How I Stopped Drowning in Drink

Not me, of course. Paul Carr. I know I promised to write about marriage counseling, when enough is enough, but then this came along and I'm such a sucker for variations on the 12 Steps.

Paul Carr stopped drinking, on his own. No 12-Step program, no mindfulness, no CBT.

Wait a minute, actually his program has elements of all three: (1) the addict (Mr. Carr) is working 12 steps;  (2) he's mindful of his experience, his past, reasons he drinks, and how being in the moment affects his decisions; (3) he is working to change his behavior by being cognizant of its effects. A writer, not a psychologist, he's either brilliant, or bumbling around drunk for so long, has finally stumbled upon a few of the very ingredients that make any good sobriety program work.

Carr, a comedian, has a website that boasts about his book, Sober is My New Drunk (costs only $1.99,  less than a drink in most clubs):

The bestselling humor writer and notorious tech blogger describes how social media helped solve his drinking problem—and explains how Twitter, Facebook, and the Internet can be more useful than AA when it comes to remaining clean and sober.

Let's take a peak, a critical look, because even though it is in jest, many a truth, you know, is said in jest. Remember, he's not going to meetings, and that his program runs contrary to what addiction therapists generally recommend.  (We tend to suggest hobnobbing with fellow addicts, all of whom have been driven to ruin and despair, then recovery, the tried and true kind, tantamount to surrender to God, peer counseling, and a mishmash of cognitive behavioral therapy or meditation.)

The steps below are excerpted from How I Stopped Drowning in Drink.  (WSJ) The commentary is mine.

Step One: Ask Yourself, "Do I Really Have a Problem?" 

Mr. Carr believes that if none of your friends have taken you aside to say that you seem to have a problem, you probably don't,  unless your friends are all alcoholics, in which case they won't.

He's right to qualify because alcoholics are like birds, they flock together.

But millions more are dependent in secret, drink alone, and have no friends, no people to gently remind them of their illness.

Mr. Carr is suggesting that everyone who drinks to excess should simply chip away at their denial, take a closer look.

But seriously, who does that?  Those who abuse and depend upon substances wrap cars around trees, wake up with strangers, lose their jobs and live to drink again.  No problem.

Step Two: Quit Publicly

This, of course, I love. If you tell everyone that matters to you that you have a problem with booze, because they care, they will work your program for you, praise your integrity, your mission to take back your life, and encourage you to rock on-- without the ale. Mr. Carr suggests posts on Facebook and Twitter, and personal emails to those who will lend support, not undermine sobriety.

But what about those who wouldn't tweet to save their lives, who eschew social networking altogether, yet pound back the drinks with the best of them? And seriously, is the type of support and caring Mr. Carr seems to have at his fingertips, something the average Joe can rally?  A good alcoholic encourages another to make a le'chaim, not to abstain.  Am I missing something? Cheers.

Step Three: Don't Fear Failure

Of course you'll slip, it is inevitable for most, and Mr. Carr acknowledges this, says don't sweat the failure.  Expect it and allow yourself one foolish fling with booze in the process of getting better.  Then get back on the wagon.

One?  Recidivism with alcohol is the rule, not the exception. Every slip is cause to restart the program, no matter which program.

 Give yourself as many slips as you need. They might become annoying after awhile.  Then you'll join a program that works.

Step Four: Pull Yourself Together

Meaning, as long as you're not drinking, get a little exercise and lose some weight. Although being British, Mr. Carr didn't seem to go for the former. What he discovered, however, is that alcohol is loaded with calories, so he lost a lot of weight getting sober and there's nothing more awesome than that.

Step Five: Stop Lying

Mr. Carr's love affair with the truth started with his public confession, telling the world that he had a serious problem with alcohol. Sober, he's finding that people really enjoy a straight man, an honest, reliable person.  It's an ah, ha moment for most alcoholics in recovery, finding they don't have to lie anymore.

Those who don't drink, who never did, find liars emotionally draining, wish they didn't have to associate with them.  They confuse us so. Wouldn't it be great if those noses really could grew when they tell a whopper?

