains? 
• Do you find that you are asking yourself if you drink or use other drugs too much? 
• Are other people telling you that your use is out of control? 
• Would you say that you are not suicidal, but wouldn't mind if your life somehow just came to an end? 
• Are you irritable and angry? 
• Do you see life as something that you wish you didn't have to endure? 
• Is it hard for you to remember a time in your life that you felt safe, happy, and secure? 
• Was your childhood traumatic? 
• Do you feel like life has been an endless amount of problems and work without any reward? 

NOWCOVERY may be the answer for you. I have found in my journey of getting healthier that by incorporating certain techniques I was successful and gaining sobriety and happiness. My life had not ever really felt fulfilling. I had always suffered from depression and anxiety. My childhood was marked with feelings of fear, loneliness, and underachievement. That had carried through into all of my adulthood until I started down the road of what I learned to refer to as wellbriety. For me, getting sober wasn't enough. I had to completely change my life, who I was, how I thought, and what I believed about myself. NOWCOVERY became my answer because there really wasn't anything I wanted to REcover. 

Through meditation, mindfulness, a relationship with my creator, and self inventories I became so much more aware of what I could and couldn't control. I was able to make decisions and take action (not reaction) based upon what outcome I needed to have. The outcome I ALWAYS NEED TO HAVE is sobriety, serenity, and peace. The process of NOWCOVERY allows that to happen more frequently. You CAN change how you think, feel, and react. 

Please contact me at http://www.freedom2b.net/ for a discussion on what NOWCOVERY is and how it could work for you. Of course this session is free of charge. 

Make your world LARGER

My world used to be very very small. Over the years it had shrunk down to the size of my yard and my house. I tried not to have to leave my house very often. Going to the grocery store twice a week was more than I could handle. My anxiety had gotten so bad that I got nervous and shaky having to go anywhere that there would not be drinking involved. Driving was particularly challenging on those hungover mornings. Due to being so sick and my anxiety being so heightened I feared I would suddenly careen off of the road.

Sunday mornings were especially awful. Many Sunday mornings had to be started with a drink simply to get my head to stop buzzing madly and my neurons to start communicating with one another. I simply couldn't even form a thought without a drink. My Friday night and Saturday binging meant I was in terrible shape by the time Sunday rolled around. I remember sitting on my couch, drunk in my living room, while the kids played around me. Looking out my window I would see people walking their dogs, jogging, cutting grass, having a life. I hated them for it and hated myself even more for not being able to something as simple as drive to the grocery store without having a nervous breakdown. 

When I was first being introduced to sobriety and the 12 steps my sponsor started to encourage me to make my world bigger. My first assignment was to make a new friend. It took me a year to do it. I was terrified to try and befriend a healthy women. I hadn't made a new friend in years and the last time I had done it the friendship was alcohol based. Two lonely housewives drinking away nights in my kitchen while our husbands worked second shift. But I kept at it and eventually I secured a friendship with a sober artist in my homegroup. She was a mother of four, just like me! My world got a little bigger. She came over to help me pack when I was divorcing. She helped me through a very difficult break up of a relationship. She encouraged me to follow my dreams. She set an example of how to do that by stepping out into the world of art with her work. I am grateful for her and her friendship to this day. 

My next order of business to make my world larger was to take some classes to update my skills for the workforce. I attended my community college for some office assistant classes. It was very rewarding and I did really well. Turns out I wasn't an idiot like I had feared I was. After that I tackled getting back in the world of work. This turned out to be incredibly challenging for me. I had to work on this skill for a few years. Fear and anxiety and old bad behaviors kept me from excelling. Once I listened to what my higher power was telling me about where I should be focusing my efforts things fell into place. Another expansion of my world!

Driving on the freeway came next. Check! Thanks to my fiance for pushing me and teaching me. After that came flying and navigating an airport. Boom! Done. Another thank you to my fiance. Public speaking....got it. Working in the inner city, completed. Sounds so easy but it was all terrifying and I had to fight against my instinct to run away the whole time. 

