Happy Holidays to all of our friends and family from Bay Area Intervention and Addiction Consulting - Alice Tanner & Loki my 3 year old Chow

I was having coffee with a friend of mine from Southern California this afternoon and we got to talking about intervention, treatment and recovery. We both are in the field of addiction recovery; he has been in this business for over 30 years. We both agreed that intervention and treatment are mere beginnings, a bridge if you will, to recovery. Recovery is long-term . . . a lifelong process if we are lucky. Intervention and treatment are short-term, the start of this lifelong journey. Comparatively, they are simple and easy when you stack them up against long-term recovery. Staying sober in a facility is not hard. The real challenge begins when addicts and alcoholics leave treatment.

Sadly, most don't make it . . . at least not the first time. They relapse, usually within the first year. Those who are most likely to do so are easy to spot. They are the ones who don't follow their discharge plans, don't follow them fully, completely and with vigor. They are the ones who want to rush back to a "normal" life, however they define that. It's madness. They have sunk to a place of such desperation and illness that they need to be in treatment for at least 30 days and then they want to fly on their own, unaided professionally, making their own decisions, picking and choosing what discharge recommendations they will follow expecting that they have the ability to do this successfully. What?? Typically, they will not go to the meetings recommended for the length of time recommended. They won't go to extended care or an SLE or if they do they won't go for the length of time recommended. They will want to get back to work or get a job if they weren't working before treatment and they will want to work long hours to make up for lost time and fill their damaged bank accounts. Then they are too busy to go to meetings. They won't engage in monitoring if that has been recommended. They begin to see recovery as a "waste of time" because they are now so busy. They might engage in some of the discharge recommendations, but not all of them. They pick and choose which ones they will do like it is a smorgasbord.

This almost always spells relapse. It is as predictable as April showers. Families are often complicit in their addict's unwillingness to do everything recommended instead urging them to get "back to a normal life", to engage in the things that normal healthy people do because that is what their loved ones so desperately want to see (normal, healthy behavior), thus bolstering their hope that their loved one is really "okay."

When the relapse comes, as it inevitably does under these circumstances, they are all dismayed and surprised. "Treatment didn't work", they claim. "Twelve step programs don't work, either", they go on. Not so. These things do work and there is living proof around us every day that they do. As my friend quite correctly pointed out, "It's not the 12 steps do the work, it is we who need to work the steps."

A final comment: it is naive and unrealistic to think that this very ill person can go from the cocoon of treatment where they are getting 24/7 care and regimentation back to an environment with no professional support, guidance or structure and expect to make it. Those who fare best will be those who continue with professional help, guidance and structure of some sort.

There is Help~There is Hope

When it comes to intervening on a licensed professional or conducting an intervention for a family member or friend of a licensed professional are all interventions and interventionists the same? Or, are licensed professionals a unique population where an interventionist's common background and experience can be beneficial?

Licensed professionals are people such as lawyers, doctors, pharmacists, dentists, veterinarians, nurses, airline pilots or other license holders. They are indeed unique in a number of ways. Overall, they generally hold a higher level of education and/or specialized training than most of the population. They are in positions of power, trust and authority. They are used to giving direction, not taking it and they are used to being in control. They are people who provide others with help and are not used to being in a position of needing it themselves. Because of this, their denial is unusually very high and is even harder to break through than the average person's. On top of this is an inherent arrogance people in this group tend to possess. They don't like being told what to do and are loathe to accept help particularly from anyone who has less education or no professional background.

When it comes to addressing their addiction licensed professionals have other considerations, too. They often have licensing board and/or malpractice issues that need to be dealt with. Whoever is conducting the intervention needs to be familiar, sensitive and prepared to deal with these issues.

Finally, when intervening on a licensed professional consideration needs to be given to the model of intervention to be used. Johnson model . . . or the invitational systemic model or executive intervention?

Yes, working with the licensed professional population takes certain skill, expertise, education and background in order to increase the odds of a successful outcome. An interventionist who holds a doctorate, shares the same or similar licensing background, knows about licensing boards and how they operate brings to the table something special and uniquely beneficial that other interventionists and consultants without such a background do not.

Addiction is not easy to deal with. Denial is extremely tough to break through. This is particularly so with licensed professionals. Having an interventionist with a professional background provides one more edge in dealing with this very unique population. I guess that is why I feel so comfortable working with this group and why they as a group feel more comfortable with me and so do their families. Having a doctorate degree, taking and passing a professional licensing board, having had a private legal practice for many years and knowing the stresses and strains of a professional life make identification and working with this special population one that goes beyond mere lip service. It is real. It is shared. And, it helps.