Honesty is a huge piece of the 12-Step program.  Nice that it's making a come back in the general public, that place people pay attention, the entertainment industry.

Step Six: Stop Apologizing

Mr. Carr suggests that in the original 12 Step Program, AA, that as soon as people get sober, they run up to everyone they have hurt or disappointed and begin to apologize for the times their past behavior, forgetting responsibilities, arguing, lying, making a public nuisance of themselves. It is ridiculous to apologize because people assume the alcoholic will do it all again, that sobriety won't take. So what if today you're sorry. Tomorrow you'll be drunk.

The apology step of AA is not a first, second or third step.  It's somewhere in the middle, well into the program.  Nobody does it without thinking, and it's never easy doing it right.

Make no mistake about it.  Alcoholics do need to apologize.  Ask their partners, their parents, ask their kids for confirmation of that.  Sobriety might suffice for some, but for others, nothing is more convincing than real remorse.  Show me the tears.

Step Seven: Rediscover Dating

Alcoholics tend to have trouble dating without liquid courage. So Mr. Carr suggests, Do it anyway.  Be honest about your sobriety because people find it sexy..

Because sex and drink run together, some professionals advise the newly sober to wait a year to date. Dating is likely to trigger drinking, the two used to go hand in hand.  Who needs the trigger?

The take on this blog is that the reason dating is so hard, can be so emotional, is that it is so likely to conclude in rejection.  Most of us never get used to that.  The attachment part is tricky, too.  Sex messes with us because it has to be perfect, and it is so mandatory in our day and age.

Does it really have to be one without the other?  Is abstinence such a crazy idea in the first year of sobriety? Apparently.

Step Eight: Replace our Ridiculous Drunken Stories With Ridiculous Sober Ones

Mr. Carr suggests that the sober wannabe take some time to plan a sober adventure.  This way he'll have what to talk about (a Yiddishism).  Friends want to hear about his past craziness.

Actually, they don't.  Those who don't have a problem with alcohol have been doing this their whole lives, living without the drama, planning fairly sober adventures. And they aren't bragging about their drama free adventures.  They will, however, show you the slides, email you videos upon request.

Change this step to: Shut Up ad Listen to Other People's Stories.

Step Nine: Spend Money On Stuff You Won't Lose

Carr is referring to buying something to remind you that you're sober, like an expensive pen, in his case. It is good, being sober, better and cheaper than being a drunk, but nice to be reminded by something concrete.

AA hands out actual tokens, rewards, coins, positive reinforcement for staying sober for long stretches at a time. I love the idea that someone gives it to you and others clap and congratulate. That intimacy thing.

Step Ten: Take a Difficult Test

An HIV test, one that many are terribly afraid they'll fail.
That sex-booze association is difficult, almost impossible for an addict to get around, can't escape it.  Date? sure.  It can't possibly hurt to get back in the saddle.

Step Eleven: Work Nicer, Not Just Harder and Smarter

Whatever that means. Guess you have to read the book.

Step Twelve: Forget Everything You Just Read

Because it works for him, but likely won't work for you.

It's funny, and honestly, the real active ingredient in Mr. Carr's twelve steps is that he uses his people, his community to keep him on track. Once everyone expects us to be straight, how can we disappoint?  How do we face others drunk at a wedding, having made such a big stink on Facebook and Twitter about our sobriety?  And what about that mass email to the entire spam folder?

Living in a glass house, nothing to hide. We're in awe of you, Mr. Carr.

A pity you don't go to meetings.  They would love you.  And you, them.  Should you slip once more, think of  AA or therapy, or both, as an adventure.

therapydoc

The Neurology of Gaming

Seems like the bad, unfortunately, outweighs the good.

I can't vouch for some of the studies here, but the findings about emotional desensitization to violence are reliable.  Investigators of different schools are finding the same thing, especially those who study the effects of violent media (not only games, but television and movies, too) on kids.

When violence is a steady diet, those who watch become immune, are no longer surprised by it.  Aggression ceases to have an emotional impact.  Our emotional systems take it for granted.  It is good to the brain, the path most frequently traveled.