This last weekend we went to Atlanta, GA. While Scott worked I was going to explore the city a bit. I started the day by walking to Peachtree Station for some shopping. It was a really windy day. I was cold so I bought a poncho and some new shoes. I picked up key chains for souvenirs for my kiddos. Then I stopped for some lunch before walking to Centennial Park. While there I stopped to take some photos of the Olympic fountains and reflected on the bombing during the Olympics. I walked over to the Coca-Cola museum and gardens. Then I bought myself a ticket for the Georgia Aquarium. What a place! It was majestic and beautiful. All the creatures I saw were so intriguing. I wished my kids were there with me to see it! The dolphin show was so breathtaking. The music, fountains, lights, and dolphins told a story of a ship lost at sea. The dolphins saved the ship and it's captain. Wonderful!

As I left the aquarium and started walking back to the hotel I decided to ask someone to take a picture of me in front of a large Christmas Tree. I wanted to send it to my sponsor and say hello. As I was sending her the message via text I became overwhelmed with gratitude and emotion. Had it not been for Maggi telling me to make my world bigger, and showing me how to do it, I might still be drunk in my living room hating the people outside of my window. Had it not been for 12 steps and sobriety my world would have kept shrinking away, along with my life. I called Maggi instead and told her through my tears how much I loved her and how large my world had become.

To Thine Own Self Be True

I remember the first time I heard this "To thine own self be true". I was early in recovery for alcoholism and was sitting in a support group meeting trying to make sense out of all the new things I was hearing. Truly it was as if these people were speaking a foreign language. My brain was numb, my thinking slow, and the only emotion I seemed to be able to convey was devastation. My neurons were having trouble connecting to form thoughts. I had a difficult time retaining information. Putting thoughts and feelings into words was too much. Mostly I sat and cried and tried to absorb information.

A topic at a meeting was "To thine own self be true." I thought to myself "what in the hell does that even mean?" People began talking about all the ways in which they were true to themselves. I was completely baffled by the whole concept. For one thing, in order to be true to myself meant I had to KNOW who myself was. That meant I would have to know what my opinions were on certain happenings. In order to have opinions, I would have to have beliefs. And if I had beliefs that would mean that I stood for something. And when you stand for something it means you have a commitment to it. One of my basic methods of operation was to be as non-committal as possible. I couldn't be committed to anything because I wanted to be able to have my time as free as possible for drinking. And if I wasn't drinking I would most certainly be hung-over. When you live your life avoiding commitments you really miss out on developing your SELF.

I also had developed the tool of taking on the beliefs of whoever I was spending time with. We all know this as "being a chameleon". I didn't take the time to develop my own personality, so I would borrow whoever's I was with at the time. If you believed in Christianity, so did I. If you didn't, neither did I. You believed in abortion? Me too. Oh, you don't believe in abortion? Me either. There's a beautiful walking trail along the river you enjoy? I love that trail too! Lying goes hand in hand with being a chameleon.

So as I start my self discovery work in sobriety I have to start getting down to brass tacks on who exactly do I think I am. I am grateful for the endless amount of questions my sponsor asked me and for the extensive "homework" she held me accountable for. A day at a time over a period of five years my "self" emerged. It's a process that I am amazed over. My goal is life pre-sobriety was to never really know who "I" was. I remember at times I would look into the mirror and into my own eyes. I could only stand to do it for a few seconds before the awareness of an inner "me" became apparent. I would count myself lucky if I never had to get to know that "me". Well, now I know her. And I know her very very well. Not only do I know her, but I love her. She's pretty damn fantastic and sometimes she's a real pain in the ass. She hates being told what to do, she won't conform, and she can have a quick temper. But she also will give every ounce of energy to the people and projects she loves. She's deeply kind. She can be a little lazy, and she seems to not be able to stop procrastinating. But when you look deeper, maybe its not laziness or procrastination. Maybe it's a process of learning to have faith to overcome fear. She is working on dispelling doubt with faith and that's really pretty wonderful. There's so much to learn about myself. There is so much to learn about yourself!