There is Help ~ There is Hope

If we do not change our direction we are likely to end up where we are headed~ Chinese Proverb

Makes sense, doesn't it? Addiction intervention is all about changing direction. It is about changing direction as a family, changing direction regarding health and wellness. Systemic Family Intervention is an open invitation to all, including the loved one you are concerned about, to embrace an opportunity to transform . . . to heal and grow in a different direction. It is not about minor little adjustments, it is about big changes, ones that are guided and supported as you go through this process. Addiction is not little; you know that. The changes necessary to deal with it will not be little either; you know that, intuitively. You know where you have come from. You know what you have done in the past has not worked. You know that the addiction is getting worse and your best efforts have not succeeded, or not succeeded for long.

Intervention is about changing direction before a consequence results from which you and your family can not recover. There are such consequences . . . the death of a loved one, a child perhaps, from drunken driving; death resulting from alcoholic or drug-fueled anger; permanent paralysis from an injury while under the influence. Yes, the proverb is right on . . . If you don't like where you are headed make a bold, healthy move and get help in intervening so that you can head in a direction that you really wish to go . . . before it is too late.

There is Help ~ There is Hope

Intervention usually happens as the result of some crisis. Think about it . . . arrest, divorce, fired from job, accident, injuries. It is never done when people are having a good day. But, people do not usually act with the first crisis. The arrest happens, lawyers fix it, time passes . . . the pain of the crisis goes away. Then there is the threat of divorce, big arguments, tempers calm, time passes . . . the pain of the crisis goes away. Then the job is lost, there is the scramble to find a new job, interviewing, finally getting the new job, time passes . . . the pain of the crisis goes away. And, the addiction all this time marches merrily along, getting worse . . . and worse . . . and worse.

Crisis is a golden opportunity to professionally intervene. It doesn't get better. The trick is not to wait for crisis after crisis after crisis. The trick is to take the crisis that you can recover from and intervene NOW.

Yes, a crisis is a terrible thing to waste. Will you waste your next one?

There are a few favorite sayings that I like because they put in a nutshell a truism. For example, "What isn't measured isn't managed"; "Pain is inevitable, suffering is optional." Some sayings sound good, but are either not true or are bad advice, such as "Sticks and stones will break my bones, but words will never hurt me"; "AA is like a smorgasbord . . . take what you like and leave the rest."

Then we have sayings or philosophies like "We control our own destinies." True? Or not? Are we the masters of our own fate? Completely? Or are some things out of our control?

Here's my take . . . There are some things we can control to a certain degree . . . where we live, who we marry, our honesty and integrity. Other things we control much of the time, but not all of the time . . . where we work, what college we attend. Some things are completely out of our control . . . natural disasters, how other people will treat us. I believe that choices we make have an impact on outcomes and, in to that degree, we do have some control over our destinies. For example, if a person studies hard, get good grades, that person will have a better chance of getting into the college of their choice. There are no guarantees, but the odds are greatly improved. The friends we choose and how we treat them will impact our futures in a positive or negative way. Is there an exact science to all of this, a certainty? Of course not. But, better choices lead to better results. So, in that way, I do believe we have some control over our destinies.

Addiction robs people of this. Addicts routinely make bad choices over and over. Life happens to them rather than the other way around. They become "victims" of consequences. Life gets "out of control" the more the disease advances and not surprisingly. Addiction, after all, is a disease of "loss of control."

If people want to have some impact on their destiny, some say in where they want life to take them, to have some control, a good place to start is by getting help for any addiction that ails them. This goes for the co-dependents as well. Then, rather than destiny controlling us we have some say in controlling our own futures.

What do you think?

I've been on a "fear" kick for the past few days, so I will wrap it up tonight with antidotes. Fear is a God-given emotion and will strike all of us at some time or another; that is a given. Big fears, little fears, all sorts of them. Some poor souls are naturally fear-based, living in a fairly constant state of worry. For me, real fear of any significant size is an uncommon and unpleasant emotion, one I want to be rid of sooner rather than later. So, as a solution-oriented person I've developed antidotes to fear that work pretty well and I share them with you here:

1. Be realistic about your fears ~ the acronym for F.E.A.R (False Evidence Appearing Real) can be an absolute truism. Assess how realistic your fear is; you will probably come to see that it is not as bad as you believe it to be

1. Visualize your worst fear ~ when I do this I can develop a familiarity with my fear that takes much of the power away from it

3. Develop a plan of action ~ once you visualize the fear figure out a plan of action around it; being prepared offers a genuine sense of comfort and control

4. Share you fear with a trusted and sound-minded friend or advisor ~ it is said that sharing pain/fear lessens it by half; sharing joy doubles it.

Do you have helpful tips to share? Stories of fear overcome? Thoughts? Please chime in.

There is Help ~ There is Hope