This explains tolerance of bullying and the bystander effect, why people can see other people being insulted or attacked, and shrug, walk away, or even encourage the behavior.  Violence is nothing new, ceases to stimulate our moral center, the thinking part of the brain, the cerebral cortex.

Obviously, it isn't only kids who change for the worse with a steady diet of violence.

Have a read through..

therapydoc


Via: Online Universities Blog

The Gray Divorcee's- Divorce Late in Life

Findings of a new study indicate that people in their fifties are divorcing in higher numbers than ever before. Women, especially, take a good look at their spouses and ask themselves, Do I really want to spend the next 20-30 years with this guy?

And the answer is a resounding, No. Having tolerated the relationship until the last launched from high school, these women stayed for the kids.

Sociologists Susan Brown and I-Fen Lin crunched the numbers and found that in 1990 only one in 10 people over fifty divorced. By 2009, the number multiplied to one in four. Strangely enough, the divorce rate fell in other age brackets.

And not as many people are marrying at all, lately, which makes some of us wonder about the fate of the institution. Is it is destined to survive? Other types of commitment are possible, and marriage appears to be a contract that is difficult and expensive to break.

It is quite socially acceptable, too, avoiding marriage altogether, moving in together, even having children sans contract. We couples therapists, however, always have a sprinkling of such couples who come to see us to resolve differences about that kinda-sorta marriage, the as what state. (Come with me, I have a great job in Seattle. . . As what?) One of the two partners in these cases wants to get married.

The investigators of the new study conceptualize marriage in the past century as having evolved, the endpoint of that evolution being its own demise. Prior to the 1940's, the arrangement was institutional, marriage an economic necessity. Then in the fifties and sixties, successful marriage meant successful role playing-- women were to shine as mothers and wives; men, as providers.

Children of the seventies ushered in an era of self-fulfillment and individualization. The Me Generation, according to Brown and Lin, leaned toward selfishness, which apparently undermined their relationships. Voila, reaching maturity in their fifties, they divorce and go their separate ways.

Now who would have ever thought that? Self-centeredness leads to divorce. But there's more. The plot thickens, according to Susan Gregory Thomas, the Wall Street Journal:

For many boomers, it is not their first marital split. Fifty-three percent of the people over 50 now getting divorced have done so at least once before. . . .Having been married previously doubles the risk of divorce for those ages 50 to 64. For those ages 65 and up, the risk factor quadruples.  For boomers who have had trouble maintaining commitments in the past, hitting the empty-nest phase seems to trigger thoughts of mortality—and of vanishing possibilities for self-fulfillment.

That finding alone gives us pause, me, anyway. Couples who weather the storm once, may not have to weather it a second or third time. This is not an argument against divorce, understand, but it is an argument that the selfishness, or need for self-fulfillment, isn't behind the rise in divorce statistics.

The theory about self-fulfillment a marriage buster leaves much to be desired. In a good marriage seeing to the happiness of the other is what partners do, have done for generations.  Other factors, and they are numerous, wear down relationships.  That much we know.

Defining a generation as self-absorbed, selfish, especially the gen that thumbed its nose to the materialism of its parents, is a very broad stroke. This is my generation we're talking about, and we spread evenly on that normal curve. Traits of a population always distribute evenly in every generation.

That means that any one of the Me Generation, on average, is selfish or generous, some of us more than others. I would like to see the group comparison study that indicates ours is somehow quantifiably different in selfishness than the generations before. Define this self-absorption, selfishness, and show me the t-scores, the f-scores.  One thing to theorize such things. Quite another to prove it.

So what is going on?

It is the elephant in the room, and it won't make me popular to say it, and no, I can't quote a study, it is only an opinion, and yes, there are countless exceptions. But what might hold couples together, values, also likely pulls them apart, differences in values. Couples who share what is important (and these often come from religion, seeking guidance from elders or God) are more likely to stick it out. Following the rules, respecting one another (that 51% positive communication factor we talk about here) tends to make people better partners.

As a social scientist, however, I would frame that, having shared values, as stacking the odds that problem solving in marriage will be successful. It is the very essence of marriage and family therapy, problem solving, and surely, successful conflict resolution renders marriage not only tolerable, but intimate.