So now I understand how to be true to myself. I am no longer perplexed by that quote. It feels good to be true to me. And when I am not true to me, I can feel it in my gut and my heart and I know it's something I need to correct. When you have turned your life and your will over to the care of God as you understand him, you feel uncomfortable when you aren't living in accordance to who you are. The reason you feel uncomfortable is because at the point of being out of harmony with yourself, you are also out of harmony with your Higher Power. You are out of sync, things are not clicking. It's not a good feeling. It's like a grinding and halting with some pain. Sometimes some shame or embarrassment.

There is no end to the journey of self-exploration. It's as deep as it is wide. It's up to us how far we want to go. My Higher Power waits for me. He asks me "are you ready to go further?" Even if I say no at first, he waits. He knows I will be along eventually.

Learning to Be.

Working a recovery program takes tons of effort and energy. It takes time and commitment. When we first come into recovery we put everything we have into it. Well, if we are serious about getting sober anyways. It's true what they teach us, we get out of it what we put into it. At first I hardly put in any effort at all. I showed up to several meetings a week. But that was all I did. Of course I ended up not being able to stay sober on that action so I had to take more. Then I couldn't stay sober on that so I had take even more action. And then I drank again and again and again. I don't call them relapses, I call it trying to get sober. So even further action had to be taken. Eventually, I had to resort to doing everything the program suggested. I went to meetings, got a sponsor, worked the steps, prayed in the morning, and prayed in the evening. I said thank you to a higher power I didn't understand for keeping me sober for the day. I asked that same higher power to keep me sober the next morning when I woke up. I changed people, places, and things. And I got sober! One year, two years, three years, four years, five years. So much work and so much change. And so much gratitude

Steps six and seven are my favorite steps, They are my most important steps, the foundation of my program after step three. Were entirely ready to have God remove all these defects of character. Humbly asked God to remove our shortcomings. Keeping my side of the street clean. Taking out my garbage. Believing I can be different and then acting as if I am. There were a lot of defects that needed to be dealt with. I wanted a different life, so I had to change. While God is changing me, it's my responsibility to act as if I am changed. This takes a lot of courage and major dependence on my higher power. When I am not strong enough Jesus is my strength. If I do not have the courage I need, Jesus is my courage. If I don't have the patience I need, Jesus, lend me your patience. I do believe it is in step six and seven that I learn to depend entirely on Jesus to supply me with what I need.

However, there is another lesson in six and seven that I have just recently had experience with. It came to me over a few months worth of work over a particular situation that seemed to keep requiring me to "look at my part in it." I kept looking at my character defects and then following the steps to cooperate with Jesus as much as I could while he worked with me. My progress was slow to say the least and at times felt non-existent. Nothing seemed to be getting better and I was starting to be filled with self-loathing. I talked to my sponsor and to some program people about what I was experiencing. I tried all of the suggestions to aid in getting this problem under control.I wanted so badly to behave differently but I kept acting exactly how I didn't want to act! In Romans 7:15 Paul says "I do not understand what I do. For what I want to do, I do not do.But what I hate I do. If Paul struggled enough with his behavior to talk about it in the Bible, then it goes to show that it is a basis of human-ness. Paul, who was greatly inspired daily by the presence of Jesus Christ and was undergoing drastic changes to become more like Jesus, struggled with shortcomings!

During one of my morning meditations after my bible reading I was talking to God about my behavior. I surrendered it all to him, and myself to him, again. Desperation to be different was permeating from my being and I got a clear message. "Just Be.". Followed by "Stop." I was really surprised and it reminded me of "Be still and know that I am God."  Psalm 46:10

God reminded me of all the other times I had made changes in my life. How slow the progress had seemed. How often had I felt that he wasn't even hearing my prayers. How many times and I been desperate and scared? How many other times had I felt like I couldn't bear my life for one more day, living it the way it was. And I had been delivered through each and every one of those situations. Nothing stays the same forever! Change happens.  But it happens one moment at a time. Not even one day at a time, one moment at a time. God is going before me, making my paths straight. That takes time. Changing hearts takes time. I had done what I could, the rest was up to God. It was a welcome relief to rest in the presence of God. I was exhausted from forcing change that wasn't meant to be yet.