Argue with one another, empathize, and resolve. If we do that, growing old with together doesn't feel scary at all.

therapydoc

Post Script:  Again, not every marriage can succeed, and certainly problem solving is dependent upon a certain emotional maturity, and a psychological-disorder-managed system, to say nothing of those in-laws.

Who Are You Calling A Mama's Boy

Tried and true template for making a male child into a mama's boy:  An emotionally intimate relationship between a mother and her son to the degree that the son shares his thoughts and feeling with his mother, probably because he trusts and respects her. But other people think he's a sissy.

Who could trust and respect a woman, right?

The same recipe, the one that formerly described the makings of a mama's boy, now predicts a young man's self-assuredness, independence, and masculinity.  Establishing intimacy in the home is the way to teach children how to be happy, stable individuals, strong enough to be independent, mature enough to know how to be masculine when need be, soft when occasion calls for it. And we mothers do this best.

Not that fathers can't, but group findings indicate women are more empathetic.

The mother-son relationship is one variable, certainly, that predicts all of these good things. But what about confounding variables? Perhaps they are discussed in a new book, about to be released in March.  Somehow I doubt it, though.

The book is called "The Mama's Boy Myth," hopefully the results of dissertation research.  I read an excerpt sipping my morning coffee Saturday.  Kate Stone Lombardi cites a few studies to support her thesis that an emotionally intimate mother-son relationship fosters a young man's emotional maturity and positive relationships, while not undermining his masculinity:

(Sourced, Child Development) A study. . .6,000 children, age 12 and younger, found that boys who were insecurely attached to their mothers acted more aggressive and hostile later in childhood—kicking and hitting others, yelling, disobeying adults and being generally destructive.

(Not sourced, but variables in the last sentences lend credibility) A study of more than 400 middle school boys revealed that sons who were close to their mothers were less likely to define masculinity as being physically tough, stoic and self-reliant. They not only remained more emotionally open, forming stronger friendships, but they also were less depressed and anxious than their more macho classmates. And they were getting better grades.

(No source, but a relationships cited are reliable, meaning repeat in other research) There is evidence that a strong mother-son bond prevents delinquency in adolescence. And though it has been long established that teenagers who have good communication with their parents are more likely to resist negative peer pressure, new research shows that it is a boy's mother who is the most influential when it comes to risky behavior, not only with alcohol and drugs but also in preventing both early and unprotected sex.

(Arguably, there are studies considered to be reputable and scientific in the Ex-gay, Project Exodus community, but the motives of researchers are suspect). Finally, there are no reputable scientific studies suggesting that a boy's sexual orientation can be altered by his mother, no matter how much she loves him.

Why bring it up?  It's obvious Ms. Stone Lombardi is on to something.
Because so much is missing.

The confounding variables include but not are limited to: fathers, grandmothers, grandfathers, uncles, aunts, cousins, teachers, siblings, mental illness, and personality disorders in the family-- they all influence a child development, as do multiple combinations of relationships and genetics.

Ms. Stone Lombardi probably focused upon only one variable, or so it seems, the mother-son dyad. That's great, but it doesn't tell the whole story, not by a long shot.

Let's repeat what family therapists see, and what we want to see in families, just in case, the family therapy spin on family alliances.

Ideally, father-mother (or mother-mother, father-father, in the case of sexual minority parents) have the closest relationship in the family.  Each of them is emotionally intimate with each child, too.  But if theirs is the strongest bond, we think that sibling relationships are more likely to be intimate, too.

The picture of health looks like this.

See how the parents get their own little cocoon? Nobody's threatening the integrity of their relationship. And in the picture below, see how the kids get to plot and plan against them?

This is nothing new to family therapists, nor to those who lived in families like these, healthy ones. It isn't new to those who find themselves working on healthy boundaries in therapy, either.









It is when the alliances get messy that we worry. Take Junior #2 out of the picture for a moment. Perhaps he's off at boarding school.  Junior #1 and Mom have such an amazing relationship that Dad can't break in.  He feels he's on the outside of what is really the most intimate relationship in the family.

Now we have what we call a perverted triangle. Dad is a child, in a way, crying to break in. He's in the generation below his spouse and his son, poor guy.   That's not where he's supposed to be according to Sal Minuchin, a father of family therapy.  This is considered Structural Family Therapy, when we structure the family in a way that stacks the deck in a good way for the kids as children, and for the parents, for their future as a couple.

A picture tells a thousand words, no?













And yet. Establishing that intimate relationship between the parents can be exceedingly difficult, and is made even more difficult when addictions, mental illness, personality disorders, and the ordinary stress of living makes life difficult. And therapy, for some, seems inaccessible, expensive and time consuming.

So yes, moms. Do what you can to stay close to the boys.

Just try not to leave Daddy out.

therapydoc

Must We Stroke That Ego?

We talk about universal needs, and one of them is to feel valued, loved, and admired. The need is beat out of some of us who become self-deprecating, very humble, omniscient in social settings. For others, it is a virus.

Those of us afflicted seek admiration at work and at home. The hunger isn't labeled or talked about, it is usually unconscious. Because it is present, however, in so many of us, therapists try to interrupt blame cycles. Blame robs the blamer of the opportunity to validate, to be a therapeutic agent in relationships. We all want to be therapeutic agents, don't we?

Social encounters, all kinds, are social experiments. We walk away feeling good (it worked!) or bad.

Although the virus is nearly universal, some have it much worse than others, present as bottomless pits for positive feedback. Somebody started digging the pit in childhood, perhaps, but adult experiences create and maintain fissures, too.

Unchecked,the need for validation, love, and admiration-- what some call positive feedback, others call healthy or unhealthy narcissism-- can be really disruptive in relationships.*

Let’s take a fictional married couple to illustrate. He dresses so that people will compliment him. His hygiene is great, and because he sees himself as very male, doesn’t overwhelm with aftershave or cologne to exude class. He shakes hands, makes eye contact, and is impressive to those of us who appreciate that sort of thing. It is likely we will compliment him on something Some of us, when we're with someone who dresses well who chooses to be with us, feel good. I'm with him.

The couple is in their late twenties, make them childless for now. (Without children, socializing with friends is easy.) The two go out three to four times a week for dinner and drinks, sometimes just drinks. Our hero gets many compliments. His wife can be drop dead beautiful or not, she can be mesmerizing or not. She doesn’t care, regardless, what others think of her. She only has eyes for him.

They are in therapy because they don’t seem to connect emotionally. They take turns at verbal blunders, hurt one another with their words. Reasons turns out to be complicated, of course. Both have life experiences that teach them the art of a good offense. Experience is fertilizer for sensitivity, insensitivity. We’re working in therapy on intimacy, understanding these things.

Our boy could have married any girl, the female partner tells me in an individual session. It is his incessant need for attention and flattery that bothers her, makes her jealous. She gives him plenty of compliments and attention, affection, but it is never enough. When she is present and he is shouting for attention, it is one thing, watching others fawn over him. But he will repeat how women do this when she’s not around, too, and he repeats it often. She doesn’t understand why he has to throw it in her face.

The whys are interesting, the nature of the human ego, narcissism. Intellectualizing it helps, and we will do this in the therapy when he's around. In healthy relationships we don’t try to make our partners jealous, we don’t add to the stresses of everyday life. Jealousy is a negative emotion, one of fear, intimidation, being threatened. Nobody likes it.

We can do that, or we can begin to treat it quickly, with some humor. Everyone likes humor.

I suggest that the next time they are at dinner or the bar in a large group, that she somehow command everyone’s attention and ask, “Raise your hand if you think ____’s tie (points at her partner's tie) is absolutely gorgeous and makes his eyes look sexy. Don’t be shy now.”

She doesn’t like this suggestion, and I don’t either. It is just a way to get her to think. She thinks a bit, I shut up, and she comes up with several alternatives. The one we like most is that she stops random beautiful women on the street as they walk together and asks, “What do you think of his tie, seriously?”