Sometimes the best way to cooperate with the changes God is making in us is to "JUST BE." There is true freedom in that. "Be STILL." Let God do his work.

Why do resentments lead us to relapse?

If you use a 12 step program for your recovery you have heard about the dangers of resentment. It's the topic of many meetings. I remember early in my recovery hearing about resentments and it seemed like at every other meeting we would talk about them. At that time I didn't really think I had a lot of resentments and I certainly doubted that they could ever lead me to pick up a drink. What I failed to recognize in my haze of early sobriety was that I was so cut off from my feelings that I could hardly tell the difference of one emotion compared to another. As time went on and feelings came back I began to understand the term "emotional sobriety" and "emotional maturity". Both of which I had very little of.

As those emotional switches got turned back on I started to struggle with feelings. I think every alcoholic struggles with feelings and accepting them. It's one of the main reasons we drink, so we don't have to feel. One of the feelings that has been most challenging to me is anger. I hadn't had much experience with anger. It was an emotion I had shut down almost completely many years ago. It was a feeling that didn't serve me well, it sometimes was even dangerous to express. I simply decided not to feel it at all. When you are drinking you can do that. However, in sobriety it's not nearly so easy. Anger can be downright explosive for me now. And that will be a topic for another day. The anger that I want to talk about today is resentment. Particularly resentment towards people.

I had been harboring resentment against a few particular people. I was venomous when speaking about them and have to admit I had fantasies of horrible things happening to these people. They had hurt me very deeply and not just once. Repeated offenses which bred in me the perfect type of victimization that leads to justified anger. The more they hurt me, the more I hated them. Then they stopped hurting me. They were out of my life and had nothing to do with me anymore. The problem is I kept on hating them. I kept on reliving the hurts. I would get so angry and upset with them as if they were hurting me all over again. But they weren't. The hurts existed only in my head. My emotional sobriety would dip according to how often I allowed myself to get caught up in the feeling of hatred. What does an alcoholic want to do when their emotional sobriety sucks? Drink. It goes with the alcoholic motto of "I am mad at you, so I am going to hurt myself." It makes no real sense but in an alcoholics emotional bottom it is almost an unconscious thought.

During one of these terrible emotional lows I reached out to my pastor. He told me something that shocked me. I was harboring unforgiveness. Maybe to someone reading this it's obvious that I was holding unforgiveness towards these people. But when you are caught up in hurt and justified anger you don't realize that it has become YOUR issue. You stay so focused on the hurt and anger, your eyes stay fixed on the person who hurt you. My pastor held a mirror up and I saw myself. The truth was, I was hurting myself over and over. I had become ugly and vengeful and stuck in a very awful emotional low.Those people who hurt me didn't create that emotional low for me. I created it by my hatred.  I had to forgive. My pastors words were "I am glad Jesus doesn't think like you do." That rocked me hard. Jesus said in Matthew 5:44 "But I say to you, love your enemy and pray for those who persecute you". Does that only apply to others and not to me? Addicts are famous for thinking rules don't apply to them. However, I am far enough along in my recovery to know that's crap. The rules do apply, especially to me.

According to The Big Book of Alcoholics Anonymous alcoholism is a spiritual malady. We absolutely need to rely on the power of something greater than ourselves to stay sober. I realized I was cutting myself off from the "sunlight of the spirit" by my refusal to forgive. No wonder I wanted to drink or commit suicide. That's another thing alcoholics do, if we can't drink we would like to just die."What we have is a daily reprieve contingent upon the maintenance of our spiritual condition." Big Book page 85. I decided to get busy getting spiritually fit. I choose to forgive. I followed the directions given to me by the Bible and the Big Book. 1. I admitted my anger and unforgiveness. (my sin, step 6)  2. I asked Jesus to take this shortcoming from me (step 7). 3. I prayed for my enemies to have everything in life that I wanted for myself. This is a process I repeat every time I start feeling that emotional low creeping back. It is not a one time event, at least not for me.

My spiritual condition is improving and so is my relationship with my higher power. Love really is the answer.