Why do this? She brings his need for compliments to the surface, takes charge, makes sure his need is met, and everyone enjoys the experience. He will get compliments. Women will make eye contact with him. Then they will be on their merry way.

Of course the two of them could have long, deep, psychological discussions about his neediness (or her lack of empathy) in my office, and if we have several of these, I could make a lot more money. But a strategic behavioral family therapy intervention like this, talking to strangers on the street or in the elevator, works just as well.


therapydoc

*Feedback, positive or negative, isn’t calledfeed back for nothing. It is emotional food, digests well or not, yet we come back for more. Some of us wish to change the menu. That’s therapy. (Okay, the metaphors are done for today.)

Whitney Houston Found Dead

The bloggers are saying that Ms. Houston's untimely death at 48 is drug related. She admitted to struggling with them in a 2002 interview with Dianne Sawyer. Under pressure from fans, perhaps from family, too, she has been in and out of rehab for years.

It's heartbreaking. In therapy (some would call it vaudeville therapy, at times), it is so hard not to break into song, and Whitney's song, I Will Always Love You, generally gets a laugh. But nobody's laughing now.

So many love songs. Didn't We Almost Have It All, You Light Up My Life, How Will I Know, Greatest Love, I Will Always Love You and more.

Quintessential Whitney Houston. She fell from fame, she died on the eve of the Grammy's.  You have to wonder, really, if this was not intentional, a suicide.  Millions will read the biography, wanting to know more. I'll want to know the depths of her narcissism (losing her voice, losing her fans) and the depths of depression, and if there was some way to save the pop star.

But at the end of the day will posit that women get sicker quicker, is all. We don't do well with drugs and alcohol. Our bodies aren't made for toxins. Men somehow tolerate them better, some who live self-destructively get a decade or so more.

Such a beautiful woman, right? We should have been able to see her age, gracefully, as time goes on, like so many Hollywood icons. Is it a Forest Gumpism, crazy is as crazy does? I hate that word, crazy, but it sums up psychotic mental illness, when a person goes to extremes, takes a life. If it even is a suicide, of course.

therapydoc

Creative Numbing

Maybe it is aging, but I don't think so. By evening I'm so wiped out physically and emotionally (and it isn't from work, although working can be emotional sometimes) that all I want to do is numb.

You know what that means, right?

For some people it is Spider Solitaire (played for months, nonstop, before realizing I'm addicted! Quit cold turkey).  There are other games, of course.  Think Angry Birds. 

Another way to numb, a personal fave, is exercise, which is recommended by doctors, so it can't be bad. But when you aren't listening to educational tapes, when you pair exercise with television, it could be filed under numbing.

For some, eating is numbing.  Drink and drugs, surely.  Numbing.

I complained to FD about it this morning, told him that it is mortifying to me that my entire evenings have been spent munching black olives and numbing.

"What's that?  What's numbing?" he asks.

Hearing the explanation, behavior that diverts negative affect but wastes time and isn't socially proactive,* he smiles. "Oh! I do that all the time!" He does work a lot of crossword puzzles.

I think of numbing as coping, really. It is a good thing, and it doesn't have to be a waste of time. FD reinforces this thought.  "Be more creative at night.  Creative numbing! I could compose songs, you could help with the  lyrics, write books!  Why don't you write a book, Creative Numbing?  Ask people who read the blog for help!"

It is what we talk about in therapy, creativity as a venue for mental health, an intervention.  Entire schools of therapy, Music Therapy, Art Therapy, exist because creativity is positive energy, life sustaining in its way.  But it is so hard when you're depressed. Creativity sparks the serotonin, gets the wheels going-- it is what some of us call really getting high. How to spark that creativity to spark that serotonin to get those wheels to turn is the million dollar question.

So we are taking suggestions. We'll put it together, write a book, call it Creative Numbing. Everyone gets an acknowledgment, and maybe even gets to write a personal explanation, take full credit for the idea.  I'll say it  right now, if it's about sex, write your own book.

We are still going to need a really good list of numbing behaviors that aren't necessarily creative, too, for comparison.
 
How hard could that be?

therapydoc

*You heard that definition here first.  It's copyright for the book, of course.